Adult Dyslexia test: How testing is done

Learning disorders like Dyslexia are more common than you think. Out of all the people with learning disorders, estimates suggest that 70 to 80% have some form of dyslexia. In total, between 5-10% of the population has dyslexia, but this number can also be as high as 17%.

According to Dystech Australia, around 1 in 10 Australians have a learning disorder. 8 in 10 individuals with a learning disorder have dyslexia. This is around two million people. However, the problem with these statistics is that they are just estimates. It is very likely that the actual number is much higher.

We are not completely sure. At least for now, the exact cause of dyslexia is not known. However, we know that dyslexia is not a result of low intelligence or seeing words backwards. These are just common misconceptions about the disorder that is not true at all. The problem with these misconceptions is that they can be damaging to individuals with the condition. For instance, many kids with undiagnosed dyslexia can grow up thinking that they are not as intelligent as others.

Experts believe that dyslexia is a result of complex gene-environment interactions and brain problems. There are around six know types of dyslexia at the moment. Out of them, the most common type runs in families. To illustrate, if you have the disorder, there is around a 50% chance that you may pass it on to your children. This means that we can identify the genes involved, right? Well, not really. There have been quite a few studies that have pinpointed certain gene sequences that may be causing dyslexia, yet, finding the exact genes involved and how they are activated is extremely difficult.

Moreover, there is of dyslexia can develop due to stroke, traumatic brain injury, and dementia.

There are three main types of dyslexia,

• Primary dyslexia: the most common form of dyslexia. Experts believe that it stems from problems in the left side of the brain (Cerebral cortex), however, the exact cause is unknown. The severity of the disorder is unique to the patient. Most can go on to become academically successful if they are given proper educational support, but there are others who constantly struggle with reading, writing, and speaking throughout their lives. This form of dyslexia is genetic and is more common in boys than in girls.
• Secondary or developmental dyslexia: a type of dyslexia that is a result of problems in brain development during the early stages of fetal development. Developmental dyslexia symptoms reduce over time.
• Trauma dyslexia: is caused by an injury or trauma to parts of the brain associated with reading and writing.

Other forms of dyslexia include,

• Visual dyslexia: a name that is sometimes used to refer to visual processing disorders. It is a condition that affects the brain’s ability to process visual signals.
• Auditory dyslexia: another term for auditory processing disorders. Similar to visual processing disorders, these disorders affect the brain’s ability to process sound and speech.
• Dysgraphia: a condition that affects a person’s ability to use and control a pen or pencil.

Symptoms and severity can change a lot depending on age and stage of development. In fact, symptoms can differ from one person to the other as well. For each person with the condition, there is a unique pattern of strengths and weaknesses. This makes the process of identifying someone with the disorder a little complicated. However. Experts have managed to pinpoint a series of common symptoms that appear before school, during school, and in adults and teens.

Before school

• Late speech.
• Talking a lot of time to learn new words.
• Talking a lot of time to learn new words.
• Having trouble remembering sequences (eg: the alphabet).
• Having a hard time learning nursery rhymes or song lyrics that rhyme.
• Mispronouncing words.

During school

• Reading abilities being much lower than average.
• Problems in processing and understanding information.
• Difficulty finding the right words or forming answers to questions.
• Trouble remembering sequences.
• Spelling difficulties.
• Avoiding activities such as reading.
• Spending a lot of time completing activities like reading or writing.
• Frequently making the same mistakes in spelling.
• Trouble recognizing common words.

Teens and adults

• Difficulty reading.
• Taking a long time to read or write.
• Difficulty in doing any math-related tasks.
• Trouble memorizing.
• Trouble learning a new language.
• Often mispronouncing words and names.
• Difficulties in understanding jokes, idioms, or puns.
• Struggling to remember common abbreviations.

ADHD (attention deficit hyperactivity disorder) and dyslexia are completely two different disorders. However, they surprisingly overlap quite a lot. About 1 in 3 people with dyslexia also have ADHD. And people with ADHD are six times more likely to develop a mental disorder or learning disorder such as dyslexia.

The two conditions have a few common symptoms as well. For instance, both can have an effect on a person’s ability to read and understand what they are reading. Nevertheless, it is important to understand that despite the similarities in symptoms, both disorders are diagnosed and treated separately. Therefore, it’s important to understand each one separately. If you want to find out more about adult ADHD and treatment, read this article by us.

Children usually learn to read in kindergarten or first grade. Did you have trouble learning to read at that age? or was your reading performance below average? Do you show any of the symptoms mentioned above? If you answered yes to these questions, you might have undiagnosed dyslexia. It’s best if you could reach out to a medical health professional and speak to them about it. Your first step must be to speak to your general practitioner, who will then refer you to a medical professional trained in treating and diagnosing dyslexia. This would most likely be a licensed psychologist, psychiatrist, or neurologist.

