I am really hoping you can help me as I'm having a hard time finding any resources regarding comprehensive neurological testing for my 10-year-old daughter who has dyslexia, dysgraphia, and may have some visual processing issues. A teacher raised a question of ADHD, and possibly anxiety.

I have had a challenging time trying to find a comprehensive neuropsychological evaluation as most centers only want to test for a specific disorder such as ADHD or autism; they request you to have the diagnosis prior to having the testing done which seems a little backwards to me.

We have had some testing done, however none being comprehensive looking at my "whole" child. Some of the centers they only focus on what they want to teach your child, so they only tested her for what they plan on teaching or the program they are selling.

Dr. Pierson's Response: 

Yes, I agree that when requesting an assessment to get at the root of a problem, you should not need a diagnosis first…that is the point of the diagnostic. I have not heard that one before.

I understand that it can be difficult to find someone who will do a comprehensive assessment and not want to market his or her program. I have seen too many clients in my private clinical practice for whom intervention was recommended for dyslexia that has no support in the literature to be effective at treating dyslexia (e.g., vision therapy, balance programs, making clay figures). For the record, the International Dyslexia Association now terms the intervention for dyslexics as structured literacy [1].

When looking for a professional to conduct a diagnostic assessment for dyslexia [2] (which it seems your daughter has), we want someone who understands the role of spoken language in learning to read, spell, and write. I think you already know this, but here is another piece that I wrote regarding diagnostic assessments [3].

I trust that you are aware that the anxiety could stem from her learning challenges. I recently evaluated a girl, who had severe dyslexia (which I diagnosed). She was previously diagnosed with an anxiety disorder and was being medicated for that -- the dyslexia was missed. I am not saying that she does not have clinical anxiety, but she is in 3rd grade and cannot read, spell, or write for beans. And, like most dyslexics, she knows it -- and she knows that she is one of the few students in her class who can't. That, in and of itself, would cause anxiety. Until she gets the proper intervention for her learning challenges (which she could have gotten had the diagnostician pinpointed the dyslexia a year ago), she is going to continue to have anxiety because we are not addressing the root of the problem -- her dyslexia.

Given that you are in Michigan, where I am, I will send some names of neuropsychologists with whom my clients have had good experiences and who are not touting a specific program. I appreciate you being wary. As was originally conceived by our founding donor, one of the goals of DyslexiaHelp is to help parents identify evidence-based practices that work for students with dyslexia and other language-based learning disabilities so as to not fall prey to shams.

Thank you for writing to me.