International Journal of Disability, Development and Education

Vol. 58, No. 1, March 2011, 7587

Learning Disabilities: Debates on definitions, causes, subtypes,

and responses
Gerhard Bttnera,b* and Marcus Hasselhornb,c
aInstitute

of Psychology, Department of Educational Psychology, Goethe University, Frankfurt,

Germany; bCenter for Research on Individual Development and Adaptive Education of Children at
Risk (IDeA), Frankfurt, Germany; cGerman Institute for International Educational Research (DIPF),
Frankfurt, Germany
Students with difficulties in specific cognitive processes and academic achievement
with otherwise normal levels of intellectual functioning are classified as having a
learning disability (LD). In spite of extensive recent research in a number of disciplines,
controversial debate continues with regard to several issues. To reconcile some of them
we first address the issue of conceptualising LDs, including the aspect of which
approaches have been developed and which criteria are used to classify and to
demarcate different LDs. Second, we reconsider some non-trivial challenges regarding
the identification of causes and consequences of the emergence of LDs. In the third part,
we summarise the heterogeneity of associated phenomena and report on the related
research targeting the identification of different LD subtypes. Finally, we address
several issues regarding responses from the educational systems of modern societies,
and make some comments on future perspectives of the field of LDs.

International
10.1080/1034912X.2011.548476
CIJD_A_548476.sgm
1034-912X
Original
Taylor
102011
58
buettner@paed.psych.uni-frankfurt.de
GerhardBttner
00000March
and
&
Article
Francis
Francis
(print)/1465-346X
Journal
2011 of Disability,
(online)
Development and Education

Keywords: classification; diagnosis; disorder of written expression; dyscalculia;

dyslexia; learning disabilities; IQachievement discrepancy; response to intervention;
policy

Introduction
Learning disabilities (LDs) are a widespread phenomenon in modern societies in which
reading, writing, and arithmetic are necessary skills in everyday life. Students with LDs
comprise the largest single category of students with special educational needs in most
countries. An estimated 47% of school-aged children are classified as having specific LDs
(Geary, 2006; Hasselhorn & Schuchardt, 2006; Mercer & Pullen, 2005). In the United
States, about 50% of the children identified for special educational services are children
with a LD, meaning that LDs constitute the largest field of special education (Kavale &
Forness, 2006; Torgesen, 2004). In accordance with the educational significance of the
field, issues surrounding LDs are subject to a large body of research in educational science,
psychology, sociology, medicine, and other disciplines. For instance, a query in the psychological database PsycInfo yields that in the past five years (20062010) about 2500 publications on LDs were recorded worldwide. The variety of activities across several
disciplines is accompanied by intensive endeavours toward creating a scientific foundation
for the field of LDs, which is currently characterised by many conceptual and methodological issues. Despite an ongoing debate, many questions on classification, definition, and
identification of LDs as well as on aetiology and effective interventions remain unsolved.
*Corresponding author. Email: buettner@paed.psych.uni-frankfurt.de
ISSN 1034-912X print/ISSN 1465-346X online
2011 Taylor & Francis
DOI: 10.1080/1034912X.2011.548476
http://www.informaworld.com

