Should My Child Be Evaluated for Dyslexia?

An excerpt from Dr. Sally Shaywitz's book, Overcoming Dyslexia, offers parents information and insight.

By Sally Shaywitz, M.D.

From Dr. Sally Shaywitz, one of the world's leading experts on reading and dyslexia, Overcoming Dyslexia is a comprehensive, up-to-date, and practical book to help parents and professionals understand, identify, and overcome reading problems that plague children today.

Drawing on recent scientific breakthroughs - many of them in her own laboratory - Dr. Shaywitz demystifies the subject of reading difficulties and explains how a child can be helped to become a good reader.

In the following excerpt from Overcoming Dyslexia, Dr. Shaywitz discusses early diagnosis of dyslexia in young children as well as in older children and young adults.

Sally Shaywitz on Diagnosing Dyslexia

I now want to gather together all the clues that combined will serve as an early-warning system for recognizing dyslexia. The clues will help you answer the question: Should my son or daughter (or I) be evaluated for dyslexia?

No one wants to be an "alarmist" and put her child through an evaluation for trivial or transient bumps along the road to reading. Evaluations can take time, and those carried out privately can be expensive. But I think we have to remind ourselves that our children are precious, one-of-a-kind individuals and have only one life to live. If we elect not to evaluate a child and that child later proves to have dyslexia, we cannot give those lost years back to him. The human brain is resilient, but there is no question that early intervention and treatment bring about more positive change at a faster pace than an intervention provided to an older child. And then there is the erosion of self-esteem that accrues over the years as a child struggles to read.

Childhood is a time for learning. A child who delays breaking the phonetic code will miss much of the reading practice that is essential to building fluency and vocabulary; as a consequence, he will fall further and further behind in acquiring comprehension skills and knowledge of the world around him. To see this happen to a child is sad, all the more because it is preventable.

Joseph Torgesen, a reading researcher at Florida State University who has carried out many of the critical studies on intervention, has this to say about the need to identify children early on and the cost of waiting: "To the extent that we allow children to fall seriously behind at any point during early elementary school, we are moving to a 'remedial' rather than a 'preventive' model of intervention. Once children fall behind in the growth of critical word reading skills, it may require very intensive interventions to bring them back up to adequate levels of reading accuracy, and reading fluency may be even more difficult to restore because of the large amount of reading practice that is lost by children each month and year that they remain poor readers."

Most parents and teachers delay evaluating a child with reading difficulties because they believe the problems are just temporary, that they wll be outgrown. This is simply not true. Reading poblems are not outgrown, they are persistent. As the participants in the Connecticut Longitudinal Study have demonstrated, at least three out of four children who read poorly in third grade continue to have reading problems in high school and beyond. What may seem to be tolerable and overlooked in a third grader certainly won't be in a high schooler or young adult. Without identification and proven interventions, virtually all children who have reading difficulties early on will still struggle with reading when they are adults.

Luckily, parents can play an active role in the early identification of a reading problem. All that is required is an observant parent who knows what she is looking for and who is willing to spend time with her child listening to him speak and read.

The specific signs of dyslexia, both weaknesses and strengths, in any one individual will vary according to the age and educational level of that person. The five-year-old who can't quite learn his letters becomes the six-year-old who can't match sounds to letters and the fourteen-year-old who dreads reading out loud and the twenty-four-year-old who reads excruciatingly slowly. The threads persist throughout a person's life. The key is knowing how to recognize them at different periods during development. Therefore, I have gathered the clues together to provide three distinct portraits of dyslexia: first, in early childhood from preschool through first grade; next, in school-age children from second grade on; and, last, in young adults and adults.

Clues to Dyslexia in Early Childhood

The earliest clues involve mostly spoken language. The very first clue to a language (and reading) problem may be delayed language. Once the child begins to speak, look for the following problems:

The Preschool Years

Kindergarten and First Grade

In addition to the problems of speaking and reading, you should be looking for these indications of strengths in higher-level thinking processes:

Clues to Dyslexia From Second Grade On

Problems in Speaking

Problems in Reading

In addition to signs of a phonologic weakness, there are signs of strengths in higher-level thinking processes:

Clues to Dyslexia in Young Adults and Adults

Problems in Speaking

Problems in Reading

Signs of Strengths in Higher-Level Thinking Processes

These clues across the life span offer a portrait of dyslexia. Examine them carefully, think about them, and determine if any of these clues fit your child, you, or someone else you are close to. Look for clues in the weaknesses and strengths. Identifying the weaknesses makes it possible to spot dyslexia in children before they are expected to read and in adults after they have developed some degree of reading accuracy but are continuing to show the remnants of earlier problems, reading slowly and with great effort.

If you think you or your child has some of these problems, it is important to note how frequent they are and how many there are. You don't need to worry about isolated clues or ones that appear very rarely. For you to be concerned, the symptoms must be persistent; anyone can mispronounce a word now and then, or confuse similar-sounding words occasionally. What you are looking for is a persistent pattern - the occurrence of a number of these symptoms over a prolonged period of time. That represents a likelihood of dyslexia.

More on Sally Shwaywitz's work:

Sally Shaywitz, M.D., is the Audrey G. Ratner Professor in Learning Development at the Yale University School of Medicine. She and her husband are codirectors of the Yale Center for Dyslexia and Creativity. Recognized as one of the country’s top doctors, Shaywitz has devoted her career to helping children and adults who are dyslexic.