Specific Learning Disorder (SLD) Assessments

What is a specific learning disorder?

Imagine a young person who has trouble with spelling. One explanation could be that this person finds learning hard in general. This could be for a range of reasons, like having trouble with their eyesight, having constant anxious thoughts or a depressed mood or missing time off school due to illness. The fact that spelling is hard is just one outcome of this. But what if it is just spelling that is difficult, and none of those big factors have been around in the young person’s life?

A specific learning disorder is a brain-based disorder, where the way the brain is wired leads to persistent difficulties with the thinking skills needed to learn and apply information in  important academic areas (e.g., reading, writing, maths, etc.). Specific Learning Disorders are specific in a couple of ways:

  • The is no better ‘general’ reason for why the young person is struggling in this area
    Some of these we’ve already pointed out, like vision or hearing problems.  Another example is cognitive (or thinking) ability. If a person’s ability to take in information, process it and do something with it is very low, this might be a better explanation for why they are struggling in this particular area of learning.

  • There are no major forces outside of the young person (i.e., external factors) that would make learning in this specific area(s) hard
    Not going to school for 2 years, during the time when everyone else was learning spelling, would be one example. In a way, some people might think COVID-19 and the impact on teaching and learning fits in here. However, an important part of a specific learning disorder is that it is persistent. If the child struggled in this area before COVID-19 lockdowns and/or continues to be behind or fall further behind after returning to school and getting targeted support, that’s when we might be seeing evidence of a specific learning disorder.

  • The learning difficulty is normally (but not always) specific to one academic skill or area
    In the Diagnostic and Statistical Manual 5th Edition (Text Revision; DSM-V-TR), specific learning disorders are defined by the broad area of learning (e.g., reading) and the specific skill or skills in that area which the person is performing below in, compared to their peers:

Reading

  • Reading words accurately

  • Reading fluently

  • Understanding what is read (i.e., comprehension)

Writing

  • Spelling accurately

  • Using grammar and punctuation accurately

  • Writing in a clear and/or organised way 

Maths

  • Number sense

  • Memorisation of maths facts

  • Doing calculations fluently and accurately

  • Mathematical problem solving (i.e., reasoning)

Please note: the word ‘Dyslexia’ is another term for someone who has trouble reading words accurately and fluently as well as with spelling. The problem with labels like this is that it can make it sound like a person can’t find any other areas of learning difficult. That’s why it's better to define a specific learning disorder by the exact areas that a person has trouble with. 

What does the assessment involve?

There is no test for a specific learning disorder. A good clinician will collect information from different sources, compare and contrast it, and make a decision about whether the person’s learning difficulty fits with the criteria for a diagnosis.

The information we might need to explore:

Important parts of the young person’s background (i.e., history)
This can include areas like:

  • Development - e.g., pregnancy and birth, walking and talking milestones, etc.

  • Medical - e.g., long hospital stays, vision or hearing testing, etc.

  • Family - Family members with a history of mental health, learning difficulties, etc.

  • Educational - Schools attended, grades completed / repeated, etc.

Evidence of the learning difficulty
It’s helpful to know:

  • When the learning difficulty was first noticed

  • The extent of the learning difficulty
    e.g., is the young person 12 months behind others their age? How did they go on NAPLAN? What other subjects need, for example, organised and structured writing and how do they go in that subject?

  • Whether the learning difficulty has been persistent
    e.g., the young person is still having difficulty despite having extra tutoring outside of school or having spent time in a small-group intervention program

  • What behaviours important people have noticed
    e.g., does the young person avoid reading? Do they get all of their maths homework done but only if a parent is providing lots of support?

Comparisons between your young person and other learners their age
Specific assessment tools can help us see where your young person’s academic and thinking skills are sitting.

