Difficulties in learning to read, write or do mathematics are referred to as "specific" disturbances since they occur in the absence of deficits in general cognitive skills (intelligence) and neurological disorders, and in spite of regular attendance to school activities. However, focusing on the specificity of these deficits neglects the presence of widespread co-morbidities among learning disturbances as well as with other developmental disturbances.
Co-morbidity represents a key issue both theoretically and clinically in the evaluation of developmental disorders. From a theoretical standpoint, it seems clear that a complex pattern of cognitive patterns can be associated to a variable pattern of co-morbidities spanning across both learning disorders and other key developmental disorders. Current cognitive models focus on a single deficit approach thereby failing to account for the partial overlap among developmental deficits. From a clinical standpoint, to draw a diagnostic profile of children, it becomes crucial to exploit the full profile of cognitive strengths and weaknesses of the child. Information on typical patterns of co-morbidities is therefore crucial to plan a diagnostic evaluation and, following, to plan individually tailored rehabilitation interventions.
In the present project, we aim to develop a proximal model of the factors which would jointly account for reading, writing and doing mathematics. To this aim, we plan to examine these behaviors in an unselected group of Italian children attending fifth grade and test them with a large set of possible cognitive predictors. This will allow to establish the best models to predict unique and shared portions of variance across reading, writing and doing mathematics.
Co-morbidity among learning disturbances and with other developmental disorders represents a key issue both theoretically and clinically. Thus, a more in-depth understanding of these phenomena is likely to have important repercussions.
From a clinical standpoint, evaluation of co-morbidities represents a key reference to the extent in which there is reason to believe that children with putatively pure syndromes are much more the exception than the rule. As stated in the project, although current consensus documents from the Superior Institute of Health emphasize this problem, we still know very little about the incidence and of co-morbidities of developmental disorders among Italian children. The availability of such information will have a direct and profound impact on the clinical assessment of children with learning and other developmental disorders. Associated to this is the possibility to develop and test tailored programs of treatments. Two of such trainings will be tested as a part of the present project.
From a theoretical standpoint, it has been emphasized that basing the analysis of learning disabilities on ¿deterministic, single deficit models¿ (Pennington, 2006) fails to account for the variety of cognitive profiles encountered among children with learning disorders. In this perspective, it becomes crucial to develop models which attempt to account not only for the presence of isolated learning disorders but also for their frequent, but partial, overlap. The present project goes along this line of research, in particular by developing a proximal model of the reading, writing and calculation disturbances. We propose that the scientific breadth of such approach can be particularly meaningful in fostering our understanding of developmental disorders. Also, placing the cognitive analysis of learning within the co-morbidity perspective may allow a closer coupling between cognitive and imaging (for a recent imaging study in this perspective see Danelli, et al., 2017).