Dyslexia or language?
Is it dyslexia or a language disorder?
A child can struggle with reading because the words on the page are hard to decode, or because understanding and using language is hard in the first place. The two can look alike at school, but they often require different types of support. A comprehensive neuropsychological evaluation helps identify whether reading difficulties are related to dyslexia, language weaknesses, or a combination of both.
Serving Long Island & Queens, NY
Dr. Courtney Duhning, Psy.D., ABSNP, NCSPPediatric Neuropsychologist · Manhasset, NY
Why it happens
Why does my child struggle with reading or language?
Two children may have the same reading difficulties but struggle for very different reasons. One child may have difficulty connecting sounds to letters, while another may recognize words accurately but struggle to understand their meaning.
Dr. Duhning takes a neuropsychological approach to understanding how children learn. Rather than looking at test scores in isolation, she examines the underlying thinking, language, memory, and reading processes that contribute to learning difficulties. This helps identify not only where a child is struggling, but why, so recommendations can be tailored to their individual learning profile.
At a glance
Understanding dyslexia and language disorders
A developmental language disorder (DLD) affects how a child understands or uses language and can interfere with learning, communication, and reading comprehension.
- ✔Main difficulty: Difficulty reading words accurately and fluently, connecting sounds to letters, and spelling
- ✔When listening: May understand information better when it is read aloud rather than having to read it independently
- ✔Reading: Slow or effortful reading, difficulty sounding out unfamiliar words, and guessing at words
- ✔Writing: Frequent spelling errors and difficulty spelling unfamiliar or familiar words
- ✔Main difficulty: Difficulty understanding or using spoken language, including vocabulary, sentences, directions, and expressing ideas
- ✔When listening: May have difficulty understanding spoken information, even when reading is not required
- ✔Reading: May read words accurately but struggle to understand vocabulary, sentences, or the meaning of a passage
- ✔Writing: Difficulty organizing sentences, using vocabulary, or clearly expressing ideas in writing
The two can also occur together, and a child with early speech or language delays may later find reading harder. That is why a single picture of all these skills matters.
Signs to look for
Signs that language may be part of the picture
- Can read words correctly but has difficulty understanding or explaining what was read.
- Has trouble following directions with several steps
- Struggles to find the right word or to explain ideas in order
- Misunderstands questions, jokes or instructions more than other children the same age
- Written work is short or hard to follow, even when the spelling is fine
- Had speech or language delays when younger
If the struggle is mainly with sounding out words and spelling, the dyslexia testing page explains the signs of dyslexia at each age.
The evaluation
How an evaluation tells them apart
A neuropsychological evaluation looks at reading and language side by side. Depending on your child’s needs, it may examine phonological processing, decoding, reading fluency, reading comprehension, listening comprehension, vocabulary and language skills, along with memory, attention, executive functioning, processing speed and emotional functioning.
An evaluation may examine how a child processes speech sounds, recognizes familiar words, reads unfamiliar words, understands spoken and written language, and remembers and organizes information. Looking at these skills together helps distinguish difficulties with decoding, word recognition, language comprehension, and other learning processes that may affect reading.
Comparing your child’s reading and listening comprehension, along with their ability to recognize words, sound out unfamiliar words, read fluently, and understand language, helps identify the skills contributing to their difficulties.
You receive a detailed written report and a feedback meeting with clear recommendations for school and home. If a speech-language evaluation or support from a speech-language pathologist would help, the recommendations will say so.
Support
What type of support helps?
The right intervention depends on the child’s specific learning profile. Children with dyslexia often benefit from explicit, systematic reading instruction targeting sound-letter connections, decoding, spelling, and reading fluency. Children with language disorders may benefit from speech-language therapy targeting vocabulary, sentence comprehension, and expressing ideas. When both conditions are present, coordinated reading and language interventions may be recommended.
Recommendations
Recommendations based on how your child learns
Not all reading difficulties respond to the same type of instruction. A child who struggles to connect sounds with letters may need a different instructional focus than a child who reads words accurately but has difficulty understanding language. By identifying the specific skills contributing to a child’s difficulties, the evaluation provides targeted recommendations for intervention, classroom accommodations, and support at home.
FAQ
Questions parents ask about reading and language
My child already sees a speech-language therapist. Why would we need a neuropsychological evaluation?
A speech-language evaluation looks closely at language. A neuropsychological evaluation looks at language alongside reading, writing, memory, attention, executive functioning and emotional functioning, so you can see how they fit together and whether a learning disability such as dyslexia is also present. Previous speech-language testing is reviewed as part of the process.
Can a child have both dyslexia and a language disorder?
Yes. Some children have difficulty with both decoding and language comprehension. An evaluation helps identify how each difficulty affects learning so interventions can target both areas.
My child reads fluently but doesn’t understand what they read. Could that be dyslexia?
Not necessarily. When a child reads words accurately and fluently but struggles to understand what they read, difficulties with language comprehension, vocabulary, or attention may be contributing. A comprehensive evaluation helps identify the underlying reasons and determine which skills need support.
At what age can this be evaluated?
Dr. Duhning evaluates children and teens ages 5 to 20. Language difficulties can be identified in early childhood, and signs of dyslexia can often be recognized as children begin learning to read. Families do not need to wait until a child falls significantly behind to seek an evaluation.
Why does my child struggle with reading even though they are intelligent?
Reading difficulties are not a reflection of intelligence. Children with strong reasoning and problem-solving skills may still struggle with decoding, reading fluency, or language comprehension. A neuropsychological evaluation helps explain these differences and identifies the specific support needed to help a child succeed.
Find out what is behind the reading struggle
At Duhning Psychological Services, evaluations go beyond identifying a diagnosis. The goal is to understand each child’s unique learning profile and translate those findings into meaningful recommendations for school and home.
Start with a free 15-minute phone consultation to talk through what you’re seeing at home and at school.
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