For Medical Professionals

Dyslexia is a prevalent disorder that is widely unidentified. A screening can change the lives of children and their families. 

Children with undiagnosed dyslexia carry a psychological burden. You may encounter a child who is intelligent yet struggling in school. Undiagnosed dyslexia can look like ADD or ADHD. There is also a high comorbidity between ADHD and dyslexia.

In some cases, insurance companies offer coverage for remediation services.

Screening for characteristics of dyslexia is designed to identify students who may have a learning disorder. It’s just like screening for vision or hearing problems. No two people with dyslexia have the same symptoms.

 

With the new app, screening for the risk of developing reading disabilities can be quick, easy, and fun for children, says Nadine Gaab, a researcher and faculty member at the Harvard Medical School and Harvard Graduate School of Education. Gaab created the app with the Innovation and Digital Health Accelerator at Boston Children’s Hospital.

  1. Equip yourself with information from Up to Date (UTD) and other research bodies such as Mayo Clinic, Yale Center for Dyslexia, or University of Michigan.
  2. Choose a screening tool for your rooming staff to administer with other well-child visit tools.
  3. If identifying characteristics are present, refer the family to a Neuropsychologist that specifically tests for dyslexia (not all Neuropsychs test for dyslexia).
  4. Screen for co-morbidities and consider setting up follow up appointments to screen for these based on the statics surrounding increased risk for mental health, substance, abuse, risk taking behavior, ODD and more. Frequency is based on the individual but often at least 3 times during the school year unless another medical health professional or school counselor is specifically targeting this.
  5. An undiagnosed, un-remediated LD is often traumatic both for the child and family. Consider arranging visits for family members including the parents to assess and support their own journeys.

Children will out grow their dyslexia/reading impairment on their own and catch up eventually.

  • Without intervention, children who are poor readers at the end of first grade almost never acquire average-level reading skills by the end of elementary school (Francis et al., 1996; Juel, 1988; Shaywitz et al., 1999; Torgesen and Burgess, 1998).

  • Even in highly transparent languages such as German, 70% of below average readers in 1st grade remain below average readers in 8th grade (Landerl & Wimmer, 2008)…early intervention is key!

Even if you screen for dyslexia and reading impairments as early as Pre-K or K, you won’t be able to intervene effectively that early anyway

  • A meta-analysis comparing intervention studies for children struggling with reading difficulties/dyslexia offering at least 100 sessions, reported larger effect sizes in kindergarten/1st grade than in 2nd and 3rd grades (Wanzek & Vaughn, 2007; Wanzek et al., 2013)

  • When “at risk” beginning readers receive intensive instruction, 56% to 92% of at-risk (for dyslexia/reading impairment) children across six studies reached the range of average reading ability (Torgesen, 2004)

  • Converging research points to the importance of early interventions for at-risk students for improving the effectiveness of remediation ( e.g.; Connor, 2009, 2013; Catts, 2015; Denton & Vaughn, 2008;Torgesen,1999; Flynn, Zheng, & Swanson, 2012; Vellutino, 1996; Morris,1997)

First Signs of dyslexia or reading impairments can only be seen after 2-3 years of reading instruction

  • Many longitudinal (following the same kids over time) studies have revealed key predictors in young children.

  • Research has shown that these key predictors of subsequent problems with learning to read include:

    • Phonological/Phonemic awareness

    • Pseudoword repetition

    • Rapid automatized naming

    • Expressive/receptive vocabulary

    • Oral listening comprehension

    • Letter (sound) knowledge

Early Screening for dyslexia/reading impairments gives students a diagnosis at age 5 before they can read

  • The purpose of early screenings is not to diagnose, but to identify children AT RISK for developing a reading impairment.
  • Dr. Gaab explains this in this article written for the BOLD blog: https://bit.ly/349VNzp :

    • “An analogy from medicine may be helpful in this context: Adults are advised to undergo screening for high cholesterol levels, which can indicate an increased risk of developing heart disease. Those diagnosed with high cholesterol don’t automatically receive a diagnosis of heart disease. They are provided with an evidence-based “response to screening,” generally a combination of prescribed exercise, dietary changes, and/or medication. This may prevent the development of the disease, or at least lessen its severity. The goal is to reduce the prevalence of heart disease, by encouraging people to take preventive action and to improve outcomes of those who will develop it by implementing lifestyle changes earlier, prior to a diagnosis.”

  • In the case of reading impairments, we need to make a similar shift from a deficit-driven to a prevention model. With the help of high-quality screening programs, we can identify AT-RISK children early, but refrain from diagnosing them while they are still in preschool/K.

  • For Gaab Lab articles on screening and prevention for dyslexia/reading impairments, please see for example: https://bit.ly/2NeKpeJ, https://bit.ly/2BO5reQ, https://osf.io/z4ryh/, and https://bit.ly/349VNzp

  • Furthermore, look at the excellent work by Hugh Catts at Florida State Unversity, e.g., this article https://bit.ly/2plrK95 and also take a look at this white paper on screening published by NCIL Literacy: https://bit.ly/31PabLG co-authored by Yaacov Petscher, Nadine Gaab, and the Texas Center for Learning Disabilities.