Commonly recognized learning disorder syndromes

Learning disorder syndrome	Clinical features in children without ASD*	Comments
Reading disability (dyslexia)	Difficulty identifying which letter/letter combination correlates with a particular sound (phonics and decoding); deficits in phonics and decoding are accompanied by deficits in spelling or encoding Difficulty reading printed text smoothly and efficiently (reading fluency) Difficulty understanding what was read (reading comprehension) May dislike or avoid reading	Can be seen in isolation Commonly associated with language impairment and language-base LD Results in secondary inattention Results in disliking and avoiding reading
Writing disability	Difficulty with handwriting (eg, copying efficiently from the chalkboard) Difficulty with spelling (phonics, encoding); this difficulty is associated with dyslexia Difficulty composing sentences and text (eg, excessive grammar and punctuation errors) Overly simple written text Written text that is difficult to follow because it is not properly organized	Can be seen in isolation though spelling errors occur in conjunction with dyslexia Commonly associated with: Language impairment and language-based LD ADHD^¶
Math LD	Difficulty with mental representation of quantity (number sense) Difficulty performing math calculations (adding, subtracting, multiplying, dividing) Difficulty performing math calculations smoothly Difficulty with automatic retrieval of basic calculations (math facts) Difficulty correctly reading and understanding math symbols Difficulty understanding word problems and transcribing word problems into numerical equations Difficulty with visual-spatial and organization skills	Can be associated with language impairment and language-based LD Math success also may be affected by: ADHD^¶ Specific deficits in visual-spatial awareness
Language-based LD	Difficulty discriminating and producing the sounds of spoken language Difficulty with vocabulary and/or word retrieval Difficulty understanding and correctly using grammar and syntax (word order) Difficulty with narrative discourse and conversation (pragmatics) Difficulty following instructions (poor verbal working memory) Difficulty with reading comprehension Difficulty writing at the sentence or text level, resulting in grammatical errors, short sentences, or poorly structured paragraphs and text	Commonly associated with: Reading disability (phonics, reading comprehension) Writing disability (spelling, written compositions) Math disability
Nonverbal LD (nonlanguage-based LD, right hemisphere developmental LD)^Δ	Weakness in visual spatial organization Weakness in nonverbal problem solving (including social reasoning) Weaknesses in higher-order reading comprehension and written expression Weaknesses in attention and executive function Well-developed basic language skills Strong rote skills (eg, single-word reading or spelling)	Usually requires neuropsychology evaluation for diagnosis

This table is meant to be used with UpToDate content on learning disorders in children. Refer to UpToDate content for additional information about the causes, components, evaluation, and diagnosis of specific learning disorders in children.

ASD: autism spectrum disorder; LD: learning disorder; ADHD: attention deficit hyperactivity disorder.

* Children with ASD have impairment in social cognition and cognitive inflexibility that may be associated with learning impairments. Impairments in social cognition and flexibility typically affect classroom participation behaviors before they affect reading, writing, and math. Children with ASD without language impairment often have grade-/age-appropriate reading, writing, and math skills in the first years of school. They may begin to show difficulties in reading comprehension, written expression, and multiple-component math problems after grade 3 when educational demands on information processing and executive skills increase. Children with ASD with language impairment are likely to have difficulties in reading, writing, and math before grade 3.

¶ ADHD affects learning broadly. It can affect reading comprehension, written expression, and math, especially as the student advances past grade 3. After grade 3, overall information processing demands increase and executive skills such as working memory, planning, and organization become more important in reading, writing, and math.

Δ Not recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).

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Commonly recognized learning disorder syndromes