Unbabbled: Dyslexia

Dyslexia Diagnosis and Intervention

With an estimated 15-20% of the population showing signs of dyslexia, it is the most common cause of reading, writing and spelling difficulties in children and persists throughout life. Yet, there is still a lot of confusions among the public, including parents and teachers, when it comes to understanding this learning disability. In this episode, we sit down with reading specialists Alison Edwards and Meagan Rosales to discuss dyslexia, including the red flags to look for, when and how to get a diagnosis, ideas parents can implement at home and best practices for intervention. We also debunk some of the most common dyslexia myths.

About Our Guests

Alison Edwards is a Licensed Dyslexia Therapist (LDT) and a Certified Academic Language Therapist (CALT) in Houston. With more than 23 years of experience in the school setting, she offers dyslexia intervention for struggling students and consulting services to parents and teachers. Alison helps navigate the daunting questions raised when children struggle in the classroom. She provides dyslexia therapy both in-person and online to help students reach their full potential. 

Meagan Rosales, MEd, is a Reading Intervention Specialist at The Parish School. She earned her Master’s in Education from the University of St. Thomas in 2014. She also holds teaching certifications for Special Education EC-12, Generalist EC-6 and Reading Specialist EC-12. Meagan has a special interest in teaching children with learning differences how to read. She loves being at The Parish School because she has space to incorporate a variety of strategies to meet the needs of individual students.

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Stephanie (00:06):

Hello, and welcome to Unbabbled, a podcast that navigates the world of special education, communication delays, and learning differences. We are your hosts, Stephanie Landis and Meredith Krimmel, and we're certified speech language pathologists who spend our days at The Parish School of these things, helping children find their voices and connect with the world around them. Dyslexia is the most common cause of reading, spelling and writing difficulties in children. Yet there's still a lot of confusion and misinformation out there. In this episode, we sit down with reading specialists, Alison Edwards and Megan Rosales to discuss dyslexia. Alison is a licensed dyslexia therapist and a certified academic language therapist in Houston, Texas with over 20 years of experience in the school setting, offering dyslexia intervention for struggling students and consulting for parents and teachers. Megan Rosales is a reading intervention specialist at the parish school in Houston. She has a master's of education in reading specialty and over 10 years of experience teaching in the early elementary levels at The Parish School. During this episode, we discuss early red flags of dyslexia when, and how to get a diagnosis, ideas for home and best practices for intervention. We also debunked some of the most common dyslexia myths.

Stephanie (01:24):

Hello, and welcome to Unbabbled. We're so excited today to have not one but two reading specialists. Speaking with us today, we have Megan Rosales and Alison Edwards. If you guys could just give me like a brief 30 second introduction of who you are, so they get to know whose voice is whose. So we'll start with you, Megan.

Meagan (01:44):

Okay. Hi, I'm Megan Rosales. I am a reading specialist here at The Parish School. I've worked at Parihs for about 13 years now in between the primary levels and now lower and upper elementary.

Stephanie (01:57):

Thank you. Alison?

Alison (02:00):

Hi. Yes, my name is Alison Edwards. I am a dyslexia therapist. As a child, I struggled greatly as a reader and um, I kind of figured things out in college and I went on to graduate school and graduated with all A's in graduate school much to my high school counselor surprise. I was Orton Gillingham trained in new Orleans and then eventually moved to Houston and was Orton Gillingham trained here with Neuhaus. I've been working with struggling students for 23 years and I'm very passionate about it.

Stephanie (02:31):

So glad to have you both. Alison, you mentioned dyslexia today. We're going to focus in on dyslexia. I know there's many different types of reading difficulties. Can you give us a little bit about what dyslexia is and then maybe how it is different from other reading disabilities?

Alison (02:49):

Sure. So, um, dyslexia is a brain-based learning disability. It originates in the brain and it is characterized by difficulty with reading and spelling. Students that have dyslexia are going to have a hard time processing the sounds of our language and blending. Those sounds together to make those words, 80% of learning disorders are related to dyslexia.

Stephanie (03:16):

Wow. You want to add anything to that, Megan?

