Executive functions in learning disorders

Growing evidence supports the involvement of EF in academic performance and, consequently, EdF in learning disorders (commonly known as learning disabilities or LD). Often, the first indicator of LD is low academic achievement in areas of reading, math, or writing. The terminology used to describe different LD conditions varies by field and includes dyslexia and reading disorder/disability, dyscalculia and mathematics disorder/disability, and disorder of written expression/writing disability. Comorbidity among these learning disorders is common, as is the co-occurrence of LD with ADHD. Recent US data indicate that almost 2.5 million public school students received special education and related services for LD in 2008, and 43% of all public school students receiving special education and related services were identified as having a specific learning disability. Federal guidelines used in educational settings indicate that a child may have a specific LD if, in the absence of any other disability or limiting condition and despite appropriate instruction and experiences, the child does not adequately achieve for age or state standards in one of the following eight academic areas: oral expression, listening comprehension, written expression, basic reading skills, reading fluency skills, reading comprehension, mathematics calculation, or mathematics problem solving. The DSM-IV-TR indicates diagnosis of specific disorders of reading, math, and written expression based on lower than expected performance on standardized tests “given the person’s chronological age, measured intelligence, and age-appropriate education.” The proposed changes for DSM-5 include defining these disorders based on low performance on standardized measures without requiring a significant discrepancy between measured intelligence and achievement.