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Dyslexia: Diagnosis, Planning & Support

Categories: Learning Disabilities, Parenting, Webinars

Dr. Paul B. Yellin of the Yellin Center for Mind, Brain and Education delivered Learning Ally's webinar on March 12, 2012 titled Dyslexia: Diagnosis Planning and Support for Struggling Readers. Watch the full event above as he provides teachers, parents and professionals with in-depth perspectives on what is meant by dyslexia and how to best support students with a variety of learning abilities and reading disorders. Dr. Yellin emphasizes how important it is to take into account a student's strengths as well as assess weaknesses, in order to develop their full learning profile. Through practical life case studies, he shows how that knowledge can help determine the best strategies to ensure their success. His presentation is followed by a lengthy and content-rich Question & Answer session which includes suggestions for improving interest in reading, tips on obtaining a diagnosis and ideas on how to ensure schools recognize a diagnosis and provide appropriate support. The session is introduced by Learning Ally's National Communications Director Doug Sprei, who provides a briefing on the 65-year old organization's scope and initiatives in 2013. Download the presentation slides. (PDF format) Attendees sent over 100 questions during the one-hour event. Following is a selection of audience questions that Dr. Yellin didn't have time to answer in the live session: Q: Why does it seem that most testers will not give a diagnosis of dyslexia but instead call it a reading disability? Is there a difference between the two? If so, how do I get my kiddo the right diagnosis?  Dr. Yellin: Since these diagnoses originally developed when little was known about the specific nature of different learning problems, they are both general ways of describing children who have trouble learning to read but are otherwise developing normally.  So, I consider them pretty much interchangeable.  I find that there are pluses and minuses to each label, depending on the specific circumstance. Q: I am a school psychologist in the public schools. Are there any assessments you recommend that I can use to identify if a student has dyslexia?  Dr. Yellin: I think that it is important to bear in mind that the WJ or WIAT are not sensitive or specific enough to rely on solely for making this diagnosis.  It is important to look at phonemic awareness with something like the Comprehensive Test of Phonological Processing, and to look at decoding and sight word recognition with assessments like the Test of Word Reading Efficiency and/or the Process Assessment of the Learner.  We also think that simply reading with the student or working with something like the Qualitative Reading Inventory can be very helpful. Q: My dyslexic daughter recently underwent updated testing and was found to no longer qualify for accommodations. The psychologist who evaluated her said people sometimes “outgrow” dyslexia. What are your thoughts on this?  Dr. Yellin: I would be very skeptical.  It would be very unusual to completely outgrow a significant reading disorder. Q: My daughter is "on grade level" but makes mistakes with word problems and takes longer than she should to do homework. Could she have dyslexia even though she is not falling behind, and could she qualify for accommodations?  Dr. Yellin: While most children with dyslexia read below grade level, this is not always the case.  So, yes, while not likely, it is possible. Q: Our son has started to make excuses for poor grades based on his reading difficulties. Any ideas on how to keep him motivated without hurting his self-esteem?  Dr. Yellin: First, I would consider the possibility that he is correct.  In any case, something is getting in the way.  Think of the poor grades as a symptom like a sore knee or a cough.  You need help in finding out what is causing the symptom. Evaluation is typically a good idea when there are unresolved questions about what is causing poor grades. Q: How much independent reading on-level versus audio book listening above-level reading should a teacher or parent do with a dyslexic child? 50/50? 70/30? Dr. Yellin: I wouldn’t set any limits to their audiobook listening.  However, I would set aside a specific amount of time each day to work on independent reading skills. Q: How do we support writing in a dyslexic student best-- shorten the writing assignment or use dictation software?  Dr. Yellin: Yes to both.  You need to do whatever is necessary to bypass their print disability and allow them to express their ideas.  At the same time, you should work on their problem areas and try to strengthen them. Q: Are there certain apps that you would recommend that can help with dyslexia? Dr. Yellin: While these aren’t apps, I do like reading pens like the Wizcom Reading Pen.  I also like the LiveScribe SmartPen for note-taking.  Voice dictation programs and audiobooks are also very helpful. Q: How important is it for the child to be reading the book while listening to the audiobook? Dr. Yellin: It can be helpful, but it is not critical. Q: What resources are available for college students? Does the student need to be assessed to acquire these resources? Will there be a negative consequence for being evaluated?  Dr. Yellin: There is a wide range of variation among colleges in what they provide.  