My practice emphasizes the importance of integrating assessment, diagnosis, and procedures that lead to a diagnosis of learning disability and eligibility for services.
Learning Disabilities Are Manifested Differently Over Time, in Severity and in Various Settings.
Learning disabilities, like other disabling conditions, vary in their manifestations and are mild, moderate, or severe. Appropriate procedures must be used from early childhood through adulthood to assess and identify individuals suspected of having learning disabilities. Procedures vary with different age groups. Problems associated with learning disabilities may be observed in both academic and non-academic settings. Consequently, procedures used to diagnose individuals should include data collected from all relevant settings. Individuals who manifest specific symptoms of—or who are considered at risk for—learning disabilities should be monitored by qualified personnel to determine if assessment or other special services are needed.
Differential Diagnosis Is Necessary to Distinguish Between and Among Other Disorders, Syndromes, and Factors That Can Interfere with the Acquisition and Use of Listening, Speaking, Reading, Writing, Reasoning, or Mathematical Abilities.
Differential diagnosis is a process and requires the formulation of hypotheses regarding the etiology and nature of the presenting problem. When one of several factors may be the cause of learning problems, low achievement, underachievement, or maladaptive behavior, all possible etiological alternatives must be considered. Intellectual limitations, sensory impairments, and adverse emotional, social, and environmental conditions may be the primary cause of low achievement and should not be confused with learning disabilities. Documentation of underachievement in one or more areas is a necessary but insufficient criterion for the diagnosis of learning disabilities. Diagnosis of learning disabilities must be based on an analysis of the individual’s strengths as well as weaknesses. Linguistic and cultural differences, inadequate instruction, and/or social-emotional deprivation do not preclude the possibility that an individual also has a learning disability. Similarly, individuals with other disabling conditions, such as intellectual disabilities, sensory impairments, autism, or severe emotional or behavioral disturbances may have concomitant learning disabilities.
A Comprehensive Evaluation Is Needed for Diagnosis and for Planning an Appropriate Intervention Program.
A comprehensive evaluation includes a variety of activities and procedures intended to ensure a comprehensive set of data for determining an individual’s status and needs. The procedures used to assess learning disabilities should address the presenting problems. A comprehensive assessment must include procedures to determine levels of performance in the following domains: motor, sensory, cognitive, communication, and behavior. When a learning disability is suspected, the following areas should be assessed: listening, speaking, reading, writing, reasoning, mathematics, and social skills. However, the assessment must focus on the presenting problem(s) and possible correlate(s). Data from case history, interviews, and direct observations are important sources of information especially when provided by parents, educators, and the individual with the suspected learning disability. The information helps to evaluate signs, symptoms, and behaviors in a historical and ecological perspective. Standardized tests must be reliable, valid, and have current normative data. Curriculum based assessment, task and error pattern analysis, diagnostic teaching, and other non-standardized approaches are viable sources of additional information, especially when data are not available through standardized testing. Information and data collected during the assessment must be used to formulate the intervention plan. That plan must address the entire range and all degrees of severity of the problem identified. Intervention and services should be based on a determination of the individual’s present level of performance and functional needs. Program planning should include appropriate provisions for social, personal, vocational, and independent living needs.