Cognitive Clusters in Specific Learning Disorder
- Michele Poletti, PsyD1⇑
- Elisa Carretta, MS2,3
- Laura Bonvicini, MS2,3
- Paolo Giorgi-Rossi, PhD2,3
- 1Child and Adolescent Neuropsychiatry Service, AUSL of Reggio Emilia, Italy
- 2Inter-Institutional Epidemiological Unit, AUSL of Reggio Emilia, Italy
- 3Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
- Michele Poletti, Department of Mental Health and Pathological Addiction, Child Neuropsychiatry Service, AUSL of Reggio Emilia, Via Amendola 2, 42100, Reggio Emilia, Italy. Email: michele.poletti2@ausl.re.it
Abstract
The heterogeneity among children with
learning disabilities still represents a barrier and a challenge in
their conceptualization.
Although a dimensional approach has been gaining
support, the categorical approach is still the most adopted, as in the
recent
fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
The introduction of the single overarching diagnostic category of
specific learning disorder (SLD) could underemphasize
interindividual clinical differences regarding
intracategory cognitive functioning and learning proficiency, according
to
current models of multiple cognitive deficits at
the basis of neurodevelopmental disorders. The characterization of
specific
cognitive profiles associated with an already
manifest SLD could help identify possible early cognitive markers of SLD
risk
and distinct trajectories of atypical cognitive
development leading to SLD. In this perspective, we applied a cluster
analysis
to identify groups of children with a Diagnostic and Statistical Manual–based
diagnosis of SLD with similar cognitive profiles and to describe the
association between clusters and SLD subtypes.
A sample of 205 children with a diagnosis of SLD
were enrolled. Cluster analyses (agglomerative hierarchical and
nonhierarchical
iterative clustering technique) were used
successively on 10 core subtests of the Wechsler Intelligence Scale for Children–Fourth Edition.
The 4-cluster solution was adopted, and external validation found
differences in terms of SLD subtype frequencies and learning
proficiency among clusters. Clinical implications
of these findings are discussed, tracing directions for further studies.