Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 4 Issue 6

Towards Correct and Safe Diagnosis of Specific Learning Disorder in Preschool Age. The perspective of Early Multi-collector Diagnostic Approaches. A Pilot Study

Victoria Zakopoulou1*, Katerina D Tzimourta2,5, Georgios Ntritsos3,4, Alexandros T Tzallas4, Markos G Tsipouras5, Loukas G Astrakas2, Pavlos Christodoulides1, Ioannis Paliokas6, Vassilis Zakopoulos7 and Nikolaos Giannakeas4

1Department of Speech and Language Therapy, Laboratory of New Approaches in Communication Disorders, University of Ioannina, Ioannina, Epirus, Greece
2Medical Physics Laboratory, School of Medicine, University of Ioannina, Ioannina, Greece
3Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
4Department of Informatics and Telecommunications, School of Informatics and Telecommunications, University of Ioannina, Ioannina, Greece
550100, Kozani, Greece
6Information Technologies Institute, Centre of Research and Technology – Hellas 6th km Harilaou - Thermi, Thessaloniki, Greece
7Department of Accounting and Finance, School of Administrative, Economics, and Social Sciences, University of West Attica, Athens, Greece

*Corresponding Author: Victoria Zakopoulou, Department of Speech and Language Therapy, Laboratory of New Approaches in Communication Disorders, University of Ioannina, Ioannina, Epirus, Greece.

Received: April 08, 2021; Published: May 17, 2021


Background: The wide range of terminology, multiple diagnostic criteria, and multifarious basis of Specific Learning Disorder (SLD) constitutes a new reality in the complex entity of SLD. In this manuscript, we address this issue and present the findings of a pilot study concerning the early diagnosis of SLD, while strongly emphasizing the necessity of integrating and testing a vast range of data from multiple domains and skills to achieve correct and safe early diagnosis of SLD.

Materials and Methods: For this purpose, statistical techniques were implemented in a well-structured methodological approach, as follows: (a) a cluster of adequate diagnostic procedures to determine the early extent of specified difficulties, (b) targeted data clustering techniques to identify clusters in the data, and (c) the Use Case method for the configuration of individualized diagnostic profiles.

Results: Through a data analysis schema, several variables were reported as significant, clustering the participants according to their strengths and weaknesses, while strong interactions between specific factors were highlighted in the background of SLD.

Conclusion: The findings of the study enhance the core argument of this pilot study that an “ever-expanding model” should be considered as the most reliable source for a comprehensive early diagnosis of SLD.


Keywords: Specific Learning Disorder; Early Diagnosis; Multifactorial Approach; Early Intervention; Clustering


