One such difficulty was its belief of central nervous system dysfunction as a basis of understanding and diagnosing learning disability. This conflicted with the fact that many individuals who experienced central nervous system dysfunction, such as those with cerebral palsy, did not experience disabilities in learning. On the other hand, those individuals who experienced multiple handicapping conditions along with learning disability frequently received inappropriate assessment, planning, and instruction. The NJCLD notes that it is possible for learning disability to occur simultaneously with other handicapping conditions, however, the two should not be directly linked together or confused. In the 1980s, NJCLD, therefore, defined the term learning disability as: a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders are intrinsic to the individual and presumed to be due to Central Nervous System Dysfunction. Even though a learning disability may occur concomitantly with other handicapping conditions (e.g. sensory impairment, intellectual disability, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient/inappropriate instruction, psychogenic factors) it is not the direct result of those conditions or influences. The 2002 LD Roundtable produced the following definition:Concept of LD: Strong converging evidence supports the validity of the concept of specific learning disabilities (SLD). This evidence is particularly impressive because it converges across different indicators and methodologies. The central concept of SLD involves disorders of learning and cognition that are intrinsic to the individual.
Reactive perforating collagenosis is a rare, familial, nonpuritic skin disorder characterized by papules that grow in a diameter of 4 to 6mm and develop a central area of umbilication to which keratinous material is lodged. The cause of reactive perforating collagenosis is unknown. Clinical Features
Inherited form
Keratotic papules measuring 1 to 6 mm develop on the extensor surface of the hands, the elbows, and the knees following superficial trauma. These lesions are painless. They appear as pin-sized lesions that grow to a papule of about 6mm in the following 3–5 weeks. They undergo spontaneous resolution in about 6–8 weeks leaving residual scarring. Lesions may recur throughout life. Cold weather is one of the factors known to trigger recurrences. Acquired form
In this form, keratotic papules develop on the trunk and extremities. These are commonly associated with pruritus. Lesions may or may not be related to superficial trauma. See also
Elastosis perforans serpiginosa
List of cutaneous conditions

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