An evaluation for developmental dyslexia or a language-learning disability is a comprehensive assessment that provides you with a clear understanding of your child's competencies in the following areas: oral language, phonological skills (e.g., phonemic awareness, rapid automatic naming), decoding, reading fluency (i.e., rate and accuracy), reading comprehension, spelling, and writing. Articulation skills, social skills, and/or oral motor difficulties may also be a part of the testing battery.

Your child can receive either a medical or school-based evaluation depending on her age and situation. It is very important that evaluations are performed by a professional with knowledge about oral language, reading, spelling, and writing development.  A school or private psychologist, learning disabilities specialist, or language specialist with extertise in literacy are good choices.

An important note about medical-based assessments is that some school districts will accept and include the results as part of the initial Student Study Team (SST) process, whereas other districts will insist on doing their own educational assessments. It might be worthwhile to discuss this issue by talking with other parents of special needs children and school administrators in your locale.

School districts will often use some of the same assessment tools that private practitioners use, but schools are generally more inclined to focus on achievement testing. Districts will vary in their choice and use of tests and screening tools, as determined by budget and time constraints, certification requirements, and training. By familiarizing yourself with the available testing procedures and options, you can better understand how your child's disability impacts his or her learning. You might want to make sure that the district does not repeat any of the tests already completed by the medical professional, and instead uses the results already acquired. Planning ahead can also help you avoid duplicate testing between schools and private professionals.

Here are some things to consider before, during, and after an evaluation for dyslexia or language disability.

What to expect before the evaluation

If your child is going to receive an evaluation in the public schools, there is a process mandated by federal law under the Individuals with Disabilities Education Act (IDEA) [1]. You should become familiar with IDEA. You should also understand the IEP (Individual Educational Plan) process [2].

As part of a comprehensive evaluation, you may be asked to fill out a checklist and/or language and behavioral inventory regarding you or your child's current status, developmental and medical history, family history, and educational history. In many cases, the professional will also have observed your child in the home, clinic, or school setting and will have completed similar checklists or inventories. When you meet with the professional, he/she will offer interpretations of the data and initial impressions, which will inform the testing. The practitioner will be able to tell you which tests will be administered and why.

Here are questions that you might want addressed prior to agreeing to assessments:

  1. What is the purpose of the testing? Is it to establish a baseline of skills or to determine whether or not a child has a specific disability? Is it to measure ability or academic achievement?
  2. What is the assessment's protocol and format? Is the test timed, multiple-choice or fill in the blank, oral or written? For what age is the test standardized? Is it administered individually or to a group?
  3. Is the choice of an instrument validated for the specific purpose for which the evaluator is seeking clarification or baseline data? Is the evaluator trained according to the publisher of the test?
  4. If a child has sensory or physical limitations, will the test provide accurate data relative to the child’s knowledge and performance capability or will it merely measure his or her disability?
  5. How often should children be tested? When is it important to vary the assessment tool so that the data are valid and not hindered by repetition?
  6. Will the whole test or only some of the subtests be administered? How are the professionals making their selections? If they are giving only part of a test, will this give you a standardized score?

It is important to have a conversation with your child before the evaluation so he or she knows what to expect and is not surprised when you arrive for the assessment or, in the case of school, is taken out of the classroom for testing. More than likely, if you have decided to have your child tested (or be tested) you understand there is an area of difficulty. Tell your child that the purpose of the evaluation is to help you both learn what he is good at, what things are difficult, and how to help him succeed.

What to expect during the evaluation

The length of time for a comprehensive evaluation will depend on the number of areas to be assessed and the age of the individual. Typically, a language and literacy evaluation lasts between 3-4 hours for a younger child, whereas to assess the skill of a teen will take 6-8 hours. The school professionals will do the testing during the school day. At an independent center, depending on the age of your child, you may be asked to be in the evaluation room. The professional will use his or her judgment to determine what is best for your child. Dr. Pierson finds it especially important that and helpful for family members to observe the assessment (and therapy for that matter) from behind a one-way mirror.

