My daughter is 8 years old and is just finishing 2nd grade. She has been in the Reading Program at her elementary school since Kindergarten. She sees the learning specialist four times per week with a 4:1 student to teacher ratio.

Unfortunately, her progress has been slow. Her reading fluency level is at 19.8% (she started the year at 21%) and her comprehension is at 40% (same). It is obvious to my husband and I that she needs help outside of school. We have tried tutors and web-based programs, but nothing has worked. Her frustration level goes through the roof.

I would like to know where to get an appointment to have her tested for any type of reading issues. Thank you so much!

Dr. Pierson's Response: 

I'm sorry that your daughter is struggling so to learn to read. You and your husband are wise to not let this wait [1]. When a capable student does not learn along with her peers, something is amiss -- and we need to figure that out, even more so when she has had intervention and there is no growth. We should be seeing change IF the program is designed to meet her needs. And, relative to her frustration -- I see that same behavior so many times in my client. They are smart kids who can't figure out why everyone else in the class is learning to read and spell. And, they work and work and do not meet with success. I'd be frustrated, too.

I typically refer people to this list of providers [2] in MI from the International Dyslexia Assoc. I am this year's MI Branch board president.

Not everyone on this lists diagnoses, though, so you'll need to ask questions. A good assessment is the first step in getting the right help. Here [3] is what a comprehensive assessment entails. Also, know that my experience is that dyslexia evaluations are not typically covered by insurance, so you'll want to check with your plan.

Getting an assessment that “gets to the bottom of it” is going to be crucial. It will be important to have a good assessment of not only her written language skills (i.e., reading, spelling, and writing), but also her spoken language skills (and it is my experience that many times this important area is overlooked). Oral language undergirds literacy learning. If your daughter has a weakness in an area of spoken language, all the literacy therapy or tutoring in the world will not be as effective unless we target her spoken language weaknesses, which, quite honestly, can (and should) be done in tandem with written literacy work. So, for example, relative to your daughter, when you tell me that her comprehension is at 40%, my first question is how does she understand what is said to her -- at the word level, sentence level, and discourse level? If her verbal comprehension skills are good, then we need to figure out where she is breaking down relative to reading comprehension -- can she simply not decode the text? Can she ultimately read it, but she has to work so hard that she can't remember what she read? Is she slow at decoding? Is her working memory affecting her ability to recall what she read? All of these questions (and more) should be answered in the diagnostic assessment. Additionally, a good assessment will set the groundwork for intervention.

Unfortunately, even when we get to the bottom of it, there's a chance she still won't qualify for services in the public schools. Public school resources seem to keep getting squeezed thinner and thinner. I am finding that it is harder and harder to get the dyslexic kids I assess/work with in my private clinical practice services in the schools. Here [4] is a piece I wrote about that issue. That said, I am also working with some school districts who are getting on the bandwagon and getting their teachers trained in Structured Literacy. Once she has a good, comprehensive assessment, we will want to be sure that she works with someone skilled in her areas of weakness and who has training in Structured Literacy [5]. But, you are right -- first things first. Get a good diagnostic assessment.

You are getting to this at the right time. Going into 3rd grade, she is on the cusp (and in 4th grade -- the rubber meets the road) when the curriculum moves from learning to read to using one's reading to learn. So now is the time to figure out what is going on with her and then, hopefully, get some good intervention this summer.

I've given you a lot of information here. Please let me know if you have other questions.