This is a guest blog post contributed by local San Diego licensed educational psychologist, Meredith Gleason.
October is Dyslexia Awareness Month. Dyslexia, which is a language-based disorder that primarily impacts reading, accounts for 70 to 80% of learning disabilities. It is defined by the International Dyslexia Association as “a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities.” These are signs you can observe in a child if you know what to look for.
Dyslexia is common; about 20% of children experience reading problems associated with dyslexia. In addition, dyslexia is hereditary, so if there is a family history, there can be an increased chance of children within that family also having dyslexia. However, children with dyslexia also possess many strengths; they are often athletic, artistic, creative, very observant, curious, can think in pictures as opposed to words, can be intuitive, deep-thinkers, and have strong imaginations.
Since it can be difficult to know whether your child’s reading or spelling difficulties are normal for their age or grade level, this article will help you understand what to look for and how to get a proper assessment to identify dyslexia in your child.
Dyslexia Defined and Diagnosed
Like many disorders, dyslexia has a range of symptoms and different degrees of impact. There are also different subtypes of dyslexia. There are many terms used to define types of dyslexia, depending on the research being referenced, which can make it confusing for parents and those trying to learn more about dyslexia. Depending on the source, there can be a range of two to six types of dyslexia.
The well-established and widely-recognized neuropsychologist, Dr. Steven Feifer, who created the Feifer Assessment of Reading (FAR), a specific assessment to identify types of dyslexia, defined dyslexia into three categories that will be used in this article: Dysphonetic Dyslexia, Surface Dyslexia and Mixed Dyslexia.
Dysphonetic Dyslexia is when an individual has difficulty sounding out words in a phonological manner, relating to our language’s sounds and symbolic representations (i.e. letters). This includes breaking down words into sounds and manipulating them, such as sounding out the word “cat” as “c-a-t” then saying replacing the “c” sound in cat with the “b” sound, which would be “bat.”
These skills can also be referred to as “phonological awareness,” which are needed to read, or what is often called “decode” (i.e. sound out) words when reading or “encode” words when spelling. Dysphonetic Dyslexia is the most common type of dyslexia. Sometimes this type of dyslexia is referred to as Phonological Dyslexia or in the school setting, it can be referred to as a reading disability due to auditory or phonological processing deficits.
Surface Dyslexia is another form of dyslexia which impacts an individual’s rapid and automatic recognition of words in print. Sometimes this is referred to as Visual Dyslexia or Orthographic Dyslexia.
Individuals with Surface Dyslexia have difficulty with rapidly recalling information from their long-term memory to identify words in print fast enough to read or spell effectively. They can also have visual perception or visual memory deficits that impact their word recognition. Symptoms of Surface Dyslexia include difficulty with sight words, irregularly spelled words, and frequent inserts or omissions when reading aloud. Surface Dyslexia often impacts reading fluency, which then can have a domino-effect on reading comprehension.
The last type of dyslexia according to Dr. Feifer is called Mixed Dyslexia or what is sometimes called Double Dyslexia. Essentially, this means a child presents with more than one subtype of dyslexia, both Dysphonetic and Surface Dyslexia elements. This is considered the most severe type of dyslexia.
Like previously mentioned, dyslexia is a spectrum reading disorder, meaning it doesn’t not always present the same way, to the same degree for each child. Identifying the individual key areas of impact for a child with dyslexia through assessment, often referred to as a psychoeducational assessment, can drive specific intervention needed to help the child start to fill in the gaps of their reading deficits.
A psychoeducational assessment is an evaluation done by a psychologist, such as myself, which includes looking at a child’s academic achievement, cognitive and psychological processing (different areas of the brain that can impact learning), and social-emotional, behavioral abilities. A psychoeducational assessment essentially puts all the puzzle pieces together to determine why a child is struggling to learn and includes a diagnosis or diagnoses, if a child meets criteria. This can include a diagnosis of a reading disorder, under which dyslexia would fall in the DSM-V, the manual used by practitioners for diagnosis. The assessment also can include specific recommendations to support the child’s areas of need as well as identify ways to play to a child’s strengths.
