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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: Oct 2017. | This topic last updated: May 22, 2017.
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  1. American Academy of Pediatrics, Section on Ophthalmology, Council on Children with Disabilities, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Association of Certified Orthoptists. Joint statement--Learning disabilities, dyslexia, and vision. Pediatrics 2009; 124:837.
  2. Adelman HS. Toward solving the problems of misidentification and limited intervention efficacy. J Learn Disabil 1989; 22:608.
  3. Adelman HS. LD: the next 25 years. J Learn Disabil 1992; 25:17.
  4. Lyon GR. Learning disabilities. Future Child 1996; 6:54.
  5. Keogh BK. A matrix of decision points in the measurement of learning disabilities. In: Frames of Reference for the Assessment of Learning Disabilities, Lyon GR (Ed), Brookes Publishing Company, Baltimore 1994. p.15.
  6. MacMillan DL. Development of operational definitions in mental retardation: Similarities and differences with the field of Learning Disabilities. In: Better Understanding Learning Disabilities: New Views from Research and Their Implications for Education and Public Policies, Lyon GR, Gray DB, Krasnegor NA, Kavanagh JF (Eds), Brookes Publishing Company, Baltimore 1993. p.117.
  7. Heward WL. Ten faulty notions about teaching and learning that hinder the effectiveness of special education. J Sepc Educ 2003; 36:186.
  8. Pashler H, Bain P, Bottge B, et al. Organizing Instruction and study to improve student learning. IES Practice Guide. US Department of Education and the Institute of Education Sciences, September 2007. http://ies.ed.gov/ncee/wwc/pdf/practice_guides/20072004.pdf (Accessed on August 21, 2013).
  9. Thalheimer W. Spacing Learning Events Over Time: What the Research Says. February 2006. www.work-learning.com (Accessed on August 21, 2013).
  10. Reid Lyon G, Weiser B. Teacher knowledge, instructional expertise, and the development of reading proficiency. J Learn Disabil 2009; 42:475.
  11. Washburn EK, Joshi RM, Binks-Cantrell ES. Teacher knowledge of basic language concepts and dyslexia. Dyslexia 2011; 17:165.
  12. Institute of Education Sciences. What works clearinghouse. http://ies.ed.gov/ncee/wwc/default.aspx (Accessed on August 26, 2013).
  13. Kretlow AG, Helf SS. Teacher implementation of evidence-based practices in tier 1: A national survey. Teach Educ Spec Educ 2013; 36:167.
  14. Vaugh S, Zumeta R, Wanzek J, et al. Intensive interventions for students with learning disabilities. DLD Position Statement 1. February 2014. http://ec.ncpublicschools.gov/disability-resources/specific-learning-disabilities/intensive-interventions.pdf (Accessed on June 12, 2015).
  15. Swanson HL, Hoskyn M. Experimental Intervention Research on students with Learning disabilities: A meta-analysis of Treatment Outcomes. Review of Educational Research 1998; 68:277.
  16. William L, Heward W. Ten Faulty Notions About Teaching and Learning That Hinder the Effectiveness of Special Education. J Spec Educ 2003; 36:186.
  17. Fleischner JE. Educational management of students with learning disabilities. J Child Neurol 1995; 10 Suppl 1:S81.
  18. Vaughn S, Gersten R, Chard D. The underlying message in LD intervention research: Findings from research syntheses. Exceptional Children 2000; 67:99.
  19. Swanson HL, Deshler D. Instructing adolescents with learning disabilities: converting a meta-analysis to practice. J Learn Disabil 2003; 36:124.
  20. Ellis E. Integrative Strategy Instruction: A potential Model for Teaching Content Area subjects to adolescents with Learning disabilities. J Learn Disabil 1996; 26:358.
  21. Harris K, Graham S. Programmatic Intervention research: illustrations from the evolution of self-regulated strategy development. Learn Disabil Q 1999; 22:251.
  22. Blair T, Rupley W, Nichols W. The Effective teacher of reading: considering the “what” and “how" of instruction. The Reading Teacher 2007; 60:432.
