Diagnosis

Private vs. School Evaluation

A school evaluation determines if a child qualifies for an IEP under an IDEA disability category. The school usually does not have staff to diagnose dyslexia. Please note, in medical and educational paperwork dyslexia is referred to as a Specific Learning Disability in Reading or SLD in Reading.

 

A private neuropsychological evaluation or psychological testing can provide an actual dyslexia diagnosis. A dyslexia diagnosis is different from qualifying for an IEP. Schools can (but do not have to) take into consideration a private evaluation. Understood.org offers a variety of evaluation basics.

 

Benefits of Diagnosis

People usually report a sense of relief after a confirmed dyslexia diagnosis. It allows them, in their minds, to separate the reading struggle from the individual. The reading struggle can be all-consuming, and some feel they need to hide or compensate for it. Some people start to feel like their reading struggles are part of their identity.

A diagnosis brings clarity and opens the door to accommodations and strengths-based learning. The pattern of diagnosis test scores allows individuals to identify strengths and weaknesses. This process is often an empowering experience.

  1. Providing clarity about the nature and type of the specific reading difficulties;
  2. Giving a neutral perspective on why the individual is struggling with reading;
  3. Assessing for other commonly co-occurring struggles like in writing, math, and attention; and
  4. Making a plan to move forward and starting intervention and/or accommodations.

Some people may fear that a diagnostic label could create or exacerbate stigma. This is understandable, given the widespread misunderstandings about dyslexia in our culture. Yet, having a name for the learning struggles is a huge relief. A diagnosis helps people understand that difficulties are due to a brain difference, not lack of intelligence. This can be a huge self-esteem boost.

The clarity of a diagnosis also helps other family members understand it. Addressing dyslexia often results in ending the shame and can help introduce pride.

A formal diagnosis can help an individual receive formal academic or work-based accommodations. An IEP or 504 plan gives students specific accommodations that help them succeed. Note that a formal diagnosis is not necessary for an IEP or 504 Plan.

  1. Gather objective quantitative data on IQ, academic skills, attention, and the underlying mechanics of reading (i.e., phonological processing and rapid automatic naming);
  2. Gather information about the individual’s history with reading and other academics, as well as family history;
  3. Screen for commonly co-occurring conditions like anxiety, dysgraphia, dyscalculia, and ADHD;
  4. Provide clear feedback on test results, diagnosis, and recommendations; and
  5. Provide a written report in a timely manner.
  • Legal rights of students with disabilities;
  • Services colleges can or need to make available;
  • Required accommodations for students; and
  • Technologies and helpful apps for students.

Always do your research and ask questions like “Can you diagnose dyslexia versus just a screening?” and “Will you use the term dyslexia in your written report?”

Note that this list is not comprehensive.

  • Do you diagnose dyslexia? What is your background?
  • When was the last time you did a dyslexia evaluation?
  • Can you provide a specific diagnosis of dyslexia?
  • Do you use the specific term diagnosis “Dyslexia” in your diagnosis or just “Specific Learning Disability”? An Independent Evaluation should evaluate for characteristics of dyslexia, NOT just an educational classification of SLD like the school provides.
  • What assessments do you use when evaluating a child for dyslexia?
  • What do you charge for testing? Do you take insurance?
  • How long does the testing take and what does that process look like?
  • When do you plan to have the results back and will you meet with us to review those?
  • How far out are you booking evaluations?
  • Can I be put on a cancellation list if you have an appointment open up before our scheduled one?

The person you choose to do this evaluation needs to be completely independent of the school district. They need to have expertise in dyslexia and should test ALL of the following areas:

  • Phonological processing
  • Rapid Automatic Naming (RAN)
  • Oral Reading Fluency (ORF)
  • Reading comprehension
  • Single-word reading
  • Nonsense word reading
  • Processing speed
  • Spelling
  • Vocabulary
  • Writing sample
  • Math skills
  • Intelligence
  • Review of school records
  • Review of family and school history
  1. Dyslexia Handbook from Colorado Department of Education.
  2. Testing and Evaluation from The International Dyslexia Association.
  3. Tips for getting a dyslexia diagnosis from the Dyslexia Training Institute. 
  4. How to Get Help from Susan Barton’s website.

