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What Lies Behind Diagnostic Labels? High Intra-Individual Variability Is the True Cognitive Signature of University
Sara Zonca1, Marzia Lucia Bizzaro2, Luisa Girelli2
1Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
Brain Sciences
|April 27, 2026
Summary
Adults with Specific Learning Disorders show significant cognitive variability, especially in working memory. A profile-based approach is recommended over traditional labels for better support.
Area of Science:
- Neurodevelopmental Disorders
- Cognitive Psychology
- Educational Psychology
Background:
- Specific Learning Disorders (SLDs) are lifelong neurodevelopmental conditions often researched in children, but persisting into adulthood with heterogeneous cognitive profiles.
- Adult SLD research lacks consensus on operationalizing diagnoses and understanding cognitive variability.
- This study addresses cognitive heterogeneity in university students with SLDs.
Purpose of the Study:
- To map cognitive functioning variability in university students diagnosed with Specific Learning Disorders.
- To investigate differences in cognitive profiles across diagnostic categories and comorbidities.
- To explore the utility of traditional diagnostic labels versus cognitive profiles in adults with SLDs.
Main Methods:
- Retrospective analysis of clinical data from 166 university students with SLDs.
- Categorization into subgroups: predominant reading disorder, arithmetic disorder, and mixed learning disorder.
- Cognitive assessment using Wechsler scales indices, analyzed with linear mixed-effects models and Latent Profile Analysis.
Main Results:
- Reasoning abilities were higher than cognitive efficiency; working memory was a consistent weakness across all participants.
- The mixed-disorder group showed the lowest cognitive scores and most pronounced working memory deficits.
- Latent Profile Analysis revealed two subgroups: 'Low Profile' (weaker working memory) and 'High Profile' (stronger reasoning). Diagnostic labels showed limited alignment with these profiles, indicating significant intra-individual variability.
Conclusions:
- Traditional categorical labels for SLDs have limited explanatory power in adults due to high cognitive heterogeneity.
- Persistent cognitive weaknesses, particularly in working memory, are evident even in high-achieving university students.
- Clinical and educational support for adults with SLDs should adopt a dimensional, profile-based model over a label-based approach.
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