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Early Identification

The following are past questions and answers from Dr. Larry Silver on this topic.

My preschool child has a severe speech impairment. What interventions are available for him?

My son Benjamin is bright and can do what some four-year-old children can't, like swim and ride a two-wheel bike. But he has a speech impairment and developmental delays. I tried to get help when he was two because he would just sit on the floor and cry when he could not express in any way what he wanted. Early Steps turned him down because he had good motor skills; and when he entered Head Start, they tested him for speech and passed him because they did not want to deal with him.

Now he is in preschool, and they tested him and found that his development is almost two years behind and his speech impairment is kind of bad. My question is … should I get other testing done by, say, a geneticist or a neurologist for different things? Should I put him and myself through this?

It is unfortunate that he did not get help earlier. It is critical that all of his needs be addressed now. Have you been to the public school yet? He is eligible for a program called Child Find. The public school team will assess for motor, cognitive, language, and social concerns. If they find concerns, the appropriate interventions should be provided by the public school. I would get these efforts started first. Depending on the findings, you might discuss with his family doctor whether medical evaluations would help clarify the reasons for his difficulties.

How can I get a 4-year-old who can only say three words tested?

How can I get an assessment or evaluation for a child who has turned 4 but can only say three words? I think he is too old for the Babies Can't Wait program.

Under the public law, IDEA, every public school program must have a Child Find program to evaluate children ages 3 to 5 who appear to be delayed in any area of development prior to entering kindergarten. Speak with the principal of your neighborhood school about how to register for Child Find.

My son is in kindergarten and cannot write his name, but the psychologist says he's on track. Should I request testing anyway?

My son is 5 and is having difficulty in school. He started in a child development program last year at age 4 and had a lot of trouble learning anything. We thought it was due to his ADHD and behavior. He could not spell or write his name, did not know colors, numbers, or any of the alphabet.

This year he is doing much better with his behavior. But he has been in school for nine weeks so far and still cannot spell or write his name without assistance. He only knows three letters of the alphabet and can only recognize the numbers one to five. He has trouble gripping a pencil tight enough to write.

He is in speech therapy and has been since last year. My husband was LD in school. My son has been evaluated by the school psychologist but she thinks that even though he has attended school for over a year, he is where he should be. Should I be concerned and request additional testing for him, or is he too young to be diagnosed with dyslexia or other LD?

I share your concerns. Yes, he might be too young to meet the school requirements to be identified as having a learning disability. (Most schools use a model that requires a child to be about two years behind and he is only five.) But, there is the opportunity to evaluate and help a 5-year-old without needing to conclude why the problems exist. If testing shows that he has areas of deficit, services can be provided without the formality of testing. Speak with the principal about getting such help.

If you are not successful, you have two options. First, you could get psychological and educational testing done privately and then take the results to the school, insisting on help. Or, you could set an appeal process in motion. To do this, send your principal a letter, requesting a meeting to discuss the need to evaluate your son. The principal must call such a meeting within 30 days (based on education law).

At this meeting, request an evaluation. If the team does not agree and does not agree to informally provide services, ask for the guidelines on how to appeal the team's decision. Such a process is required by law. Then, appeal to the next level within your school system. If the principal refuses to call a meeting, comment that IDEA, the federal education law, requires that the principal call such a meeting. If he or she still refuses, ask for information on how to appeal.

(Should the principal refuse, I would meet with your superintendent of school or an assistant. Bring your notes about each step you went through and ask what your rights are.)

Good luck.

Is LD passed on to offspring?

I was diagnosed with LD in math and reading when I was in eighth grade. Recently, my daughter has had problems with reading and writing. She is 6 years old and I was just wondering if LD is passed on to offspring.

There is a strong family pattern for learning disabilities. I would encourage you to keep a close eye on your daughter. If she continues to struggle, ask the school to evaluate her for possible learning disabilities.

Who should I go to first to find out if my child has dyslexia — the school or an outside professional?

How does one find out if their child has dyslexia? I have approached the teachers regarding this and they told me to seek help outside school. Yet when I speak to professionals outside school they say it is up to the school to test the child. Can you give me advice to help my daughter before she falls any further behind in school? She is entering third grade.