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G. Bttner and M. Hasselhorn

This article aims to provide an overview of some of the most relevant and controversial
issues we have identified as being affiliated with contemporary research contributions in
the field of LDs. First, we focus on the issue of conceptualising LDs in terms of the
approaches that have been developed and the criteria that are used to classify and to
demarcate different LDs. Second, we reconsider non-trivial challenges of the causes and
consequences of emerging LDs, trying to make clear that despite considerable effort to
identify causal factors, the present research does not allow for deciding whether specific
cognitive deficits are covariates, precursors, or indeed causes of LDs. Third, we discuss the
problem of the heterogeneity of associated phenomena and problems and related research
activities concerned with identifying subtypes of different LDs. Fourth, some issues related
to the responses from the educational systems of modern societies are addressed, along with
some comments on future perspectives of the field of LDs.
Defining and Diagnosing Learning Disabilities
In the International Classification System (ICD-10; World Health Organization, 1992), LDs
are described as specific developmental disorders of scholastic skills (F81). According to
domain-specific contents, a specific reading disorder (F81.0), often called developmental
dyslexia, a specific spelling disorder (F81.1), and a specific disorder of arithmetic skills
(F81.2), also called dyscalculia, are differentiated. In the Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), a very similar classification is used that encompasses reading disorder (315.00), disorder of written expression (315.2), and mathematics disorder (315.1). Historically, LDs are related to an
unexpected underachievement at school (Fletcher, Morris, & Lyon, 2006). Children with
LDs show poor performance in reading, written expression (including spelling), and/or
mathematics that cannot be explained by their learning potential or by external factors. The
unexpectedness of underachievement is reflected by the absence of intellectual disability,
sensory impairment, emotional disturbance, cultural deprivation, and insufficient instruction. Both international classification systems, ICD-10 and DSM-IV, concurrently refer to
the concept of the unexpectedness of poor performance in an academic domain as a crucial
component of the concept of LDs. Accordingly, ICD-10 as well as DSM-IV describe LDs
as a poor academic achievement that cannot be explained by intelligence or external factors.
The most common scientific approach to dealing with an unexpected poor performance
in an academic domain is the aptitudeachievement discrepancy, with aptitude represented
by general intelligence and specific performance in reading, written expression or mathematics representing academic achievement. It is assumed that within an individual the capabilities can vary to a certain extent. The intellectual abilities (IQ) and the performance in
reading, written expression or mathematics are assessed by a general intelligence test and
specific achievement tests respectively. A learning disability first of all entails that the
relevant academic achievement is significantly lower than expected from the childs
academic age (i.e., the grade level he or she has reached in formal schooling). Second, the
IQ has to be in the normal range or above average, and the score on the achievement test
has to be considerably lower than the score on the IQ test (e.g., according to the research
criteria of the ICD-10, the discrepancy should be of at least two standard deviations).
The aptitudeachievement discrepancy approach has been criticised with respect to
several aspects. First, the approach implies that, in spite of a poor academic performance,
some children are not described as learning disabled because the discrepancy between their
intelligence and their academic achievement is less than required. On the other hand, gifted
children who meet the criterion of a large difference between IQ and academic achievement

Learning Disabilities: Causes, subtypes, and responses

77

may not be accepted as learning disabled because their academic achievement scores are
not low enough. Since children with low achievement scores that do not deviate sufficiently
from their low IQ scores, as well as gifted children with significantly different IQ and
achievement scores that are still relatively high, may be excluded from special education
services, the issue of IQachievement discrepancy has enormous practical relevance in
education. It is therefore important to note that the differentiation between garden variety
poor achievers and learning disabled children has been challenged by several studies showing that the two groups do not differ in skills and in the cognitive processes that are thought
to underlie performance in academic domains (Fletcher, 2005; Fletcher et al., 1994; Gonzales
& Espinel, 2002; Maehler & Schuchardt, 2011; Siegel, 1989, 1992). Meta-analyses synthesising a large number of studies that aimed to compare discrepant and non-discrepant poor
readers cognitive abilities closely related to reading have questioned the validity of IQ
achievement discrepancy-based classifications of poor readers (Hoskyn & Swanson, 2000;
Stuebing et al., 2002). In addition, there is no clear evidence that IQ or IQachievement
discrepancies are related to intervention outcome. While a number of studies found IQ to
be a significant predictor of the response to instruction (e.g., Fuchs, Fuchs, Mathes, & Lipsey,
2000; Fuchs & Young, 2006), other studies came to different conclusions (Fletcher
et al., 2002; Stuebing, Barth, Molfese, Weiss, & Fletcher, 2009; Vellutino, Scanlon, & Lyon,
2000). As a consequence, the IQachievement discrepancy approach lacks information
about efficacious intervention. The diagnosis of a learning disability typically does not
include any information about how to devise an appropriate form of intervention.
Related to the problem of IQachievement discrepancy is the issue of the distribution
underlying the difficulties of acquiring knowledge and skills in reading, written expression,
and mathematics. Organising children with difficulties at school into garden-variety poor
achievers and learning disabled children implies a dichotomous distribution with clear-cut
categories. However, most of the empirical evidence indicates that scholastic difficulties
have a continuous distribution of severity, meaning that differences between children with
LDs are qualitative rather than quantitative (Fletcher, Lyon, Fuchs, & Barnes, 2007; Shaywitz, Escobar, Shaywitz, Fletcher, & Makuch, 1992). In addition, the variables used to
define LDs (intelligence and academic achievement) are continuously distributed. Without
clear-cut qualitative categories, the cut-off point is to a large extent arbitrary. In the past,
this has led to inconsistencies in different studies in the operationalisation of LDs. For
instance, poor academic achievement usually is defined by a low percentile in the distribution of test scores. However, there is no clear consensus about which percentile should be
used as the cut-off point. Thus, different percentiles (from 10th or 16th to 25th or even 30th)
are used in different studies, leading to inconsistent results and consequently very different
prevalence rates (Fuchs, Mock, Morgan, & Young, 2003). Again, this issue has important
educational implications since children may be included in or excluded from special educational services depending on the percentile used as the cut-off point in a diagnostic decision.
Altogether, although IQachievement discrepancy is used in many empirical studies as
the criterion for defining the sample of children with LDs, its validity has increasingly been
put into question (Stanovich, 2005). As a consequence of the critical aspects of the IQ
achievement discrepancy approach, researchers have suggested that the diagnostic concept
of two discrete categories of poor achievers and children with LDs separated by different
discrepancies between intelligence and achievement scores be abandoned (e.g., Elliott &
Gibbs, 2008). An alternative process focusing on the resistance of at-risk children to highquality intervention has been recommended as more helpful for identifying children who
need special support in the acquisition of skills in reading, written expression and mathematics. This approach, called response to intervention (RTI), relies on ipsative rather than

