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Diagnosing specific learning disorder in adults Part I: conceptual and methodological challenges
Allyson G Harrison1, Richard Sparks2
1Regional Assessment & Resource Centre, Queens University, Kingston, ON, Canada.
Summary
Diagnosing specific learning disorders (SLDs) in adults is challenging due to unclear criteria and inconsistent application, impacting equity and validity. New frameworks are needed for accurate identification in postsecondary settings.
Area of Science:
- Neurodevelopmental disorders
- Educational psychology
- Clinical psychology
Background:
- Specific learning disorders (SLDs) are considered lifelong neurodevelopmental conditions.
- The validity of diagnosing SLDs for the first time in adulthood is not well-established.
- Current research lacks a stable definition and validated criteria for distinguishing SLDs from normative academic variability.
Purpose of the Study:
- To critically review the historical development and diagnostic frameworks of SLDs in adults.
- To examine the psychometric validity and diagnostic utility of various SLD identification approaches.
- To address concerns regarding construct drift, equity, and validity in adult SLD diagnoses.
Main Methods:
- A critical narrative review of historical SLD construct development and prevalence estimates in adults.
- Examination of diagnostic frameworks including IQ-achievement discrepancy, Response to Intervention, and DSM criteria.
- Analysis of evidence concerning psychometric validity and diagnostic utility.
Main Results:
- Persistent definitional instability and reliance on unsupported discrepancy-based logic in SLD diagnosis.
- Extreme heterogeneity in adult and postsecondary SLD samples, with frequent misclassification of individuals with average or above-average achievement.
- Disproportionate concentration of adult SLD diagnoses among socioeconomically advantaged students, raising equity and validity concerns.
Conclusions:
- Contemporary adult SLD identification lacks sufficient grounding in population-referenced academic impairment and functional limitations.
- Shortcomings in current diagnostic practices undermine confidence in SLDs as a neurodevelopmental construct.
- A stepped, empirically grounded framework is proposed for diagnosing SLDs in adolescents and adults.
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