Ask Dr. Pierson: First grader avoiding homework

Hello Dr. Pierson. I have read a lot about you and your work on the internet and was emailing you with the hope you could help me. My child is in first grade this year and he has begun to have problems reversing his 6s and 9s and 2s and 5s as well as some letters. He has some behavioral and work avoidance problems as well and the school and his mother and I suspect he might have dyslexia. Can you recommend someone who can evaluate him? Can you recommend a private tutor we could hire to work with him and help him after school with his reading and math? Maybe someone who could also help us understand how we can work with him to succeed at school and feel confident about his academic abilities? I know you are a very busy woman and I appreciate any advice or help you may have for us. He is very smart and creative, but I worry his possible dyslexia is negatively effecting his view of academics, reading and learning. Thank you again so much for your time.


Dr. Pierson's Response: 

Well, let's see—first reversing those numbers and letters at 6 years of age is not our biggest concern. Many kids his age still do that. And, reversing letters is not indicative of dyslexia. Dyslexia is a language-based learning disability. The flag for me is that already in 1st grade he is avoiding work, suggesting he is finding it difficult. Plus, we've also the fact that both the school and you all suspect dyslexia.

First, are you aware that he can be evaluated by the public schools for a suspected specific learning disability (SLD)? We've a lot of information about that on our Know Your Rights page. This is a service of the public school under federal law and the Individuals with Disabilities Education Act (IDEA), which is paid by our tax dollars so is of no cost to the family.

That said, the school personnel may tell you that they do not diagnose dyslexia; and moreover, unless his skills are VERY poor, he may not qualify for services. In my private clinical practice where assessment, diagnosis, and treatment of dyslexia is our specialty, I see a lot of kids who are not succeeding in school, who are indeed dyslexic, and who do not qualify for services under the special education guidelines. Students may have to really fail before getting help— it can be quite frustrating. Even if diagnosed, there is still the question of someone knowing how to treat dyslexia, which can be a challenge.

So, the first order of business is a good comprehensive assessment of your son's spoken and written language skills. Oral language skills undergird learning to read, spell, and write, and therefore, it is essential that these areas be assessed in addition to written language. We can totally evaluate his skills at this age and make a diagnosis. (I'm actually in the process of evaluating a little guy who is 6 1/2 right now.) My colleague Dr. Lauren Katz and I gave a talk at the International Dyslexia Association (IDA) conference in New Orleans titled, “Toddlers and Preschoolers at Risk for Literacy Disorders: Impact of Language Delay and Disorder.” The signs that place a child at risk for learning to read, spell, and write are present even younger than 6 years of age. You may find our developmental checklist of skills helpful.

I typically refer people to the IDA provider list for their state. This list of providers has people in Michigan—including those who can diagnose, provide therapy, and tutor (there is a difference between therapy and tutoring and the assessment will help determine which route to go with your son).

A language-literacy evaluation is around $1800, whereas an evaluation by a neuropsychologist costs $3000 or more and may be needed, in part, if the child has attentional issues compounding learning. You will want to ensure that the professional has experience in diagnosing dyslexia at this young age. You want an assessment and subsequent report that results not only in a diagnosis, but provides prescriptive information as well. Most tutors do not diagnose, but a good one should get some baseline data in order to determine where to begin tutoring. In order to do that, some type of assessment of skills must occur. Tutoring would be a good route once we know what we are dealing with—i.e., where his strengths and weaknesses are.

You are getting to this at the right age—before he begins to fail too much. Good for you to be concerned about his self concept as a learner and his development of a love for learning. So many of these smart, creative kids with dyslexia get beat down in school and can't figure out how to get back up. It really breaks my heart. But, the good news is that with systematic, explicit, and intensive intervention, our kids with dyslexia do learn to read, spell, and write, and can become totally successful in academics and life! Please don't hesitate to ask if you've further questions.