Meagan (03:18):

Well, you think about dyslexia and being at Parish, we understand that it is a language based disorder on top of that. And so there's this underlying foundation of language that is not necessarily developed.

Stephanie (03:32):

There are many SLPs along with special ed teachers and reading interventionists that work with dyslexia because there is such an overlap with the language aspect to it.

Meredith (03:44):

So what are some early signs and red flags for dyslexia?

Alison (03:49):

So some of the red flags for a learning disorder like dyslexia might be, um, difficulty hearing rhyme, difficulty manipulating sound. Um, my daughter used to say the word coat hanger. She used to say tope hanger. So right away when she started mixing up the sequence of those sounds, my radar went up and I started paying attention to that. Also difficulty with the alphabet reciting the alphabet, reciting nursery rhymes, recalling words. If I say something like this is a Christmas tree, being able to repeat, Oh, this is a Christmas tree. Being able to say that back, um, and keep all those syllables together. Meagan mentioned about speech delays. That can also be an indicator when, when a toddler struggles, um, with speech and adding new vocabulary, that can also be an indicator of possibly dyslexia. Dyslexia can also run in families. So knowing that, you know, I struggled as a reader, so I was on guard when my three children came along and I was really looking for those red flags.

Stephanie (05:03):

One of the things it seems like you mentioned in there was sequencing sequencing, syllables. Is, would that happen within sequencing like events as well?

Meagan (05:13):

Yes, I definitely think so because there's a whole organizational piece, whether it goes down to the minute details of a word and syllables to, I mean, you can see it in narrative re-tells when it comes to language. I tend to see that along with, um, kind of that bigger detail of retelling narratives.

Meredith (05:32):

My, my son doesn't have a speech disorder. His sounds developed pretty typically, but he has a few words that he always says what the wrong sounds like. He commonly calls a remote a commote. Um, no matter how many times we repeat in model, um, would that just be something that's more developmental or would you think that that could be a sign and something to keep an eye on?

Meagan (05:57):

I think it would be good to err on the side of caution and you know, continue to monitor it and see if it kind of you know, works. It works its way out of it, out of his system. If you know, in time it could be more of a developmental thing, but if it doesn't, then you have your eye on it and it's a good red flag to keep your eye on.

Stephanie (06:19):

So one of the things I'm noticing when you're talking about red flags is that a lot of these things seem to happen with really early in development. Like really young children start to be able to repeat nursery rhymes or say, come up with rhyming words or even just identify rhyming words. How early can you identify dyslexia and when are kids most often identified?

Alison (06:45):

You can screen for dyslexia as early as preschool. Dyslexia is typically diagnosed, starting around kindergarten, 5 or 6, but it's good to look for it early in preschool because early intervention is key. If, if I have a student that's struggling with rhyming or blending sounds or segmenting sounds or even something as basic as counting the number of words in a sentence that I orally say, um, then if I can determine that that is an area of difficulty, then I can jump in right away and start intervening and providing some good support. And what we know about the brain is that the brain responds really well to those activities. So it's good to get in there early.

Meredith (07:31):

So you mention getting in there early, what does that look like? If I suspected my preschooler or kindergarten or might be at risk, what would you recommend I do?

Alison (07:42):

So there, there other, some really fun drills that you can do in the car, you can do them in the bag. You can do the walking on the sidewalk. When you're walking the dog, you don't need any materials. And they all revolve around manipulating sound. So we can be walking the dog one day and I can say, say the word cat. And then the child will say the word cat. And I'll say, how many seconds do you hear in cat? And I'll say, ca-at what if we reply first out and we puh up on that word, what's the new word? And the child should be able to say pack. Dyslexic profile would really struggle with that activity. So to provide lots of activities where you're manipulating sound, um, I used to do with my own children. They would say, um, you know, what's for dinner tonight. And I would say, ur-I-si, and they would say rice. And I was like, okay, chi-ick-en. And I would always say, hey, that's a lot of sounds. They had to hold all those sounds in the correct sequence and blend all those sounds together. And I'd say, Oh, I haven't chicken. So things that you, um, would do that required that require you to manipulate the sound, um, that require any materials. You can do it in the dark. I always say because, um, they're not looking at letters. This is all working through sound in the ears.

