By Cheryl Murphy, OD
Dyslexia is a learning disorder that affects one’s ability to perform reading, writing and spelling efficiently. It is inheritable and is present due to neurobiological differences in the wiring of the brain.
Sometimes it is incorrectly thought of by the public as a condition in which those affected only reverse letters1. However, that is only one of the many possible components of the disorder. People with dyslexia often have difficulty connecting sounds to letters, a process known as phonetic decoding. It can affect reading comprehension and the retention of vocabulary and other material. They may also experience issues with articulation and speech production. Once thorough testing is performed to help identify areas that need to be worked on, targeted coping strategies can help individuals manage dyslexia and perform at their best.
UNDERSTANDING DYSLEXIA
Some studies suggest that dyslexia affects approximately 5-10% of the population while others estimate those numbers could be as high as 15-20%.2,3,4 Legislation introduced this past December in New York state is aimed to allow more school age children to be properly evaluated for dyslexia so that interventional strategies tailored to the individual can be applied sooner rather than later. While there is no cure for dyslexia, assessment by a trained psychologist is key in identifying those who need help and in providing those individuals with customized recommendations and referrals to help ensure their long-term success in school and in their future careers.
Many of those affected by dyslexia go on to achieve amazing things in life. According to dyslexia.com, run by Davis International, examples of famous writers, actors and directors with dyslexia include F. Scott Fitzgerald, Agatha Christie, Stephen Spielberg, Jennifer Aniston, Orlando Bloom and Keanu Reeves. Innovative thinkers, scientists and businessmen with dyslexia include Thomas Edison, Albert Einstein, Henry Ford, Charles Schwab and Nelson Rockefeller. And some examples of artists, musicians and athletes with dyslexia are Cher, John Lennon, Andy Warhol, Ansel Adams, Pablo Picasso and Mohammed Ali.
WHAT REALLY IS DYSLEXIA?
The definition of dyslexia has been debated for over 100 years. However, the International Dyslexia Association (IDA) organized a Definition Consensus Project in 2002 and officially defined dyslexia as “a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.”
School screenings are vital in identifying children that may need help but testing shouldn’t stop there. Services available at SUNY College of Optometry can provide the further, in-depth diagnostic testing needed once dyslexia is suspected. Steven Larson, OD, an optometrist at SUNY College of Optometry who also holds a doctoral degree in Child/Clinical Psychology, works in SUNY’s Vision Rehabilitation Clinic. Being a psychologist, he is trained to perform the more in-depth neuropsychological evaluation on patients with suspected dyslexia. He receives not only internal referrals from other clinics at the college such as Pediatrics but also from schools and local optometrists in the New York city area.
“A neuropsychological evaluation typically consists of an initial intake meeting with me, two 4-hour testing sessions and a feedback conference in which I explain all of my findings, diagnoses and recommendations to the parents,” Dr. Larson says. “Based upon the neuropsychological testing, I diagnose and make referrals for other services that the child may need. Dyslexics often have [other coexisting] conditions such as mental health disorders, attention deficits, language and visual processing deficits, memory problems, fine and gross motor issues and I will refer the child [to the appropriate specialist] for these other services. The most important referral [I make] will be to an educator who is trained in working with dyslexic students.”
While Dr. Larson performs the thorough neuropsychological testing and gives his report and findings at its conclusion to the parents of children with suspected dyslexia, he himself is not trained in educational remediation. “I can treat the vision coordination problems the child may have, but not the dyslexia,” he says. For that, he refers the patient to educational professionals that he knows or to organizations in the New York area that offer the educational remediation services they need. “People obtain their master’s degrees in reading, or they get certified in one of the reading methods that have been developed to treat dyslexia, the most famous of which is the Orton Gillingham reading method. It takes two years of classes and supervised training to get that certification.” Once the testing has been completed and appropriate referrals and recommendations have been made, patients usually return to Dr. Larson for re-evaluations in three to four years.
