Version June 2024
| Feature | Clinical implications |
| Perinatal history | |
| Maternal drug or alcohol intake | May cause neurologic problems (eg, fetal alcohol spectrum disorder) |
| Congenital infections | May cause neurologic or hearing problems |
| Gestational age, birth weight | Premature birth is a risk for learning disability |
| Medical history | |
| Recurrent or persistent ear infections | May be associated with hearing impairment |
| Iron deficiency | Associated with neurologic deficits |
| Lead poisoning | Associated with neurologic deficits and hearing impairment |
| Seizures | May be associated with neurologic problems |
| Frequent injuries | May indicate coordination difficulties, history of closed head injury, poor supervision, and/or environmental deprivation |
| Chronic illness or medication usage | May be associated with side effects or school absences with secondary effects on learning |
| Developmental history | |
| Delayed or disordered acquisition of language milestones and communication skills | Language delay is a risk for reading difficulty |
| Uneven pattern of skills and interests | May indicate learning disability |
| Behavioral history | |
| Problems with attention, impulsivity, overactivity, acting out | Behavioral problems may affect learning |
| Sadness | Emotional problems may affect learning |
| Poor self-esteem | May be a consequence of reading difficulty |
| Social history | |
| Child abuse or neglect, or other social stressors (eg, homelessness, poverty, illness in family member) | These stressors may affect learning |
| Family history | |
| Learning problems, reading or spelling problems, avoidance of reading, school failure among first-degree relatives | Increases risk of reading disability |
| School history | |
| Academic achievement | |
| Best and worst subjects | Children with reading disability may excel in other areas or areas of interest (eg, math, science) |
| History of grade retention | |
| Classroom behavior | |
| Long-standing problems with attention, impulsivity, overactivity | Reading disability is associated with attention deficit hyperactivity disorder, which can further interfere with school function |
| Depression, moodiness | Emotional problems may affect learning |
| Behavior differs in reading versus other subjects | Children with reading difficulty may "act out" during activities that require reading |
| Attendance | |
| Excessive absenteeism | Frequent absences may affect learning |
| School avoidance | Children with reading difficulty may try to avoid school |
| Past psychoeducational testing | |
| Discrepancy between cognitive abilities and academic achievement | Suggestive of a learning disability |
| Special educational services | |
| Response to educational interventions | Lack of response suggests a learning disability rather than lack of exposure to reading and or inadequate instruction before formal schooling |
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