  1. Poletti B., et al. “Cognitive-behavioral longitudinal assessment in ALS: the Italian Edinburgh Cognitive and Behavioral ALS screen (ECAS)”. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration5-6 (2018): 387-395.
  2. Newbury DF and Monaco AP. “Genetic advances in the study of speech and language disorders”. Neuron2 (2010): 309-320.
  3. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA: American Psychiatric Association (2013).
  4. Plenty S., et al. “Applying an ESSENCE Framework to Understanding Adult Autism Spectrum Disorder and ADHD: Retrospective Parent Reports of Childhood Problems”. The Scientific World Journal (2013): 1-8.
  5. Gillberg C. “The ESSENCE in child psychiatry: Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations”. Research in Developmental Disabilities 31 (2010): 1543-1551.
  6. Fletcher J., et al. “Learning Disabilities: From Identification to Intervention”. New York: Guildford Press (2007).
  7. Andrande OVCA., et al. “Collective screening tools for early identification of dyslexia”. Frontiers in Psychology 5 (2015): 1-13.
  8. Clark KA., et al. “Neuroanatomical precursors of dyslexia identified from pre-reading through to age 11”. Brain12 (2014): 3136-3141.
  9. Elliott JG and Grigorenko EL. “The Dyslexia Debate”. Cambridge: University Press (2014).
  10. Mascheretti S., et al. “Neurogenetics of developmental dyslexia: from genes to behavior through brain neuroimaging and cognitive and sensorial mechanisms”. Translational Psychiatry1 (2017): e987.
  11. Oliver BR and Plomin R. “Twins' Early Development Study (TEDS): A multivariate, longitudinal genetic investigation of language, cognition and behavior problems from childhood through adolescence”. Twin Research and Human Genetics1 (2007): 96-1055.
  12. Zakopoulou V., et al. “Linking Early Life Hypothalamic-Pituitary-Adrenal Axis Functioning, Brain Asymmetries, and Personality Traits in Dyslexia: An Informative Case Study”. Frontiers in Human Neuroscience 13 (2019): 327.
  13. Couto JM., et al. “Association of reading disabilities with regions marked by acetylated H3 histones in KIAA0319”. American Journal of Medical Genetics. Part B. Neuropsychiatric Genetics2 (2010): 447-462.
  14. Tzoufi M., et al. “Early Identification and Intervention in Children with Developmental Dyslexia and Neurological Diseases”. Insights οn Learning Disabilities1 (2010): 29-47.
  15. Norton ES., et al. “Functional neuroanatomical evidence for the double-deficit hypothesis of developmental dyslexia”. Neuropsychologia 61 (2014): 235-246.
  16. Raschle N., et al. “Pediatric neuroimaging in early childhood and infancy: challenges and practical guidelines”. Annals of the New York Academy of Sciences 1 (2012): 43-50.
  17. Xu M., et al. “Atypical lateralization of phonological working memory in developmental dyslexia”. Journal of Neurolinguistics 33 (2015): 67-77.
  18. Papavasiliou A., et al. “Written language skills in children with benign childhood epilepsy with centrotemporal spikes”. Epilepsy and Behavior1 (2005): 50-58.
  19. Spironelli C., et al. “Dysfunctional hemispheric asymmetry of theta and beta EEG activity during linguistic tasks in developmental dyslexia”. Biological Psychology2 (2008): 123-131.
  20. Purcell JJ., et al. “Shared orthographic neuronal representations for spelling and reading”. NeuroImage 147 (2017): 554-567.
  21. Younger JW., et al. “Longitudinal changes in reading network connectivity related to skill improvement”. NeuroImage 158 (2017): 90-98.
  22. Stein J and Kapoula Z. “Visual Aspects of Dyslexia”. Oxford University Press (2012).
  23. Ozernov-Palchik O and Gaab N. “Tackling the Early Identification of Dyslexia with the Help of Neuroimaging”. Perspectives on Language and Literacy1 (2016): 11-17.
  24. Tammimies K., et al. “Ciliary dyslexia candidate genes DYX1C1 and DCDC2 are regulated by Regulatory Factor X (RFX) transcription factors through X-box promoter motifs”. The FASEB Journal 10 (2016): 3578-3587.
  25. Papadopoulos TC and Kendeou P. “Investigating the Factor Structure and Measurement invariance of Phonological Abilities in a Sufficiently Transparent Language”. Journal of Educational Psychology 2 (2012): 321-336.
  26. Anthony JL., et al. “Assessment of individual differences in phonological representation”. Reading and Writing 23 (2010): 969-994.
  27. Verhoeven L., et al. “Cognitive and linguistic factors in reading acquisition”. Reading and Writing 4 (2011): 387-394.
  28. Plakas A., et al. “Impaired non-speech auditory processing at a pre-reading age is a risk-factor for dyslexia but not a predictor: an ERP study”. Cortex 4 (2013): 1034-1045.
  29. Vidyasagar TR and Pammer K. “Dyslexia: a deficit in visuo-spatial attention, not in phonological processing”. Trends in Cognitive Sciences 2 (2010): 57-63.