Learning disorders like dyslexia are only diagnosed after formal education starts. Beyond that point, health professionals use 4 diagnostic indicators to find out if you actually have dyslexia or not.

On the first day of meeting your mental health professional, they will most likely interview you to gather information about you. For instance, they may ask questions about your lifestyle or work life, relationships, and symptoms. Furthermore, they may also check your medical and family history. This is done to determine if you have any medical conditions which can be causing symptoms similar to dyslexia or if there is a history of dyslexia in your family. Like we mentioned above, genetics are a risk factor for the disorder.

Moving on, if the medical professional suspects that you have the disorder, they will put you through a series of tests. The purpose of this procedure is to identify specific areas of weakness associated with reading, and language processing, which is an excellent predictor of dyslexia. To do this, dyslexia tests usually measure four areas associated with reading and language processing.

• Phonological awareness: refers to the skill of identifying and controlling units of oral language such as words, syllables, and rhymes.
• Decoding: The skill of sounding out words.
• Reading fluency and understanding.
• Rapid naming: the ability to name letters, symbols, words, or objects quickly and automatically.

Phonological awareness is a foundation in reading skills. Therefore, trouble with phonological awareness is a good indicator of dyslexia. When taking one of these tests, your clinician would ask you to blend sounds and segment words. For example, you may be asked to say what’s left of the word cat if one sound is taken out or fill in the middle sound for certain words.

When testing children, the words given are simple. For an adult, the words used are most likely difficult with more syllables. Examples of phonological awareness tests are the Phonological awareness test (PAT-2:NU) and the Wechsler Individual Achievement Test (WIAT).

The Phonological awareness test (PAT-2:NU)

PAT-2:NU is specifically designed to measure a person’s ability to isolate and work with sounds. The test about 40 to 50 minutes long and includes eight sub-tests that measure eight different skills of speech and reading:

• Rhyming: picking out rhyming pairs and coming up with rhyming words.
• Segmentation: identifying the individual sounds (phonemes) in a word.
• Isolation: recognizing sound position in words.
• Deletion: manipulation of root words, syllables, and phonemes in words.
• Substitution and manipulatives: isolating a phoneme in a word, then changing it to another phoneme to form a new word.
• Blending: blending units of sound to form new words.
• Phoneme-Grapheme Correspondence: a person’s ability to associate the phonemes they hear with the graphemes (letters and letter combinations) they see.
• Phonemic Decoding: pronouncing and reading written or printed words correctly.

The Wechsler Individual Achievement Test (WIAT)

WIAT accesses academic achievement and skills of children, adolescents, college students, and adults between the ages of 4 and 85. The full version of the test has four scales, including reading, math, writing, and oral language. Within the four scales, there are nine more sub-tests. To illustrate, the Reading scale has word reading, reading comprehension, and Phonetic decoding. The math scale has numerical operations and math reasoning. The writing scale has spelling and written expressions. Lastly, the oral language scale has listening comprehension and oral expression.

Aside from being a dyslexia testing tool, WIAT is also useful in planning treatment/aid interventions for people with the disorder. Simply put, clinicians can use to recognize any academic areas in a patient’s life where they need support.

Decoding tests are designed to assess your ability to decode words quickly and accurately, along with the ability to recognize familiar words. Let’s look at how they are done. Your clinician would make you read single real words and fake words out aloud. Fake words look like real ones but have no meaning. For example, “Horridge” and “minulle”. The clinician will then assess the accuracy in pronunciation of the words, reading fluency, and the ability to decode the fake words. A famous example of a decoding test is the Test of Word Reading Efficiency-2 (TOWER-2).

Test of Word Reading Efficiency-2 (TOWER-2)

TOWER-2 is used by clinicians to measure the ability to pronounce printed words accurately and fluently in both adults and children (6 to 24 years). The test has a high efficiency rate and only takes around 5 to 10 minutes to finish. Furthermore, it is divided into two subtests: The Sight Word Efficiency (SWE) subtest and the Phonemic Decoding Efficiency (PDE) subtest.

SWE measures the number of real words printed on vertical lists that a patient can identify within 45 seconds of time. PDE, on the other hand, measures the number of pronounceable fake words that a patient can decode within 45 seconds.

The main point of assessment in these tests is your ability to accurately and fluently read a paragraph while also understanding what you read at the same time. To do this, the clinician would first make you read a few paragraphs out loud and ask multiple-choice or open-ended questions about them. In some tests, you will be allowed to refer back to the text, and in some, you won’t. The most widely used test for reading fluency and understanding is probably the Gray Oral Reading Test (GORT-5).

Gray Oral Reading Test (GORT-5)

GORT-5 takes around 20-30 minutes to complete, and it is used to access both adults and children. The test consists of two forms, each containing 16 reading passages in developmental order. Each passage also has 5 comprehension questions underneath it. Patients are scored based on their time taken to read a passage aloud, the number of words pronounced correctly, and the number of questions answered correctly.