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normative assessment of academic performance (Fletcher et al., 2006). According to Fuchs

et al. (2003), two distinct models of RTI have been developed, differing in their extent of
individualisation and standardisation. The problem-solving approach aims at supporting
an individual child by analysing his or her problems and developing an individualised intervention. Thus, the problem-solving approach differs from one child to the next. Not surprisingly, this approach is highly regarded by practitioners (Fuchs & Fuchs, 2006). The
standard-protocol approach is favoured by researchers: it uses standardised evidencebased interventions either for an individual child or for a group of children. Typically, RTI
with a standard-protocol is a multi-tiered cyclic procedure (Reschly, 2005; Vaughn, LinanThompson, & Hickman, 2003; Vellutino, Scanlon, Small, & Fanuele, 2006). In a first step,
at-risk children are identified through a screening process, using standardised or nonstandardised tests. In the next step, these children receive a well-established intervention
for a fixed period of time. Typically, many of the at-risk children show substantial progress
and do not need further support. The children who do not benefit from this intervention are
provided with a more intensive intervention in very small groups or even individually for a
fixed period of time. At the end of this second intervention, progress is once more examined. Children who have not benefited are provided with an even more intensive intervention or are referred to a special education service. The non-responders are the ones who are
very likely to develop LDs.
Although RTI is about to become the dominant approach in the field of LDs, some
issues associated with this approach should be taken into consideration. Like the IQ
achievement discrepancy approach, the RTI approach does not solve the issue of the dimensional versus categorical nature of learning disability. The cut-off point for defining a child
as learning disabled remains unspecified. This is reflected in the question of how many tiers
the RTI approach should include (Reschly, 2005). Since each tier leads to a smaller number
of children requiring more intensive intervention, the prevalence of children with LDs
depends on the number of tiers included in the approach. Related to the issue of a cut-off
point is the question of how to deal with children who successfully pass a tier, return to their
regular classroom and fail again, implying that they need some additional support (Vaughn
et al., 2003). Under such circumstances the question arises whether these children should
be classified as learning disabled or assigned to another category, and, in addition, what
kind of supplementary remedial instruction should the children receive?
Another issue associated with the RTI approach relates to the validity of the classification; this concerns two matters. The first matter concerns the measurement, test instruments,
and performance standards used to assess non-responsiveness that in turn suggests more
intensive instruction. Second, describing children who are unresponsive to the second tier
as learning disabled is valid only if the instruction was appropriate, something that is certainly
not always guaranteed. Although the literature on the RTI approach provides some indications as to the tools that should be used to assess non-responsiveness and how to proceed
to make sure that the instruction given to the child is evidence-based and appropriate, the
diagnostic validity of non-responsiveness needs further discussion. Although the RTI
approach is currently highly regarded by many experts in the field of LDs, it is associated
with issues and unresolved questions that deserve exhaustive scientific debate (Kavale &
Forness, 2006).
Causes and Consequences of Learning Disabilities
The most prominent assumption about the causes of LDs is that some children have
biologically-based cognitive deficits or cognitive dysfunctions that hinder their adequate

