Specific Learning Disorder 71
mathematics. However, precursors such as la nguage delays or defi cits, difficulties in
rhyming or counting, or difficulties with fine motor skills required  for writing commonly
occur in early childhood before the start of formal schooling. Manifestations may be be-
havioral (e.g., a reluctance to engage in le arning; oppositional beha vior). Specific learning
disorder is lifelong, but the course and clinical expression are variable, in part depending
on the interactions among the task demands of  the environment, the range and severity of
the individual’s learning difficulties, the indi vidual’s learning abilities, comorbidity, and
the available support systems and intervention . Nonetheless, problems with reading flu-
ency and comprehension, spelling, written expr ession, and numeracy sk ills in everyday life
typically persist into adulthood.
Changes in manifestation of symptoms occur with age, so that an individual may have
a persistent or shifting array of learning difficulties across the lifespan.
Examples of symptoms that may be observed among preschool-age children include a lack
of interest in playing games with language s ounds (e.g., repetition, rhyming), and they may
have trouble learning nursery rhymes. Preschool children with sp ecific learning disorder may
frequently use baby talk, mispronounce words,  and have trouble remembering names of let-
ters, numbers, or days of the week. They may fa il to recognize letters in their own names and
have trouble learning to count. Kindergarten-age children with specific learning disorder may
be unable to recognize and write letters, may be unable to write their own names, or may use
invented spelling. They may have trouble brea king down spoken words into syllables (e.g.,