TIME IS OF THE ESSENCE: An official diagnosis is not necessary before beginning a dyslexia-specific intervention. In fact, waiting for further testing and diagnosis before starting an intervention is unwise.
HOW SCREENERS WORK
Screeners do not provide an official diagnosis of dyslexia. Their purpose is to quickly and accurately identify risk factors and deficits known to be associated with dyslexia. Dyslexia screening is being mandated from kindergarten through second grade, in most states. But a well-designed screener can identify a student at risk of reading failure, even before formal reading instruction has begun – in the first few weeks of PreK. This has important implications in terms of preventing the first grade reading gap.
Screening in early PreK does not need to be complicated. For example, any PreK child who was diagnosed with early language delay is at risk for dyslexia. A PreK child with a family history of reading problems is also at risk - especially if one or both parents (or siblings) have dyslexia or undiagnosed reading problems. Along with an informal parent survey to screen for these two risk factors, there is another test that can identify a risk for dyslexia, before reading instruction begins. An abbreviated version of a test known as RAN (Rapid Automatized Naming) measures how fast a child can name a matrix of objects, such as a chair, key, car, or other familiar objects.
RAN tests are important for identifying dyslexia risk because the tasks included in RAN tests recruit the same brain network used for reading. In fact, these tasks actually represent a microcosm of the reading process. RAN tests measure the overall efficiency of the child's reading network and can predict future reading problems – especially whether a child will have difficulty learning to read fluently. This means that by identifying the two major risk factors (early language delay and family history of reading problems) and conducting a brief RAN assessment, a preventative intervention could begin as early as the first few weeks of PreK.
Throughout the PreK through second grade window, screeners can also identify weaknesses in a child's awareness of, and ability to recognize the units of sound in spoken language, such as the individual syllables in a spoken word. This ability to recognize and
manipulate units of sound is called phonological awareness. A weakness in phonological awareness is common in dyslexia. The ability to recognize and manipulate individual sounds is called phonemic awareness. A child with strong phonemic awareness can successfully substitute the b sound in bat and change it to the c sound and tell you that the new word is cat. This is a difficult task for many students with dyslexia.
A deficit in verbal working memory is common in dyslexia, and it is a domain often included in dyslexia assessment. When a child is first learning to read, they try to sound out the letters in a word, in sequence, in order to blend them. Poor verbal working memory interferes with their ability to remember and sequence the sounds they have just spoken, making it almost impossible to blend those sounds into a word. Poor verbal working memory also shows up when a child is trying to spell a spoken word or when asked to write a word or sentence when dictated.
The number and types of domains assessed in a dyslexia screener change as a child progresses from PreK to second grade. Most screeners for kindergarten and first grade assess letter name and letter sound knowledge, and look for difficulties in word reading and spelling. Poor performance in these areas are key indicators of future reading problems. By mid-year of first grade, screeners may examine how fluently students can read a brief passage, and how well they understood what was read. It is in passage reading that a screener can identify any of those unusual reading behaviors noticed by Chloe’s parents, when she was reading.
Screeners are not perfect and sometimes students with dyslexia are missed. Risk identification errors may be minimized by capturing more information about the student. Unfortunately, many screeners do not screen for the two most predictive risk factors early language delay and family history of reading problems.
Dyslexia screeners should provide more than a simple yes or no answer to the dyslexia question. Since dyslexia is not a one-size-fits-all reading disability, the screening results should provide a