What Else Can Look Like Dyslexia
Is It Dyslexia Or Something Else?
Dyslexia is one cause of reading difficulty, not the only one. If you are asking whether it is dyslexia or something else, the other causes are a language disorder, a history of unclear speech, a vision or hearing problem, attention difficulties, handwriting or coordination difficulties and gaps in teaching. Some children have more than one.
How To Tell Them Apart
The way to tell is to look at which part of reading breaks down. Reading has two parts: working out the words on the page (decoding) and understanding what they mean. Dyslexia is a difficulty with the first part. A child with dyslexia struggles to sound out words and to spell them, yet usually follows the same story easily when someone reads it aloud.
When the trouble is somewhere else, the pattern is different. The table shows the four patterns a speech pathologist looks for. The causes that someone else checks are set out further down.
| What you notice | What it can point to | Who looks at it |
|---|---|---|
| Cannot sound out new words and spells by guessing, but understands a story read aloud | Dyslexia | A reading and spelling assessment. A formal diagnosis is usually made by a psychologist |
| Reads the words fairly accurately but cannot say what the passage meant, even after hearing it read aloud | A language disorder | A speech pathologist |
| Struggles to sound out words and also struggles to follow spoken stories and instructions | Dyslexia and a language disorder together | An assessment that covers language and literacy |
| Was hard to understand as a preschooler, and spelling follows the way the child says the word | A history of speech sound difficulties | A speech pathologist |
Dyslexia Or A Language Disorder?
Dyslexia is a difficulty reading the words. A language disorder is a difficulty understanding and using language itself, spoken as well as written. Both lead to poor results on a school reading test, which is why one is so often taken for the other.
Developmental language disorder is common. A population study of children starting school found about two children in every class of 30 had a language disorder that held back their learning. It is also easy to miss, because a child can chat happily and still not follow longer or more complex language.
A rough check at home, which is not a test: read a page of your child’s school book aloud to them and ask what happened. Then ask them to read the next page themselves.
- If they understand well when you read but stumble over the words when they read, the difficulty is with decoding. That is the pattern of dyslexia.
- If they can read most of the words but cannot tell you what happened, and listening did not help much either, the difficulty is with language.
- If both are hard, both may be involved.
Other signs that language is part of the picture:
- They were late to talk, or spoke in short sentences for longer than other children
- They lose track of instructions with more than one step
- Their sentences have grammar errors that children their age have left behind
- They retell a story out of order or leave out who did what
- They often cannot find the word they want
When It Is Both
A child can have dyslexia and a language disorder. Research that followed children from the first year of school found dyslexia and developmental language disorder are separate conditions that can occur in the same child. A study of eight-year-olds found that children with dyslexia alone had mild difficulty understanding what they read, children with a language disorder alone had marked difficulty, and children with both had the most.
It matters which one it is, because the help is different. Teaching a child to decode does not build vocabulary and sentence understanding, and language work does not teach decoding. Dr Lauren Crumlish assesses both. Her Long Assessment ($1,290) looks at language and literacy together, for a child who also finds spoken language hard.
Can Early Speech Difficulties Be Behind A Reading Problem?
Early speech sound difficulties can contribute to a reading problem, but on their own the effect is small. Speaking and spelling draw on the same store of speech sounds. A child who was hard to understand at three or four can find it harder to hear the separate sounds in a word, and early reading and spelling are built on that skill.
A study that followed children with early speech sound difficulties found a small added risk of weak spelling at five and a half and weak word reading at eight. The risk was greater in three situations:
- The speech difficulties were still there when the child started school
- The child’s understanding or use of language was also affected
- Dyslexia ran in the family
What it can look like: spelling that follows the child’s own pronunciation, such as “fing” for “thing”, and trouble with rhyme or with breaking a word into sounds.
How it differs from dyslexia: a child whose speech has cleared by the time they start school, and who has no other risk, mostly learns to read as other children do. When reading and spelling stay stuck after speech has cleared and the teaching has been sound, dyslexia becomes more likely. A child can have both.
Dr Lauren’s assessment looks at awareness of the sounds in words, spoken language, reading and spelling together, the skills an early speech difficulty can affect, so a speech history can be weighed beside reading. The full list is in what a dyslexia assessment looks at.
What Dr Lauren’s Assessment Can And Cannot Tell You
Dr Lauren Crumlish (PhD), Certified Practising Speech Pathologist, assesses reading, spelling and the language skills underneath, online, for school-aged children and teenagers. The assessment can show whether the difficulty is with decoding, with language or with a mix.
It does not test vision, hearing, attention, movement or autism, and Dr Lauren does not diagnose dyslexia. A formal diagnosis is usually made by a psychologist, so a family who needs one will also need a psychologist’s assessment. The guide to who can diagnose dyslexia in Australia sets out who does what.
