Current Psychology (2024) 43:25551–25567

https://doi.org/10.1007/s12144-024-06231-x

Preliminary developmental challenges of children at risk for specific

learning disabilities: Insights from parents and teachers—a qualitative
study
Aslı İzoğlu-Tok1,2 · Özcan Doğan2

Accepted: 3 June 2024 / Published online: 26 June 2024

© The Author(s) 2024

Abstract
This study aims to uncover the preliminary developmental challenges experienced by children from infancy to their
primary school years, who are subsequently diagnosed with specific learning disabilities during their primary education.
The ultimate goal is to develop an item pool to identify early symptoms of specific learning disabilities. This qualitative
descriptive design study employed semi-structured interviews with 20 participants, comprising both parents and teachers
of 10 children aged 8–11. The interviews lasted between 45 and 60 min. To ensure the research's quality and reliability,
we applied evaluation criteria and performed six-stage thematic analysis framework. The results indicate that children
experienced developmental difficulties from infancy to preschool period that impacted their social-emotional development,
language and communication, motor and self-care skills, as well as their perception, memory, attention, and self-regulation
capabilities. These challenges were exacerbated during the school years by motivation-related issues. Parental observa-
tions primarily highlighted difficulties in language and communication, such as pronunciation, initiating conversations, and
speech, during the first three years of life. Significant issues in social-emotional development included introversion, a need
for physical contact, challenges in maintaining relationships, and adherence to rules. These challenges emerged during the
first three years of children and progressively worsened across all developmental domains. This study contributes valuable
insights into the literature by providing past observations from parents and teachers, thus enhancing understanding of the
preliminary developmental challenges faced by children at risk of specific learning disabilities.

Keywords Specific learning disabilities · Developmental challenges · Qualitative research · Parental observations ·
Teacher observation · Preschool

Introduction mathematics, and written expression (American Psychiatric

Association [APA], 2013; Melekoğlu, 2020). SLD encom-
SLD is classified as a neurodevelopmental disorder char- passes three primary types: dyslexia, dyscalculia, and dys-
acterized by significant disparities between intelligence graphia. Diagnostic criteria are drawn from the Diagnostic
scores, which are within the normal or above-normal range, and Statistical Manual of Mental Disorders (DSM-5), the
and performance in key academic areas such as reading, International Classification of Diseases (ICD-10), and the
American Psychiatric Association's Diagnostic and Statisti-
cal Manual of Mental Disorders (APA, 2013; World Health
Organization, 2019).
This study is produced from corresponding author’s doctoral thesis. Originating from neurobiological factors, SLD's man-
agement focuses on early educational interventions rather
Aslı İzoğlu-Tok
[email protected]; [email protected] than pharmacological treatments, highlighting the impor-
tance of early assessment and intervention (Thapar et al.,
1
Department of Child Development, Faculty of Health 2017). The reason for this is that if children are not inter-
Sciences, Kırşehir Ahi Evran University, Kırşehir, Turkey vened in the early period, the difficulties they experience
2
Department of Child Development, Faculty of Health will increase (Sullivan et al., 2017; Zhang et al., 2020).
Sciences, Hacettepe University, Ankara, Türkiye

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25552 Current Psychology (2024) 43:25551–25567

Therefore, intervention services provided in the early period emphasizes the significance of teachers' insights into the
can also contribute to reducing the negative effects (Lange children's academic and developmental profiles.
& Thompson, 2006). The importance of the situation is fur- Specialized educational support requires obtaining a
ther underscored by the prevalence of SLD. Special Needs Report for Children (SNRC), which is con-
SLD was identified as the most common disability among tingent upon a formal medical diagnosis. Importantly, the
students aged 6 through 21 in the U.S., with 37.1% of those evaluation of a child's academic progress over a minimum
receiving special education services diagnosed with SLD span of six months forms a critical component of this diag-
(U.S. Department of Education, 2021). Additionally, 15% nostic framework. Considering that the diagnosis process
of the European population is affected by SLD (Institute of takes an average of one year, it is obvious that we cannot
Entrepreneurship Development, 2019). Despite these strik- provide support to children in the early stages. However,
ing rates, Turkey reports a notably lower prevalence rate of both national and international research always emphasizes
approximately 3%, highlighting a significant discrepancy the importance of early detection (Chordia et al., 2020; Firat
in the identification and diagnosis of SLD, and pointing to & Bildiren, 2024; Kaya-Döşlü & Bağlama, 2022; Roama-
a need for improved diagnostic tools and data collection Alves et al., 2020; Thapar et al., 2017). Therefore, research
methodologies (Melekoğlu, 2020). The fact that children at on the characteristics of at-risk children is essential to
risk of SLD show similar characteristics to normally devel- inform the development of intervention programs, evalua-
oping children makes early diagnosis even more difficult tion tools, and understanding children's profiles.
(Steele, 2004).
Research is advancing in early diagnosis by concentrat- The current study
ing on identifying children at risk of SLD and preventing
issues before they arise. Researches underscore the impor- While existing literature underscores the significance of
tance of early indicators in predicting future SLD, focusing early identification of children at risk of SLD, there remains
on areas such as early literacy, rapid naming, phonological a noticeable knowledge gap regarding the characteristics of
awareness, and working memory (Ozernov-Palchik et al., children in Turkey. This gap about which areas and what
2017; Snowling et al., 2019). Moreover, early quantitative difficulties children experience is evidenced by the limited
challenges, such as deficiencies in understanding number availability of early assessment tools (Melekoğlu, 2020).
relations, might lead to future difficulties in mathematics Therefore, the primary sources of information crucial for
for children (Bull et al., 2021; Zhang et al., 2020). When fill this knowledge gap are the child's parents and teach-
viewed within the framework of developmental domains, ers. who possess invaluable insights into early indicators of
early challenges in language, social-emotional development, SLD due to their extensive interactions with the child dur-
psychomotor skills, cognitive development, and self-care ing the preschool and early school years. With this regard,
skills are identified as predictors of SLD (Firat & Bildiren, this study aims to identify the difficulties experienced by
2024; İzoğlu-Tok & Doğan, 2022). International researches children diagnosed with SLD in the preschool and school
also focus on intervention programs (Almulla et al., 2021; periods, with the ultimate goal of creating an item pool for
Aunio et al., 2021; Sakellariou et al., 2020), development identifying early symptoms of SLD. The quality of the rela-
of identification tools (Flores et al., 2022; Hellstrand et al., tionship that professionals establish with parents and school
2020; Navarro Soria et al., 2020), and profiles of children personnel can affect the quality of the children's assessment
at risk (Bonti et al., 2021; Quiroga Bernardos et al., 2022). process (Lange & Thompson, 2006). Engaging with fami-
These studies emphasize the critical role of early detection lies and teachers for their insights is deemed crucial for a
and intervention. comprehensive understanding of children at risk for SLD,
informing strategies for health and education profession-
The situation in Turkey als to enhance early intervention services. By addressing
these challenges, we expect that this study will enhance the
In Turkey, the pathway to diagnosing SLD and providing comprehension of the challenges faced by children at risk
special education services involves a multi-step process that of SLD, and facilitate the development of assessment tools
engages both educators and medical professionals. Within and intervention strategies. This study offers comprehensive
the Turkish education system, primary education spans a insights into the challenges faced by children, addressing
four-year period following preschool, during which chil- the roles of adults both in school and at home. The research
dren undergo initial assessments. Notably, when special question regarding the challenges experienced by children
needs are suspected, classroom teachers play a pivotal role with SLD in pre-school (0–3 years and 3–6 years) and
by referring children to medical or guidance and research school periods guided the study.
centers for further evaluation. This diagnostic journey

