Unlocking the Mystery: Can a Speech Pathologist diagnose dyslexia?
As a speech pathologist who works almost solely with students with dyslexia, one of the most common questions I get asked is ‘Can a Speech Pathologist diagnose dyslexia?’ The short answer to this is ‘yes’. There are some caveats to this though, and it is a highly contentious topic. At the moment, formal diagnoses of dyslexia typically sits in the domain of Educational Psychologists, but increasingly, speech pathologists who have significant experience and knowledge in dyslexia, or have undertaken further learning are making the diagnosis. Let me explain why speech pathologists are one of the professionals best placed to make such a diagnosis.
Let’s look at what dyslexia is. The well-recognised and universally accepted definition of dyslexia is: “Dyslexia is a language-based learning disability of neurological origin. It primarily affects skills involved in accurate and fluent word reading and spelling. It is frequently associated with difficulties in phonological processing. It occurs across the range of intellectual abilities with no distinct cut-off points. It is viewed as a lifelong disability that often does not respond as expected to best-practice evidence-based classroom methods for teaching reading.” What does that all mean though? Let’s look at these areas individually, and how Speech Pathologists (SPs) are involved in these areas.
Dyslexia is a language-based learning disability.
One of the fundamental reasons SPs are qualified to identify dyslexia is our in-depth knowledge and expertise in assessing language abilities. SPs are highly skilled at evaluating various components of language, including phonological awareness, auditory processing, and morphological skills. By conducting comprehensive language assessments, SPs can identify specific language weaknesses that may be indicators of dyslexia.
Dyslexia is frequently associated with difficulties in phonological processing.
The American Speech-Language-Hearing Association (ASHA) defines phonological processing as “the use of the sounds of one’s language (i.e., phonemes) to process spoken and written language. The broad category of phonological processing includes phonological awareness, phonological working memory, and phonological retrieval.”
Phonological awareness refers to the ability to recognise and manipulate the sounds of spoken language, such as identifying individual sounds in words (phonemes), rhyming, blending sounds, and segmenting words into syllables and sounds. For SPs who work in the area of literacy, this is our bread and butter. Not only do we receive rigorous training in how to support the development of phonological awareness skills, but we are also adept at recognising and assessing difficulties in this area. Since deficits in phonological awareness are closely associated with dyslexia, SPs can use our expertise in this area to pinpoint indicators of dyslexia.
Dyslexia primarily affects skills involved in accurate and fluent word reading and spelling.
Another crucial area where SPs excel is assessing reading and writing abilities. We can administer standardised reading and spelling tests, analyse reading patterns and spelling errors, and assess writing samples to identify any specific challenges individuals may face. SPs often collaborate with literacy specialists within schools to conduct a comprehensive evaluation that combines both linguistic and cognitive perspectives. By analysing errors made during reading and writing tasks, SPs can gain valuable insights into whether dyslexia is a potential underlying cause.
Dyslexia is viewed as a lifelong disability that often does not respond as expected to best-practice evidence-based classroom methods for teaching reading.
One of the criteria for diagnosing a child with dyslexia is that the difficulties have persisted and failed to improve as expected, despite the provision of targeted intervention for at least six months. This intervention should be recognised as evidence-based and ideally delivered by an experienced and qualified person. Another question I get asked, as a SP who works in the area of teaching literacy, is “What is meant by ‘evidence-based’ classroom methods for teaching reading?” This is a huge area, and a topic for another blog post, but this is an area that SPs in literacy work intensively in. One of my main roles is to support schools in understanding what the best-practice, evidence-based methods for teaching reading are. Essentially, these methods should be explicit, structured and systematic. For more information on that, see this great explanation on the Five from Five website. SP’s have a thorough understanding of how to provide evidence-based and structured intervention to support the development of reading and spelling skills. We are able to understand why this is important, and to identify whether or not this has been provided by liaising with the school.
Obtaining further background information from parents and educators.
A vital part of any diagnostic process is gathering background information. Apart from conducting assessments, SPs are highly proficient in collaborating with parents, educators, and other professionals to gather information about a child's history and classroom performance. By studying a child's educational background and behavior, SPs can further strengthen our understanding of dyslexia indicators. These collaborative efforts ensure a holistic approach to identifying dyslexia and promote effective intervention planning.
So, I have explained why SPs are amongst the best professionals to diagnose dyslexia. As I mentioned above, SPs role in diagnosing dyslexia is an area of controversy, and many will argue that it is the domain of Educational Psychologists. Speech Pathology Australia, the national peak body for the speech pathology profession in Australia, made the following comments in their Practice Guidelines designed to support SPs in the field of literacy. “At present, formal diagnoses of dyslexia and other specific learning disorders typically sit in the domain of educational psychologists, although increasingly, speech pathologists who specialise in and who have undertaken further professional learning in literacy-based disorders are making the diagnosis.”
The International Dyslexia Association (IDA) provides the following information about who can diagnose dyslexia: “Assessment of dyslexia involves individual testing, most often provided by a team of qualified professionals who have had extensive clinical training in assessment as part of a graduate degree program. Professional clinicians who assess Specific Learning Disabilities (SLD) and dyslexia may have further degrees in Education, Reading, Speech Language Pathology, School Psychology, Psychology, or Neuropsychology.” So the gold-standard for dyslexia diagnosis would be a team of professionals, as educators, psychologists and SPs all bring their own areas of expertise to the party. However, there are very few centers around Australia where there is a team approach.
In conclusion, speech pathologists have a unique set of skills and specialised knowledge that we bring to the diagnosis of dyslexia. By assessing language abilities, analysing phonological awareness skills, evaluating reading, spelling and writing competency, and collaborating with other professionals, SPs can confidently identify dyslexia and provide targeted interventions. Early identification of dyslexia is crucial for developing appropriate strategies and accommodations, enabling individuals with dyslexia to thrive academically and reach their full potential. If you suspect dyslexia in yourself or your child, consulting a qualified SP can be an essential first step on the path to understanding and overcoming this often misunderstood learning difference.
For more information about the role of speech pathologists in dyslexia diagnosis, please check out these links:
International Dyslexia Association
Michigan Speech-Language-Hearing Association
Five Ways Speech-Language Pathologists Can Positively Impact Children With Dyslexia
The Speech-Language Pathologist’s Role in Diagnosing Dyslexia