Frequently Asked Questions

Licensed Psychologists (Ph.D. or Psy.D.) diagnose dyslexia. This is the recommended route, as psychologists can assess all areas listed above. A Speech-Language Pathologist (SLP) can assess for phonological processing and rapid automatic naming, but not intelligence, attention or provide a comprehensive academic test battery. Family physicians, counselors, social workers, and teachers do not diagnose dyslexia.

First, contact your health insurance company and ask if they cover educational or neuropsychological testing. It is very important that the evaluator understands dyslexia and how to test for it. We recommend asking the evaluator a few questions before making your decision.

Schools can test for a specific learning disability (SLD), which is the IEP category that dyslexia falls under. But, a dyslexia diagnosis does not mean that a child will qualify for an IEP. If a student does not qualify for an IEP, they may still be able to get a 504 plan. A diagnosis also helps give a specific roadmap for interventions.

Testing involves assessment of the following areas:

  1. IQ
  2. Attention
  3. Memory/executive functioning for older kids and adults
  4. A complete academic skills test battery
    1. All the main composite scores, including Reading, Written Expression, and Mathematics to screen for co-occurring conditions.
    2. All aspects of reading, including single word reading, nonword decoding, oral reading fluency and comprehension.
    3. Assessment of written language skills is crucial.
    4. Math skills can be a strength for some individuals with dyslexia and a weakness for others. Due to the likelihood of overlap, assessments must include math, even if there are no concerns.
  5. Phonological processing and Rapid Automatic Naming

Dyslexia can impact many areas of functioning and can range from mild to moderate to severe. An evaluator will gather thorough background information about your family and your child. Parents and teachers answer questionnaires about the child’s behavior and performance.

The evaluator will choose specific tests based on your child’s age. Testing usually takes at least four hours. A good evaluator will provide a report with the test results, diagnoses and recommendations. Good evaluators will also schedule a face-to-face meeting to discuss the results.

There are unproven ‘treatments’ for dyslexia. Be wary of therapies suggesting a cure for dyslexia. A qualified diagnostician can provide appropriate guidance based on your child’s results.

Many parents and educators are told that dyslexia can’t be diagnosed until 3rd or 4th grade. This myth can cost your child years of lost learning. In fact, according to the National Institute of Health (NIH), reading disabilities can be diagnosed as early as age 5½. In Minnesota, the youngest most evaluators will diagnose dyslexia is starting at age 7.

Without health insurance coverage, diagnostic testing for dyslexia can be expensive. Fees can range from $1,000 to $3,200. A good evaluation takes about 12-14 hours of the psychologist’s time, and this is reflected in the fees. Note that many health insurance companies do not cover the diagnostic testing. But, you may use funds from a Health Savings Account (HSA) in some cases.

This cost may not be possible for many families. A diagnosis is helpful, but not required to work on your child’s difficulties. See the Tutoring section for more information.

Check with your insurance company and HSA to see if they cover diagnosis or remediation or if you can claim it as part of a medical Flex Spending Account (FSA).

Educating yourself will empower your child and create change in the classroom.

The American Psychological Association (APA) recently updated the Diagnostic and Statistical Manual (DSM-V). The DSM-V contains the diagnostic criteria used by Licensed Psychologists. Dyslexia is now listed as a “Specific Learning Disability with Impairment in Reading.” Some psychologists use this terminology, but using the term dyslexia provides consistency. Be sure to ask your evaluator about this before your evaluation. This article, by psychologist Steve Dykstra, further addresses dyslexia in the DSM-V.

This is due to several factors, including the high cost of diagnosis, the assumption that poverty causes reading difficulties, the misdiagnosis of Emotional and Behavioral Disorder (EBD) in Black children, the stigma of special education, and the lack of awareness of dyslexia in under-resourced communities​.