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Current Psychology (2024) 43:25551–25567 25553

Method commenced concurrently with the interviews and persisted

until the parents and teachers of the 10th child were inter-
Study design viewed. The decision to conclude the interviews was made
when no new codes emerged, indicating that the data had
This qualitative study employed a qualitative descriptive reached saturation. Details on the participating parents (P)
design aimed at offering descriptions of experiences and and teachers (T) are provided in Table 1.
perceptions, especially in areas with limited understanding
(Sandelowski, 2010). This qualitative study utilized semi- Recruiting participants
structured interviews and thematic analysis to delve into the
experiences and perspectives of parents and teachers regard- Approval was obtained from the [Blinded] University
ing children’s developmental challenges from infancy up Clinical Research Ethics Committee (KA-19141), along
to the present. The reporting guidelines of “Standards for with administrative permissions from the Turkish Ministry
Reporting Qualitative Research- SRQR” (O’Brien et al., of National Education (MoNE). The first author contacted
2014) and “Consolidated Criteria for Reporting Qualita- school administrators to introduce the study to parents and
tive Research- COREQ” (Tong et al., 2007) were followed. teachers, focusing on children diagnosed with SLD.
The study was adhered to a postpositivist paradigm. In the Interviews were initiated following verbal confirmations
postpositivist paradigm, researchers integrate the diverse from parents and subsequent confirmations from teachers
perspectives of participants rather than relying on a singular regarding the children's diagnosis and inclusive education
viewpoint and employ various validity approaches (Cre- status.
swell & Creswell, 2017). Consequently, in this study, we Written informed consent was then collected via Google
brought together the perspectives of both parents and teach- Forms. Due to COVID-19 pandemic restrictions, interviews
ers and applied validity approaches. were conducted by phone from September to November
2020, with durations ranging from 45 to 60 min.
Sampling and participants
Developing interview schedule
Participants were selected through typical case sampling, a
targeted method aimed at obtaining a representative cross- We developed two semi-structured interview schedules,
section of cases. For parents, the criteria were: (1) having distinct for teachers and parents, informed by a compre-
a child diagnosed with SLD in primary school, and (2) no hensive literature review on developmental stages. These
additional diagnoses besides ADHD, given its frequent co- schedules were then refined based on feedback from three
occurrence with SLD (Araz Altay & Gorker, 2017). For faculty members specializing in special needs education.
teachers, we included those who taught the children of the The interview for parents comprised eleven main questions
interviewed parents. across three categories: general information, past expe-
The first author conducted interviews with 20 partici- riences, and current status. Parents were prompted with
pants: parents and teachers of 10 children who are currently questions designed to elicit their insights and reflections on
attending primary school. All participants, including the their children's development from infancy up to the pres-
children, were monolingual Turkish speakers, hence the ent, including the diagnostic journey and aspects of school
interviews were conducted in Turkish. Prior to conducting life (detailed in Appendix A). Similarly, the teachers' inter-
the interviews, arrangements were made to meet primarily view schedule featured six main questions, organized into
with one parent-typically the mother due to their predomi- the same three categories. Teachers, were questioned about
nant role in care and education involvement. This selection the developmental traits, diagnostic procedures, school
was made acknowledging that recalling past experiences experiences, and peer interactions they've noted from the
might be affected by the passage of time. Therefore, our commencement of the children's primary education to the
focus was on the primary school period, during which the present (outlined in Appendix B).
children were first medically diagnosed.
All educators involved were classroom teachers, with the Rigor
duration of their acquaintance with the children varying due
to school changes or different grade levels. Typically, class- To ensure the integrity and reliability of our research, we
room teachers remain with the same group of students from adhered to Lincoln and Guba (1985) criteria. The interviews
the first to fourth grade unless their assignment changes. were conducted with 20 participants, with the first author
The size of the sample was determined based on data sat- allowing flexibility in timing to enhance the credibility
uration and representativeness (Guest et al., 2006). Coding and internal validity. She probed further when responses

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25554 Current Psychology (2024) 43:25551–25567

were unclear, ensuring comprehensive understanding. The

Number
of CPC
30–40
30–40
20–30
20–30
10–20
10–20
40–50
10–20
40–50
30–40
diverse perspectives from both teachers and parents enriched
the internal validity. Data saturation was confirmed when no
Other SNC in new information emerged from the interviews.
Classroom
For external validity criterion, transferability, we
meticulously outlined the inclusion and exclusion cri-
teria, aiming to ascertain that our findings could be
X
X

X
X
X
X

X
√
√

√
applicable in various contexts (Lincoln & Guba, 2013,
Child Recognition

p. 103). Our methodical approach, from participant

recruitment to the detailed explanation of our analysis
process, supports the study's transferability. The coding
4 years
4 years
4 years
5 years
3 years

3 years

4 years
1 year
1 year

1 year
process and its rationale are elaborated under the find-
ings section, with clear definitions and descriptions to
facilitate understanding.
Practice

