How to talk about your kid’s learning disorder: Part 1

The importance of terminology

If you have a kid with a learning disorder, you probably talk about it a lot with many different people. Treating learning disorders requires a team approach—parents, teachers, tutors, therapists—so it’s important that everyone speaks the same language. That’s easier said than done, though, since there are so many ways to label similar problems. So I thought I’d devote a few posts to terminology so you can make sure you’re describing things as clearly and accurately as possible.

The first part of this series will focus on the three dys-es: dyslexia, dysgraphia, and dyscalculia.

These terms seem to be the go-to labels for learning disorders, even though, technically, they are not the official diagnostic labels.

In the DSM-5, the diagnostic manual published by the American Psychiatric Association, all learning disorders fall under the umbrella label “Specific Learning Disorder (SLD).” In order to meet criteria for SLD, academic skills must be below age expectations, and the skills deficit cannot be explained by other factors like another medical disorder, intellectual disability, or inadequate instruction. Diagnoses of SLD include specifiers to indicate whether the skills deficit is in reading, writing, or math. So, if your kid has a learning disorder, according to the DSM, the correct way to label it is Specific Learning Disorder with impairment in Reading, Writing, or Math.

Unfortunately, there are many different sub-skill deficits that cause learning disorders in reading, writing, and math, and the SLD labels are pretty broad, so they don’t describe what exactly is going on. To explain what I mean, it’s helpful to think about the foundational and higher-order skills that comprise each academic domain.

• The foundational skill of reading is decoding, or the ability to sound out a word. The higher-order skill is reading comprehension.

• The foundational skill of writing is handwriting. The higher-order skill is composition, or explaining your thoughts in writing.

• The foundational skills of math are number sense and arithmetic. The higher-order skill is problem solving.

In general, the ‘dys’ terms refer to the foundational skills. Dyslexia is impaired decoding, dysgraphia is impaired handwriting, and dyscalculia is impaired arithmetic. Though some people use the ‘dys’ terms to describe all learning disorders, really that’s not correct. SLD with impairment in math, for instance, is the umbrella term to describe all math learning disorders, and dyscalculia is one specific type of math impairment.

There aren’t great terms to describe impairments in higher-order academic skills, unfortunately. So if your basic calculation skills are fine but your math problem solving is poor, you have SLD with impairment in math, but you do not have dyscalculia. Likewise, if you can sound out words but your reading comprehension is poor, you have SLD with impairment in reading, but you do not have dyslexia.

A few other important facts about these terms:

1.      Dyslexia does not describe letter reversals. Letter reversals are pretty common until about age 8, after which case, I’d be more concerned about dysgraphia than dyslexia, since neuroimaging studies of people with letter reversals tend to implicate neural correlates of writing rather than reading.

2.      Though, intuitively, many people consider spelling to be a foundational skill of writing, poor spelling does not mean dysgraphia. Poor spelling is actually a sign of dyslexia, since spelling depends on phonological processing—the ability to manipulate the sounds of language--which is the major cognitive skill that makes decoding possible.

3.      SLD with impairment in writing is a tricky diagnosis. The research to support its existence really isn’t great. Generally, when I see a kid with a writing disorder (not dysgraphia!), I wonder if poor executive functioning, rather than a learning disorder, is making it difficult to write. Writing, after all, requires planning and organization, so if a kid is struggling to develop those core executive functions, writing is going to be really tough.

4.      Likewise, some of the areas of the brain that are implicated in ADHD are the ones responsible for fine motor control, so whenever I see a kid with dysgraphia, I wonder about ADHD, too.

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I think it’s so cool that my 4-year-old daughter is a huge fan of Alex Newell!