However, if you are seeking accommodations and significant support, almost all colleges will require an evaluation.  I am not aware of people experiencing negative consequences for being evaluated.  My wife Susan Yellin wrote a book entitled Life After High School: A Guide for Students with Disabilities and Their Families that is an excellent resource for these kinds of questions. Q: What are your thoughts about keeping a child in a public school environment where his rights are protected vs. placing a child in a private school where the class size is smaller and more individual attention can be given to each student? Dr. Yellin: There is no simple answer.  It depends on your child’s needs, what the public school is capable of and willing to do, and what the private school is capable of and willing to do.  We often recommend several options for parents to consider, including public schools. Q: Does dyslexia impact speech?  Dr. Yellin: Not generally, but language problems can affect reading and speech. Q: Do some children take medication for dyslexia? If so, what?  Dr. Yellin: There is no proven medical treatment for dyslexia. Q: How do I teach my 10 year old child to be his own advocate so he’s not always depending on me to do it for him? Dr. Yellin: Learning to self-advocate is a gradual process that takes time, so I would be patient.  At this age I would focus on building self-awareness about his profile of strengths and challenges.  We actually create a chart that lists strengths on one side and challenges on the other. In reviewing them with the child we make sure that the notion that everyone has challenges is reinforced.  The process builds self-awareness and can be extremely empowering.  By naming both strengths and challenges, it underscores that the challenges have boundaries and can be managed.  Once the child understands that he can acknowledge his challenges without being defined by them, he is likely to feel more comfortable self-advocating.  It is also important to set appropriate expectations for self-advocacy that will vary with the child’s age, temperament, specific needs, and academic setting. Q: What can I do for a dyslexic child who seems academically paralyzed in other ways? For example, my son gets "stuck" -- unable to do math problems or other work that I know he can do. Some days he can do it, and other days he just sits there, stressed and stuck. My daughter also has the same problem. Is this related to the dyslexia? Dr. Yellin: It is certainly possible that the math problems are related to their dyslexia.  Almost every subject involves reading, so dyslexia might be playing a major role in math difficulties, particularly if the struggles most involve word problems.  On the other hand, you cannot assume that is the case, so I would definitely recommend looking into their math difficulties. Q: You mentioned AIM and IDEA. Are there tools/materials available to parents that would be appropriate to share at an IEP meeting to support this need?  Dr. Yellin: Yes, I would recommend checking out the CAST (www.cast.org) and AIM (aim.cast.org) websites. Q: How often do you see auditory processing delays in a child with dyslexia? What therapies are available for auditory processing delays? Dr. Yellin: Auditory processing is a very broad category that can be associated with reading problems.  For example, many children with dyslexia have trouble with phonological processing, which involves processing the individual sounds within words.  They generally do very well with multisensory reading programs, like Orton-Gillingham.  Reading specialists and speech and language specialists can be extremely helpful.  Also, there are a number of computer-based programs that can also be helpful. Q: One of the biggest issues I come across is students who can identify and say individual letter sounds but can't blend the sounds into words. Once that issue is identified, what do I do next? Dr. Yellin: First, I think you need to tease the problem apart a bit more.  Can the student blend the sounds if he or she hears them rather than reads them?  Is he or she more fluent with sight words?  How about nonsense words?  Can he/she manage an elision task?  Is there a problem with word retrieval in general? Once you pinpoint the problem I would focus on activities/exercises that isolate that specific function.  I would also have the child read along with audiobooks.  Fluency exercises can be helpful as well.  For example, have the child read the same passage while timing them and plotting their time over the course of several days. Q: Do you have recommendations on how to help a dyslexic child who also struggles with math? My son really struggles with learning his addition, subtraction, multiplication, and division math facts. Dr. Yellin: As with reading problems, math problems need to be looked at as symptoms like knee pain.  You wouldn’t treat knee pain from an athletic injury the same way that you would knee pain in someone with the flu.  A professional needs to help you get to the bottom of your son’s math problem so it can be addressed appropriately.
About Dr. Yellin: 
Paul B. Yellin, MD, FAAP, is Director of The Yellin Center for Mind, Brain, and Education, a New York City-based learning evaluation, support, and professional development organization which provides customized support for students and educators based on emerging knowledge in neuroscience. Dr. Yellin is an Associate Professor of Pediatrics at New York University School of Medicine, Department of Pediatrics.