Dependability was achieved through a rigorous and trans-

Year
34
27
34

34
10
16
16

41

parent process, defining key concepts like social-emotional

5

and language development, motor skills, self-care, percep-

Teachers
Gender

tion, memory, attention, and motivation based on prior lit-

erature. Each participant's experiences were deductively
M
M

M
F
F
F
F
F

analyzed within these frameworks. An external researcher

with expertise in early intervention and qualitative methods
T10
T1
T2
T3
T4
T5
T6
T7
T8
T9

reviewed the themes, further validating the study's reliabil-

ity by assessing code accuracy and researcher impartiality
(Lincoln & Guba, 1985).
*M Mother, F Father, R Retired, SNC Special Needs Children, CPC Children Participating in Classroom
Diagno- Gender

Confirmability and objectivity were reinforced through

Boy
Boy
Boy

Boy
Boy
Boy
Boy
Girl

Girl
Girl

data triangulation, collecting data from multiple sources—

teachers and parents—to verify consistency across differ-
sis Age

ent perspectives (Lincoln & Guba, 2013, p. 106). The first

10
10
11

11
11

11

author meticulously transcribed interviews, with all data

9

9
8

securely stored in MAXQDA qualitative research software

(version 20.4.1), ensuring a robust framework for our quali-
Children
Siblings

tative analysis.
2
3
1
1
1
0
1
1
1
1

Researcher background
Working

In qualitative research, the experience of researchers is

pivotal for knowledge generation (Creswell & Creswell,
X

X
R
R
R
√

√
√
√

2017). Our team, composed of academic staff, under-

Table 1 Information on parents, children, and teachers

takes clinical studies to assess and support children

High school

High school
High school

High school

and offers family counseling services focused on child

University
University
University
University

University

University
Education
Level (F)

development. Acknowledging the influence of our back-

grounds and experiences, we endeavored to mitigate
potential biases. We documented our initial assumptions,
insights from the literature, and our theoretical and prac-
High school

High school
High school

High school
University
University
University
University

University

University

tical expertise. Engaging in continuous reflection and

Level (M)
Parent's Education

dialogue throughout the study (Watt, 2015), we main-

tained a postpositivist perspective, anticipating a variety
of developmental challenges. For instance, we defined
Parents

the possible areas we expected to emerge by keeping in

Age
32
40
49
49
49
41
35
43
38
47

mind that there may be different areas of development

where difficulties may arise.
P10
P1
P2
P3
P4
P5
P6
P7
P8
P9

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Current Psychology (2024) 43:25551–25567 25555

Data analysis procedure, systematic data coding, we read and coded the
transcriptions line by line. We outlined the distinct early
Following Braun and Clarke (2021) six-stage thematic developmental characteristics observed by teachers and par-
analysis framework, our approach facilitated both induc- ents in children diagnosed with SLD compared to peers. For
tive and deductive analysis. To prevent data loss, the first example, one parent commented: “He was having too many
author meticulously transcribed the interviews, resulting in accidents compared to his peers. He was constantly getting
a comprehensive document of 231 pages. This document injured. We never missed a visit to the hospital anyway. He
was analyzed using MAXQDA qualitative research soft- still has a scar on his eyebrow. He burned his arm. So, he
ware, starting with a thorough reading to gain an overall was always clumsy. He loses his balance and falls on the
understanding of the data. straight road.”. We coded this comment as ‘difficulty with
In the first procedure, familiarizing with the data, we balance skills.’
read transcripts to look at the data holistically. In the second

Map 1 Early developmental symptoms of SLD in the preschool period. The filled symbols ( ): developmental symptoms from ages 0–3; the
empty symbols ( ): developmental symptoms from ages 3–6

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25556 Current Psychology (2024) 43:25551–25567

In the third procedure, generating initial themes from children's developmental indicators for SLD from infancy
coded and collated data, we organized the codes into to the school years. This approach, grounded in a develop-
potential themes and sub-themes, ensuring all related codes mental model (Kass & Maddux, 2005), aimed to present a
were considered. In the fourth procedure, developing and holistic understanding of the identified early symptoms of
reviewing themes, we checked coded quotations, poten- SLD.
tial categories, and themes to see if they were related. We
made additions or substructions during this control process. Declaration of generative AI and AI-assisted
A thematic map was created by establishing a relation- technologies in the writing process
ship between quotation, code, category, and theme. In the
fifth procedure, refining, defining, and naming themes, we While composing this work, the authors used Scholar Chat-
named each theme so that it could create a related story GPT by Open-AI in order to improve the readability and use
for the research. In the sixth procedure, writing the report, of existing language. It is crucial to emphasize that Scholar
we determined compelling quotations for inclusion in the Chat-GPT was solely employed to enhance the quality of
report. After compiling the study into a report in Turkish, the writing and facilitate better communication of ideas,
we translated the text into English with an expert support. and not to generate new content. Following the application
Our analysis, presented through thematic maps, adopted of this tool, the authors reviewed and edited the content as
a developmental lens, offering a comprehensive view of the

Map 2 Early developmental symptoms of SLD in the school period. Filled symbols ( ): parents’ expressions; empty symbols ( ): teachers’
expressions; the symbol ( ): parents’ and teachers’ expressions

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Current Psychology (2024) 43:25551–25567 25557

needed and takes full responsibility for the content of the showing difficulty in expressing their feelings and thoughts,
publication. often relying on fillers like "err" and "umm." One parent (P9)
shared about their child's struggle to initiate conversation:

Results “When he wanted to be friends and get closer, but he

did not get a reaction, he gave up. So, he was very
Four maps were created regarding the early symptoms after eager to have friends, but he had difficulty establish-
the data analysis of the interviews. In these maps, categories ing that friendship. He was not a child who communi-
or periods are indicated by different symbols. cated a lot with his friends, nor was he social.”