  23. Rosenshine B. Advances in research on Instruction. J Educ Res 1995; 88:262.
  24. Slavin R, Lake C, Chambers B, et al. Effective Reading programs for the elementary grads: a best-evidence synthesis. Review Educ Res 2009; 79:1391.
  25. Scruggs TE, Mastropieri MA, Okolo CM. Science and social studies for students with Disabilities. Focus on Exceptional Children 2008; 41:24.
  26. Stenhoff DM, Lignagaris B. A Review of the Effects of Peer Tutoring on Students with Mild Disabilities in Secondary Settings. Exceptional Children 2007; 74:8.
  27. Barrio BL, Combes BH. General Education Pre-Service Teachers’ Levels of Concern on Response to Intervention (RTI) Implementation. TESE 2015; 38:121.
  28. National Center For Education Statistics. Teacher Preparation and Professional Development: 2000. http://nces.ed.gov/pubs2001/2001088.pdf (Accessed on August 21, 2013).
  29. Castro-Villarreal F, Rodriguez BJ, Moore S. Teachers' perceptions and attitudes about Response to Intervention (RTI) in their schools: A qualitative analysis. Teach Teach Educ 2014; 40:104.
  30. Fuchs LS, Vaughn S. Responsiveness-to-intervention: a decade later. J Learn Disabil 2012; 45:195.
  31. Fuchs D, Compton D, Fuchs L, et al. Making “secondary intervention” work in a three-tier responsiveness-to-intervention model: findings from the first grade longitudinal reading study of the National Research Center on Learning disabilities. Reading and Writing 2008; 21:413.
  32. Reutebuch CK. Succeed with a Response-to-Intervention model. Interv Sch Clin 2008; 44:126.
  33. Gartland D, Strosnider R. NJCLD Position Paper: Responsiveness to Intervention and Learning Disabilities. Learn Disabil Q 2005; 28:249.
  34. Wanzek J, Vaughn S. Is a Three-Tier Reading Intervention Model Associated With Reduced Placement in Special Education? Remedial and Special Education 2010; 31.
  36. Torgesen JK. The response to intervention instructional model: Some outcomes from a large-scale implementation in Reading First schools. Child Dev Perspect 2009; 3:38.
  37. VanDerHeyden AM, Witt JC, Gilbertson D. A multi-year evaluation of the effects of a response to intervention (RTI) model on identification of children for special education. J Sch Psychol 2007; 45225.
  38. Wanzek J, Vaughn S. Is a three-tier reading intervention model associated with reduced placement in special education? Remedial Spec Educ 2010; 32:167.
  39. IDEA 2004. CFR 34 CFR 300.500. Procedural safeguards. Authority: (20 U.S.C. 1415[a]). Downloaded from http://idea.ed.gov. (Accessed on July 29, 2010).
  40. Fletcher J, Francis D, O'Malley K. Effects of bundled accommodations package on high stakes testing for middle school students with learning disabilities. Except Child 2009; 75:447.
  41. Fuchs L, Fuchs D, Capizzi A. Identifying appropriate test accommodations for students with learning disabilities. Focus on Exceptional Children 2005; 37.
  42. National Center on Universal Design for Learning. http://www.udlcenter.org/aboutudl/whatisudl (Accessed on December 06, 2010).
  43. CAST. http://www.cast.org/about (Accessed on December 06, 2010).
  44. Pisha B, Stahl S. The promise of new learning environments for students with learning disabilities. Intervention in School and Clinic 2005; 41:67.
  45. Hitchcock C, Meyer A, Rose D, Jackson R. Providing new access to the general curriculum. Universal Design for Learning. Teaching Exceptional Children 2002; 35:8.
  46. Olinghouse NG. Student- and instruction-level predictors of narrative writing in third-grade students. Read Writ 2008; 21:3.
  47. Troia G, Graham S. Effective writing instruction across the grades: what every educational consultant should know. J Educ Psychol Consult 2003; 14:75.