ADVANTAGES OF THERAPY
One of the advantages of getting a neuropsychological evaluation performed at SUNY Optometry is “all of the children have to have an eye exam with an eye care professional before they are seen by our psychologists,” says Dr. Larson. “The optometrists in our pediatric clinic check for visual coordination problems during their exams [which are sometimes also present in those with dyslexia.] Additionally, I also always recommend that the kids have a vision therapy evaluation here at SUNY to further test the child’s visual coordination skills.”
Optometrists are not trained and licensed to test and diagnose learning disabilities like dyslexia but the optometry students at SUNY learn about dyslexia in their classes and help to screen for it through case histories while in clinic. Some even get to observe sessions of neuropsychological testing performed by psychologists like Dr. Larson at SUNY. The value of neuropsychological testing is immeasurable and more children with dyslexia may soon have access to it thanks to a new bill and task force in New York State.
A NEW ACTION ACT
On December 11th, 2024, Governor Hochul signed into law the Dyslexia Diagnosis Access Action Act (A.2898/S.5491.) This bill requires private health insurances to cover the neuropsychological exams. Previously, this testing was not covered by insurance and parents would have to self-pay for this more thorough testing. Additionally, schools have limited ability to assess this complex condition, despite offering screenings for dyslexia.
Senator Brad Hoylman-Sigal said: “Parents like me with a dyslexic child generally have to shell out anywhere between $5,000 and $10,000 or more for neuropsychological exams used to accurately diagnose dyslexia. No longer. Our first-in-the-nation law signed by Governor Hochul requires private health insurers to cover neuropsychological exams. As a result, more New York kids will get the professional help they need to learn to read and become successful students and productive citizens. I’m grateful to Governor Hochul and Majority Leader Stewart-Cousins for continuing to prioritize the well-being of our young people.”
According to his website, Assemblyman Robert C. Carroll, who introduced the bill, was passionate about it being signed into law as he himself was diagnosed with dyslexia as a child and received early interventions. While he says his family was fortunate enough to be able to self-pay for his neuropsychological assessment, he understands many families in New York may not be able to afford to do so. This bill is a step in the right direction in not only identifying children who are struggling but in carefully assessing their deficits in order to construct a targeted set of coping strategies that can help them succeed and not struggle.
In addition to the bill, Assemblyman Carroll along with Senator Brad Hoylman-Sigal established the New York State Dyslexia and Dysgraphia Task Force in 2023 which released its final report in December 2024 outlining fourteen recommendations for screening, interventions and educational support for students affected by dyslexia and dysgraphia in grades K-5. Among those recommendations was the calling for the creation of a Center for Dyslexia and Dysgraphia to be run by the New York State Department of Education or the Board of Regents through which guidelines for serving students with dyslexia and dysgraphia would be established and preparatory programs and certifications for teachers through which the teachers would learn how to properly recognize and address dyslexia and dysgraphia would be created.
To find out more about the neuropsychological evaluations available at SUNY College of Optometry or to make an appointment with Dr. Larson, call (212)-938-4001 or visit universityeyecenter.org.
REFERENCES
- Macdonald K, Germine L, Anderson A, Christodoulou J, McGrath LM. Dispelling the Myth: Training in Education or Neuroscience Decreases but Does Not Eliminate Beliefs in Neuromyths. Frontiers in Psychology. 2017;8:1314. pmid:28848461
- org | Dyslexia Fact Sheet, https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyslexia/dyslexia-fact-sheet
- Wagner RK, Zirps FA, Edwards AA, Wood SG, Joyner RE, Becker BJ, Liu G, Beal B. The Prevalence of Dyslexia: A New Approach to Its Estimation. J Learn Disabil. 2020 Sep/Oct;53(5):354-365. doi: 10.1177/0022219420920377. Epub 2020 May 26. PMID: 32452713; PMCID: PMC8183124.
- Stark Z, Elalouf K, Soldano V, Franzen L, Johnson AP. Validation and Reliability of the Dyslexia Adult Checklist in Screening for Dyslexia. Dyslexia. 2025 Feb;31(1):e1797. doi: 10.1002/dys.1797. PMID: 39660384; PMCID: PMC11632572.
Featured photo credit: Elena Pimukova, Getty Images
