Specific Learning Disorder (SLD)

What specific learning disorder means

The DSM-5 (the diagnostic manual used by psychologists and psychiatrists) combined older separate diagnoses, such as reading disorder and mathematics disorder, into one: specific learning disorder. Clinicians then add a specifier for each area affected and a severity rating.

"Specific" means the difficulty is limited to particular academic skills. It does not mean low intelligence. Many people with SLD have average or above-average intelligence and strong abilities in other areas. For a broader, parent-friendly overview of the different learning disabilities, see our learning disabilities page.

Specific learning disorder vs learning disability vs intellectual disability

The DSM-5 criteria explained

A diagnosis requires all four:

1. Persistent difficulties in at least one of six areas, lasting at least 6 months despite targeted intervention: inaccurate or slow reading, poor reading comprehension, spelling, written expression, number sense or math facts, and math reasoning.
2. Skills well below age level on standardized tests, causing significant problems at school, work or daily life. For adults, a documented history of difficulties can substitute for testing.
3. Onset in the school years, though it may only become obvious when demands rise, for example in timed tests or heavy reading loads in high school or college.
4. Not better explained by intellectual disability, uncorrected vision or hearing problems, other neurological or mental disorders, lack of proficiency in the language of instruction, or inadequate teaching.

Subtypes

With impairment in reading

Problems with word reading accuracy, reading speed or fluency, and reading comprehension. Dyslexia is the term for the pattern of difficulty with accurate or fluent word recognition and poor spelling. It is the most common type, making up most cases of SLD.

With impairment in written expression

Problems with spelling, grammar and punctuation, and organizing ideas clearly in writing. Dysgraphia is often used for this, and sometimes for handwriting problems, though messy handwriting alone may relate to motor coordination.

With impairment in mathematics

Problems with number sense, memorizing arithmetic facts, accurate or fluent calculation, and math reasoning. Dyscalculia describes the pattern of difficulty with number processing and math facts.

Severity

• Mild: some difficulty in one or two areas, manageable with accommodations.
• Moderate: marked difficulties needing periods of intensive, specialized teaching.
• Severe: major difficulties across several years that need ongoing intensive, individualized teaching; some skills may remain limited even with support.

Causes and risk factors

SLD reflects differences in how the brain processes language or numbers. It is strongly genetic: having a parent or sibling with dyslexia raises a child's risk several times. Other risk factors include premature birth, very low birth weight, and prenatal exposure to alcohol or nicotine. It is not caused by laziness, poor parenting or lack of intelligence.

Up to a third or more of children with SLD also have ADHD. Developmental language disorder, developmental coordination disorder, anxiety and depression are also more common.

How it is diagnosed

1. Rule out other causes: vision and hearing checks, and a medical history.
2. Response to intervention: schools often provide structured extra help first and track progress.
3. Psychoeducational evaluation: a licensed psychologist or school psychologist assesses intelligence (cognitive ability), academic achievement in reading, writing and math, and processing skills such as phonological awareness, memory and processing speed.
4. History and records: school reports, work samples, developmental and family history.
5. Screening for co-occurring conditions such as ADHD, language disorder and anxiety.

In the US, parents can request a free evaluation from their public school district in writing. Private evaluations are also available.

Treatment and support

There is no medication for SLD itself. Support works best when it starts early:

• Structured literacy instruction for reading: explicit, systematic teaching of phonics, decoding and spelling (for example Orton-Gillingham-based programs).
• Explicit math instruction using visual models and repeated practice.
• Writing support: teaching planning strategies, keyboarding, and spelling.
• Accommodations: extra time, audiobooks and text-to-speech, speech-to-text, calculators, reduced copying, and alternative ways to show knowledge.
• School plans: an IEP (Individualized Education Program) under IDEA provides specialized instruction. A 504 plan provides accommodations.
• Treating co-occurring conditions, such as ADHD medication when appropriate.
• Emotional support: many children feel "stupid" before diagnosis. Explaining the diagnosis and building on strengths protects self-esteem.

Outlook

SLD is lifelong, but skills improve substantially with good teaching. Many adults with SLD complete college and succeed in demanding careers using strategies and assistive technology. Adults can request accommodations at college and at work under the Americans with Disabilities Act with appropriate documentation.

Frequently asked questions

What is specific learning disorder in DSM-5?

It is a neurodevelopmental diagnosis for persistent difficulties in reading, writing or math that are well below age expectations, begin during school years, last at least 6 months despite help, and are not explained by intellectual disability, sensory problems, other conditions or poor teaching.

What are the three types of specific learning disorder?

The DSM-5 specifiers are impairment in reading (including dyslexia), impairment in written expression, and impairment in mathematics (including dyscalculia). A person can be diagnosed with more than one, and each is rated mild, moderate or severe.

Is specific learning disorder the same as dyslexia?

Not exactly. Dyslexia is one pattern within specific learning disorder, under the reading specifier. Specific learning disorder is the broader diagnosis that also covers difficulties with written expression and math. Dyslexia is by far the most common type.

Who can diagnose a specific learning disorder?

Licensed psychologists, school psychologists, neuropsychologists, and some psychiatrists and developmental pediatricians can diagnose it, usually after standardized testing. In US public schools, a team led by the school psychologist determines eligibility for special education under the specific learning disability category.

Can adults be diagnosed with a specific learning disorder?

Yes. Many adults were never assessed as children. A psychologist can evaluate an adult using current testing plus a history of school difficulties. A diagnosis can support accommodations in college, licensing exams and the workplace.