Written by Karen Hovav, MD, FAAP | Analysis by Katie E. Golden, MD
Published on February 27, 2024
Key takeaways:
Early signs of dyslexia can be seen before kindergarten. Some examples include trouble remembering nursery songs, trouble naming things, and speech delay.
Testing for dyslexia can involve screening children as young as age 4 to see if they are high-risk. Diagnostic testing for dyslexia is more involved and is done after they have started formal schooling.
Early intervention for dyslexia is most effective when it’s started during kindergarten or first grade.
Table of contents
Definition
Diagnosis age
Signs in preschool
Signs in elementary school
Other learning disabilities
Dyslexia test
Early intervention
Bottom line
References
jacoblund/iStock via Getty Images Plus
There’s a good chance that either you or someone you know has dyslexia. Dyslexia is the most common learning disability, affecting somewhere between 5% and 15% of people. But for such a common condition, there are still a lot of myths surrounding what it means to have dyslexia. And many people don’t realize that early signs of dyslexia can show up even before a child starts to read. But you need to know what to look for.
Here, we’ll discuss how to spot early dyslexia symptoms, what you should know about testing, and early intervention.
What is dyslexia?
Dyslexia is a learning disability that makes it hard to read and write. But there’s more to it than that. People with dyslexia have a neurological difference that makes their brain process language differently. Dyslexia involves problems with:
The ability to recognize and manipulate speech sounds. This also involves the ability to hear individual sounds (like hearing the “b,” “a,” and “t” in the word “bat”).
Breaking down the components of words. This leads to trouble sounding out words, spelling, and recognizing words.
Even though dyslexia is considered a neurological condition, it does not affect intelligence. Many people with dyslexia are smart, creative, out-of-the-box thinkers who accomplish great things even though reading isn’t easy for them.
How early can dyslexia be diagnosed?
Children can be screened for dyslexia as early as 4 years of age. This involves simple questions to see if a child is at high risk for dyslexia or having learning problems with reading.
However, many experts say you can only diagnose dyslexia after the start of formal schooling, around 6 or 7 years of age. Diagnosis is a more detailed, time-consuming, and expensive type of testing. It is for children who have been identified as high-risk through screening or who have been struggling with reading.
Some people think that a child can’t be screened or diagnosed with dyslexia until they fall behind their peers. This isn’t recommended though. It can mean a child struggles to read for years and then suffers from poor self-esteem, anxiety, and depression, as well as having to catch up to grade-level later.
Early signs of dyslexia in preschool-aged kids
Early signs of dyslexia are often called pre-literacy signs. This means they happen before a child starts reading. They can be different for each child. But the following dyslexia symptoms can be seen before kindergarten:
Trouble remembering nursery songs: Mixing up words, being unable to remember a song despite repetition, or having trouble with the rhythm
Difficulty naming objects or symbols: Identifying colors, shapes, numbers, or letters
Trouble rhyming: Hearing and creating rhyming words, such as if your 5 year old doesn’t hear the rhyme in “fat” and “bat”
No interest in letters or words: Likes listening to stories but not naming letters or looking at words, including trouble identifying the letters in their name
Speech problems: Any speech difficulties, including starting to speak later than most children; also, a great vocabulary but trouble pronouncing words clearly
Family history of learning disability or trouble in school: Having a parent with dyslexia means a 40% to 60% chance of having dyslexia
Early signs of dyslexia in kindergarten to second grade
When children enter elementary school, symptoms of dyslexia can show up differently as they start learning to read. Some signs of dyslexia that might show up in early elementary school (kindergarten to second grade) include:
Persistent trouble remembering sounds of letters or sounding out simple words
Trouble with short words that can’t be sounded out (“the,” “of,” and “said”)
Problems with understanding a story if they read it, but good comprehension if someone else reads them the story
Difficulty learning spelling rules
Avoids reading, disappears when it’s time to read, or refuses to engage in games that involve letters or words
Uses vague words to describe objects because of their trouble with RAN; might say something like, “I left my thing with the stuff in that place”
Trouble with sequencing; difficulty remembering days of the week, months of the years, or even their birthday
Handwriting that is very difficult to read
Mood problems; kids with dyslexia have higher rates of anxiety and depression, and mental health issues can lead to more problems concentrating
Other learning disabilities that can look like dyslexia
Dyslexia can be tricky to diagnose because the symptoms overlap with other conditions. And many kids with dyslexia may also have these other conditions as well. So, your child could also have symptoms of:
Dyscalculia: This is a learning disability that makes it hard to remember number-related concepts, which creates trouble learning math.
Dysgraphia: This can cause problems with handwriting and spelling. Many children with dyslexia have handwriting that is very hard to read because they also have dysgraphia.