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79

acquisition of fundamental academic skills. However, for a number of reasons it is difficult

to empirically identify those causes. One of these reasons is that we do not exactly know
how cognitive dysfunctions are related to specific LDs. Although the respective literature
has identified cognitive deficits as closely associated with specific LDs (e.g., Landerl,
Fussenegger, Moll, & Willburger, 2009; Swanson, Harris, & Graham, 2006; van der Sluis,
van der Leij, & de Jong, 2005), it remains unclear whether the identified cognitive deficits
are causal factors or a mere consequence or even a covariate of the disability (see Geary,
2006; Vellutino, Fletcher, Snowling, & Scanlon, 2004). For example, even if reliable findings
from well-controlled studies were to suggest that children who have been diagnosed with a
specific LD, such as dyslexia or dyscalculia, display specific deficits in a cognitive function
x, we do not know whether these cognitive deficits are really responsible for the emergence
of the LD since the deficits themselves might result from the emergence of the LD. The
history of LD research provides many examples of overgeneralisations of this type where
reliable performance differences between children with and without a LD diagnosis were
prematurely interpreted as causal factors. For instance, for many years, a dominant view in
dyslexia research was that reading difficulties are caused by specific dysfunctions in the
visual system. During the 1970s and 1980s, many studies were conducted that systematically
evaluated this assumption using a wide variety of visual processing paradigms. Many of them
found reliable performance differences between children with versus without reading
disability. However, in many cases the design of these studies did not control for confounding
with phonological and verbal mediation. Thus, more recent studies with adequate control
for this confound have concluded that reading disabilities are not caused by impairments in
visual processing but rather by cognitive deficits in phonological coding, auditory processing, and semantic and syntactic skills (for an overview see Vellutino et al., 2004).
There is even more controversy about the causes of mathematical LDs or developmental dyscalculia. Although recently there have been some important advances in characterising crucial differences between students with and without mathematical disabilities, experts
in the field see converging evidence that dyscalculia is not a unitary LD, but varies widely
betweenand perhaps also withinindividuals (e.g., Geary, 2006).
This raises the question about whether the results of the more recent elaborated studies
on the cognitive deficits of children with specific LDs actually provide us with definite
knowledge about the causes of LDs like dyslexia or dyscalculia. Playing the devils advocate for an instant, we have to admit that this is not the case. Even if those studies were able
to account for the potentially relevant processes and mechanisms and their confounding
with the deficits under scrutiny, for logical reasons the identified dysfunctions might not be
a main causal factor of the LD, but might be a consequence or even a covariate of the LD.
More recent research studies have therefore shifted their focus from comparing children
with and without diagnosed LD to longitudinal analyses of cognitive conspicuousness as
developmental precursors to the emergence of specific LDs (e.g., Geary et al., 2009, for
mathematical LD). Although the evidence that early cognitive deficits contribute substantially to predicting later emergence of a specific LD can be taken as a good empirical argument for their causal role in the manifestation of the LD, we can again not preclude
logically that the identified deficits are not actual causes of the LD, but only covariates of
the actual causes.
Subtypes of Learning Disabilities
In attempting to account for the diverse range of cognitive deficits associated with LDs, it
has become popular to distinguish between LDs not only with regard to different

