Differential Diagnosis
Normal variations in academic attainment. Specific learning disorder is distinguished
from normal variations in academic attainment due to external factors (e.g., lack of edu-
cational opportunity, consistently poor instru ction, learning in a second language), be-
cause the learning difficulties persist in the presence of adequate educational opportunity
and exposure to the same instruction as the p eer group, and competency in the language of
instruction, even when it is different  from one’s primary spoken language.
Intellectual disability (intelle ctual developmental disorder). Specific learning disorder
differs from general learning difficulties assoc iated with intellectual  disability, because the
learning difficulties occur in the presence of normal levels of intellectual functioning (i.e.,
IQ score of at least 70 ± 5). If intellectual disa bility is present, specific learning disorder can
be diagnosed only when the learning difficult ies are in excess of those usually associated
with the intellectual disability.
Learning difficulties due to neurological or sensory disorders. Specific learning dis-
order is distinguished from lear ning difficulties due to neurological or sensory disorders
(e.g., pediatric stroke, traumatic brain injury , hearing impairment, vi sion impairment), be-
cause in these cases there are abnormal findings on neurological examination.
Neurocognitive disorders. Specific learning disorder is distinguished from learning
problems associated with neurodegenerative cognitive disorders, because in specific
learning disorder the clinical expression of specific learning difficulties occurs during the
developmental period, and the difficulties do not manifest as a mark ed decline from a for-
mer state.