  48. Asher AV. Handwriting instruction in elementary schools. Am J Occup Ther 2006; 60:461.
  49. Hoy MM, Egan MY, Feder KP. A systematic review of interventions to improve handwriting. Can J Occup Ther 2011; 78:13.
  50. Santangelo T, Graham S. A comprehensive meta-analysis of handwriting instruction. Educ Psychol Rev 2015; 28:225.
  51. Ritchey K. The building blocks of writing: Learning to write letters and spell words. Read Writ 2008; 21:27.
  52. Graham S. Handwriting and spelling instruction for students with LD: A Review. Learn Disabil Q 1999; 22:78.
  53. Wanzek J, Vaughn S, Wexler J, et al. A synthesis of spelling and reading interventions and their effects on spelling outcomes of students with LD. J Learn Dis 2006; 39:528.
  54. Scott CM. Principles and Methods of spelling instruction: Applications for Poor spellers. Topics in Language Disorders 2000; 20:66.
  55. Gersten R, Chard D, Jaynathi M, et al. Mathematics Instruction for Students with Learning Disabilities: A meta-analysis of instructional components. Rev Educ Res 2009; 79:1202.
  56. Troia G, Graham S, Harris K. Teaching students with Learning disabilities to mindfully plan when writing. Exceptional Children 1999; 65:235.
  57. Gibson SA. An Effective Framework for primary-grade guided writing instruction. The Reading Teacher 2008; 62:324.
  58. Batorowicz B, Missiuna CA, Pollock NA. Technology supporting written productivity in children with learning disabilities: a critical review. Can J Occup Ther 2012; 79:211.
  59. MacArthur CA. Using technology to enhance the writing processes of students with learning disabilities. J Learn Disabil 1996; 29:344.
  60. MacArthur C. New Tools for Writing: Assistive Technology for students with Writing Difficulties. Topics in Language Disorders 2000; 20:85.
  61. Englert CS, Mariage TV. Shared understandings: structuring the writing experience through dialogue. J Learn Disabil 1991; 24:330.
  62. Harris K, Graham S, Mason L. Self-regulated strategy development in the classroom: Part of a balanced approach to writing instruction for students with disabilities. Focus on Exceptional Children 2003; 35.
  63. Englert RS, Raphael TE, Anderson LM, et al. Making strategies and self-talk visible: Writing instruction in regular and special education classrooms. Am Educ Res J 1991; 28:337.
  64. Gersten R, Baker S. Teaching expressive writing to students with Learning Disabilities: A meta-analysis. Elementary School J 2001; 97:475.
  65. Harris, Learning Differences Conference, Harvard University Graduate School of Education, 2009, personal communication.
  66. Gersten R, Chard D. Rethinking mathematics instruction for students with Math Disabilities. J Spec Educ 1999; 33:19.
  67. Gersten R, Jordan NC, Flojo JR. Early identification and interventions for students with mathematics difficulties. J Learn Disabil 2005; 38:293.
  68. Geary DC. Consequences, characteristics, and causes of mathematical learning disabilities and persistent low achievement in mathematics. J Dev Behav Pediatr 2011; 32:250.
  69. Dowker A. Early identification and intervention for students with mathematics difficulties. J Learn Disabil 2005; 38:324.
  70. Bryant B, Bryant D, Kathley C, et al. Preventing mathematics difficulties in the primary grades: The critical features of instruction in textbooks as part of the equation. Learn Disabil Q 2008; 31:21.
  71. Bryant B, Bryant D. Introduction to the special series. Mathematics Learning Disabilities. Learn Disabil Q 2008; 31:3.
  72. Kroesbergen EH, Johannes EH, Van Luit C, Maas JM. Effectiveness of Explicit and Constructivist Mathematics Instruction for Low-Achieving Students in The Netherlands. Elementary School J 2004; 104:233.
  73. Fuchs LS, Fuchs D, Powell SR, et al. Intensive Intervention for Students with Mathematics Disabilities: Seven Principles of Effective Practice. Learn Disabil Q 2008; 31:79.