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academic skills (i.e., reading, written expression, arithmetic), but also with regard to the
heterogeneity of phenomena and causes within a specific category of LD. Such phenomena of within-LD category heterogeneity may be at least partially explained by the existence of distinct subtypes. However, the literature on subtypes of LDs is voluminous.
Focusing only on reading disabilities, hundreds of studies have been published in the past
three decades. The approaches to subtyping either are based on a rational division of children with LD into subtypes according to clinical experience and detected patterns of
performance, ormore appropriatelyapply multivariate classification methods to
datasets from children with a specific LD diagnosis where batteries of cognitive and
neuropsychological tests were used (e.g., Hendriksen et al., 2007). However, the relationships between cognitive conspicuousness and the behavioural phenomena of LDs are not
isomorphic at all, since different cognitive deficits might produce similar behavioural
phenomena and different phenomena exacerbate the estimation of the number of subtypes
that should be classified.
In a more theoretically driven study, Morris et al. (1998) provided support for the
phonological core-variable differences model introduced by Stanovich (1988) to explain
specific reading disabilities. Their study relied on a number of theories for selecting potential variables to be used in subtyping, including measures of phonological skills, rapid
automatised naming, phonological working memory capacity, vocabulary, and visual
perceptual skills. The classificatory analyses by Morris et al. (1998) revealed nine subtypes,
including five subtypes with specific reading disability, two subtypes with pervasive
impairments in language and reading, and two groups representing normally achieving
children. Importantly, six of the seven identified reading disability subtypes shared deficits
in phonological awareness skills, indicating the prominent role that phonological awareness plays in reading-related LDs (see Vellutino & Fletcher, 2005, for a summary).
However, this conclusion might be restricted to alphabetical languages. The picture
seems to be somehow different in non-alphabetical languages. Chinese, as the major nonalphabetic language with the largest population of readers in the world, for example, has
unique linguistic characteristics that are different from those of alphabetic languages.
Some recent research studies have demonstrated clear differences in the cognitive characteristics of reading disability between English and Chinese learners. While poor phonological awareness has been reported as a major feature of dyslexia in alphabetic languages,
rapid naming and orthographic deficits have been reported as the major reading-related
cognitive deficits for Chinese students with a reading disability (e.g., Ho, Chan, Tsang,
Lee, & Luan, 2004). Difficulty with naming familiar, visually presented materials (e.g.,
digits) in Chinese children with dyslexia may reflect their problems in developing a stable
and strong orthographic representation that allows rapid retrieval. Ho et al. (2004) have
suggested that orthography-related difficulties may be crucial in Chinese reading
disability.
Other studies also show that a morphological deficit (i.e., difficulty in understanding
and manipulating the meaningful units in words) may be another salient feature of reading
disability in Chinese. Morphological awareness has recently been found to be an important
predictor of reading success and failure in Chinese (e.g., Shu, McBride-Chang, Wu, & Liu,
2006). In a study that examined the subtypes of reading disabilities in Hong-Kong, Ho,
Chan, Chung, Lee, and Tsang (2007) reported in their study that more than 60% of the
Chinese children with dyslexia were classified as belonging to a surface subtype, but no
children were classified as belonging to the phonological subtype usually found in alphabetical languages. The Chinese children with surface dyslexia were found to have greater
difficulties in phonological working memory and learning new exceptional words than

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81

younger typically-achieving readers. Taken together, the results of reading disability

research in Chinese children cast more doubts on the generalisability of hitherto existing
conclusions about the causes and subtypes of LDs.
Responses
Educational systems in different countries vary considerably with respect to dealing with
LDs in schools. It is thus impossible for us to present a detailed discussion of countryspecific responses to the support of children with LDs here. Instead, we focus on the
situation in the United States since developments that occur in the United States are likely
to at least partially influence the current and future developments in other countries.
The history of the field of LDs in the United States shows that social/political developments and scientific research on LDs, although separate areas of interest, were intrinsically
tied to each other in the pastthat is, a reciprocal influence occurred (Fletcher et al., 2007;
Hallahan & Mock, 2006; Torgesen, 2004). For instance, at the very beginning of the field
of LD research in the early 1960s, the endeavour to establish special educational support
for children with difficulties in acquiring skills in reading, written expression, and mathematics was accompanied by a concept of LDs that assured the newly developing field was
distinct from the already existing fields of intellectual disabilities and emotional/behavioural disorders, respectively (Torgesen, 2004). At the same time, efforts were made to
include as many children as possible in the category of LDs in order to acquire maximum
funding for the new field, culminating in the warning that a narrow definition of LDs would
cause a massive exclusion of children from the category (Barsch, 1992). This efforts
success led to a steadily increasing number of children being diagnosed with LDs (in the
United States, the percentage rose from 2% to more than 6% between 1976 and 2000),
implying both an increase in the economic costs for teaching these children and strong
disparities among the individuals described as learning disabled. This heterogeneity interfered with the scientific research on LDs since the concept of LDs became vague, resulting
in inconsistent findings in different studies (Stanovich, 1988). In addition, a gap emerged
between science and practice due to the overgeneralisation of LDs in schools, leading to
many of the children identified as learning disabled not meeting the operational criteria of
an IQachievement discrepancy (Kavale & Forness, 2006). The dissatisfaction with this
situation contributed, together with other reasons, to the development of an alternative
approach to defining and diagnosing LDs, leading more recently to RTI. Today, the RTI
approach has become an official part of public special education measures. The statutes and
regulations of the Individuals with Disabilities Education Improvement Act (2004) indicate
that it is no longer a requirement to use an IQachievement discrepancy model and, in addition, that it is permissible to include a students response to scientific research-based intervention as part of the diagnostic process.
In summary, an era of LD classification dominated by the abilityachievement discrepancy approach that lasted approximately three decades has now been superseded by a new
era in which the response to intervention approach is expected to become dominant.
However, the ongoing political and scientific debate concerning which kind of response to
LDs is adequate and how it should be implemented indicates that many issues remain unresolved. Another crucial concern is the variability in LD identifications, which for the main
part are due to heterogeneous outcomes of the diagnosing process identified in the federal
regulations. Additionally, this variability is a consequence of differing RTI approaches
implemented in various states, districts and schools (Berkeley, Bender, Peaster, & Saunders,
2009; Reynolds & Shaywitz, 2009). The variability leads to inconsistencies and, at least

