Ask The Expert

Ask An Expert

Why would I see an occupational therapist to help my daughter with dyslexia? Doesn’t she need to see a reading specialist?

A dyslexia diagnosis focus is on word reading, reading rate, fluency and comprehension. Dyslexia is a language processing disorder. The ability to visually focus and process what is seen does not cause dyslexia, but it will impact the ability to read. Visually processing what we see is key, and a foundational skill, required for reading success. Occupational therapy can evaluate visual perceptual and visual memory skills that impact letter and number reversals, placing letters in the correct order when spelling, reading comprehension, and skipping lines when reading as examples. Ensuring strong visual memory and visual perceptual skills first will set your child up for reading success to work with the reading specialist.

My child is in the 2nd grade and their school told me it is too early to test for dyslexia. How early can a child be tested for dyslexia and what is the ideal age for testing?

When your smart and bright child has success in academics aside from reading and activities such as sports or hobbies but struggles with the foundational reading skills it is time to seek testing. Every day your child continues to grow and develop. Each day that passes without therapy intervention is a missed opportunity to close the gap between their potential and performance. When you look back on the early years when your child was struggling to learn to crawl, identify letter names and letter sounds, tie their shoes, ride their bikes, or print their name these were all signs of a learning struggle that may be dyslexia. The moment you see the sign is the ideal time for testing regardless of age or grade. Early testing can lead to early therapy intervention. Teachers have an important role as they are on the front line when it comes to identifying reading, learning, or dyslexia delays. But, action can be taken as early as Kindergarten. Even though early evaluation and treatment are recommended if you suspect dyslexia in an older child it is still a good idea to request an evaluation. The saying, better late than never rings true as treatment at any age can make all the difference!

I've noticed on homework he writes letters backwards letter that he knows. Could this be dyslexia?

Letter reversals are the most common thought of sign of dyslexia, yet not everyone who has dyslexia will have difficulties with reversing letters or numbers. Dyslexia is a language processing disorder. Letter reversals are typically do to spatial awareness (knowing how to put parts together to create an image) or an ocular motor dysfunction (eye muscles coordinated to work together to clearly steady an object for visual interpretation) separate from and not associated with the language processing centers of the brain. Left untreated difficulty with letter or number reversals can make reading, writing, spelling, and math challenging and frustrating. An evaluation with an occupational therapist can help identify why he is writing letters backwards and develop a treatment plan.

I have a 16-year-old daughter who has always struggled with reading and spelling and in other areas academically. She was diagnosed with ADD and did much better after getting on Vyvanse in middle school, but I noticed that she’s continued to struggle with spelling and reading. She’s super driven to have good grades and studies a lot, so she has A’s and B’s, but she spells phonetically or sounds in an incorrect order and when she’s reading a word quickly (like on a billboard or something) it seems she sees the first and last letter and the middle letters jumble for her and she reads it incorrectly. She’s quite smart and learns quickly, but this really embarrasses her. It never occurred to me she may have dyslexia until she read a billboard wrong, and I thought, she should really know that word, that wasn’t even close to what it said outside of the first and last letter, it’s almost like she has dyslexia. It was a light bulb moment for me because learning to read and the 20-minute reading time in elementary was a complete nightmare for both of us. She would sound out a word and the very next page she’d say it wrong again and must sound it out as a brand-new word again. So although she seems to have good grades, she took a practice ACT recently and got a 15. She always scored super low on her timed reading tests too, scored a 6th-grade reading level this year (10th grade). She initially wasn’t sure if she wanted a diagnosis due to the pressure to get on an IEP at school, but now we’re worried about the ACT and college. Can she have an assessment this late in life? Would it be of any benefit?

Diagnostic testing does not directly require an IEP as the next step in school. Many families get testing and treatment outside of school all while choosing to not seek IEP or 504 services from the school. Those reasons are diverse. Currently in your daughter’s life, the importance of testing is twofold. First, it will permit her to request increased time and perhaps questions read to her via audio on the ACT and open the door to see accommodations in college or higher education as she chooses.  Secondly, it does open the door for treatment to begin now. It is never too late to improve our brain’s ability to process what we see and hear for reading to become easier. A diagnostic test is recommended by a neuropsychologist or clinical psychologist.  An evaluation through DCT will enable us to develop a treatment plan to improve her reading. You pointed out she is reading and missing letters it makes me curious if she is having visual perceptual or eye-teaming challenges. Dyslexia is not related to vision or how the eyes work together, but if there are difficulties in those areas reading will be a struggle.

My child spends five hours on homework every night. Her teachers say she is bright and it should only take 20 min utes. Could she have dyslexia?

