According to the DSM-5*, the term Specific Learning Disorder (aka SLD) is a neurodevelopmental disorder with a biological origin that affects an individual’s academic skills, not their developmental milestones.
Let me break down some of those terms for you and then provide you with a definition that you can understand.
Neurodevelopmental-> has to do with how the brain develops
Disorder-> refers to a disruption in functioning; in the psychological field, the term disorder is used instead of disability
Biological origin-> refers to the condition being part of who the person is, not caused by an outside source
Academic skills-> things learned in school such as reading, writing, spelling and mathematics
Developmental milestones-> these are the expected stages of development that typically follow a specific order
In other words, a specific learning disorder is a brain-based disorder that affects the way individuals learn how to read, write, spell, count and answer math questions.
An individual with a specific learning disorder in reading will have problems with at least one of the following:
- Reading words accurately (decoding)
- Read slowly (fluency)
- Have problems understanding what they have read.
Individuals are sometimes said to have dyslexia, a reading disability or a learning disability.
An individual with a specific learning disorder in written expression will have problems with at least one of the following:
- Spelling words accurately
- Their writing will have issues with grammar, sentence structure and punctuation
- Their writing may be challenging to read because it is disorganized and they cannot get their ideas across clearly
An individual with a specific learning disorder in mathematics will have problems with at least one of the following:
- Understanding number concepts such as counting and making comparisons (number sense)
- Memorizing their math facts such as basic addition, subtraction and multiplication
- Performing math calculations
- Difficulty using mathematical reasoning
Individuals are sometimes said to have dyscalculia, a math disability or a learning disability
As with other disorders, there are varying degrees to which an individual can have a specific learning disorder.
Individuals with a mild specific learning disorder have difficulties with one or two areas, but they can manage when they are provided with the right accommodations and or the proper supports.
These accommodations and support are especially important while the individual is attending school.
Individuals with a moderate specific learning disorder will likely require some intensive, specialized teaching to learn the skills they need to be competent in their areas of difficulty.
Once they have received the appropriate remediation, they will continue to need some accommodations and/or support in some areas to complete different assignments and activities.
Individuals with a severe specific learning disorder struggle in many different areas and they will likely require ongoing, intensive, individualized interventions to learn the expected content in school.
They will probably need to use appropriate accommodations, assistive technology and strategies at home, in school and in the workplace. Even with these supports in place, they may not be able to be as efficient at completing their tasks.
The DSM-5 has 4 criteria that must be met based on a ‘clinical synthesis’ of an individual’s developmental, medical, familial and educational history, school reports and a psychoeducational assessment.
This means that multiple aspects of the individual will be looked at from different perspectives to ensure the diagnosis of a specific learning disorder is appropriate for the individual.
1. An individual must show difficulties learning and using an academic skill such as:
- Problems decoding words; reading is slow and requires a significant amount of effort
- Difficulty understanding what has been read
- Poor spelling
- Trouble expressing themselves in writing
- Problems with mastering number sense, number facts and/or performing calculations
- Difficulty with math reasoning. The individual must have had the difficulty for at least six months even after being provided with targeted interventions.
2. The skills they are having difficulty with are substantially and quantifiably below those expected for individuals their age. These difficulties interfere with the individual’s daily activity. Specific learning disorder must be diagnosed through a comprehensive, clinical assessment using individually administered standardized achievement measures.
3. The difficulties must begin during school years but may not become fully apparent until the demands in those areas are tested.
For example, someone who has a specific learning disorder with an impairment in reading may not have any problems with reading the actual words. The may have issues with reading comprehension so their specific learning disorder may not be apparent until they have to start to learn information from what they are reading.
4. The specific learning disorder must not be explained better by another primary issue such as an intellectual disability, problems with the individual’s vision or hearing, not speaking the language of instruction fluently, a medical or neurological condition, psychosocial adversity or not being provided with adequate instruction.
Comorbidity means that two or more conditions can occur at the same time. Specific learning disorder commonly cooccurs in individuals with ADHD, Communication Disorders, Developmental Coordination Disorder, Autism Spectrum Disorder, Anxiety Disorders, Depressive and Bipolar Disorders.
If an individual has another diagnosed condition, it does not necessarily exclude the diagnosis of a specific learning disorder. It does, however, make the differential diagnosis more difficult for professionals. It is more challenging to diagnose comorbid disorders because the conditions listed above also interfere with an individual’s daily activity.
This means the professional has to tease out whether the symptoms are best described by one condition or if in fact, the individual has both the condition and a specific learning disorder. This requires expert clinical judgement that has experience in both of the disorders in question.
- Specific learning disorders will present differently in different settings and across a lifetime. There are some activities where the individual’s difficulties will not be apparent.
- It is possible for an individual to be considered gifted and have a specific learning disorder. These individuals may be able to use their gifts to disguise their specific learning disorder until the demands on their learning or methods that their knowledge is assessed provide too much of a barrier.
- With the proper accommodations and support, an individual with a specific learning disorder can lead a very successful life.
- Specific learning disorders are persistent and lifelong.
- Problems in other academic areas such as history and science might actually be due to the student’s specific learning disorder
- With the appropriate intervention, individual’s with specific learning disorder can succeed!
*The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a handbook published by the American Psychiatric Association. It is used by professionals to guide in the diagnosis of different conditions. It provides a description of the condition with a list of symptoms and additional criteria for the diagnosis of the condition.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Association.