Is There Uniformity in the Diagnosis of Learning Disability Globally?

Learning disabilities (LDs) are a group of neurodevelopmental deficits that negatively affect the acquisition, organization, retention, comprehension, or application of age appropriate knowledge. Persons with LD lead a subsidized quality of life, especially in academic/vocational and psychosocial domains. A certificate issued by the medical boards at a state or district level is required to avail benefits such as scribes or relaxations. This may be done through a series of assessments by psychologists, special educators, or other health-care professionals. The authors aim to understand if uniformity exists in the assessment methods used for the diagnosis of LD globally and to prepare a gap analysis for the same. A systematic review was performed on English literature articles published from January 2005 to August 2023. Full-text studies reporting assessment and diagnostic methods of LD were included. A total of 1246 records were identified through a manual search of an electronic database. Seven duplicates were removed and 1174 studies were excluded based on the relevance by screening titles, abstracts, and full texts. Sixty-five studies were included and analyzed. The authors found a lack of uniformity in this diagnostic protocol, leading to uncertainty in disability certification, doctor shopping, and additional stress for the patients, as well as added burden on the government. Identification of LD requires a multistep assessment process with culturally relevant tools and norms and the participation of a multidisciplinary team of experts.

Is disease a threat to identity? A systematic review of parkinson's disease and personal identity.

Introduction: Parkinson's disease (PD) is a neurological condition that impacts the physical and psychological functioning of the patients. The physical and cognitive changes come with social stigma and threats to roles previously associated with their identities. Objectives: The current paper attempts to study the influence of the disease on the personal identity of the patients. Methods: A systematic review was done on PD and personal identity following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The Consolidated Criteria for Reporting Qualitative Research checklist was used to assess the quality of the papers. The selected papers were synthesized to understand the relationship between PD and personal identity. Results: The emerging themes were: (1) dissociation of old personal identity: (1.1) Influence of physical symptoms, (1.2) influence of society and stigma, and (1.3) threats to roles associated with identity and (2) changing family dynamics. A Model of Personal, Family, and Disease Dynamics was also developed based on clinical first-hand experience with the patients and the review. Conclusion: The personal identity of the PD patients shifts drastically as a result of their physical and psychosocial experiences. This also results in changed family dynamics, with the patient feeling sidelined due to loss of control and responsibilities in the family.