Thank you,


Submit a letter to the principal requesting a meeting to discuss your child's difficulties. The principal must schedule this meeting within 30 days. At the meeting, present your concerns and ask that the school evaluate her to clarify if she has learning disabilities. The principal must respond by either agreeing or saying that the school will observe her and test her if she continues to have problems. If you disagree, you can request an appeal process.

Should a school retain a first grader with special needs?

My son is 7 years old with ADHD and is in the first grade. He had a rough time this year in school and the school wants to hold him back. I just found out that my son was diagnosed with special needs. Now the school is giving me a choice of whether I want him to go to the next grade or stay in the first grade. I do not know what to do.

Your school professionals concluded that your son has learning disabilities and ADHD. He will need special education services along with the general education programs. He will also need medication to address the ADHD.

The question of repeating first grade or moving on to second grade should be based on the extent of his problems and his basic skill levels. The school professionals should make a specific recommendation and not leave the decision to you.

Should you agree, fine. Should you not, you might want to seek the advise of a private special education consultant to advise you. Without more information, I cannot make a recommendation.

My 6-year-old son is reversing letters and numbers. Should I get him tested?

I have a 6-year-old son that is having trouble at school. He reads a lot of common words backwards, such as reading pan for nap or dull for pull. He can do basic math, but if the answer is 32, sometimes he'll write 23.

It was upsetting me that he was making simple mistakes because he wouldn't take the time to look at things, and then I noticed he was having trouble focusing his eyes. I had his vision tested and it's fine.

I asked his teacher if she would refer him to get tested for a learning disability. She told me the school's waiting list is about 60 days. Am I going about it the right way by getting him tested? Where do I go from here? Can my son's doctor have him tested or refer me to a testing center? What kind of test do you do to identify learning disabilities? I feel completely lost and worry that I am failing my son. Please help!

Sometimes, 6 year olds still reverse letters and numbers. If this is his only problem, you might wait a little longer. If, however, you find that he is not mastering his first grade skills (reading, writing, math), then I would not wait.

Don't discuss this with the teacher. The process is for you to write a letter to the principal, requesting a meeting to discuss your son's difficulties. The principal must call such a meeting. The school psychologist and special education person will be present. Discuss your concerns with this team. If they agree, they will schedule testing. If they do not feel testing is needed now, you will still have focused everyone on his difficulties. If in the fall he has not made progress, request another meeting.

You can always have him evaluated privately. The testing is called psycho-educational testing.

My sister's first grade teacher said my sister will be in special ed classes for the rest of her life and won't go to college. Isn't this setting her up for failure?

I am not a parent but my younger sister, who is in first grade, is having difficulties with reading and other basic skills. Today our older sister went in to talk with the teacher and the teacher told her that our younger sister is going to be in special ed for the rest of her life and that it is likely that she will not be going to college. I guess they are teaching her life skills at the school and they do not look at the homework that she is doing.

This aggravates me because it seems like they are just setting her up for failure. I read an article about one student who said that it is better for these kids to be challenged and placed in mainstream classes — he was placed in special ed second through eleventh grade and once they did put him in mainstream it was a lot more difficult to transition. His was a success story, but I completely agree students should be put in mainstream classes earlier. I would just really appreciate your input on this situation because I do not want to see my little sister fail.

Your younger sister is fortunate to have you as an older sister who cares about her. I do wonder why you and another sister are involved. Where are your parents/guardians?

It is essential that the parents request a meeting with the school principal and school professionals. What studies have been done to support this teacher's comments? A child cannot be placed in special education without studies to support this need. AND, no decisions can be made without the parents' consent. First, speak with your mother and find out what she knows. If there are no formal studies or no official meetings, this teacher needs to be confronted about such comments. If there have been such studies and your mother has not shared them with you, ask that they be discussed.

Could a pre-kindergarten student who identifies numbers but not letters be showing early signs of dyslexia?

I teach early childhood special education and have a student who is pretty good at identifying numbers, but is not identifying letters or showing much interest in emergent reading. He likes books and looking at the pictures or singing the songs, but not identifying letters or sounds.

The child is 4.5 years old. His speech is good — he has received SLP therapy and his receptive and expressive language are both high. Could any of this difficulty in expressing letter knowledge, but not number knowledge, be an early sign of dyslexia? Is it perhaps just a matter of being 4 and not wanting to answer the questions? Also, his parent had a learning disability as a child — could this be genetic?

