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The physical examination

The paediatrician will check the child’s growth (height, weight, and head size). He or she will search for any unusual features in the child’s body that suggest one of the rare genetic syndromes that are occasionally associated with specific learning difficulties.

He or she will examine the nervous system with particular care, looking for clear evidence of any abnormality (‘hard neurological signs’). This is done by checking the child’s coordination and balance, as well as his muscular strength, tone, and reflexes. The paediatrician also tests the functioning of the various nerves in the body.

The paediatrician may also look for other so-called ‘soft neurological signs’, which are more subtle evidence of difficulties in processing sensations and controlling movement. Although these signs are more common in children with specific learning difficulties, they may also be present in children without learning difficulties. They do not have the same implications as hard neurological signs and their significance remains controversial.

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