A Strengths-Based, Whole-Child Approach to Testing
A family friend recently reached out to me about testing for their third-grade daughter. She’s been receiving excellent, evidence-based reading intervention but still struggles, and now her parents are wondering if she might have Dyslexia. They’d seen “Dyslexia-only” evaluations advertised and wanted my perspective.
Testing is a significant commitment – of time, energy, and financial resources. It’s not something I ever recommend lightly. I am deeply aware of the cost for families, and I make every effort to avoid over-testing or under-testing. Even though I know it would appeal to many families like my friends whose concerns are only about reading, I rarely provide brief screening evaluations because a narrow lens risks missing important pieces of the puzzle.
Why a Narrow Lens Can Miss the Full Picture
Think about trying to understand an elephant while wearing a blindfold. Touching only the trunk tells you something true – but not enough to make sense of the whole animal.
That’s what happens with narrow testing. If we only test for Dyslexia, we may capture part of the truth, but we miss the bigger picture of how a child learns, what other factors may be contributing to the challenges that prompted testing in the first place, how Dyslexia fits them, and which strengths should drive individualized interventions. Sometimes what looks like a reading problem is driven by a different learning process. Sometimes Dyslexia is present, but it’s entangled with memory differences, attention challenges, broader language processing problems, or writing difficulties that are underappreciated if we don’t look. And sometimes what’s driving the concern isn’t Dyslexia at all, but other factors that also affect reading.
What We Know About Dyslexia
I say this not only as a practicing neuropsychologist, but as someone who spent the early years of my career on Dyslexia research teams led by leaders in the field. Fresh out of fellowship training I worked at Yale with Drs. Sally and Bennett Shaywitz, whose groundbreaking research showed that Dyslexia is not a problem of intelligence or motivation but a language-based learning difference in the brain’s reading circuits. I was also fortunate to work on teams led by Drs. Robin Morris, Maureen Lovett, and Maryanne Wolf whose NIH-funded research furthered our understanding of the reading brain and interventions that work.
Dyslexia is fundamentally about processing language. Individuals with Dyslexia struggle with phonemic awareness, the ability to hear and manipulate the smallest units of sound in words. They may also struggle with phonological processing, the bridge between sounds and those squiggles on the page we call letters, and/or rapid naming, retrieving and applying that information fluently and automatically.
But here’s where it gets more complicated: these processes don’t exist in isolation. A child who burns extra fuel to decode words may tire more quickly, lose focus, or struggle to keep up with note-taking or writing. What looks like a “just a reading problem” can extend into math, writing, attention, and even self-confidence in the classroom. Comprehensive testing isn’t about diagnosing a laundry list – it’s about understanding how Dyslexia fits that person and building a plan that leverages strengths to support learning across settings while both accommodating and intervening.
Why a Broader Lens Matters
- Memory and math facts. The same systems that support less-effortful word reading and decoding also support automatic recall of math facts and sequences. A child may “know” multiplication yet retrieve it slowly, making multi-step calculations particularly challenging.
- Written expression. Reading and writing are deeply intertwined. Many individuals with Dyslexia also have writing-related difficulties and struggle getting their thoughts on paper, whether it’s spelling, organizing sentences, or the mechanics of handwriting. For some, motor-planning or fine-motor demands add another drain. Evaluating writing gives us insight into how to reduce the load and how to help them to show what they know.
- Emotional well-being. Some children with learning differences may begin to doubt themselves, avoid certain tasks, or feel less confident compared to peers. Others mask their struggles and carry quiet frustration. Looking at social-emotional functioning ensures we support not only learning skills but also resilience and self-esteem, known secondary effects of learning disabilities.
- Attention and focus. Imagine the brain as a gas tank. For a person without Dyslexia, decoding words might use just a little fuel. For someone with Dyslexia, it might take half the tank, leaving less for comprehension or writing, or just to sustain consistent attentional focus. This doesn’t mean Dyslexia automatically co-occurs with ADHD (although there are high rates of co-occurrence), but it does mean that cognitive stamina and focus can be affected. A thorough evaluation helps us sort this out and distinguish fuel-use from focus so that supports fit the needs. It provides insights into the why and how, not just the what.
My Step-by-Step Approach
My evaluations begin with a detailed intake – an hour just with parents (or the adult to be tested), along with detailed intake forms and any records they wish to share at the beginning. We discuss developmental history, current concerns, goals, and strengths. Sometimes, that conversation suggests alternative steps before diving into testing. I may recommend targeted screening by reading experts and early intervention first.
When testing is the right next move, my test batteries are individualized – developmentally appropriate and comprehensive enough to provide a true picture and without measures that don’t add value. I actively solicit multiple perspectives from family, teachers, and tutors.
That is, my evaluations and testing do not occur in a silo, either. Collaborative approaches to assessment are time-consuming, but I have learned that every perspective, along with a thorough history that extends beyond my testing office and over time, provides a critical context for interpreting testing results and crafting individualized recommendations that address referral concerns and next steps.
Final Thoughts
I absolutely understand why a Dyslexia-only evaluation is tempting. It feels efficient, and it often costs less. But children are complex, and learning is interconnected. A narrow focus may answer one question, or one facet of a diagnostic question, but it risks leaving many others unasked – and unanswered.
Comprehensive testing not only clarifies diagnoses, it highlights and leverages strengths, identifies opportunities to enhance learning, and gives families and teachers the best roadmap for support.
Testing is never just about checking a box – it’s about understanding a child well enough to help them thrive.
Want more information? Visit the Resources page on my website for more information about Dyslexia and reading, and more.
A Note on Cost & Insurance
Although Dyslexia has a clear neurobiological basis, most medical insurance plans categorize Dyslexia evaluations as educational, not medical, and do not cover them. Insurance may cover testing when there are differential-diagnosis questions (e.g., Dyslexia vs. ADHD), but even then the number of authorized hours is often insufficient and excludes critical academic testing. I’m always happy to consult with families about cost-effective strategies, and to talk with parent organizations about what to expect in and from an evaluation.
