Understanding Specific Learning Disorder

Posted on September 22nd, 2014

UnderstandingSpecificLearningDisorderSpecific learning disorder is a newly defined condition that appears in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM 5). It replaces several different conditions—known collectively as learning disorders—contained in the fourth edition of the manual, including mathematics disorder, disorder of written expression, reading disorder and learning disorder not otherwise specified. People with specific learning disorder still have significant problems doing such things as reading, writing, or using math. However, the criteria for the condition focus on the effect these problems have on school performance and other real-world factors, rather than focusing on the problems themselves.

Learning Disorder Basics

Learning disorders are also sometimes known as learning disabilities. The mental health community and the rest of the medical community use somewhat different terms to describe these conditions. In everyday medical usage, people who have unusual difficulties acquiring or using language and reading skills have a condition called dyslexia. People who have unusual difficulties acquiring or using handwriting skills have a condition called dysgraphia. People who have unusual difficulties acquiring or using math-related skills have a condition called dyscalculia. General medical terminology also acknowledges a number of other learning disabilities, including unusual speaking problems (apraxia of speech), unusual hand-eye coordination problems (dyspraxia), an inability to correctly interpret nonverbal language cues (nonverbal learning disorder) and unusual verbal comprehension problems (central auditory processing disorder).

As a rule, people with learning disorders first develop symptoms during the early stages of childhood, the U.S. National Library of Medicine reports. However, these symptoms don’t usually come to light until a child starts attending school and lags behind his or her classmates in one way or another. Doctors identify learning disorders through standardized testing and other diagnostic procedures, then devise appropriate treatment plans in collaboration with other specialists. In many cases, these treatment plans prove effective and learning issues are resolved successfully. Unfortunately, some affected individuals still experience significant problems after receiving appropriate treatment.

Previous Definitions

According to the criteria set forth in the previous edition of the Diagnostic and Statistical Manual (DSM IV), people with mathematics disorder have test scores that indicate the presence of dyscalculia. They also have no physical problem that fully accounts for their condition, and experience significant deficits in their academic performance or life opportunities as a result of their math-related difficulties. People with DSM IV-defined disorder of writing expression have test scores that indicate the presence of dysgraphia, have no physical problem that fully accounts for their condition, and experience significant academic or general life impairment. People with DSM IV-defined reading disorder have test scores that indicate the presence of dyslexia, have no physical problems that fully account for their condition, and also experience general or academic impairment. People with DSM IV-defined learning disorder not otherwise specified have clear learning deficits that don’t meet the criteria for a more well-defined learning disorder.

Current Definition

The American Psychiatric Association introduced specific learning disorder into DSM 5 in order to emphasize the effects commonly attributed to all of the various learning disorders and de-emphasize the focus placed on the specific learning disorder present in a given individual. People diagnosed with the disorder must experience ongoing problems with their age-appropriate practical math skills, conceptual math skills, writing skills or reading skills during their school years. Critically, in addition to producing specific learning-related symptoms that doctors can detect outside of a testing environment, these skill impairments must manifest in testing scores that fall below the norm established by peers unaffected by learning disorders. An affected individual must also experience significant life disruptions as a result of his or her condition, and must not have some other physical problem that explains his or her learning difficulties.

While the definition for specific learning disorder eliminates the diagnostic barriers that separated reading disorder, mathematics disorder, disorder of writing expression and learning disorder not otherwise specified, it does not stop doctors from addressing the details of a given patient’s condition. Instead, DSM 5 allows doctors to make a generalized specific learning disorder diagnosis, then designate the exact combination of learning problems that’s present in the individual. In this way, the diagnostic process keeps its emphasis on the common effects of all learning-related difficulties while still giving physicians the freedom to provide the additional information needed for the establishment of effective treatment plans that meet each patient’s situation and needs.

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