  74. National Research Council. How Students learn: History, mathematics and science in the classroom, Donovan MS Bransford JD (Ed), National Academies Press, Washington DC 2005.
  75. Coyne MD, Carnine DW, Kame'enui EJ. Effective Teaching Strategies that Accommodate Diverse Learners, 4th ed, Prentice Hall, Upper Saddle River, NJ 2011.
  76. Confrey J. Comparing and Contrasting the National Research Council Report on “evaluating curricular effectiveness” with the What Works Clearinghouse approach. Educ Eval Policy Analysis 2006; 28:195.
  77. Slavin R, Lake C. Effective programs in elementary mathematics: A best evidence synthesis. Rev Educ Res 2008; 78:427.
  78. Assisting students struggling with reading: Response to intervention (RtI) and multi-tier intervention in the primary grades. US Department of Education NCEE 2009-4045. National Center for Educational Evaluation and Regional Assistance. http://ies.ed.gov/ncee/wwc/pdf/practice_guides/rti_reading_pg_021809.pdf (Accessed on October 04, 2011).
  79. Clarke B, Doabler CT, Nelson NJ, Shanley C. Effective Instructional Strategies for Kindergarten and First-Grade Students at Risk in Mathematics. Interv Sch Clin 2015; 50:257.
  80. Jimerson S. Meta-analysis of grade retention research: Implications for practice in the 21st century. School Psychol Rev 2001; 30:420.
  81. Jimerson SR, Fletcher SM, Graydon K. Beyond grade retention and social promotion: Promoting the social and academic competence of students. Psychol School 2006; 43:85.
  82. Bonvin P, Bless G, Schuepback M. Grade retention: decision-making and effects on learning as well as social and emotional development. School Effectiveness and School Improvement 2008; 19:1.
  83. Corman H. The effects of state policies, individual characteristics, family characteristics, and neighborhood characteristics on grade repletion in the United States. Economics Educ Rev 2003; 22:409.
  84. Silberglitt B, Jimeson S, Burns M, Appleton J. Does the timing of grade retention make a difference? Examining the effects of early versus later retention. School Psychology Review 2006; 35:134.
  85. Frederick CB, Hauser RM. Have we put an end to social promotion? Changes in school progress among children aged 6 to 17 from 1972 to 2005. Demography 2008; 45:719.
  86. Wu W, West SG, Hughes JN. Effect of Retention in First Grade on Children's Achievement Trajectories Over 4 Years: A Piecewise Growth Analysis Using Propensity Score Matching. J Educ Psychol 2008; 100:727.
  87. Wu W, West SG, Hughes JN. Effect of Grade Retention in First Grade on Psychosocial Outcomes. J Educ Psychol 2010; 102:135.
  88. Jimerson S, Anderson G, Whipple A. Winning the Battle and losing the war: Examining the relation between grade retention and dropping out of high school. Psychol School 2002; 39:441.
  89. Stearns E, Moller S, Blau J, Potochnick S. Staying back and Dropping out: the relationship between grade retention and school dropout. Sociol Educ 2007; 80:210.
  90. McCoy AR, Reynolds AJ. Grade retention and school performance: An extended investigation. J Sch Psychol 1999; 37:273.
  91. Eide E, Showalter M. The effect of grade retention on educational and labor market outcomes. Economics Educ Rev 2001; 20:563.
  92. Allen CS, Chen Q, Willson VL, Hughes JN. Quality of Research Design Moderates Effects of Grade Retention on Achievement: A Meta-analytic, Multi-level Analysis. Educ Eval Policy Anal 2009; 31:480.
  93. Alexander K, Entwisle D, Dauber S. On the Success of Failure: A Reassessment of the Effects of Retention in the Primary School Grades, 2nd ed, Cambridge University Press, Cambridge, UK 2003.
  94. Jimerson S, Woehr S, Kaufman A, Anderson G. Grade Retention and Promotion: Information and strategies for Educators. Position paper: National Association of School Psychologists. Downloaded from www.nasponline.org (2004). (Accessed on July 29, 2010.).
