Specific Learning Disorder

Psychopathology Assignment

Kodhai B Narayanan

M21CSP116

1MSc Counselling Psychology

Specific Learning Disorder is a childhood developmental disorder characterized by delays in

development of one or more specific psychological processes manifesting in language, speech,

mathematical or motor skills. The inadequacy is not always a result of an underlying

neurological condition. The term ‘learning disabilities’ was introduced by Dr. Samuel A Kirk,

the Father of Learning Disabilities in 1963. An increasing number of children were exhibiting

difficulties in doing academic schoolwork but showed no other signs of mental retardation,

sensory dysfunction or deficits in other mental capacities. The history of Learning Disabilities

can be traced back to the 1800’s and is usually classified into four phases:

1. Foundational Phase (1800-1930): The symptoms of learning disabilities were first

observed and described by various medical practitioners from different fields.

2. Transition Phase (1930-1960): Significant brain research took place in understanding

children who were underperforming and terms such as ‘brain-injured child’ were

replaced with ‘brain dysfunction’.

3. Integration Phase (1960-194): The term ‘learning disabilities’ was first used to describe

children facing academic difficulties and several acts such as The Rehabilitation Act of

1973 were passed to ensure that children with learning disabilities faced no
 discrimination. Several reports were also published in this phase to enhance special

education services.

4. Modern Phase (1974-present): Greater awareness of and research on helping children

with learning disabilities. Movements for sensitizing parents and peers to create a

positive learning environment for children with learning disabilities.

Children usually have to be in school for at least three years and perform at a level that is two

years below their academic grade for a diagnosis of Learning Disability to be considered. A

diagnosis of Specific Learning Disability is only made after eliminating any neurological

conditions, motor dysfunctions and sensory impairments. Dr. Rosemary Tannock, a member of

the DSM 5 board has stated that “ SLD is a clinical diagnosis that is not necessarily synonymous

with ‘learning disabilities’ as identified within the education system: that is, not all children with

learning disabilities/difficulties identified by the school system would meet a DSM-5 clinical

diagnosis of SLD. By contrast, those with a DSM-5 diagnosis of SLD would be expected to meet

the educational definition.” The DSM 5 outlines the criteria for diagnosis of Specific Learning

Disorder which is classified under Childhood Neurodevelopmental Disorder. The following is

the DSM criteria:

A. Difficulties learning and using academic skills, as indicated by the presence of at least

one of the following symptoms that have persisted for at least 6 months, despite the

provision of interventions that target those difficulties:

1. Inaccurate or slow and effortful word reading (e.g. - reads single words aloud incorrectly

or slowly and hesitantly, frequently guesses words, has difficulty sounding out words).
 2. Difficulty understanding the meaning of what is read (e.g. - may read text accurately but

not understand the sequence, relationships, inferences, or deeper meanings of what is

read).

3. Difficulties with spelling (e.g. - may add, omit, or substitute vowels or consonants).

4. Difficulties with written expression (e.g. - makes multiple grammatical or punctuation

errors within sentences; employs poor paragraph organization; written expression of ideas

lacks clarity).

5. Difficulties mastering number sense, number facts, or calculation (e.g. - has poor

understanding of numbers, their magnitude, and relationships; counts on fingers to add

single-digit numbers instead of recalling the math fact as peers do; gets lost in the midst

of arithmetic computation and may switch procedures).

6. Difficulties with mathematical reasoning (e.g. - has severe difficulty applying

mathematical concepts, facts, or procedures to solve quantitative problems).

B. The affected academic skills are substantially and quantifiably below those expected for the

individual’s chronological age, and cause significant interference with academic or occupational

performance, or with activities of daily living, as confirmed by individually administered

standardized achievement measures and comprehensive clinical assessment. For individuals age

17 years and older, a documented history of impairing learning difficulties may be substituted for

the standardized assessment.

C. The learning difficulties begin during school-age years but may not become fully manifest

until the demands for those affected academic skills exceed the individual’s limited capacities

(e.g. - as in timed tests, reading or writing lengthy complex reports for a tight deadline,

excessively heavy academic loads).

visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of

proficiency in the language of academic instruction, or inadequate educational instruction.

The diagnostic criteria is a development from the previous edition of the DSM. The new criteria

no longer necessitates IQ-achievement discrepancy and it also includes ‘specifiers’ to indicate

the different manifestations of learning disabilities with respect to different academic skills under

one bracket. Based on the DSM specifiers, three broad categories of specific learning disabilities

can be identified and these include:

1. Dyslexia: A difficulty in processing language especially in the domain of reading which

affects skills such as word recognition, word decoding, reading speed, prosody (oral

reading with expression), and reading comprehension among many others. It is the most

commonly occurring form of Specific Learning Disorder and around 80% of the children

diagnosed with SLD have dyslexia.

