Understanding the professional evaluation process
Being tested for dyslexia or a language or learning disorder involves a comprehensive assessment that provides you with a clear understanding of your competencies in the following areas:
- Oral language
- Phonological processing skills (e.g., phonemic awareness, rapid automatic naming)
- Decoding (i.e., word reading)
- Reading fluency (i.e., rate and accuracy)
- Reading comprehension
- Spelling
- Writing
- Skills that might also be a part of the testing battery may include: articulation, social, and/or oral motor difficulties.
Evaluations should be performed by a professional with knowledge about speech, language, reading, spelling, and writing development. A Master’s-level speech-language pathologist who is certified by the American Speech, Language, and Hearing Association (ASHA) and has training in reading disorder is an excellent choice, as is a school or private psychologist or a learning disorders specialist. By familiarizing yourself with the available testing procedures and options, you can better understand what you need in an assessment and how your challenges impact your learning or work performance.
Here are some things to consider before, during and after an evaluation for dyslexia or language-based learning disorder.
What to expect before the evaluation
As part of a comprehensive evaluation, you may be asked to fill out a checklist and/or language and behavioral inventory regarding your current status, developmental and medical history, family history, and educational history. 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:
- What is the purpose of the testing? Is it to establish a baseline of skills or to determine whether or not I have a specific disability? Is it to measure ability or academic achievement?
- 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?
- 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?
- If I have sensory or physical limitations, will the test provide accurate data relative to my knowledge and performance capability or will it merely measure my disability?
- How often should I be tested? When is it important to vary the assessment tool so that the data are valid and not hindered by repetition?
- 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?
Remember the purpose of the evaluation is to help you learn what you are good at, what things are difficult, and how to help you 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. A language and literacy evaluation typically lasts between 3-4 hours for younger children and 6-8 hours for teens and adults. The professional will use his or her judgment to determine what is best for you.
You’ll want to be sure that the diagnostic tools are age-appropriate and designed to assess the specific areas of concern. Everyone, regardless of age, should have passsed a recent screenings for hearing and vision. 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, you (the client) are provided with a report that gives a diagnosis, outlines recommendations for therapy, activities for home practice, school support and accommodations. Recommendations should include your present level of functioning and clearly outline the path you need 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 were 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
- A prognostic statement, which is the professional’s best prediction of long-term outcomes for you
- 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 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 insight into the next steps they will need to take to support your 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.
- He/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. The report is likely to focus more on deficits than 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 and assessments 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!
This initial diagnostic report represents the first step in a long journey. 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. Once your language skills improve, you may be able to retake the test and demonstrate your growing capabilities.
Key to helping you 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
- Request a meeting
- Write down all of your questions
- Request the professional’s interpretation of the evaluation
- Compare the results
- Request clarification
- Ask for resources and references
- View the statement as a starting point and baseline measurement
- Pursue research on the issue
- Pull out the last section in your report
- Set up a loose-leaf binder
- 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.).