ABSTRACT
Consultation for the possible diagnosis of a learning disability (LD) is far less common than one for attention deficit hyperactivity disorder (ADHD) and=or developmental motor coordination disorder (DMCD). Nevertheless, because of a substantial overlap (about a third either way) between LD and ADHD, and because superficially diagnosed ADHD may actually be secondary to LD, the clinician must know how to evaluate for LD in all ‘‘school problem’’ referrals. Unfortunately, the ‘‘official’’ manner in which educational and legal systems define LD differs from state to state depending on variations in statistical comparisons of aptitude and achievement scores. In general, however, the term implies a significant deficit in learning relative to expectations based on intellectual ability, not explained by environment or psychological symptoms. While mention is sometimes made of ‘‘underlying psychological processes,’’ even after aptitude-achievement discrepancies are judged statistically significant, these descriptors of the student are remote from concepts in cognitive neuroscience=neuropsychology. Additionally, the roles of subcategories of DMCD in various aspects of child development (e.g., handwriting, neatness of appearance, ability to participate in sports or music or art) should be of special concern to the pediatric neurologist, whose training equips him or her to appreciate the motor status of the student in ways that other specialities do not.
