It can be daunting to know what to do when you suspect or a teacher tells you that your child is struggling with literacy learning. For many parents, getting their child the right help is a new, dare I say, “adventure.” What should be your first step?

Diagnostic Assessment: The First Step to Getting your Child Help

It can be overwhelming to know how to proceed when your creative, engaging, fun-loving child begins to struggle to learn to read, spell, and/or write. And, when you begin researching options, there are so many programs and methods from which to choose, many of which claim to be the answer.

In my opinion, the first step should be a good comprehensive assessment of both spoken and written language skills. Recently, I have seen a number of children and teens who have come for a diagnostic assessment after they have been receiving intervention. This can be problematic for a few reasons.

First, intervention works – this is a good thing! The challenge, then, is that because of the positive outcomes associated with getting intervention, the child or teen may not score poorly enough on standardized measures in order to make a definitive diagnosis of reading disorder, including dyslexia. For example, difficulty in phonological (i.e., sound) awareness can be one of the hallmarks of dyslexia. We know that structured literacy approaches can effectively teach students letter-sound relationships, which includes working on phonological awareness skills. Subsequently, when administered a standardized measure of phonological awareness, the student may either score in the average range or evidence a relative weakness rather than scoring in the clinically disordered range; and therefore, he or she does not meet the diagnostic criteria for a diagnosis of dyslexia. (Admittedly, we use more than one data point when making a diagnosis.) The score may over represent the student’s actual skills in that area. A comprehensive assessment requires gathering multiple data points, including a case history and school records, as well as both quantitative and qualitative data. Using these data, my professional opinion may be that, indeed, the student is dyslexic, but the data will not support a definitive diagnosis at this time. That can be frustrating to a parent, the student, and the diagnostician; and may not serve the student well. In the short term, he or she will most likely need accommodations to succeed in school. And, looking long term, when a student applies for accommodations on college entrance exams, the College Board requires documentation of a disability, and that can include the student’s educational and developmental history. Therefore, getting a diagnosis is paramount.

Another reason, and perhaps an even more compelling one, is that a good comprehensive diagnostic assessment identifies a student’s pattern of strengths and weaknesses. This, then, lays the groundwork for intervention. Without knowing a student’s strengths and weaknesses, we risk designing an intervention plan that may not be as tailored to the individual’s needs. This can waste a family’s precious resources, both time and money, not to mention that the student may begin to feel defeated if the intervention is not working. For example, perhaps he can take words apart, but due to weak working memory skills, he has difficulty remembering the sounds in order to put them back together. Maybe he can perceive the sounds in words, but hasn’t yet learned the letter(s) or letter combinations that represent those sounds. Perhaps the problem with his writing is not due to spelling, but he can’t come up with the words he wants to write. There are many skills that underlie learning to read, spell, and write. A good diagnostic assessment will parse out the areas that we need to focus on when designing an individual intervention plan. And thus, time and money will be better spent.

Finally, I have found that many students are relieved to receive a diagnosis. A dyslexic student knows he or she is capable even though he or she is not experiencing being capable at school. I have found that when I talk about the dyslexia diagnosis, one’s pattern of strengths and weaknesses (at my private clinical practice we plot scores on a bell curve to show the student and parents), and, importantly, that we know how to teach these skills, not only are students relieved, they have hope.

So, what is a parent to do? I recommend getting a good comprehensive diagnostic assessment before embarking on an intervention path. I realize that this can be a challenge for a couple of reasons. First, by the time a student is referred for a special education evaluation in the US, he or she has already received intervention (although not always structured literacy) under the practice of RTI (Response to Intervention). Second, obtaining an evaluation outside of the school system can be cost prohibitive for many families. I do think that if you plan to get intervention for your child, it behooves you to begin with a diagnostic assessment. In the long run, this may be cost effective as the therapy or tutoring will be better tailored to your child’s specific needs when you and the practitioner are armed with a good comprehensive assessment. At the very minimum, the practitioner should obtain baseline data in the areas that undergird reading and spelling, ideally using standardized measures that a diagnostician could then make use of to inform a definitive diagnosis of dyslexia.