Skip to main content

Advertisement

SpringerLink
Log in

A cross-sectional study to assess the prevalence of DSM-5 specific learning disorders in representative school samples from the second to sixth grade in Brazil

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 05 July 2015

Abstract

Little is known about specific learning disorder (SLD) in low- and middle-income countries (LMICs), and even less from representative school samples in small size cities outside huge urban centers. Few studies addressed the new DSM-5 criteria for SLDs. We investigated the prevalence of DSM-5 SLDs, their comorbidities and correlates in school samples of students from the second to sixth grades living in median cities from four different geographic regions in Brazil. A national test for academic performance covering reading, writing and mathematical abilities was applied. Psychiatric diagnoses were assessed by the K-SADS-PL applied to the primary caregiver. A total of 1618 children and adolescents were included in the study. The following prevalence rates of SLDs were found: 7.6 % for global impairment, 5.4 % for writing, 6.0 % for arithmetic, and 7.5 % for reading impairment. Attention-deficit/hyperactivity disorder (ADHD) was the only comorbidity significantly associated with SLD with global impairment (p = 0.031). Anxiety disorders and ADHD were associated with SLD with arithmetic impairment. Significant differences were detected in prevalence rates among cities, and several socio-demographic correlates (age, gender, IQ, and socioeconomic status) were significantly associated with SLD with global impairment in our sample. Careful validation and normatization of instruments to assess academic performance is a major problem in LMICs. As expected, we found a significant heterogeneity in prevalence rates of SLD according to geographic regions considering that Brazil is a country with a robust diversity. SLD with global and arithmetic impairment was significantly associated with psychiatric comorbidities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Alesi M, Rappo F, Pepi A (2012) Self-esteem at school and self-handicapping in childhood: comparison of groups with learning disabilities. Psychol Rep 111(3):952–962

    Article  PubMed  Google Scholar 

  2. Al-Yagon M, Cavendish W, Cornoldi C, Fawcett AJ, Grünke M, Hung LY, Jiménez JE, Karande S, van Kraayenoord CE, Lucangeli D, Margalit M, Montague M, Sholapurwala R, Sideridis G, Tressoldi PE, Vio C (2013) The proposed changes for DSM-5 for SLD and ADHD: international perspectives–Australia, Germany, Greece, India, Israel, Italy, Spain, Taiwan, United Kingdom, and United States. J Learn Disabil 46(1):58–72

    Article  PubMed  Google Scholar 

  3. Altarac M, Saroha MA (2007) Life time prevalence of learning disability among U.S. children. Pediatrics 119(Suppl):S77–S83

    Article  PubMed  Google Scholar 

  4. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders 4th edn (DSM-IV). APA, Washington, DC

    Google Scholar 

  5. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders 5th edn (DSM-5). APA, Washington, DC

    Google Scholar 

  6. American Psychiatric Association (2013) Specific Learning Disorder Fact Sheet. American Psychiatric Publishing

  7. Associação Brasileira de Pesquisa de Mercado A (2007) Critério de classificação econômica Brasil. Available at: www.abep.org/novo/FileGenerate.ashx?id=250

  8. Atlas do Desenvolvimento Humano (2013) based on 2010 census data. Available at: http://www.atlasbrasil.org.br/2013/

  9. Brasil HH, Bordin IA (2010) Convergent validity of K-SADS-PL by comparison with CBCL in a Portuguese speaking outpatient population. BMC Psychiatry 10:83

    Article  PubMed Central  PubMed  Google Scholar 

  10. Bruckner TA, Scheffler RM, Shen G, Yoon J, Chisholm D, Morris J, Fulton BD, Dal Poz MR, Saxena S (2011) The mental health workforce gap in low- and middle-income countries: a needs-based approach. Bull World Health Organ 89(3):184–194

    Article  PubMed Central  PubMed  Google Scholar 

  11. Capellini SA, Coppede AC, Valle TR (2010) Fine motor function of school-aged children with dyslexia, learning disability and learning difficulties (Função motora fina de escolares com dislexia, distúrbio e dificuldades de aprendizagem). Pró-Fono Revista de Atualização Científica 22(3):201–208

    Article  PubMed  Google Scholar 

  12. Capozzi F, Casini MP, Romani M, De Gennaro L, Nicolais G, Solano L (2008) Psychiatric comorbidity in learning disorder: analysis of family variables. Child Psychiatry Hum Dev 39(1):101–110

