These terms have different histories but have come to mean the same thing. Essentially, what it boils down to is that a specific reading disability/dyslexia is unexpected underachievement in reading. Simple as it sounds, the devil is in the details of how you define and measure “unexpected” and “difficulty” in reading. One approach to defining a reading disability/dyslexia is the traditional diagnosis-driven approach which entails extensive testing up-front (psychoeducational, multi-disciplinary). A more recent model that I strongly favor has been permitted in the most recent version of the Individuals with Disabilities Education Act IDEA (2004) emphasizing a child’s “Response to Intervention” (RTI) in determining which children need services and the intensity of those services. RTI has been incorporated into school service delivery under a framework called Multi-Tier System of Supports (MTSS).

In some ways one can think of a Nonverbal Learning Disability (NLD/NVLD) as the opposite of a specific reading disability in which reading is intact, or even advanced, while math is unexpectedly poor. Profiles of cognitive abilities show a corresponding pattern of strength in many verbal abilities and weaknesses in non-verbal/visuospatial abilities. Unlike reading disability/dyslexia, though, NLD/NVLD is not yet recognized in official medical and educational diagnostic systems. Having worked as a Neuropsychology Intern in the laboratory of Dr. Byron Rourke, who did pioneering work on NLD/NVLD in the 1970s and 1980s, I have a particular interest in this condition and currently serve on a Panel of Scientific Experts developing formal diagnostic criteria for proposed inclusion in the next version of the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association.

Basically, a Psychologist has a doctorate from a University Graduate School (Ph.D., Psy.D., sometimes Ed.D.) while a Psychiatrist has a doctorate from a Medical School (M.D., D.O.). While both deal with mental and developmental conditions, their training prepares Psychologists and Psychiatrists with somewhat different skill sets. Both may be trained for psychotherapy and other non-medical interventions, but the emphasis in most Psychiatric training is on “biological psychiatry”, meaning they emphasize medical treatments and psychotropic medications for mental health problems. Psychologists, on the other hand, are experts in the use of formal, standardized testing (i.e., Psychological Testing) in the diagnosis and evaluation of mental and developmental/learning conditions.

A Neuropsychologist is a Clinical Psychologist with advanced training in brain-behavior relationships. Psychologists and Neuropsychologists may use some of the same tests, but the Neuropsychologist typically conducts more extensive testing and tries to understand the results in terms of the integrity of brain function. Accordingly, Neuropsychological testing is most appropriate in cases in which injury or dysfunction of the brain is suspected.

A Neuropsychologist is trained as a Psychologist whereas a Neurologist is a medical doctor. Both specialize in the effects of brain injury/disorder. Whereas Neurologists emphasize the diagnosis of neurological syndromes and their treatment, Neuropsychologists emphasize the assessment/measurement of what are often referred to as “higher cortical functions”, such as memory, language functions, visuo-spatial abilities, executive functions, etc. as well as behavior and personality. As with Psychiatrists and Psychologists, Neuropsychologists and Neurologists have complementary skill sets, and both are often involved in the comprehensive management of patients with neurologically-based conditions.

This is a broad, overarching term for a somewhat open-ended set of abilities that are of increasing interest to Neuropsychologists and others involved in the management of neurological and developmental conditions. EF include such things as the ability to inhibit inappropriate responses, to monitor and correct inappropriate behavior, to modulate emotional responses, to address complex problems systematically, and to efficiently switch back and forth between tasks. What these diverse functions have in common is their reliance on the functional integrity of the frontal areas of the brain and also their slower and later maturity compared to simpler cognitive, sensory, and motor functions. In some ways, these higher-order functions represent the essence of personhood, i.e., what it is to be human, making them extremely important but also challenging to measure and quantify.

Not to be confused with a License to Practice issued by a State Board of Psychology, Board Certification attests to one’s specialized training after extensive review of education/training, passing written and oral examinations, and a review of submitted work-samples. While most physicians are boarded in their specialty, there has not been as broad acceptance of the need for such a credential in Psychology. While Board Certification does not ensure the highest quality professional services, it represents a clear statement to consumers and to the profession that you uphold the highest standards of the profession by undergoing a rigorous process of evaluation by your peers, demonstrating competence as a health care provider and protecting the interests of consumers of your services.

The DSM 5, i.e., 5th version of the DSM, was developed and published by the American Psychiatric Association and represents the most up-to-date terms and criteria used to diagnose mental and developmental disorders distilled from the research literature and clinical conventions of mental health practitioners. It is the official “rule-book” for classifications used by clinicians in the mental health field. It is relied upon by third party payers to determine reimbursement policies, and also by researchers seeking to understand the biological and environmental/social bases of mental disorders and how they should be treated.

Co-morbidity means meeting diagnostic criteria for more than one disorder. In mental health, co-morbidity is common. For example, children diagnosed with ADHD are more likely to also have Oppositional-Defiant Disorder or to be diagnosed with a learning disability.

Historically, many treatments that were developed for emotional, behavioral and developmental disorders have been strong on theory but weak on scientific evidence. The more scientifically-minded clinician, though, is always asking “where is the beef?”, meaning how strong is the evidence for these claims of effectiveness? The body of knowledge we now have attesting to the benefits of certain interventions is substantial. Practitioners in the field of mental health should be offering these proven treatments and abandoning treatments found to be ineffective.