Specific learning disorders OSCE — evaluation and family counselling

Station objectives

1. Take a domain-focused academic and developmental history. [3]
2. Identify mandatory sensory and red-flag checks. [1]
3. Explain SLD in plain language without diagnosing from a single worksheet. [3]
4. Counsel against vision therapy as primary dyslexia treatment using AAP/Handler principles. [1] [2]
5. Outline interim teaching, formal assessment and school coordination. [7] [17]

Candidate brief

You are the doctor in a community paediatric clinic. Station A is 10 minutes with a parent. Station B is 8 minutes of explanation and shared planning. [3]

Station A — History and formulation

Setup: Parent of a 7-year-old. Teacher letter: “cannot blend sounds; bright in conversation.” Child hates reading aloud. Uncle “was dyslexic.” Parent asks about coloured lenses and eye exercises. No formal hearing test. Some “daydreaming” in class. [1] [3] [5]

Expected actions: [3] [1] [5]

• Map reading vs writing vs maths domains. [3]
• Ask instruction quality, attendance, languages at home. [3]
• Screen development, ear infections, family academic history. [3]
• Ask ADHD, sleep, anxiety, bullying. [5]
• Check for regression or progressive features. [1]
• Plan hearing and vision assessments. [1]
• Avoid diagnosing from history alone; form a working problem representation. [3]

Station B — Counselling and plan

Expected communication: [3] [1] [17]

• “This may be a specific learning disorder affecting reading — often called dyslexia — meaning the sound–print pathway is hard work, not laziness.” [3]
• “Eye exercises are not the treatment for dyslexia; we still check eyes and ears carefully.” [1] [2]
• “We start structured reading teaching now and arrange proper educational assessment.” [7]
• “If attention difficulties are real, we assess that too — both can be true.” [5]
• Agree school letter, interim supports, follow-up owner and date. [17]

Marking domains

• Clinical reasoning (domain + differentials) [3]
• Medical safety (senses, red flags) [1]
• Evidence-aligned counselling (vision therapy) [1] [2]
• Shared plan and care coordination [17]
• Empathy without false certainty [3]