Paeds · growth-development-and-behaviour
Specific learning disorders
Also known as Specific learning disorder · Learning disability · Dyslexia · Dyscalculia · Dysgraphia · Reading disability · Written expression disorder · Mathematics learning disorder
Fellowship guide to specific learning disorders: DSM-5 domain thinking for reading, writing and maths; medical evaluation of academic underachievement; differentials from IDD, ADHD and sensory impairment; psychoeducational pathway; evidence-based remediation; school supports; and exam defence across ANZ, UK, US and Canada.
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Red flags
- Developmental regression or new focal neurology mislabelled as learning difficulty
- Suspected untreated hearing or vision impairment
- Suicidal ideation or severe school refusal during academic crisis
- Vision therapy sold as primary treatment for dyslexia
- Academic failure attributed only to ADHD without skill assessment
- Progressive school collapse after previously normal attainment
- Safeguarding concern unmasked during school-history review
Life stages
Care settings
Clinical exam formats
Board mappings
- Growth and development
- Behavioural and mental health
- Health promotion and disease prevention
- Learning goal 10 developmental and behavioural paediatrics
- Learning goal 15 essential general paediatrics
- Community and school health
- General and Community Paediatrics
- Clinical Applications
- Developmental and behavioural paediatrics
- Long Cases
- Short Cases
- Communication
- Neurodevelopment and Neurodisability
- Patient management
- Health promotion and illness prevention
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- History
- Development
- Clinical
- General Pediatrics Content Outline — Domain 2: Growth and Development
- General Pediatrics Content Outline — Domain 4: Behavioral/Mental Health
- General Pediatrics EPA: Assess and manage children with developmental and learning concerns
- Patient Care 1: History
- Patient Care 4: Clinical Reasoning
- Patient Care 5: Patient Management
- Systems-Based Practice 3: System Navigation for Patient Centered Care – Coordination of Care
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Medical Expert
- Health Advocate
- Communicator
- Collaborator
- Pediatrics: Foundations EPA — Assessing development and school function
Overview & Definition
A Year 3 teacher writes: “bright child, cannot read.” The parents ask whether the eyes need exercises. Your job is not to hand out a brand of therapy. Your job is to decide whether this is a specific learning disorder (SLD), what domain is affected, what medical mimics must be excluded, and how the child will be taught and supported while you wait for formal testing. [1] [3]
SLD means persistent difficulty learning and using academic skills. The difficulty starts during the years of formal schooling. It is not better explained by intellectual disability, uncorrected sensory impairment, neurological disease alone, lack of instruction, or psychosocial adversity alone. The child’s general reasoning is usually within the broad average range or higher. The underachievement is unexpected relative to age, opportunity and overall ability. [3] [4]
Older labels such as “learning disability,” “dyslexia,” “dysgraphia” and “dyscalculia” still appear in school reports and family language. DSM-5 folds them into one clinical category — specific learning disorder — with domain specifiers. In clinic you still use the familiar words, because families recognise them, but you diagnose with domain precision. [3] [4]
This page owns the medical and developmental approach to SLD. Global cognitive impairment belongs with intellectual developmental disorder. Attention-first pathways belong with ADHD. Pure oral language delay has its own leaf. Do not hide those chapters here. Cross-link them. [5] [15]
References20ShowHide
- [1]Handler SM Learning disabilities, dyslexia, and vision. Pediatrics, 2011.PMID 21357342
- [2]American Academy of Pediatrics, Section on Ophthalmology, Council on Children with Disabilities Joint statement--Learning disabilities, dyslexia, and vision. Pediatrics, 2009.PMID 19651597
- [3]Peterson RL Developmental dyslexia. Lancet, 2012.PMID 22513218
- [4]Moll K Specific learning disorder: prevalence and gender differences. PLoS One, 2014.PMID 25072465
- [5]DuPaul GJ Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment. Journal of learning disabilities, 2013.PMID 23144063
- [6]Berninger VW Evidence-based diagnosis and treatment for specific learning disabilities involving impairments in written and/or oral language. Journal of learning disabilities, 2011.PMID 21383108
- [7]Torgesen JK Intensive remedial instruction for children with severe reading disabilities: immediate and long-term outcomes from two instructional approaches. Journal of learning disabilities, 2001.PMID 15497271
- [8]Stevens EA Current State of the Evidence: Examining the Effects of Orton-Gillingham Reading Interventions for Students With or at Risk for Word-Level Reading Disabilities. Exceptional children, 2021.PMID 34629488
- [9]Fricke S The efficacy of early language intervention in mainstream school settings: a randomized controlled trial. Journal of child psychology and psychiatry, 2017.PMID 28524257
- [10]Butterworth B Dyscalculia: from brain to education. Science, 2011.PMID 21617068
- [11]Cartwright JD Provision of educationally related services for children and adolescents with chronic diseases and disabling conditions. Pediatrics, 2007.PMID 17545394
- [12]Klass P Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Policy Statement. Pediatrics, 2024.PMID 39342414
- [13]van Bergen E Co-Occurrence and Causality Among ADHD, Dyslexia, and Dyscalculia. Psychological science, 2025.PMID 40098496
- [14]Hulme C The Nuffield Early Language Intervention (NELI) programme is associated with lasting improvements in language and reading. Journal of child psychology and psychiatry, 2025.PMID 40074549
- [15]Snowling MJ Dyslexia with and without developmental language disorder: Profile analysis. Annals of dyslexia, 2026.PMID 41774411
- [16]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
- [17]Council on Children with Disabilities and Medical Home Implementation Project Advisory Committee Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems. Pediatrics, 2014.PMID 24777209
- [18]Arnett AB Explaining the sex difference in dyslexia. Journal of child psychology and psychiatry, 2017.PMID 28176347
- [19]Reigosa-Crespo V Basic numerical capacities and prevalence of developmental dyscalculia: the Havana Survey. Developmental psychology, 2012.PMID 21910533
- [20]Berninger V Relationships of Attention and Executive Functions to Oral Language, Reading, and Writing Skills and Systems in Middle Childhood and Early Adolescence. Journal of learning disabilities, 2017.PMID 26746315