Prevalence and pattern of learning disability in India: A systematic review and meta-analysis

Introduction: Specific learning disorder (SLD) is a much common concept widely discussed nowadays. Specifically, it is a neurodevelopmental disorder found in children and adults. According to the Diagnostic and Statistical Manual of Mental Disorder (DSM)-V, SLD stands for a group of disorders that impedes the ability to learn or to use the requisite academic skills. It comprises impairment in reading, writing, and mathematical ability. Aim of the Review: This systematic review aimed to identify the prevalence and pattern of learning disability among children of India. Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and is also registered under PROSPERO vide CRD Number: CRD42021286224. The literature search was done using Boolean operators in databases such as PubMed, ProQuest, Cochrane, ScienceDirect, Google Scholar, and websites such as ResearchGate, Academia, and so on. The literature search was focused on Indian studies conducted between 2000 and 2020 (20 years). The initial search identified 122 articles across the databases. Following the screening process and removing the duplicate files, 20 articles were included in the review. According to the predetermined protocol, the researcher independently searched, reviewed, collected, extracted, and evaluated the requisite data and relevant information from each research article. Each individual research article was assessed for its quality using the “critical appraisal tool for use in systematic reviews addressing questions of prevalence.” In the current review, considering the heterogeneity between the studies with regard to sample selection, geographical location, and instrument used for data collection, a random-effect model was adopted. The statistical evaluations were done through OpenMeta (Analyst). Results and Discussion: The prevalence of learning disability among Indian children ranges from 2.16% to 30.77% across the studies. The pooled prevalence of LD among children and adolescents is estimated to be 10.70% (95% confidence interval [CI]: 7.10% to 14.3%), and the median age was 6–12 years. The prevalence of dyslexia among children and adolescents is estimated to be 6.20% (95% CI: 4.40% to 7.90%; I2 = 97.01% P < 0.001), while the prevalence of dysgraphia is estimated to be 6.30% (95% CI: 3.60% to 9%; I2 = 97.83% P < 0.001). Moreover, the prevalence of dyscalculia is much lower and it is estimated to be 4.90% (95% CI: 2.60% to 7.20%; I2 = 97.59% P < 0.001). The finding of this review is consistent with another review by the National Survey of Children's Health, USA, which estimated the lifelong prevalence of learning disability to be 9.7% in children (USA) from 3 to 17 years of age. Conclusion: The finding of the review explains that learning disability affects quite a large number of Indian Children. The information from the current review may set a benchmark to assess the disease burden of the country and it will be a reference for resource planning and health-care policymaking.