Diagnosing Dyslexia

The information in this blog is focused on developmental dyslexia, which is acquired through genetics.  Usually, students who acquire dyslexia through environmental causes can be flagged or diagnosed using the same information.

The definition of dyslexia is:

Dyslexia is a specific learning disability that is neurobiological in origin.  It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities.  These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction.  Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge (International Dyslexia Association, 2002).

I am not big fan of labeling students for various reasons, but labeling must occur if the student is not getting the support and instruction that they need to acquire literacy skills.  Students will continue to struggle to acquire and use grade-level literacy skills, if they do not learn foundational literacy skills during their early elementary school days.  Most students can receive the support and instruction that they need to remain at grade-level through a response to intervention (RTI) or multitiered program.   RTI is a program that when implemented with fidelity can provide instructional lessons at student learning level, in addition to their regular classroom literacy instruction.  Some students will need more intense intervention that may include special education services, which requires the development of a 504 or IEP plan.  This will depend on your school’s literacy program and student learning needs.

Diagnosing dyslexia can be tricky and complex.  Dyslexia affects approximately 3 of every 20 students.  Dyslexia is blind to ethnicity and socioeconomic status.  Some students will “scream” dyslexia, many will not. Some students will never be diagnosed.  Children of parents diagnosed with developmental dyslexia have a 50% higher chance of having dyslexia.  It is also important to note that students can show traits of dyslexia, but not have developmental dyslexia.

Diagnosing dyslexia usually begins with a screening of student literacy skills.  A screening is a series of short probes or assessments used to learn student reading ability.   Most schools universally screen students three times a year.  Universal screenings can flag students who may have dyslexia, this will depend on the reading probes used to screen students.  Some probes have a stronger correlation to reading deficits normally found in individuals diagnosed with dyslexia.  Student knowledge of phonological awareness is a stronger flag until Grade 2, when rapid automatized naming tests (RAN) or reading fluency probes become a stronger flag (Ray, 2017).  Usually students that show a deficit in decoding nonsense words are dyslexic.  Teacher observations of student reading ability can strengthen the validity of a word decoding outcome.  There are also “private” on-line screenings.  Use on-line screening with caution, as not all screenings are valid.  The Shaywitz DyslexiaScreenTM was developed by Dr. Sally Shaywitz, a professor and researcher in Learning Development at Yale University. This screening can be used for students in kindergarten and Grade 1.  The screener can be found at https://dyslexia.yale.edu/, the Yale Center for Dyslexia and Creativity.  Students who show signs of literary deficits or traits of dyslexia may be assessed deeper or more extensively by a trained educational professional.

Diagnosing Dyslexia

The Gillingham (1955) formula of diagnosing dyslexia was developed by Anne Gillingham while she was working for Dr. Samuel Orton in the early 1900s.  She believed that standardized achievement tests were not a valid method to diagnose students’ reading deficits or to place students in remediation.  Gillingham determined that the following seven assessments should be given to students one year before beginning reading instruction: (a) intelligence, (b) optical or vision, (c) family history, (d) motor pattern or skills, (e) visual sensory recall skills, (f) auditory sensory recall skills, and (g) kinesthetic sensory skills.  The data from each assessment should be compiled and analyzed for each child.  The child is then placed into a classroom setting, based on the analyzed outcome of these assessment.  Gillingham noted that when students were assessed correctly and place in the proper programs, many of the emotional issues disappeared.  Gillingham also noted that occasionally the analyzed placement needed to be revisited as the child progressed through their formal education.  Gillingham (1956) believed that teachers in the regular classroom were the first to identify students at-risk for reading acquisition.

Today, dyslexia can be diagnosed by a neuropsychologist who specializes in educational disabilities, in particular dyslexia.  The process includes three or four hours of testing that can be quit tiring for students.  Most public schools do not have licensed psychologists trained to administer the depth of assessment required to diagnose dyslexia.  Students can also be diagnosed using MRI imaging.  This method of diagnosis should be used with caution, as very few people know how to conduct or correctly read the MRI screening images for dyslexia traits.

