I’m not sure about other assessors, but whenever the outcome of one of my assessments is a “no” to dyslexia, I always feel a bit anxious about the potential reaction of the client. After all, the reason they can to me was because they thought their child was dyslexic.
It seems that when an individual is struggling with reading, writing or spelling, dyslexia is almost always the first explanation that comes to mind. It’s one of the most widely recognised learning differences, and for good reason – it affects a noteworthy number of people and has a clear, research-backed profile. But what happens when you go through the assessment process and the result comes back as not dyslexia? Assessors know it can feel confusing and often frustrating for those involved. After all, the difficulties are real. So, what’s going on?
The truth is that literacy challenges can arise from a wide range of causes…
Students in exam
Why a dyslexia assessment might say “No”
A dyslexia diagnosis is based on a specific pattern of strengths and weaknesses, identified using standardised tests, but it also takes into account other factors which are known to impact upon the development of fluent and accurate reading and spelling skills. An assessment report may conclude “no dyslexia” when:
- The person’s cognitive profile doesn’t align with dyslexia indicators – e.g. there is limited evidence of phonological difficulties, compromised orthographic skills, reduced working memory capacity and/or slow processing speed.
- The nature of the person’s literacy difficulties don’t match the dyslexic profile – e.g. the difficulties are not at word-level; they relate predominantly to handwriting; reading comprehension difficulties appear linked to wider language needs.
- Environmental or educational factors better explain the difficulties e.g. inattention; lack of good intervention; inconsistent engagement with support.
- The assessor considers there may be a more fitting explanation for the literacy difficulties – and further investigation is recommended.
- The person has made strong compensations - these can mask typical dyslexic markers.
So, a “no” doesn’t necessarily mean “nothing is wrong” or that the concerns are not valid. It simply means that dyslexia almost certainly isn’t the best ‘label’ for the assessment outcomes.
Literacy Difficulties That Aren’t Dyslexia
Here are some of the most common “non-dyslexic” reasons someone might struggle with reading, writing, or spelling (in no particular order!):
1. Gaps in Teaching and/or Interrupted Education
Not everyone has had consistent, high-quality literacy instruction. Factors like:
- lack of targeted support
- ineffective early phonics teaching
- inconsistent school attendance
- frequent school moves
…can all lead to literacy gaps that may look similar to dyslexia, but stem more from experience (i.e. the environment) rather than a specific learning difficulty. That is why assessors will look to establish what has been put into place to support an individual over time.
2. ADHD and attention-related difficulties
ADHD can significantly affect literacy skill development because:
- attention drifts during reading
- engagement may be inconsistent during class teaching and interventions
- working memory can become overloaded
- organisation of written work is difficult
- proofreading work and self-monitoring is a struggle
These challenges can almost mimic dyslexia, but arise more from attentional regulation, not phonological or orthographic processing, for example.
3. Speech, Language and Communication Needs (SLCN)
Language skills go hand in hand with literacy skills. So, if there are difficulties with the former, it is almost always the case that there will be difficulties with latter. Dyslexia assessors now have to assess language skills as part of an assessment in order to try and tease out the causes of reading and spelling difficulties, particularly in younger children.
An individual with SLCN may present with challenges relating to:
- expressive (use of) language – which impacts directly upon written literacy.
- receptive (understanding of) language – which can affect reading skill development at both word level and in terms of comprehension, because of reduced vocabulary knowledge.
To add to the potential confusion of the two, issues with phonological processing are associated with both language difficulties and dyslexia, and this is because phonology relates to the sound structure of a language.
Where language difficulties are considered to be contributing to literacy skill struggles, it is common for an assessor to suggest a referral to a Speech and Language Therapist in the first instance, so they are able to provide appropriate SLCN-related recommendations for support, which can be put into place alongside those for reading and spelling. Quite often, children with SLCN may be diagnosed with dyslexia when they are older; speech and language difficulties are a known risk factor for dyslexia, but early on, it is often difficult to distinguish between the two.
4. Visual disturbance/discomfort – often referred to as ‘visual stress’
This is not the same as dyslexia – and any Behavioural Optometrist that uses the term “visual dyslexia” is going against their professional body’s guidelines – but visual disturbance can cause:
- difficulty tracking text – which can result in skipped lines/words
- losing place when reading
- blurred text
Sometimes these issues are mistaken for dyslexia – and the media certainly seems to perpetuate this myth – and whilst they often coincide with dyslexia a) they occur in the general population and b) they may be indicative of other eye-health issues. As a consequence of the latter, these types of issues need exploring well before an assessment for dyslexia.
5. Developmental Coordination Disorder (DCD) – also known as Dyspraxia
DCD is a different specific learning difficulty which can affect coordination, motor-planning, balance, sensory-processing (for example). As a result, it can affect:
- handwriting execution (and the fine-motor skills/coordination required to draw tables, underline headings etc.)
- sequencing ideas and words within sentences
- planning written work
- working memory – which can impact upon reading comprehension etc.
This can make certain literacy tasks harder, even when reading and/or spelling skills are relatively strong.
6. English as an Additional Language (EAL)
Learning to read and write in a second language is complex. Challenges may include:
- remembering unfamiliar spelling patterns
- a limited knowledge of vocabulary – which impacts comprehension
- working with different grammar structures
- interference from the first language
These are language-acquisition issues, not dyslexia.
7. Anxiety, Stress or even Low Confidence
Emotional factors can have a surprisingly strong effect on literacy:
- fear of failure
- perfectionism
- test anxiety
- past negative school experiences
These can all have an impact upon cognitive capacity and make reading or writing feel overwhelming. This can then result in reduced engagement with learning opportunities, for example.
So, What Does a “No” Really Mean?
A dyslexia report that comes back as “no” doesn’t close a door – it tends to just open a different one. Literacy skill acquisition is complex. Human brains are perhaps even more complex!
If you or someone you support has received a “no dyslexia” result, it’s not the end of the story. In fact, it should hopefully be the beginning of a more accurate one – one that leads to the right tools, the right support, and a clearer understanding of what’s really going on!