While language-based learning disorders—like dyslexia—fall squarely in the purview of speech-language pathologists, I’ve talked to several pediatric SLPs who don’t feel entirely comfortable treating—let alone diagnosing—this disorder. In my relatively short career as an SLP, I’ve worked with skilled SLPs treating children with dyslexia. We address various language and reading needs every day with our clients. When faced with the prospect of providing a diagnosis of dyslexia, however, I felt uneasy. Until recently.
My graduate program didn’t comprehensively cover dyslexia and all its complexities. In my clinical fellowship, I encountered a case and received the appropriate guidance, but few of my friends or co-workers benefited from the same experience. I know my friends and I aren’t alone in these education gaps. These factors might cause some SLPs to hesitate in giving a diagnosis or even knowing they can diagnose dyslexia.
So, how do we go about evaluating dyslexia?
Typically, SLPs work on a team with other professionals and caregivers during the assessment process. SLPs are critical in making a differential diagnosis. They can evaluate all language domains—listening, speaking, reading and writing. It’s important to screen for vision problems and to rule out attention deficit hyperactivity disorder (ADHD) and hearing loss before diagnosing dyslexia.
I also recommend these resources on the topic:
- ASHA’s position statement on Roles and Responsibilities of Speech-Language Pathologists With Respect to Reading and Writing in Children and Adolescents
- Dyslexia Assessment: What Is It and How Can It Help?
- ASHA Evidence Maps on Written Language Disorders for School-Age Children
- ASHA Practice Portal on Written Language Disorders
Often, SLPs or reading specialists use a combination of standardized tests to help them make a diagnosis. Popular choices include sections of the Clinical Evaluation of Language Fundamentals, Oral and Written Language Scales, Gray Oral Reading Test, Comprehensive Test of Phonological Awareness, and Test of Word Reading Efficiency.
Don’t have any standardized tests to use? Don’t worry! Informal assessment measures can give you the information you need to make an informed diagnosis. It is crucial to evaluate all potentially affected areas and underlying skills, including:
- Phonological awareness
- Word recognition
- Word automaticity
- Reading fluency
- Reading comprehension
- Processing speed
- Rapid naming
- Auditory comprehension
- Verbal expressive language
- Working memory
Further, interviewing parents provides valuable case history details. Family history of dyslexia, for example, is an important factor to consider, as are possible delays in talking. A parent interview can also reveal red flags that standardized testing might not cover, such as chronic ear infections, poor handwriting, difficulty reading an analog clock, confusion with left and right and directionality, trouble learning a foreign language, and more.
Let’s educate ourselves to the degree needed to help the one in five individuals with a language disorder like dyslexia. Take that continuing education course! Read that research article! It might make all the difference to the next client to walk into your office.
Corie Viscomi, MA, CCC-SLP, is the owner and director of The Speech Studio in Westchester, New York. She received her first ASHA Award for Continuing Education (ACE) this year. Corie@TheSpeechStudioNY.com