Key Components to Diagnosing Dyslexia

Diagnosing Dyslexia is usually tricky! There are common deficits of individuals who have developmental dyslexia that give educators a better idea of who may be dyslexic. These clues may be used to better meet the instructional needs of these types of students. All students benefit from the same type of instruction-structured literacy. Students of inclusion classes or classes that encompass students of different first languages benefit from the same type of instruction, as well.

Not every dyslexic student will show the same outward signs. Students will often develop ways to mask their lack of processing skills for literacy and/or math. Student personalities and their environment effect the amount of outward masking students will develop to hide their lack adequate processing connections.

Many states are now conducting dyslexic screenings 1-3 times a year (often included in universal screenings) to assist in identifying students who are struggling to acquire reading skills and/or may be dyslexic. Teachers also play a vital role in unmasking dyslexic students through their observations. Teachers usually work with students in a small group setting during the primary and elementary grades. Small instruction groups make it easier to observe key flags that usually identify students with dyslexia. Writing tasks or data will assist in exposing current student spelling abilities. Students with dyslexia will often spell the same word different within the same sample of writing.

Students of “classic/heritable” dyslexia usually have orthography and phonology deficits. Some of the characteristics of these deficits include:

Phonological Issues

  • Sequencing of sound (bran for barn)
  • Omission of addition of sounds (jup for jump)
  • Confusion with similar sounds phonemes (f and th)
  • Limited knowledge of spelling rules (chik for chick)

Orthographic Issues

  • Sequencing of nonphonetic patterns (cloud for could)
  • Confusion with graphemes that look similar (e.g., b/d, p/q)
  • Transposition of letters (e.g., gril instead of girl)
  • Overgeneralization of rules
  • Overreliance on auditory features (e.g., becuz for because)” (Redding, 2023, slide 38)

The earlier a student with the characteristics of dyslexia receives intervention services or structured literacy instruction, the more likely they are to be at their expected level for reading.

The Interactive Relationship of Letter Knowledge and Phonological Awareness in Learning How to Read

Learning the names and sounds of letters is one of the first steps in reading acquisition. Students often struggle with learning the letters of similar shapes before age four (Thompson, 2009; Molfese et al., 2006). Older students learn and recall letter names and sounds at a higher rate than younger students; older students often have higher cognitive skills. Thompson noted that students typically learn upper case letters before learning lower case letters because the letters classified as having “cross-case visual dissimilarity” are easier for younger students to learn (p. 58). Eight letters are classified as having this cross-case dissimilarity: Aa, Bb, Dd, Ee, Gg, Hh, Nn, and Rr. Learning the corresponding sounds to the letters can also be a challenge. Several studies have found that letter knowledge is related to a student’s phonological skills and cognitive abilities (Molfese et al., 2008; Leppänen, Aunola, Niemi, & Nurmi, 2008; Thompson, 2009). The higher a child’s cognitive processing skills are the higher his rate of letter acquisition. Leppänen et al. and Molfese et al. argued, respectively, that letter knowledge at the end of kindergarten is the best predictor of language skills in grade 4 and in grade 6.

Letter knowledge also involves the idea that each letter has one corresponding sound; some letters have up to three corresponding sounds. The letter sounds also change when the letters are combined with other letters to form words. The letter sounds and rules of letter sounds are part of phonological awareness, which includes a student’s ability to process letter sounds, rhyming words, and segmenting letters within words (Molfese et al., 2006). Phonological awareness is part of the dual route cognitive processing that changes letters into words. Phonological awareness level affects the ability of students to retain individual letter knowledge. Students who demonstrate low phonological awareness skills often need intervention to stay at grade level. However, these phonological awareness skills play a smaller part in reading as students get older. The transition begins

Socio-economic status (SES) can also impact letter knowledge skills for children. For example, children of low SES are usually at a disadvantage when they begin their formal education because they typically have had less exposure to written and spoken words. Parents of low SES are also less likely to have written material in their homes, and they are less likely to read to their children. Parents of low SES children typically have less formal education than parents of higher SES children. High phonological awareness skills will void the effects of lower SES (Nobel, Farah, & McCandliss, 2006).

Phonological awareness skills are more important during the early years of education when children are learning to read (Vaessen & Blomert, 2009). Earlier language skills often predict later phonological awareness skills (Peterson, Pennington, Shriberg, & Boada, 2009). The phonological processing skills of students also determine their rate of letter identification (Molfese et al., 2006). The reliance of students on phonological awareness skills often declines as their cognition develops, and proficient readers use their memory rather than the assistance of phonological awareness skills to decode written words.

Phonological awareness includes ability to process letter sounds, rhyming words, and segmenting letters within words (Molfese et al., 2006). Phonological awareness is a key cognitive function in learning how to read. Students use phonological awareness skills to process pseudo words or non-words, and they provide the rules and sounds of letters to sound out these words. Phonological awareness skills are often used for initially processing letters into words that are coded into memory for future use in reading fluency and reading comprehension. Students’ level of phonological awareness is often used as a predictor for later reading skills. High phonological awareness skills frequently void the effects of lower socioeconomic status (Nobel, Farah, & McCandliss, 2006). Low phonological awareness can also lead to diagnoses of developmental phonological dyslexia.

References

Leppänen, U., Aunola, K., Niemi, P., & Nurmi, J. (2008). Letter knowledge predicts grade 4 reading fluency and reading comprehension. Learning and Instruction, 18, 548-564.

Molfese, V., Modglin, A., Beswick, J., Neamon, J., Berg, S., Berg, C., & Mohar, A. (2006). Letter knowledge, phonological processing, and print knowledge: Skill development in nonreading preschool children. Journal of Learning Disabilities, 39(4), 296-305.

Noble, K., Farah, M. & McCandliss, B. (2006). Socioeconomic background modulates cognition-achievement relationships in reading. Cognitive Development, 21(3), 349-368.

Peterson, R., Pennington, B., Shriberg, L, & Boada, R. (2009). What influences literacy outcome in children with speech sound disorder? Journal of Speech, Language, and Hearing Research, 52, 1175-1188.

Thompson, G. (2009). The long learning route to abstract letter units. Cognitive Neuropsychology, 26(1), 50-69.

Vaessen, A, & Blomert, L. (2009). Long-term cognitive dynamics of fluent reading development. Journal of Experimental Child Psychology, 105, 213-231.

 

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/

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