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Classification & Assessment in Psychiatry · Paper A

Specific learning disorder (dyslexia)

The idea

Specific learning disorder matters because it names a deficit in one specific academic skill that sits well below what the person's general intellectual ability would predict, unlike a global cognitive impairment. It is diagnosed as persistent difficulty in a specific area, such as reading (dyslexia), writing, or mathematics, that is substantially below what is expected for age despite adequate instruction, with normal general intellectual ability. For example, imagine a bright ten-year-old with an entirely normal IQ (intelligence quotient, a standardised score of general cognitive ability) score who still reads two years behind her classmates and struggles badly to sound out unfamiliar words. In practice, that gap between her normal general ability and her specific reading difficulty is what defines the disorder.

How it works

Dyslexia, the reading form, typically involves difficulty with phonological processing, connecting letters to their sounds, causing slow, effortful, or inaccurate reading and poor spelling. The deficit is specific to the affected academic skill; other cognitive abilities, and general IQ, remain within the normal range, which is what distinguishes it from a broader intellectual impairment. Say the same ten-year-old is tested on mathematics and verbal reasoning: both come back at an age-appropriate level, confirming the difficulty is confined to reading and phonological processing. In practice, this profile, one weak skill amid otherwise normal ability, guides targeted educational support such as structured phonics teaching.

How to spot it

  • A child of average ability cannot learn number facts or carry out simple calculations, though reading is fluent. Which term applies?
  • Which condition most commonly coexists with a specific learning disorder?
  • What happens to dyslexia as a person reaches adulthood?

Tell it apart

  • Intellectual disability, global deficits in both intellectual and adaptive functioning, unlike specific learning disorder's single, isolated skill deficit against normal general ability.
  • Dyslexia, a phonological-processing-based reading difficulty, unlike dyscalculia, which is a specific difficulty with mathematics rather than reading.
  • ADHDAttention-deficit hyperactivity disorder, a condition of inattention, impulsivity and sometimes hyperactivity.Read more → (attention deficit hyperactivity disorder): inattention can cause academic underperformance across subjects, whereas specific learning disorder causes a focused deficit in one skill area despite adequate attention and instruction.
  • Specific learning disorder, normal IQ score with one weak academic skill, rather than the below-average IQ score seen across intellectual disability.

Watch for

  • Written expression is not the difficulty described, which is specific to calculation.
  • Language disorder affects comprehension and expression rather than calculation specifically.
  • General ability is average, which excludes intellectual disability.
  • Coordination disorder affects motor skills.
  • Tic disorders are more closely linked with obsessive-compulsive symptoms.

Use it again

  • Extract the defining phenomenology, duration, severity and functional-impact clues.
  • Match the pattern to the most specific diagnostic or assessment construct.
  • Actively test the closest look-alike against the missing or contradictory clue.
  • Choose the precise term rather than a broader category that is merely compatible.

Try a question from this area

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