Patterns of specific learning disorder and comorbid psychiatric disorders among children at the child psychiatry clinic of Kenyatta National Referral Hospital, Kenya

Abstract

Introduction: Many mental illnesses coexist with Specific Learning Disorder (SLD), as is widely acknowledged around the world. The presence of these psychiatric conditions in children with SLD worsens their clinical image and has an effect on their learning disability prognosis. In the Kenyan context, there is a scarcity of literature on comorbid conditions in learning disabilities. Aim: The aim of this study was to examine specific learning disorder and comorbid psychiatric disorders among patients who attended child psychiatry clinic at Kenyatta National Hospital between 1st January 2019 and 31st December 2019. Methodology: This was a descriptive retrospective study where clinical records of 256 patients between the age of 7 to 12 years, were reviewed. Out of the 256 patient files, thirty-five 35 were found to have a diagnosis of SLD. Data collection and analysis was done from the 35 patients files for the study. A data tool designed by the researcher was used to collect data. Data analysis: Data was entered into RedcaP then transported to MS Excel. Analysis was done using SPSS version 27. For discrete variables, frequency tables were provided, while for continuous data, means and standard deviations were provided. Pearson Chi-square and fishers exact test were used to analyse the associations between variables. For variables with cell numbers less than 5 fishers exact test was used. Statistical significance thresholds were set at p < 0.05. Results: Thirty-five 35 (13.7%) of the patients’ files were found to have a diagnosis of SLD. The mean age was 9.31 years. Dyslexia and dysgraphia were diagnosed in 11.7%, 6.3% of the cases respectively. Dyscalculia was diagnosed only as combined type in 2.9% of the cases. The study found that, SLD was more among boys than girls at the ratio of 4:1. Psychiatric comorbidities were diagnosed in 82.3% of cases with SLD. ADHD was the most common diagnosed psychiatric comorbidity, it accounted for 40% of the cases. In this study; family history of SLD, neonatal complications, delayed milestones, post-natal complications, parental level of education and parental occupation did not reach significant statistical difference with SLD. Maternal age and dyslexia, conduct disorder and dysgraphia, conduct disorder and dyslexia and conversion disorder and dyscalculia reached a significant statistical difference.