I have my doctorate in clinical psychology and am working part time in the New England area. I am wondering what you would recommend as the best battery to use to evaluate a 7-year-old child for dyslexia. I have experience in evaluating children for various presenting concerns, but it's been a while since I've done any learning disabilities assessment specifically. Any thoughts/input would be greatly appreciated so we can decide if we can provide this service for this client.


Dr. Pierson's Response: 

The short answer is that you need to get measures of oral language comprehension and use, phonological processing (both phonemic awareness and rapid naming), reading decoding, fluency, and comprehension, spelling, and writing. You may also want to assess expressive naming skills and working memory. At my private clinical practice, we assess, diagnose, and work with many kids this age, so I'll give you some idea of what that battery looks like for a 6-year-old.

We always give the Peabody Picture Vocabulary Test-4 (PPVT-4) to get a baseline receptive vocabulary score. This is important given that we know that the vocabulary skills of children with reading disability can be at risk to degrade over time if they don't have access to the written texts and information that their peers do. This score can also act as a comparison for the other language and literacy scores to determine a discrepancy and help us diagnose dyslexia.

If we observe the child to have word-finding problems, we give an Expressive Vocabulary Test -2 (EVT-2) to compare receptive versus naming vocabulary. We also will give Rapid Automatic Naming (RAN) tasks, typically from the Comprehensive Test of Phonological Processing -2 (CTOPP-2).

We always get a measure of oral language comprehension and use—the Clinical Evaluation of Language Fundamentals-5 (CELF-5) or the Comprehensive Assessment of Spoken Language (CASL). We will also give number repetition forward and backward from the CELF-4 or CTOPP-2 if working memory looks compromised.

We give the Gray Oral Reading Test-5 (GORT-5) to assess decoding and rate, which yields a fluency score, as well as a reading comprehension score. You should know that the research has demonstrated that the GORT-4 was problematic in its assessment of reading comprehension, so you will definitely want to use the GORT-5. Although the GORT- 5 still has issues relative to the purity of measuring comprehension, it is much better. If we are looking at a child who already has standardized scores in reading, then we like to give a Qualitative Reading Inventory-4 (QRI-4) as that is a useful tool in providing prescriptive and descriptive information, i.e., you know exactly where to begin therapy.

We give the Test of Word Reading Efficiency-2 (TOWRE-2) to look at sight and non-word reading and fluency, analyzing the error patterns to determine where to go with intervention. Sometimes we opt for the Letter-Word ID and the Nonsense Words subtests from the Woodcock-Johnson III - Diagnostic Reading Battery (WJIII-DRB).

We use the Test of Written Spelling-5 (TWS-5) to assess spelling. An error analysis of phonological and/or orthographic errors informs what to give relative to phonological processing/awareness. We may give the CTOPP-2 or the Lindamood Auditory Conceptualization-2 (LAC-2) test. If standardized scores are not needed, then we may use the Wilson Assessment of Decoding and Encoding (WADE) to gain prescriptive information relative to therapy starting points.

To assess writing, we use the Test of Early Written Language-3 (TEWL-3). At this early age, many of the questions still tap rudimentary language-based understandings of writing, such as “what is a word,” instead of formulation, mechanics, etc., so you’ll want to keep tabs on this area as the child gets older and the demands of writing change.

We have most of these tests listed on the website so you can get the info about them here. Let me know if you can't find one or you need more specifics.

Also, if you come across other good tests, I’d love to hear about them! I hope this gets you going in the right direction.