Screening for Reading Difficulties and Dyslexia

Since dyslexia lies on a continuum of severity, determining whether a student is truly dyslexic is not an exact science. In this issue of the Reading Expert we will discuss early screening for students who may be at risk for reading difficulties or dyslexia and evaluating a child for a diagnosis of dyslexia. Both universal screening and evaluation are important assessment processes that serve different purposes.

CORE has long been clear on the four types of reading assessment and their purposes— screening, diagnostic, progress monitoring, and summative/outcome—and has been unequivocal in the message that all schools should be using early and universal reading screening as part of an MTSS/RtI approach. The International Dyslexia Association (IDA) has a series of fact sheets about dyslexia. Two of their fact sheets, on universal screening and assessment of dyslexia, shed light on the potentially confusing topic regarding screening for students who may have reading difficulties or dyslexia and dyslexia evaluation. Universal screening is a way for teachers to quickly assess all students and identify those who may be at risk for reading difficulties or dyslexia and would benefit from early, high-quality intervention. The purpose of dyslexia evaluation is to determine and document the nature of a student’s learning difficulty to provide the intensity of support needed.

Universal Screening K–2 and Prevention

The IDA fact sheet on universal screening provides suggestions on the types of measures to screen all students for reading difficulties in kindergarten through second grade. The recommendation for kindergarten is “phonological awareness, including phoneme segmentation, blending, onset and rime; rapid automatic naming, including letter naming fluency; letter sound association; and phonological memory, including non-word repetition” (Catts et al. 2015; Jenkins & Johnson, 2008). Some researchers suggest that screening measures as early as kindergarten should also include phonological deletion tasks (e.g., say cowboy, now say it without cow [boy]; Kilpatrick, 2015).

For first grade, the IDA fact sheet suggests “phoneme awareness, specifically phoneme segmentation, blending, and manipulation tasks; letter naming fluency; letter sound association; phonological memory, including nonword repetition; oral vocabulary; and word recognition fluency (i.e., accuracy and rate)” (Compton et al., 2010; Jenkins & Johnson, 2008). In second grade, word identification (real and nonsense words), oral reading fluency, and reading comprehension are the recommended constructs to screen students for reading difficulties. Many of the commonly adopted universal screeners (e.g., DIBELS 8th Edition, IDEL, aimswebPlus) assess most of the constructs listed above, with the exception of possibly phonological memory in kindergarten and oral vocabulary and phoneme manipulation tasks in first grade.

In addition, more educators and researchers recognize that having multiple data sources is beneficial as universal screeners may overidentify students who need intervention. A tool that can serve as a companion data source is Pearson’s Shaywitz DyslexiaScreen. This screener is a teacher survey that takes about five minutes to complete per child. The recommendation is to complete this companion survey for only those students who have performed below benchmark on the universal screener. It is not necessary to complete the survey for every child in the teacher’s classroom. The data from these two types of screening is then used to determine who needs additional support/intervention. High-quality instruction that follows IDA’s recommended structured literacy approach should be provided in Tier 1 instruction and also during Tier 2 targeted intervention and Tier 3 intensive intervention based on student need. If a student continues to perform significantly below grade level after receiving evidence-based reading instruction and intervention, then further evaluation by a skilled clinician who is licensed to evaluate for specific learning disabilities/dyslexia is warranted.

Dyslexia Evaluation

Consider the following quote from the IDA Assessment Fact Sheet:

When students do not catch up after additional instruction and support using an RtI/MTSS approach, clinical evaluation is needed to determine and document the nature of the learning problem. After evaluation, the school team will consider the case history and the testing data and will determine eligibility for Special Education services under IDEA (Individuals with Disabilities Education Act). Data and evaluation results should be shared with parents throughout this process. For students with diagnosed SLD and dyslexia, the plan is typically an Individualized Education Plan (IEP), which provides both remediation and accommodations.

