Learning Disorders: Diagnosing

1. Differential Diagnosis

Learning Disorders must be differentiated from normal variations in academic attainment and from scholastic difficulties due to lack of opportunity, poor teaching, or cultural factors. Inadequate schooling can result in poor performance on standardized achievement tests. Children from ethnic or cultural backgrounds different from the prevailing school culture or in which English is not the primary language and children who have attended class in schools where teaching has been inadequate may score poorly on achievement tests. Children from these same backgrounds may also be at greater risk for absenteeism due to more frequent illnesses or impoverished or chaotic living environments.

Impaired vision or hearing may affect learning ability and should be investigated through audiometric or visual screening tests. A Learning Disorder may be diagnosed in the presence of such sensory deficits only if the learning difficulties are in excess of those usually associated with these deficits. Accompanying neurological or other general medical conditions should be coded on Axis III.

In Mental Retardation, learning difficulties are commensurate with general impairment in intellectual functioning. However, in some cases of Mild Mental Retardation, the level of achievement in reading, mathematics, or written expression is significantly below expected levels given the person's schooling and severity of Mental Retardation. In such cases, the additional diagnosis of the appropriate Learning Disorder should be made.

An additional Learning Disorder diagnosis should be made in the context of a Pervasive Developmental Disorder only when academic impairment is significantly below expected levels given the individual's intellectual functioning and schooling. In individuals with Communication Disorders, intellectual functioning may have to be assessed using standardized measures of nonverbal intellectual capacity. In cases in which academic achievement is significantly below this measured capacity, the appropriate Learning Disorder should be diagnosed.

Mathematics Disorder and Disorder of Written Expression most commonly occur in combination with Reading Disorder. When criteria are met for more than one Learning Disorder, all should be diagnosed.

2. DSM IV Criteria

Please view the subsequent sections which discuss the specific Learning Disorders.

4. Reference:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.