The goal of an evaluation
What is an Evaluation?
When a child is struggling to read, someone will probably suggest that he or she be tested for dyslexia. What does it mean to be tested? You might think that of a test as something you take in an afternoon. Someone scores it and tells you how you did. Evaluation is a more accurate word to describe the process of determining if someone has dyslexia. The word evaluation encompasses identification, screening, testing, diagnosis, and all the other information gathering involved when the student, his or her family, and a team of professionals work together to determine why the student is having difficulty and what can be done to help.
Why Get One?
An evaluation is the process of gathering information to identify the factors contributing to a student's difficulty with learning to read and spell. First, information is gathered from parents and teachers to understand development and the educational opportunities that have been provided. Then, tests are given to identify strengths and weaknesses that lead to a diagnosis and a tentative road map for intervention. Conclusions and recommendations are developed and reported. When a student is having difficulties with reading and spelling, an evaluation is important for three reasons.
1. Diagnosis An effective evaluation identifies the likely source of the problem. It rules out other common causes of reading difficulties and determines if the student profile of strengths and weaknesses fit the definition of dyslexia.
2. Intervention planning An effective evaluation develops a focused remedial program. Students who have a specific learning disability in reading (dyslexia) need a specialized approach to reading instruction to make progress. It is crucial that this specialized instruction begin at the student's current level of reading skill development, rather than at the student's grade level. An effective evaluation helps parents and teachers see which specific skills are weak and where reading and spelling instruction should begin.
3. Documentation An effective evaluation documents the history of a student's learning disability. One purpose of this documentation is to determine eligibility for special services, including special education. Documentation is also important for obtaining accommodations on college entrance exams (ACT, SAT), in college, or in the workplace.
The identification of a reading disorder (dyslexia) needs to happen as soon as it is suspected by a parent, teacher or physician. Individuals need intervention so they can learn to read and go on to be skilled readers. Developmental dyslexia is a language-based disorder that is neurological in origin. It affects reading and it runs in families.
As children grow older difficulty with reading can begin to become more obvious. As the demand for good reading and related skills (spelling, writing, test taking) increases in quantity and quality a child with poorly developed reading and writing abilities begins to fall behind. Parents and teachers often don’t realize reading is the problem. When speed and accuracy are compromised because a student cannot accurately decode new vocabulary, reading slows down in a greater effort to understand or comprehend the text. Frustration can take over as the student begins to feel like they “just don’t get it”.
Skilled readers develop a large storage system of word representations having built this across years of reading instruction, practice and application. Skilled readers can digest words quickly, accurately moving through text building meaning and reflecting on what is being taken in. When it is difficult to process print accurately and quickly developing ideas from reading is labor intensive. It is difficult to generate creative thinking when the reading is slow and the volume is overwhelming.
Reading fluently (accurately and quickly) for meaning is what drives a reader through the print. Evaluation of Dyslexia or a reading disorder identifies a phonological, language- based disorder, and related deficits such as poor spelling, reading comprehension, and sometimes attentional problems. “The most identifiable and consistent characteristic of dyslexia is encapsulated in a phonologic weakness.” Dr. Sally Shaywitz, Overcoming Dyslexia
The phonological weakness can be treated successfully if the right instruction and enough of the right instruction is put into place. It is important to establish exactly what areas are giving a student difficulty and impeding achievement. A phonologic weakness makes reading difficult, slow and labor intensive. Verbal skills, such as listening and understanding complex information, are different from reading and usually not affected by the phonologic weakness. It is not uncommon for a person with a reading disorder to have an impressive knowledge base about a particular subject. These higher level verbal abilities can disguise a reading disorder.
A phonologic deficit makes it hard for a person to decode or pull apart sounds (phonemes) in a word. How smart a person is does not matter. Individuals try to decode words they can’t read by using pictures or they guess a word based on the surrounding text or the beginning sound of the unknown word. Younger students try to cope or compensate by memorizing a large store of reading vocabulary. Memorizing all the words you need to be able to read is one way to read, but it is not the best or most efficient way to read. It breaks down when a student starts to come across a lot of words they have never seen or heard before.
Reading English means that a person has to master the sound system of the language not the way a word looks. Our language is alphabetic not a picture language. Reading efficiently requires knowing the sounds and the rules that field of study or vocation. Even though they may be able to read material related to their particular interest a lack of reading fluency may still be existent and spelling is difficult. Writing is really hard when spelling is not fluent In school age children it is important to document overall achievement (grades, work samples, standardized tests) to gather evidence of strengths as well as weaknesses in achievement.
Who Does Them?
A full psycho-educational evaluation is best done by a Licensed Clinical Psychologist who specializes in this type of testing.
Upon request, we can provide a short list of evaluators to you. Our office can review the results of your testing and provide intervention for the identified deficits.
What should be Included?
