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Letter   |    
Dysproccia: A Necessary New Term for Impaired Higher Brain Processing
Vernon M. Neppe, M.D., Ph.D., F.R.C.P.C., F.F.Psych., M.Med.
The Journal of Neuropsychiatry and Clinical Neurosciences 2001;13:428-429. doi:10.1176/appi.neuropsych.13.3.428
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Learning DisabilityDiagnosisNomenclature

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SIR: Neuropsychiatrists, neuropsychologists, child psychiatrists, educational psychologists, and teachers frequently see a common unlabeled educational disability—a brain-related difficulty in processing information. People with this type of disability do not exhibit overt dyslexic, dysgraphic, dyscalculic, anosognosic, aprosodic, apraxic, agnosic, aphasic, or attentional deficits, yet they do not perform well. Most of the time, their hard-wired brain deficit is missed and they are regarded as "slow" or "unintelligent." Yet, when given time to perform tasks, they will negotiate them successfully. When diagnosed, they may be incorrectly labeled, almost by exclusion, as having "anxiety disorder" despite no defining symptoms, or "attention deficit disorder" despite attention and response being normal on continuous performance tests.

We lack a vocabulary for such deficits of processing information. We dearly need a new term. I suggest "dysproccia," implying an impairment of processing speeds due to presumptive higher brain dysfunction. The endpoint is slowed production, although the exact level of the difficulty—visual, auditory, reading, pure motor, or combinations thereof—may vary and may be difficult to differentiate.

Dysproccic difficulties are common. Students characteristically report insufficient time to complete their tests, or that supposedly 30 minutes of homework took hours. They may drop out of school or college or score poorly despite seeming intelligent. On multiple-choice questionnaires, they often score well on the initial items, yet the later items may be unanswered or randomly guessed at. When unrestricted in time they improve considerably, concentrating effectively on their tasks for prolonged periods.

These students lack a label despite deficits in items requiring speed in processing neuropsychological information. Because of the absence of a diagnostic label, important educational remediation may not occur. Dynamically, these students learn patterns of secondary frustration, anxiety, obsessional checking, and inadequacy. Often they are intelligent enough to cope to a point; then their non-coping leads to impairments in achievements. They may be compromised in career choice by the lack of extended time for students on college aptitude tests such as the SAT and ACT.

Dysproccia is a broad term: deficits of several different higher cortical processing mechanisms—specific auditory-motor, visuomotor or reading processing, or pure motor—could produce slowed output ultimately manifesting as school- and work-related disability. Dysproccia would be mixed when two or more subgroups coexist and undifferentiated when not subdivided. The recognition of this learning disorder is of great practical and theoretical importance. I suggest "dysproccia" and its subdivisions be introduced into our diagnostic nomenclature.




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