PONE-D-25-04864Exploring the Impact of Specific Learning Disabilities on University Service Utilization: A Cross-Sectional AnalysisPLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear authors,

- Overall: strong article, you're addressing a critical gap in higher education research. Holistic approach to examine both, “common” and “specific” services, providing a nuanced look at which resources students use and where improvements may be needed

- Feedback:

a) Definition/Assessment of SLD: Relies on self-report rather than official (while also GEO dependent) diagnostic criteria or validated instruments. You might consider explaining how students identified their SLD and acknowledging that self-report may differ from formal diagnoses.

b) Cross-Sectional Design: While capturing correlations you'll have a hard time establish causal relationships. I recommend emphasizing these design limitations in your Discussion

c) Sampling Strategy: The recruitment process (e.g., invitations, announcements) needs more detail to assess representativeness. While you're mentioning random sampling, large parts feel like convenience sampling. Please clarify potential response biases (e.g., if certain student groups were more likely to participate).

d) Instrumentation and Reliability: Only one overall Cronbach’s alpha reported; subscale reliabilities would improve clarity and shed light on specifics. Please provide definitions or at least examples for response categories (e.g., “rarely,” “often”) to ensure consistent interpretation and minimize interpretation possibilities, as they're quite broad.

e) Statistical Reporting: While the use of chi-square tests and multinomial regressions is appropriate, I'd like to see greater transparency. For instance, if you performed multiple comparisons, please clarify whether any p-value adjustments were made (like Bonferroni). Also, please justify the choice of multinomial over simpler logistic models. Additionally, consider reporting more precise effect sizes—such as Cohen’s d or odds ratios with full confidence intervals—in the tables for clarity.

f) Detail on Service Usage: “Common” vs. “specific” categories are helpful to grasp the big picture but may obscure usage differences for individual services. You could highlight which specific resources are used most/least to pinpoint where support might be lacking.

g) Interpretation of SLD Subtypes: You could offer more context on how each SLD subtype might explain different usage rates and tie the nature of each SLD to potential barriers in accessing or benefiting from certain services.

h) Documentation of Oral Consent: While you state that oral informed consent was obtained, without having access to the files it remains unclear how exactly you documented participants’ agreement in the online setting. Please clarify especially whether participants, for example, had to check a digital box or confirm an introductory text or audio file before proceeding, so readers understand how consent was explicitly provided and recorded.

Reviewer #2: Reviewer’s Comments on the Manuscript

General Assessment:

This study addresses a critical and timely issue—service utilization among university students with specific learning disabilities (SLDs). While the cross-sectional design offers valuable preliminary insights, certain methodological and conceptual aspects require refinement to enhance clarity, rigor, and impact. Below are detailed recommendations for improvement.

Abstract:

1. Sample and Recruitment:

o Specify the sample size and recruitment method (e.g., random sampling, convenience sampling).

o Clarify whether SLDs were self-reported or clinically diagnosed, as this significantly affects validity.

2. Interventions:

o The conclusion should explicitly recommend targeted interventions (e.g., awareness campaigns, tailored accommodations, faculty training) rather than broadly stating "improved support."

3. Statistical Presentation:

o Ensure P (for probability) is italicized throughout the manuscript.

o Briefly mention any validation performed for the study tool (e.g., pilot testing, Cronbach’s alpha).

Introduction:

1. Local Context:

o The introduction focuses heavily on SLDs in the US (Lines 79–86) but lacks context about the study’s regional setting (e.g., Middle East, specific country). Incorporate local data on SLD prevalence and university support services to strengthen relevance.

2. University Services and Gaps:

o Describe common and specific services available in regional universities, citing recent literature.

o Explicitly state the knowledge gap (e.g., "Few studies in [Region] have examined...") and how this study addresses it.

Methods:

1. Section Title:

o Rename "Materials and Methods" to "Subjects and Methods" for accuracy.

2. Single-Center Study:

o Since this is a single-center study, the title should reflect this (e.g., "…among University Students at [Institution]").

3. Questionnaire Validation:

o While Cronbach’s alpha (0.859) is reported, detail the steps in questionnaire development (e.g., expert review, factor analysis) and attach the full questionnaire as a supplementary file for reproducibility.

Results:

1. Statistical Consistency:

o Italicize P-values consistently in text, tables, and figures.

o Report all significant predictors with full statistics: odds ratio (OR), 95% confidence interval (CI), and P-value (e.g., "OR 2.68, 95% CI 1.03–7.01, P = 0.044").

2. Table & Figure Revisions:

o Expand all abbreviations in table legends (e.g., "cGPA: cumulative grade point average").

o Replace ambiguous symbols (e.g., "+") with standardized notation.

o Ensure bolded values (indicating significance) are used uniformly across tables.

o Check all figures for standard errors addition.

o Correct inconsistencies (e.g., Table 1 uses "*" for cGPA but legend uses "a").

3. Interpretation of Findings:

o Discuss why students with dyslexia/auditory processing disorder used specific services more (e.g., "This may reflect targeted accommodations like extended exam time or assistive technologies").

Discussion:

1. Substantiate Claims:

o Line 443: Clarify the incomplete reference ("As reported in [19], ...").

o Line 496: Support the claim about gender differences in help-seeking behavior with references.

2. Specialization-Specific Analysis:

o Add a paragraph discussing how students’ academic specializations may influence service utilization (e.g., STEM vs. humanities).

3. Structural Improvements:

o Include a dedicated "Strengths" subsection (e.g., large sample, validated tool) before limitations.

o Consolidate recommendations into a standalone subsection (e.g., "Policy and Practical Implications").

4. Language Refinement:

o Avoid overusing "underscores"; substitute with alternatives like "highlights," "emphasizes," or "demonstrates."

Final Recommendations:

• Methodological Transparency: Disclose limitations (e.g., cross-sectional design, self-report bias).

• Intervention Specificity: Propose actionable strategies (e.g., "Universities should implement mandatory SLD awareness modules for faculty").

• Reproducibility: Share the questionnaire and detailed validation steps.

This study has significant potential to inform inclusive education policies. With these revisions, it will achieve greater scholarly impact.

Overall Rating: Good (with revisions recommended for methodological and presentation clarity).

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Reviewer #1: Yes:  Nora Fink

Reviewer #2: Yes:  Mohsin Kazi

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Attachments

Attachment

Submitted filename: Reviewer_Comment-prof mohsin kazi.docx

University Service Utilization Patterns in Students with Specific Learning Disabilities: An Institutional Cross-Sectional Study

PONE-D-25-04864R1

Dear Dr. Asdaq,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Thiago P. Fernandes, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: The authors have thoroughly and satisfactorily addressed all the comments and suggestions raised during the review process. The revised manuscript demonstrates improved clarity, scientific rigor, and completeness. I recommend accepting the manuscript in its current form for publication.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: Yes:  Nora Fink

Reviewer #2: No

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