I have a 10-year-old daughter who is having extreme difficulty with writing b/d (reversal). As a teacher myself, I am struggling with what to do to get her evaluated. She has already gone to a psycho-educational clinic at Syracuse University. The only thing they really found was anxiety. She really only seems to struggle with writing, spelling, segmenting, and blending words. Not as much with reading. Although comprehension is low and fluency could be better. She has used the SONDAY system for phonics in class and receives AIS services at school. Please let me know what I can do to help and get answers.


Dr. Pierson's Response: 

Hopefully, the professional at the clinic looked at your daughter’s spoken language skills and then compared her other skills (i.e., written language and phonological and morphological awareness) to her spoken language. Here are the pieces of a comprehensive assessment.

The error on “SONDAY” indicates that your daughter has the underlying phonological (sound) awareness skills in that she is representing all the sounds with letters, but she has not learned all of the correct the orthographic representations (i.e., all of the ways that you spell short ‘u’). A good assessment will parse out where she is breaking down relative to spelling—phonological or orthographic or both.

You write, "She really only seems to struggle with writing, spelling, segmenting, and blending words." These are signs of dyslexia. Dyslexics can have difficulties with spelling, and not with reading. We are seeing these kids in my private practice. In fact, a recent article came out in the Journal of Learning Disabilities that discussed the role of working memory that seems to differentiate between these types of dyslexia.

Although it appears that your daughter can decode given that “she doesn't struggle much with reading,” she has “problems with comprehension;” and that is why we read. So, it seems that she does struggle with reading, although maybe not as much as when spelling. The literature has identified a subset of individuals who can decode text, but who have difficulty with reading fluency, and that can affect comprehension. Reading comprehension strategy work is needed for these kids. Importantly, your daughter is getting at the age where the curriculum changes from learning to read to reading to learn, and much more reading is required. The onus transfers from the teacher to the student relative to learning. It is not uncommon when a student hits 4th grade for challenges to appear, known as the 4th grade slump. I’ve got information about reading comprehension strategies. And, as a result of reading less than their peers, we can see their vocabulary skills slide.

Additionally, this is another reason that her oral language skills need to be assessed. As a child gets older and particularly by the late elementary years, the language of the curriculum (and that of their peers) moves from the literal to the non-literal. Text contains more inferences and ambiguous references and one must make meaning from context. This requires strong spoken language skills. We cannot understand what we read if we do not understand it when it is spoken. Unfortunately, I find that many times a student’s oral language skills are overlooked during assessment. As a result, progress in therapy is mitigated because the underlying language skills are not addressed. Here is some more information on assessment.

In my private clinical practice, I am frequently asked to review reports and IEPs to help parents figure out what to do. You could ask someone to consult on the report to determine whether the assessment actually dug deeply enough into her skill set to determine where her strengths and weaknesses are. I don't know if there is anyone in your area on this list. Additionally, you should talk with your school district about having her assessed for a specific learning disability. I have a lot of information on the special education process.

Last, we’ve got a really good piece written by a former parent who has been down this road. You might find her advice helpful.