Diagnostic Evaluation: Learning Disability

It is important to remember children with learning disabilities can have normal or above average IQ tests but do not fully demonstrate that potential on achievement tests. A discrepancy between test scores and IQ scores shows the presence of a learning disability.

Why are children referred for a learning disability evaluation?

Children who have challenges with learning but do not seem to have intellectual limitations can benefit from a learning disability evaluation. Children are commonly referred for a learning disability evaluation by parents and teachers when it is believed their performance in school should be better based on their intellectual capacity. This allows children the opportunity to be evaluated for an Individualized Education Program (IEP).

Who can do an evaluation?

A wide variety of specialists can do a diagnostic evaluation. These professionals include, but are not limited to, learning specialists, educational therapists, speech-language pathologists, occupational therapists, psychologists, and neuropsychologists. Evaluations cannot be done by a professional who assesses vision, hearing, movement, or any other skill in isolation. 

What are the components of an evaluation?

A diagnostic evaluation includes family interview, observation, and standardized tests.

What is a family interview used for?

A family interview is used to gather information about early developmental issues, any areas of life the child is struggling in, how the child is doing, and their perception of the child’s adjustment in school.

What is being observed?

A child is observed in the classroom to see where they struggle to meet expectations and to evaluate their response to academic interventions.

What are standardized tests used for?

Standardized tests are used to measure and evaluate how a child is performing in reading capacity, writing capacity, and mathematics. These tests include standardized achievement tests and intelligence (IQ) tests to measure a child’s skill sets and capacities.

How long does an evaluation take?

The length of a diagnostic evaluation depends on the extent to which a child needs to be evaluated. Comprehensive evaluations can include intellectual functioning, academic functioning, emotional functioning, speech and language concerns, and neuropsychological evaluations. Evaluations are broken down according to a child’s age. Younger children are evaluated for shorter periods of time during parts of the day that accommodate their sleep and stress schedules.

What skills are being tested?

The areas of reading capacity, writing capacity, and mathematics are being assessed during a diagnostic evaluation.

What is reading capacity?

Reading capacity is the ability to recognize words by sight, sound out unfamiliar words, read words in sentences, and derive meaning from what was read. This is a process of developing the skills of decoding, fluency, and eventually comprehension.

What is writing capacity?

Writing capacity is the ability to plan, translate, and review written language. This is a process of developing writing skills.

What area of mathematics is being assessed?

A child’s mathematical skills include basic math fact knowledge, speed of applying math facts, computation skills, and solving functional word problems.

Comorbidities

It is common for a child with a learning disability to have comorbidities. The effects of comorbidities need to be closely considered in order to create an effective intervention plan.

What is a comorbidity?

A comorbidity is the presence of one or more conditions or disorders. Comorbidities are co-existing conditions in a person.  

What are common comorbidities?

Children diagnosed with learning disabilities are often diagnosed with anxiety, depression, and various emotional effects.

What are the emotional effects of a learning disability?

Children with learning disabilities may experience sadness, frustration, disappointment, and increased stress. Behavior problems can result from a combination of the emotional effects experienced by a child including misunderstandings, blaming others, and straining relationships. 

DSM-V criteria for a learning disability

All four criteria must be met and the level of functional impact is determined as being mild, moderate or severe. The level of functional impact relates to the degree to which the child struggles to perform in comparison with his/her peers and the amount of support required, both in terms of remediation and accommodation, to enable the child to participate effectively in all classroom activities.

Criteria A: Ongoing difficulties in the school-age years learning and using at least one academic skill (e.g. reading accuracy/fluency; spelling accuracy; written expression competence and fluency; mastering number facts). These difficulties have persisted and failed to improve as expected, despite the provision of targeted intervention for at least six months. This intervention should be recognized as evidence-based and ideally delivered by an experienced and qualified person.

Criteria B: The difficulties experienced by the individual will be assessed using standardized achievement tests* and found to be at a level significantly lower than most individuals of the same age. Sometimes individuals are identified with a learning disability even though they are performing within the average range. This is only the case when it can be shown that the individual is achieving at this level due to unusually high levels of effort and ongoing support.

Criteria C: The difficulties experienced by the individual usually become apparent in the early years of schooling. The exception to this is where problems occur in upper-primary or secondary school once the demands on student performance increase significantly. For example – when students have to read extended pieces of complex text or write at a more sophisticated level under timed conditions.

Criteria D: Specific learning disorders will not be diagnosed if there is a more plausible explanation for the difficulties being experienced by the individual. For example, if the individual has: an intellectual disability; a sensory impairment; a history of chronic absenteeism; inadequate proficiency in the language of instruction; a psychosocial condition; or, not received appropriate instruction and/or intervention.