Speech-Language Pathologists – The Critical Evaluation Component

Recognizing your child may have dyslexia is a major step, but what comes next can be daunting. Making phone calls and finding an evaluator is no carnival ride. The evaluation itself is important, but what matters more is that you and the evaluator come to a conclusion that best fits your child whether or not the conclusion involves a dyslexia diagnosis.

There are no scoring systems for diagnosing dyslexia. Reaching a diagnosis requires reviewing many contributing data points. As Sally Shaywitz (2020) puts it “There is no natural joint separating dyslexic and good readers” (p.27). Regardless of whether your child receives a dyslexia diagnosis, the purpose of an evaluation is to gauge where your child’s strengths and weaknesses are. If done right, an evaluation should leave you with not only a diagnosis (or lack thereof), but a blueprint of next steps you can take to support their reading.

One of those first steps may be consulting a speech-language pathologist (SLP) to obtain a diagnosis. Along with a psychologist or reading specialist, an SLP offers clinical expertise that can support you and your child toward receiving a thorough evaluation.

In the public schools, psychologists and SLPs work together on a multidisciplinary evaluation team, making their clinical findings complementary. Psychologists test verbal and non-verbal IQ, along with decoding (word reading). SLPs can test overall language abilities, speech sound production, and phonological awareness.

If you are seeking an outside evaluation, common practice has relied on IQ testing to support the discrepancy between a child’s average or above average intelligence and their poor reading skills. However, an IQ test is not required for a dyslexia diagnosis to be considered valid. Multiple sources of information create a case to support a diagnosis.

One caveat–the same way you make sure your doctor has relevant qualifications and training before seeing them for surgery, it’s vital you find an SLP with a background in language and literacy disorders before giving consent to have them evaluate your child. If you don’t know their background, simply ask.

Here are 3 reasons why you should see an SLP for a dyslexia evaluation:

1. Dyslexia is a language-based reading disability. SLPs are language and literacy specialists.

The International Dyslexia Association (2002) states that dyslexia “is characterized by difficulties with accurate and/or fluent word recognition” and that such “difficulties typically result from a deficit in the phonological component of language.” Remember “phono” means sound and the phonological component of language is the part of our brain that analyzes individual sounds to help create meaning out of chunks of sounds (words). Before we can even look at words, we have to have an appreciation for the sounds within them that are represented in the written form as words.

Because written and spoken language are so connected, SLPs can provide support for children in all facets of their life. Our roles pertaining to literacy include promoting language, reading, and writing acquisition, identifying children at-risk for language, reading, and writing disorders, reading and writing assessment and intervention, and supporting general education teachers, parents, and other staff in these topics (ASHA position statement). SLPs’ unique skill sets target language and literacy and allow them to view various strengths and areas of need, rather than viewing reading from a single vantage point.

2. Dyslexia is often diagnosed late. SLPs work with kids from a young age.

Children with dyslexia are often diagnosed at or after third grade, when systematic intervention places children at a disadvantage as their peers are focusing less on phonics and more on reading comprehension (Shaywitz, 2020, p. 30). Research has shown that children with dyslexia can be diagnosed as early as kindergarten, and early intervention can begin as early as preschool. Therefore, if you have a family history of dyslexia, or if you are beginning to see signs of dyslexia in your child (late-talking, speech sound difficulties, trouble with phonological awareness skills, etc), you may want to seek out intervention as soon as possible. That’s where SLPs come in.

SLPs work with every age group and can support people at every level. For example, if your child is already being seen by an SLP for a lisp, and their teacher calls to let you know about phonemic awareness difficulties in the classroom, you can ask your SLP to target the lisp and the phonemic awareness issue. There may be barriers such as insurance coverage or whether your child is being seen in a public school/private clinic setting; however, these may be overcome. Rather than shying away from bringing up reading concerns with an SLP, be brave and ask them what they know about literacy assessment and intervention. (You can even lead them here to the American Speech-Language Hearing Association’s Position Statement on Reading and Writing https://www.asha.org/policy/ps2001-00104/) If your child is nearing an evaluation, you can specifically request that the SLP assess phonemic and phonological awareness and thus provide clarity of where they stand in relation to their peers.

3. Children with dyslexia often struggle with other areas of language and reading. SLPs can identify specific areas of need during assessment.

As mentioned previously, SLPs see reading through a language-based perspective. If a child is working with an SLP on a reading passage, the SLP may target decoding (word-reading) during one session, but may find time to target comprehension at another session. Similarly, the SLP could take the same passage and find ways to target vocabulary, summarizing, and more. During an evaluation, an SLP can use different assessment tools to assess reading comprehension, decoding, language comprehension, etc.

Written and spoken language are inextricably connected. SLPs can help you see your child’s strengths and areas of need through a thorough assessment. Some children with dyslexia have co-occurring disorders such as developmental language disorder, or more commonly known as language impairment, and others may have subclinical deficits which may not warrant a diagnosis, but require further monitoring. As such, SLPs are trained to support children with only dyslexia and those with dyslexia and other co-occurring disorders.

References
American Speech-Language-Hearing Association. (2001, January 1). Roles and responsibilities of speech-language pathologists with respect to reading and writing in children and adolescents. American Speech-Language-Hearing Association. https://www.asha.org/policy/ps2001-00104/.
Definition of dyslexia. International Dyslexia Association. (2018, July 16). https://dyslexiaida.org/definition-of-dyslexia/.
Shaywitz, S. E., & Shaywitz, J. (2020). Overcoming dyslexia (p. 27-30). Alfred A. Knopf.