Comments on “Specific Learning Disability: Ten Challenges and Ten Recommendations in Current Indian Context”

The article by Tom A et al., ¹ is relevant in the current Indian scenario, with every department of psychiatry in government institutions flooded with students for the specific learning disability (SLD) certification process. It pointed out the lacunae and made suggestions to address them.

In the third challenge, the authors identified the multilingual social context, the scarcity of tools in different languages, and the unique nature of each language. They also pointed out the difficulties experienced when the medium of instruction is switched, which the law misses out on as the board proceeds with the assessment. They recommended developing tools and assessing SLD in the language in which difficulties are experienced.

It is a complex topic and needs extensive discussion. To summarize, the core aspects of SLD are explained with grapheme-phoneme mismatch and variation in the language’s orthography. All the emerging biological evidence indicates that inadequate development of neural substrates related to a particular academic skill leads to a particular SLD. When this is the current focus of research in SLD, the concept of uniform SLD criteria for students of all languages can be questioned. It is well-established that opaque languages, ² such as English and French, are known to exacerbate SLD prevalence. Those having simple grapheme-phoneme connections tend to have less prevalence of SLD. Unfortunately, no epidemiological research has been carried out on this issue, so the focus needs to be shifted to the impact of language on the expression of SLD.

In the fourth challenge identified, they pointed out the lack of human resources availability, especially psychiatrists, psychologists, and special educators. In their recommendation, they support uniform provisions across all educational boards and entrance examinations to facilitate a seamless transition for children with SLD across different boards and institutes. While we agree on increasing the number of qualified professionals, many complex social and linguistic issues cannot be ignored as one pushes for standardization of provisions and tools across boards. The authors are also not specific about educational psychologists’ roles, ³ and the research done by NCERT (National Council for Education and Research), SCERT (State Councils for Education and Research), and various state and central education universities. Further discussion would take us to different domains involving administration, resource allocation, constitutional authority on education, etc. So, it would finally end up in policy matters and reforms in education systems. Standardization appears good from the perspective of system functioning or administration. However, individualized focus on everyone’s abilities is well-established in educational research works worldwide, which is against the all-for-standardized approach. It would be futile to go for a standardized approach across all states of India, considering the plural nature of this country and the variation of SLD based on language orthography.

As they identified the sixth challenge, the authors agreed on the complexity of the issues involved in education, like multiple curriculums, varying standards, and multilingualism interfering with a unified, standardized approach. They expressed concerns about the level of awareness and the possible role of stigma in availing consultations related to SLD. Finally, they recommended proactive approaches for increasing awareness and training of at least one teacher per school in SLD. We understand that the entire approach to SLD has changed in developed countries, and they have started focusing on education system management and remedial measures and less on relying on health systems for support. This is evident from Response-to-Intervention (RTI) models and Multi-Tiered Support Systems (MTSS).

In their identification of the seventh challenge, they mentioned children with borderline intelligence being missed out in the current paradigm of functioning despite being more in need of support, and the authors recommended a task force be assigned the prepare a separate care plan. We wonder about this idea. It is conceptualized because we are all used to categorical approaches and medical concepts of the need for diagnosis to work on. This can be overcome with a dimensional model and a spectrum approach. It would be more useful to adapt the multiple intelligence approach by identifying the strengths and weaknesses of the individual child and providing guidance as per the requirements. The authors’ concern about leaving these children out is justified. When the purpose of classificatory systems is to identify people in need of support and plan on providing support, it is missing for persons with borderline intelligence. ⁴

Misuse and issues related to reservations and accommodations are well pointed out in the subsequent challenges identified. However, as they put forth the recommendations in the eighth and ninth sections, they introduce new concepts like tasking the rehabilitation institute to develop guidelines and proposing a continuum model. In their tenth recommendation, they pitch in for a comprehensive understanding of children’s needs and capabilities, periodic assessment, and adjusting support measures. All these challenges and recommendations are born out of the current Intelligence Quotient (IQ)—achievement discrepancy model,^5–7 of SLD certification and remediations. If we understand this model well, it heavily relies on the wait-to-fail concept, ⁸ and referral to health systems, where outdated and yet-to-be validated tools for IQ assessment, ⁹ and copyright-protected assessment tools are used, as expected to be followed in the Rights of Persons with Disabilities Act (RPwD) 2016. Is it acceptable to allow an individual to fail, after which they are referred to the health system for assessment and certifications, with so many limitations, and later refer them back to academic institutions for remedial measures? These questions were well discussed in developed countries with advanced education systems, and they finally put the onus on teaching inputs and grading up the specialized teaching instructions as per the requirements. ¹⁰ It is understandable to keep the maximum efforts within the education system and get collaborative support from health institutions whenever required. The models developed in a few countries, like RTI and MTSS, would address all the lacunae identified with the RPwD Act and best address the tenth recommendation made. So, it would be appropriate to push for a paradigm shift in the approach to SLD and liaise with education systems to help all children with various levels of disadvantages,and need to remid ourselves this is an 'likely to improve disability'.