Evaluation of the prognosis, prognostic factors, and quality of life in individuals with specific learning disorder during adolescence

Objective: This study aimed to evaluate the current status of children who were diagnosed with specific learning disorder (SLD) during primary school in their adolescence, to identify factors affecting the prognosis of SLD (such as age at diagnosis, educational support, and comorbid psychiatric conditions), and to examine the quality of life of individuals with SLD by determining the factors that influence it. Method: The sample of the study consisted of 81 adolescents aged between 13 and 18 years who had been diagnosed with SLD during their primary school years. There was no control group in this study. Participants were identified either during their outpatient visits or through screening of the hospital information system, and were invited to participate via telephone. The interviews were conducted between June and December 2024 at the outpatient clinic of the Department of Child and Adolescent Psychiatry at Celal Bayar University. During the interviews, the K-SADS-PL-DSM-5 (Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version) and TILLS (Test of Integrated Language and Literacy Skills) were administered by the researcher, and a clinical follow-up data form was completed. Parents were given a sociodemographic data form to fill out, while adolescents completed the Pediatric Quality of Life Inventory (PedsQL), Adolescent Coping Orientation for Problem Experiences (ACOPE), Rosenberg Self-Esteem Scale, Social Support Evaluation Scale for Children and Adolescents, Strengths and Difficulties Questionnaire (SDQ), and a form assessing perceived negative outcomes and socio-emotional and environmental factors related to the diagnosis of SLD. The data were analyzed using SPSS software through descriptive statistics, correlation analysis, and multiple regression analyses. Results: A total of 81 adolescents diagnosed with SLD during primary school, including 33 girls and 48 boys aged between 13 and 18, were included in the study. No significant relationship was found between language and literacy skills assessed by TILLS and the duration of education; however, TILLS total scores were significantly associated with the age of reading and writing acquisition and WISC-R scores. In evaluations using the PedsQL, no significant relationships were found between quality of life and sociodemographic variables such as age, gender, parental education level, family history of illness, or type of education. Higher quality of life scores were observed in individuals with longer durations of special education, higher levels of social support, greater self-esteem, and higher scores on active coping strategies. In contrast, lower quality of life scores were found among individuals with more emotional and behavioral problems, lower perceived academic achievement, reported literacy difficulties, and those using maladaptive coping strategies. Significant negative correlations were found between the SDQ total score and all subscales of the PedsQL. According to regression analyses, the most influential variables on quality of life were the SDQ total score, level of social support, self-esteem, avoidant coping strategies, and perceived literacy difficulties. It was also observed that individuals who had received special education support had higher quality of life scores. Conclusion: This study provides a multidimensional evaluation of the language, literacy, and quality of life profiles of adolescents diagnosed with SLD, contributing valuable insights to the literature. The findings reveal that individuals with SLD continue to experience significant difficulties in language and literacy skills during adolescence, and that these difficulties are associated not with the duration of education, but with individual cognitive factors and the age at which literacy skills were acquired. Significant relationships were found between quality of life and variables such as self-esteem, social support, coping styles, and emotional-behavioral symptoms, demonstrating that quality of life is affected not only by academic but also by psychosocial components. The data clearly show that the impact of education on the individual depends not solely on its duration, but on how well it is structured to suit the individual's specific characteristics. Therefore, flexible and goal-oriented special education practices that take into account individual strengths and weaknesses are critically important for supporting both academic progress and quality of life. Accordingly, the study emphasizes the need to support individuals with SLD not only academically, but also in psychological, social, and emotional domains, and recommends that structured and multidimensional intervention programs that enhance self-esteem, foster effective coping skills, and strengthen social support be integrated into educational processes. Additionally, the developmental course of SLD should be better understood through large-scale, multicenter, and long-term follow-up studies, which would allow for early intervention and the development of individualized, holistic, and sustainable support models. Keywords: Specific learning disorder, quality of life, adolescence, language and literacy skills, special education