Specific Learning Disorders (SLD), also referred to as Specific Learning Disabilities (DSA), are neurodevelopmental disorders characterized by significant difficulties in the acquisition and application of academic skills, particularly in reading, writing, and mathematics.
It is not uncommon for children to experience challenges with reading or writing at the onset of their educational journey. Typically, these difficulties are resolved within the first year of schooling. However, in some cases, these challenges may persist despite the child’s efforts, as well as the reinforcement provided by educational interventions and support from parents and teachers.
In such instances, it is possible that the child may be diagnosed with a Specific Learning Disorder (DSA), which encompasses various conditions, including dyslexia, dysgraphia, dysorthographia, and dyscalculia.
While diagnosis often occurs after the completion of second grade, early intervention is crucial in equipping children with the necessary tools to navigate their daily challenges effectively.
Definition of DSA
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), specific learning disabilities are defined as “difficulties in learning and using academic skills that are quantitatively and qualitatively below those expected for chronological age. These difficulties are not attributable to intellectual disabilities, neurological disorders, lack of language proficiency, or inadequate instruction.”
It is important to note that these disorders affect specific academic abilities rather than overall intellectual functioning. Consequently, children with DSA typically possess average or above-average intelligence. Furthermore, they are capable of articulating thoughts and establishing connections between concepts that may be challenging for their peers.
Children with DSA often think visually, recalling words and events as experiences rather than abstract concepts.
Classification of Specific Learning Disorders
Specific Learning Disorders are categorized into four primary types: dyslexia, dysorthographia, dysgraphia, and dyscalculia.
- Dyslexia
Dyslexia is a specific learning disorder of neurobiological origin, characterized by difficulties in reading and comprehending text. Children with dyslexia may struggle to read fluently, quickly, and accurately, often making errors and having trouble recognizing similar letters, associating graphic symbols with sounds, and automating these processes. These challenges can hinder their overall comprehension of the text.
Common difficulties experienced by children with dyslexia include:
- Reversal of letters and numbers (e.g., dal/dla; 43/34)
- Letter substitution (e.g., m/n; b/d; v/f)
- Inability to learn multiplication tables or sequential information (e.g., days of the week, months of the year)
- Challenges with left/right spatial orientation
Dyslexia is frequently associated with other disorders, such as dysorthographia, dysgraphia, and dyscalculia.
- Dysorthographia
Dysorthographia is a specific learning disorder of neurobiological origin characterized by difficulties in spelling and phonological processing. Children with dysorthographia struggle to apply spelling rules and recognize the sounds that comprise words, leading to challenges in converting these sounds into written form and arranging letters correctly.
Common errors made by children with dysorthographia include:
- Spelling mistakes
- Inversion of graphemes, syllables, and/or letters (e.g., lad/dal)
- Omissions of graphemes (e.g., alone/school)
- Errors related to missing double letters
- Substitution of letters or words (e.g., m/n; b/d; v/f; car instead of airplane)
- Difficulty composing texts (e.g., writing essays or sentences)
- Dysgraphia
Dysgraphia is a specific learning disorder of neurobiological origin characterized by difficulties in writing. Children with dysgraphia may experience challenges in producing legible writing due to both motor and cognitive issues. Effective writing requires the integration of linguistic and motor information; however, this integration may be impaired, resulting in poor handwriting quality. Additionally, children with dysgraphia may exhibit improper grip of writing instruments and difficulty utilizing space on the page, often alternating between uppercase and lowercase letters.
Children with dysgraphia may demonstrate:
- Slow and disorganized writing
- Difficulty reading their own handwriting
- Challenges in copying or producing geometric shapes, which are inappropriate for their chronological age
- Increased difficulty when copying sentences from the board
- Dyscalculia
Dyscalculia is a specific learning disorder of neurobiological origin characterized by difficulties in numerical understanding, arithmetic, and calculation. Children with dyscalculia may struggle to recognize and name numerical symbols, perform mental calculations, and organize quantities. They may also have difficulty writing, reading, and arranging numbers for calculations, as well as memorizing multiplication tables.
