GV Basavaraja
National President 2024
An Algorithm
Yogesh Parikh
Secretary 2024–25 Approach
to Pediatric
Atanu Bhadra
Treasurer 2024–25
National Scientific Convenor
Sumitha Nayak
Advisor
Diagnosis
Gnanamurthy Narasimha
Core Team Members
B Rajsekhar
Janani Shankar
Kripasindhu Chatterjee
Nehal Patel
Rupesh Masand
Section Editor
Sumitha Nayak
Section Co-Editor
Priya Shivalli
Learning Disability 2
Manini Moudgal
Introduction
Learning disability (LD) is a group of neurodevelopmental disorders wherein a child has difficulty
acquiring, retrieving, and using information, especially with reading, writing, and/or mathematics. LD
usually manifests in preschool years and is unrelated to neurological or motor disorders, intellectual
disability, and socioeconomic and environmental disadvantages. Based on the child’s overall intelligence,
academic achievement is lower than expected.
The prevalence of LD in India is 1.6–15%. Under Rights of Persons with Disability Act, India, 2016, people
with LD have a right to free education till 18 years. They also have 5% reservation for higher education in
government institutes and 1% for government jobs.
Etiology
Heredity (accounts for 50% of LD): Chromosomal abnormalities; single gene, imprinting and mitochondrial
disorders
Prenatal, birth, and postnatal factors: Congenital infections (rubella, CMV, toxoplasmosis), birth asphyxia,
teratogens (alcohol, anticonvulsants), prematurity
Environment: Lead poisoning
Inborn errors of metabolism: Wilson’s disease
Learning Disability
Common Types
Dyslexia: Difficulty in reading
Dysgraphia: Difficulty in visual spatial perception and handwriting
Dyscalculia: Difficulty with understanding how numbers work
Nonverbal LD: Difficulty reading facial cues, body language, social appropriateness, and coordination
All these may exist alone or in varying degrees in the same person.
Comorbidities
Attention-deficit hyperactivity disorder (ADHD)
Autism spectrum disorders (ASD)
Dyspraxia: Difficulty with movement and coordination, speech and language
Anxiety
Depression
Red Flag Signs
Symptoms in each column are cumulative with the next.
Concerns in two or more of these areas warrant further investigation.
PRESCHOOL PRIMARY SCHOOL MIDDLE AND HIGH SCHOOL
Late speech development Poor memory for poems, tasks, facts, and Trouble understanding abstract
with unclear speech numbers concepts and reading comprehension
Difficulty recognizing simple Errors connecting letters to sounds and Confusion with complex arithmetic,
letters, words, and numbers differentiating similar or rhyming words signs, and word problems
Clumsy, fidgety, and easily Slow learner compared to kids of own age Difficulty with friendships
distracted
Difficulty following Poor fine motor skills and organizational Hates school because of constant
directions ability poor academic performance, bullying
Odd pencil grip, jumbled handwriting, and
writing avoidance
3
Learning Disability
Approach
Suggested Reading
American Psychiatric Association Diagnostic and Statistical Manual of Psychiatric Disorders (DSM V). Washington,
DC: American Psychiatric Association; 2013.
Foster A, Titheradge H, Morton J. Genetics of learning disability. Paediatr Child Health. 2015;25(10):450-7.
Indian Academy of Pediatrics. D’Souza N, Somasundaram A, Vinchurkar S. (2022). Standard Treatment Guidelines
2022. [online] Available from [Link] [Last accessed
December, 2023].
Ministry of Social justice and Empowerment. Rights of Persons with Disability Act 2016 (RPWD Act 2016).
Government of India.