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Angela Fawcett looks at dyslexia assessments and screenings and why they are important

Children with dyslexia will fail to progress in the early stages of learning, although they may seem to have the ability to achieve in line with their peers. This seems to be because they need to be taught very explicitly in order to pick-up and remember what they have been taught. Dyslexia is one of the most commonly occurring developmental differences, and it runs in families, so that if a parent is dyslexic, there is a 50 per cent chance that the child too will be dyslexic. The good news is that with appropriate support dyslexic children can be helped to overcome their problems with reading, writing, spelling and phonology, and even their self-esteem. The bad news is that without this help, they will fall further and further behind, and this will impact not just on their achievement but on their whole persona. 

Research evidence from the USA has shown that children who do not receive the support they need in the early years may need 67.5 hours of one-to-one support in order to catch up with their year group in junior school. This is an enormous amount of support and will inevitably be very expensive to deliver. So why is it that problems become so entrenched and what can we do to help these children reach their potential? My own research with Rod Nicolson suggests that dyslexic children have a problem in learning, first of all in acquiring the building blocks of literacy, links between the grapheme and phoneme and phonological awareness, and then in becoming automatic in their processing, in order to become a fluent reader.  

Traditionally, dyslexia cannot be diagnosed until a child is at least eight, based on a full diagnosis from a qualified psychologist or a specialist teacher. But now screening tests have been designed to empower teachers, who may have a gut feeling that a child has problems, but need evidence to show that their difficulties are greater than others in the same age range. Screening is generally a quick, low-cost test suitable for widespread use, which is administered by trained, but not specialist, personnel. Where a full diagnosis of dyslexia involves an educational psychologist or a specialist teacher, takes two to four hours and generates a full report, a screening test should take no more than 30 minutes per person and should generate a short report. Screening may be given to everyone, or to a subset identified by the teacher as having difficulties.   

Understanding risk

It seems that many children at risk for dyslexia do not have the language or executive skills in place to benefit fully from classroom teaching in the first years of school. These skills change over time, with rhyming and articulation in pre-school children the best predictor of later phonological skills. More recently, executive skills such as attention and memory have been identified as crucial for early learning. There is also clear evidence for overlap between disorders. It is therefore important that a screening test is sufficiently broad to assess the full range of skills that may need support.

The crucial aspect of early screening is that it moves away from the “wait to fail” approach that formerly characterised diagnosis in dyslexia, and tries to identify problems early on and provide appropriate intervention. This leads to an ethical dilemma. The most successful screening tests are those that accurately predict which children will have difficulties. From an experimental viewpoint, it would be ideal if schools were not made aware of any potential difficulties, so that none of the children identified as “at risk” were supported in school. However, if a child is identified as being at risk at five years, from an applied perspective, in my view, it is unethical not to provide the support needed to help the child to learn to read as normally as possible. 

Although screening tests should be objective, reliable and valid, they also need to be quick, suitable for non-specialists, and provide a quantitative “at risk” score. Two key aspects for any screening test are the hit rate (the percentage of “really at risk” children who are screened as “at risk”) and the false positive rate (the percentage of “really not at risk” children who are screened as “at risk”). An ideal screening test would have a 100 per cent hit rate and zero per cent false positive rate, but a more realistic target would be more like 85 per cent hits and only 20 per cent false positives. There is a trade-off between hits and false positives, so that it is easy to increase the proportion of hits by relaxing the at-risk cutoff, but this will increase the proportion of false positives. Interestingly, it is always much easier to predict those who have strengths in literacy rather than those who are at risk.  It is particularly important that tests used for screening are set at the right level for the age group, and normed on a representative population, with no more than around 20 per cent coming out at risk. 

Types of screening tests

There are a number of advantages for computer based screening, which places fewer demands on teachers and teaching assistants than paper based tests. On the other hand, many teachers prefer to administer tests themselves because they gain so much information from how the test is completed, which itself forms part of the profile. Moreover, there is potential for error in work on computers, because participants may not understand the demands of the task, and the computer cannot identify this, whereas a teacher can.   

