My child was diagnosed with dyslexia in the fall. His phonemic awareness and spelling skills are still at mid-1st grade. Is it important to go back and systematically teach the missed skills, or due to his age, begin work with multisyllabic words and affixes? He has deficits in letter-sound knowledge, suffixes, inflections, and syllable insertion or omission. He also has deficits in segmenting (sound and syllable) and in phoneme isolation. I believed it was best to go back and teach systematically. I was told that due to his age and time left in school, working with multisyllabic words and affixes will yield the best results.

Dr. Pierson's Response: 

You did not say how old your son is but I’m guessing 4th grade or so. My answer to your question would be to target both aspects -- underlying skills and morphologically-complex words (i.e., multisyllabic words). It is important that he has the underlying skills in order to read multisyllabic words, so he will need to learn rules for, say, silent e in order to learn to ‘drop the -e to add a suffix.’ He needs to learn that every syllable (and word) must have a vowel and he’ll need to know the vowel teams in order to spell them. Counting syllables in words will help him figure out whether he’s got a vowel represented in every syllable. Having strong mental orthographic images (i.e., pictures of words) will aid him with spelling those pesky words that don’t follow the rule. As you may know, the International Dyslexia Association has termed the intervention for students with dyslexia as “structured literacy” [1].

One thing that I know after teaching these students for 40+ years, instruction needs to be recursive and we need to revisit concepts regularly until we are sure that the student has fully assimilated the concept into his knowledge base and, importantly, is able to execute it in various contexts. Therefore, I do think it would be beneficial to revisit the underlying skills. This can certainly be done while introducing new ones.

In regard to the multisyllabic words, assuming he is around 4th grade where 60-80% of the words he will be encountering in grade-level text are morphologically complex, he should also be learning prefixes, derivational suffixes, and Latin and Greek roots. It is very important that our students learn that no matter what sound they hear in a word that the root spelling doesn’t change. For example, the Latin root ject, which means “to throw,” is spelled the same no matter whether you hear “t’ (ejecting) or “sh” (rejection).

In regard to his phonological processing challenges, I recommend Dr. David Kilpatrick's book Equipped for Reading Success. Also, Marcia Henry's Words book might be helpful at getting at both those 'earlier' sound-letter combinations that he does not yet have, as well as introducing Latin and Greek roots. I have both of them here [2]. I wish you the best of luck with all of this.