"But, Does She Have Dyslexia?"

December 29, 2014

Lauren is an 8 year old child in the first half of the third grade who I recently evaluated, just before the start of her school year.  My evaluation found Lauren to be a somewhat inefficient reader, although almost all of the scores obtained on her fell solidly in an average range.

In the conclusion of the report I said something like, “While a formal diagnosis of reading disability (dyslexia) was not offered at this time…” and hedged my bets a bit.  I did recommend Orton-based tutoring to help solidify her skills.

I explained the data that I had to the parents, but sometime afterward they called back with the question that I occasionally dread, “But does she have dyslexia?”  The reason I dread the question is I am often unsure.  There are kids who fall in a grey zone or they have not had any legitimate intervention to see how they would respond.

In spite of all of the “science” and good work in this field, this assessment process and the “diagnosis” is not an exact science and “dyslexia” is not something that shows up like a broken bone on an x-ray.

Here’s what I said to the mom in a subsequent letter clarifying my positon

Looking to the information derived from the Word Identification subtest of the Woodcock, it is clear from the way in which she responded that Lauren has memorized a fair number of “high-frequency” words. However, once the reading of words goes beyond Lauren’s sight memory, Lauren was seen to have difficulty. For example, words such as the following proved to be challenging for Lauren:  hurry, largest, expert, evening and passage.

Similar functioning was noted when Lauren was presented with nonsense words assessing her phonological decoding skills. Particularly noteworthy was the fact that Lauren read many of the nonsense words correctly, but did so very inefficiently. Thus, there was a significant amount of time between the presentation of the word and Lauren’s ultimate response. 

In context, from an informal reading inventory, Lauren was observed to read in a choppy and slow manner within a second grade range, although most of the words from that level passage were read accurately and her comprehension was good.   The third grade level passage proved to be very challenging and difficult for her.

As I had indicated in my original report, I do believe that Lauren continues to need solidifying of her basic decoding skills and reading fluency to improve her foundation of reading skills. Particularly important would be the development of Lauren’s multisyllabic decoding skill.

My best suggestion would be to continue to provide Lauren with as much targeted instruction focusing on enhancing her core skills.  I would then reevaluate her toward the end of the school year with an informal reading inventory, as well as word reading efficiency tasks.

In my estimation from the combined data Lauren does appear to be a “borderline” child in terms of the issue of whether she does maintain a legitimate reading disability. Since reading disability/dyslexia is a spectrum that goes from mild to severe, it is sometimes difficult to know just where the cut-off is in terms of the presence or absence of such a disability. Depending upon how Lauren responds to instructional intervention would add greater information to whether Lauren does, in fact, maintain a learning/reading disability (dyslexia).  

After reading the letter that I sent, the mom called back with a follow-up question.

“But, does she have dyslexia?”




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