According to the DSM-5, 5-15% of children have a SLD. [American: 2015] Thirty-three percent of children with SLDs also have ADHD.[Margari: 2013] A notable proportion of children with ADHD also have a specific learning disability (SLD), with approximately 45% co-morbidity rates. [DuPaul: 2013]
Parents and teachers often report that effective medication treatment of ADHD results in improved reading fluency and accuracy, handwriting, on-task behavior, and overall “availability” to learn. If the child is putting in good effort and has good educational and parent support, but is still struggling academically after ADHD medications are administered, the presence of a SLD should be considered. In a study of children with hard to treat ADHD or with ADHD and co-morbid conditions, 50% were found to have an SLD. [Koolwijk: 2014] If there is a family history of SLD, then it is important to assess for the presence of a SLD when first assessing for ADHD.
The public school system is another resource for assessments when a full neuropsychological evaluation is not available. The school system can administer psychoeducational testing including I.Q. and achievement testing. The public school system has traditionally identified learning disabilities through the “Discrepancy Model.” For instance, if the child’s I.Q. score is greater than their achievement score by a certain number of points determined by a formula specific to each state, then a Learning Disability is identified. Since 2004, however, school districts are allowed to use alternative methods such as documenting ongoing underachievement as a means of determining if a student will qualify for special services due to a learning disability. For example, a number of school systems use “Response to Intervention” (RTI) to systematically monitor for a child’s response to a set of classroom interventions, and to provide additional evaluation if the classroom interventions are not sufficient to enable the child’s performance to improve.
Learning Disabilities and the Pediatric Professional Community
Provides guidance about screening, diagnosing, and supporting children with learning disabilities and their families; a joint effort of the National Center for Learning Disabilities, the American Academy of Pediatrics, and the National Association of Pediatric Nurse Practitioners.
National Center for Learning Disabilities
Support and advocacy group for individuals with learning disabilities and their families. Links to additional information
Understood for Learning & Attention Issues
A collaboration among 15 non-profit agencies to provide resources to parents of children with learning and attention disorders.
IDEA Parent Guide (National Center for Learning Disabilities) ( 1.1 MB)
A comprehensive guide for parents on rights and responsibilities under the Individuals with Disabilities Education Act (IDEA 2004). Helps parents determine if their child might be eligible for services, what kind of services to expect, how to request an evaluation, how to develop a plan for services, and what their legal rights are.
|Lead Author:||Jennifer Goldman-Luthy, MD, MRP, FAAP - 4/2015|
|Author:||Dorothee Serpas, PhD - 9/2008|
|Reviewing Author:||Robyn Nolan, MD - 4/2015|
|Content Last Updated:||4/2015|
American Psychiatric Association .
Neurodevelopmental Disorders .
American Psychiatric Association ; (2015) http://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425.... Accessed on 2/2015.
DuPaul GJ, Gormley MJ, Laracy SD.
Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment.
J Learn Disabil. 2013;46(1):43-51. PubMed abstract
Koolwijk I, Stein DS, Chan E, Powell C, Driscoll K, Barbaresi WJ.
"Complex" attention-deficit hyperactivity disorder, more norm than exception? Diagnoses and comorbidities in a developmental clinic.
J Dev Behav Pediatr. 2014;35(9):591-7. PubMed abstract
Lovett BJ, Sparks RL.
The identification and performance of gifted students with learning disability diagnoses: a quantitative synthesis.
J Learn Disabil. 2013;46(4):304-16. PubMed abstract
Margari L, Buttiglione M, Craig F, Cristella A, de Giambattista C, Matera E, Operto F, Simone M.
Neuropsychopathological comorbidities in learning disorders.
BMC Neurol. 2013;13:198. PubMed abstract / Full Text
U.S. Department of Education.
IDEA Title IA602(30).
(2015) http://idea.ed.gov/explore/view/p/,root,statute,I,A,602,30,. Accessed on Feb. 2015.