Information from parents and teachers tells us a lot about a student's overall development and pattern of strengths and weaknesses. Because dyslexia is genetically linked, a family history of dyslexia indicates that a student is more likely to have dyslexia. A history of delayed speech or language also puts a child at-risk for reading difficulties. It is important to know the types and length of time of any interventions the student has received at school, home, or through tutoring, as well as the student's response to the intervention. School attendance problems should be ruled out. A history of poor attendance, alone, can explain an identified weakness in skill development.
Until recently, an intelligence test was considered to be a necessary part of the evaluation because the diagnosis of a learning disability was based on finding a significant difference between IQ and reading skill. Poor achievement despite average or better intelligence was considered a key indicator. Current regulations no longer require that such a discrepancy be present when making a diagnosis. This change in the regulations came about because many studies have shown that intelligence is not the best predictor of how easily a student will develop written language (reading and spelling) skills. Instead, oral language abilities (listening and speaking) are considered the best predictors of reading and spelling. A formal measure of intelligence is not always needed to document average intellectual abilities. For younger children, parent information about language development and teacher information about the child's ability to learn orally may indicate average intellectual abilities. For older students or adults, past achievement in school or work may indicate at least average intelligence.
Oral language skills
Oral language, simply stated, refers to our ability to listen to and understand speech as well as to express our thoughts through speech. Oral language is made up of low-level skills, such as recognizing and making the sounds within our speech, and higher-level skills, such as getting meaning by listening to someone speak or creating sentences to express thoughts. Students with dyslexia typically have adequate higher-level language skills. Indicators of higher-level oral language skills include being able to understand an age-appropriate story and spoken directions, to carry on a conversation, and to understand and use words that are age appropriate. If a student has average higher-level oral language skills but much difficulty developing written language (reading and spelling) skills, the need for evaluation for dyslexia is recommended.
Although students with dyslexia usually have strong higher-level language skills, they typically have problems (a deficit) in low-level language skills (see following section "Phonological processing"). This deficit limits the ability to learn to read and spell using the sounds of the language. Young children with dyslexia often have delays in language development, but their higher-level language skills are usually age-appropriate by the time they enter school. Difficulties with higher-level language skills suggest a need for a language evaluation by a speech-language pathologist to rule out language impairment.
Word recognition is the ability to read single printed words. It is also called word reading or word identification. Tests of word recognition require that students read individual words printed in a list. The student is not able to use cues, such as the meaning of a sentence, to help them figure out the word. Tests of word recognition that score both accuracy and the time it takes for the student to read the words (fluency) are particularly useful. Students with dyslexia often become accurate but are still very slow when reading words. Both accuracy and the speed of word reading can affect understanding what is read.
Decoding is the ability to read unfamiliar words by using letter-sound knowledge, spelling patterns and chunking the word into smaller parts, such as syllables. Decoding is also called "word attack". Decoding tests should use nonsense words (words that look like real words but have no meaning, such as frut or crin) to force the student to rely on these decoding skills rather than on memory for a word already learned.
Tests of spelling measure the student's ability to spell individual words from memory using their knowledge of, for example, letter-sound pairings, patterns of letters that cluster together to spell one sound (igh in high; oa in boat), the way plurals may be spelled (s, es, ies) and so on. Spelling is the opposite of word attack but is even more difficult. It requires separating out the individual sounds in a spoken word, remembering the different ways each sound might be spelled, choosing one way, writing the letter(s) for that sound and doing the same, again, for the next sound in the word. Spelling stresses a child's short and long-term memory and is complicated by the ease or difficulty the child has in writing the letters, legibly and in the proper order. Spelling is usually the most severe weakness among students with dyslexia and the most difficult to remedy.
Phonology is one small part of overall language ability. It is a low-level language skill in that it does not involve meaning. Phonology is the "sound system" of our language. Our spoken language is made up of words, word parts (such as syllables), and individual sounds (phonemes). We must be able to think about, remember, and correctly sequence the sounds in words in order to learn to link letters to sounds for reading and spelling. Good readers do this automatically without conscious effort. However, students with dyslexia have difficulty with identifying, pronouncing, or recalling sounds. Tests of phonological processing focus on these skills.
Students with dyslexia often have a slow speed of processing information (visual or auditory). Tasks measure Naming Speed (also called Rapid Automatic Naming). Sets of objects, colors, letters, and numbers are often used. These items are presented in rows on a card, and the student is asked to name each as quickly as possible. Naming speed, particularly letter naming, is one of the best early predictors of reading difficulties. Therefore, it is often used as part of screening measures for young children. Slow naming speed results in problems with developing reading fluency. It also makes it difficult for students to do well on timed tests. Students with both the naming speed deficit and the phonological processing deficit are considered to have a "double deficit." Students with the double deficit have more severe difficulties than those with only one of the two.