Early developmental symptoms of SLD

For social-emotional development, parents noticed early
In Map 1, the early developmental symptoms of SLD in the symptoms such as a need for physical contact and intro-
preschool period fall under nine categories: social-emotional verted behavior from ages 0–3. Between the ages of three
development, language and communication development, and six, parents reported their children facing challenges
motor development, self-care skills, perception, memory, with following rules, sustaining peer relationships, making
attention, self-regulation, and other difficulties. friends, experiencing low self-esteem, becoming victims of
From ages 0–3, parents frequently noticed issues with their bullying, displaying emotional overreactions, and prefer-
children's language and communication development. Prob- ring to play alone.
lems with speaking, pronunciation, and starting conversations In the motor development category, parents reported
were common in this age group. After turning three, kids started that their children, between the ages of 0–3, encountered

Map 3 Early academic symptoms of SLD in the school period. Filled symbols ( ): parents’ expressions; empty symbols ( ): teachers’ expres-
sions; the symbol ( ): parents’ and teachers’ expressions

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25558 Current Psychology (2024) 43:25551–25567

Map 4 Developmental symptoms

pyramid of children at risk for
SLD

difficulties with activities requiring coordination, speed, when we read stories together, I used to realize she did
or strength. They described these challenges as clumsiness not remember anything about the story.”
during running or an inability to participate in games like
football. Between the ages of 3–6, the difficulties shifted In general, the challenges identified between the ages of
towards activities that demand balance, drawing skills, and 0–3, with the exception of speaking difficulties, continue
holding a pen properly.In the perception category, parents into the ages of 3–6. This means that issues such as pro-
identified issues related to visual and auditory perception, nunciation, initiating communication, introverted behavior,
including difficulties in perceiving auditory stimuli, recog- and difficulties with tasks requiring coordination, speed, or
nizing colors, writing and learning numbers, interpreting strength that begin to emerge from ages 0–3 tend to persist
visual or auditory inputs, and slow perception speed. These through to ages 3–6.
difficulties became apparent to the parents after their chil- In Map 2, which focuses on the school period, the early
dren reached the age of three. Additionally, in other areas, developmental symptoms of SLD are categorized into ten
parents observed challenges with direction skills. areas: social-emotional development, language and commu-
Parents also highlighted that their children experienced nication development, motor development, self-care skills,
difficulties with memory, attention, and self-regulation. perception, memory, attention, self-regulation, motivation,
They observed issues with memory, particularly in recall- and other difficulties. Within the language and communi-
ing information. Furthermore, there were struggles with cation development category, difficulties were reported in
maintaining attention during games or tasks that required initiating communication, expressing feelings and thoughts,
concentration. Both parents and teachers shared the belief overusing fillers, and speaking in context.
that the children could accomplish any task if they managed Difficulties in social-emotional development emerged
to focus. Challenges in self-regulation were noted as well, as a category in which parents and teachers predominantly
especially in terms of being tidy at home and in school set- share their observations. The frequency of codes in this
tings. One parent (P1), who has twins, with one diagnosed field has increased in school age. Parents have observed
with SLD, discussed memory difficulties by drawing com- challenges in engaging in casual conversations and diffi-
parisons in the developmental process between her twins: culty in defense own rights, while teachers have identified
reluctance, choosing to play individual games, and diffi-
“…about describing the picture she saw .... Whenever culty maintaining communication. Both participant groups
I asked her, she had a blank stare on her face. Later, have highlighted a range of early symptoms including low

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Current Psychology (2024) 43:25551–25567 25559

Table 2 Early symptoms of SLD

*1: ages 0–3, 2: ages 3–6, 3: School; The filled symbols ( ): The parents’ expressions; The empty symbols ( ): The teachers’ expressions; The
symbol ( ): parents’ and teachers’ expressions

self-esteem, bully victimization, exclusion, introversion, “He was an oppressed child. One child in the class-
emotional overreactive state, willingness to be invisible, room put him under the pressure. He could not defend
and difficulty in following the rules. One child’s parent (P6) himself. When he wanted to protect himself, he was
and teacher (T6) expressed low self-esteem as follows: doing it wrong.” (T8)

“She constructs barriers in unfamiliar situations, In the perception category, difficulties with matching let-
quickly abandoning tasks and expressing self-doubt. She ters to sounds were commonly reported by both parents and
often declares, ‘I cannot do this. Why do you insist? That teachers. Furthermore, teachers noted challenges in inter-
is enough; it is not working; give up.” (P6) preting stimuli and understanding instructions. Both par-
“There was a situation like this where her self-esteem ents and teachers reported difficulties in the self-regulation
was low and quite challenging. She frequently began category such as external audit, disorganized notebook, and
sentences by stating, ‘I cannot do it.’ While many stu- difficulty in planning. Difficulties in the field of attention,
dents experience this to some degree, she struggled memory, motivation, and self-care skills were expressed
with it more than most.” (T6) by both parents and teachers during the school period as
well. They expressed difficulty paying attention to a game/
Parents and teachers used the phrase “vulnerable, sensitive, task, difficulty recalling information, reluctance, and low
and combative” to describe the emotionally overreactive self-motivation about a game/task in the field of attention,
state of the children. One child’s parent (P8) and teacher memory, and motivation. Considering other difficulties, the
(T8) expressed bullying victimization as follows: teachers emphasized that children made more effort to learn,
were reluctant to go to school, and could only learn until a
“I did not know if he was beaten so much. He suffered certain difficulty level.
a lot from a friend. He was a quiet kid. He was not a
kid who defended his rights.” (P8)

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25560 Current Psychology (2024) 43:25551–25567

Early academic symptoms of SLD independent in the first grade. All the difficulties above
started to show their effects more clearly in the academic
In Map 3, the early academic symptoms of SLD in the field during school years.
school period appeared under three categories: reading, When we look at the developmental process holistically,
writing, and mathematics. social-emotional development and motivation challenges
In the reading category, reading comprehension was the become more pronounced in school life. Parents and teach-
most emphasized difficulty. Mixing letters, reading slowly, ers have reported that children exhibit a notable lack of
making reading mistakes, and reluctance to read were motivation in addition to other difficulties. They tend to be
expressed by both parents and teachers. One child’s par- invisible, become introverted, show reluctance in both their
ent (P1) and teacher (T1) expressed the mixing of letters as social and academic lives, and strive to be unnoticed.
follows: We also saw the process progress increasingly in the
seven steps. For instance, language difficulties emerged in
“I turned the house into a map. Because I thought she the 0–3 age period and continued to increase and intensify
could not forget letters if she saw them all the time. during the school period. The frequency of codes in socio-
But she would do a lot of constant b-d shuffling.” (P1) emotional development has increased in school age. While
“When I realized she was confusing the letters b-d, I the difficulties that appeared on the pyramid's base were
thought this was not a problem. Because my four or expanded, new difficulties accrued on top of them. That was
five students made the same mistake as her… There why we visualized this process as a pyramid. One child’s
was an application in the curriculum that I found very parent (P2) expressed the increase in difficulties experi-
wrong. When I taught the letter groups b-d in the first enced as follows:
grade, there was only one letter (s) between them. In
other words, children are more confused because these “He began speaking later than his peers and entered
letters are given one after the other… When these two kindergarten at five. During that time, his speech
letters are taught in proximity, students often experi- development lagged, causing communication chal-
ence confusion. Therefore, there is a need for change lenges with his teacher and impacting his ability to
in this regard.” (T1) form friendships. Even now, he faces difficulties in
making friends. When my son started first grade, I
Most of the difficulties in the writing category were became suspicious of his learning difficulties as he
expressed by both parents and teachers. Difficulties hold- struggled with reading words composed of two letters,
ing the pencil, writing numbers in the correct direction, often reading them backward. I shared my concerns
leaving appropriate spaces between words, legible writing, with his teacher, who insisted on waiting. Despite
the proportionality of letters, and making spelling mistakes waiting patiently, the difficulties persisted and even
emerged in this area. In the mathematics category, both par- worsened. At this point, the formal reporting process
ents and teachers expressed difficulty solving problems. was initiated.” (P2)

