Diagnosing Learning Disorders in Children

As many as 30 percent of children have a learning disorder, which can affect reading, math, writing, or nonverbal skills. Learning disorders often occur in children who have normal or higher-than normal intelligence but may have difficulty receiving, effectively using (or “processing”), storing, or responding to information.

Children who were born prematurely or underweight are at increased risk of having a learning disorder. Learning disorders occur frequently in children with developmental delays and in those who have conditions such as attention deficit hyperactivity disorder (ADHD) and mood disorders, which may interfere with their ability to focus. Learning disorders also are seen in children with more complex medical problems that can affect brain function, such as epilepsy. Children with a family history of learning problems are also more likely to have a learning disorder. In many instances, however, the cause is unknown.

Some signs of a learning disorder, such as trouble with distinguishing letters or numbers or with rhyming and manipulating sounds, may become apparent when a child is in preschool. But as a child begins school, learning disorders can be difficult to distinguish from behavioral and emotional problems, especially if a child becomes frustrated when trying to complete assignments. Delays in language skills can also be confused with a learning disorder in children raised in a bilingual home.

Doctors at Hassenfeld Children’s Hospital at NYU Langone are experienced in diagnosing learning disorders in children and young adults of all ages. Our neuropsychologists—specialists in evaluating the relationship between brain structure and behavior—use information from your child’s medical and family history and previous learning assessments, such as those given at school, to guide them as they determine the most accurate diagnosis.

Our doctors use a variety of tests, performed over several days at the Child Study Center, part of Hassenfeld Children’s Hospital, to determine if your child has a specific learning disorder. Test results are combined with information from classroom observations and from teachers, therapists, doctors, and others familiar with your child’s medical and academic situation, so that our experts can make individualized recommendations.

Psychoeducational Tests

Psychoeducational tests, performed by a neuropsychologist or psychologist, include specialized interviews and written assessments. These tests are designed to measure a child’s intellectual capability, or IQ (intelligence quotient); academic skills; social and emotional skills; and speech and language skills. These test results can shed light on underlying processing disorders that may affect a child’s performance in school. They can also help to put behavioral and other problems into greater context for parents and healthcare professionals.

Neuropsychological Evaluations

To gain more insight into how your child thinks and learns, and to find out what factors are contributing to his or her difficulties in school, a neuropsychological evaluation is conducted to identify the underlying cause of a learning disorder. These tests evaluate areas of brain function that can affect learning, including:

• attention, which allows a child to focus
• memory, which enables a child to retain information
• visual–spatial perception, which helps a child to understand and organize information seen, such as maps, graphs, and grids
• motor skills, which enable a child to grasp and manipulate objects
• executive function, which allows a child to plan, organize, and accomplish tasks in a given amount of time

These assessments can sometimes reveal learning problems or patterns that are caused by a brain injury or by other medical or behavioral conditions.

Classroom Observation

A neuropsychologist, a specialist who understands the relationship between the brain and behavior, can visit your child’s school, interview the teacher, and observe the child in the classroom. The specialist looks at how well he or she is functioning, both academically and socially, and compares your child’s behavior with that of a peer in the classroom who appears to be following instructions without difficulty.

Classroom observation is an important part of a learning disorder diagnosis; it can show if your child is struggling in his or her current academic setting and is receiving the appropriate support. It can also reveal whether differences in ability are affecting your child’s mood, behavior, or willingness to participate in classroom discussions.

Information from classroom observations can be used to identify strategies, such as allowing extra time to finish tests or using different teaching methods, that may help your child function better in the classroom. It can also help to determine if a different educational setting may better address your child’s learning style.

An accurate diagnosis of a learning disorder or of other conditions that affect learning, such as ADHD, is necessary in identifying the most appropriate treatment and building an effective support system for your child. Our doctors can refer your child to another specialist for treatment of any underlying condition identified during testing.