The fact sheet outlines the following areas that should be assessed as part of a specific learning disability (SLD) or dyslexia evaluation:

• Phonological Awareness
• Phonological or Language-Based Memory
• Rapid Automatic Naming
• Receptive Vocabulary
• Phonics Skills
• Decoding (real and nonsense words)
• Oral Reading Fluency
• Single Words
• Sentences and Paragraphs
• Spelling
• Writing (at the sentence and paragraph level)

In addition, the IDA recommends that the evaluation should include a family history of reading problems, the history of the child’s speech and language development, and early educational history. Once the assessment and historical data have been collected by the skilled clinician, the information and test scores are synthesized into a well-written report to share with the parents and school team. When a student is identified as having a SLD or dyslexia, the team must determine whether the impact of the disability creates the need for special services. If so, the student will be eligible for special education services as mandated by federal law. After this comprehensive evaluation process, only then will a diagnosis of SLD/dyslexia, or lack thereof, be clear.

Through the use of valid and reliable universal screeners, educators can identify children at risk for reading difficulties early and intervene swiftly. Conducting comprehensive evaluations when a disability is suspected can ascertain the nature of the learning difficulty and determine special education eligibility, potentially leading to specially designed instruction for a student. Having both of these systems (screening and evaluation) in place is critical. The real key, however, is doing everything we can to prevent reading problems from developing in the first place. It is imperative that every classroom in every school provides high-quality, evidence-based Tier 1 instruction to prevent reading difficulties. This means that teachers faithfully implement a proven curriculum that demonstrates results with the majority of students. Prevention of reading difficulties is very possible for students who may enter school showing risk factors for reading difficulties, including dyslexia. Students with moderate to severe dyslexia will especially need initial high-quality instruction and early intervention—and this can significantly decrease the severity of their reading difficulty. The students who still struggle even after receiving high-quality, evidence-based reading instruction in Tier 1 and early intervention (Tier 2) should be evaluated for dyslexia, and this can happen early in a student’s educational career. Unfortunately, many students never obtain a diagnosis of dyslexia or are diagnosed with dyslexia late in their educational careers. The academic and social suffering that these late or undiagnosed students endure can and should be prevented.

References

Catts, H. W., Nielson, D. C., Bridges, M. S., Liu, Y. S., & Bontempo, D. E. (2015). Early identification of reading disabilities within an RTI framework. Journal of Learning Disabilities, 48(3), 281–297.

Compton, D. L., Fuchs, D., Fuchs, L. S., Bouton, B., Gilbert, J. K. , Barquero, L. A., Cho, E. A., & Crouch. R. C. (2010). Selecting at-risk first grade readers for early intervention: Eliminating false positives and explaining the promise of a two-stage gated screening process. Journal of Educational Psychology, 102(2), 327–340.

Consortium on Reaching Excellence in Education (CORE). (2017). Understanding dyslexia: Why early prevention and intervention are crucial. Retrieved from https://www.corelearn.com/resource-posts/understanding-dyslexia-early-prevention-intervention-crucial/

International Dyslexia Association (IDA). (2017). Dyslexia assessment: What is it and how can it help? Retrieved from https://dyslexiaida.org/dyslexia-assessment-what-is-it-and-how-can-it-help/

International Dyslexia Association (IDA). (2017). Universal screening: K–2 reading. Retrieved from https://dyslexiaida.org/universal-screening-k-2-reading/.

Jenkins, J. R., & Johnson, E. S. (2008). Universal screening for reading problems: Why and how should we do this? New York: RTI Action Network. Retrieved from http://www.rtinetwork.org/essential/assessment/screening/readingproblems.

Kilpatrick, D. A. (2015). Essentials of assessing, preventing, and overcoming reading difficulties. Hoboken, NJ: John Wiley & Sons, Inc.

Pearson. (2016). Shaywitz Dyslexia Screen. Retrieved from https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/MTSS-RTI-PBIS-Benchmarking/Shaywitz-DyslexiaScreen/p/100001918.html