    Article  PubMed  Google Scholar 

  13. Del’Homme M, Kim TS, Loo SK, Yang MH, Smalley SL (2006) Familial association and frequency of learning disabilities in ADHD sibling pair families. J Abnorm Child Psychol 35(1):55–62

    Article  PubMed  Google Scholar 

  14. DuPaul GJ, Gormley MJ, Laracy SD (2013) Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment. J Learn Disabil 43–51

  15. DuPaul GJ, Volpe RJ (2009) ADHD and learning disabilities: research findings and clinical implications. Curr Atten Disord Rep 1(4):152–155

    Article  Google Scholar 

  16. Fluss J, Ziegler JC, Warszawski J, Ducot B, Richard G, Billard C (2009) Poor reading in French elementary school: the interplay of cognitive, behavioral, and socioeconomic factors. J Dev Behav Pediatr 3:206–216

    Article  Google Scholar 

  17. Francis DJ, Fletcher JM, Stuebing KK, Lyon GR, Shaywitz BA, Shaywitz SE (2005) Psychometric approaches to the identification of LD: IQ and achievement scores are not sufficient. J Learn Disabil 38(2):98–108

    Article  PubMed  Google Scholar 

  18. Hale J, Alfonso V, Berninger V, Bracken B, Christo C, Clark E, Yalof J (2010) Critical issues in response-to-intervention, comprehensive evaluation, and specific learning disabilities identification and intervention: an expert white paper consensus. Learn Disabil Q 33(3):223–236

    Article  Google Scholar 

  19. Huc-Chabrolle M, Barthez MA, Tripi G, Barthélémy C, Bonnet-Brilhault F (2010) Psychocognitive and psychiatric disorders associated with developmental dyslexia: a clinical and scientific issue. Encephale 36(2):172–179

    Article  CAS  PubMed  Google Scholar 

  20. IBGE. IB de G e E (2013) Cidades@. http://www.ibge.gov.br/cidadesat

  21. IBGE. IB de G e E (2010) Séries historicas e estatísticas. http://seriesestatisticas.ibge.gov.br/series.aspx?no=10&op=0&vcodigo=CD97&t=numero-municipios-censo-demografico-classes-tamanho

  22. Kaufman J et al (1996) Kiddie-sads-present and lifetime version (K-SADS-PL) Version 1.0. http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf

  23. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36(7):980–988

    Article  CAS  PubMed  Google Scholar 

  24. Landerl K, Moll K (2010) Comorbidity of learning disorders: prevalence and familial transmission. J Child Psychol Psychiatry 51(3):287–294

    Article  PubMed  Google Scholar 

  25. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  CAS  PubMed  Google Scholar 

  26. Lyon GR (1996) Learning Disabilities. Future Child 6(1):54–76

    Article  CAS  PubMed  Google Scholar 

  27. Lyon GR, Fletcher JM, Shaywitz SE, Shaywitz BA, Torgesen JK, Wood FB, Schulte A, Olson R (2001) Rethinking learning disabilities. In: Finn CE Jr., Rotherham RAJ, Hokanson CR Jr. (eds). Rethinking special education for a new century. Washington, DC: Thomas B. Fordham Foundation and Progressive Policy Institute, pp 259–287

  28. Mayes SD, Calhoun SL, Crowell EW (2000) Learning disabilities and ADHD: overlapping spectrum disorders. J Learn Disabil 33:417–424

    Article  CAS  PubMed  Google Scholar 

  29. McCann BS, Roy-Byrne P (2000) Attention-deficit/hyperactivity disorder and learning disabilities in adults. Semin Clin Neuropsychiatry 5(3):191–197

    Article  CAS  PubMed  Google Scholar 

  30. McGillivray JA, Baker KL (2009) Effects of comorbid ADHD with learning disabilities on anxiety, depression, and aggression in adults. J Atten Disord 12(6):525–531

    Article  CAS  PubMed  Google Scholar 

  31. Mello CB de, Argollo N, Shayer BPM, Abreu N, Godinho K, Duran P, Vargem F, Muszkat M, Miranda MC, Bueno OFA (2011). Abbreviated version of the WISC-III: correlation between estimated iq and global iq of brazilian children (Versão Abreviada do WISC-III: correlação entre QI estimado e QI total em crianças brasileiras). Psic.: Teor e Pesq 27(2):149–155

