Specific Developmental

Disorder of Scholastic Skills

Nitisha Shrestha
Table of content
• Introduction
• Diagnostic Criteria
• Specific learning disorder with impairment in reading
• Specific learning disorder with impairment in mathematics
• Specific learning disorder with impairment with written expression
• Specific Spelling Disorder
• Prevalence
• Treatment
Introduction
• Specific developmental disorders of scholastic skills (ICD-10)
or Learning disorders (DSM-V) include disorders
characterized by one or more significant impairments in
acquisition of reading, spelling, or arithmetic skills.
• These are disorders in which the normal patterns of skill
acquisition are disturbed from the early stages of
development.
Diagnostic Criteria
A. Difficulties learning and using academic skills, as indicated
by the presence of at least one of the following symptoms
that have persisted for at least 6 months, despite the
provision of interventions that target those difficulties:
• Inaccurate or slow and effortful word reading.
• Difficulty understanding the meaning.
• Difficulties with spelling.
• Difficulties with written expression.
• Difficulties mastering number sense, number facts, or
calculation.
• Difficulties with mathematical reasoning.
B. The affected academic skills are substantially and
quantifiably below those expected for the individual’s
chronological age, and cause significant interference with
academic or occupational performance, or with activities of
daily living.
C. The learning difficulties begin during school-age years but
may not become fully manifest until the demands for those
affected academic skills exceed the individual’s limited
capacities.
D. The learning difficulties are not better accounted for by
intellectual disabilities, uncorrected visual or auditory
acuity, other mental or neurological disorders, psychosocial
adversity, lack of proficiency in the language of academic
instruction, or inadequate educational instruction.
Specific learning disorder with impairment in
reading
• The main feature of this disorder is a specific and
significant impairment in the development of reading
skills.
• Dyslexia is an alternative term used to refer to a
pattern of learning difficulties characterized by
problems with accurate or fluent word recognition,
poor decoding, and poor spelling abilities.
Etiology
• Neurological Factors
Etiology
• Genetic Factors
 Up to 50 percent of children of parents with reading disorder, 50
percent of sibling of a child with reading disorder, and 50 percent of
parents of children with reading disorder may have the disorder
(Sadock, 2009)
Twin studies have reported high concordance rates and heritability
estimates for reading disorder.
• Cognitive Factors
 Phonological Theory
 Cerebellar Theory
 Visual/Magnocellular Theory
Specific learning disorder with impairment in
mathematics
• Dyscalculia is an alternative term used to refer to a pattern of
difficulties characterized by problems processing numerical
information, learning arithmetic facts, and performing accurate
or fluent calculations.
• There are four groups of skills that are poorly achieved by
individuals with impairment in mathematics.
 Linguistic skills
 Perceptual skills
 Mathematical skills
Attentional skills
Etiology

• Neurological Factors
The behavioral and functional neuroimaging studies of the healthy
adult brain reveal that activation in bilateral regions of the inferior
parietal lobules whereas children with dyscalculia showed
significantly reduced gray matter volumes in the right inferior parietal
sulcus, left inferior frontal gyrus.
The calculation ability was found to be related to taurine in neonatal
period as it is important in neural development.
Etiology
• Genetic Factor
Family studies suggest that 50 to 60 percent of all siblings
and parents of children with mathematics disorder also have
mathematics disorder.
• Environmental Factors
Schooling.
Affective factors, such as anxiety and motivation.
Specific learning disorder with impairment in
written expression
• Dysgraphia is a term used to describe difficulties with
putting one’s thoughts on to paper.
• People with impairment in written expression have
trouble getting words on paper, either by handwriting
or typing them.
• Problems with writing can include difficulties with
spelling, grammar, punctuation, and handwriting.
Specific spelling disorder
• The main feature of this disorder is a specific and
significant impairment in the development of spelling
skills.
• The ability to spell orally and to write out words
correctly are both affected.
• Spelling mistake are often phonetic errors for example
fone for phone or beeleve for believe.
Etiology
• Neuropsychological Factors
One of the most well-developed and empirically validated
developmental models of writing identifies three critical components
which are transcription, text generations and executive functions of
the writing system that take place in an environment supported by
short-term memory, working memory, and long-term memory.
• Perinatal Factors
Extreme prematurity has been associated with extremely poor
spelling in the primary grades, as well as with poor reading and
mathematics.
Etiology
• Genetic Factors
Family studies reveal increased rates of spelling-disabled
siblings in families with a spelling-disabled proband.
Twin studies indicate that deficits in spelling are substantially
heritable.
Molecular genetic studies provide preliminary evidence for
linkage of spelling to chromosome 15 and for orthographic
skills to be linked to chromosome 6.
Prevalence
• The prevalence of specific learning disorder across the
academic domains of reading, writing, and
mathematics is 5%-15% among school-age children
across different languages cultures (DSM-V, 2013).
• In context of Nepal, there has been a small scale
studies where in a study of 554 primary school going
children prevalence of dyslexia was estimated to be
13.54 percent (Thapa, 2018).
Prognosis
• Available evidence from prospective longitudinal
studies indicates that impairment in reading,
mathematics and written expression is an enduring
learning disability that persists into late
adolescence/young adulthood.
Treatment
• Instructional approaches that have proved highly successful with
children with reading problems are Reciprocal Teaching, story
mapping.
• The only treatment of mathematics disorder proved effective is
systematic instruction guided by principles where the first is making
sure to consider the strengths and weaknesses of the individual and
second is providing a balanced mathematics program.
• Educational intervention is thought to improve disorder of written
expression.
• Various types of cognitive-perceptual skills training.
• Psychosocial approaches to reading disorders include supportive
psychotherapy, parent guidance and training, social skills training,
relaxation training, and behavioral modification approaches.
References
• Diagnostic and statistical manual of mental disorders: DSM-5 (2013).
American Psychiatric Publishing
• Sadock, B.J. and Sadock, V.A. (2009). Kaplan and Sadock’s
Comprehensive Textbook of Psychiatry. Lippincott Williams and
Wilkins Publishers.
• Thapa, K.B. (2018). Preliminary Scenario of Dyslexia among Nepalese
Primary School Children. A Nepalese Journal of Participatory
Development.