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partially, subjectivity in both diagnosis and treatments of LDs. This leads to other non-trivial
difficulties for research on LDs because findings based on conflicting operationalisations
are not compatible.
Another fundamental issue associated with the RTI approach refers to the problem that
the diagnosis of non-responsiveness alone is incapable of distinguishing LDs from other
possible causes of low achievement like intellectual disabilities or emotional disorders
(McKenzie, 2009). In line with this analysis, the National Joint Committee on Learning
Disabilities (2005) in the United States suggested that, at least in the third tier of RTI, diagnosers should not only rely on the assessment of responsiveness but also conduct a comprehensive evaluation of a childs difficulties using multiple sources, including data from
standardised and norm-referenced measures. Moreover, in a recently published White
Paper, a group of experts in the field of LDs have recommended the inclusion of cognitive
and/or intellectual measures of processing strengths and weaknesses for the identification
of LDs instead of confining the diagnosing process to response to intervention (Hale et al.,
2010). These statements indicate a third way as a solution to the search for an appropriate
response by the educational system to the problem of unexpected scholastic underachievement of children; that is, neither the IQachievement discrepancy approach nor the RTI
approach, but an aggregation of both approaches which would fully comply with the
Individuals with Disabilities Education Improvement Act (2004).
Future Perspectives
The conceptualisation and definition of LDs remains one of the major issues to be tackled
in the future. Currently it is widely accepted that researchers are able to differentiate
between a reading disorder, a written expression disorder, and a disorder of arithmetic
skills. However, as mentioned earlier, alternative conceptions may arise and several other
lines of development are possible. Based on more sophisticated knowledge about a close
relationship of particular impairments and processing difficulties like phonological
processing, word recognition, reading comprehension, basic arithmetic skills, or computational abilities to poor performance in reading, spelling and mathematics, categories may
arise that are more specific than the ones that are currently used: these may include particular processing deficits as part of the definition of a learning disability (e.g., Lyon, 1995,
for a more specific definition of dyslexia). These categories may even consider cultural
aspects, such as the language characteristically used in a particular society. The advantage
of such categories would be their closer relationship to appropriate instruction and interventions aimed at minimising the detrimental consequences of LDs. For instance, establishing
different subtypes of reading disorders associated with problems in an alphabetic and nonalphabetic language, respectively, would suggest quite different approaches or strategies to
remedial instruction.
The evolution of more instruction-related categories of LDs could be advanced by the
implementation of the RTI approach, which is explicitly designed to include instructional
aspects in the definition of LDs. The multi-tiered procedure of RTI means students who
most probably have very strong impairments and severe cognitive processing problems
(e.g., in decoding skills) will be identified as learning disabled. These students may differ
from those identified as learning disabled by the traditional IQachievement discrepancy
approach. Considering students response to intervention for the conceptualisation of LDs
could result in a very different classification, in an extreme case meaning that the concepts
of dyslexia and dyscalculia may even be abandoned (Elliott & Gibbs, 2008; Mastropieri &
Scruggs, 2005).

