Feature | Clinical implications |
Perinatal history |
Maternal drug or alcohol intake | May cause neurologic problems (eg, fetal alcohol spectrum disorder) |
Congenital infections | May cause neurologic or hearing problems |
Gestational age, birth weight | Premature birth is a risk for learning disability |
Medical history |
Recurrent or persistent ear infections | May be associated with hearing impairment |
Iron deficiency | Associated with neurologic deficits |
Lead poisoning | Associated with neurologic deficits and hearing impairment |
Seizures | May be associated with neurologic problems |
Frequent injuries | May indicate coordination difficulties, history of closed head injury, poor supervision, and/or environmental deprivation |
Chronic illness or medication usage | May be associated with side effects or school absences with secondary effects on learning |
Developmental history |
Delayed or disordered acquisition of language milestones and communication skills | Language delay is a risk for reading difficulty |
Uneven pattern of skills and interests | May indicate learning disability |
Behavioral history |
Problems with attention, impulsivity, overactivity, acting out | Behavioral problems may affect learning |
Sadness | Emotional problems may affect learning |
Poor self-esteem | May be a consequence of reading difficulty |
Social history |
Child abuse or neglect, or other social stressors (eg, homelessness, poverty, illness in family member) | These stressors may affect learning |
Family history |
Learning problems, reading or spelling problems, avoidance of reading, school failure among first-degree relatives | Increases risk of reading disability |
School history |
Academic achievement |
Best and worst subjects | Children with reading disability may excel in other areas or areas of interest (eg, math, science) |
History of grade retention | |
Classroom behavior |
Long-standing problems with attention, impulsivity, overactivity | Reading disability is associated with attention deficit hyperactivity disorder, which can further interfere with school function |
Depression, moodiness | Emotional problems may affect learning |
Behavior differs in reading versus other subjects | Children with reading difficulty may "act out" during activities that require reading |
Attendance |
Excessive absenteeism | Frequent absences may affect learning |
School avoidance | Children with reading difficulty may try to avoid school |
Past psychoeducational testing |
Discrepancy between cognitive abilities and academic achievement | Suggestive of a learning disability |
Special educational services |
Response to educational interventions | Lack of response suggests a learning disability rather than lack of exposure to reading and or inadequate instruction before formal schooling |