One of the major problems in using screening tests is that teachers may then be alerted to the ongoing needs of the children, but it is not always easy to identify the best approach to provide support, and many of these approaches will be expensive. In earlier work, my colleague Rod Nicolson and I developed and evaluated an approach based on screening plus a short-term small group intervention for one hour weekly, over a period of ten weeks for young children in the early years of school. This approach has now been taken up by the inclusion service led by Nichola Jones in Pembrokeshire, working with children in their first term in school. The intervention, Hands on Literacy, is available free to schools and was developed by teachers, based on structured multi-sensory teaching through games and activities covering language, memory, motor, visual and auditory skills, using concrete examples designed to build executive function. It includes a wide range of practical ideas for teachers to provide support for a range of individual differences, adaptable to suit their needs which has proved one of the most satisfying and enjoyable features. The approach has been used very successfully in Bridgend and Pembroke with over 1000 children taking part to date. Risk levels have been reduced from 24 per cent risk to 8.5 per cent, although those with the most severe risk will continue to need further support. Interestingly, 48 out of 54 schools in the Vale of Glamorgan used this approach and 100 per cent of their children moved into Year 1 no longer at risk for failure. 

Looking for strengths

The opportunity to benefit from screening and assessment is not just for the youngest children starting school. There are many children in school struggling to keep pace with their peers whose performance is well below that predicted by their ability. Unfortunately, this can mean that both teachers and parents assume that the child is lazy and even the child themselves may attribute their difficulties to their own stupidity. The problem here is that a child with low self-esteem will struggle to achieve their potential and it becomes difficult to maintain your motivation to succeed in the face of constant failure or mediocre performance. An understanding that these difficulties are not the fault of the child, the system or the teacher has an empowering effect for all concerned. It is therefore particularly important that we try to measure not just the weaknesses, but also the strengths of dyslexia. For a child whose parents suffer from dyslexia, there may be positive role models, in the form of a parent who has succeeded despite the odds, but for others the identification of successful dyslexics in the media can provide a stimulus to greater effort; it should become clear to everyone involved that if you are dyslexic, you need to try harder to achieve the same level as your peers. 

The SEN and Disabilities Code of Practice replaced School Action and School Action+ in 2014, and places a responsibility on both the school and the parents to work together for the whole child, emphasising the importance of the parents more clearly than ever before. A key element is a process of continuous assessment and planning to ensure the best outcomes for the child. This is a graduated process and may include the development of a passport for the individual child reflecting their needs and aspirations. It is not yet clear how well this system will work, particularly in a climate of austerity and limitations in funding that is currently experienced, and moves to promote academies that take control of the school policies away from the local education authority. There is a very real danger that an overemphasis on results, without considering issues of value added, may lead to reluctance to take children with special needs because their results could impact on overall standards.  

Keeping it going

In this environment of change, it is particularly important that we do not lose sight of the potential victims here, and that children with dyslexia are given every opportunity to shine. Identifying dyslexia through screening and assessment has a key role to play here, if we are not to lose the strengths of a group with so much positive potential to contribute to the world. We must remember that research indicates that dyslexia is a real condition, based on a difference in processing that impacts throughout life. We must ensure that the work of charities and research groups continues to be supported for the research evidence it brings on the continued need for differentiation and awareness, and the importance of ongoing teacher training on dyslexia and other special needs.

Further information

Emeritus Professor Angela Fawcett of Swansea University is a leading international researcher into dyslexia and other developmental disabilities. She is the author with Professor Rod Nicolson of eight screening tests for dyslexia, all published by Pearson Education and translated into many languages. She has contributed three of the major theories of dyslexia, one authored book and seven edited books, in addition to over 60 publications in international peer-reviewed journals and 40 contributions to edited works. Angela is Vice President of the British Dyslexia Association:
www.bdadyslexia.org.uk

Dyslexia Awareness Week 2016

3 to 9 October 2016
Dyslexia Awareness Week is a combined initiative of the charities the British Dyslexia Association, Dyslexia Scotland, Helen Arkell, Xtraordinary People and Dyslexia Action.

The theme of this year’s Dyslexia Awareness Week is “identification of dyslexia”.

Getting assessed and actually knowing if you are or might be dyslexic is a huge issue at any stage of an individual’s personal dyslexic journey. Given the fact that dyslexia is a hidden disability and believed to be the most common learning difficulty, the charities are planning to deliver a powerful message that will prompt people to think and consider if they themselves, or those close to them, could be dyslexic.

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