Thank you!

The problems you describe could be the initial clues that this child might have learning disabilities. The fact that he needed language therapy adds to the possibility of this diagnosis. If this child is in your class, it suggests that he is already seen as in need of special education services. The current approach would be to try remedial interventions and see how he responds. If he does not respond, then formal studies might be done.

Our pre-kindergartner can only speak in words (not sentences) and shows little interest in learning. What should we do?

Hello Dr. Silver,

I have a 5-year-old boy that had craniosinostosis surgery when he was 3 years and 9 months old. Next year he is going to be in kindergarten but he can't talk well - he can say words but not sentences. He does not know his colors, numbers, or letters and he is not interested in learning. He has short attention span (2 or 3 minutes at most). I'm really concerned. Please advise.

You should be concerned. Have you discussed your questions with the professionals who have been working with your son? Given your descriptions, I suspect that you have had evaluations and services since he was three. If not, you should know that you are entitled to a full assessment and services from your public school. Discuss this with the principal of the school where he would attend for kindergarten. Don't stop asking until you get your answers.

My son had the precursors for dyslexia in preschool two years ago but is reading well now. Should I still be concerned?

My 6-year-old son was evaluated in 2007 by a neuropsychologist. She determined that he does have the precursors for dyslexia and what appeared to be the beginnings of it. I then had him evaluated for dyslexia and pre-screened for the Barton Reading and Spelling System. He is very intelligent and is reading above grade level. He can write, but it takes him time. His school refuses to believe he has dyslexia.

Where can I find more information to prove he has dyslexia even though he can read and write?

Your child was tested when he was in preschool. The results were based on levels of expected performance for that age. It may be that what was seen as a weakness then (precursor), improved with maturation and is not an issue now. You say he can read and write at grade level. So, he does not appear to have any deficits that might suggest dyslexia at this time.

It is difficult to use these data to assess if he has learning disabilities. I suggest that you stop pushing for a diagnosis (dyslexia) and ask the school to help clarify if he has any problems at this time.

Should a 6-year-old boy who struggles with reading be evaluated?

Hi Dr. Silver,

How early can a child be tested for disabilities? I have a 6-year-old boy who is now in first grade and struggling with reading. He reads below grade level and is unable to comprehend what he reads.

When he was in kindergarten, I was told that something was not right, but they didn't know what it was. So, in first grade I have been pushing the school. We are now going to do testing for learning disabilities. They said that they do not think anything will show up because of his age and that they will recommend retention.

This is so frustrating! He currently has B's in everything except reading, in which he has a D and sometimes an F. Is it too early to tell?

If your child is struggling with reading, testing should clarify why and how best to help him. If he is doing well in all other areas, retention may not be recommended. He might continue on to second grade but receive remedial help for the rest of this year and for next year. And, if you wish, you can supplement this help by getting the right private help over the summer.

Don't let your fear of retention stop the school from clarifying why he is struggling with reading. Only with this information will the appropriate interventions be clarified.

How do we help a kindergartner who cannot complete assignments independently and gets distracted easily?

Dear Dr. Silver,

I have a 5-year-old son that is in kindergarten. Prior to this year, he attended some daycare but never attended pre-k.

We have been experiencing problems with his learning. His teacher complains to us everyday that he does not complete his assignments in class. She has shown my husband the packets they need to do in class and his are blank. I have noticed that if I sit down with him, he will finish the work. However, if he does not have supervision he gets distracted.

This happens consistently. Please tell me your suggestions on what to do. I am very concerned about his learning ability. He is a normal child - he communicates normally and understands my instructions when it comes to home duties. But when it comes to school he does not seem to get it.



Ask to meet with the principal of the school. Explain your concerns and the comments from his teacher. Request that the principal assign the school psychologist or other school professional to observe your son and to talk with the teacher.

Then, ask that the principal, this professional, and the teacher meet with you to discuss their ideas on why he is having difficulty. (If you make this request to the principal in writing, the principal must respond and schedule this meeting within 30 calendar days.) Don't accept a no or a "let's wait until the end of the school year." If you hear this, seek help from a private educational consultant.

Is it dyslexia when our three-year old can't identify letters and numbers?

