| Potential significance | |
| History of the learning problem | |
| When did the family first notice learning problems in the child? Is the child learning successfully now or still struggling? | Persistent learning problems over time are more highly associated with LD than a learning problem of recent onset; LD can first manifest at any time throughout the primary and elementary school years but usually manifests in the primary school years |
| What helps the child learn more successfully (eg, small group instruction; 1:1 instruction, etc)? | Greater success in small groups as opposed to the general classroom may be related to LD or may be related to other factors such as a language disorder or weak executive skills |
| School performance | |
| What are the child's grades? | Past or current poor academic achievement is a significant risk factor for LD |
| Can the child complete homework independently? | Inability to complete homework independently, especially after grade one, can indicate LD |
| Did the child receive any early intervention or special education services? | Past early intervention or special education services are a significant risk factor for LD, regardless of the type of service that was offered and regardless of whether the child was found to be no longer eligible for services |
| Did the child's teachers provide any indication that they were concerned about the child's educational progress? | Not all teachers can identify LD specifically, and not all teachers have access to a student support team to facilitate identification of LD; however, teacher observations of learning failure is a sensitive indicator of LD |
| Past grade retention | Past grade retention is a significant risk factor for LD |
| School attendance | |
| Does the child attend school regularly, now and in the past? | Past school absences have a significant impact upon learning success and can mimic LD or be due to LD |
| Does the child have a history of school avoidance? | School avoidance may be due to perceived lack of competence because of LD and may also lead to school absences, aggravating learning problems |
| Current psychiatric or behavioral conditions | |
| Mental health conditions often occur with LD and are a risk factor for LD | |
| Ability to focus and sustain attention to complete tasks of the daily routine; participate in social activities; and/or complete homework independently | Symptoms of inattention are associated with attention deficit hyperactivity disorder, which is highly comorbid with LD; LD can also cause inattention during academic tasks |
| Capacity to regulate anxiety (eg, separation anxiety when leaving the home to go to school or elsewhere); other symptoms of anxiety | Symptoms of anxiety are a risk factor for LD, either as a comorbid condition or as a result of LD |
| Capacity for managing frustration (waiting his/her turn in a game; capacity to self-soothe when angry) | Symptoms of difficulty regulating anger are a risk factor for behavior disorders, which are highly comorbid with LD; low frustration tolerance for school activities specifically is a significant risk factor for LD |
| Medical history | |
| Prenatal health problems; prenatal exposure to medications, toxins (alcohol, nicotine, etc), or infection | Past neurologic insults are a risk factor for learning problems in general and for LD |
| Perinatal course and complications | Perinatal complications are a risk factor for learning problems in general and for LD |
| Gestational age; birth weight | Prematurity is a risk factor for learning problems in general and for LD |
| Past illnesses, especially affecting the CNS | Past neurologic insults are a risk factor for learning problems in general and for LD |
| Past lead exposure | Lead exposure is associated with lower cognitive potential |
| Past or current medications | Medications may interfere with CNS functioning and may be associated with learning failure |
| Current neurologic symptoms to suggest seizures | Seizures can interfere with learning |
| Current sleeping habits | Poor sleeping habits may interfere with learning success |
| Developmental history | |
| Age-appropriate attainment of gross motor skills | Motor problems are related to cerebral palsy and other neurologic conditions, which are comorbid with learning failure in general and may be associated with LD |
| Age-appropriate attainment of language skills | Language problems are highly comorbid with LD |
| Age-appropriate attainment of adaptive skills such as personal care, toileting | Age-appropriate attainment of adaptive skills requires general cognitive skills, as well as attention regulation skills; poor adaptive function may be associated with learning failure and with LD |
| Attainment of social and play skills (ability to play successfully with same-age peers without parent supervision; capacity for friendships) | Social skills may be delayed as a primary problem (eg, autism spectrum disorder) or may be due to perceived lack of self-confidence due to LD |
| Able to participate in community activities such as sports teams or other recreational activities | Motor, adaptive, and social skills are required for success in community activities; LD is associated with lower success in these areas |
| Family history | |
| Do any first- or second-degree relatives have learning problems? | LD is often inherited |
| Do any first- or second-degree relatives have mental health or developmental conditions such as anxiety, depression, attention problems, learning problems, etc? | Mental health conditions often occur with LD and are a risk factor for LD |
| What are the parents' or family's current reading habits? | The history of current reading habits can serve as a proxy for an unidentified reading disability |
| How far did the parents take their education? | Poor educational achievement is related to LD |
| Social history | |
| Current parent employment status | Current parental employment status may be related to the parents' success at school and maybe an indicator of LD |
| Past abuse or neglect | Past abuse or neglect is a significant risk factor for poor educational achievement in general and may be related to LD, regardless of current social status |
| Past or current homelessness | Past homelessness is a significant risk factor for poor educational achievement in general and may be related to LD, regardless of current living circumstances |
| Past or current parental illnesses in family members | Past illnesses in the family is a risk factor for poor educational achievement, for both social and heritable reasons |
