Learning and Motor Skills Disorders as a category generally lump together learning disabilities (LD) including those associated with reading, written expression, mathematics, and motor control (developmental coordination disorder). It’s important to note that the category of LD is rooted in the education field, not the medical, and that “individuals identified as having a learning disability constitute a highly heterogeneous group.” (Netherton, Holmes, & Walker, 1999, p. 25) Additionally, because so many disciplines serve the LD population, there is no standard definition for LD. Although it might appear to be a matter of semantics, the definition does seem to matter… especially when it comes to who qualifies for a$$i$tance.
Regardless of what definition you choose, or what discipline you yield from, discrepancy is a key concept. Learning Disorders (formerly Academic Skills Disorders) are diagnosed when the individual’s achievement on individually administered, standardized tests in reading, mathematics, or written expressions is substantially below that expected for age, schooling, and level of intelligence. (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2000, p. 49) While there are a whole host of dimensional aspects we could use to measure discrepancy, it suffices to say that if there is a clinically significant delta between “the norm” and your client, the first pre-requisite is met.
Also implicit in the diagnosis of LD disorders is the concept of exclusion. Learning Disorders must be differentiated from normal variations in academic attainment and from scholastic difficulties due to lack of opportunity, poor teaching, or cultural factors. (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000, p. 51) In addition, we should pay specific attention to special provisions we may need to provide for individuals with impaired vision or hearing, mental retardation.
Motor Skills Disorder presents us with a different set of challenges, including marked impairment in the development of motor concentration and/or significant interference with academic achievement or daily living. Exclusions include various medical conditions, or mental retardation (unless the impairment exceeds what is usually associated with mental retardation). (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000, p. 57)
On the whole, what surprised me most was that all learning disabilities are more prevalent in males than they are in females. It was suggested in both the DSM –IV-R and the text that the increased attention to males may be due to sampling errors, or simply that males are more subject to behavior disorders. I tend to think it’s the latter, it seems reasonable.
I also noticed that the statement that “the relative lack of specificity of the DSM-IV categories may serve to decrease their clinical usefulness.” (Netherton et al., 1999, p. 28) It’s evident to me that we intend to serve this population well we are going to have to team with the disciplines that “own” LD, namely education. Reading and writing about learning disorders, I got the feeling that we, as psychologists, weren’t “on our home field” when discussing it. Perhaps some of the other disciplines (educators) probably have more influence over it?
I think the concept of “learned helplessness” is also important to consider when diagnosing LD’s. Perhaps we can contribute to growth though exercises that enrich and fortify self-image, self esteem, and motivational training.
Anyone reading this, or am I talking to myself? 😉
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Netherton, S. D., Holmes, D., & Walker, C. E. (1999). Child and adolescent psychological disorders: A comprehensive textbook. Oxford, NY: Oxford University Press.