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Published Online:https://doi.org/10.1024/2235-0977/a000027

Diese Studie zielte auf die Untersuchung psychischer Begleitsymptome bei Kindern und Jugendlichen mit Umschriebenen Entwicklungsstörungen (UES) schulischer Fertigkeiten ab. Ausgehend von einer großen, nicht-klinischen Stichprobe von 6- bis 16-Jährigen wurden Schüler mit Lese-Rechtschreibstörungen (n = 136), mit Rechenstörungen (n = 39) und eine Kontrollgruppe ohne Leistungsprobleme (n = 1798) verglichen. Zur Erfassung psychopathologischer Symptome wurden die Eltern befragt sowie die Schüler selbst um eine Einschätzung ihrer Lebensqualität, ihres Selbstwertgefühls und ihrer emotionalen und sozialen Schulerfahrungen gebeten. Die Ergebnisse verdeutlichen, dass Eltern bei Kindern mit Lese-Rechtschreibstörungen und jenen mit Rechenstörungen mehr psychisch auffällige Symptome angeben. Insbesondere hyperkinetische Symptome sind häufiger als in der Kontrollgruppe. Eine Differenzierung der Leitsymptome der Hyperkinetischen Störung in beeinträchtigte Aufmerksamkeit, motorische Überaktivität und Impulsivität unterstreicht, dass insbesondere Aufmerksamkeitsprobleme unabhängig vom Geschlecht mit beiden Störungsbildern verknüpft sind. Anders als erwartet werden keine erhöhten Verhaltens- oder emotionalen Probleme bei Kindern und Jugendlichen mit UES berichtet. Zudem gab es keine signifikanten Unterschiede zwischen den Störungsgruppen, mit Ausnahme eines tendenziellen Effekts bei somatischen Symptomen. Demnach scheinen LRS und Rechenstörung nicht mit unterschiedlichen Profilen psychischer Komorbidität einherzugehen. Kinder und Jugendliche mit UES gaben, unabhängig vom Störungstyp, im Bereich der Schule erwartungsgemäß höhere Problemwerte an. Des Weiteren gehen Rechenstörungen mit höheren Problemwerten in der Gesamteinschätzung der Lebensqualität einher. Während das Selbstwertgefühl insgesamt sowie die generelle Einstellung zur Schule nicht geringer ausgeprägt sind, lässt sich unabhängig vom Störungsbereich eine geringe Anstrengungsbereitschaft bei Kindern mit UES aufdecken. Diese Ergebnisse unterstreichen die Bedeutung psychosozialer Komponenten, die in Diagnostik und Förderung der UES schulischer Fertigkeiten Berücksichtigung finden sollten.


Mental Health Problems in Specific Developmental Disorders: Are there Differences between Dyslexia and Dyscalculia?

Background: This study investigated psychopathology in children with specific developmental disorders by comparing children with dyslexia, and children with dyscalculia to children without learning deficits within a large community sample. Past research demonstrated that reading disorders and externalizing disorders co-occur more frequently than would have been expected in both clinical and population-based samples (Fischbach et al., 2010; Hinshaw, 1992; Maughan, 1995; von Aster et al, 2007). In particular, dyslexia frequently co-occurs with attention deficit/hyperactivity disorder (ADHD, e. g., Capano et al., 2008; Mayes & Calhoun, 2006; Willcut & Pennington, 2000a, b). Findings of studies investigating internalizing problems are less clear and depend on the used definition criteria. For example, Esser and Schmidt (1994) did not find increased prevalence rates of depression in dyslexic children. Dyscalculia has also been found to be associated with attention disorders (Gadeyne et al., 2004; Gross-Tsur et al., 1996; Shalev et al., 1995), possibly even without hyperactivity (Marshall et al., 1999). Additionally, it is assumed that dyscalculia is often associated with internalizing symptoms, in particular for boys (Fischbach et al., 2010; Prior et al., 1999; Shalev et al., 2000; von Aster, 1996). In a clinical sample, children with reading and spelling difficulties tend to be more affected by externalizing disorders compared to children with arithmetic difficulties (Fischbach et al., 2010). So far there is a lack of research concerning the differences in comorbid psychopathology between dyslexia and dyscalculia in community samples.