Ray, J.S. (2017).  Tier 2 interventions for students in grades 1-3 identified as at-risk in reading.  (Doctoral dissertation, Walden University).  Retrieved from https://scholarworks.waldenu.edu/dissertations/3826/

Universal Screening

In my last post I defined universal screening as:  a series of short, easy-to-administer probes of 1-3 minutes used determine student learning level.  The data from universal screening is used to determine those students who are at-risk for reading acquisition and for student placement in the response to intervention model.  Universal screening is usually given three times a year.  This screening should identify 90% of the students who may be at-risk for reading acquisition.  Universal screening is often used to monitor student progress and as a diagnostic assessment to determine students’ individual learning needs.

Universal screening is a vital component of the response to intervention (RTI) model. Screening students with the right assessment probes at the right time is essential to an effective RTI model.  Students should be assessed for proficiency of their current grade level.  Students not showing grade level proficiency should be placed in tiers or groups of focused instruction to improve their literacy skills.  The groups may look different in each classroom or school depending on the current learning needs of present students.  Students should be monitored to ensure that current placement is effective for them.

The following is a timeline for the types of universal screeners that should be used to determine students who are at-risk for literacy acquisition.  This table was developed while I was conducting research for chapter 2 of my dissertation.

Table 1

Universal Screening Grade Level Timeline

 

Reading Skill

Column A

Gersten et al., 2009

Column B

Kashima et al., 2009

Column C

Lam & McMaster, 2014

Column D

NJCLD, 2011

 

Letter naming & fluency

 

Grade K-1

 

Grade K-1

 

Grade K-1

 

 

Phoneme segmentation Grade K-1 Grade K-1
Phonemic awareness

Nonsense fluency

 

Grade 1

Grade K-3
Word identification Grade 1-2 Grade K-3
Oral reading fluency Grade 1-2 Grade 1 Grade K-3 Grade K-3
Sound repetition Grade K-1
Vocabulary Grade 1
Reading comprehension Grade 2-3 Grade K-3
Listening comprehension Grade 2-3 Grade K-3
Written expression Grade K-3
Basic reading skills Grade K-3
Oral expression Grade K-3

 Note: Column A was adapted from “Assisting Students Struggling with Reading:  Response to Intervention (RTI) and Multi-Tier Intervention in the Primary Grades” by R. Gersten et al., 2008, National Center for Education Evaluation and Regional Assistance, Institute of Education Sciences, U.S. Department of Education, 2009-4045, p. 13. Column B was adapted from “The Core Components of RTI: A Closer Look at Evidence-Based Core Curriculum, Assessment and Progress Monitoring, and Data-Based Decision Making by Y. Kashima, B. Schleich, and T. Spradlin, 2009, Center for Evaluation & Education Policy, p. 6.  Column C was adapted from “A 10-Year Update of Predictors of Responsiveness to Early Literacy Intervention” by E. A. Lam and K. L. McMaster, 2014, Learning Disabilities Quarterly, 37(3), p. 143.  Column D was adapted from “Comprehensive Assessment and Evaluation of Students with Learning Disabilities” by The National Joint Committee on Learning Disabilities, 2011, Learning Disability Quarterly, 34(1), 3-16. 

Other references

Gilbert, J., Compton, D., Fuchs, D., & Fuchs, L. S. (2012). Early screening for risk of reading disabilities: Recommendations for a four-step screening system. NIH Public Access, Author Manuscript. Retrieved from  http://www.ncbi.nim.nih.gov/pmc/articles/PMC3903290 doi:10.1177/1534508412451491

Kilgus, S. P., Methe, S. A., Maggin, D. M., & Tomasula, J. L.(2014). Curriculum-based measurement of oral reading (r-cbm): A diagnostic test accuracy meta-analysis of evidence supporting use in universal screening. Journal of School Psychology, 52, 377-405. doi:10.1016/j.jsp.2014.03.002.

Ray, J.S. (2017). Tier 2 interventions for students in grades 1-3 identified as at-risk in reading.  (Doctoral dissertation, Walden University). Retrieved from https://scholarworks.waldenu.edu/dissertations/3826/

error

Enjoy this blog? Please spread the word :)