Stephanie (09:09):

Yeah. In the early childhood classroom, I spent many years there and we loved playing little rhyming games. And one of the kids' favorites was a song, Willaby, Wallaby, woo, an elephant sat on you. And then you replaced the first sound of their name with a w and the kids think it's hilarious, but just singing that sound over and over again. And I've done that at home with my kids, like changing up their names and I'll be like, Wandrew, wait, your name's not Wandrew. And then they'll laugh. And just trying to play little games to get them to attend to this sounds.

Meagan (09:40):

Absolutely nursery rhymes, sing-song type things are the best to kind of draw in early childhood and preschool kids.

Meredith (09:48):

So if you have been playing these games at home and working with your child, but now you're really starting to suspect that this could be dyslexia and you might, need to take the next step. What would you recommend the next step be for families? Where do you go, to have your child tested. Who can diagnose and treat dyslexia?

Meagan (10:06):

I've worked at the primary level for years. So kindergarten-1st is typically like the kids that I see get tested by a neuropsychologist. And you said there's a lot of private clinics that can, um, test students for dyslexia. There are also some SLPs that are trained that can test for dyslexia.

Stephanie (10:27):

So Alison you're a, a CALT, right? A certified academic language therapist. Would that be somebody we could search out for a dyslexia diagnosis or mainly for treatment?

Alison (10:41):

So a CALT can talk you through what you're seeing at home or what the teacher has reported to you that they are seeing, but a CALT would not diagnose dyslexia. We would refer you to someone, um, like what Meagan mentioned, a psychologist, a, um, SLP, even an educational diagnostician. So they would make the diagnosis and then you would turn around and work with, a CALT for the dyslexia intervention.

Stephanie (11:11):

What about your child's school system? Whether you're in private or public, will they help get a diagnosis?

Alison (11:17):

Your public schools can do the testing and they can do the diagnosis. You would request in writing that you would like to have your child diagnosed. And then there are some steps you would go through for the testing and the diagnosing.

Stephanie (11:31):

Do you see that public schools are just as apt to start diagnosing in preschool or kindergarten or do they do a little more wait and see, is it more common for that to happen in later years?

Alison (11:44):

You have to be persistent as the parent. You have to be the advocate for your child. So you have to be pretty vocal about what you and where your concerns are. And if you put that in writing and get the process started, your public school can do all of that testing to find that diagnosis as early as 5 or 6.

Meredith (12:07):

Great. And if your child receives the diagnosis, what kind of modifications or therapy techniques would we expect to see working with our reading specialist or a speech language pathologist?

Meagan (12:19):

I think first and foremost, it's really important to have any students that are diagnosed with dyslexia enrolled in a program that has a structured literacy approach to reading. I think speech therapies, language therapy, I think is important as well.

Meredith (12:34):

Do you have anything to add to that, Alison?

Alison (12:35):

So in that structured literacy program, that is what the reading scientists are saying. Supports dyslexia, um, really helps target the weaknesses for dyslexia. So that program would be explicit. It would have directed these new concepts. It would be multisensory the con introduced in a way that has multiple pathways into the brain. So you're gonna hear the words, see the words, say the word lots of different ways into the brain or the, um, the sound for the, and it would be cumulative, which means it would constantly be introduced. It would be systematic, which also means you're going to start with the easiest concept and then build on that to more complex concept. So the structured literacy programs follows these principles, which make it a good intervention for a dyslexic profile.

Stephanie (13:41):

And how would a parent find the right structured literacy program for their child? Do you have any recommendations?

Meagan (13:47):

I think it's always great to get screened. Um, first you could always go through if you're in Houston, like the Neuhaus tutors that they have, or the cat certified dyslexia interventionists that, um, can provide some kind of screening for that in our own private school. We, we do the reading screenings here. We can't diagnose dyslexia, but we do know enough about it to be able to target those like phonemic awareness skills that dyslexia students might have that might have lagging skills in.

Meredith (14:22):

And after you do that screener, that would help identify what type of approach.

Meagan (14:25):


Alison (14:26):

Also a, one of our other local organizations is, um, Houston branch of international dyslexia association, HBIDA, a lot of resources that can guide a parent into, you know, what do I need to do being untapped? What are my resources? How do I get help for my child?

Stephanie (14:47):

That's fantastic. Yeah. We'll put a link to that in our show notes for anybody who's listening in once a direct link to that. Is there any type of treatment that you would not recommend for a child with dyslexia, Alison?

Alison (15:01):

I would say that if the program is not evidence based, I would steer clear of that. You know, we need valid evidence, the program will support a struggling reader. That evidence comes from reach. So I would say if it's not evidence based, I would turn the other way.

Meredith (15:24):

And to piggyback off of that, are there any myths or misconceptions surrounding dyslexia that you feel like people should know about?

Meagan (15:32):

Dyslexia is not always the students that flip in reverse letters. They have difficulty decoding. They have difficulty following the small details of language and written language. I'm trying to think of what else,

Meredith (15:46):

Because flipping letters can be developmental at a certain age, correct?

Meagan (15:49):

Absolutely. Especially, especially in when you are, when, when you're focusing on written language, as opposed to flipping it while reading. Developmentally, you're going to get flipped letters and reversed letters.

Stephanie (16:03):

I think I heard this from a reading therapist, but they were giving the clue of a D wears a diaper and B has a belly. And when I used that excuse with my daughter, it suddenly like clicked in her head and she stopped reversing B and D when she was writing. I never would have thought of that, but it keeps making sense. And we tried for so long and it was just like, Oh, well, that makes sense. Now I love that. Totally random, but I'm so glad you brought up the letter reversal. Is there anything else, like, I, I know sometimes families get information that maybe it's a vision difficulty.

Alison (16:43):

We definitely know that, um, dyslexia is not a vision problem or reading backwards. You know, it's a myth out there, but that goes back to the, this learning disability is neuro-biological in origin. It originates in the brain. Certainly the visual field makes the experience more comfortable, more enjoyable, but it originates in the brain. We also know that dyslexia is not a problem with intelligence. We know that these kids are just as smart is that their peers in the classroom, they're harder or peers. Um, but we know that they can be very gifted, artistically and athletically. Um, it is not a result of a lack of intelligence. It's also not a lot of, um, effort and they're not lazy at all. Oh, and another, um, dyslexia myth would be either they outgrow this. It, it doesn't go away. Um, but through good intervention and good accommodations, it can move to the back burner, but it, it doesn't go away permanently.

Stephanie (18:00):

You mentioned good accommodations. What are some of the accommodations you frequently recommend to families and teachers?

Alison (18:08):

I think technology has helped a lot with audio books. Maybe the class is assigned five chapters to read for homework, well, a dyslexic profile. That's going to take him a long time, him or her a long time. Maybe his peers can knock that out pretty quickly. So accommodations help level the playing field. You can both access that assignment. You can access that curriculum with an accommodation of an audio book. Just listening to that book on audio, text to speech technology or speech to text technology can be really helpful for me. I really struggled with getting things down on paper and I had great ideas. I had great creativity, lots of organization, but when it got time to put it on paper, I fell apart. I can spell anything. And so my mom just sort of naturally accommodated me and she would do all of the writing for me. I would do the dictating and she would write, or she would type. And so now I've sort of taken that, um, experience as a child and in my life, in my professional life, I tell my students, you know, I'm a hand your, the brain, I will do the writing for you, but you're going to dictate the words to me. And so that's how we will be able to accomplish this task. And maybe it's a homework task or something. So that accommodation will level the playing field. Also extended time. You know, if, if I have to do an assignment that requires reading and spelling, I need a little bit more time, as a dyslexic student. Oral testing can also be really helpful to help the student access that curriculum.

Meredith (19:55):

Do you have anything to add to that, Meagan?

Meagan (19:57):

I think she, you know, hit the nail on the head when you're working with a student with dyslexia, because not only are you thinking about what is, what is it you're working on? What's the important piece of information? Is it more about what the student knows or is it a part of handwriting and spelling? Really? What tasks do we want to complete with this child? What's the importance?

