Specific Learning Disability - Impairment in Written Expression in Children and Adolescents


ICD-10 code: F81.81

Specific Learning Disorder, Impairment in Written Expression is part of a cluster of diagnoses called Specific Learning Disorders. Specific Learning Disorders are a group of psychiatric conditions that include:

  • Impairment in Reading
  • Impairment in Written Expression
  • Impairment in Mathematics

These disorders are categorized by a persistent difficulty learning keystone academic sills with an onset during the years of formal schooling. Key academic skills include reading of single words accurately and fluently, reading comprehension, written expression and spelling, arithmetic calculation, and mathematical reasoning. Difficulties learning to map letters with the sound of one’s language- to read printed words- is one of the most common manifestations of specific learning disorder. Children and adolescents with specific learning disorder experience a persistent, or restricted progress in learning for at least six months despite intervention. The learning difficulties are usually readily apparent in the early school years in most children.

Children and adolescents with Specific Learning Disorders also perform well below average for their age, and average achievement is only attained through extraordinarily high levels of effort or support. The low academic skills cause significant interference with school skills that is usually indicated by school report or teacher’s grades. These learning difficulties are considered “specific” for four reasons: (1) they are not attributable to an intellectual disability; (2) the difficulty cannot be attributed to external factors such as economic or environmental disadvantage, chronic absenteeism, or lack of education in the individual’s community context; (3) it cannot be attributed to a neurological or motor disorder and (4) the difficulty must be restricted to one academic skill or domain (i.e., reading single words, retrieving or calculating number facts).

Note that Dysgraphia is a general term used to describe difficulty in written expression. If dysgraphia is used to specify this particular pattern of difficulties, it is important to specify what difficulties are present.

What is Specific Learning Disorder, Impairment in Written Expression?

Approximately 5-5% of individuals in the general population have a learning disorder. The prevalence of writing impairments is not widely known. Research estimates place the prevalence of writing impairments in elementary schools ranging between 3-5%.

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Understanding Impairment in Written Expression

Impairments in writing severity can range from mild to severe.  In severe cases, writing disorders can impact several academic domains so that the individual is unlikely to learn those skills without ongoing intensive individualized and specialized teaching for most of the school years

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How is Impairment in Written Expression treated?

Impairments in written expression are treatable using a targeted, individualized intervention. The intervention is uniquely tailored to remedy the child’s weaknesses in a targeted area of writing (e.g., spelling, grammar and punctuation, clarity or organization of written expression).

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