Specific learning difficulties
Children of normal intelligence who have not learned to read despite exposure to adequate instruction:
• Aetiology uncertain; often family history, M:F 4–8:1.
• Cognitive processes involved include decoding (converting letter strings into sound sequences), encoding (spelling), and linguistic comprehension.
• Diagnosis is educational but a child may have language difficulties and/ or co-ordination difficulties.
• If severe, can lead to low self-esteem and school refusal.
• Dyslexia support societies (national and local) are often helpful.
• Specialist advice and support required from education.
• Paediatrician’s role is limited to consider the diagnosis and exclude other conditions.
A specific learning disability affecting the acquisition of arithmetic skills. Less commonly recognized than dyslexia. Can co-exist with writing dif-ficulties and DCD.
Previously referred to as dyspraxia or clumsy child syndrome. Defined as marked impairment in the development of motor abilities not explained by mental retardation and not due to a physical disorder. The diagnosis is only made if this impairment interferes with academic achievement or with activities of daily living:
• Prevalence: 10% of 8–12-yr-olds; 1–3% of all children. M:F 4:1.
• Presenting features and signs.
• Characterized by perceptual difficulties that impede academic progress. For example:
• poor motor planning;
• poor visual perceptual skills (discrimination, memory, visual spatial).
• Clinical assessment:
• neurological examination to exclude other conditions (mild CP, muscle disease);
• overlapping with other conditions including autism and social skills problems;
• may have additional learning difficulties.
• occupational therapy.
Advice to school as well as parents is vital