Dyslexia & Other Elusive SLDs (Specific Learning Disorders)

The American Psychological Association’s DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) defines a Specific Learning Disorder as a developmental disorder that begins by school-age, although it may not be recognized until later. It involves ongoing problems learning key skills, including reading, writing and math. DSM-IV classified these as separate diagnoses; however, they are now listed under one diagnosis, along with the specific competencies, which may be affected within each domain.

Federal law mandates students be evaluated, if they are suspected of having learning disabilities. Schools usually do their own testing for learning disorders to see if a child needs intervention. An evaluation by a healthcare professional is needed if there are other concerns about the child’s behavior or emotions. Parents, healthcare providers, and the school can work together to find the right referrals and treatment.

Children with learning disorders often need extra help and instruction that are specialized for them. Having a learning disorder can qualify a child for special education services in school.

A student with a SLD may be prescribed academic intervention, and/or be entitled to reasonable accommodations within the classroom. Services can range from differentiated instruction within the classroom, extended time on tests or projects, additional instruction at school or during summer break, and/or one on one tutoring beyond school hours. Multi-sensory instruction is especially helpful for students with SLDs, but can certainly benefit all students. Learning disorders are typically identified when there is a significant difference between a student’s intelligence and that individual’s academic performance.

The DSM-5 (2013) diagnostic subtypes of specific learning disorders include:

A Specific learning disorder…

1. With impairment in reading includes possible deficits in:

Word reading accuracy
Reading rate or fluency
Reading comprehension

(Dyslexia is an alternative term used to refer to a pattern of learning difficulties characterized by problems with accurate or fluent word recognition, poor decoding, and poor spelling abilities. It is also considered a language based disorder with difficulty hearing the separate sounds within words.)

2. With impairment in written expression includes possible deficits in:

Spelling accuracy
Grammar and punctuation accuracy
Clarity or organization of written expression

(The term Dysgraphia is also used to refer to difficulty with writing.)

3. With impairment in mathematics includes possible deficits in:

Number sense
Memorization of arithmetic facts
Accurate or fluent calculation
Accurate math reasoning

(The term Dyscalculia refers to difficulty with math.)

It is believed that learning disorders are caused by a difficulty with the nervous system that affects receiving, processing, or communicating information.

PsychCentral suggests,

The biological origin of a learning disorder is likely an interaction of genetic and environmental factors, which affect the brain’s ability to perceive or process verbal or nonverbal information efficiently and accurately.

In contrast to talking or walking, which are acquired developmental milestones that emerge with brain maturation, academic skills (e.g., reading, spelling, writing, mathematics) have to be taught and learned explicitly. Specific learning disorder disrupts the normal pattern of learning academic skills; it is not simply a consequence of lack of opportunity of learning or inadequate instruction.

A key feature is that the individual’s performance in a particular area is well below average for age. Oftentimes, individuals with a learning disorder will achieve at least 1.5 standard deviations below the norm for their age on standardized achievement tests within domain of difficulty.

Another core feature is that the learning difficulties are readily apparent in the early school years in most individuals. However, in others, the learning difficulties may not manifest fully until later school years, by which time learning demands have increased and exceed the individual’s limited capacities.

Finally, the learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction.

Psychiatrists stress the importance of early intervention. Ensuring a solid foundation can help minimize long term academic challenges, and ensure students do not become frustrated, or develop emotional problems in response to repeated failure.

Learning difficulties can affect communication, self help skills, the willingness to accept discipline, play, and the capacity for independence. Children should have a comprehensive evaluation to assess all issues that may affect them. Parents need to be cognizant of the delicate balance necessary in helping a child meet educational goals; because too much, or too little assistance, can impact the individual’s self-confidence.

Some of the symptoms of learning disorders might be

Difficulty telling right from left
Reversing letters, words, or numbers, after first or second grade
Difficulties recognizing patterns or sorting items by size or shape
Difficulty understanding and following instructions or staying organized
Difficulty remembering what was just said or what was just read
Lacking coordination when moving around
Difficulty doing tasks with the hands, like writing, cutting, or drawing
Difficulty understanding the concept of time

Children with learning disorders may feel frustrated that they cannot master a subject despite trying hard, and may act out, act helpless, or withdraw. Learning disorders can also be present with emotional or behavioral disorders, such as attention-deficit/hyperactivity disorder (ADHD), or anxiety. The combination of problems can make it particularly hard for a child to succeed in school. Properly diagnosing each disorder is crucial, so that the child can get the right kind of help for each.