The reason these tools are useful is because they are often:

  • Standardised: Everyone does the assessment in the same way, so its easier to compare scores between different young people

  • Norm- or criterion-referenced: These refer to who or what we’re comparing your young person’s ability and achievement to. Norm-referenced means making comparison to the ‘average’ score of similar young people, while criterion-referenced is about comparing what your young person can do to a set standard or list (think: school reports or NAPLAN and the idea of ‘at standard’)

The ways we might explore this information:

  • Interview with parents (sometimes called a development history intake)

  • Previous school reports

  • Interview with current teacher(s)

Achievement testing

  • e.g., Wechsler Individual Achievement Test 3rd edition [WIAT-III]

  • Cognitive ability assessment
    e.g., Wechsler Intelligence Scale for Children 5th Edition [WISC-V]
    Please note that a cognitive ability assessment is not a formal requirement for diagnosing a specific learning disorder, but it can provide useful information. Your clinician will discuss whether or not it will be helpful in the case of your young person


Assessments in specific academic areas or abilities

  • e.g., Comprehensive Test of Phonological Processing 2nd Edition [CTOPP-2]
    Phonological awareness is what we use to take in and make sense of the patterns of sounds in words. If reading is an area your young person finds difficult, your clinician may work with them on certain items that capture phonological awareness

Why is it important?

  • This information is helpful for ruling out those factors that can make learning generally more difficult. If there is no evidence of these reported by important people like parents, we can be more confident that the learning disorder is specific.

  • There are also common - although not universal - things that tend to come up in the lives of people with specific learning disorders. For example, genetics plays a role in the development of learning difficulties so we can sometimes find a history of other family members who have struggled with the same or similar area of learning.

Evidence of the learning difficulty

  • This helps us understand the extent of the difficulty. The more information we have, the more we can understand what your young person does - and doesn’t - find difficult when it comes to learning.

Comparisons between your young person and other learners their age

  • Schools do lots of high-quality assessment to understand where a young person’s knowledge is sitting. But even though they work towards the same standards (e.g., the national curriculum), the way they assess it can be different from school to school. 

  • Standardised tools are not perfect, but they are often an accurate and reliable way of saying “This is where your child’s learning is currently at in this area”

What will - and won’t - the assessment tell us?

What this assessment will tell us:

A specific breakdown of academic areas of need

Particularly as young people move through primary school and into high school, it can be harder and harder for teachers to identify the specific learning challenges faced by an individual student beyond, for example, “difficulty with reading”. By exploring different aspects of these main areas, this assessment should provide a deeper understanding of the specific areas of need - whether a diagnosis of specific learning disorder is made or not.

Suggestions for evidence-based supports
As more and more research goes into specific learning disorders, we are learning more about the underlying brain-based abilities that a young person has trouble with. This means companies and organisations are continuing to develop high-quality programs and interventions - online, classroom-, or home-based - that target these abilities and skills. 

What this assessment won’t tell us:

What might happen to your child’s difficulties if they had targeted support
The idea of a ‘persistent’ difficulty in learning and using a particular academic skill is a key part of a specific learning disorder diagnosis. While the definition for what the ‘support’ needs to look vary, if there is no evidence of extra support at home or school over a 6-month period then no diagnosis will be made.
This will be discussed with you early in the assessment process, but still keep in mind that ‘further assessment following intervention’ may be a recommendation.

A list of things teachers / schools MUST do
Providing recommendations for how to support and overcome any challenges is a key reason why we do these assessments. However, we aren’t the people on the ground who are putting those recommendations into action. All teachers and schools will be working hard to support every young person - with or without a diagnosis - but it is possible that they can’t do everything we suggest. We can advocate for our recommendations through a teacher feedback session, but ultimately you and the young people have to work closely with the school to make sure your child’s learning needs are met and understood.

How much will it cost?

Clinical Assessments with reports and feedback meetings can range from $900 - $2200 including GST.

The specific cost depends on exactly what needs to happen in each specific assessment. For example, the following play a role in how much an assessment costs:

  • The time it takes to complete the ‘typical’ activities and tasks
    E.g., most cognitive assessments with young people take place over a 2-hour session but issues – positive and negative – can come up that mean it takes longer.

  • Additional testing or tools that need to be used, following the results of earlier assessment

  • How complex the information provided is to pull together and report on.

As noted on our fees page, we will provide an individual fee schedule for each assessment. The costs outlined here are determined by:

  • The clinician’s hourly rate

  • The cost of the certified assessment form/s ($5-25 each)

  • The time required to

    • administer the assessment/s

    • score the assessment/s

    • evaluate the results

    • produce a report

meet with the client/parents and/or teacher to discuss the results and recommendations.