Early Intervention is Key
Once a child is diagnosed or identified as having dyslexia the next step is developing an effective treatment plan, often referred to in an educational setting as intervention. Schools can have a range of interventions available for students with reading difficulties; they can have reading intervention programs that can be done within a child’s classroom or they can have more intensive reading interventions that require the child to work outside the classroom with a specifically trained reading interventionist or educational specialist.
Families looking for help outside their child’s school can find individualized support from learning centers like, La Jolla Learning, where founder, Megan Trezza, M.Ed., specializes in helping students of all ages with dyslexia.
Children who have been assessed and identified as having a significant reading disability or dyslexia in the schools may be eligible for special education, in which they might require an individualized education program (IEP) that outlines specific needs, goals, accommodations and services that child requires to learn in school. Some children with dyslexia can also be eligible for a 504 plan, which is a plan that identifies accommodations or supports a child’s needs within the general education setting.
“When should intervention start?” is often a question I get from parents. It is best to help a child with dyslexia as early as possible. Research shows that intervention works best for children with dyslexia or reading difficulties when it has taken place between kindergarten and second grade. This is when a child is learning pre-reading and basic reading skills, including the ability to identify and manipulate individual sounds which is taught as early as preschool.
Understanding that the sounds in our language connect to letters and words is another basic reading skill learned during the first couple years of school. Children with dyslexia will often show signs of difficulty in these areas, and without specific intervention or educational therapy, they may not acquire these foundational reading skills. Research shows children with dyslexia respond best to a multisensory reading intervention program which requires specific implementation, including sequencing of lessons and careful progress monitoring.
Parents also often share with me their frustration that reading concerns weren’t really noticed or identified until their child was in third or fourth grade, especially when the prime intervention window is in earlier grades. There is an unfortunate reason for this pattern of “late” identification of reading disability, such as dyslexia. From kindergarten through second grade, children are “learning to read” and from third grade on, they are “reading to learn.” When a child has not mastered the “learning to read” phase in the early grades, it is often found that when they get to the upper elementary grades, they will struggle to show their learning compared to their peers.
Unfortunately, children are most often identified in school as having a reading disability or dyslexia when they make that transition in upper elementary grades to “reading to learn,” requiring more independence in the classroom. While intervention can still be effective for upper grade students with dyslexia, they are often playing constant catch-up with their peers, and some never close that gap between their reading ability and their peers’ reading ability. Long-term effects of unidentified dyslexia can include impact on high school graduation rates and the chance of attending a 4-year college.
Evaluation Models in Schools
Parents of children struggling in reading often ask, “How do I get my child the help they need in school?” Alas, the answer to this can often be discouraging and feel like schools are waiting until a child fails before providing intervention. Sometimes school districts tell parents that a child has to be at least 2 grade levels below before they will evaluate a child for special education. However, there is no law stating as such and parents have the right to request a special education evaluation for their child at any time, at no cost to them. I recommend parents put this request for a psychoeducational assessment for special education in writing so a documentation trail can begin. It is also important to become familiar with your parent rights, such as knowing your child’s school district has to respond to your request for a special education evaluation within a 15 day time period.
When a child receives an evaluation for special education, which includes looking for a specific learning disability (SLD) like dyslexia, school districts can use different evaluation models to determine if a child meets SLD criteria. Different SLD evaluation models include the Discrepancy Model, Response to Intervention (RTI) or Patterns of Strengths and Weaknesses (PSW). Each model has different ways of identifying SLD, which can be confusing for parents because sometimes that means a child would or would not meet criteria for special education depending on which SLD model their child’s school district uses.
For example, the discrepancy model is the oldest but often viewed as the most flawed model of identifying a child with SLD. It requires the use of standardized tests to identify that a child has a significant discrepancy between their IQ and an area of academic achievement, such as reading, writing or math as well as a processing deficit (aka the direct reason for the academic deficit). However, there is about 20 years of research which indicates the discrepancy model is flawed when attempting to identify students with SLD. Many districts often still use this model though because it has been around a long time, is fairly simple to use, and is still upheld by case law.