Dyspraxia: This is trouble performing coordinated movements. This can affect gross motor function (like doing cartwheels) or fine motor function (like tying shoelaces).
ADHD: About 30% of kids with dyslexia have ADHD, and about 25% of kids with ADHD may also have dyslexia.
How do you test for dyslexia?
You can test for dyslexia using a screening test or a diagnosis test.
Screening tests
Screening tests are much more simple and easier to do. Over 40 states in the U.S. have laws requiring schools to screen for dyslexia between kindergarten and 2nd grade. But there isn’t one screening test that is officially recognized as the best screening test to use for dyslexia.
Some commonly used screening tools that are available to the public include:
Learning Ally: a not-for-profit organization that has a free online screening tool
Lexercise: an online education platform with a free dyslexia screen
Reading Horizons: an organization for educators that also provides a free online screening test
A screening test can diagnose a child as being at high-risk for dyslexia, which means they should start a reading program that is helpful for kids with dyslexia. Not everyone who has a positive screen will end up being diagnosed with dyslexia. But even if a child does not have dyslexia, they will benefit from more specialized educational help.
Diagnostic testing
The other way to test for dyslexia is called diagnostic testing. This is a more time-consuming and detailed type of testing. The common types of tests are:
Psychoeducational testing: This involves testing a child’s academic abilities and IQ to understand how they learn best.
Neuropsychological testing: This is a more comprehensive test. In addition to intelligence, it tests other types of brain functioning. These include things like attention, memory, sensory skills, and mood disorders like anxiety or depression.
To have a diagnostic test, your child will need to be evaluated by a trained specialist. These specialists can be school psychologists, clinical psychologists, neuropsychologists, or developmental pediatricians.
Some speech and language pathologists are trained in doing a more targeted diagnostic test to diagnose dyslexia. Other speech and language pathologists will not diagnose the condition, but they may identify a child as high-risk and recommend further testing.
Costs and next steps
Diagnostic testing can be expensive, and isn’t always covered by insurance. You can also request an evaluation through the public school system if your child is struggling with reading or writing. Under federal law, you have a legal right to request that your public school evaluate your child for special education services. These tests will not specifically diagnose dyslexia. Instead, they may identify a child as having a “specific learning disorder” in reading or writing. If they do, your child will qualify for early intervention services, which are the same as those for dyslexia.
If you are concerned about a possible learning disability like dyslexia, you should reach out to your child’s healthcare provider, and to your school, to learn about the best way to get tested in your community.
What do early interventions for dyslexia look like?
Children with dyslexia will have different strengths and weaknesses. They won’t all need the same thing. But early intervention can help a child become a skilled, confident reader.
Early interventions for dyslexia in school
Many different types of reading programs have been shown to be most effective for kids with dyslexia. A child who is starting kindergarten or in elementary school usually needs:
Intensive reading instruction with a program shown to be helpful for children with dyslexia
One-on-one teaching with a tutor or educational therapist who has experience working with children with reading difficulties
Extra time on tests
Modifications in the classroom that will help a child learn better — like sitting in front of the class or having a sheet with the alphabet written to help identify letters
Early intervention for dyslexia at home
Early intervention for children at home involves exercises that help them hear the different sounds in language. As a parent, you can help them become more aware of the sounds in words, so that they can start to break down words. Here are some good exercises to do with children who are high-risk for dyslexia:
Sing nursery rhymes together and practice songs until they remember them.
Read books with rhymes or play games that involve rhyming words.
Sound out words and ask them if they can put it together. For example, say “c,” “a,” and “t,” and have them repeat after you. See if they can add the sounds together to say “cat.”
Play games that involve recognizing the first sound in a word. For example, say, “Guess what I’m thinking of, it starts with a ‘T’.”
Play rhythm games by having them copy the rhythm you make with clapping.
Use clay or pipe-cleaners to shape out letters and numbers.
Sing songs that involve days of the week and months of the year.
Also, it’s important to focus on your child’s special talents or skills. They can be very creative, gifted builders, or all-star athletes. Help them find ways to shine in non-academic ways — and praise who they are as separate from their academic skills.
The bottom line
Signs of dyslexia can show up well before a child starts learning to read. Early screening and testing for dyslexia can help make sure that the interventions are most effective. They also help lower the chances that a child will have anxiety or depression from their learning disability. There are many interventions that can help your child at school and at home. And it’s important to remember that dyslexia also comes with special talents that should be nurtured and appreciated.
References
Balsiger, L. E., et al. (n.d.). The importance of early intervention for reading problems. Internet Special Education Resources.
Czamara, D., et al. (2013). Children with ADHD symptoms have a higher risk for reading, spelling and math difficulties in the GINIplus and LISAplus cohort studies. PloS One.
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