The notion of learning disorders gained momentum during the 50’s and 60’s, when it began to be appreciated in professional circles that there were a small number of individuals who, although quite bright, seemed to experience inordinate difficulty learning to read. They juxtaposed letters or did not seem to readily “see” the patterns of letters in words, and the term “dyslexia” was used to describe this condition, which was relatively rare in school-aged children.
Today DSM-IV identifies three different sub-categories of learning disorder: reading disorder, mathematics disorder, and disorder of written expression. Clearly the general concept has expanded markedly during the intervening decades, and DSM’s own estimate of total prevalence for all categories among school-aged children is five percent and in the general population (i.e., including adults) is two to ten percent.
DSM defines a learning disorder as a condition in which the individual’s performance in the area in question (reading, writing or arithmetic) is substantially below expectations given his intelligence, educational opportunities, etc… “Substantially below” is defined as two standard deviations, which in fairness to DSM does constitute a very major discrepancy. A child of average intelligence would have to be reading at or close to the bottom of the class level to meet this criterion.
The inherent drawback in the DSM definition, however, is that it takes no cognizance of the reason for the discrepancy.
If a child’s reading level is extremely low because his brain can’t process letters, DSM considers him to have a mental disorder called “reading disorder.” Another child of similar intelligence and education whose reading is similarly low will receive exactly the same diagnosis, even though his inability stems not from a neurological problem, but from laziness, lack of motivation, or general failure on the part of the parents to instill age-appropriate habits of discipline and self-control. It is obvious from even a most cursory familiarity with the day-to-day dynamics in our schools that the numbers of such children have increased markedly in the past two decades, and that it is this increase that has swollen the ranks of the “learning disordered.”
Essentially what the APA have done is taken a simple fact of child-rearing reality, namely that if children to not receive appropriate training, direction, discipline, etc. at home, they frequently remain self-centered, unmotivated, and uncommitted in the school context, and transformed it into a mental disorder from which they and the ever-collaborative pharmaceutical companies can profit.
Once again, cause and effect become obscured. Parents and teachers are routinely told that the child “has a learning disorder.” Parents gladly accept this bogus explanation because it lets them off the hook with regards to their child-rearing responsibilities. Teachers accept it for similar reasons. The diagnosis can be used to move the child from the regular to a special classroom, and of course, the school receives additional funding.
There are many other reasons why an otherwise intelligent child might be reading, writing, or calculating way below expectations, including: particular tension or unhappiness in the home; recent serious grief or losses; being the victim of bullying or other unpleasant experiences, etc.. The DSM blanket, however, makes no distinction. The child “has a learning disorder,” is referred for “treatment,” swells the ever-growing ranks of the mentally disordered, and is groomed for life-time involvement as a client of the mental health system. He is also given the extremely destructive messages that he is “damaged” in some way (even though he probably isn’t), and that there is nothing that he or his caregivers can do about this damage other than consult experts. In many cases, other diagnoses will be “uncovered” as “treatment” progresses, and the child has a high probability of ending up on psychotropic drugs. He also has a high probability of remaining a mental health client for life and of enrolling his own children in turn, as and when problems arise in their development.
An interesting sideline to the learning disorder label is the inclusion of a fourth sub-category called Learning Disorder Not Otherwise Specified (NOS). This is a residual category for individuals who do not meet the criteria for any one of the specific “disorders” (reading, writing, and arithmetic), but who nevertheless seem to have significant difficulty learning in general. The NOS suffix allows the diagnoser an enormous amount of leeway with regards to the criteria. The marketing and service expansion implications are obvious, and the NOS suffix is used extensively throughout DSM.