A parent whose child I worked with recently, was told the following:
“Dyslexia. is a medical condition and only medical doctors (i.e., neurologists) are in a position to diagnosis dyslexia.”
Neurologists rarely assess for dyslexia. They would not have the time, nor are the tasks needed to be done typically done in a neurologist’s office.
A typical neurological consultation lasts between a half-hour to 45 minutes. If it is the first visit (often this is the only visit), the first half will be taken up with a clinical interview with the parents to clarify the course of the problem and to take a detailed history.
The next 15 minutes or so has the child going through a variety of neurological function screening tasks such as tapping each finger rapidly to the thumb in succession, walking on a straight line, tracking visual field, and other fine and gross motor type of activities for the purpose of screening for any neurological irregularities.
These screenings can offer commentary on whether there are any gross neurological concerns, as well as what has been historically called “minimal neurological dysfunction.” Some neurologists may have the child write their name and copy a series of symbols using paper and pencil.
Schools have even said that parents need to get an MRI. Really???? For a reading problem????
fMRI studies have been used in research, but do not offer the diagnostic utility needed in a dyslexia evaluation. Not only that, but the child would be given the absolutely wrong message that there is something wrong with his/her brain. When children are struggling with reading, spelling and writing, that is the last thing that they need.
Essential of a Dyslexia Evaluation
The following are the essentials to include in a good dyslexia assessment. rarely do medical doctors do such testing;
- Reading from a graded word list to determine word identification skill adequacy and levels of automatic word reading response.
- Reading from real and nonsense words in isolation under timed conditions.
- Reading graded level passages aloud under standard conditions to determine reading accuracy, reading fluency and oral reading competence.
- Spelling of real and nonsense words.
- Writing of a paragraph.
- Screenings of phonological processing competence including phonemic awareness and measure of rapid automatic naming
- Perceptual screenings including copying a series of increasing geometric designs.
- Screenings of language functions.
Minimally, to do the above tests it would probably involve at least two hours of face time with the child, not to mention the time scoring, interpreting and writing up the results.
In order to make a competent statement about the diagnosis of dyslexia the elements mentioned in the list above must be included. The manner in which a child responds to the words and passages is the primary way that a determination of dyslexia can be made. Spelling and writing need to be a part of the story as they are essential in terms of the ultimate clinical diagnosis.
Who Should Do the Testing?
Who then are the best professionals to do an assessment of dyslexia?
Typically psychologists, (also school psychologists) are very well versed in the assessment areas of concern. However, you have to make certain that this domain of expertise is under their area of competence. For example, a psychologist specializing in the treatment of eating disorders or depression may not have the experience or expertise to assess dyslexia.
Reading/Learning specialists and other special educators who do this type of testing are also worth considering, as they often have a solid experience in assessing a broad number of areas that should be considered.
Speech and Language professionals and specialists in auditory processing may also be helpful, but they are typically not as versed in the broad areas of academic functioning that are necessary in assessing.
Don’t let mythologies get in the way.