Aims: This study aimed to investigate whether children with dyslexia and those with dyscalculia are more prone to have psychopathological symptoms compared to children without any difficulties in academic achievement. It is postulated that dyslexic and dyscalculic groups are more frequently affected by symptoms of ADHD. Additional research questions concern the differences of comorbid psychopathology between children with dyslexia and dyscalculia. Another aim was to examine how specific developmental learning disorders affect the children's quality of life. Special emphasis was placed on the self- evaluation of school attitudes and self-esteem.

Methods: In an epidemiological study 2515 six- to sixteen-year-old school children (mean = 120.49; sd = 25.07 months) were examined. For children up to fifth grade the BUEGA (Esser et al., 2008) was used to assess verbal and nonverbal intelligence as well as their performance in reading, spelling and arithmetic tasks. This test battery was standardised on one sample as opposed to different standardisation samples, and therefore enables us to relate differences between the actual performances to individual differences. Children from the sixth grade were assessed using alternative standardized tests appropriate for this age group.

The participants were allocated to the following three groups: children with a reading and spelling disorder (n = 136, 36 % girls), children with an arithmetic disorder (n = 39, 64 % girls), and children showing an average academic performance (n = 1798, 50 % girls). To define the specific developmental disorders, the following two criteria were employed: an achievement discrepancy as well as an IQ-achievement discrepancy of 1.5 standard deviations (Esser et al., 2008). Children in the control group reached average or at least not more than 1 SD below the mean level of the grade's reading, spelling and arithmetic performances (⩠ T-score ≥ 40).

Additionally, parents were asked to fill out a questionnaire concerning the presence of psychopathological symptoms, mainly based on observable behaviour within the past six months (MEF, Esser, 2006). The children were also asked to assess their quality of life (ILK, Mattejat & Remschmidt, 2006), their self-esteem (KINDLR, Ravens-Sieberer & Bullinger, 2000), and their emotional and social experiences at school (FEESS, Rauer & Schuck, 2003).

Results: We found that parents of children with learning disorders reported more psychopathological symptoms than parents of the control children. In particular hyperkinetic symptoms were more frequently reported for both groups with learning disorders than for the control group. Differentiation of main symptoms of ADHD indicates that attention deficits are strongly associated with both types of learning disorders, regardless of gender. However, the following gender differences emerged. Increased scores of hyperactivity were reported only for boys, both with dyslexia and dyscalculia. For girls with dyscalculia, however, more impulsive symptoms are reported compared to the control and the dyslexic group. There were no group differences concerning symptoms of conduct disorders or emotional disorders. Somatic symptoms, however, were more frequent in girls with dyscalculia compared to those with dyslexia. Even for girls with average achievement an increased score of somatic symptoms compared to those with dyslexia was found.

Analysis of children's self-reports yielded the following main results. Children with learning disorders reported lower quality of life. For children with dyslexia these problems were related to the school context only, whereas children with dyscalculia evaluate their mood overall more negatively than the children of the control group.

However, there were no group differences in self-esteem. Additionally, children with learning disorders reported a lowered level of motivation to work hard at school.

Discussion: To summarise, we found dyscalculia and dyslexia to be associated with more psychopathological symptoms, in particular hyperkinetic symptoms, thus replicating previous studies of dyslexia (Esser & Schmidt, 1993; Fischbach et al., 2010; Gadeyne et al., 2004; Mayes & Calhoun, 2006; Willcut & Pennington, 2000a, b) and dyscalculia (Gross-Tsur et al, 1996; Fischbach et al., 2010; Gadeyne et al., 2004; Shalev et al., 1995; Shalev et al., 2000). Unexpectedly, parents did neither report more symptoms of conduct disorder nor more internalizing symptoms for children with specific developmental learning disorders. Additionally, there were almost no differences between children with dyslexia and dyscalculia, except for somatic symptoms. This implies that neither dyslexia nor dyscalculia are associated with a distinct profile of comorbid psychopathology. Parameters identified in this study, such as attention problems, poorer self-assessment of school performance and reduced willingness to work hard might interact with lower performance in reading and spelling as well as in arithmetic. As the current study employed a cross-sectional design, we were unable to examine these relationships. However, the planned follow-up of our study will allow such causal analyses.

Finally, the results highlight the importance of psychosocial aspects in children with specific developmental learning disorders. Therefore, the process of diagnostic assessment and therapy should always include psychosocial components. Particularly, the treatment of ADHD should play an important part in remediation.

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