DSM-5 Diagnostic Criteria

Specific learning disorder is a classification of disorders in which a person has difficulty learning in a typical manner within one of several domains. Often referred to as learning disabilities, learning disorders are characterized by inadequate development of specific academic, language, and speech skills. Types of learning disorders include difficulties in reading (dyslexia), mathematics (dyscalculia), and writing (dysgraphia).

The diagnosis of specific learning disorder was added to the DSM-5 in 2013. The DSM does not require that a single domain of difficulty (such as reading, mathematics, or written expression) be identified—instead, it is a single diagnosis that describes a collection of potential difficulties with general academic skills, simply including detailed specifiers for the areas of reading, mathematics, and writing. Academic performance must be below average in at least one of these fields, and the symptoms may also interfere with daily life or work. In addition, the learning difficulties cannot be attributed to other sensory, motor, developmental, or neurological disorders.

Learning disabilities are cognitive disorders that affect different areas of cognition, particularly language or reading. It should be pointed out that learning disabilities are not the same thing as intellectual disabilities. Learning disabilities are considered specific neurological impairments rather than global intellectual or developmental disabilities. Often, learning disabilities are not recognized until a child reaches school age. One confounding aspect of learning disabilities is that they most often affect children with average to above-average intelligence. In other words, the disability is specific to a particular area and not a measure of overall intellectual ability. At the same time, learning disabilities tend to exhibit comorbidity with other disorders, like attention-deficit hyperactivity disorder (ADHD).

Dyslexia

Dyslexia, sometimes called reading disorder, is the most common learning disability; of all students with specific learning disabilities, 70–80% have deficits in reading. The term developmental dyslexia is often used as a catch-all term, but researchers assert that dyslexia is just one of several types of reading disabilities. A reading disability can affect any part of the reading process, including word recognition, word decoding, reading speed, prosody (oral reading with expression), and reading comprehension.

Figure 1. People with dyslexia may have difficulties in spelling words, reading quickly, writing words, “sounding out” words in their head, pronouncing words when reading aloud, and understanding what they’re reading.

Dyscalculia

Dyscalculia is a form of math-related disability that involves difficulties with learning math-related concepts (such as quantity, place value, and time), memorizing math-related facts, organizing numbers, and understanding how problems are organized on the page. People with this dyscalculia are often referred to as having poor “number sense.”

Dysgraphia

The term dysgraphia is often used as an overarching term for all disorders of written expression. Individuals with dysgraphia typically show multiple writing-related deficiencies, such as grammatical and punctuation errors within sentences, poor paragraph organization, multiple spelling errors, and excessively poor penmanship.

An additional type of learning disability is nonverbal, also known as NVLD. Nonverbal learning disabilities represent another type of learning difficulty in which individuals demonstrate adequate vocabulary, verbal expression, or reading skills, but present difficulties with certain nonverbal activities (e.g., problem-solving, visual-spatial tasks, reading body language, and recognizing social cues).

Figure 2. Dysgraphia is often characterized by grammatical and punctuation errors within sentences, poor paragraph organization, multiple spelling errors, and excessively poor penmanship.

The causes of learning disabilities are not well understood. However, some potential causes or contributing factors are

• heredity. Learning disabilities often run in the family—children with learning disabilities are likely to have parents or other relatives with similar difficulties.
• problems during pregnancy and birth. Learning disabilities can result from anomalies in the developing brain, illness or injury, fetal exposure to alcohol or drugs, low birth weight, oxygen deprivation, or premature or prolonged labor.
• accidents after birth. Learning disabilities can also be caused by head injuries, malnutrition, or toxic exposure (such as heavy metals or pesticides).

Treatment

Individuals with learning disorders face unique challenges that may persist throughout their lives. Depending on the type and severity of their disability, interventions and technology may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simple while others are intricate and complex. Teachers, parents, and schools can work together to create a tailored plan for intervention and accommodation to aid an individual in successfully becoming an independent learner. School psychologists and other qualified professionals often help design and manage such interventions. Social support may also improve learning for students with learning disabilities.