To clarify, the state of Oklahoma home does not base grade promotion or retention on one test taken on one day. Promotion may occur by one of the following met criteria:

  1. Meet the RSA criteria on state reading testing.
  2. Demonstrate reading on state approved screener.
  3. Meet 1 of 7 Good Cause Exemptions> to learn more > http://bit.ly/2GkTHod

Yes. Your child may have dyslexia or another learning difference. Spending significantly more time to complete homework than expected, getting good grades and excelling in other areas of life or academics is a sign of dyslexia. Research from the Yale Center of Creativity and Dyslexia, Dr. Sally Shaywitz, notes that a person needs to have an IQ of average or above to be diagnosed with dyslexia. When academic performance does not live up to potential (average IQ) dyslexia is suspected. A professional evaluation, of Executive Cognitive Function required for reading and learning success is recommended. Once an evaluation is completed a therapy treatment plan to address those area below average and recommendations for accommodations to keep up with school work can help your daughter bridge the gap between performance and academic potential.

My son hates going to reading tutoring and honestly isn’t making much progress, but he needs the practice. Do you have any suggestions?

Dyslexia is so much more than reading struggles. If it was as simple as just re-teaching how to read long term tutoring would not be in the experiences of those who struggle with dyslexia.Tutoring focuses on the issue at hand. This could be current school work or re-learning a concept to keep up with school assignments.Occupational and SpeechTherapy delves much deeper and explores the “why” behind the struggles you see and your child experiences. There is always an underlying reason why someone has a difficulty with reading. For some, reading difficulties are due to less than average ability in memory, unable to accurately process what they see or hear or associating sounds with letters. Understanding the “why” is the first step to reading success. Accommodations and strategies are only a piece of what would be helpful.Without treating the “why” many children go from one reading program to the next without ever making permeant change, feeling frustrated and often are on an academic or career trajectory that does not really reflect their true potential.

My daughter used to love to go to school. Now in the third grade she tells me she doesn’t want to get to school. She is falling behind and often leaves homework at school. When I am able to sit down with her to do homework quickly she begin s to tear up and sometimes will have a full meltdown. We know she needs to do her schoolwork, but how do we help her?

This question always hurts my heart as it is hard to see the joy of learning lost on such a young child. Children often do not have the words to express what they are really feeling. In many cases crying, teary eyes, tantrums, and becoming withdrawn are signs of frustration, processing the world around them, overwhelming feelings or just a simple case of the child does not understand the work they need to complete. Early on children with dyslexia understand they are different from others. Watching their peers and younger siblings soar past them in reading and learning can be very defeating. Understanding this as the underlying issue is the first step in supporting your daughter for learning and reading success. Approaching with empathy, rewarding effort, asking open ended questions, acknowledging frustration and pain validates that they have been heard. This keeps them open to learning. Seeking professional support such as a play therapist or a trauma specialist can also be helpful in the long-term to resolve their feelings

My child seems to be a good reading, but his test scores are much lower than they should be. He wants to do well. Is he just a bad test - taker or could it be something else?

I don’t believe anyone is a bad test-taker. Test taking is a skill that is not typically taught. For some test taking can provoke anxiety which can override the ability to recall the required information particularly with timed tests.A professional evaluation, of Executive Cognitive Function required for learning and test taking, to rule out any learning disability, dyslexia, hearing and visual deficits would be recommended as a start. An evaluation can identify if there is an underlying reason for recall, organization of thoughts, written or verbal communication difficulties that occur at the time of the test. Proper therapy treatment along with accommodations could be very helpful in ensuring test performance matches your child’s abilities

My daughter is in 4th grade enrolled in a Spanish immersion curriculum. I have noticed her English reading level is lower than her brother who is in 3rd grade. Is this because she has not been taught how to read in English or should I be worried she may have dyslexia? If she has dyslexia should I transfer her to an English curriculum?

This is a very common question. If a child has dyslexia adding another language that associates a different sound for the sound recognized in English does make learning to read a bit more complicated. An in-depth evaluation to assess phonological awareness, phonological memory, visual perceptual skills, auditory and visual memory are recommended. Testing these specific executive cognitive functions required for reading success will identify if there is an underlying reason for the reading delay or if it was a lack of opportunity to learn English. The evaluation results are the foundation for your child’s treatment. If a child has dyslexia adding another language that associates a different sound for the sound recognized in English does make learning to read a bit more complicated. Immersion is a great opportunity to learn a new language. In making this decision it would be to identify your end goal.

We had testing scheduled through the school that was delayed due to COVID - 19. There's a lot of uncertainty about what the new school year will look like, and I don't want to lose more time waiting on testing. How can I help my daughter while we wait?

As a parent, you know your child best. Trust your intuition and observation of your daughter over the years. Ask yourself, “What does she avoid or not enjoy doing?” For example, if jigsaw puzzles are challenging, she may have difficulty with spatial awareness skills, which is the ability to process shapes. Or, she may have difficulty finding her striped shirt when looking in her closet at multi-pattern shirts. This could be an indication of figure ground delays, which is having difficulty identifying something specific when there is a lot of visual stimuli to sort out.The observations you make could indicate that there is an underlying skill that is not as strongly developed as it could be, which causes the task to be a real struggle. Breaking down the tasks and working on them in small increments from simple to complex will help strengthen these skills that are required for reading success.

We keep seeing signs of dyslexia. Our son spells his Father’s name, with the right letters, but in the wrong order. He spells the word “feeling” as “fleeing.” He may verbalize the correct spelling of feeling, but in writing, he does not get it right. What do you think? With the reversals of consonants - (to us not explained by the other issues), would this suggest a mild form of dyslexia and worthy of testing?

