New Processes for Diagnosing Dyslexia
Once an RTI system is in place, many schools realize that the number of students who are struggling to keep pace in the classroom is larger than expected. Research indicates that many students—possibly as many as 15–20% of the population as a whole—have some of the symptoms of dyslexia, including slow or inaccurate reading, poor spelling, poor writing, or mixing up similar words.
In the past, testing for learning disabilities could be completed by qualified school personnel and, based on the results, students could be classified under the category of Specific Learning Disability (SLD) and receive services through special education.
As the result of state legislation and policies, however, this process is much different for diagnosing dyslexia. Many states have regulations that require dyslexia evaluations to be conducted by neuropsychologists, physicians, or other specialists who work in private settings.
Since schools are not able to identify dyslexia, fewer children have access to these evaluations due to the high costs and limited numbers of qualified evaluators in many communities. Furthermore, even when a dyslexia diagnosis is obtained from a private provider, schools are not mandated to classify a student or provide services based on these results.
Another option for diagnosing dyslexia may also include a clinical evaluation provided by a psychologist or psychiatrist. Learning Disorders are developmental disorders that begin when children enter school, but may not be recognized until later.❞ These professionals are qualified to evaluate for Specific Learning Disorders, a clinical diagnosis that does not necessarily mean the same as Specific Learning Disabilities in an educational context.
Learning Disorders are developmental disorders that begin when children enter school, but may not be recognized until later. Diagnosis is based on a review of developmental, medical, educational, and family history, test scores, teacher observations, and RTI results.
A clinical diagnosis of a learning disorder is based on a diagnostic manual called the DSM. DSM-5, published in 2013, established the criteria for deficits in general academic skills and provided “specifiers” for the areas of reading, mathematics, and written expression, as well as a level of severity from mild to severe.
Rather than create separate categories for dyslexia, dyscalculia, and other learning problems, the DSM-5 has broadened the category to a single, overall diagnosis to incorporate deficits that impact academic achievement. The criteria for a reading disorder include deficits in word reading accuracy, reading rate or fluency, and reading comprehension. In the case of print-based disabilities, the clinical diagnosis would be Specific Learning Disorder with Impairment in Reading, however, not dyslexia.
A third new approach for evaluating students with reading problems is the replacement of the discrepancy model with a process called Patterns of Strengths and Weaknesses (PSW). PSW is designed to be used by schools as part of a comprehensive evaluation. The difference between the former Discrepancy Model and PSW is that the Full Scale IQ score is not a focus unless an intellectual disability is suspected and most likely the cause of learning problems. The PSW model utilizes a cognitive evaluation to measure a student’s performance on a range of areas such as memory, processing speed, and phonemic awareness.
To qualify as having a disability, a student must demonstrate average ability in most cognitive areas but have one or more specific cognitive weaknesses associated with a related academic weakness. The results of the evaluation would not determine if a student has dyslexia but whether the criteria for a specific learning disability in reading is met as defined by the federal regulations.
“The child exhibits a pattern of strengths and weaknesses in performance, achievement, or both, relative to age, State-approved grade-level standards, or intellectual development, that is determined by the group to be relevant to the identification of a specific learning disability, using appropriate assessments.” (34 CFR 300.309)
While the goal of obtaining a diagnosis of dyslexia is important for many reasons, it is unlikely that this will possible for most students until schools are part of this process. The use of RTI and PWS models are generally viewed as moves in the right direction toward appropriately identifying students and providing intervention until diagnosing dyslexia becomes a readily available reality.