Overview of developmental symptoms When examining the pyramid, it is evident that there is
an increase in the child's symptoms, coupled with a reluc-
We created Map 4 by considering the chronological and tance to understand, difficulty in motivation, and lack of
developmental processes. Firstly, the parents observed dif- self-esteem. Parents describe this situation as “He has
ferences in their children’s language and communication potential, but he believes he cannot do it,” “He gives up
development. In particular, they emphasized difficulties quickly,” or “It is tough to break his prejudice that he can-
in speaking, pronunciation, and limited vocabulary. In the not do it.” Consequently, researchers believe that all the
following process, difficulties in social-emotional develop- difficulties experienced by children point to a theme linked
ment were remarkably noted by the parents. This develop- to challenges in their perception of themselves. Hence, we
ment area was that what both parents and teachers most have labeled the final step of the pyramid “negative self-
expressed. Afterward, they started to mention motor devel- concept.” Self-concept encompasses an individual's per-
opment difficulties. Although parents believed their children ceptions of themselves across various aspects, including
had difficulties in motor development in preschool, they physical appearance, achievements in sports and academ-
determined this to be an issue during school years. ics, behavior, social acceptance, and interpersonal relation-
This situation proceeded similarly for self-care, percep- ships (Butler & Gasson, 2005). We referred to the negative
tion, attention, and memory. While self-care skills were self-concept when children held negative perceptions of
tolerated in preschool, the child was expected to become themselves in these areas.

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Current Psychology (2024) 43:25551–25567 25561

In general, the findings reveal difficulties across 13 areas. their receptive language skills. Thus, it is plausible that par-
Only parents or teachers reported some of these difficul- ents primarily focus on expressive language skills when
ties. Both parents and teachers expressed some of the other considering language development. Consequently, assess-
difficulties. Table 2 presents all the difficulties mentioned ing language and communication development skills should
above, categorized by developmental areas, period, and the be central to identifying risk groups. The literature supports
individual expressing the difficulty. the inclusion of these difficulties in the item pool. However,
difficulty in speaking was not reported between the ages of 3
and 6. Lyytinen et al. (2005) found that late-talking toddlers
Discussion with expressive delays caught up to their peers in language
proficiency by the age of 3.5 years. Therefore, we suggest
This study aimed to explore early developmental challenges including this difficulty as a topic in preliminary interviews
of children diagnosed with SLD and to contribute to the rather than incorporating it into assessment tools.
creation of an item pool for early symptom identification. The most pronounced difficulties identified in our study
Through qualitative interviews with parents and teachers, relate to social-emotional development. Parental observa-
we identified a broad range of developmental symptoms tions indicated that children exhibited symptoms such as
from infancy to primary school, including difficulties in introversion and a need for physical contact within the first
language and communication, social-emotional and motor three years of life. After the age of three, challenges in main-
development, self-care skills, perception, memory, atten- taining relationships and adhering to rules became apparent.
tion, self-regulation, and academic challenges. These find- Both parents and teachers noted an increase in introversion
ings underscore the multifaceted nature of SLD and the upon the children's entry into first grade, describing them as
importance of early identification and intervention. feeling excluded and invisible. Previous research has high-
According to the findings, parents and teachers high- lighted the importance of recognizing difficulties in social-
lighted difficulties in 13 distinct areas. We categorized emotional development as early indicators of potential
these difficulties to create an item pool for early symp- issues (İzoğlu-Tok & Doğan, 2022; Sakellariou et al., 2020;
toms. We created an item pool at the end of the study and Tercan & Yıldız-Bıçakçı, 2018). In particular, a qualitative
organized it by age groups (0–3, 3–6 and school age, out- study by İzoğlu-Tok et al. (2021) found that children with
lined in Appendix C). SLD felt marginalized and invisible due to experiences of
bullying, with participation in mainstreaming services often
Early developmental symptoms of SLD equating to feelings of "rejection" and "not belonging."
Reflecting on both our findings and those of previous stud-
Our results showed that, according to parent observations, ies, children were frequently described as "silent," "vulner-
children primarily experienced language and communica- able," "sensitive," and "introverted." Thus, it is essential that
tion difficulties—such as challenges with pronunciation, these characteristics be considered as potential risk factors
initiating communication, and speaking—during the first and integrated into the item pool for developing assessment
three years of their lives. After age three, they also struggled tools.
to express their feelings and thoughts and tended to overuse Another significant observation was that children showed
fillers in their speech. Previous studies have consistently challenges in motor skills that require coordination, speed,
identified these difficulties in language and communication application of strength, balance, and drawing abilities. Par-
development as early symptoms (Aunio et al., 2021; İzoğlu- ents often described these challenges as clumsiness during
Tok & Doğan, 2022; Price et al., 2022; Quiroga Bernardos physical activities, such as running or playing basketball.
et al., 2022). Longitudinal research emphasizes that chil- These issues were noted to persist throughout the school
dren diagnosed with SLD face challenges in both receptive years. Similar challenges have been highlighted as early
and expressive language skills during early developmental indicators of SLD in prior studies (Flores et al., 2022). Wes-
stages. Consistent with our findings, these challenges per- tendorp et al. (2011) determined that a greater learning lag
sist into later years (Carroll et al., 2014; Thompson et al., in children correlates with poorer motor skill scores. Firat
2015; van Viersen et al., 2017, 2018). Van Viersen et al. and Bildiren (2024) observed that children with SLD often
(2017) reported that children diagnosed with SLD begin to began walking later than typical in the 0–2 age range and
lag behind their peers in receptive language skills around faced challenges in both fine and gross motor skills as they
the 17th month and in expressive language skills around the grew older. Although our study provides additional insights
23rd month. Unlike this study, our participants did not report from parents regarding motor development issues, there is a
any challenges related to receptive language skills. Parents general agreement that difficulties in motor skills are criti-
in Turkey apparently prioritize their children's speech over cal for identifying children at risk. Hence, it's essential to

