Specific learning disorder — structured clinical viva · Psych Vivas

Prompt

You are the CAMHS registrar. A school refers a child with persistent reading failure despite intervention. Parents want a medical cure and fear intellectual disability. Discuss definition/domains, assessment including instructional response, mechanisms, differentials including ADHD comorbidity, and a multiagency educational plan.

Interpretation

Reveal interpretation

This is a classic CAP viva on SLD as educationally treated neurodevelopmental disorder, not a medication diagnosis and not synonymous with ID.[1][6]

Definition. Persistent domain-specific academic deficits (reading / written expression / mathematics) below age expectations despite intervention; exclusions for ID, sensory impairment, inadequate instruction and related better explanations.[1][6]

Assessment. Multi-source history, work samples, instructional response data, educational psychology achievement testing, ADHD/language/mood screens, hearing/vision.[3][6]

Mechanisms. Phonological/mapping vulnerability; multiple-deficit and oral-language contributions; family aggregation.[4]

Plan. Intensive phonics-based literacy intervention, accommodations, school partnership; treat ADHD/anxiety if present; no tablet for pure dyslexia.[2][5]

Key points

[2] [3] [6]

References

[1]American Academy of Child and Adolescent Psychiatry Practice parameters for the assessment and treatment of children and adolescents with language and learning disorders. AACAP J Am Acad Child Adolesc Psychiatry, 1998.PMID 9785728
[2]Galuschka K, Ise E, Krick K, Schulte-Körne G Effectiveness of treatment approaches for children and adolescents with reading disabilities: a meta-analysis of randomized controlled trials PLoS One, 2014.PMID 24587110
[3]Miciak J, Fletcher JM The Critical Role of Instructional Response for Identifying Dyslexia and Other Learning Disabilities J Learn Disabil, 2020.PMID 32075514
[4]Peterson RL, Pennington BF Developmental dyslexia Lancet, 2012.PMID 22513218
[5]Willcutt EG, Petrill SA Comorbidity between reading disability and ADHD in a community sample: Implications for academic, social, and neuropsychological functioning Mind Brain Educ, 2023.PMID 38898939
[6]Grigorenko EL, Compton DL, Fuchs LS, et al. Understanding, educating, and supporting children with specific learning disabilities: 50 years of science and practice Am Psychol, 2020.PMID 31081650

Interpretation

Reveal interpretation

This is a classic CAP viva on SLD as educationally treated neurodevelopmental disorder, not a medication diagnosis and not synonymous with ID.[1][6]

Assessment. Multi-source history, work samples, instructional response data, educational psychology achievement testing, ADHD/language/mood screens, hearing/vision.[3][6]

Mechanisms. Phonological/mapping vulnerability; multiple-deficit and oral-language contributions; family aggregation.[4]

Plan. Intensive phonics-based literacy intervention, accommodations, school partnership; treat ADHD/anxiety if present; no tablet for pure dyslexia.[2][5]

Key points

[2]

[3]

[6]

References

[1]American Academy of Child and Adolescent Psychiatry Practice parameters for the assessment and treatment of children and adolescents with language and learning disorders. AACAP J Am Acad Child Adolesc Psychiatry, 1998.PMID 9785728
[2]Galuschka K, Ise E, Krick K, Schulte-Körne G Effectiveness of treatment approaches for children and adolescents with reading disabilities: a meta-analysis of randomized controlled trials PLoS One, 2014.PMID 24587110
[3]Miciak J, Fletcher JM The Critical Role of Instructional Response for Identifying Dyslexia and Other Learning Disabilities J Learn Disabil, 2020.PMID 32075514
[4]Peterson RL, Pennington BF Developmental dyslexia Lancet, 2012.PMID 22513218
[5]Willcutt EG, Petrill SA Comorbidity between reading disability and ADHD in a community sample: Implications for academic, social, and neuropsychological functioning Mind Brain Educ, 2023.PMID 38898939
[6]Grigorenko EL, Compton DL, Fuchs LS, et al. Understanding, educating, and supporting children with specific learning disabilities: 50 years of science and practice Am Psychol, 2020.PMID 31081650