Question: We suspect our daughter is dyslexic, but think she may also have ADHD or executive function disorder along with dysgraphia and possibly anxiety.
We would like to do some neurological testing, but are not sure who we should go to and what type of testing we should request. We want the testing to give us some road maps to help us understand all of our daughter’s challenges and how we can best support her. Any ideas would be very much appreciated.
Answer: ADHD (Hyperactive-Impulsive, Inattentive, and Combined Types), anxiety and dysgraphia are common comorbid conditions of dyslexia. A good place to start for any suspected learning differences would be with a health care professional, such as a pediatrician, a child psychologist or a neuropsychologist; these professionals can diagnose ADHD and screen for anxiety disorders.
Child psychologists, educational psychologists and neuropsychologists can identify executive functioning disorders, as can some LDTCs (Learning Disabilities Teacher Consultant) and SLPs (Speech and Language Pathologists).
Re: dysgraphia, I’ve found that skilled occupational therapists are exceedingly good at diagnosis and therapy. Choosing a diagnostician who is familiar with the issues your child is experiencing, as well as one who is knowledgeable about children and adolescents, should be a priority. Learning Ally presented a free one-hour webinar on this subject with Dr. Michael Hart earlier this year. Watch the recording here.
Dyslexia: When looking for someone to diagnose dyslexia, you want to make certain the evaluator uses the word "dyslexia" in their reports. I know it may sound like a no-brainer, but honestly some evaluators do not use this term. So, that is the first question you need to ask. When dyslexia is suspected, your child will complete evaluations in phonological awareness, decoding, rapid automatic naming, etc.
A good evaluator will offer a full report detailing your child's areas of strengths and weaknesses as well as recommendations to which reading programs and accommodations may help your specific child.
A comprehensive evaluation for ADHD includes three types of evaluations: behavioral, educational, and medical.
- A behavioral evaluation typically includes rating scales and questionnaires designed to assess ADHD behavioral characteristics.
- Educational evaluations quantify to what degree a child’s behavior and conduct affect school performance; the evaluator observes the child in a classroom setting and records how often the child exhibits ADHD symptoms as compared to peer norms.
- Medical evaluations assess the severity of the problems of hyperactivity and attention that a child is experiencing; they also include information about how other types of conditions or disabilities may be contributing to the child’s behavior.
Dysgraphia: 
Common signs of dysgraphia are messy handwriting, incomplete words or letters, slow and unintelligible printing or copying, poor spatial planning on paper, and trouble with simultaneous thinking and writing. A dysgraphic child’s writing may appear careless and sloppy, even when they are attentive. Dysgraphia is sometimes referred to as a "disorder of written expression". For the dysgraphic child, simply holding a pencil and printing letters and numbers on a line is laborious work.
Please have a look at the International Dyslexia Association’s Just the Facts document on dysgraphia. My dyslexic daughter also has dysgraphia. Our personal experience has been that the best, most comprehensive evaluations for dysgraphia were done by a medical pediatric occupational therapy group. Thorough testing can reveal subtle abnormalities pertaining to fine and gross motor skills, manual dexterity, range of motion, and visual-motor integration organization.
What about our child's school? You can proceed by requesting that your daughter be evaluated by your school district or by private diagnosticians. If you would like the school district to evaluate her, write a letter to the school district and list all areas of suspected disability. Please note that if your school district evaluates for ADHD, they are not required to conduct a medical evaluation. (However, if the district believes that a medical evaluation is needed to establish that if a child suspected of having ADHD meets the criteria to be classified as "Other Health Impaired," the school may, in certain circumstances, be required to ensure that the child receives this evaluation at no cost to you.)
Diane Taranto is a parent support specialist at Learning Ally.
As a mother, Diane considers her biggest advocates to be fellow parents. When Diane was first navigating the often-confusing world of learning disabilities, she credits the support and guidance of other parents with getting her through those difficult times.
Now well-versed on the subjects of dyslexia and advocacy herself, Diane helps other families bypass the confusion. You can schedule a one-on-one phone consultation with Diane or another parent support specialist by calling 800.635.1403 or by logging onto your membership dashboard.
To learn how your school or district can transform more struggling readers into grade-level achievers, schedule a demo or call 800-221-1098.