DSA, the new guideline on specific learning disorders’learning disorders

The new DSA Guideline has updated and integrated guidance for increasingly accurate diagnoses, effective rehabilitation interventions and early detection of specific learning disorders.

These are valuable guidance

It is about valuable indications that will also have important repercussions for the vast world of schooling, from childhood to university, and the world of work, ensuring adequate rights and compensatory tools for a population of about 3 million people. In fact, it is estimated that in Italy specific learning disorders affect 5 percent of the population.

The most relevant elements of the document will be the focus of the conference ” From white paper to clinical practice: the new DSA Guidelines “, promoted by the scientific secretariat of the Draft DSA Guidelines, which will be held Saturday, March 26, 2022, from 9 a.m.00 to 6 p.m.00 , and will be streamed live on the facebook page and youtube channel of AID-Italian Dyslexia Association.

A day of in-depth discussion aimed at both clinicians and the world of education and other stakeholders, representing the official presentation of the “Guideline on the Management of Specific Learning Disorders (Update and Additions)” published January 2022 from the’ Superior Institute of Health, within the National Guideline System.

Andrea Novelli, president of AID

“The Italian Dyslexia Association,” says Andrea Novelli, president of AID, “was among the main promoters of the project and contributed to the work of producing the clinical recommendations, which lasted four years, with the active participation of numerous experts from both the health area and the world of schooling, and with the contribution of parents of children with DSA and dyslexic people. One of the most innovative aspects of the new Guideline concerns predictive indices and early identification of the disorder . The new indications will make identification more effective by enabling early intervention on the youngest children to increase their academic competence and avoid negative psychological consequences. Indeed, the heart of our mission is precisely to improve the quality of life of children and people with DSA. The new Guidelines are an important step in this direction “.

“Accurate diagnosis and early intervention are a positive prognostic factor on a school, social and psychological level,” says Mario Marchiori, Italian Association of Psychology . “A late diagnosis, on the contrary, can have very negative consequences on a child, considering that DSAs have a remarkable impact both on the person’s life and on a societal level . In many cases, the diagnosis comes only in adulthood, when a person, often, has already accumulated failures and frustrations without understanding why.”.

Along with the Guideline and the document with indications of good clinical practices, the DSA Guidelines Project has produced an analysis of the application and general effects of Law 170 of 2010 and the recommendations of previous Consensus conferences in schools and universities, regional regulations and the world of work .

“The results of the analysis,” explains Marchiori, “flowed into a white paper that allowed for highlighting the strengths of Law 170, but also the critical issues that still remain . In fact, the white paper in its conclusions proposes some important solutions to fill the gaps present in the world of school, university and work.”.

Among the most important new features of the new Guideline are

“Among the most important new features of the new Guideline are new indications for rehabilitation activities, more supported today by experimental results,” says Luigi Marotta, Federation of Italian Speech Therapists . “What emerged from our research was above all the importance of offering integrated interventions, which, to give an example, work not only on improving reading difficulties but also on other functions, such as language and memory, that support learning. The now accepted finding is that ASDs are the outcome of neurobiological dysfunction, and are therefore chronic disorders that do not disappear, even in adulthood. However, the expressiveness of such disorders varies with age, environmental demands and contextual factors, such as family, school or work, involving varying degrees of adaptation of the individual. Building on this assumption, it becomes apparent how the application of treatments cannot have as its goal the elimination of the disorder itself as much as a reduction in its severity and an improvement in the person’s adaptive conditions “.

Among the most important themes emerging from the paper is certainly that of assessment and Diagnosis of DSA in students bilingual , increasingly present in our schools.
“From the latest research, it has been seen that in assessing a bilingual child, it is important to make an analysis of the linguistic biography, that is, how long the child has been in Italy, how long he has been exposed to our language, whether his bilingualism is simultaneous, late bilingualism, …,” he explains Pierluigi Zoccolotti, Italian Psychology Association . “We know that the bilingual population is very heterogeneous, which makes it complex to define uniquely applicable diagnostic criteria”.

Zoccolotti continues

“The guidance on these aspects was very limited in previous consensus documents, so we felt it was very important to give new and more stringent guidance. In the absence of a clear medical history, for example, it is recommended to observing the child for a period of at least six months, in the presence of educational or specialized interventions, before diagnosing any learning disorder. It is also essential Use standardized tests on bilingual populations for diagnosis . Indeed, if we subjected these children to the same tests used for their Italian peers, we would risk overestimating the presence of DSAs. In other words, there would be a risk of identifying false positives.”.

Another important topic addressed was that of assessment and diagnosis of ASDs in young adults , essential to enjoy compensatory tools and dispensatory measures in college and other social settings. Clinicians, however, until now did not have specific and adequate tests on which to base the diagnostic process.

Enrico Ghidoni, Italian Dyslexia Association, provides clarity

“ DSAs persist into adulthood, requiring diagnostic assessments. Current legislation and standards, in fact, require diagnostic certifications in adult subjects to access support measures in various contexts: universities, bar exams, night schools, public competitions, driver’s license exams. Also, there are people with ASDs who have never been diagnosed at a developmental age and a diagnosis is important not only from the standpoint of awareness, but also to adopt tools and accommodations that can improve quality of life.

There is generally little knowledge and experience in Italy about DSA assessment in adults, therefore, assessment procedures and tools for adults need to be better specified, and this is what has been done . For example, it is necessary, in the most doubtful cases, to perform multiple tests in different modalities: under normal and stress conditions, with interference during task performance “.

DSAs are not a disease as they are not due to organic impairment, but a different neurofunctioning of the brain , which does not prevent the achievement of the specific skill (reading, writing, numbering or other) but requires longer time and higher attentional loads. The new Guideline represents an important step forward in the clinical management of dyslexia and other DSA , affecting 5% of the population.

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The new Guideline is produced by:

• Italian Association of Psychology (AIP)

• Italian Association of Orthoptists Assistants in Ophthalmology (AIOrAO)
• Italian Association of Neuro and Psychomotricity Therapists of the Age of Development (AITNE)
• National Association of United Neuro and Psychomotricity Therapists of the Italian Developmental Age (ANUPI TNPEE)
• Italian Speech Therapy Scientific Association (ASIL)
• Italian Society of Audiology and Phoniatrics (SIAF)

• Italian Society of Childhood and Adolescent Neuropsychiatry (SINPIA)
• Italian Society of Neuropsychology (SINP)
• Italian Ophthalmological Society (SOI)

The Project was also made possible thanks to the collaboration and participation of: