I wish things weren't this hard.
I am an SLP working in NYC -- I've worked with school-age children for the past 20+ years in both school settings and in private practice.
Because dyslexia is a language-based learning disability that some stats say affects as many as one in five children, I've encountered countless dyslexic students throughout my career.
Dyslexia -- or really anything related to literacy -- was not covered (or even mentioned) in my graduate program 23 years ago. Because of this, I have spent a considerable amount of my own time and money taking courses, reading articles, listening to podcasts, etc. to learn as much as I can about dyslexia -- about its assessment and management, as well as my role in all of it as an SLP, since we have a responsibility to do right by the kids we serve.
Per ASHA, "Speech-language pathologists play a critical and direct role in the development of literacy in children and adolescents and in the diagnosis, assessment, and treatment of written language disorders, including dyslexia."
After that, things get very muddy, especially around the diagnosis of dyslexia. Part of the confusion stems from the fact that different states have different rules about who can diagnose it. In some states, SLPs can diagnose dyslexia (Kansas and Missouri are two that I'm aware of).
Who can diagnose dyslexia in New York?
There is no question that we, as SLPs, can contribute to a dyslexia diagnosis; many of the findings we make during an assessment can add evidence that dyslexia is present. For 2 free and easy assessment tools I use in my assessments when literacy issues are suspected, see this post.
But from what I can tell, the New York State Education Department stipulates that only psychologists and neuropsychologists can diagnose dyslexia in New York because it is classified as a learning disability. In addition, in school settings, dyslexia is not considered to be a disability classification on its own; rather, it is treated as part of a broader group of issues known as "Specific Learning Disabilities." For this (and possibly other) reason(s), school-based psychologists don't typically diagnose children specifically as dyslexic -- or even utter the term.
The result is that I see kids on my caseload who I am certain are dyslexic (based on knowledge of their performance in school, teacher reports, and my own assessment). Still, my hands are tied in terms of helping these kids to get critical school-based services (outside of speech and language therapy) that they need (e.g., SETSS instruction, assistive technology, additional time on tests, etc.) because:
School-based psychological assessments are sometimes poorly done in my opinion -- at least in New York City -- as they are often contracted out to agencies where psychologists are churning out these reports without input from the SLP or even the child's teachers. This is especially true in cases where the child in question is otherwise bright and scraping by in school.
A private psychological/neuropsychological assessment (which can be used to support/supplement a school-based assessment) is cost-prohibitive -- often upwards of $6K in New York City -- and is usually not covered by insurance. Who can afford that?!
So many parents do not have the bandwidth, or even the awareness of the need for, or existence of lower-cost alternatives.
I think we should be making the case that SLPs, and even teachers, with the proper training, should be able to diagnose dyslexia in New York State. If there ever was a training that would bring SLPs through the dynamics of diagnosing dyslexia and then offer certification to do so, I'd be first in line.
I know many SLPs may not want this extra task to fall to them, so maybe this certification could be optional. It would also be good if graduate programs could step up and cover this common, language-based learning disability so that more SLPs felt more confident in this area.
Here is some additional info:
I would love for SLPs to be recognized as professionals who can diagnose dyslexia, as they already are in other states. As it stands now, a dyslexia diagnosis remains elusive for many (most?) of the kids who have it in this city, meaning that way too many dyslexic students are not, and will not, get the help they need. SLPs could be playing a critical role in changing this for the better.
What's your experience with dyslexia diagnosis where you live? Leave a comment!
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