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LETTERS TO EDITOR
Year : 2018  |  Volume : 40  |  Issue : 6  |  Page : 590-591  

Comments on “Specific learning disabilities: Issues that remain unanswered”


Department of Psychiatry, Govt Medical College, Kozhikode, Kerala, India

Date of Web Publication9-Nov-2018

Correspondence Address:
Dr. Varsha Vidyadharan
Department of Psychiatry, Govt Medical College, Kozhikode, Kerala – 673 008
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPSYM.IJPSYM_384_18

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How to cite this article:
Vidyadharan V, Harish M T. Comments on “Specific learning disabilities: Issues that remain unanswered”. Indian J Psychol Med 2018;40:590-1

How to cite this URL:
Vidyadharan V, Harish M T. Comments on “Specific learning disabilities: Issues that remain unanswered”. Indian J Psychol Med [serial online] 2018 [cited 2018 Dec 19];40:590-1. Available from: http://www.ijpm.info/text.asp?2018/40/6/590/245083



Sir,

We read the guest editorial “Specific Learning Disabilities: Issues That Remain Unanswered”[1] with interest. Authors have reviewed this important area from different perspectives, including social issues such as stigma. But, we wish to point out certain areas that lack clarity. It is true that the abbreviation “SLD” has been expanded as Specific Learning Disorder or Disability by different persons in different contexts. However, the usage of the word “disorder” in this article (Para 2) appears contradictory to us. It says, “Disorder refers to significant problems faced by children in academic areas, but this is not sufficient to warrant an official diagnosis.” But in International Classification of Diseases, tenth edition (ICD-10),[2] this word is used to imply “the existence of a clinically recognisable set of symptoms or behaviour associated in most cases with distress and with interference with personal functions.” It is clear from this that “disorder” implies existence of a clinically diagnosable condition with impairment in function. The usage is more or less the same in the Diagnostic and Statistical Manual, fifth edition (DSM-5)[3] and ICD-11.[4] Thus, the usage of the word “disorder” in this article is different from its usage in the above, standard classification systems. This will create confusion among clinicians and epidemiologists.

Specified disabilities in Rights of Persons with Disabilities Act (RPWD Act) are given in its schedule.[5] No. 2 is Intellectual Disability, and it is defined in line with Disorders of Intellectual Development/Intellectual Development Disorder (IDD) as given in ICD-11/DSM-5. The same condition was called mental retardation in ICD-10. In the Act, it is also stated that it includes A—Specific learning disabilities and B—Autism spectrum disorders. Here, the description of learning disabilities is in line with specific learning disorder in DSM-5/ICD-10. The definition of autism spectrum disorder (ASD) is again in line with that in ICD/DSM.

To put it simply, IDD/SLD/ASD etc., are independent diagnoses which may or may not co-occur. There is a blurring of concepts in the Act which needs clarification or correction. This leads to serious consequences, as persons affected with these conditions may get wrongly diagnosed, certified, or treated. Interventions and rehabilitative methods needed in these three conditions are different. Educational approaches are also totally different in these conditions. Hence it is important that this is corrected.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Kohli A, Sharma S, Padhy SK. Specific learning disabilities: Issues that remain unanswered. Indian J Psychol Med 2018; 40:399-405.  Back to cited text no. 1
  [Full text]  
2.
World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization; 1992.  Back to cited text no. 2
    
3.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Arlington, VA: American Psychiatric Publishing; 2013.  Back to cited text no. 3
    
4.
Available from: https://icd.who.int/browse11/lm/en#/http://id.who.int/icd/entity/2099676649. [Last accessed on 2018 Sep 06].   Back to cited text no. 4
    
5.
Rights of Persons with Disabilities (RPWD) Act, 2016. National Centre for Promotion of Employment for Disabled People [Internet]. Ncpedp.org. 2018. Available from: http://www.ncpedp.org/RPWDact201. [Last accessed on 2018 Apr 09].  Back to cited text no. 5
    




 

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