Evaluation for Dyslexia: An Overview

Parents are at their most vulnerable when their child is struggling. They want information and trust experts to tell them what is wrong—and to give advice about how they can make it better. But they need to be careful about finding the information they desperately seek and the advice they fervently want. We often get asked whom a parent should contact if they have a concern about dyslexia and would like to have their child evaluated for dyslexia, and what such an evaluation should include.

Finding an evaluator

A number of professionals have the training and experience to evaluate children, or oversee an evaluation, for dyslexia. They include psychologists (school psychologists, educational psychologists, neuropsychologists), developmental-behavioral pediatricians, child neurologists, reading specialists and, especially in very young children, speech pathologists. Evaluations can be expensive; the Scottish Rite Children’s Dyslexia Centers often evaluate children for dyslexia on a sliding scale of fees. Make sure that the evaluator is comfortable using the word “dyslexia” and will state the word in the diagnosis.

Components of an evaluation for dyslexia

The evaluator should have a deep knowledge of dyslexia which will allow him or her to explore and identify the most relevant symptoms in a careful and complete clinical history. No two evaluators or evaluation centers will test for dyslexia exactly the same way.

The diagnosis of dyslexia is discussed in Dr. Sally Shaywitz’s book Overcoming Dyslexia (p. 133) and is outlined briefly here. The clinician evaluating your child uses his or her knowledge of dyslexia and, through history, observation and psychometric assessment, makes a judgment whether or not your child has dyslexia. In order to accomplish this the evaluator should: establish a reading problem, determine whether it is “unexpected” and demonstrate evidence for a relative weakness in phonology. The diagnosis of dyslexia should reflect a thoughtful synthesis of all the clinical data available.

A typical evaluation will include:

• An informed history of the child’s language development and any issues relating to attention
• A careful history of the child’s educational progress
• Assessment of reading accuracy (untimed tests of reading individual words and nonsense words)
• Assessment of reading fluency (timed measures of reading individual words and nonwords as well as timed measures of reading connected text)
• Assessment of phonological processing (blending and pulling apart individual words into their basic sounds)
• Assessment of spelling
• Assessment of math, including word problems and calculations
• Assessment of general intelligence, including verbal and nonverbal ability

Evaluations often take place over two days, with about four to five hours of testing each day. But the duration can vary, depending on the individual being evaluated and the evaluator.

After the evaluation, the evaluator will review and synthesize the components of the assessments and make a determination about whether the child has dyslexia.

Why it is important to diagnose dyslexia in your child

As discussed in Overcoming Dyslexia, a diagnosis of dyslexia should empower you and your child to know:

• What your child is experiencing in school has a name—dyslexia
• Scientific progress enables us to know how to define dyslexia
• How to screen for dyslexia
• The most effective, evidence-based interventions
• There is a neural basis for dyslexia

Keep in mind our sea of strengths model (below) that dyslexia is a paradox, that the same child who has a weakness in decoding or reading fluently also may have significant strengths in reasoning and thinking. A dyslexia diagnosis should never limit expectations for children’s futures. Instead, it should empower them to obtain the evidence-based interventions and accommodations needed, so that they are defined by their strengths rather than the circumscribed weaknesses in decoding and fluent reading that characterize dyslexia.