  32. Mogasale VV, Patil VD, Patil NM, Mogasale V (2012) Prevalence of specific learning disabilities among primary school children in a South Indian city. Indian J Pediatr 79(3):342–347

    Article  PubMed  Google Scholar 

  33. Ohlweiler L (2006) Transtornos da Aprendizagem. In: Rotta NT, Ohlweiler L, Riesgo RS (eds) Transtornos da Aprendizagem—Abordagem Neurobiológica e Multidisciplinar. Artmed, Porto Alegre, pp 124–130

    Google Scholar 

  34. Oliveira GE, Magalhães LC, Salmela LF (2011) Relationship between very low birth weight, environmental factors, and motor and cognitive development of children of 5 and 6 years old. Rev Bras Fisioter 15(2):138–145

    Article  PubMed  Google Scholar 

  35. Parliamentary Office of Science and Technology Dyslexia and Dyscalculia (2004) Scientific capacity in developing countries. London: Post note, Number 226

  36. Pastor PN, Reuben CA (2002) Attention deficit disorder and learning disability: United States, 1997–98. Vital Health Stat 10(206):1–12

    Google Scholar 

  37. Pastor PN, Reuben CA (2008) Diagnosed attention deficit hyperactivity disorder and learning disability: United States, 2004–2006. Vital Health Stat 10(237):1–14

    Google Scholar 

  38. Paula CS, Bordin IAS, Mari JJ, Rohde LA, Velasque L, Coutinho ESF (2014) The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions. PLoS One 9:e88241

    Article  PubMed Central  PubMed  Google Scholar 

  39. Presidência da Republica do Brasil (1996) Diretrizes e Bases da Educação. Lei no 9.394, de 20 de dezembro de 1996. http://www.planalto.gov.br/ccivil_03/leis/l9394.htm

  40. Prova Brasil 2011, Inep. Dados do Ideb/Inep (2013). www.QEdu.org.br

  41. Rock EE, Fessler MA, Church RP (1997) The concomitance of learning disabilities and emotional/behavioral disorders: a conceptual model. J Learn Disabil 30(3):245–263

    Article  CAS  PubMed  Google Scholar 

  42. Rodriguez A, Järvelin MR, Obel C, Taanila A, Miettunen J, Moilanen I, Henriksen T, Pietiläinen K, Ebeling H, Kotimaa A (2007) Do inattention and hyperactivity symptoms equal scholastic impairment? Evidence from three European cohorts. BMC Public Health 7:327

    Article  PubMed Central  PubMed  Google Scholar 

  43. Rutter M, Caspi A, Fergusson D, Horwood LJ, Goodman R, Maughan B, Moffitt TE, Meltzer H, Carroll J (2004) Sex differences in developmental reading disability: new findings from four epidemiological studies. JAMA 291(16):2007–2012

    Article  CAS  PubMed  Google Scholar 

  44. Sanson A, Prior M, Smart D (1996) Reading disabilities with and without behaviour problems at 7–8 years: prediction from longitudinal data from infancy to 6 years. J Child Psychol Psychiatry 37(5):529–541

    Article  CAS  PubMed  Google Scholar 

  45. Sexton CC, Gelhorn HL, Bell JA, Classi PM (2012) The Co-ocurrence of Reading Disorder and ADHD: epidemiology, treatment, psychosocial impact, and economic burden. J Learn Disabil 45(6):538–564

    Article  PubMed  Google Scholar 

  46. Scerri TS, Schulte-Körne G (2010) Genetics of developmental dyslexia. Eur Child Adolesc Psychiatry 19(3):179–197

    Article  PubMed  Google Scholar 

  47. Shalev RS, Auerbach J, Manor O, Gross-Tsur V (2000) Developmental dyscalculia: prevalence and prognosis. Eur Child Adolesc Psychiatry 9:58–64

    Article  Google Scholar 

  48. Silverstein AB (1985) Two-and four-subtest short forms of the WAIS-R: a closer look at validity and reliability. J Clin Psychol 41(1):95–97