Rapid naming tests measure how fast and easy it is for a patient to name common letters, numbers, objects, and colours on a page. This skill has a link to reading fluency, something that dyslexia patients lack. Consequently, it affects their ability to read, write and speak.

To start a rapid naming test, the clinician would show you a series of cards containing various items such as letters, numbers, colours, and pictures of common objects. You are then asked to name these cards as quickly as possible, starting at the top left and going row by row. The clinician will record the time taken for you to finish and access you based on it.

Mental health experts carry out a series of other tests aside from the ones that directly access a child’s ability to read, write and process language. The purpose behind these tests is to determine suitable learning interventions for the patients. Therefore, they access whether a patient learns best by hearing information, looking at information, or performing doing a task.

Until recently, IQ tests were used as a standard test for dyslexia. The diagnosis was based on finding large differences between IQ and reading level. However, this practice is no longer in use. With progress in research, experts now know that intelligence is not a good predictor of how easily a person learns reading and writing.

You won’t get a diagnosis right away. Instead, it would most likely take a bit of time. Your clinician will have to access all the reports and the scores of the tests. They may even choose to interview someone in your family, a co-worker, friend, spouse, or someone you have a close relationship with, to further dig deep into your condition. Nonetheless, this is often only done with written consent from both parties involved.

Then comes the treatment part. Your clinician will discuss a treatment and support plan with you. Let’s explore the types of treatment that will be available to you.

At the moment, there is no way to treat the brain abnormality that causes dyslexia. Similarly, there are no drugs that can successfully counter the disorder as well. Therefore, Dyslexia is a lifelong condition. However, support interventions can still help patients reduce and cope with symptoms, which will, in turn, help them live a much productive life. These interventions are designed to identify and facilitate reading, writing, and other skills that are affected by dyslexia.

Educational interventions

These interventions are aimed at children who are still in school. However, they can still help adults who are in university or following any educational program. Here educators who are trained in working with people with dyslexia use a wide range of techniques involving hearing, vision, and touch to improve reading skills.

The main focus of these interventions is to help patients,

• Learn to recognize phonemes that form words.
• Understand that letters and series of letters represent these sounds and words (phonics).
• Understand what they are reading.
• Read aloud to form reading accuracy, seep, and fluency.
• Build a vocabulary.

Tutoring sessions

For some patients with severe dyslexia, tutoring sessions with a reading specialist can be very helpful.

Individualized Education Programs (IEP)

IEP’s are special education plans that provide dyslexia patients with special instruction, support, and services they need to make progress and thrive in educational environments. As the name suggests, they are very individualized and unique to each patient, depending on their strengths and weaknesses.

Occupational therapy

Certain occupational therapy approaches are often useful in the treatment of dyslexia. They can support patients in their normal day-to-day lives and in their careers. For instance,

• Multisensory approach: Making patients use a lot of different senses including seeing, listening, doing, and speaking to learn.
• Visual prompts: Providing patients with visual prompts for both instructions and organization.
• Visually sequencing tasks: Using visual cues.
• Visual strategies: Using visuals such as colour-coded paper to assist patients with reading and spelling.
• Visual modeling rather than just using verbal instructions.
• Letter formation practice: Helping patients build muscle memory on letter formation through practice.

Speech therapy

Much like occupation therapy, speech therapy can also help patients cope with the condition better. Speech therapists teach or develop on patient’s language skills such as phonological awareness, oral language skills, letter/sound identification, and spelling out words.

Alternative techniques for coping with dyslexia

• Requesting special accommodation at your university or workplace.
• Requesting for instructions to be spoken instead of written.
• Getting additional training in subjects or tasks that make you feel uncomfortable.
• Recording meetings or information, or asking someone else to do it for you so that you could listen to it again later and catch up on any missed information.
• Using a speech-to-text software or app to make it easier to write.

If you are reading this for a loved one or someone you know who has dyslexia, there are some important things that you should know. Most patients with the disorder sometimes have low self-esteem. Simply put, they can be a little hard on themselves. Therefore, they need constant emotional support from the people around them. Don’t treat them any differently or make them feel isolated, instead acknowledge and congratulate their effort and hard work even if there are any mistakes in it.

Furthermore, you can also help them recognize their strengths. This is important because most dyslexia patients have a lot of strengths. Research has also indicated that building on strengths is an effective treatment intervention. For instance, two researchers from the Drexel University who conducted studies on the subject found out that identifying strengths led to patients having higher self-efficacy and more positive teacher-student interactions. Here, Self-efficacy is a person’s belief in their ability to succeed in various situations.

Having dyslexia is not a lifetime of suffering. With proper treatment and help from others, you can successfully manage your symptoms. However, the way you do and learn things would be a little different from other people. You need to come to terms with that.

That being said, if you want to get an adult dyslexia test or treatment, reach out to us. At Epsychiatry, , we have a team of amazing psychologists and psychiatrists who can guide you through every bit of the process.