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83

Comorbidity is one further issue related to the conceptualisation of LDs that is increasingly becoming important. In many cases a learning disability does not occur as an isolated
phenomenon but rather in combination with other cognitive disabilities or emotional/
behavioural disorders. For instance, dyscalculia and dyslexia have been shown to be
combined with attention-deficit hyperactivity disorder at a rate of 26% and 33%, respectively. In addition, 17% of children with dyscalculia also showed severe deficits in reading
(Gross-Tsur, Manor, & Shalev, 1996; Mayes & Calhoun, 2006; Shaywitz & Shaywitz,
1988). In the future, more detailed attention will have to be paid to the question of whether
a comorbid disability constitutes a category in its own right, with symptoms in different
domains that have a common genetic pathway, or whether a comorbid disability comprises
distinct disabilities, each of which has its own aetiology and independent cognitive deficits.
Other questions of interest will be whether the impairments in comorbid disabilities are
non-additive; that is, whether children with comorbid disabilities are more impaired in a
particular domain than those with a single disability only, whether the pattern of strengths
and weaknesses is different across comorbid and isolated disabilities, and whether the same
relationship between comorbid disability and isolated disabilities is applicable to different
comorbid disabilities (Landerl, Fussenegger, Moll, & Willburger, 2009; Tiffin-Richards,
Hasselhorn, Woerner, Rothenberger, & Banaschewski, 2008; Willcut, Pennington, Olson,
Chhabildas, & Hulslander, 2005).
So far, research on comorbidity of LDs has been restricted by a limited understanding
of dyscalculia and the written expression disorder. Most of our knowledge on LDs refers
to reading disabilities, as the most common form of LDs. It is assumed that about 8090%
of children served in special education programmes are children who have problems in
reading (Fletcher et al., 2007). The reason for the predominance of reading disorders in
research, as well as in special education services, may be that modern societies demand
reading skills in almost all aspects of everyday life. However, the recent past has seen a
growing scientific interest in dyscalculia and written expression disorder, even more so as
studies show that both disabilities seem to have similar frequencies of occurrence to reading disability (e.g., Katusic, Colligan, Weaver, & Barbaresi, 2009; Shalev, Auerbach,
Manot, & Gross-Tsur, 2000). Although most of the ongoing research in the field of LDs is
still related to reading disability, a steadily growing number of studies particularly dedicated to dyscalculia and, to a lesser extent, to written expression disorder, gives reason to
expect that in the near future, some of the enigmas of these disabilities will be better
understood.
As a last aspect in our discussion of future perspectives on the field of LDs we would
like to address the issue of professionals daily routine in diagnosing and treating children
with LDs. The criteria used to identify children as learning disabled vary considerably
amongst different countries and even amongst various federal states within a country, leading to heterogeneous and inconsistent prevalence rates (Lester & Kelman, 1997; Reschly &
Hosp, 2004; Torgesen, 2004). The reauthorisation of the Individuals with Disabilities
Education Improvement Act (2004), allowing states in the United States to use different
approaches to specific learning disability identification, has not contributed to any alignment. A similar situation can be observed in countries like Germany where each federal
state has its own regulations related to identification and even treatment of LDs. In addition
to different regulations across states, some research has suggested that requirements in
federal and state regulations have not been administered adequately by professionals at the
local level. Accordingly, many students diagnosed as learning disabled did not meet the
appropriate criteria and thus were not instructed effectively (MacMillan, Gresham, &
Bocian, 1998). Both the IQachievement discrepancy approach and the RTI approach face

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the issue of across-state and within-state variability in identification rates of LDs due to
different regulations as well as to subjective local practices. Regardless of whether the IQ
achievement discrepancy approach or the RTI approach or a combination of both is applied,
a core task for the future will be to ensure that the stated criteria are extensively implemented and, in addition, that the local practice adheres to current scientific knowledge
(Scruggs & Mastropieri, 2002).
Acknowledgements
The findings reported here are based on research conducted as part of the work of the Center
for Individual Development and Adaptive Education of Children at Risk (IDeA) funded by
the federal state government of Hesse (LOEWE initiative) to the German Institute for International Educational Research. No restrictions have been imposed on free access to, or
publication of, the research data. The content of this publication does not necessarily reflect
the views or policies of the funding agency, nor does mention of trade names, commercial
products, or organisations imply endorsement by any organisation. Opinions reflect those
of the authors and do not necessarily reflect those of the funding agency. The authors had
no financial or other conflicts of interest.
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