Specific learning disorder — domains, identification and multiagency plan (MEQ)

(i) Definition and domains. SLD is a neurodevelopmental disorder of persistent academic skill deficits substantially below age expectations despite intervention, with functional impact, school-age onset, and exclusions (not better explained by ID, uncorrected sensory impairment, other mental/neurological disorder, psychosocial adversity, lack of language proficiency, or inadequate instruction). This boy's profile suggests impairment in reading (decoding/fluency; dyslexia-type) ± written expression contribution; maths relatively spared. Rate severity by support need/functional impact. Low IQ is not required; SLD can occur with average or high IQ.^[1][4]

(ii) Assessment. Multi-informant history (language milestones, literacy exposure, family history, school trajectory), document nature/intensity of prior support and instructional response, work samples, hearing/vision (done), screen ADHD/anxiety/mood/language, educational psychology achievement battery (decoding, fluency, comprehension, spelling/writing, maths) ± cognitive profile. Differentials: ID, language disorder, ADHD-only performance failure, inadequate instruction, sensory, anxiety/trauma, ASD. Contemporary identification privileges skill deficit plus inadequate response to effective instruction over IQ–discrepancy alone.^[1][4][5][8]

(iii) Mechanisms. Many reading disabilities involve phonological processing and phoneme–grapheme mapping vulnerability within the reading network; oral language shapes comprehension pathways. Multiple-deficit thinking: phonological, language and attention risks may combine. Family history fits heritable polygenic risk narrative — not laziness.^[2][6][7]

(iv) Plan. Intensive systematic phonics-based / structured literacy intervention; classroom and exam accommodations (extra time, assistive tech); school learning support + educational psychology loop; CAMHS for demoralisation/anxiety/ADHD if criteria met. Medication does not fix dyslexia — treat comorbidity only when indicated. Psychoeducation: neurodevelopmental, strengths-based, early intensity better than wait-and-see; review progress with curriculum-based measures; safety-net school refusal/self-worth risk.^[1][3][4]