According to recent research, 8 to 10 percent of American students under 18 have some type of learning disability. That translates to 38 percent of all children with an IEP, so let’s take a look at who qualifies for a specific learning disability.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines a specific learning disorder as “a type of neurodevelopmental disorder that impedes the ability to learn or use specific academic skills (e.g., reading, writing, or arithmetic), which are the foundation for other academic learning.”
In order to be diagnosed with SLD, the DSM-5 requires that a student meet the following four criteria:
It should be noted that there is a slight difference in how SLD is applied. A “specific learning disorder” is a medical term used in making a medical diagnosis, while school districts use the term “specific learning disability” (also abbreviated as SLD). Children identified by their school district as having a specific learning disability — one of thirteen categories that make a child eligible for an IEP — can receive services accordingly. But not all learning disabilities that a school recognizes would be necessarily categorized by the DSM-5 as a learning disorder.
Updates in 2006 to the Individuals with Disabilities Education Act (IDEA) clarified the need to support students with learning disabilities regardless of their perceived intellectual abilities. To determine whether a child has an SLD, a state cannot “require the use of a severe discrepancy between intellectual ability and achievement for determining whether a child has a specific learning disability.” Instead, a student must be identified as not meeting grade-level standards or “achieving adequately for the child’s age” if they have been “provided with learning experiences and instruction appropriate for the child’s age” in the following areas:
But like the DSM-5, IDEA also states that a child can only be diagnosed with learning disabilities if the learning challenges are not the result of other disabilities, including visual, hearing, motor, intellectual, emotional disturbance/disability, or factors including cultural differences, environmental or economic disadvantages, or limited English language.
SLD covers a wide range of learning challenges. However, IDEA lists the following as specific learning disabilities: perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. The DSM-5 lists three: dyslexia, dysgraphia, and dyscalculia. Let’s explore a few of these. *Note that sometimes language disorders, usually listed under speech and language category of IDEA, can be listed as an SLD.
Dyslexia
Children with dyslexia have difficulties with word recognition, spelling, and decoding; as a result, they typically struggle with learning how to read and write. Signs of dyslexia vary from person to person and evolve over a person’s life. Some of the most common include delayed speech development or articulation issues, difficulty reciting the alphabet (e.g., saying “lelomenopee” instead of l, m, n, o, and p), tendency to mix up names of familiar people, places, and objects, difficulty pronouncing words with three or more syllables, etc. Read more about dyslexia in our article Dyslexia 101.
Dysgraphia
Dysgraphia is a neurological condition that causes a child to struggle with handwriting because of impaired fine motor skills. People with dysgraphia don’t just have “bad handwriting” — because of differences in their brains, they struggle to turn their thoughts into written language at the same level of complexity as their typically developing peers. There are five dysgraphia subtypes: dyslexic dysgraphia, motor dysgraphia, spatial dysgraphia, phonological dysgraphia, and lexical dysgraphia. Read more in our article Dysgraphia 101.
Dyscalculia
Dyscalculia is a learning disability that impacts a child’s ability to understand math and other number-based information. Somewhere between 3 and 7% of people live with dyscalculia, making it somewhat less common — or, more accurately, more frequently misdiagnosed or underdiagnosed. Read more about dyscalculia in our article Dyscalculia 101.
Auditory Processing Disorder (APD)
If your child seems to frequently struggle to process what they hear, they may actually have an auditory processing disorder (APD). Children with this disability may mix up the order of sounds or struggle to distinguish between different sounds. For example, hearing “break” when the person said “bake,” or having difficulty picking up common nursery rhymes or songs. Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is often confused with or misdiagnosed as ADD, ADHD, or autism, but sometimes it turns out to be a co-occurring diagnosis, which is fairly common among children who have already been diagnosed with other disorders such as a speech delay or learning disability.
“Among populations of children who are already identified as having a learning disability or speech and language disorder, I want to say that number is close to fifty percent,” Dr. Bea Braun, founding audiologist at the Auditory Processing Center, says. “[APD] is a big part of the whole picture of a kid who is struggling with learning issues, and it often gets completely ignored.” Learn more in our article Auditory Processing Disorders: What You Need to Know.
