Clinical and psychoeducational profile of children with specific learning disability and co-occurring attention-deficit hyperactivity disorder

Background: Almost 10% of school-going children have specific learning disability (SpLD) in the form of dyslexia, dysgraphia and/ or dyscalculia. Attention-deficit hyperactivity disorder (ADHD) occurs as a comorbidity in about 20% of these children. Aims: To document the clinical profile and academic history of children with SpLD and co-occurring ADHD. Settings and Design: Prospective observational study conducted in our clinic. Materials and Methods: From August to November 2004, 50 consecutively diagnosed children (34 boys, 16 girls) were included in the study. SpLD was diagnosed on the basis of psychoeducational testing. Diagnosis of ADHD was made by DSM-IV-revised criteria. Detailed clinical and academic history and physical and neurological examination findings were noted. Statistical Analysis : Chi-square test or unpaired student′s t-test was applied wherever applicable. Results: The mean age of children was 11.4 years (±SD 2.5, range 7-17.1). Fifteen (30%) children had a significant perinatal history, 12 (24%) had delayed walking, 11 (22%) had delayed talking, 5 (10%) had microcephaly, 27 (54%) displayed soft neurological signs and 10 (20%) had primary nocturnal enuresis. There were no differentiating features between the two gender groups. Their academic problems were difficulties in writing (96%), inattentiveness (96%), difficulties in mathematics (74%), hyperactivity (68%) and difficulties in reading (60%). All children had poor school performance, 15 (30%) had already experienced class retention and 20 (40%) had developed aggressive or withdrawn behavior. Conclusion: Children with SpLD and co-occurring ADHD need to be identified at an early age to prevent poor school performance and behavioral problems