Psych · Child and adolescent psychiatry — specific learning disorder
Specific learning disorder
Also known as Specific learning disorder · Specific learning disability · Dyslexia · Dyscalculia · Dysgraphia · Reading disability · Disorder of written expression · Mathematics learning disability · Developmental learning disorder
Exam-exhaustive fellowship reference on specific learning disorder — DSM-5-TR domains (reading, written expression, mathematics), dyslexia science, instructional-response identification, comorbidity with ADHD, and multiagency educational management. FRANZCP-primary, globally tagged.
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Red flags
- Self-harm, suicidality, or severe school refusal secondary to chronic academic failure — risk assess first
- Attributing SLD to laziness or poor parenting and withholding educational supports
- Prescribing psychotropics solely to force academic compliance without ADHD/comorbidity indication
- Missing hearing/vision impairment or intellectual disability masquerading as 'learning problem'
- Delaying intensive literacy intervention while waiting for a perfect psychometric battery
- Pathologising bilingualism or interrupted schooling as primary SLD without opportunity assessment
Meet the patient
A bright, chatty 9-year-old is referred because he "won't write". His oral ideas are rich; his page is sparse and misspelled. He reads slowly, guesses from pictures, and has started calling himself stupid. His father is dyslexic. The registrar reaches for a stimulant. The examiner wants the domain map and the instructional history first.[1][6]
The question is never "is he dyslexic". It is "which domain, since when, despite what intervention, and what is not causing it?" Four questions, in order.[1][7]
References16ShowHide
- [1]American Academy of Child and Adolescent Psychiatry Practice parameters for the assessment and treatment of children and adolescents with language and learning disorders. AACAP J Am Acad Child Adolesc Psychiatry, 1998.PMID 9785728
- [2]Peterson RL, Pennington BF Developmental dyslexia Lancet, 2012.PMID 22513218
- [3]Peterson RL, Pennington BF Developmental dyslexia Annu Rev Clin Psychol, 2015.PMID 25594880
- [4]Vellutino FR, Fletcher JM, Snowling MJ, Scanlon DM Specific reading disability (dyslexia): what have we learned in the past four decades? J Child Psychol Psychiatry, 2004.PMID 14959801
- [5]Galuschka K, Ise E, Krick K, Schulte-Körne G Effectiveness of treatment approaches for children and adolescents with reading disabilities: a meta-analysis of randomized controlled trials PLoS One, 2014.PMID 24587110
- [6]Grigorenko EL, Compton DL, Fuchs LS, Wagner RK, Willcutt EG, Fletcher JM Understanding, educating, and supporting children with specific learning disabilities: 50 years of science and practice Am Psychol, 2020.PMID 31081650
- [7]Miciak J, Fletcher JM The Critical Role of Instructional Response for Identifying Dyslexia and Other Learning Disabilities J Learn Disabil, 2020.PMID 32075514
- [8]Moll K, Kunze S, Neuhoff N, Bruder J, Schulte-Körne G Specific learning disorder: prevalence and gender differences PLoS One, 2014.PMID 25072465
- [9]Pennington BF From single to multiple deficit models of developmental disorders Cognition, 2006.PMID 16844106
- [10]Willcutt EG, McGrath LM, Pennington BF, Keenan JM, DeFries JC, Olson RK, Wadsworth SJ Understanding Comorbidity Between Specific Learning Disabilities New Dir Child Adolesc Dev, 2019.PMID 31070302
- [11]Willcutt EG, Petrill SA Comorbidity between reading disability and ADHD in a community sample: Implications for academic, social, and neuropsychological functioning Mind Brain Educ, 2023.PMID 38898939
- [12]Butterworth B, Varma S, Laurillard D Dyscalculia: from brain to education Science, 2011.PMID 21617068
- [13]Chung PJ, Patel DR, Nizami I Disorder of written expression and dysgraphia: definition, diagnosis, and management Transl Pediatr, 2020.PMID 32206583
- [14]Snowling MJ, Hulme C Annual Research Review: Reading disorders revisited - the critical importance of oral language J Child Psychol Psychiatry, 2021.PMID 32956509
- [15]Snowling MJ, Hulme C Annual research review: the nature and classification of reading disorders--a commentary on proposals for DSM-5 J Child Psychol Psychiatry, 2012.PMID 22141434
- [16]Doust C, Fontanillas P, Eising E, Gordon SD, et al. Discovery of 42 genome-wide significant loci associated with dyslexia Nat Genet, 2022.PMID 36266505