Dyslexia Therapy: Evidence and Emotion

About a year ago, Dr. William O. Young wrote two guest posts for Lexercise on how not to treat dyslexia — Part I and Part II. These articles generated considerable reactions and continue to spark inquiries even after all this time. This interest has led me to today’s post, which looks not at specific treatments, but more generally at the challenge of making good decisions.

A parent or teacher notices that a child is struggling to read, write or spell. But children don’t all learn at exactly the same rate as their peers or siblings, so the difference is, at first, accepted as normal. After a while, as the child’s difficulties continue or become more acute, parents begin to acknowledge that there may be a problem. By this time, considerable time has been lost, the child is unhappier and the parents are beginning to feel desperate. They want answers, but they also realize that if the school or the pediatrician really understood the problem, they would be doing something about it.

The parents start to realize that help is not likely to come from the school. They talk with other parents, consult with “experts,” sift through online information, and even look in the yellow pages. Maybe, along the way, they get lucky and someone advises them to get a language processing evaluation for their child so they have an actual diagnosis to work with.

But parents are still faced with the problem, every step of the way, of knowing what questions to ask and how to judge the answers. Even if, intellectually, they want treatment for their child that is validated by scientific evidence, emotionally they want to believe the messages of hope offered by practitioners who promise miracles.

For best results, a skeptical consumer mindset is essential. Here is a checklist of things you should look for in language processing therapy:

1. Does the therapy address speech sound (phonemic) awareness and memory?
2. Does the therapy address reading accuracy and speed and oral reading expression?
3. Does the therapy address spelling patterns based on word structure (phonics plus word analysis)?
4. Does the therapy address transcription (handwriting and/or keyboarding)?
5. Does the therapy address written language (i.e., narratives and expository essays)?
6. Does the therapy address assistive technologies and legally required accommodations (e.g., text-to-speech and speech-to-text technologies)?
7. Does the provider have a professional degree in clinical science (psychology, speech-language pathology, special education)?
8. Is the evaluator’s training and experience consistent with the Knowledge and Practice Standards of the International Dyslexia Association?
9. Will there be regular, formal progress monitoring and written progress reports?
10. Will the provider take into account the priorities of parents and children when planning therapy?
11. How long will treatment be likely to last, and how much will it cost?

At the 2012 convention of The American Speech-Language-Hearing Association (ASHA), Dr. Gregory L. Lof* presented a poster to help clinicians in communication sciences and disorders (CSD) distinguish between science and pseudoscience. Dr. Lof has generously allowed us to offer this link to a PDF of his poster, Science vs. Pseudoscience in CSD: A Checklist for Skeptical Thinking. Perhaps it will help you to evaluate claims as you seek care for your dyslexic child.

If your child is struggling to read, write or spell, the critical first step in effective treatment is a professional evaluation. Take a look at the Lexercise Online Dyslexia Testing and Treatment pages or contact us at Info@Lexercise.com or 1-919-747-4557.

*Gregory L. Lof, PhD, CCC-SLP, ASHA Fellow, Professor and Chair, Department of Communication Sciences and Disorders, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston
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Lof, G.L. (Nov., 2012). Science vs. pseudoscience in CSD: A checklist for skeptical thinking. Poster presented at the National Convention of the American Speech-Language-Hearing Association, Atlanta, GA.