skills is well below average for age, or acceptable performance levels are achieved only with
extraordinary effort. Specific learning disorder may occur in individuals identified as intellec-
tually gifted and manifest only when the le arning demands or assessment procedures (e.g.,
timed tests) pose barriers that cannot be overcome by their innate intelligence and c ompensa-
tory strategies. For all individuals, specific le arning disorder can produce lifelong impairments
in activities dependent on the skills , including occupational performance.
The use of specifiers for the neurodevelopme ntal disorder diagnoses enriches the clin-
ical description of the individual’s clinical  course and current symptomatology. In addi-
tion to specifiers that describe the clinical presentation, such as age at onset or severity
ratings, the neurodevelopmental disorders ma y include the specifier “associated with a
known medical or genetic condition or environmental factor.” This specifier gives clini-