Neurodevelopmental Evaluation (The Physician’s Diagnostic Role in Learning Disabilities)

Abstract

The diagnosis of learning disabilities for school-age children has traditionally depended upon measurement of, and establishment of, a discrepancy between academic achievement and cognitive functioning levels. In Chapter 2 we noted some of the difficulties in using discrepancy definitions to identify preschool-age children at risk for subsequent learning disabilities, and we discussed the utility of a neurodevelopmental/behavioral approach to facilitate early identification of children at risk for subsequent poor academic achievement. The physician plays a vital role in the interdisciplinary approach to identification and remediation of learning disabilities. In the case of preschool-age children, the physician frequently is the first professional resource consulted regarding questions of neurodevelopmental/behavioral progress. When questions arise about learning disabilities in school-age children, the physician can contribute both in the diagnostic process and in ensuring a balance of professional perspectives when establishing a remediation program. To make these contributions to the diagnostic and prescriptive process for both preschool and school-age children, the physician must expand the traditional role of medical history taking and examination to include a neurodevelopmental history and neurodevelopmental examination.