When to seek a dyslexia evaluation?
The email I received from a parent sounded like many other inquiries I have been getting this year – her son, heading to third grade in September, is still struggling to sound out many words, does not read fluently even some of the more common words despite reading them over and over, and has been dreading reading in school and avoiding it at home. And yet, the teachers do not seem to be particularly concerned and the child’s grades are mostly fine, even if his progress in reading levels is notably slow. Should the child be evaluated for dyslexia, the parent wondered. Perhaps it would make sense to wait another year and see if the child grows out of it and catches up with peers? Could the disruption of COVID and remote schooling be the reason the child is not progressing in reading?
Unlike some other conditions, where symptom management without a diagnosis is a perfectly acceptable option, with dyslexia, a neurological condition that affects reading at the word level, it is clear, that an evaluation should be done as early as possible so that the appropriate treatment can begin. Children who struggle with acquiring reading skills early on, do not grow out of it. In fact, the opposite tends to happen as the gap between average readers and struggling readers only widens with time without appropriate interventions. Eventually, not only reading, but their self-esteem and self-confidence become affected as well.
It does not have to be this way. Decades of research show that the earlier the appropriate intervention or even prevention measures are put in place, the greater the child’s chances of overcoming their reading difficulties. Even older struggling readers can make substantial progress in their reading skills with appropriate treatment, yet the older the child the more likely they are to continue to read less fluently than their peers. Ideally, the child should be evaluated by kindergarten or first grade.
How early can we look for signs of dyslexia? Children at risk for dyslexia can be reliably identified even before their reading skills are expected to develop. Researchers have even identified newborn babies at risk for dyslexia based on their EEG recordings, though this method may perhaps not be too practical for most people. Fortunately, expensive equipment is not necessary and equipped with basic knowledge, an observant parent can watch out for signs that the child would benefit from an evaluation. Signs of dyslexia vary by age, but can usually be noticed as early as preschool, before actual reading develops. Here are some things to be on a look out for:
Preschool Years (before age 5):
Your child may begin to speak later than other children, then take longer to acquire new words
Has trouble learning the alphabet in sequence (the ABC song)
Not recognizing and naming the letters in the alphabet
Trouble recognizing letters in their own name
Difficulty learning nursery rhymes (e.g., Twinkle, Twinkle Little Star; Row, Row, Row Your Boat)
Not recognizing when words rhyme, such as cat/bat, hop/pop, difficulty playing rhyming games
Frequently mispronouncing simple words (e.g., “aminals” for animals)
Using baby talk persistently beyond the first few years
Kindergarten and First Grade:
Difficulty retrieving names of familiar objects, using non-specific words, such as “stuff” or “that” to refer to familiar objects
Trouble learning and remembering sequences, such as months, days of the week, phone numbers
Difficulty breaking words into parts, first into syllables, such as rainbow can be broken down into rain and bow, and later into individual sounds – r, ay, n, b, oh
Being unable to count the number of syllables in a word
Not associating letters with sounds – e.g., not connecting the b sound to the letter b
Nor connecting the letters and sounds in simple, common words, such as big, dog, bus
Guessing the written words, often saying a word that has no connection to the sounds of the letters – e.g., word “dog” is read as “book.”
Not reading simple words by the end of first grade
Not progressing in reading levels through the school year
Avoiding not enjoying reading
Trouble spelling short, easy words
Second Grade and Beyond:
Continues to read slowly and with effort
Not reading words with more than syllable
Continues to have trouble sounding out unfamiliar words, tries to take guesses often not even close to the actual word
Relies on context to figure out the word, often substitutes a word when unable to figure out the one in front of them (for example reads “boat” for “ship”)
Avoids reading out loud, gets anxious about being called on to read in class
Has difficulty spelling even simple words
In conversation, may have trouble with retrieving the precise word, say “umm” frequently
In speech and reading, may confuse words that sound alike
Finds reading tiring and hard and, therefore, does not read for fun
If you’re noticing these signs consistently, it is a good time to seek an evaluation for your child. A neuropsychological evaluation for dyslexia offers a comprehensive assessment of your child’s cognitive and academic abilities with a particular emphasis on language and reading skills and will offer not only a diagnosis but a specific plan for intervention so that your child can become a better and more confident reader.
Kilpatrick, D. (2015). Essentials of Assessing, Preventing, and Overcoming Reading Difficulties, 1st Edition
Shaywitz, S. & Shaywitz, J. (2020). Overcoming Dyslexia, 2nd edition