Dyslexia Evaluation

The eye doctors at Artisan Pediatric Eyecare provide a specialized vision evaluation for individuals suspected of having dyslexia.

Some vision conditions have symptoms similar to those of dyslexia, while other vision conditions can co-exist with dyslexia. A vision evaluation at Artisan Pediatric Eyecare is an important part of the inter-disciplinary care team evaluation process. Why an inter-disciplinary care team? Because an inter-disciplinary care team is made up of providers who are sub-specialists within their areas of expertise, providing the combination of evaluations necessary to correctly diagnose dyslexia.

An inter-disciplinary care team evaluation for dyslexia is recommended during the second semester of first grade, or before second grade. This allows for earlier intervention and academic support. However, evaluation can be performed and intervention approaches implemented for older children and adults.

The term dyslexia is often used to describe a child who reverses letters or words, or has reading difficulties. As we learn more about dyslexia, there is a clearer understanding that these symptoms alone cannot be used to diagnose dyslexia.

Dyslexia refers to a grouping, or cluster, of symptoms that cause individuals (both children and adults) to exhibit difficulty with both oral and written language skills. Statistically speaking, and based on current research, it is estimated that 5-10% of the population has dyslexia. The remaining 90-95% of individuals exhibiting these symptoms would not be diagnosed as having dyslexia.

It is important to keep in mind that reading or writing letters and words backward (reversals) are common among early learners. In other words, in the beginning stages of learning to read or write, letter and word reversals are common among all children.

WHAT IS DYSLEXIA?

Dyslexia is thought to be one of the most common language-based learning disabilities, and best characterized as a deficit in language processing at the phoneme level. Individuals have problems accessing the sound of spoken language. Dyslexia is not a visual disorder, even though both dyslexia and some visual disorders share many symptoms. This further contributes to the complexity of an early and accurate diagnosis.

Dyslexia is a brain-based type of learning disability that specifically impairs an individual's ability to read. The symptoms of dyslexia vary from person to person, from mild to severe. At one point in time, it was thought that of those with dyslexia a greater percentage were boys. However, current research indicates that dyslexia occurs in equal proportions among both boys and girls.

WHAT CAUSES DYSLEXIA?

The causes of dyslexia are varied, currently being researched, and not yet fully established. Current research indicates that dyslexia has a genetic component, and it is clear that dyslexia tends to run in families. Research has identified several chromosomes that appear to contain the gene or combination of genes for dyslexia. To date it is suggested that chromosomes 6 and 15 may be involved.

It is also possible to acquire adult onset dyslexia, which usually occurs as a result of an acquired brain injury or associated with the onset of dementia. This type of dyslexia should not be confused with dyslexia found in adults who simply were next identified as having dyslexia as a child or adolescent.

WHAT ARE THE DIFFERENT TYPES OF DYSLEXIA?

Primary dyslexia: This is considered to be the most common type of dyslexia, is not caused by injury, and does not change with age. Primary dyslexia is considered to be hereditary.

Secondary (or developmental) dyslexia: This type of dyslexia is caused by congenital and developmental factors in brain development during the early stages of fetal development. This type of dyslexia usually diminishes as the child matures.

Trauma (acquired) dyslexia: This type of dyslexia can occur after an acquired brain injury.

COMMON SIGNS AND SYMPTOMS OF DYSLEXIA:

  • Struggles to learn rhymes
  • Difficulty recognizing differences between similar sounds
  • Difficulty segmenting words
  • Difficulty learning to read

DIAGNOSING DYSLEXIA

There is no single test to determine if an individual has dyslexia. It is more accurate to use the term evaluation, which describes the process of determining if someone has dyslexia. The evaluation process involves an inter-disciplinary team of specialized providers working together to determine the cause(s) of difficulty, and results in an individualized treatment and intervention plan.

The inter-disciplinary evaluation team should include doctors and a speech-language pathologist, all of whom are considered specialists within their fields.:

  • Eye doctor who specializes in neuro-optometry and binocular vision function
  • Doctor of audiology (audiologist)
  • Doctor who specializes in brain and nervous system disorders (neurologist)
  • Doctor who specializes in neurobehavorial medicine (psychiatrist or neuropsychologist)
  • Doctor who specializes in children's development abilities and behavior (developmental or behavioral pediatrician)
  • Speech-language pathologist who specializes in diagnosing communication disorders

An early and accurate diagnosis of dyslexia can be challenging. There is no specific blood test or brain imaging that can provide a diagnosis. Reading tests are equally challenging because reading is measured on a continuum and there is no cutoff score on a reading test that clearly identifies individuals as dyslexic or non-dyslexic. The distinction between dyslexia and normal reading is arbitrary, and is considered a subjective (rather than objective) determination by the test administrator.

Previously, the definition of dyslexia involved a discrepancy between the IQ score and a reading score. If the IQ score was significantly higher than the reading score this discrepancy was used as an index of dyslexia. This definition has been discredited for a variety of reasons.

An approach to diagnosis that is being more commonly used is that of diagnosis by elimination using a combination of assessments. It is important that all children undergo these assessments prior to beginning kindergarten. This allows the child's care team to assess age-appropriate developmental milestones (physical, visual, language, auditory) and identify any underlying deficits and/or diagnoses that could impact learning and academic performance. These assessments serve as a baseline, allowing the care team to monitor future development using age-appropriate benchmarks. If a child falls behind or fails to meet developmental milestones, intervention can be implemented at a younger age.

IS THERE A CURE FOR DYSLEXIA?

Dyslexia is not a disease, and therefore there is no cure. It is important to remember that dyslexia is a life-long condition. Proper intervention can have a positive effect on symptoms and outcomes.

ARE SCHOOLS REQUIRED TO PROVIDE ACCOMMODATIONS?

If a student qualifies for an IEP (Individualized Education Program) under the Individuals with Disabilities Education Act (IDEA), and the IEP recommends accommodations, then the school must provide them. If the student does not qualify for an IEP, they may be eligible for accommodations under a 504 plan (Section 504 of the Rehabilitation Act of 1973).

WE CAN HELP:

Our doctors routinely serve as members of a child's inter-disciplnary care team, and play a vital role in diagnosing vision problems that may be contributing to cluster symptoms. If you suspect you or your child has dyslexia, please call our office to schedule an assessment with our neuro-optometrist to rule out undiagnosed or underlying vision problems.

Call our office at 208.900.3336 to schedule an appointment

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