It may sound obvious, but it is important for school psychologists (SP) and speech language pathologists (SLP) to work together in the diagnosis of dyslexia, since they are both integral examiners in the process. Increased communication, note comparison and multiple perspectives are important components of the dyslexia diagnostic journey including evaluation, diagnosis and intervention.

Promoting collaboration is imperative to prevent over testing and to paint a complete picture of a student’s profile, yet in my decades of work as a school psychologist, I have realized that this coordination isn’t consistent across school districts, with many districts reporting the following:

  • SLP’s, OT’s and SP’s conducting the same tests without knowing it, resulting in over testing
  • Multiple reports on the same issues without reading each other’s report
  • The expectation that parents and teachers are to consolidate the findings themselves
  • Reports are filled with numbers and not information that is easily digestible
  • Schools deliver multiple reports connected by a staple instead of one comprehensive report

I would argue that to be helpful, assessments should be based on multiple sources of information to obtain a comprehensive picture of the child's functioning as no single measure can provide sufficient information. Assessment data should reflect multiple perspectives and should include consultation with team members as we may be misinterpreting the data if we do assessments in isolation.

What do we know?

Not every student who struggles in school is disabled nor does every student who fails the state test due to learning problems has a specific learning disability. We should also not identify a learning disability for the convenience of adults.

Some students just aren’t taught correctly. Unfortunately, many people think there is a way to get students back to grade level immediately, but sometimes that's not necessarily going to happen, and teachers are often under pressure with mixed messages. For example, a fifth-grade teacher may have a student that's reading at a second-grade level, and so they're told “teach the kids where they're at and by the way, by the end of the year get them to fifth grade level."

Teachers are not necessarily sure of their next move and their training and knowledge hasn't really set them up to be as effective as they want to be - the professional development, support and background and what they get from administrators isn't necessarily in place, which is unfortunate. This cycle then leads to a higher rate of referrals for a child to be identified with a learning disability, but if they haven't been taught how to read, write, or math, then my evaluation is not going to be helpful to identify a learning disability, because they may be a weak reader, but it's not because of a neurological issue - it's because they haven't been taught correctly.

The disconnect

When we think about a student who is having difficulty in reading, and I mean really struggling, that child is suffering. Parents are seeing the suffering and it's awful. If a child was suffering with a medical issue and had four doctors, would any parent allow one doctor to do anything without conferring with the other three doctors? Generally, you want everyone's opinion. But for some reason in schools, we let it happen. The SLP could do their assessment, the school psychologist could do their assessment, the OT could do their assessment, all working with the same student from different lenses and not really collaborating and not being efficient. Our tests are invasive. If we establish a child has a bad working memory - how many times do I have to measure working memory before we all say he has bad working memory?

There is a specific conundrum I'm in as a school psychologist. If I realize a student really wasn't taught reading and I give them a normative reading measure, they're going to perform low, which makes sense but I'm going to misinterpret that if I just look at the number. It's really more of a result of ineffective curriculum which is why that student isn’t reading. And for me to identify that student with a learning disability, is misdiagnosing a student. This is why we need a full academic history of a child before any diagnosis. Practitioners need to start writing about the child rather than the tests.

Understanding the whole child

At the end of the day, if an SLP and SP work together collaboratively and don’t overlap the tests, they will save the student at least one hour of unnecessary assessment time. And if they use the Cross-Battery Assessment Software System (X-BASS), which allows school psychologists and other assessment professionals access to efficient, expert analysis of cross-battery assessment findings they'll be able to combine all the information from all the different measures to come up with new composites to better understand who that student is - the whole child.

About the author

Dr. Andrew Shanock has been teaching at The College of Saint Rose since 2005 and is the chair of the School Psychology/Educational Psychology Department. He specializes in cognitive and academic assessment. Previously, he was a practicing school psychologist within a variety of school settings. To learn more, you can find a webinar at the Riverside Insights website.