For Specific Learning Disorder, there are certain contextual diagnostic issues that should be taken into consideration when making a diagnosis. These diagnostic issues are related to:

- Culture
- Sex and Gender


Specific Learning Disorder, as a diagnosis in the DSM-5-TR, is a broad diagnosis that covers many different specific learning disorders or deficiencies. This disorder typically manifests in early years of schooling and is recognized by concerns related to foundational academic skills in areas of reading, writing, and mathematics. When assessments recognize a marked difference in an individual’s ability in one of these areas, compared to their peers, they may be diagnosed with a specified variant of this disorder. It is important to note that children who are recognized as “gifted” in their education, may struggle with their abilities to perceive or process information and can still be diagnosed with Specific Learning Disorder. 

Specific Learning Disorder

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). https://doi.org/10.1176/appi.books.9780890425596

DSM-5-TR

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: 

1. Inaccurate or slow and effortful word reading (e.g., reads single words aloud incorrectly or slowly and hesitantly, frequently guesses words, has difficulty sounding out words).
2. Difficulty understanding the meaning of what is read (e.g., may read text accurately but not understand the sequence, relationships, inferences, or deeper meanings of what is read)
3. Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants). 
4. Difficulties with written expression (e.g., makes multiple grammatical or punctuation errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity). 
5. Difficulties mastering number sense, number facts, or calculation (e.g., has poor understanding of numbers, their magnitude, and relationships; counts on fingers to add single-digit numbers instead of recalling the math fact as peers do; gets lost in the midst of arithmetic computation and may switch procedures).
6. Difficulties with mathematical reasoning (e.g., has severe difficulty applying mathematical concepts, facts, or procedures to solve quantitative problems). 

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, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment. For individuals age 17 years and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment. 

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 (e.g., as in timed tests, reading or writing lengthy complex reports for a tight deadline, excessively heavy academic loads). 

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. 


[DSM-5-TR] Diagnostic Criteria of Specific Learning Disorder

Associated Features of Specific Learning Disorder

The prevalence of specific learning disorder across the academic domains of reading, writing, and mathematics is 5%–15% among school-age children in Brazil, Northern Ireland, and the United States. Prevalence in adults is unknown.


Prevalence of Specific Learning Disorder 

The onset of learning disabilities often occurs during childhood, but they are frequently not identified until a child begins formal schooling and faces academic challenges.

Development and Course of Specific Learning Disorder

For Specific Learning Disorder, there are several aspects that can influence the risk and/or prognosis for a Specific Learning Disorder diagnosis. These aspects are within the areas of:

- Environmental Factors
- Genetic and Physiological Factors
- Course Modifiers


Risk and Prognostic Factors of Specific Learning Disorder

Related Diagnostic Issues of Specific Learning Disorder

Association of Specific Learning Disorder with Suicidal Thoughts or Behavior

Functional Consequences of Specific Learning Disorder

Differential diagnoses to Specific Learning Disorder include:
- Normal Variations in Academic Attainment
- Intellectual Developmental Disorder (Intellectual Disability)
- Learning Difficulties due to Neurological or Sensory Disorders
- Neurocognitive Disorders
- Attention-Deficit/Hyperactivity Disorder
- Psychotic Disorders


Differential Diagnoses to Specific Learning Disorder

Comorbid Diagnoses to Specific Learning Disorder

This includes the intersection of connections and/or research related to Specific Learning Disorder in other fields of study and research. Such fields include:

- Behavioral Neuroscience
- Disability Studies
- Education
- Psychology

Note: Add subjects as needed


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