My son is six years old and has been having reading difficulties and is starting to reverse his letters and numbers. Dyslexia is a concern of mine and the elementary school in which he attends does not seem to want to help me with testing. Is this something that you do at your facility?
Dr. Pierson's Response: 
First, let’s address the letter and numbers reversals -- there is some evidence in the literature that letter reversals in kindergarten predicted spelling outcomes at 2nd grade. That said, non-dyslexic children can also evidence letter reversals when learning to write. So, this may be an indicator of dyslexia. But, one of the defining areas lies in the child’s ability to perceive, manipulate, and blend the sounds of our language (i.e., phonological processing) and then learn to map those sounds on to letter representations and learn orthographic spelling patterns and rules in order to read and spell.

Second, I am rather surprised by the school’s response -- not wanting to help you with testing. It's not a matter of "want" on their part; it's a matter of required by law.....Your son has a right to a free and appropriate education (FAPE).

He needs a comprehensive assessment of his spoken and written language skills to determine what his strengths and weaknesses are. You have the right to request this from the public schools (at no charge given that our tax dollars support special education) by going into the special education office and signing a request for an evaluation for a suspected learning disability. In many states, the schools will not assess for dyslexia per se; but dyslexia is a specific learning disability (SLD), and the schools do test for SLD. Depending on whether your son qualifies as SLD, the school will determine an appropriate program for him through an Individual Education Plan (IEP). Now, just because he doesn't meet the school criteria for SLD does not mean that he is not dyslexic. These days kids have to score pretty poorly to qualify for school services. By nature of the definition of dyslexia, dyslexic kids have average to above-average intelligence, and as a result, may not score low enough on the testing measures. A good diagnostic assessment will pinpoint a pattern of strengths and weaknesses indicative of dyslexia.

We can predict who is at risk for reading challenges in children as young as 4 and diagnose dyslexia (or SLD) in a 6 year old (I have presented on this very topic). Some of the information here, including the checklist, might be helpful to you.

You are right to be getting on this now before he misses valuable time in which he could be engaged in intervention and his self-esteem starts to erode. Early intervention that is systematic and research-based is the key!

You might find this article by a parent helpful as you work through all of this. Best of luck!