  95. David JL. What the research says about grade retention. Educational Leader 2008; 65:83.
  96. Jimerson S, Kaufman A. Reading, writing, and retention: A primer on grade retention research. Reading Teacher 2003; 56:622.
  97. US DOE practice guide: Dropout Prevention. NCEE 2008-4025. National Center for Education Evaluation and Regional Assistance. Institute of Education Sciences
  98. Picklo DM, Christenson SL. Alternatives to Retention and Social Promotion: The Availability of Instructional Options. Remedial Spec Educ 2005; 26:258.
  99. Lerner J. Learning Disabilities: Theories, Diagnosis, and Teaching Strategies, Houghton Mifflin Company, Boston 2000.
  100. IDEA 2004. 34 CFR 300.115(b). Authority: (20 U.S.C. 1412[a][5]). 34 CFR 300.114 (a)(2)(i) and (ii). Authority: (20 U.S.C. 1412[a][5]). Downloaded from: http://idea.ed.gov. (Accessed on July 29, 2010).
  101. Lerner JW. Educational interventions in learning disabilities. J Am Acad Child Adolesc Psychiatry 1989; 28:326.
  102. McLeskey J, Landers E, Williamson P, Hoppey D. Are We Moving Toward Educating Students With Disabilities in Less Restrictive Settings? J Spec Educ 2012; 46:131.
  103. McInerny TK. Children who have difficulty in school: a primary pediatrician's approach. Pediatr Rev 1995; 16:325.
  104. Baker JM, Zigmond N. The meaning and practice of inclusion for students with learning disabilities: Themes and implications from the five cases. J Spec Educ 1995; 29:163.
  105. Zigmond N. Models for delivery of special education services to students with learning disabilities in public schools. J Child Neurol 1995; 10 Suppl 1:S86.
  106. Whinnery KW, King M. Perceptions of students with learning disabilities. Preventing School Failure 1995; 40:5.
  107. Edgar E, Polloway E. Education for Adolescents with disabilities: Curriculum and placement issues. J Spec Educ 1994; 27:438.
  108. Deshler DD, Schumaker JB, Lenz BK, et al. Ensuring content-area learning by secondary students with learning disabilities. Learning Disabilities Research and Practice 2001; 16:96.
  109. Ellis ES, Deshler DD, Schumaker JB. Teaching adolescents with learning disabilities to generate and use task-specific strategies. J Learn Disabil 1989; 22:108.
  110. Ellis ES. Watering up the curriculum for adolescents with learning disabilities - Goals of the knowledge dimension. Remedial and Special Education 1997; 18:326.
  111. Casareno A, Ellis E. Ed Ellis: Working to improve education for adolescents with learning disabilities. Intervention in School and Clinic 2002; 37:292.
  112. Lieberman LM. The LD adolescent.... When do you stop? J Learn Disabil 1981; 14:425.
  113. Whinnery KW. College preparation for students with learning disabilities: A curriculum approach. Preventing School Failure 2003; 37:31.
  114. Cawley JF, Kahn H, Tedesco A. Vocational education and students with learning disabilities. J Learn Disabil 1989; 22:630.
  115. Janiga SJ, Costenbader V. The transition from high school to postsecondary education for students with learning disabilities: a survey of college service coordinators. J Learn Disabil 2002; 35:462.
  116. Brinckerhoff LC. Making the transition to higher education: opportunities for student empowerment. J Learn Disabil 1996; 29:118.
  117. Hock MF, Deshler DD, Schumaker JB. Learning strategy instruction for at-risk and learning-disabled adults: The development of strategic learners through apprenticeship. Preventing School Failure 1993; 38:43.
  118. Skinner ME, Lindstrom BD. Bridging the gap between high school and college: Strategies for the successful transition of students with learning disabilities. Preventing School Failure 2003; 47:132.
