What Is Specific Learning Disorder?
by The American Psychiatric Association (APA)
Specific learning disorder (often referred to as learning disorder or learning disability, see note on terminology) is a neurodevelopmental disorder that begins during school-age, although may not be recognized until adulthood. Learning disabilities refers to ongoing problems in one of three areas, reading, writing and math, which are foundational to one’s ability to learn.
An estimated 5 to 15 percent of school-age children struggle with a learning disability. An estimated 80 percent of those with learning disorders have reading disorder in particular (commonly referred to as dyslexia). One-third of people with learning disabilities are estimated to also have attention-deficit hyperactivity disorder (ADHD).
Other specific skills that may be impacted include the ability to put thoughts into written words, spelling, reading comprehension, math calculation and math problem solving. Difficulties with these skills may cause problems in learning subjects such as history, math, science and social studies and may impact everyday activities.
Learning disorders, if not recognized and managed, can cause problems throughout a person’s life beyond having lower academic achievement. These problems include increased risk of greater psychological distress, poorer overall mental health, unemployment/under-employment and dropping out of school.
A note on terminology: Specific learning disorder is a medical term used for diagnosis. It is often referred to as “learning disorder.” “Learning disability” is a term used by both the educational and legal systems. Though learning disability is not exactly synonymous with specific learning disorder, someone with a diagnosis of specific learning disorder can expect to meet criteria for a learning disability and have the legal status of a federally recognized disability to qualify for accommodations and services in school. The term “learning difference” is a term that has gained popularity, especially when speaking with children about their difficulties, as it does not label them as “disordered.”
Diagnosis
Learning disorder can only be diagnosed after formal education starts. To be diagnosed with a specific learning disorder, a person must meet four criteria.
1) Have difficulties in at least one of the following areas for at least six months despite targeted help:
- Difficulty reading (e.g., inaccurate, slow and only with much effort)
- Difficulty understanding the meaning of what is read
- Difficulty with spelling
- Difficulty with written expression (e.g., problems with grammar, punctuation or organization)
- Difficulty understanding number concepts, number facts or calculation
- Difficulty with mathematical reasoning (e.g., applying math concepts or solving math problems)
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Diagnosis
Learning disorder can only be diagnosed after formal education starts. To be diagnosed with a specific learning disorder, a person must meet four criteria.
1) Have difficulties in at least one of the following areas for at least six months despite targeted help:
- Difficulty reading (e.g., inaccurate, slow and only with much effort)
- Difficulty understanding the meaning of what is read
- Difficulty with spelling
- Difficulty with written expression (e.g., problems with grammar, punctuation or organization)
- Difficulty understanding number concepts, number facts or calculation
- Difficulty with mathematical reasoning (e.g., applying math concepts or solving math problems)
2) Have academic skills that are substantially below what is expected for the child’s age and cause problems in school, work or everyday activities.
3) The difficulties start during school-age even if in some people don’t experience significant problems until adulthood (when academic, work and day-to-day demands are greater).
4) Learning difficulties are not due to other conditions, such as intellectual disability, vision or hearing problems, a neurological condition (e.g., pediatric stroke), adverse conditions such as economic or environmental disadvantage, lack of instruction, or difficulties speaking/understanding the language.
A diagnosis is made through a combination of observation, interviews, family history and school reports. Neuropsychological testing may be used to help find the best way to help the individual with specific learning disorder.
Types of Learning Disorders: Dyslexia, Dysgraphia, and Dyscalculia
Dyslexia is a term that refers to the difficulty with reading. People with dyslexia have difficulty connecting letters they see on a page with the sounds they make. As a result, reading becomes a slow, effortful and not a fluent process for them.
Problems in reading begin even before learning to read, for example when children have trouble breaking down spoken words into syllables and recognizing words that rhyme. Kindergarten-age children may not be able to recognize and write letters as well as their peers. People with dyslexia may have difficulty with accuracy and spelling as well. It’s a common misconception that all children with dyslexia write letters backwards or those who write letters backwards all have dyslexia.
People with dyslexia, including adolescents and adults, often try to avoid activities involving reading when they can (reading for pleasure, reading instructions). They often gravitate to other mediums such as pictures, video, or audio.
Dysgraphia is a term used to describe difficulties with putting one’s thoughts on to paper. Problems with writing can include difficulties with spelling, grammar, punctuation, and handwriting.
Dyscalculia is a term used to describe difficulties learning number related concepts or using the symbols and functions to perform math calculations. Problems with math can include difficulties with number sense, memorizing math facts, math calculations, math reasoning and math problem solving.
Learning disorder can vary in severity:
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- Mild: Some difficulties with learning in one or two academic areas, but may be able to compensate
- Moderate: Significant difficulties with learning, requiring some specialized teaching and some accommodations or supportive services
- Severe: Severe difficulties with learning, affecting several academic areas and requiring ongoing intensive specialized teaching
More information:
What are some signs of learning disabilities?by NIH Publication
Understanding Dyslexia Know the signs, and how to help kids with the most common learning disabilityby Katherine Martinelli
Parents’ Role in Fostering Young Children’s Learning and Language Developmentby Catherine S. Tamis-LeMonda, PhD, Eileen T. Rodriguez, PhD New York University, USA
Detecting Learning Disabilitiesby webmd.com
References
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. (DSM-5) American Psychiatric Association. American Psychiatric Association Publishing. 2013.
Gerber PJ: The impact of learning disabilities on adulthood: a review of the evidenced-based literature for research and practice in adult education. J Learn Disabil 45(1):31–46, 201
Gabbard, GO. Gabbard’s Treatments of Psychiatric Disorder, Fifth Edition. American Psychiatric Publishing. 2014
Tannock, R. DSM-5 Changes in Diagnostic Criteria for Specific Learning Disabilities (SLD): What are the Implications? International Dyslexia Association. 2014.
Every Student Succeeds Act: Opportunities for school psychologists. National Association of School Psychologists. Communiqué. 44(8):13, 2016.
Shaywitz, S. Overcoming Dyslexia, Yale Center for Dyslexia and Creativity. Random House. 2005