Who Checks What
Other Causes, And Who Checks Each One
Rule out vision and hearing first. For the rest, the person to see depends on what else you notice.
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Vision
Looks like dyslexia: slow reading, losing the place, tired or sore eyes and avoiding books.
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How it differs: the trouble is seeing the print clearly, so it shows up with all close work. Children with dyslexia have the same eyesight and eye health as other children.
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Who checks it: an optometrist. An eye test shows whether your child sees the page clearly. It cannot show or rule out dyslexia.
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Hearing And Auditory Processing
Looks like dyslexia: mixing up similar sounds, weak spelling and not following spoken instructions.
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How it differs: the child mishears, most of all in a noisy room, so the difficulty goes well beyond print.
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Who checks it: a GP or audiologist for hearing, and an audiologist for auditory processing.
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Attention
Looks like dyslexia: skipped lines and words, careless errors, unfinished work and avoiding reading.
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How it differs: the child can sound out a word when their attention is on it, and the difficulty usually shows up across subjects, not only in reading.
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Who checks it: a paediatrician, child psychiatrist or psychologist.
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Movement And Handwriting
Looks like dyslexia: messy, slow written work with little on the page.
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How it differs: the difficulty is forming the letters, not choosing them. Spelling aloud and reading may be fine.
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Who checks it: an occupational therapist.
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Autism
Looks like dyslexia: reading comprehension well below what the child’s reading aloud suggests.
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How it differs: word reading is often accurate. Social communication differs in everyday life, not only in reading.
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Who checks it: a psychologist or psychiatrist, often with a paediatrician. This is also the pattern of a language disorder, so a speech pathologist’s language assessment helps too.
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A Child Who Is Behind
Looks like dyslexia: reading and spelling below the rest of the class.
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How it differs: there is a reason, such as missed school, a change of schools or learning English as an additional language, and the child catches up with good teaching.
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Who checks it: the classroom teacher first. Dyslexia is considered when the difficulty lasts despite at least six months of extra teaching.
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Read Next
The Full Guides And Your Next Step
Two of these causes have a guide of their own. If the signs still point to reading and spelling, the screener and the assessment are the next steps.
Who does the assessment
Dr Lauren Crumlish (PhD), Certified Practising Speech Pathologist
Dr Lauren Crumlish assesses reading, spelling and the language skills underneath, online, for school-aged children and teenagers across Australia. She holds a PhD from The University of Queensland and does every assessment herself.
$890 or $1,290, online, with Dr Lauren Crumlish
About Dr Lauren
Questions
Questions About What Else It Could Be
What is commonly misdiagnosed as dyslexia?
Conditions that can be taken for dyslexia include a language disorder, a history of speech sound difficulties, attention difficulties such as ADHD, an unnoticed vision or hearing problem, handwriting difficulties and gaps in teaching. Each one lowers reading results for a different reason. Dyslexia is specifically a difficulty sounding out and spelling words that lasts despite good teaching.
Is my child a late reader, or is it dyslexia?
A late reader catches up once they get good, direct teaching in sounds and letters. With dyslexia the difficulty lasts. In Australia a diagnosis looks at how a child has responded to at least six months of targeted teaching. The question is less how far behind they are today and more whether extra help is closing the gap.
Can dyslexia be misdiagnosed?
Yes, in both directions. A reading difficulty with another cause can be called dyslexia, and dyslexia can be put down to poor attention or immaturity. A dyslexia misdiagnosis is less likely when vision and hearing are checked first, when the assessment looks at spoken language as well as reading, and when the child’s response to teaching is taken into account.
Should my child have an eye test before a dyslexia assessment?
Yes. Have vision and hearing checked first, so a problem seeing the page or hearing the teacher is not missed. An eye test cannot diagnose dyslexia, and dyslexia is not caused by eyesight.
Is auditory processing disorder the same as dyslexia?
No. Auditory processing disorder is a difficulty with how the brain handles sound and is diagnosed by an audiologist. Dyslexia is a difficulty reading and spelling words. The two can look alike in a classroom because both affect listening to sounds in words.
Can Dr Lauren tell me whether it is dyslexia?
Dr Lauren assesses reading, spelling and the language skills underneath, and tells you what she found and which difficulty it points to. She does not diagnose dyslexia. A formal diagnosis is usually made by a psychologist.
What does an assessment with Dr Lauren cost?
The assessment is $890 or $1,290, online, with Dr Lauren Crumlish. She recommends the level once she understands the concerns.
Dyslexia Assessment With Dr Lauren
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Dr Lauren works with a small number of families and has limited availability. Our team will review your application. A place cannot be guaranteed, and not every application receives an individual reply.
Apply Now- Online, Australia Wide
- Reading, Spelling And Language
- Children And Teenagers Up To 18
- $890 Or $1,290