You’ll want to be sure that the diagnostic tools [3] are age-appropriate and designed to assess the specific areas of concern. Everyone, regardless of age, should have a recent hearing screening and have passed a vision screening. Examples of appropriate tests in the areas of oral and written language are:

  • Peabody Picture Vocabulary Test (PPVT-4) assesses one’s receptive vocabulary knowledge
  • Clinical Evaluation of Language Fundamentals, Fourth Edition (CELF-4) assesses receptive and expressive oral language skills
  • Comprehensive Test of Phonological Processing (CTOPP) assesses phonemic awareness and rapid automatic naming
  • Gray Oral Reading Tests, Fourth Edition (GORT-4) tests oral reading decoding and fluency
  • Test of Written Language, Third Edition (TOWL-3) assesses writing a story, grammar, and spelling

What to expect after the evaluation

Following the evaluation, clients and/or families are provided with a report that gives a diagnosis, outlines recommendations for therapy, activities for home practice, and school supports and accommodations. Recommendations should include your child’s present level of functioning and clearly outline the path he or she needs to take to get the needed support to succeed academically and in life.

A typical diagnostic report from a professional1 might include the following:

  • A statement about how or why you or your child was referred to this professional
  • A one-paragraph summary of the professional’s initial impressions
  • A comprehensive list of the assessments/tools used to reach a diagnosis
  • Information regarding how the test is typically administered and scored
  • A summary of findings and results related to you or your child
  • A prognostic statement, which is the professional’s best prediction of long-term outcomes for you or your child
  • A list or summary of needed interventions to accomplish short and long-term goals, with some descriptions of types of intervention as well as number and/or length of appointments
  • Follow-up assessments, if recommended

Diagnostic reports will likely contain information and terminology [4] that you may find difficult to understand.

Prior to the delivery of a written copy, the professional will usually schedule a face-to-face meeting (i.e., consultation) to review the findings. This will give you and your child (if older) insight into the next steps they will need to take to support your child’s academic or work success. It is our recommendation that you indeed request a meeting if one has not been set up in advance.

  • It might be a good idea to write down all questions that you would like to address at this appointment. Remember to take the questions with you and make sure that they get answered.
  • During the consultation the professional will review all aspects of the report.
  • She will respond to your questions/concerns.

The period following the initial processing of this information can be emotional and confusing. You may or may not have the peace of mind to ask all of the questions that you would like to, because this report is all about you or your child, and likely will focus more on deficits than on skills and strengths. You may see phrases like “significant language delay,” “dyslexia,” “learning disorder,” or “developmental delay,” to list a few.

Here are some suggestions to help you navigate:

  • It is important for you to request clarification about any of the terms or results that you find unclear.
  • Ask for resources and references so that you can begin to understand the nature of the delay or disorder. You may need to do this more than once.
  • It might be useful to pull out the section in your report on recommendations and print it separately to use as a starting point in the educational and therapeutic planning process. This section will help you negotiate the type of intervention needed, along with the corresponding levels of intensity and duration. Decisions about intensity and duration are critical aspects of early intervention planning.
  • Setting up a binder in which to store all reports, assessments, and school documents in chronological order will prove useful. All written correspondence to and from the schools or professionals should be dated and saved for future reference. You will refer back to this information time and time again. It will be a nice reference for growth!

In the public school, an IEP meeting will be scheduled to discuss the results and determine a course of action based on your child’s individual needs (Special Ed: Next Steps [5]).

This initial diagnostic report represents the first step in a long journey. If this is about your child remember—children are very dynamic beings, so an early prognosis may or may not be an accurate projection of your child’s future. It might be most useful to view this diagnosis as a starting point or baseline measurement, subject to modification with follow-up testing. If your assessment includes an intelligence quotient (IQ), then it is quite possible that this number will improve over time. This is especially true for children with language-based delays and disorders and that includes dyslexia, as the test relies heavily upon language ability. Once your child’s language skills improve, he or she may be better able to take the test and exhibit his or her capabilities.

Key to helping you or your child is early assessment and a good diagnosis, followed by a systematic approach to treatment. This formula will help you succeed.

Summary of Steps to Take When You Receive a Diagnostic Report

  1. Request a meeting
  2. Write down all of your questions
  3. Request the professional’s interpretation of the evaluation
  4. Compare the results
  5. Request clarification
  6. Ask for resources and references
  7. View the statement as a starting point and baseline measurement
  8. Pursue research on the issue
  9. Pull out the last section in your report
  10. Set up a loose-leaf binder
  11. Date and save correspondence

1 The term "professional" is used as a general term and refers to any of the following: neuropsychologist, psychologist, psychiatrist, speech-language pathologist, pediatrician, neurologist, and all members of a school special education staff: teaching consultant, speech-language therapist, occupational therapist, reading specialist, etc.

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