Parents and teacher have an urgent need for low cost, rapid, accurate identification of reading problems in order to move on with remediation as soon as possible. Yet conventional wisdom has it that one cannot diagnose dyslexia, only identify those at risk for it. This isn’t quite true. The Diagnostic and Statistical Manual (5th Edition) used by psychologists and psychologists can be used to formally diagnose a Specific Learning Disability (SLD) in reading, written expression, or mathematics contingent on four criteria being met. Importantly, the DSM V includes the following note:
“Dyslexia is an alternative term used to refer to a pattern of learning difficulties characterized by problems with accurate or fluent word recognition, poor decoding, and poor spelling abilities.” (p.67, DSM-5)
This formally equates the diagnosis of “SLD with impairment in reading.” with dyslexia. While a DSM based clinical diagnosis is the gold standard it can easily cost several thousands of dollars to procure privately, and public school wait times can run into years. This leaves most parents and teachers hanging. Bridging the gap are a myriad of screeners, assessment tools and standardized tests, each more rigorous than the latter. Googling “dyslexia test” will round up countless examples. Screeners typically take the form of a free, self-administered checklist of symptoms of signs and can be completed in minutes. Assessment tools such as the Shaywitz Dyslexia Screen or Nessy Learning’s Dyslexia Quest are more rigorous, but still generally parent or self administered, and build a simple cognitive profile of a student containing metrics on things like phonemic awareness, working memory and rapid naming. Such tools may take an hour to complete, and cost up to $200, but often much less. Standardized tests such as the CTOPP or Woodcock Johnson provide the same kind of cognitive metrics, but with more rigour and detail. They are administered by a professional, certified in the delivery of the test and may take one to two hours to administer in full, costing up to $500. A complete battery of standardized tests usually constitute a psychoeducational assessment which would form the basis of a DSM diagnosis, bringing us full circle.
Which instrument a parent, teacher or school might use will depend on budget, time, availability and the purpose of the assessment. If the purpose of the assessment is to force a school to take action or an employer to recognize a disability, then the more rigorous standardized tests would be the wise choice. But a formal DSM diagnosis should not be required before students begin receiving remediation in the classroom. While a checklist screener may not suffice to form the basis of an individualized education plan, many assessment tools and all standardized tests have science based evidence behind them that can and should be recognized by our educational system.
Michael Bates is the Director of Communications for Nessy Learning, a leading educational software company for students with dyslexia. He is the founder and webmaster for the Reading Well website and currently sits on the board of the Learning Disabilities Association of Ottawa Carleton.