How Do We Identify and Support Children with Dyslexia?

By Christine S. Ghilain, Ph.D., ABPP-CN

Dyslexia is one of three subtypes of Reading Disability and is diagnosed when a person has difficulties with recognizing, spelling, or decoding (sounding out) unfamiliar words. As you might expect, challenges when acquiring these early foundational skills can have a ripple effect, leading to struggles with reading comprehension or learning of new vocabulary words as the child matures.  

So how do we identify when a child has dyslexia, and what can we do to support them? First, parents or teachers may notice that the child struggles to sound out words or is not recognizing words they’ve seen before. Parents and teachers may notice the child avoids reading altogether or becomes upset when they are asked to read. The child may work harder than peers to get through reading tasks, exerting a lot of mental energy with mixed levels of success, unfortunately leading to increased frustration, fatigue, and overwhelm. 

When these challenges are observed, an evaluation is the appropriate next step. Early intervention is key to enhancing success, as the faster supports are put in place, the faster the child can catch up to peers. You may be familiar with the transition in third to fourth grade, where children move from “learning to read” to “reading to learn,” and thus intervention before third grade is optimal. However, it is not uncommon to see the “fourth grade slump,” when children who are not as strong in reading begin to show more difficulties keeping up with peers. Intervention at any stage of learning promotes skill building, but the earlier the child has tools to add to their reading toolbox, the more they will benefit long term.  

An evaluation for dyslexia should include measures looking at fundamental skills needed for reading, including two core prerequisites of reading success: (1) phonological awareness and (2) rapid automatized naming. Both skills are strongly predictive of reading ability, and a child is diagnosed with dyslexia when they struggle with one of these skills. Double dyslexia, as the name suggests, is identified when a child struggles with both phonological awareness and rapid automatized naming. Any observed difficulties are considered within the context of the child’s developmental, familial, medical, cultural and educational histories, and a formal diagnosis is made by a neuropsychologist or related professional. 

Neuropsychological evaluations assess foundational reading skills, but also delve deeper into all core domains of functioning. This is because often weaknesses in other skill areas may look like dyslexia but are not dyslexia after all. For example, a child with an attention disorder such as ADHD may look like they are struggling to read, but in fact are struggling to pay attention enough to focus on the words in front of them. Their reading skills may be great, but they can’t focus long enough to demonstrate them! A child with a slower processing speed may look like they are struggling to read, when in fact they simply require more time to demonstrate what they know. Thus, a comprehensive neuropsychological evaluation looks across all domains of functioning, in order to understand the unique abilities of the child.  In fact, between 25 and 40 percent of children with ADHD also have dyslexia, and thus knowing a child’s specific areas of strengths and weaknesses allows the neuropsychologist to provide targeted, child-specific recommendations for support. 

Research-based, highly successful interventions for children with dyslexia include the Orton-Gillingham Approach or the Wilson Reading System, among others. Neuropsychologists also provide tailored strategies for ongoing reading support across home, school, and community-based settings. Given the plethora of programs advertised on the internet or social media, it can be helpful to work with a neuropsychologist to identify what specific programs work best based on the child’s areas of difficulty. Unfortunately, many programs tout success, but do not have any evidence to back their claims and end up wasting time, money, and resources with no improvement of the child’s reading skills in the end. Thus, a neuropsychologist helps to connect families with programs that translate strategies into success!  

About the Author

Christine S. Ghilain, Ph.D., ABPP-CN

Board Certified Clinical Neuropsychologist

Director & Owner, Brain Health Neuropsychology, LLC

Dr. Christine S. Ghilain is a board-certified clinical neuropsychologist in private practice. She earned her undergraduate degree with honors in Psychology and Education from Bucknell University. She then worked for the Center for Autism Research (CAR) at the Children’s Hospital of Philadelphia (CHOP) before attending graduate school. She obtained her Master’s and Doctoral degrees from the University of Miami. She completed her residency in Lifespan Neuropsychology at Emory School of Medicine, and her fellowship at the Children’s Healthcare of Atlanta (CHOA). Dr. Ghilain was then certified by the American Board of Professional Psychology (ABPP) in Clinical Neuropsychology. Dr. Ghilain is passionate about supporting individuals seeking to reach their best potential. Please head to www.njbrainhealth.com for more information.  

 

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