Understanding Specific Learning Disorders: Reading, Writing, and Mathematics

Specific learning disorders are neurodevelopmental conditions that affect the acquisition and use of academic skills.

A person with a specific learning disorder may experience persistent difficulty with reading, writing, or mathematics despite receiving appropriate instruction and having opportunities to learn.

These difficulties are not simply the result of low motivation or lack of effort.

Understanding the different types of learning disorders can help individuals and families recognize when a comprehensive psychoeducational evaluation may be appropriate.

What Is a Specific Learning Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) recognizes Specific Learning Disorder as a diagnostic category.

Rather than treating reading, writing, and mathematics difficulties as entirely separate disorders, the DSM-5-TR uses one overarching diagnosis with specifiers identifying the affected academic domains.

The three principal specifiers are:

• With impairment in reading
• With impairment in written expression
• With impairment in mathematics

An individual may experience difficulties in one or more of these areas.

The diagnosis also considers the severity of the impairment and its effects on academic or everyday functioning.

Specific Learning Disorder With Impairment in Reading

This presentation involves persistent difficulties with reading-related skills.

The DSM-5-TR identifies several relevant areas:

• Word reading accuracy
• Reading rate or fluency
• Reading comprehension

Some individuals struggle to recognize written words accurately or efficiently.

Others can read individual words but have difficulty reading fluently or understanding written material.

What Is Dyslexia?

Dyslexia is a commonly used term for a pattern of learning difficulties involving accurate or fluent word recognition, decoding, and spelling.

The term is closely associated with specific learning disorder with impairment in reading, although the formal diagnostic description should specify the actual areas of difficulty.

Dyslexia does not necessarily involve reversing letters, and letter reversals alone do not establish the condition.

Reading difficulties may persist into adulthood, even when individuals have developed compensatory strategies.

Specific Learning Disorder With Impairment in Written Expression

This presentation involves persistent difficulties with writing-related academic skills.

The DSM-5-TR identifies three relevant areas:

• Spelling accuracy
• Grammar and punctuation accuracy
• Clarity or organization of written expression

An individual may have difficulty spelling familiar words, constructing grammatically accurate sentences, or organizing written ideas coherently.

Some people can communicate complex ideas verbally but struggle to express those ideas effectively in writing.

What Is Dysgraphia?

Dysgraphia is a term used in educational and clinical discussions, but its meaning varies.

Sometimes it refers to difficulties with spelling or written expression.

In other contexts, it refers primarily to handwriting or the motor aspects of writing.

Because these are not identical difficulties, a comprehensive evaluation should clarify whether the primary concern involves written language, handwriting production, motor coordination, or a combination of factors.

The DSM-5-TR does not establish dysgraphia as a separate formal diagnosis within the specific learning disorder category.

Specific Learning Disorder With Impairment in Mathematics

This presentation involves persistent difficulties with mathematical skills.

The DSM-5-TR identifies several relevant areas:

• Number sense
• Memorization of arithmetic facts
• Accurate or fluent calculation
• Accurate mathematical reasoning

An individual may struggle to understand numerical relationships, retrieve basic arithmetic facts, perform calculations accurately, or solve mathematical problems.

These difficulties may become increasingly noticeable as academic demands become more complex.

What Is Dyscalculia?

Dyscalculia is a commonly used term for a pattern of difficulties involving numerical information, arithmetic facts, and mathematical calculation.

Like dyslexia, it is a descriptive term associated with a particular learning profile rather than an entirely separate DSM-5-TR diagnostic category.

A comprehensive evaluation helps identify the specific mathematical processes affected.

Can Someone Have More Than One Learning Disorder?

Yes.

A person may have impairments involving reading, written expression, and mathematics simultaneously.

For example, an individual may experience significant difficulty with word reading and spelling, alongside relatively intact mathematical reasoning.

Another person may have difficulties in both reading and mathematics.

Learning profiles vary, and assessment should identify the specific skills affected rather than assuming that all academic abilities are equally impaired.

How Are Specific Learning Disorders Diagnosed?

Diagnosis involves more than obtaining a low score on an academic test.

A comprehensive evaluation considers:

• The history and persistence of academic difficulties
• Standardized measures of academic achievement
• Educational opportunities and instruction
• Developmental and clinical history
• Functional impact
• Relevant cognitive and language abilities
• Other conditions that may contribute to academic difficulties

DSM-5-TR criteria require persistent academic skill difficulties, typically despite targeted intervention, with affected skills substantially below expectations for age and causing significant interference.

The difficulties must begin during the school-age years, although they may not become fully apparent until academic demands increase.

They also must not be better explained by factors such as intellectual disability, uncorrected sensory difficulties, inadequate instruction, or limited proficiency in the language of instruction.

How Are Learning Disorders Different From ADHD?

ADHD can affect academic performance through difficulties with attention, organization, working memory, or task completion.

A specific learning disorder involves persistent difficulty acquiring or using particular academic skills.

For example, someone with ADHD may understand reading material but struggle to remain attentive while completing assignments.

Someone with a reading disorder may have difficulty accurately or fluently decoding written words.

Both conditions can also occur together.

A comprehensive evaluation considers whether academic problems reflect a learning disorder, ADHD, another condition, or multiple contributing factors.

Can Adults Have Specific Learning Disorders?

Yes.

Specific learning disorders begin during development and may persist throughout adulthood.

Some adults were never formally evaluated during childhood.

Others received accommodations or developed strategies that allowed them to manage academic demands until entering more challenging educational or occupational environments.

Adult evaluations can help clarify longstanding difficulties and identify appropriate recommendations.

Learning and Academic Evaluations

Cogniscribe Psychological Services provides learning and academic evaluations for children, adolescents, and adults.

Our assessments examine academic skills, relevant cognitive processes, developmental history, and other factors that may contribute to learning difficulties.

The goal is to clarify the nature of the difficulties and provide individualized recommendations for educational and everyday functioning.