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25562 Current Psychology (2024) 43:25551–25567

include these challenges in the item pool for early identifica- research, where children exhibited difficulties in initiating,
tion of SLD. maintaining, or completing activities or tasks (Firat & Bil-
Parents reported that children faced difficulties with diren, 2024; Squarza et al., 2016; Tercan & Yıldız-Bıçakçı,
self-care skills after the age of three, a concern that aligns 2018). Our findings indicate that parents and teachers
with findings from previous studies (İzoğlu-Tok & Doğan, believe that children could achieve any task if they were
2022; Tercan & Yıldız-Bıçakçı, 2018). In Tercan and Yıldız- able to focus their attention. Consequently, problems related
Bıçakçı (2018) qualitative study, parents emphasized the to attention could be mistakenly conflated with other dif-
challenges their children encountered during toilet routines ficulties. A common dilemma faced by parents is discerning
and the dressing process. It was also observed that close rel- whether the challenges with attention are a result of learn-
atives often described the child as “unskillful” during early ing difficulties or if the inability to complete tasks stems
childhood. Consequently, challenges associated with self- from inherent attention issues. As such, our analysis sug-
care skills should be considered when developing the item gests that difficulties in various domains are often attributed
pool for an assessment tool. to an overarching issue of attention deficit by both parents
Our study revealed that children encountered difficul- and teachers.
ties with perception after age three. According to parents, In the context of diagnoses accompanying SLD, attention
these challenges were related to visual and auditory stimuli. deficiency is commonly identified (Araz Altay & Gorker,
Previous research on children at risk for or diagnosed with 2017; Squarza et al., 2016). Thus, while attention is a neces-
SLD has also underscored the significance of perception sary condition for any learning activity, it is not sufficient
skills. Some studies have focused on difficulties in color and for diagnosing the early symptoms of SLD (Learning Dis-
shape perception, while others have addressed challenges abilities Association, 2001). Assessing learning disabilities
with numbers (Aunio et al., 2021; Hellstrand et al., 2020; based solely on attention can risk misidentification as Atten-
Quiroga Bernardos et al., 2022). Additional research has tion Deficit and Hyperactivity Disorder (ADHD), another
highlighted challenges in letter knowledge, speech percep- neurodevelopmental disorder (APA, 2013). Therefore, chal-
tion, and following instructions (Quiroga Bernardos et al., lenges related to attention should be considered alongside
2022; Snowling et al., 2019). In our study, parents did not other difficulties when developing an assessment tool.
report difficulties with letter knowledge. This may be influ- Our results also indicated that children have faced dif-
enced by the prevailing belief in Turkey that children should ficulties with memory recall since preschool, a symptom
not learn letters before formal education begins. However, corroborated by previous research (Bonti et al., 2021).
in the literature, visual perception is connected with read- Studies have demonstrated a significant correlation
ing difficulties and phonological awareness (Baluoti et al., between memory deficits and learning challenges, par-
2012; Frostig, 1972). The phonological approach posits that ticularly in reading and mathematics (Mammarella et al.,
children diagnosed with learning disabilities have trouble 2018; Moll et al., 2016; Peng et al., 2018). For instance,
recognizing and manipulating phonemes in speech and mak- Moll et al. (2016) found that verbal memory deficits are
ing letter-sound matches during early phases (Wolf, 2017, p. linked to disorders in reading and mathematics, while
173). Therefore, perception skills play a crucial role in the visuospatial memory impairments are specifically asso-
learning process. Thus, we suggest that challenges related to ciated with mathematics disorders. Although our study
perception should be included in any assessment tool devel- primarily relied on reports from parents and teachers,
oped on this topic. thus lacking detailed data on memory, the recurring
Our results also showed that children had significant theme of memory challenges emphasizes its importance.
escalation in self-regulation difficulties during the school According to the information processing approach, mem-
period. Parents and teachers reported that children struggled ory plays a crucial role in learning, further highlighting
with planning and maintaining the organization of their memory as a key symptom to consider when identifying
notebooks, which often required external audits. This find- children at risk for SLD (Baddeley & Hitch, 1974). This
ing aligns with findings from other studies in the literature underscores the necessity of including memory-related
(Tercan & Yıldız-Bıçakçı, 2018; Thompson et al., 2015). A difficulties in the item pool for an assessment tool aimed
thorough review makes it clear that challenges in this par- at early detection of SLD.
ticular area are crucial and, therefore, should be included in Our findings showed that children have shown difficulty
the item pool for early identification of SLD. with location-orientation skills after age three, a challenge
Moreover, our study has demonstrated that children face highlighted in previous studies (Açıkgöz, 2019; İzoğlu-Tok
challenges with paying attention to games or tasks from & Doğan, 2022). Research into the causes of SLD points to
preschool onwards, as reported by both parents and teach- communication issues between the brain hemispheres, par-
ers. This observation aligns with findings from previous ticularly noting that problems in the right hemisphere can

