Brandenburg Janin, Huschka Sina S, Visser Linda, Hasselhorn Marcus
Leibniz Institute for Research and Information in Education (DIPF), Frankfurt, Germany.
Individual Development and Adaptive Education, Frankfurt, Germany.
Front Psychol. 2021 Oct 25;12:725374. doi: 10.3389/fpsyg.2021.725374. eCollection 2021.
DSM-5 presented a revised conceptualization of specific learning disorders (LD). Contrary to former versions, the various types of LD-i.e., mathematics disorder, reading disorder, and writing disorder-are not treated as distinct diagnostic entities but are integrated into one single LD category. In support of this new classification, it has been argued that the various types of LD overlap to a great extent in their cognitive functioning profiles and therefore do not exhibit a distinct set of cognitive causes. In contrast, ICD-11 still adheres to the idea of discrete categories and thus follows the specificity hypothesis of LD. Using latent profile analysis (LPA), we therefore tested the specificity of cognitive strengths and weaknesses in children with different types of LD. Secondly, we aimed at examining the extent to which observed LD characteristics (type and severity of LD as well as IQ-achievement discrepancy) were consistent with the membership of a given latent profile. 302 German third-graders (134 girls; IQ ≥ 85; = 111.05 months; = 5.76) with single or comorbid types of LD in the domains of mathematics, reading, and spelling completed a wide range of domain-specific and domain-general cognitive functioning measures. Five qualitative distinct profiles of cognitive strengths and weaknesses were identified. Profile 1 (23% of the sample) showed Comprehensive Cognitive Deficits, performing low in all measures except for naming speed, language, and inhibition. Profile 2 (21%) included children with a Double Deficit in Phonological Awareness and Phonological Short-term Memory. Profile 3 (20%) was characterized by a Double Deficit of Phonological Awareness and Naming Speed. Profile 4 (19%) included children with a Single Deficit in Attention, and profile 5 (17%) consisted of children without any cognitive deficits. Moreover, type and severity of LD as well as IQ-achievement discrepancy discriminated between the profiles, which is in line with the specificity hypothesis of LD. Overall, the finding of specific associations between the LD types and the identified cognitive profiles supports the ICD-11 classification of LD. Yet, those inferences may not be valid for an individual child but need to be examined through comprehensive diagnostic.
《精神疾病诊断与统计手册》第五版（DSM - 5）提出了特定学习障碍（LD）的修订概念。与以前的版本不同，各种类型的学习障碍，即数学障碍、阅读障碍和书写障碍，不再被视为不同的诊断实体，而是被整合到一个单一的学习障碍类别中。支持这种新分类的观点认为，各种类型的学习障碍在认知功能特征上有很大程度的重叠，因此不存在一组独特的认知原因。相比之下，《国际疾病分类》第11版（ICD - 11）仍然坚持离散类别的观点，因此遵循学习障碍的特异性假设。因此，我们使用潜在剖面分析（LPA）来测试不同类型学习障碍儿童认知优势和劣势的特异性。其次，我们旨在研究观察到的学习障碍特征（学习障碍的类型和严重程度以及智商与成绩差异）与给定潜在剖面成员资格的一致程度。302名德国三年级学生（134名女生；智商≥85；平均年龄 = 111.05个月；标准差 = 5.76）在数学、阅读和拼写领域患有单一或共病类型的学习障碍，他们完成了一系列特定领域和一般领域的认知功能测量。确定了五种在认知优势和劣势方面性质不同的剖面。剖面1（占样本的23%）表现出全面的认知缺陷，除了命名速度、语言和抑制能力外，在所有测量中得分都很低。剖面2（21%）包括在语音意识和语音短期记忆方面存在双重缺陷的儿童。剖面3（20%）的特征是语音意识和命名速度双重缺陷。剖面4（19%）包括注意力单一缺陷的儿童，剖面5（17%）由没有任何认知缺陷的儿童组成。此外，学习障碍的类型和严重程度以及智商与成绩差异在各剖面之间存在差异，这与学习障碍的特异性假设一致。总体而言，学习障碍类型与确定的认知剖面之间存在特定关联的发现支持了ICD - 11对学习障碍的分类。然而，这些推断可能对个别儿童无效，需要通过全面诊断进行检查。
