How Are Learning Disabilities Formally Diagnosed?

By law, learning disability is defined as a significant gap between a person's intelligence and the skills the person has achieved at each age. This means that a severely retarded 10-year-old who speaks like a 6-year-old probably doesn't have a language or speech disability. He has mastered language up to the limits of his intelligence. On the other hand, a fifth grader with an IQ of 100 who can't write a simple sentence probably does have LD.

Learning disorders may be informally flagged by observing significant delays in the child's skill development. A 2-year delay in the primary grades is usually considered significant. For older students, such a delay is not as debilitating, so learning disabilities aren't usually suspected unless there is more than a 2-year delay. Actual diagnosis of learning disabilities, however, is made using standardized tests that compare the child's level of ability to what is considered normal development for a person of that age and intelligence.

For example, as late as fifth grade, Susan couldn't add two numbers, even though she rarely missed school and was good in other subjects. Her mother took her to a clinician, who observed Susan's behavior and administered standardized math and intelligence tests. The test results showed that Susan's math skills were several years behind, given her mental capacity for learning. Once other possible causes like lack of motivation and vision problems were ruled out, Susan's math problem was formally diagnosed as a specific learning disability.

Test outcomes depend not only on the child's actual abilities, but on the reliability of the test and the child's ability to pay attention and understand the questions. Children like Dennis, with poor attention or hyperactivity, may score several points below their true level of ability. Testing a child in an isolated room can sometimes help the child concentrate and score higher.

Each type of LD is diagnosed in slightly different ways. To diagnose speech and language disorders, a speech therapist tests the child's pronunciation, vocabulary, and grammar and compares them to the developmental abilities seen in most children that age. A psychologist tests the child's intelligence. A physician checks for any ear infections, and an audiologist may be consulted to rule out auditory problems. If the problem involves articulation, a doctor examines the child's vocal cords and throat.

In the case of academic skills disorders, academic development in reading, writing, and math is evaluated using standardized tests. In addition, vision and hearing are tested to be sure the student can see words clearly and can hear adequately. The specialist also checks if the child has missed much school. It's important to rule out these other possible factors. After all, treatment for a learning disability is very different from the remedy for poor vision or missing school.

ADHD is diagnosed by checking for the long-term presence of specific behaviors, such as considerable fidgeting, losing things, interrupting, and talking excessively. Other signs include an inability to remain seated, stay on task, or take turns. A diagnosis of ADHD is made only if the child shows such behaviors substantially more than other children of the same age.

If the school fails to notice a learning delay, parents can request an outside evaluation. In Susan's case, her mother chose to bring Susan to a clinic for testing. She then brought documentation of the disability back to the school. After confirming the diagnosis, the public school was obligated to provide the kind of instructional program that Susan needed.

Parents should stay abreast of each step of the school's evaluation. Parents also need to know that they may appeal the school's decision if they disagree with the findings of the diagnostic team. And like Susan's mother, who brought Susan to a clinic, parents always have the option of getting a second opinion.

Some parents feel alone and confused when talking to learning specialists. Such parents may find it helpful to ask someone they like and trust to go with them to school meetings. The person may be the child's clinician or caseworker, or even a neighbor. It can help to have someone along who knows the child and can help understand the child's test scores or learning problems.