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Specific learning disabilities in children: Educational management

L Erik von Hahn, MD
Section Editors
Carolyn Bridgemohan, MD
Marc C Patterson, MD, FRACP
Deputy Editor
Mary M Torchia, MD


Learning disabilities (LD) are a heterogeneous group of disorders characterized by the unexpected failure of an individual to competently acquire, retrieve, and use information. They are caused by inborn or acquired abnormalities in brain structure and function and have multifactorial etiology [1]. LD are the most severe, pervasive, and chronic form of learning difficulty in children with average or above-average intellectual abilities [2,3].

Definitions of LD vary. The main feature that is common to all definitions is academic achievement that is lower than expected based on the child's overall intelligence [4-6]. LD manifests as a failure to acquire reading, writing, or math skills at grade- and age-expected levels. LD is often accompanied by other challenges to learning, such as poor study skills and problems with executive functioning. (See "Specific learning disabilities in children: Clinical features", section on 'Clinical expression'.)

The educational management and prognosis of LD in children will be presented here. The definition, epidemiology, clinical features, evaluation, and role of the primary care provider are discussed separately. (See "Definitions of specific learning disability and laws pertaining to learning disabilities in the United States" and "Specific learning disabilities in children: Clinical features" and "Specific learning disabilities in children: Evaluation" and "Specific learning disabilities in children: Role of the primary care provider".)

In some countries, the term "learning disability" is used to refer to intellectual disability (mental retardation). Intellectual disability is discussed separately. (See "Intellectual disability in children: Definition, diagnosis, and assessment of needs" and "Intellectual disability in children: Management, outcomes, and prevention" and "Intellectual disability in children: Evaluation for a cause".)


The management of the student with learning disability (LD) begins with quality instruction, even before the student is identified as having an LD. Inadequate exposure to quality instruction may account for the student's learning failure as early as kindergarten or first grade. It is generally believed that early intervention with quality instruction improves outcomes for all students with learning failure (including those with LD) and that it is more difficult to educate students with LD when they are older [7]. Thus, quality instruction should be provided early and before attempts are made to identify an LD. This is the rationale behind legislation introduced under the No Child Left Behind Act, which requires schools to provide "highly qualified" teachers as well as "responsiveness to intervention" services. These stipulations are also required under the reauthorization of general education law (Every Student Succeeds Act), which will be fully implemented by September 2017. (See 'Quality instruction' below and 'Responsiveness to intervention services' below and "Definitions of specific learning disability and laws pertaining to learning disabilities in the United States", section on 'Every Student Succeeds Act' and 'Mandated school based services' below.)


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Literature review current through: Apr 2017. | This topic last updated: May 22, 2017.
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