This is a great question and a frequently asked question. Letter reversals could be due to a variety of reasons. Eye teaming, or eye muscles not working together could cause difficulties in processing what is being seen because it may appear as if the letters or shaking or moving as one example. This is different than visual acuity. Visual acuity is the measure of the distance a person can see an object in focus. Another reason could be impaired by visual perceptual skills.In this case, the eye muscles are working together but what he sees is not what you see. Dyslexia is a language processing disorder. A person can have visual challenges (acuity, eye muscle teaming and/or visual perceptual skill deficits), but that does not mean they have dyslexia. A person can have both. We can certainly test to determine what is causing the reversals and develop a plan to increase those skills for learning success.

Is it possible for my child to have dyslexia if it does not run in our family?

Dyslexia can be acquired due to physical trauma, an injury to the brain. This is called Trauma Dyslexia. Other trauma such as separation from the mother at birth (premature birth or adoption), or being bullied, suffering from physical or psychological trauma/abuse, or having anxiety or Post Traumatic Stress Disorder can cause the child to show symptoms of dyslexia when, in actuality, it is not dyslexia. These types of trauma can interfere with the language processing centers of the brain, causing it to function very much like someone with dyslexia. The child may have difficulty with attention and learning to read. For this reason, it is important to share your child’s life events with the person who evaluates your child. Trauma resolution by a counselor or psychologist often can improve the child’s performance in these areas. When the trauma is not recognized, a misdiagnosis of dyslexia may occur. Having the correct diagnosis is especially important as it provides the best direction for treatment.

Are there other learning disabilities that can be confused with dyslexia?

Yes. Often characteristics such as fidgeting, difficulty following verbal directions, misunderstanding the meaning of words, difficulty with verbal expression or spelling are associated not only with dyslexia, but may also be associated with Dysgraphia (difficulty with handwriting), Auditory Processing Disorder (perfectly functioning hearing, but unable to understand noise) or Attention Deficit Hyperactive Disorder (can impact hearing). One disability does not cause the other, but a person may have a combination of disabilities. It is important for your provider to understand the nuances of each to ensure proper diagnosis and treatment.

My child seems to have overcome reading struggles over the years as we have been able to use helpful techniques and take our time as we have been homeschooling. But Math! No matter what we try or how hard she studies, she still struggles with simple math calculations, remembering formulas or information for algebra and geometry. We are at a loss.

Dyscalculia is often associated with persistent math struggles that seem to defy tutoring or extend math support. About 2-5 percent of the population have Dyscalculia. It is often associated with Dyslexia or ADHD, but it does not necessarily mean if you have one you will have the other. Dyscalculia is understood as having difficulties with comprehending arithmetic, manipulation of numbers, math fluency, learning math facts or performing mathematical calculations, which can be linked to difficulty with working memory and visual perceptual skills. Working memory helps us hold on to information so we can use it later in real life, or, in this case, to work out a mathematical problem. Visual perceptual skills help us interpret what we see, such as manipulating pieces of a puzzle together. If you suspect Dyscalculia, it is important to include testing for working memory and visual perceptual skills. Both skills are essential for math success.

My daughter's teacher suspects dyslexia and has recommended extra support with reading. Why would I seek out occupational therapy for reading support?

Reading is a high-level executive function skill that relies on strong sensory processing, vision and vision skills. Research has shown that 20-30% of children with dyslexia also have sensory processing deficits or difficulty reading without being distracted by visual, auditory or tactile sensations. There is also a lot of debate about the impact vision has on dyslexia. Dyslexia is a language processing disorder. Vision does not cause dyslexia, but often if a child loses their place when reading, has rapid eye movement, experiences word reversals or skips words, they will also have difficulty with language, reading comprehension, and sounding out words, which may be attributed to difficulty with phonics. In actuality, it can be due to difficulty with visual tracking, convergence, visual perception, visual sequencing, visual memory or saccadic eye movements. Occupational therapy can treat and remediate vision, vision skills and sensory processing challenges to support reading success.

I am a Dyslexia Therapist and a Certified Academic Language Therapist. Which instructional reading curriculum do you use?

As an occupational therapist, I approach dyslexia intervention as therapy from a medical model versus an educational model. The services are evidence-based on the Magnocellular Theory of Dyslexia. The focus is to support auditory, visual, and motor deficits compounding existing phonological deficits associated with reading delays. We start with in-depth testing of the executive cognitive function required for reading success. Based on the results, we develop a customized therapy treatment plan. For example Dyslexia is a language processing disorder. Vision issues do not cause dyslexia. However, if the eye muscles do not team correctly, visual processing is impaired, and a person will score low on evaluations that only test reading skills. Our treatment follows the same developmental sequence in which the skills occur naturally. Once a foundational skill reaches an average level, we transition the client to the next skill in the developmental sequence. Reading and reading skills are the final area we address, to ensure all necessary executive cognitive skills are at their highest potential.

Have another question?