Response to Intervention (RTI) is another evaluation method districts can use to identify students with SLD. In 2004, a law called Individuals with Disabilities Education Improvement Act (IDEA) was reauthorized to include RTI as a valid way school districts could assess for specific learning disabilities. RTI operates in terms of tiers of intervention:
- Tier 1 being what is often called “universal” and is what all students have access to in the general education classroom.
- Tier 2 is a more specific tier, targeting intervention for students “at-risk” for a disability, such as dyslexia. This group of students receive a higher level of intervention than students in Tier 1.
- Tier 3 can be interpreted differently depending on the school district; sometimes Tier 3 includes special education services and sometimes it does not.
Essentially, if a school district uses the RTI model to determine eligibility for a specific learning disability, then the district would evaluate your child’s response to intervention with alternative assessment (meaning other assessments than the traditional standardized assessments such as those used in the discrepancy model). If limited or no progress was made based on these assessments, then often the evaluation would conclude your child requires special education because they have a specific learning disability and the district would offer an IEP.
Lastly, a newer model being adopted in more progressive school districts is called Pattern of Strengths and Weaknesses (PSW). Because this is the newest model, many districts do not want to use this model due to lack of case law behind it. However, there is much research and many organizations who support the PSW model. This model uses standardized assessments to measure psychological processing and academic achievement like the discrepancy model; however, unlike the discrepancy model, the PSW model does not rely on there to be a discrepancy or gap between a child’s IQ and academic achievement.
The PSW model attempts to look more specifically at why a child is having difficulty in an area of academic achievement. This looks at a child’s pattern of strengths and weaknesses in psychological processing which includes areas such phonological awareness and rapid naming, which we know are often areas of deficits for students with dyslexia. It also looks to see if that pattern in psychological processing directly impacts a child’s academic achievement.
For example, if a child has average scores in most areas tested but then has low scores in reading, particularly in decoding, and he or she also shows a weakness in phonological awareness (an area of psychological processing related to the Dysphonetic Subtype of dyslexia), it can be concluded that the phonological awareness deficit is impacting the child’s ability to read. In the PSW model, this makes the child eligible for a specific learning disability. While the PSW model is often viewed as a refreshing, updated take on how to use standardized assessments to identify a child with a learning disability, it is also viewed as a model that needs more research behind it.
There are pros and cons for using any of these three models above, and, public school districts face the daunting task of choosing which model to adopt when it comes to identifying students with specific learning disabilities. As previously mentioned, students can meet criteria for SLD under one model but not another in the school setting, which can make the process of getting your child the help they need feel very daunting as well. This is why some parents choose to seek private services to address their child’s reading needs.
While a parent can request a school-based evaluation for special education at no cost to them, some parents prefer to pay for a psychoeducational evaluation that includes a diagnosis and specific recommendations for treatment, such as educational therapy. My practice, Empower Child Learning offers free consultations to help parents decide if their child needs an assessment for dyslexia and/or other educationally related disabilities. La Jolla Learning also offers free consultations to help parents determine what type of support their child might need to remediate reading difficulties such dyslexia.
While there is no cure for dyslexia, children can make significant progress with the right intervention. And while the journey can be more difficult past the early elementary grades, an intensive intervention can effectively teach older students to read and write and support them to perform well through school. Many adults with dyslexia, such as myself, can go on to lead academically and professionally successful lives.
About the Author
Meredith Gleason is a Licensed Educational Psychologist (LEP #3847) and the owner of Empower Child Learning with over 14 years of experience with students from preschool to college age. She has worked throughout Southern California from Los Angeles to San Diego, and received awards at the district and county level for the work she has done to help students of all abilities succeed in school. She specializes in diagnosing and identifying interventions for students with Dyslexia, Anxiety, ADHD, and Autism. In her private practice, she conducts assessments to diagnose educationally-related disorders, provides student counseling and executive functioning intervention and parent consultation on IEPs, 504s and supporting their children at home. You can connect with her at: firstname.lastname@example.org.