Meredith (20:21):

Yeah. I remember hearing learning about that early on in my time in the elementary classrooms, you know, what is the focus of the activity? If the focus is not handwriting in print, then they don't need to write it. There are other opportunities to practice that. So, yeah.

Meagan (20:34):

Absolutely. Yeah. Shortening and clarifying instructions as well, written instructions, especially I think that's really important as well and repeated repeated instructions for sure.

Stephanie (20:46):

It seems like it's things that are very similar for, um, for children who are having language difficulties since they're so connected.

Alison (20:52):

Another one that just popped into my head was, um, students can also get a copy of the teacher's notes, maybe also a copy of the audio from the class that can be very helpful for a student. I remember when I was in college, I would get a copy of the lecture notes. And that was so helpful for me to be sitting in class, listening to the professor talk and following along with the notes, I wasn't stressed to try to do all that writing at the same time.

Stephanie (21:25):

That's fantastic. That's a great tip. This is random again, but it just popped into my brain. I'm hearing you talk about how difficult writing and coming up with these ideas and spelling is for children. And that there's the common myth that they're lazy. I'm wondering if another red flag would be a child getting tired easily during activities, not having a lot of academic stamina. Is that something you see frequently in students with dyslexia?

Meagan (21:56):

I think absolutely. Especially when it comes to heavy reading and writing tasks, we will definitely see that. Or you might even see avoidant behaviors depending on how difficult it is for the student or how, how high the level of reading or writing is for that student.

Stephanie (22:13):

So you said him, and then you said, or her, it makes me think that oftentimes we see that language disorders tend to be a little more prevalent in boys than girls. Is that the same with dyslexia or is it evenly distributed?

Alison (22:32):

Well, they say that dyslexia affects about 15 to 20% of the population. Um, which means about 1 in 5 people will have dyslexia. The numbers are really close between girl versus boy. Um, you hear some times that it's more boys than girls, but then at the same time, I'll hear that it's, it's pretty close to being equal.

Stephanie (22:56):

1 in 5, that's staggering. I didn't know it was that prevalent.

Meredith (23:02):

Yeah. I'm really surprised by that number. Is there anything that really sets dyslexia apart from other reading disabilities and on top of that, what are some other reading disabilities that you might see?

Meagan (23:14):

One, one of them that pops into my mind hyperlexic, hyperlexic students, but you see these students that can read, read, read, read, read, but have difficulty comprehending the content of the passage that they're reading, um, which is total opposite because you're not really working, working on fluency, but comprehension at that point. And then, you know, with dyslexia, you're working a lot with students that have difficulty with fluency and decoding and they ultimately can comprehend the text, but may need a different way to, you know, to accommodate their needs in a way that they could understand.

Stephanie (23:55):

Alison, any other things that set dyslexia apart?

Alison (24:00):

I wouldn't add anything. I think her example is perfect.

Stephanie (24:04):

Alison, can you give a quick definition of what decoding is?

Alison (24:07):

So decoding is sounding out the word it's looking at the letter, making the sound that's associated with that letter and then blending. Those sounds together in the sequence of those letters. So if I look at the word cat, I should be able to say, well, the C says cook, the AA says AF and the T says to now I'm going to go back to the beginning of that and go, C-A-T and now I'm going to do it faster hat. And a lot of times with dyslexic students, they can make those sounds, those initial sounds, but blending, those sounds together in that correct sequence, that's where the problem comes in.

Meagan (24:52):

Yeah. You see a lot of difficulty with, you know, the executive functioning piece of organizing those, um, sounds in the correct sequence like Alison said, or even just holding them, holding them together, to be able to repeat the same sounds back. Sometimes they substitute a sound, a student may substitute the T for a D sound and say, duh, if they're not auditorily processing that sound correctly.

Meredith (25:19):

Something that happens in our house a lot is C-A-T and then what word did I say? And he'll just guess a word that starts with T because it was the last sound he heard. So he's like Thai or whatever too. So we see that a lot in our house, but he's pretty young. So it could be developmental instill learning, or it could be a flag, but I'm keeping my eye on it.