13
Current Psychology (2024) 43:25551–25567 25563

impede the acquisition of directional concepts (Silver, 1989; phonological awareness and letter knowledge, among pre-
Vellutino, 1987). Therefore, this skill is essential for inclu- school children. This discrepancy may be attributed to the
sion in the item pool. Turkish curriculum, which discourages the teaching of read-
After preschool, parents reported that their children ing and writing, including letter introduction, before formal
exerted more effort to learn, exhibited reluctance to attend education begins (Ministry of National Education, 2013).
school, and could only advance to a certain level of diffi- Hence, it's likely that parents did not recognize their chil-
culty in other areas. We interpreted these behaviors as out- dren’s difficulties in this area as notable challenges during
comes of the cumulative difficulties experienced across all the preschool period. Apart from reluctance to read, all other
areas. For example, an increased effort to learn may stem difficulties align with the DSM-5 diagnostic criteria (APA,
from perception challenges (Karakoç, 2020). The DSM-5 2013), suggesting that reluctance to read may stem from
also points out a decline in academic performance as a dis- underlying challenges.
tinguishing feature of SLD from other neurodevelopmental One teacher we interviewed suggested revising the cur-
disorders (APA, 2013), suggesting that children may need to riculum, especially regarding the teaching of certain letters,
work harder to achieve the same performance level as their such as 'b' and 'd'. In Turkish, each sound corresponds to
peers in early stages. These indicators should, therefore, a letter, and when teaching reading, letters are introduced
enhance the comprehensibility of the item pool. in groups. For example, the third group includes six letters
Our findings underscore that motivation is a critical early ('ö', 'r', 'ı', 'd', 's', 'b'), taught consecutively, placing 'b' and
symptom in the developmental process, especially post-pre- 'd' close together, which can confuse many children. This
school. Previous research has identified a lack of motivation curricular approach may influence teachers' perceptions of
as an early indicator of SLD (Firat & Bildiren, 2024; Pesova these issues as early symptoms of SLD in Turkey.
et al., 2014). The decrease in motivation during the school Challenges in writing and mathematics are consistent
period may be attributed to ongoing difficulties. Since strong with DSM-5 diagnostic criteria and existing literature (APA,
motivation and a positive self-image are essential for learn- 2013; Fırat & Erdem, 2020; Zhang et al., 2020). Fırat and
ing, challenges in this domain can significantly obstruct Erdem (2020) found that a significant portion of students
educational progress (Aro & Ahonen, 2011). Pesova et al. who struggled with mathematics in the 1st grade continued
(2014) observed that many students with SLD often remain to face challenges in the 4th grade, including issues with
unnoticed for extended periods, further complicating their rhythmic counting, concept comprehension, problem-solv-
learning, motivation, and confidence. Thus, early detec- ing, number knowledge, and making comparisons. Mathe-
tion is vital. Accordingly, challenges related to motivation matics skills are often less emphasized compared to literacy
should be included in the item pool of any assessment tool skills in early education. Thus, difficulties in reading, writ-
designed to identify children within the risk group. ing, and mathematics should be integral to the item pool for
early SLD detection.
Early academic symptoms of SLD
Overview of developmental symptoms
According to our research, difficulties in reading, writing,
and mathematics become evident during the school period, A significant finding from our study is the progressive
as specified in the DSM-5 (APA, 2013). Additionally, simi- increase in difficulties experienced by children at risk for
lar challenges have been recognized as early symptoms in SLD, which closely follows the critical stages of their devel-
previous literature (Hellstrand et al., 2020; Navarro Soria et opment. Initially, parents noted early symptoms in language
al., 2020; Quiroga Bernardos et al., 2022). and communication skills, identifying developmental lan-
Reading has been the most extensively studied area (Ozer- guage disorders and language skill difficulties as potential
nov-Palchik et al., 2017; Quiroga Bernardos et al., 2022; indicators of future SLD (Quiroga Bernardos et al., 2022;
Snowling et al., 2019) as it represents the most common Thompson et al., 2015; van Viersen et al., 2017, 2018).
difficulty associated with SLD (APA, 2013). Parents and We observed that language development difficulties
teachers in our study reported that children faced challenges became evident in social settings, potentially impacting chil-
with reading comprehension, letter mixing, slow reading, dren's social development (Sakellariou et al., 2020). Con-
frequent reading errors, and reluctance to read. Partanen and sequently, social-emotional development challenges may
Siegel (2014) found that children at risk of reading difficul- arise following difficulties in language and communication.
ties in kindergarten scored lower in word and letter recogni- Socialization introduces environments where motor skills
tion, phonological processing, and rapid naming compared are actively utilized, making differences in motor develop-
to their peers not at risk. Unlike other studies, our research ment noticeable as children engage with their surroundings.
did not identify challenges in early literacy skills, such as Similarly, parents did not perceive challenges in perception,

13
25564 Current Psychology (2024) 43:25551–25567

attention, and memory as significant until entering the first informing policymakers and education officials. Longitu-
grade. These early developmental symptoms can influence dinal tracking of children with difficulties ensures ongoing
academic performance later on. assessment and progress monitoring, empowering families
Our study uncovered developmental symptoms across and educators to intervene early and improve developmen-
multiple areas at early life stages, suggesting that accumu- tal outcomes and educational success for affected children.
lating difficulties prevent children from realizing their full
potential. This accumulation leads to diminished motivation
and self-esteem, driving children towards invisibility-a phe- Conclusion
nomenon we described as a negative self-concept.
Parents and teachers reported developmental difficul- The exploration of early developmental challenges among
ties early on, noting that foundational challenges expanded children diagnosed with SLD presented in this study illumi-
as new difficulties emerged. We depicted this progression nates the multifaceted nature of this condition and underscores
as a pyramid, illustrating the Matthew effect—where ini- the critical importance of early identification and interven-
tial disadvantages lead to compounded challenges, echo- tion. Through qualitative interviews with parents and teach-
ing the adage "the rich get richer, and the poor get poorer" ers, a comprehensive item pool was established, delineating
(Gladwell, 2008). This effect, evident in both reading and difficulties across various developmental domains from
mathematics, highlights the escalating nature of difficulties infancy through primary school. The findings highlight that
in development (Flores et al., 2022; Ozernov-Palchik et al., challenges in language and communication emerge as early
2017; Zhang et al., 2020). as infancy, followed by social-emotional, motor, perceptual,
Analyzing these challenges, we noted the influence of the attentional, self-regulatory, memory, and academic difficul-
developmental model, which suggests a complex interplay ties during subsequent developmental stages. The study's
of factors in a child's development. Before facing academic thorough examination not only contributes to the existing
challenges, children experience difficulties in multiple literature on early symptoms of SLD but also emphasizes the
developmental areas, underlining the potential long-term necessity of integrating these findings into assessment tools
impact on learning behaviors (Kass & Maddux, 2005). for timely identification and intervention. By elucidating the
Theories from Piaget, Vygotsky, and others highlight progression of challenges experienced by children at risk
critical periods in development. Observations from par- for SLD, this research underscores the cumulative impact of
ents and teachers suggest that learning difficulties are often developmental difficulties and advocates for proactive mea-
perceived as delays in achieving expected milestones. sures to support affected children's holistic development.
For instance, a delay in language development can affect Moreover, the study's insights hold significant implications
social interactions, emphasizing the importance of recog- for practitioners and policymakers, emphasizing the impera-
nizing and addressing challenges early. In Turkey, regula- tive of early intervention strategies aligned with the develop-
tions emphasize early intervention for children with diverse mental needs of children with SLD, ultimately fostering their
needs (Decree-Law No. 573, 1997). However, SLD diag- optimal growth and learning outcomes.
noses typically occur after the first grade, underscoring the
need for earlier assessment and intervention tools. Limitations
This study has provided researchers with a crucial item
pool sample, facilitating the development of comprehensive This study primarily examined the past observations of
screening tools tailored to various age groups (0–3, 3–6, teachers and parents. Additionally, it was confined to the
and school age). Collaboration with families, educators, research questions formulated by the researchers, which
and health professionals ensures the validity and reliability encompass information about the children's preschool and
of these tools across different populations. Moreover, the pre-diagnosis school period. A notable limitation of this
research contributes to expert and educator training, offer- research is the potential variance in the levels of perception
ing sessions on early sign recognition across multiple devel- and expression skills among participants in the study group.
opmental domains. By identifying specific areas of concern
like language, communication and social-emotional skills, Acknowledgements We would like to express our gratitude to the
children, parents, and teachers who generously shared their experi-
the study informs the creation of early intervention pro- ences and time with us. Additionally, a heartfelt thank you to our col-
grams. Advocating for the integration of screening and leagues for their valuable contributions.
intervention protocols into educational systems, including
kindergartens and primary schools, underscores the impor- Author contributions 1st author: conceptualization, data curation, for-
tance of early support for children at risk of SLD. This mal analysis, investigation, methodology, software, writing – original
draft, visualization, validation.
research sheds light on the needs of children from infancy, 2nd author: visualization, supervision, writing – review & editing.