  30. Goswami UA. “Temporal sampling framework for developmental dyslexia”. Trends in Cognitive Sciences1 (2011): 3-10.
  31. Department for Children Schools and Families. Practice Guidance for the Early Years. Foundation Stage. Crown, UK (2008).
  32. Dahle AE and Knivsberg AM. “Internalizing, externalizing and attention problems in dyslexia”. Scandinavian Journal of Disability Research 2 (2014): 179-193.
  33. Maughan B and Carroll J. “Literacy and mental disorders”. Current Opinion in Psychiatry 4 (2006): 350-354.
  34. Zoccolotti P., et al. “Editorial: Understanding developmental dyslexia: linking perceptual and cognitive deficits to reading processes”. Frontiers in Human Neuroscience 140 (2016): 7-9.
  35. Zoccolotti P., et al. “Isolating global and specific factors in developmental dyslexia: a study based on the rate and amount model (RAM)”. Experimental Brain Research 4 (2008): 551-560.
  36. van Bergen E., et al. “Dutch children at family risk of dyslexia: Precursors, reading development, and parental effects”. Dyslexia1 (2011): 2-18.
  37. Franceschini S., et al. “Action video games make dyslexic children read better”. Current Biology 6 (2013): 462-466.
  38. Richards TL and Berninger VW. “Abnormal fMRI connectivity in children with dyslexia during a phoneme task: Before but not after treatment”. Journal of Neurolinguistics 4 (2008): 294-304.
  39. World Medical Association Declaration of Helsinki. “Ethical Principles for Medical Research Involving Human Subjects”. JAMA20 (2013): 2191-4.
  40. Zakopoulou V. “Early Dyslexia Identification Test (EDIT)”. PsycTESTS (2003).
  41. Paraskevopoulos IN., et al. “Αθηνά τεστ διάγνωσης δυσκολιών μάθησης. [Athena Test: Diagnosis of Learning Difficulties]”. Ellinika Grammata (1999).
  42. Roussou A. “Εγχειρίδιο για τα ερωτηματολόγια και προφίλ προσχολικής ηλικίας του ΣΑΕΒΑ (Σύστημα Achenbach για Εμπειρικά Βασισμένη Αξιολόγηση) [Manual for the ASEBA Preschool Forms and Profiles]”. Ellinika Grammata (2009).
  43. Sideridis G and Antoniou F. “Wechsler preschool and primary scale of intelligence-third edition (WPPSI-III GR)—Standardization in Greek”. Topos (2015).
  44. Mahalanobis PC. “On tests and measures of groups’ divergence”. Journal of the Asiatic Society of Bengal4 (1930): 541-588.
  45. Friedmann N., et al. “Developmental attentional dyslexia”. Cortex10 (2010): 1216-1237.
  46. Alloway TP., et al. “The cognitive and behavioral characteristics of children with low working memory”. Child Development 2 (2009): 606-621.
  47. Lyytinen H., et al. “Early development of children at familial risk for dyslexia-follow-up from birth to school age”. Dyslexia 3 (2004): 146-178.
  48. Zakopoulou V., et al. “An interpretative model of early indicators of Specific Developmental Dyslexia in preschool age. A comparative presentation of three studies in Greece”. Research in Developmental Disabilities 30 (2011): 3003-3016.
  49. Wolf U and Gustafsson J. “Structure of phonological ability at age four”. Intelligence 53 (2015): 108-117.
  50. Zakopoulou, V., et al. “Children ‘at Risk’ of Specific Learning Disorder: Individualized Diagnostic Profiles and Interventions”. Acta Scientific Neurology 2 (2021): 25-41.
  51. Sorrenti L., et al. “The predicting role of school Learned helplessness in internalizing and externalizing problems. An exploratory study in students with Specific Learning Disorder”. Mediterranean Journal of Clinical Psychology2 (2019): 1-14.
  52. Mazzocco MM., et al. In Alloway TP. Working Memory and Clinical Developmental Disorders. Routledge. “Working Memory and Specific Learning Disability: Math”. (2018): 106-130.
  53. Diamond KE and Baroody AE. “Associations among name writing and alphabetic skills in prekindergarten and kindergarten children at risk of school failure”. Journal of Early Intervention 35 (2013): 20-39.
  54. Francis DA., et al. “The association between poor reading and internalising problems: a systematic review and meta-analysis”. Clinical Psychology Review 67 (2018): 45-60.
  55. Horbach J., et al. “Development of behavior problems in children with and without specific learning disorders in reading and spelling from kindergarten to fifth grade”. Scientific Studies of Reading1 (2020): 57-71.
  56. Tzallas AT., et al. “Epileptic Seizure Detection in Electroencephalograms using Time-Frequency Analysis”. IEEE Transactions on Information Technology in Biomedicine5 (2009): 703-710.


Citation: Victoria Zakopoulou., et al. “Is Tricortical Screw Better than Quadricortical Screw in Syndesmotic Fixation of Ankle Fractures?”. Acta Scientific Neurology 4.6 (2021): 39-50.


Copyright: © 2021 Victoria Zakopoulou., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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