Some professionals claim types or subtypes of dyslexia; however, none of the scholarly research I’ve read is convincing. It seems more like they are either misinterpreting what they see, or don’t realize dyslexic children do not exist in a vacuum, and each comes to the evaluator or educator with different home and educational experiences which may impact their reading skills. Further, like any group of people, dyslexics are of course individuals. Since so few evaluators and educators can even recognize dyslexia, especially in a bright or gifted student, it’s difficult to see the benefit to breaking it down further, but the terms I’ve seen include: surface, phonological or dysphonetic, rapid automatic naming dyslexia, visual or dyseidetic, double deficit, attentional. When reading the descriptions, they all sound like aspects of dyslexia which may present more or less severe in any particular child at a particular time, depending on where they are in reading skills and what instruction they’ve received. The “attentional” label simply refers to the typical letter reversals and misreading of letters or letter-sound connection difficulties that are typical with young dyslexic readers — due to the harmful and over-mislabeling of gifted dyslexic children with ADHD apart from any diagnostic support and contrary to what parents may witness, or educators suggesting dyslexics struggling in the classroom or on a spelling test aren’t “paying attention” or are making “careless mistakes,” it seems like a very poor choice of terms. What is your perspective on the “types of dyslexia”?

Dr. Pierson's Response: 

Indeed, the terms you list are all 'out there' being used. In addition to managing DyslexiaHelp, I have a private clinical practice (3LI) where I evaluate, diagnose, and treat individuals with dyslexia. When making a diagnosis, we do differentiate the individual's skills in (or challenges with) phonological awareness (PA), rapid naming (RAN); and phonological memory (PM); and how challenges in those areas impact reading, spelling, and writing. I agree with you that this then results in the individual’s skills falling somewhere along a continuum of dyslexia. For example, someone may have very poor PA skills, but only a relative weakness in RAN, whereas another may have poor RAN but relatively intact PA skills. This latter pattern can sometimes be seen in someone who has been getting intervention (since intervention improves PA as you point out). This can make the diagnosis tricky since poor PA skills are one of the hallmarks of dyslexia. Someone who has poor PA and RAN (i.e., the double deficit) is a much more clear-cut case to diagnose.

At 3LI, we stick to this definition and instead of putting a label on the diagnosis beyond ICD-10 Developmental Dyslexia, we work very hard in our reports to describe the individual's profile of strengths and weaknesses.

Things get muddy when we throw in ADHD, particularly, and I just wrote about this issue today -- a student who gets "distracted" when reading. Many times, I find that the pure act of reading is so hard to the student and so fruitless (i.e., the efforts are not paying off), the student exhibits inattentive behaviors IN RESPONSE TO THE TASK OF READING (or writing). We can also see it as a response from a smart kiddo who knows that he can't access (i.e. read) the text, so why bother... I think we need to be very cautious when throwing out a label or premature diagnosis of ADHD for a student with a reading disorder, especially prior to having carefully looked at reading/writing skills.

So, I do think we see a continuum, and a student can look different depending at what point we get him/her for an assessment (i.e., what type of intervention has been delivered, if any, and how much). I do think it is key to describe the behaviors and the student’s profile of strengths and weaknesses. This is what will drive intervention...and that is the whole point of doing a diagnostic assessment.