Common challenges faced by children with dyscalculia include:
- Left/right spatial orientation difficulties
- Problems with sequential organization of numbers and recognizing similar numbers (e.g., 6/9), including reversals (e.g., 43/34)
- Inability to read or write mathematical symbols
- Difficulty counting backward, despite the ability to count progressively
- Inability to memorize multiplication tables
- Challenges in performing mathematical operations and establishing mathematical relationships
Distinction Between DSA, BES, and ADHD
BES, or Special Educational Needs, encompasses a range of learning difficulties that may not always be linked to a specific diagnosis but nonetheless impact a child’s academic performance. This category includes:
- Children with disabilities who receive support from a teacher following a medical diagnosis
- Children facing socio-economic, linguistic, or cultural disadvantages who may require specific educational support without necessarily having diagnosed physical or mental disorders
- Children with DSA, who experience recognized difficulties in reading, writing, or calculation and may require a Personalized Educational Plan (PDP) and compensatory tools to facilitate academic success
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by difficulties in attention, impulse control, and hyperactivity, and is classified within the Special Educational Needs group.
Causes of DSA
There is a consensus regarding the presence of a neurobiological disorder that disrupts the typical learning processes associated with reading and writing. Contributing factors may include genetic predispositions, epigenetic influences, and acquired deficits, particularly those occurring perinatally, such as brain damage, lesions, and delays in maturation.
Additionally, environmental factors, in conjunction with neurobiological influences, play a role in determining the severity of the disorder and the associated challenges. DSA is often co-occurring with other disorders, such as ADHD, conduct disorders, anxiety, or depression.
Diagnosis of DSA
Diagnosis requires consultation with a child neuropsychiatrist or psychologist, either through local health services or accredited private specialists. A clinical evaluation is essential for diagnosis. While dyslexia, dysgraphia, and dysorthographia are typically diagnosed after the completion of second grade, dyscalculia is diagnosed after third grade. However, it is important to note that intervention should not be delayed until diagnosis.
Early diagnosis facilitates a more effective recovery process for the child, making the involvement of parents and educators during this initial phase critical. Following diagnosis, parents should request a Personalized Educational Program (PDP) from the school, which should outline appropriate accommodations and compensatory measures tailored to the child’s needs, with the assistance of a specialist. This PDP should be provided to the family within the first quarter of the academic year.
Identifying a Child with DSA
Indicators of DSA may vary among children and do not always present uniformly. Frequently, children with DSA are mischaracterized as lazy, unintelligent, or disruptive, or conversely, as overly quiet and withdrawn. They may excel in oral assessments while struggling with written tasks, often becoming distressed during reading tests or class assignments. Their errors may increase significantly under conditions of confusion and stress, and they may appear distracted, frequently losing focus.
As a result, these children often experience low self-esteem, perceiving themselves as inadequate, and may resort to compensatory strategies to divert attention from their struggles.
Symptoms of DSA
Common symptoms may include:
- Difficulties in reading and writing, characterized by specific errors such as letter or number reversals (e.g., 34 vs. 43), letter substitutions, and omissions of similar-sounding graphemes (e.g., m/n; b/d; v/f)
- Inability to retain sequential information, such as days of the week, months of the year, and the alphabet
- Confusion regarding spatial and temporal relationships (e.g., right/left; yesterday/tomorrow)
- Challenges in interpreting symbols, codes, or musical notation, as well as difficulties reading an analog clock
- Inability to perform rapid calculations, multiplications, and divisions, along with challenges in geometry, such as recalling types of angles or triangles and relevant formulas
- Significant difficulty in learning foreign languages
Treatment for DSA
Treatment typically involves a clinical rehabilitation program conducted by a speech therapist or another qualified health professional capable of diagnosing and rehabilitating DSA. The initial focus is on developing tools and metacognitive awareness, enabling the child to understand their difficulties and seek solutions independently.
Children learn to employ effective strategies tailored to specific tasks. Treatment plans are individualized and vary according to the specific disorder presented by the child.
