Abstract
Introduction: DSM-5 presented a revised conceptualization of specific learning disorders (LD). Contrary to former versions, the various types of LD—i.e., mathematics disorder, reading disorder, and writing disorder—are not treated as distinct diagnostic entities but are integrated into one single LD category. In support of this new classification, it has been argued that the various types of LD overlap to a great extent in their cognitive functioning profiles and therefore do not exhibit a distinct set of cognitive causes. In contrast, ICD-11 still adheres to the idea of discrete categories and thus follows the specificity hypothesis of LD. Using latent profile analysis (LPA), we therefore tested the specificity of cognitive strengths and weaknesses in children with different types of LD. Secondly, we aimed at examining the extent to which observed LD characteristics (type and severity of LD as well as IQ-achievement discrepancy) were consistent with the membership of a given latent profile.Method: 302 German third-graders (134 girls; IQ ≥ 85; Mage = 111.05 months; SD = 5.76) with single or comorbid types of LD in the domains of mathematics, reading, and spelling completed a wide range of domain-specific and domain-general cognitive functioning measures.Results: Five qualitative distinct profiles of cognitive strengths and weaknesses were identified. Profile 1 (23% of the sample) showed Comprehensive Cognitive Deficits, performing low in all measures except for naming speed, language, and inhibition. Profile 2 (21%) included children with a Double Deficit in Phonological Awareness and Phonological Short-term Memory. Profile 3 (20%) was characterized by a Double Deficit of Phonological Awareness and Naming Speed. Profile 4 (19%) included children with a Single Deficit in Attention, and profile 5 (17%) consisted of children without any cognitive deficits. Moreover, type and severity of LD as well as IQ-achievement discrepancy discriminated between the profiles, which is in line with the specificity hypothesis of LD.Discussion: Overall, the finding of specific associations between the LD types and the identified cognitive profiles supports the ICD-11 classification of LD. Yet, those inferences may not be valid for an individual child but need to be examined through comprehensive diagnostic.
Highlights
DSM-5 presented a revised conceptualization of specific learning disorders (LD)
The Lo-Mendel-Rubin test (LMR) pointed to the 2-profile solution, the bootstrapped likelihood ratio test (BLRT) and all the information criteria suggested that models with more than two profiles fit the data better
The two emerging profiles in this model were not informative in understanding the various cognitive patterns associated with LD, as the children were just separated into a big subgroup of individuals with poorer cognitive functioning skills (64% of the sample, with average scores of around T = 45) and a small group of children (36%) with higher performance scores (T-scores around 53)
Summary
Contrary to former versions, the various types of LD—i.e., mathematics disorder, reading disorder, and writing disorder—are not treated as distinct diagnostic entities but are integrated into one single LD category In support of this new classification, it has been argued that the various types of LD overlap to a great extent in their cognitive functioning profiles and do not exhibit a distinct set of cognitive causes. Different manifestations at the symptom level present at the time of diagnosis can be expressed through the use of specifiers, taking into account that children might exhibit severe learning problems in one or two academic domains only In support of this new classification, the DSM task force (Tannock, 2013) argued that the various types of LD seem to overlap considerably in their cognitive functioning profiles and, may not exhibit a distinct set of cognitive causes. Kohn et al (2013) examined the longitudinal stability of MD and found that after 2.5 years, 21% of the children did not reach the criteria of an MD anymore, but exhibited an LD in reading and spelling challenging the clinical validity of the various LD types as distinct diagnostic entities
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