    Article  CAS  PubMed  Google Scholar 

  49. Silverstein AB (1990) Short forms of individual intelligence tests. Psychol Assess 2(1):3–11

    Article  Google Scholar 

  50. Spencer T, Biederman J, Wilens T (1999) Attention-deficit/hyperactivity disorder an comorbidity. Pediatr Clin N Am 46(5):915–927

    Article  CAS  Google Scholar 

  51. Stein LM (1994) TDE: Teste de Desempenho Escolar—Manual para aplicação e interpretação. Casa do Psicólogo, São Paulo

    Google Scholar 

  52. Stough LM, Aguirre-Roy AR (1997) Learning disabilities in Costa Rica: challenges for an “army of teachers”. J Learn Disabil 30(5):566–571

    Article  CAS  PubMed  Google Scholar 

  53. Taanila A, Yliherva A, Kaakinen M, Moilanen A, Ebeling H (2011) An epidemiological study on Finnish school-aged children with learning difficulties and behavioural problems. International Journal of Circumpolar Health 70(1):59–71

    Article  PubMed  Google Scholar 

  54. Tannock R (2012) Rethinking ADHD and LD in DSM-5: proposed changes in diagnostic criteria. J Learn Disabil 46(1):5–25

    Article  PubMed  Google Scholar 

  55. Veenstraa R, Lindenbergb S, Oldehinkelc AJ, Winterc AFDe, Verhulstd FC, Ormelc J (2008) Prosocial and antisocial behavior in preadolescence: teachers’ and parents’ perceptions of the behavior of girls and boys. Int J Behav Dev 32(3):243–251

    Article  Google Scholar 

  56. Von Aster MG, Shalev RS (2007) Number development and developmental dyscalculia. Dev Med Child Neurol 49:868–873

    Article  Google Scholar 

  57. Wechsler D (1991) Wechsler Intelligence Scale for Children—Third Edition (WISC-III); Figueiredo VLM (2002) Adaptação e Padronização de uma amostra Brasileira—Primeira Edição—São Paulo: Casa do Psicólogo

  58. Whitsell LJ (1969) Learning disorders as a school health problem—neurological and psychiatric aspects. Calif Med 111(6):433–445 (791)

    PubMed Central  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by a grant from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil), number 573974/2008-0 and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), number 2008/57896-8. JJM is an I-A level Researcher from the National Research Council (CNPq). CSP is a Researcher from the CNPq (level 2).

Conflict of interest

Dr. Luis Augusto Rohde has been a member of the speakers’ bureau/advisory board and/or acted as a consultant for Eli-Lilly, Janssen-Cilag, Novartis and Shire in the last 3 years. He receives authorship royalties from Oxford Press and ArtMed. He has also received travel awards from Shire for his participation of the 2014 APA meeting. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last three years: Eli-Lilly, Janssen-Cilag, Novartis, and Shire.

Author information

Authors and Affiliations

  1. National Institute of Developmental Psychiatry for Children and Adolescents, Porto Alegre, Brazil

    Isabela S. Fortes & Luis A. Rohde

  2. Graduate Program in Psychiatry, Universidade de São Paulo, São Paulo, São Paulo, Brazil

    Isabela S. Fortes & Luis A. Rohde

  3. Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Luis A. Rohde

  4. Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, São Paulo, Brazil

    Cristiane S. Paula

  5. Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

    Cristiane S. Paula, Isabel A. Bordin & Jair de Jesus Mari

  6. Instituto de Matemática e Estatística, Universidade de São Paulo, São Paulo, São Paulo, Brazil

    Melaine C. Oliveira

  7. ADHD Outpatient Program (ProDAH) at the Child and Adolescent Psychiatric Division, Hospital de Clínicas de Porto Alegre, Ramiro Barcellos, 2350, 90035-003, Porto Alegre, RS, Brazil

    Luis A. Rohde

Authors
  1. Isabela S. Fortes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristiane S. Paula
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Melaine C. Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Isabel A. Bordin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jair de Jesus Mari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Luis A. Rohde
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Isabela S. Fortes.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fortes, I.S., Paula, C.S., Oliveira, M.C. et al. A cross-sectional study to assess the prevalence of DSM-5 specific learning disorders in representative school samples from the second to sixth grade in Brazil. Eur Child Adolesc Psychiatry 25, 195–207 (2016). https://doi.org/10.1007/s00787-015-0708-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-015-0708-2

Keywords

Search

Navigation