Meagan (25:41):

There's also very visual ways that we represent sounds to be able to manipulate them whenever we're working with students as well.

Stephanie (25:50):

Yeah. You guys have mentioned that multiple sensory, multiple modalities of getting something physical to put their hands on, like Unix cubes or a little other Legos or things, and then smushing them together to represent the three sounds and blending them. Absolutely segmenting, I believe is something else you guys have discussed. Megan, can you give us a definition of segmenting?

Meagan (26:12):

Segmenting is where you can take it, take a word and basically break that word apart into its individual sounds so, you know, going off of the word box. Well, that one's a little tricky, cause it's got four sounds to it, b-u-o-x, box. So being able to take that word, segment it, so take those individual sounds apart. And then that's another step that goes into writing that is really difficult, um, for a student with dyslexia. So on top of that, having to recall the letter, they would have to write,

Stephanie (26:44):

Do students with dyslexia often struggle with spelling?

Meagan (26:49):

Yes, absolutely.

Stephanie (26:53):

Cause it sounds like what you need to spell is the ability, ability to segment and then blend back the words together.

Meagan (27:01):

Absolutely. And then not just that, it's a lot of letter recall. It plays into handwriting. You're thinking about beginning strokes of handwriting. And then depending on, you know, if I can recall a, B or D or a P or Q, which way is that curve going to go? Is it going to come before the line is again and come after the line? Okay.

Meredith (27:23):

Yeah. D has a diaper, B has a belly. I love it.

Alison (27:28):

Also you see students when they're learning that alphabetic principle, but the sounds that match with the letters, they learn that reading piece first, and then the piece we teach it at the same time we teach the reading and the spelling together. But that reading piece, it's just a little bit lower level on the ladder because when you get into the spelling piece, like Megan was saying, there are lots of other cognitive skills that go into the spelling piece, the letters in this, the size, the shape, the formation, all of that makes it a more complex task for the student. So it's harder. So spelling just takes longer to master for the student.

Meagan (28:13):

So one more question I have is, um, what is a common age that a student learns to read or has learned to read? When would you expect decoding and fluency to be mastered?

Alison (28:28):

Well, it used to be, we would teach reading in first grade that was sort of the introduction to reading and the pendulum has swished. And now we are teaching, reading as early as kindergarten. So we're teaching children to read a little bit earlier. So there is an expectation that they're going to be reading a little bit more proficiently at an earlier age. Um, but we're teaching reading typically through 3rd grade. Around 3rd grade is kind of where you see that shift of, we're not really teaching you how to read or teaching you how to learn through your reading. So reading to learn kind of makes that shift around third grade. Again, that's another for early intervention, get, get, pay attention to those red flags, get the diagnosis, get that early intervention going during those years where we're really teaching kids to read

Stephanie (29:32):

At the end of every podcast, we ask our guests the same question, sounds like Alison has done her homework and came prepared. So we'll go with her first to give Meagan time to, if you have one piece of advice to give to our listeners, it can be about dyslexia or any great advice you have in general, what would you give?

Alison (29:50):

Well, I love to tell my students that their struggle won't define them, but it will shape them into the person that they will become. For me. I'm thankful for my reading struggle. It gave me a strong purpose to do this lifesaving work.

Meagan (30:09):

I love that. Thank you. Can I just agree with hers? Absolutely. I mean that ties in everything from growth mindset and what are, what we really want our students and children to learn and understand as they're growing. So yes, I agree wholeheartedly with what Alison just stated.

Stephanie (30:27):

Yeah. Great advice. Well, thank you both so much for being here with us. We appreciate it. I've learned a lot. So I hope that the listeners and families learn a lot as well. I appreciate both of you.

Meredith (30:40):

Thank you guys. I thank you.

Meredith (30:46):

Thank you for listening to the Unbabbled podcast. For more information on today's episode, please see our episode description for more information on the parish school, visit parishschool.org. If you're not already, don't forget to subscribe to the Unbabbled podcast on your app of choice. And if you like what you're hearing, be sure to leave a rating and review a special thank you to Stig Daniels, Amanda Arnold and Stella Limuel for all their hard work behind the scenes. Thanks again for listening.