I am a school psychologist. I was recently asked to assess a child for dyslexia to help assist with developing reading interventions. Based on my training background, I find this to be a very difficult request for many of the reasons outlined below (e.g., no consensus on criteria for diagnosis, does not provide valuable information on how to change interventions) and I'm not sure where to turn for help… this is not my area of expertise. Based on my training, I have been told that dyslexia is a medical diagnosis and cannot be diagnosed by a school psychologist. We can look at symptoms, but cannot give a formal diagnosis.

Below are my questions:

1. Legally, are school psychologists able to give a formal dyslexia diagnosis? On your website it says we can, but the National Association of School Psychologists says we cannot. Parents are confused and so are school psychologists.

2. Are there specific interventions for an individual diagnosed with dyslexia? Would the interventions change if you simply assessed the child’s reading skill deficit and provided more targeted instruction?

Dr. Pierson's Response: 
I am so glad you wrote to me. Quite honestly, I’m surprised at where these people are getting their information and how it is being interpreted. We can clearly diagnose dyslexia and, moreover, we know how to intervene.

#1. We can "make a decision in a clear and consistent way" as to whether a child is dyslexic. I diagnose kids all the time and I differentiate between dyslexia versus language disorder coupled with reading disorder versus weakness in reading/spelling. In short, I assess a child's spoken language abilities and then compare them with the skills that undergird learning to read, spell, and write, including, and importantly, phonological processing. A discrepancy between spoken language skills, particularly receptive vocabulary (although you need to be careful when assessing an older student because we know that as children get older, reading contributes to vocabulary development, and therefore, a lack of exposure to the same material as one's peers may already have caused one's vocabulary to have degraded...) and phonological processing, reading decoding and fluency, spelling, and/or writing. Over -1 standard deviation discrepancy between a student’s receptive language skills and written language skills can indicate dyslexia. You need to triangulate the data as one always does when making a diagnosis. We also know that there are three types of dyslexia -- the child who has difficulty with phonological awareness (PA), but not RAN (rapid automatic naming), the one who has problems with RAN only, and those who have problems with both PA and RAN (the most severe). And, phonological memory challenges can be mixed up in there as well. We can differentiate between these different types of kids.

#2. The fact that a professor states that “there is no educational treatment which you would do differently for that child than you would do for any other child who is struggling to learn to read” tells me that he doesn't understand dyslexia or how to treat it. This kind of information does nothing to help these kids who are struggling to learn how to read, spell, and write, and succeed in school and life.

While it is indeed true that the intervention for the dyslexic child would work for the non-dyslexic or the child with a reading disorder or the one with a weakness, the dyslexic child needs very specific work in phonological processing (i.e., phonological awareness, phonological memory, rapid automatic naming depending on where the breakdown is) and making the connections between sounds and letters and letter combinations, not to mention targeted work in orthographic knowledge, such as spelling rules (and there is much more). And, intervention needs to be systematic, explicit, intensive, and evidenced-based.

And, our understandings are scientific -- the difference in the way the dyslexic brain processes linguistic information at the level of the phoneme, and in some cases the syllable when perceiving words is well documented in the scientific literature. Similarly, we have data from fMRI as to the difference in the dyslexic brains when they are trying to read versus when a non-dyslexic reads. Samuel Orton began documenting the difference in the 1920s...We have had lots of research since then.

Your situation is not uncommon relative to diagnosing dyslexia in the schools. It is a myth that dyslexia is a medical diagnosis. Quite honestly, it becomes an educational problem when a child does not learn to read, because it is the job of the public schools to teach children how to read. Dyslexia is a specific learning disability (SLD), which is diagnosed in the schools. We have this same issue in Michigan where I am. Even though the word "dyslexia" is listed under the rule for SLD in the Michigan Administrative Rules for Special Education, school personnel say they do not diagnose it.

I don't even know where to begin, there is so much I could say. I suggest starting with Sally Shaywitz's book Overcoming Dyslexia, which is written for parents, but very good and, despite its 2003 publication date, still relevant.

I think knowing the current definition of dyslexia is important.

Here's information as to how to diagnose, which is written for the professional new in the field, so much of it you will know. And then I have a LOT about treatment under the sub tabs here.

I would also search for Sally Shaywitz on YouTube -- she has a bunch of videos -- and Maryanne Wolf. You can trust these two women! The International Dyslexia Association’s Perspectives journal is very reader-friendly. That would be a good place to look for information as well.

I've given you a lot of food for thought here. Again, I am so glad you asked. Misinformation is doing nothing to help the thousands of kids with dyslexia in our schools. Good for you to question! And just take it one step at a time -- i.e., one kid at a time -- and you will make a huge difference in kids' lives. Let me know if you have other questions. Don't hesitate to ask.