Specific Learning Disorder 73
slow but accurate reading. In English-language learners, assessment should include con-
sideration of whether the source of reading difficulties is a limited proficiency with Eng-
lish or a specific learning disorder. Risk fact ors for specific learning  disorder in English-
language learners include a family history of specific learning disorder or language delay
in the native language, as well as learning difficulties in English and failure to catch up
with peers. If there is suspicio n of cultural or language differences (e.g., as in an English-
language learner), the assessment needs to ta ke into account the individual’s language
proficiency in his or her first or native lang uage as well as in the second language (in this
example, English). Also, assessment should co nsider the linguistic and cultural context in
which the individual is living, as well as his or  her educational and learning history in the
original culture and language.
Gender-Related Diagnostic Issues
Specific learning disorder is more common in males than in fema les (ratios range from
about 2:1 to 3:1) and cannot be attributed to factors such as ascertainment bias, definitional
or measurement variation, language , race, or socioeconomic status.
Functional Consequences of
Specific Learning Disorder
Specific learning disorder can have negative functional consequences across the lifespan,
including lower academic attainment, higher ra tes of high school dropout, lower rates of
postsecondary education, high levels of psyc hological distress and poorer overall mental
health, higher rates of unemployment and under-employment, and lower incomes. School
dropout and co-occurring depressive symptoms increase the risk for poor mental health
outcomes, including suicidality, whereas high levels of social or emotional support predict
better mental health outcomes.
Differential Diagnosis
Normal variations in academic attainment. Specific learning disorder is distinguished