Diagnosing Dyslexia

March 11, 2019 by Amanda Davis in Speech Therapy

written by Amanda Davis MSc, MA, BSc (Hons) Speech and Language Therapist and Dyslexia Specialist 

I recently read a report by an optometrist who diagnosed a child with dyslexia. It got me wondering about the standards of diagnosis in South Africa versus the United Kingdom. As many of you will know, we are lucky enough to share ideas between Kids First SA (in South Africa) and Words First Ltd (in London) to benefit children and families in our care. So, I started thinking about the diagnostic process in the UK, which follows international guidelines and the process in South Africa which seems to have limited (if any) guidelines (and in many cases false guidelines such as many of them written for You Magazine https://www.news24.com/You/Archive/how-to-help-a-child-with-dyslexia-20170728-2)

To fully understand dyslexia, one must analyse the definition of dyslexia from the Rose Review of reading (2006):

  • ‘Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling.
  • Characteristic features of dyslexia are difficulties in the phonological awareness component of language, verbal memory and verbal processing speed.
  • Dyslexia occurs across the range of intellectual abilities.
  • It is best thought of as a continuum, not a distinct category, and there are no clear cut-off points.
  • Co-occurring difficulties may be seen in aspects of: language, motor co-ordination, mental calculation, concentration and personal organisation, but these are not, by themselves, markers of dyslexia.
  • A good indication of the severity and persistence of dyslexic difficulties can be gained by examining how the individual responds or has responded to well-founded intervention.’

Please note how the word LANGUAGE is in bold. Dyslexia is a language-based disorder and therefore, this gives a hint as to the diagnostic process. It is NOT a visually-based disorder and therefore, anyone working in the field of vision should not be making conclusions about dyslexia (unless they have specific additional training). Yes, children with dyslexia may make letter reversals, but this it NOT usually because their vision is a problem, it is because their brain can’t access the sound that matches the visual.

In the UK, the person making the diagnosis must be certified such as a:

  • Chartered Psychologist specialising in Specific Learning Difficulties registered with the Health Care Practitioners Council (HCPC)
  • Specialist Teacher/Assessor with an Assessment Practising Certificate

The qualified professional will assess the areas of language processing that need to be in tact for fluent reading and comprehension. These may include:

  • Language Skills / vocabulary
  • Phonological processing
  • Naming Speed
  • Processing Speed
  • Reading / spelling
  • Reading comprehension – accuracy, fluency and rate

A good professional will also delve into the type of intervention the child has already had. If it has been good quality synthetic phonics and the child has not responded, then the diagnosis is more robust. However, if there are any concerns regarding the quality of intervention, the child should undergo a period of specialist intervention and the response should be monitored to see how she / he improves (or doesn’t). A one-off assessment is not always appropriate for a diagnosis that has such a big impact on a child’s life.

Children will be referred to a Behavioural Optometrist if there are concerns regarding head aches, eyes jumping or words ‘swimming’ on the page. However, the optometrist will not be making any diagnosis about dyslexia.

I hope this goes some way to shed light on the process of getting a diagnosis and the complexities. There is a need for a clearer and coherent system in South Africa that matches international standards and I hope one day, we will get to that point. In the meantime, please feel free to ask us any questions about the process. Next week we will talk about how to address the diagnosis with you child.

Thanks for reading!