A Checklist to Aid Clinicians in Excluding Specific Learning Disorder in Adolescents with Academic Difficulties: Delphi Validation

Background: Among treatment-seeking adolescents, academic difficulties that are secondary to factors such as emotional disturbances may respond to relatively simple educational or behavioral interventions. In contrast, those with specific learning disorder (SLD) typically require specialized interventions, which are often unavailable in low-resource settings. Currently, no screening tool exists to help clinicians distinguish these groups. Hence, this study aimed to develop and content-validate, using a Delphi process, a parent-rated checklist designed to exclude SLD and identify secondary causes of academic difficulties in treatment-seeking adolescents. Methods: Checklist items were derived from established diagnostic criteria and existing assessment tools. A panel of five experts (two child psychiatrists, one psychiatrist, and two clinical psychologists) participated in a structured Delphi process to evaluate the relevance and clarity of the items. Results: The Checklist for Learning Evaluation in Adolescent Remediation (CLEAR) was developed. After three Delphi rounds, all items met the predefined consensus criteria. The final tool comprises 34 items across six sections—early language development; reading development; writing development; mathematical development; school and environmental factors; and emotional and behavioral observations—with an optional 12-item Extended Checklist. Conclusions: CLEAR demonstrated satisfactory preliminary content validity; further field testing and psychometric evaluation are required to establish its clinical utility.