Referring a child with suspected Specific Learning Disability

When the difficulty stops looking like a slow start and starts looking like a pattern — that is the moment to act, and acting early changes the arc.

In short

Refer a child with suspected Specific Learning Disability (DLD/SLD spectrum; reading, writing or arithmetic difficulties classified under ICD-11 6A04) when academic skills fall persistently and significantly below age expectation despite adequate instruction and effort, the difficulty has lasted at least six months, and it cannot be better explained by intellectual disability, sensory impairment, neurological disorder, or psychosocial adversity. In practice, meaningful identification clusters around ages 6–8, once formal literacy and numeracy instruction has begun — but do not wait for failure: refer at the first persistent gap, even from age 5–6, for assessment and developmental support.

When to refer — the clinical decision

Refer for structured developmental assessment and therapy when you observe, persisting beyond a reasonable instructional window:

• Reading — slow, effortful or inaccurate word reading; poor decoding; phonological-awareness deficits disproportionate to overall ability.
• Writing — persistent spelling errors, poor written expression, disorganised output despite verbal competence.
• Arithmetic — difficulty with number sense, fact retrieval or calculation procedures.
• Functional impact — academic achievement quantifiably below expectation, with rising frustration, avoidance or falling confidence.

Refer sooner — and rule out first: screen hearing and vision, review attention and language history, and exclude an unidentified intellectual disability. A child below ~6 with emerging concern is better routed to a broad developmental and language review than labelled prematurely. A child losing previously held skills, or with seizure-like episodes, warrants prompt medical, not therapy-first, pathways.

The Pinnacle way

Developmental measurement supports care planning; diagnosis requires an appropriately qualified healthcare professional., under qualified clinician care — never from an online form or a single observation. Our clinician-administered structured assessment benchmarks the child against their own baseline, distinguishes a learning disorder from a maturational lag or instructional gap, and builds a targeted learning and language therapy plan. Across 70+ centres in 4 states, the aim is mainstream success — skills, confidence and momentum restored.

Trusted sources

WHO ICD-11 6A04 (developmental learning disorder); CDC Learn the Signs. Act Early.; Indian Academy of Pediatrics; American Academy of Pediatrics (HealthyChildren.org).

Next step — When the pattern is persistent, refer rather than watch. Refer for a developmental learning assessment with a Pinnacle clinician.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.