“Specific Learning Disorder:” The Case Against Labeling

How a learning disorder diagnosis can become a self-fulfilling prophesy.

By Peter Gray Ph.D.  Freedom to Learn

Source:Randen_pederson_creative_commons

Many years ago, Robert Rosenthal and Lenore Jacobson (1968) performed a fascinating experiment in elementary school classrooms. They led teachers to believe that a special test had revealed that certain students would show a spurt in intellectual growth during the next few months. Only the teachers were told of the supposed test results, not the students. In reality, the students labeled as “spurters” had been selected not on the basis of a test score but purely at random. Yet, when all the students were tested 8 months later, the selected students showed significantly greater gains in IQ and academic performance than did their classmates! These were real gains, measured by objective tests, not just perceived gains. Somehow, the teachers’ expectations that certain children would show more intellectual development than other children created its own reality.

Effects such as this are often referred to as self-fulfilling prophesies. You give someone a label that seems to hold certain expectations of them, and, lo and behold, they live up to those expectation. In this case, that occurred even though the labeled students were uninformed about the label. Subsequent research, involving elaborations on Rosenthal and Jacobson’s original study, revealed that teachers behaved differently toward the “spurters” than toward other students—in ways that may very well have caused the spurts. They were warmer toward them, gave them more challenging work, gave them more time to answer difficult questions, and noticed and reinforced more often their self-initiated efforts (Cooper & Good, 1983; Rosenthal, 1994). In short, either consciously or unconsciously, they created a better learning environment for the selected students. In these experiments, the students themselves were not told about the labels, but nevertheless they developed better self-concepts, because of how they were treated (Cole, 1991; Jussim, 1991). They began to see themselves as more capable academically than they had before, which led them to work harder to live up to that self-perception.

Today we live in a schooling world where many children are labeled not as spurters, but as people with learning disorders. It is generally not just teachers who know who has what label, but the kids themselves and also their parents. Hmmm. If a positive label like spurter improves academic performance, I wonder what a negative label, like learning disorder might do? In this essay my focus is on the disorder referred to, by DSM-V, the official diagnostic manual of the American Psychiatric Association, as specific learning disorder (SLD).

How is SLD defined and how is the label assigned?

According to DSM-V, “Specific learning disorder is a neurodevelopmental disorder with a biological origin that is the basis for abnormalities at the cognitive level that are associated with the behavioral signs of the disorder.” That’s a direct quote. The manual goes on to explain that the behavioral signs are manifested as difficulty learning some basic academic skill. Subtypes correspond with difficulties in reading, writing, and arithmetic, commonly referred to, respectively, as dyslexiadysgraphia, and dyscalculia. To receive such a diagnosis, according to the manual, it is necessary to show that the academic learning difficulty is quite severe (the person should rank in the bottom 7% on test scores of the specific ability for their age) and is not the result of low general intelligence, nor of some brain injury occurring after birth, nor of lack of conventional instruction. For the complete DSM-V description, see here.

Although specific leaning disorder is regularly described as a biological disorder with its basis in some defect in the brain, the truth of the matter is that there is little evidence supporting that description. Brain imaging studies are reported by some to show brain differences associated types of specific learning disorder, but there is little consistency from study to study and no consensus on what brain areas might be involved. In a review, Peters and Ansari (2019) conclude that there is no good evidence for localized neural deficits associated with learning disorders, that “all the estimates [from brain studies] are weak and noisy.” The claim that any SLD is the result of some brain difference is simply a hypothesis. Nobody has ever been diagnosed with such a disorder by looking at the brain.

Claims that some quite specific cognitive deficit underlies any given category of SLD are also undermined by research. Again, regarding dyslexia, a common claim is that the core problem lies at the ability to perceive the differences among basic language sounds, or to keep track of a sequence of such sounds, but research provides no consistent evidence for this claim (Benson et alˆ., 2020: Peters & Ansari, 2019; Ziegler & others, 2020). The only real behavioral link among people diagnosed with dyslexia is that they don’t read well.

How a learning disability label may hinder learning.

Identifying and labeling people as having specific learning disorder might be worthwhile if some of the claims about the disorder were true. If we really knew that everyone with the label had the same underlying neural-cognitive deficit, and if we had a reliable treatment for the deficit, then labeling might be beneficial. It would tell us to whom to provide the treatment. As it is, however, the evidence is not strong that labeling leads to beneficial treatments, and there are good reasons to think that the label may hinder learning more often than it helps (see Cainelli & Bisiacchi, 2019; Coon, 2014; Peters & Ansari, 2019). Here are some of the possible harmful consequences of the label:

The label may lead to a sense of helplessness in the labeled person.

The assumption conveyed in most of the writings about diagnosed learning disorders is that they result from defects in the brain. This assumption is not well founded, but it gets conveyed, nevertheless, not just to the teachers and parents but also to the labeled person. It would seem quite reasonable that this could promote a sense of helplessness in the labeled person, a sense that there is not much they can do to remedy the problem. They may submit to a special education program imposed on them by the school but fail to take the individual effort required to find their own best ways of learning, independent of that program or even consistent with that program. In line with this possibility, many research studies have shown that students labeled with a learning disorder have significantly lower beliefs in their own abilities to learn than do other students (e.g. Chan et al., 2017; Tabassam & Grainger, 2002). They also have what clinicians call a negative attributional style, which means that they attribute their failures to their own inadequacies and their successes to luck or to other factors outside of themselves (Tabassam & Grainger, 2002). This attributional style is well known to lead to reduced effort and can also lead to both anxiety and depression.

The label may stigmatize the labeled person, thereby reducing learning opportunities and lowering the quality of life.

A large-scale study revealed that parents and, even more so, teachers have lower academic expectations of students who have been labeled as having a learning disorder than they do of other students, who perform equally poorly but have not been given a label (Shifrer, 2013). Just as higher expectations can lead teachers and parents to provide extra opportunities and encouragement for learning, lower expectations can do the opposite. There is evidence that teachers believe that those with a learning disorder aren’t going to show much improvement no matter what the teacher does, so they are more likely to put their effort into helping those low achievers who haven’t been labeled with a supposed brain abnormality (Shifrer, 2013).

The label may lead to treatment programs that interfere with real learning.

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