Picture showing the difference in processing of reading

which affects skills like spelling, grammar, punctuation, and handwriting among many

others. It essentially refers to skills relating to the transcription of words including poor

grammar usage in sentences, poor handwriting, lack of organization of sentences and

paragraphs.

Picture showing sample writing of child with dysgraphia

3. Dyscalculia: A difficulty in processing numerical concepts and number related

information including basic arithmetic functions such as calculations, learning math facts

or solving math problems. There is an inability to reason mathematically or understand

the number system.

Picture showing sample calculations by a child with dyscalculia

considered to be a part of Learning Disabilities, these include Dyspraxia, Visual Processing

Disorder, Auditory Processing Disorder, Non-Verbal Learning Disorder, Specific Language

Impairment etc. The DSM also makes provision for specification of the current severity of the

disorder which could be mild, moderate or severe depending on the extent to which it interferes

in academic performance and amount of support needed.

Specific Learning Disorder is usually recognised first during elementary school years wherein

children begin to learn skills such as reading and writing. There may however be other

difficulties such as delayed language development that can be noticed before formal schooling

which could contribute to a learning disability in the future. The course is usually life long but

the extent of distress depends on the specific demands of the environment and situation. Some of

the signs that could indicate a presence of a learning disability in preschool children could

include refusal to learn rhymes, inability to identify alphabets or spell their own name,

continuing to ‘baby talk’. This continues into elementary and middle school when they struggle

to learn basic mathematical and logical functions. Children may avoid any hobbies or activities

that involve these skills. Poor spellings, incorrect grammar and inability to solve mathematics

may continue throughout school life. Though by adolescence, the children may have become

better at certain skills such as word comprehension, their performance will still be lower than

their peers and they sill shy away from any leisure activities involving reading or calculations to

an extent wherein they even refrain from reading instruction manuals or important documents.
Specific Learning Disorder has negative functional consequences in a wide range of areas since

it impacts a critical function at an early age. Children with SLD are likely to drop out of school,

develop a low self esteem and have difficulties in working in conventional settings. Those who

do continue education have poor peer relationships and are unlikely to study beyond high school

which limits their career opportunities. Those with SLD are likely to have poor mental health due

to criticism and pressure to perform but emotional and social support systems can improve their

mental health.

The DSM has identified genetic and environmental risk factors for Specific Learning Disorder.

Genetic Factors: The risk for SLD is significantly higher when there are first degree family

members who have been diagnosed with SLD. Academic skills have proven to be a highly

heritable skill and studies have shown a high positive correlation between the heritability of the

gene for SLD and the manifestation of that gene. Low birth weight and premature delivery also

increases the risk for SLD.

Environmental Factors: The genetic component is vulnerable to environmental influences such

as parental literacy rate and accessibility to good education. Exposure to tobacco and nicotine

during pregnancy also increases the risk for SLD in the baby.

As discussed in its course, Specific Learning Disorder is lifelong but early intervention can help

in coping better leading to greater adaptability. Addressing SLD early is key in aiding children to

be able to function in a school setting without feeling inferior to their peers. The focus is on

identifying and encouraging areas of strength rather than entirely targeting the weakness. Schools

are required to have Special Education Services which provide remedial training and equal
opportunities to children with learning disabilities as children without. Special teaching

techniques such as oral, visual or multisensory approaches to learning can be applied. Tools and

computer technologies can be used to help the children perform certain functions that they are

unable to perform manually. The treatment plans are highly individualistic and are designed to

suit the child’s specific needs by compensating for the weakness by using the child’s strength.

Apart from directly targeting the problem, treatment may also include Cognitive Behavioural

Therapy techniques to address emotions or behaviours that might be distressing as a result of

inadequacies and inferiority arising from SLD.

References

A history of learning disabilities and ADHD. (2019, August 5). Understood - For learning and

thinking differences.

https://www.understood.org/articles/en/history-of-learning-disabilities-and-adhd

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC

A timeline of learning disability history. (n.d.). Learning Disabilities Association of America –

Support. Educate. Advocate. https://ldaamerica.org/a-timeline-of-learning-disability-history/

from the One About the Other?. Frontiers in psychology, 6, 2045.

https://doi.org/10.3389/fpsyg.2015.02045

Gulf Bend MHMR Center. (n.d.). Retrieved March 11, 2022, from

https://www.gulfbend.org/poc/view_doc.php?type=doc&id=1220&cn=113

Tannock, R., 2022. DSM-5 Changes in Diagnostic Criteria for Specific Learning Disabilities

(SLD)1: What are the Implications? (n.d.). Retrieved March 11, 2022, from

https://dyslexiaida.org/dsm-5-changes-in-diagnostic-criteria-for-specific-learning-disabilities-sld

1-what-are-the-implications/

What Is Specific Learning Disorder? (n.d.). Retrieved March 11, 2022, from

https://www.psychiatry.org/patients-families/specific-learning-disorder/what-is-specific-learning-

disorder