  119. US Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs. (2006, April). with Disabilities Education Act, Vol. 1, Washington, DC. 26th Annual(2004) Report to Congress on the Implementation of the Individuals
  120. Patton JR, Cronin ME, Jairrels V. Curricular implications of transition. Remedial Spec Educ 1997; 18:294.
  121. Cummings R, Maddux C, Casey J. Individualized transition planning for students with Learning Disabilities. Career Development Quarterly 2000; 49:60.
  122. DuFur S. IEP transition Planning- from compliance to quality. Exceptionality 2003; 11:115.
  123. Kohler P, Field S. Transition-focused education: foundation for the future. J Spec Educ 2003; 37:174.
  124. IDEA 2004. Definition of transition planning. 34 CFR 300.43(a). Authority: (20 U.S.C. 1401[34]). Age requirement for start of transition planning. 34 CFR 300.320(b) and (c) Authority: (20 U.S.C. 1414 [d][1][A][I][VIII]). Downloaded from http://idea.ed.gov.
  125. Hildreth BL, Dixon ME. College readiness for students with learning disabilities: The role of the school counselor. School Counselor 1994; 41:343.
  126. Kohler PD, Field S. Transition-Focues Education: Foundation for the Future. J Spec Educ 2003; 37:174.
  127. Sitlington PL. Transition to living: the neglected component of transition programming for individuals with learning disabilities. J Learn Disabil 1996; 29:31.
  128. Bouck E. Functional Curriculum Models for Secondary students with mild mental impairment. Educ Training Devel Disabil 2009; 44:435.
  129. Zhang D, Ivester J, Katsiyannis A. Teachers’ view of transition services: results from a statewide survey in South Carolina. Educ Training Devel Disabil 2005; 40:360.
  130. McGee A. Skills, standards, and disabilities: How youth with learning disabilities fare in high school and beyond. Econ Educ Rev 2011; 30:109.
  131. Thurlow ML, Ysseldyke JE, Reid CL. High school graduation requirements for students with disabilities. J Learn Disabil 1997; 30:608.
  132. National Center for Education Statistics. Post secondary students with disabilities: enrollment, services, and persistence. June 2000. Downloaded from: http://nces.ed.gov/pubsearch/pubsinfo.
  133. Shaw S. Transition to postsecondary education. Focus on Exceptional Children 2009; 42:2.
  134. National Joint Committee on Learning Disabilitites. The documentation disconnect for students with learning disabilities. Learn Disabil Q 2007; 30.
  135. Mull C, Sitlington P, Alper S. Postsecondary education for students with learning disabilities. Except Child 2001; 68:97.
  136. Rath K, Royer J. The nature and effectiveness of learning disability services for college students. Educ Psychol Rev 2002; 14:353.
  137. Undheim AM. A thirteen-year follow-up study of young Norwegian adults with dyslexia in childhood: reading development and educational levels. Dyslexia 2009; 15:291.
  138. Morris MA, Schraufnagel CD, Chudnow RS, Weinberg WA. Learning disabilities do not go away: 20- to 25-year study of cognition, academic achievement, and affective illness. J Child Neurol 2009; 24:323.
  139. Wagner MM, Blackorby J. Transition from high school to work or college: how special education students fare. Future Child 1996; 6:103.
  140. Janus AL. Disability and the Transition to Adulthood. Social Forces 2009; 88:99.
  141. Dickinson DL, Verbeek RL. Wage differentials between college graduates with and without learning disabilities. J Learn Disabil 2002; 35:175.
  142. Kavale K, Forness S. Learning disability grows up: Rehabilitation issues for individuals with Learning disabilities. J Rehab 1996; 62:34.
  143. Seo Y, Abbott RD, Hawkins JD. Outcome status of students with learning disabilities at ages 21 and 24. J Learn Disabil 2008; 41:300.
  144. Madaus JW. Employment outcomes of university graduates with learning disabilities. Learn Disabil Q 2006; 29:19.
  145. Gerber PJ, Reiff HB, Ginsberg R. Reframing the learning disabilities experience. J Learn Disabil 1996; 29:98.