Greetings Dr. Silver,

While our three-year-old seems age appropriately advanced in all other areas, she cannot identify letters/numbers. For example, we have been reviewing the five letters for days now and she cannot accurately identify more than two consistently. We have used flash cards, hand writing them, utilized her favorite books, etc. to no avail. Should we be doing anything at this stage? We are concerned about dyslexia or some other LD we are not familiar with. Many thanks!

It is not uncommon for three year olds to not recognize letters and numbers. I suggest that you hold off on these exercises for now and just have fun with her. If you have other reasons for being worried about her having dyslexia, speak with your family physician about having her assessed.

When is the earliest that a child should be assessed for a learning disability?

I have a 4-and-a-half-year-old son. I have recently been through two assessments with a pediatrician. One says says he has learning difficulties and the other says he comes somewhere under the Austism Spectrum Disorder. I think there is a possibility of dyslexia. Could you advise me what the minimum age of a child is to assess for dyslexia?


The earliest clues of a possible learning disability might be noticed in preschool. Formal testing often is not done until first grade.

How can I help my preschool son with a complicated diagnosis?

My four-year-old son is considered twice exceptional. Academically, he is above age appropriate (reading at a third grade level) and shows a great interest in math (addition and subtraction). Socially, he has no trouble making friends but not great at keeping them. He is impulsive in his actions, which makes most children shy away from him.

He has a medical history of open heart surgery and was hospitalized for ten weeks at birth. He was recently diagnosed with ADHD, but his pediatrician and cardiologist disagree with this diagnosis. We struggle to find the right academic setting for him (his two previous schools say they are not for him and that he needs more structure and academic). It has also been suggested that we check him for Sensory Integration Dysfunction, which we are in the process of researching. Resources are available for LD and for gifted, but we struggle to find someone that can help us with both issues. Any suggestions?


Your description of your four-year-old son is complex. I recommend that you meet with the preschool evaluation service of your neighborhood public school. Every public school system must have an age three to five assessment team. These professionals should help to clarify what is happening.

Is it dyslexia when a four-year-old reverses letters?

I have a 4-year-old that I'm afraid might have dyslexia. The other day we came to a stop sign and spelled out the letters backwards, and it's happened a few times since then. Is this normal or should I do something about it?

Most children reverse letters and numbers until about five or six, some longer. I would not be worried. Watch and see if this pattern disappears by the time she finishes kindergarten.

Where can low-income people get help for three-year of children who might have learning disabilities?

I need assistance with my 20-month-old son who may be showing early signs of learning disabilities. I need some assistance with counseling for him and just learning in general how to direct his energy. We are a low income family and don't know where to start to look for free assistance. Can you please direct me to the appropriate place. Thank you for your time, our family greatly appreciates it. We live in Monterey CA.


Every public school in the country is required to run a "Zero-to-Three" diagnostic program. Go to the principal of your neighborhood elementary school and ask how to be referred to this program. Your son will be seen by many professionals. Should help be needed, it will be provided. And, there is no charge.

How do you decide the most important therapy for a six-year old child?

My son just turned 6 years old and is about to repeat kindergarten. We just moved from Michigan to Florida where the school systems are quite different.

We had some concerns last year when my son had difficulty learning his numbers and letters. Our son was tested by an occupational therapist and she suggested that he had visual motor processing problems and recommended occupational therapy. We were also told by a behavioral optometrist we should start vision therapy because there are eye tracking issues beyond the processing problems.

He is currently reviving tutoring and is scheduled for a speech evaluation next week. Are we overwhelming our son with therapy? Which therapy should be the priority? Is it too early to get comprehensive I.Q. and L.D. testing?

We met with a psychologist who feels we should wait until he is seven for best results because the delays could be resolved through maturation. Should we wait for comprehensive testing if he is getting therapy anyway or should we get the whole picture? We are confused, concerned, and spending a whole lot of money.

Please let us know what we should do.

Thank you,

The best time to intervene is when you find that your child has a problem. You have done just that. If the reason for the problems is a developmental delay, the interventions can only facilitate catching up. Should the problems no longer be there by first or second grade, you can stop.

However, if what you have found is the earliest phases of a learning disability, the early interventions will help him keep up and learn. In this case, he might need help for several more years.

So, yes, you are doing the right thing. The only suggestion is to focus the intervention on the problems found. He is old enough to have psycho-educational testing. These results will help to pinpoint the problems and will direct you to the necessary interventions.