How “Specific” Are Specific Learning Disabilities After All?

How “Specific” Are Specific Learning Disabilities After All?

Copyright: © 2023 |Pages: 12
DOI: 10.4018/979-8-3693-0644-4.ch012
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Abstract

Learning-related NDDs, such as Specific Learning Disorders (SLD) and Attention-Deficit/Hyperactivity Disorder (ADHD), appear in childhood, and due to their high connectivity with children's schooling, they attract the intense interest of scientists. Successive questions arise about when and what is the most appropriate intervention, what are the benefits, what is the method of implementation, where should the intervention take place, and other related questions that arise always with the aim of optimizing support. But the question that precedes all the above is which exactly is the disorder? Is it only one? How are its symptoms distinguished and how could anybody be sure of its distinctiveness from others with a high rate of overlap? The introduction of the term ‘spectrum of NDDs' could pave the way for a re-approach of the clinical continuum of NDDs. This chapter aims to open a discussion and raise concerns about overlapping symptoms in learning-related NDDs, with the aim of achieving better intervention through a clearer system of diagnosis.
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Introduction

According to the latest determination of American Psychiatric Association (APA, 2013;2022) ‘Specific learning disorder (often referred to as learning disorder or learning disability) is a neurodevelopmental disorder that begins during school-age, although may not be recognized until adulthood. Learning disabilities refer to ongoing problems in one of these three areas, reading, writing and math, which are foundational to one’s ability to learn. An estimated 5 to 15 percent of school-age children struggle with a learning disability. An estimated 80 percent of those with learning disorders have reading disorder in particular (commonly referred to as dyslexia). One-third of people with learning disabilities are estimated to also have attention-deficit hyperactivity disorder (ADHD)’. The limits between these disorders are often indiscernible, even among experts. But do these limits exist or do experts should struggle distinguish and categorize symptoms in order to conclude to a dominant diagnosis? Which is the final educational goal? How diagnostic tools in all languages can guarantee discreteness of symptoms? What should be reconsidered?

Neurodevelopmental Disorders

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) Neurodevelopmental Disorders (NDD) are defined as ‘a group of conditions with onset in the developmental period. The disorders typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning’ (APA, 2013;2022).

The DSM-5 categorizes the following learning -related disorders among others under Neurodevelopmental Disorders: Intellectual Disorders (Intellectual Developmental Disorder; Global Developmental Delay; Unspecified Intellectual Disability), Communication Disorders (Language Disorder; Speech Sound Disorder; Childhood-Onset Fluency Disorder /Stuttering; Social /Pragmatic Communication Disorder); Unspecified Communication Disorder; Autism Spectrum Disorder; Attention-Deficit/Hyperactivity Disorder; Specific Learning Disorders (Impairment in reading; Impairment in written expression; Impairment in mathematics) (APA, 2013;2022).

This chapter will discuss Specific Learning Disorders and especially RD (Reading Disorder) and ADHD due to their high comorbidity and high prevalence in the pediatric population (Bosch et al., 2022; Español-Martín et al., 2023). Considering that ADHD and SLD have large public health implications as they can lead to both short- and long-term consequences, including academic underachievement, lower productivity, unemployment, economic hardship, behavioral problems, emotional problems, such as stress, anxiety, depression, and low self-esteem (Condo et al., 2022; Deacon et al., 2022; Livingston et al., 2018; Miranda et al., 2014; Shaywitz & Shaywitz, 2020; Wilmot et al., 2023) prevention and intervention it is crucial and therefore diagnosis procedure must be governed by inclusive rather than exclusionary criteria.

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