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Current Psychology (2024) 43:25551–25567 25565

Funding Open access funding provided by the Scientific and Techno- American Psychiatric Association. (2013). Diagnostic and statistical
logical Research Council of Türkiye (TÜBİTAK). The authors did not manual of mental disorders (DSM–5) (5th ed.). American Psychi-
receive support from any organization for the submitted work. atric Organization.
Araz Altay, M., & Gorker, I. (2017). Assessment of psychiatric comor-
Data availability The data that support the findings of this study are bidity and wısc-r profiles in cases diagnosed with specific learn-
available on request from the corresponding author. The data are not ing disorder according to DSM-5 criteria. Noro Psikiyatri Arsivi,
publicly available due to privacy or ethical restrictions. 55(2), 127–134. https://doi.org/10.5152/npa.2017.18123
Aro, T., & Ahonen, T. (2011). Assessment of learning disabilities:
Cooperation between teachers, psychologists and parents.
Code availability The code conducted from the findings of this study
NiiloMäki Institute.
is available on request from the corresponding author. The code is not
Aunio, P., Korhonen, J., Ragpot, L., Törmänen, M., & Henning, E.
publicly available due to privacy or ethical restrictions.
(2021). An early numeracy intervention for first-graders at
risk for mathematical learning difficulties. Early Childhood
Declarations Research Quarterly, 55, 252–262. https://doi.org/10.1016/j.
ecresq.2020.12.002
Ethics approval Ethics approval was obtained from Hacettepe Univer- Baddeley, A. D., & Hitch, G. (1974). Working memory. Psychology
sity Clinical Research Ethics Committee (KA-19141), along with ad- of Learning and Motivation, 8, 47–89. https://doi.org/10.1016/
ministrative permissions from the Turkish Ministry of National Educa- S0079-7421(08)60452-1
tion (MoNE). The study was performed in accordance with the ethical Baluoti, A. R., Bayat, M. R., & Alimoradi, M. (2012). Relationship
standards as laid down in the 1964 Declaration of Helsinki and its later between visual perception and reading disability in primary stu-
amendments or comparable ethical standards. dents of Ahwaz city. Research Journal of Applied and Basic Sci-
ences, 3(10), 2091–2096.
Consent Informed consent was obtained from all individual partici- Bonti, E., Sofologi, M., Efstratopoulou, M., Katsiana, A., Papanto-
pants included in the study. niou, G., & Kougioumtzis, G. A. (2021). Low auditory-verbal
cognitive profile: A “risk factor” for specific learning difficulties
in preschool Children in Greece. Psychology, 12(02), 181–204.
Declaration of generative AI and AI-assisted technologies in the writ-
https://doi.org/10.4236/psych.2021.122012
ing process While composing this work, the authors used Scholar
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existing language. It is crucial to emphasize that Scholar Chat-GPT
ogy, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238
was solely employed to enhance the quality of the writing and facili-
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tate better communication of ideas, and not to generate new content.
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Following the application of this tool, the authors reviewed and edited
later mathematical difficulties? Journal of Educational Psychol-
the content as needed and takes full responsibility for the content of
ogy, 113(5), 911–928. https://doi.org/10.1037/edu0000640
the publication.
Butler, R. J., & Gasson, S. L. (2005). Self esteem/self con-
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Competing interests The authors have no competing interests to de- and Adolescent Mental Health, 10(4), 190–201. https://doi.
clare that are relevant to the content of this article. org/10.1111/j.1475-3588.2005.00368.x
Carroll, J. M., Mundy, I. R., & Cunningham, A. J. (2014). The roles of
Open Access This article is licensed under a Creative Commons family history of dyslexia, language, speech production and pho-
Attribution 4.0 International License, which permits use, sharing, nological processing in predicting literacy progress. Developmen-
adaptation, distribution and reproduction in any medium or format, tal Science, 17(5), 727–742. https://doi.org/10.1111/desc.12153
as long as you give appropriate credit to the original author(s) and the Chordia, S. L., Thandapani, K., & Arunagirinathan, A. (2020). Chil-
source, provide a link to the Creative Commons licence, and indicate dren ‘At Risk’ of developing specific learning disability in pri-
if changes were made. The images or other third party material in this mary schools. The Indian Journal of Pediatrics, 87(2), 94–98.
article are included in the article’s Creative Commons licence, unless https://doi.org/10.1007/s12098-019-03130-z
indicated otherwise in a credit line to the material. If material is not Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualita-
included in the article’s Creative Commons licence and your intended tive, quantitative, and mixed methods approach. Eğiten Kitap.
use is not permitted by statutory regulation or exceeds the permitted Firat, T., & Bildiren, A. (2024). Developmental characteristics of
use, you will need to obtain permission directly from the copyright children with learning disabilities aged 0–6 based on parental
holder. To view a copy of this licence, visit http://creativecommons. observations. Current Psychology, 43(4), 2909–2921. https://doi.
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Fırat, T., & Erdem, E. (2020). Views of classroom teachers regarding
the processes of 1st and 4th graders having difficulty in learning
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