Language Processing Disorder (LPD)
A language processing disorder (LPD) is a type of learning disorder that affects a child’s ability to understand and use spoken language. Students with LPD may find it challenging to attach meaning to groups of sounds that form words or sentences. For example, a child might struggle to understand a joke or a sarcastic comment from a peer, or may frequently feel like the right word is on the tip of their tongue. It’s different from a speech or hearing disorder because children with LPD can often hear sounds and speak normally, but they struggle with interpreting, organizing, and expressing language.
Unlike APD, in which there is difficulty identifying and retaining sounds after hearing them, in LPD, a child will struggle to process the language once they hear it, such as “attaching meaning to words, sentences and stories.” While there are three different kinds of LPD — expressive, receptive, and a mix — a child with LPD might exhibit symptoms such as using a lot of filler words like “um,” or use “stuff” and “things” instead of more specific words, having trouble rhyming at an early age, having difficulty recollecting a specific word but can describe or illustrate it, constantly repeating and overusing the same phrases, having difficulty getting jokes, and having difficulty following directions.
Some interventions for LPD include a focus on building a child’s ability to understand, process, and respond to spoken language. A speech and language therapist, for example, can evaluate your child’s receptive and expressive language and create a plan that could help kids distinguish sounds, understand words, and process sentences more effectively. They could use repetition and sequencing games to help children practice auditory memory and processing and storytelling to encourage kids to retell stories in their own words to improve their ability to process and organize spoken language.
There are also accommodations that can be made in school, such as providing extra time to process or express themselves, as well as for assignment completion, using visual aids and/or multisensory materials, such as pairing speech and nonverbal signals and pictures, providing materials like lesson outlines and notes, breaking directions into simple steps, using role play to help them understand concepts, and asking students to summarize what they hear or read.
Nonverbal Learning Disabilities (NVLD)
Children with a nonverbal learning disability often have trouble with organization, attention, executive functioning, nonverbal communication, and motor skills. Unlike the other learning disabilities which can be language-based, NVLD are about nonverbal skills, such as motor, visual-spatial, and social skills. So kids with NVLD are often well-spoken and can write well but find it challenging to recognize and understand patterns in body language, visual-spatial information, and other forms of non-verbal communication. Note that NVLD is not an official diagnosis and some experts may not recognize it. Symptoms can also overlap with other disabilities, such as autism or ADHD.
Some challenges for kids can show in many ways, including: low spatial awareness (e.g. bumping into people and things, standing too close to people, etc.), trouble reading non-verbal social cues (e.g.facial expressions, other people’s emotions, and body language, unaware of people’s reactions, etc.), difficulty understanding sarcasm, seeming clumsy and uncoordinated, trouble understanding visual information, like maps and graphs, struggle with higher level math concepts, missing social cues, subtle messages, and misreading situations, hyper-talkativeness, trouble breaking down a project into smaller steps, etc.
According to the Child Mind Institute, children with NVPD often benefit from “intensive practice at pattern recognition and organizing thoughts, as well as coaching in understanding social patterns and expectations.” Occupational therapy can also help improve coordination and fine motor skills. There are also accommodations that can be utilized, such as explicit verbal directions, movement breaks, seating with limited distractions, and visual examples of how spaces should look, such as their desk. Read more about NVLD on The NVLD Project website.
Visual Perceptual/Visual Motor Disabilities
Visual perceptual/visual motor disabilities affect how a child interprets and responds to visual information — what they see. These disabilities are not related to eyesight; rather, they impact how the brain processes what the eyes see. Some common areas of difficulty include spatial awareness, which can refer to the position of objects in space or the ability to accurately perceive objects in space with reference to other objects. This looks like the inability to read a map, organize their desk, or judge distances; visual discrimination, where a child may not be able to see the differences or similarities between objects, such as a circle from a square, or green from blue, or the number 6 from 9; visual memory, or difficulty remembering visual information, such as faces, shapes, or sequences of letters or numbers, or even directions to a location; poor hand-eye coordination, such as handwriting or catching a ball; whole/part relationships, in which a child has difficulty distinguishing objects from the background, such as finding an object in a messy room or putting together a puzzle; and poor depth perception, such as stubbing their toes frequently, running into walls, or bumping into others during P.E.
Some accommodations to help kids with visual perceptual/visual motor difficulties include large print for books, papers, worksheets, or other materials; zooming in on images if using a tablet or computer; using a reading guide strip to block out other lines; using paper with raised lines to provide kinesthetic feedback; posting visual schedules; narrating lessons or presentation aloud; and incorporating auditory feedback when possible.
