Evaluating for Dyslexia: Understanding the Process and the Path to Support

Reviewed by David Porrino, PsyD, Neuropsychologist, Director of Diagnostic Testing Services, Sasco River Center

Dyslexia is one of the most common specific learning disabilities, affecting a child’s ability to develop reading skills, written language, and in more severe or untreated cases, reading comprehension and vocabulary. Dyslexia absolutely does not reflect a lack of intelligence or effort. Numerous successful individuals from many industries have dyslexia: Stephen Spielberg, Keira Knightley, Richard Branson, and Whoopi Goldberg, to name a few. However, dyslexia can create challenges in the classroom and beyond if left undiagnosed and unsupported.

Early identification is key. When a child struggles with word reading, decoding (i.e., sounding out) new words, reading fluency (i.e., balancing speed and accuracy in reading), or reading comprehension, a thorough evaluation is needed to determine if the profile is consistent with dyslexia (or a different learning disability) and which interventions may be most effective. Early intervention can significantly improve outcomes, helping children develop essential literacy skills, develop confidence with reading, and help bridge literacy gaps before demands get too extensive.

This article overviews how dyslexia is evaluated, the role of pediatric neuropsychologists and clinical psychologists, and the steps parents and educators can take to ensure children get the support they need.

Understanding Dyslexia and Its Impact on Learning

Dyslexia is a specific learning disability that primarily affects the foundational aspects of reading, which include recognizing printed words, decoding new words, and overlearning spelling rules. The majority of cases are rooted in difficulties with phonological awareness, or the ability to access and manipulate the sounds in words. Many cases of dyslexia also involve deficits in rapid naming, or the ability to access overlearned symbols. Rapid naming involves the language and long-term memory systems, which affects orthographic awareness, or the ability to recognize written words and recalling various reading rules and sequences that make up the words we read. When individuals have both deficits in phonological awareness and rapid naming, this is often called a double deficit dyslexia or mixed dyslexia, which requires more intensive forms of specialized reading instruction.

Challenges with the above skills often lead to struggles with word reading, decoding, the ability to “crack the code” for reading, and reading fluency. Not all children with dyslexia struggle with reading comprehension, but reading is still taxing, slow, and effortful for them. Children with dyslexia may exhibit signs such as:

• Difficulty sounding out words or recognizing common words
• Difficulty retaining words or specific reading and spelling rules
• Struggles with reading fluency, often reading slowly or with many mistakes
• Trouble understanding what they’ve read (reading comprehension difficulties, though these may be a trickle down effect of foundational reading deficits)
• Difficulty with spelling and writing
• Avoidance of activities that require reading aloud (read aloud hesitancy)
• Early childhood: difficulty with rhyming or remembering specific sequences (e.g., the ABCs)

While no person was ever born with the ability to read, slowness in learning to read and persistent reading problems often require an evaluation of literacy development including a comprehensive test of phonological processes.

The Evaluation Process: How Dyslexia is Diagnosed

A formal evaluation is essential to clinically diagnose dyslexia and develop a targeted intervention plan. In the clinic setting, this is typically performed by a pediatric neuropsychologist, clinical psychologist, and at times with involvement from a speech-language pathologist. The assessment process is designed to measure multiple aspects of a child’s language abilities, including phonological processing skills, that underlie their reading skills.

Key components of a dyslexia evaluation include:

1. Phonological Awareness Testing

Phonological awareness is the ability to identify and manipulate the sounds in words. Tests of phonological processing assess a child’s ability to break down words into smaller sound units, an essential skill for reading development.

2. Rapid Naming or Rapid Automatic Naming (RAN) Tests

Children with dyslexia often struggle with rapid naming or rapid automatic naming tasks, which measure how quickly they can name familiar objects, letters, or numbers. Delays in RAN can indicate difficulty in developing fluent reading skills.

3. Reading and Spelling Assessments

These assessments evaluate word reading, decoding abilities, and spelling skills. They help determine whether a child’s reading problems stem from phonological deficits.

4. Oral Language and Listening Comprehension Evaluation

Because reading and spoken language are closely linked, a pediatric neuropsychologist, clinical psychologist, or speech-language pathologist may assess oral language abilities to determine if difficulties with language processing contribute to reading struggles.

5. Reading Comprehension and Fluency Tests

These tests evaluate a child’s ability to understand what they read and their ability to read smoothly and accurately. Reading fluency issues often accompany dyslexia and can impact overall learning.

6. Cognitive and Academic Achievement Testing

Standardized tests compare a child’s abilities to their peers, helping determine if dyslexia or another specific learning disability is present. Additionally, broad based assessment of neuropsychological abilities, such as working memory, processing speed, problem-solving skills, vocabulary, learning and memory, visual-spatial abilities, and motor functions is important to obtain the whole picture of the individual’s profile,

The Importance of Early Intervention

Research consistently shows that early intervention is critical in helping children with dyslexia develop effective reading strategies. The sooner a child is tested for dyslexia and receives appropriate support, the greater their chances of overcoming reading problems and building strong literacy skills. 

Intervention programs for children with dyslexia often include:

• Structured Literacy Instruction: A research-based approach that explicitly teaches phonics, decoding, and spelling rules. Often this is implemented for a minimum of 45 minutes daily in a child’s academic program.
• Multisensory Teaching Methods: Engaging multiple senses (visual, auditory, and kinesthetic) to strengthen learning.
• Speech-Language Therapy: Working with a speech-language pathologist to support oral language development and improve language processing.
• Reading Fluency Practice: Guided read-aloud sessions and fluency-building exercises.

Under the Individuals with Disabilities Education Act (IDEA), children diagnosed with dyslexia who meet classification criteria may qualify for specialized educational services. Schools can develop Individualized Education Programs (IEPs) to and embed crucial literacy programming to structured support as well as reasonable accommodations for children with dyslexia.

Next Steps: How to Seek a Dyslexia Evaluation

If you suspect your child may have dyslexia, seeking a formal evaluation is the best first step. A comprehensive evaluation can provide clarity and guidance on how to support your child’s literacy development.

Key steps to take include:

1. Talk to Your Child’s Teacher and Team of Educators– Share your concerns and ask about their observations regarding reading skills, literacy development, and written language development.
2. Seek a comprehensive evaluation – This can be done within the public school system, though it is a different process than obtaining private testing with a clinician such as a pediatric neuropsychologist, clinical psychologist, or literacy specialist. A private assessment from a specialist in dyslexia can provide an in-depth evaluation that covers a broader range of cognitive processing areas, a more tailored evaluation process, and personalized recommendations.
3. Develop an Intervention Plan – Once dyslexia is diagnosed, you can work with professionals to create a targeted support plan that addresses your child’s specific needs.

We’re Here to Help

At Sasco River Center, we specialize in dyslexia evaluations and comprehensive neuropsychological and psychoeducational evaluations for children, adolescents, and adults in Fairfield County, Connecticut, including Westport, Darien, Wilton, Fairfield, Greenwich, and surrounding areas such as Westchester County. Our team of experienced professionals provide thorough testing to identify dyslexia and other learning differences.

If your child is struggling with reading fluency, word reading, decoding, or reading comprehension, don’t wait—early intervention can make all the difference and increasing your understanding of your child’s profile is immensely helpful.