Similar to IDEA, previous DSM definitions of specific learning disabilities used what is called an “IQ-discrepancy model,” which allowed a child to be diagnosed with a learning disability only if there was a substantial difference between their tested general intelligence (IQ) and their academic achievement. To put it bluntly, a child had to be smart in order to be assessed for a learning disability that explained why they weren’t performing as expected.
Luckily, the new criteria for diagnosing SLD means that more kids should have access to the reading interventions they need. As Rosemary Tannock explains on the International Dyslexia Association website, “For the education system, the elimination of the IQ achievement discrepancy criterion might mean they are able to provide special education services to children with SLD and lower IQ (e.g., IQ score above 70 ± 5), but who do not have an Intellectual Disability. These children show a similar response to intervention as do children with SLD and higher IQ scores.”
And while there is evidence to suggest that a person’s IQ does not determine whether or not they can have a learning disability, it’s still generally accepted that children with developmental disabilities, particularly intellectual disability, cannot also be diagnosed with a learning disability because one disability would negate the need to define a second. One reason for this is merely diagnostic. A specific learning disorder is classified as one type of neurodevelopmental disorder as distinct from other neurodevelopmental disorders, including intellectual disability (ID), autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), communication disorders, and motor disorders.
Learning difficulties must be "unexpected"
Another has to do with age-old assumptions. As Tannock puts it, the DSM-5 definition of an SLD includes the necessity that “the learning difficulties are ‘unexpected’ in that other aspects of development seem to be fine.” Dr. Sally Shaywitz, co-director of the Yale Center for Dyslexia & Creativity, writes in her book Overcoming Dyslexia, “Since its first description over a century ago, dyslexia has been recognized as an unexpected difficulty in reading for an individual who has the ability to be a much better reader.”
It’s this word “unexpected” that prevents children with developmental disabilities from accessing reading interventions even though they can struggle with reading in the same ways as children with learning disabilities and can benefit from structured reading intervention in the same ways too. As this article argues, continuing to focus on what’s “unexpected” means that schools take a “wait to fail” approach: “The higher the IQ, the earlier the discrepancy is detected — so students with lower IQs have to wait longer for interventions, and most never catch up.”
Of course, a child can have more than one neurodevelopmental disorder, so parents, clinicians, and teachers are left with the task of assessing a child accurately to make sure they receive all the interventions — both therapeutic and academic — that they need regardless of whatever diagnosis they receive.
Make sure assessments are thorough
Elizabeth Bloom, Education Advocate and Regional Leader–Los Angeles of Decoding Dyslexia CA, reminds us that “generally speaking, interventions are based on assessment results.” Therefore, as parents, we should make sure our kids are being assessed accurately and thoroughly. When students are assessed for an IEP, they should be given a multidisciplinary set of assessments in suspected areas of need: academics, speech and language, occupational, behavioral, vision/hearing, motor skills, and more.
Because students with co-occurring diagnoses can present with challenges in any or all domains of assessment, Bloom says, “I advise parents who have kids with co-occurring diagnoses to explore which domains of learning and development they think are impacted by their underlying skill challenges.” And it’s important to remember that looking at a child’s strengths is just as important as examining their challenges so that providers can “utilize strengths when building interventions for weaker skill sets.”
Make sure goals and services are written into the IEP
Dr. Sarah Pelangka, BCBA-D, special education advocate and owner of KnowIEPs, says, “Any area that arises as a barrier to accessing education needs to be supported via the IEP, be it by goals and services or accommodations. If you have a student who qualifies under multiple disabilities and intellectual disability is one of them, their primary IEP eligibility category can arguably be ‘Multiple Disabilities.’ That triggers the IEP team (e.g., the teacher when they see the front page of the IEP) to really dive into what, specifically, that student's needs are.” For example:
In short, she says, “Parents need to know what the eligibilities entail — what all the information means and how to best support those areas. If the psychologist doesn't explain it clearly, ask them to — it’s their job! It’s a lot of information, but understanding how your child’s brain processes information REALLY helps.”
If you feel the school has not assessed your child accurately or thoroughly, you have the right to request additional assessments, including an Independent Educational Evaluation, or IEE. You can read more about IEEs and how to request one in our article Independent Educational Evaluations 101.
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