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Dyslexia Screening and Interventions: State Requirements and Resources

Posted on by Nicol Walsh

A Brief Overview

  • Dyslexia is a common condition that makes it hard to work with language. Reading difficulties are one sign of dyslexia.
  • Washington passed a law in 2018 requiring schools to screen young children for indicators of dyslexia. The law took effect in the 2021-22 school year.
  • Dyslexia is a Specific Learning Disability. Students with learning disabilities are eligible for an Individualized Education Program (IEP) if they demonstrate a need for Specially Designed Instruction (SDI). SDI is key when a student isn’t keeping up with grade-level work and standard teaching strategies aren’t working.
  • The Revised Code of Washington (RCW 320.260) requires schools to support literacy with “multi-tiered” programming. That means schools provide different levels of help for all students who need it, regardless of special education eligibility.
  • Washington Office of Superintendent of Public Instruction (OSPI) has handouts about dyslexia screening and supports in WA Schools, some in multiple languages.
    [ ខ្មែរ (Khmer), 한국인(Korean), ਪੰਜਾਬੀ (Punjabi), Русский (Russian), Soomaali (Somali), Español (Spanish), Filipino/Tagalog, 中國人(Traditional Chinese), and Tiếng Việt (Vietnamese)] They are listed at the end of this article.

Full Article

A child who struggles to read can quickly fall behind in school. Nearly every learning area includes some reading, and children might become confused or frustrated when they don’t get help to make sense of their schoolwork. Behavior challenges can result, and sometimes schools and families struggle to understand why the student is having a hard time. Reading difficulties affect a student’s literacy. One definition of literacy is the ability to read, write, speak and listen in ways that let people communicate well. The Revised Code of Washington (RCW 320.260) requires schools to support literacy with “multi-tiered” programming to help with reading difficulties.

One cause of difficulty with reading is a specific learning disability called dyslexia. The state’s definition of dyslexia, adopted in 2018, is similar to a definition promoted by the International Dyslexia Association. According to Washington State’s definition:

“Dyslexia is a specific learning disorder that is neurological in origin and that is characterized by unexpected difficulties with accurate or fluent word recognition and by poor spelling and decoding abilities that are not consistent with the person’s intelligence, motivation, and sensory capabilities.”

Understood.org provides a video and additional materials to learn about dyslexia. Here’s their plain language definition: “Dyslexia is a common condition that makes it hard to work with language.”

Washington State requires dyslexia screenings (tests to find out if a student may have or be at risk for dyslexia) and interventions (help with reading). Lawmakers in 2018 passed Senate Bill 6162 to require schools to screen children from kindergarten through second grade using state-recommended literacy screening tools. The law took effect in 2021-22.

Since reading is used in almost every learning area, this law means schools have a duty to identify students who show signs of possible dyslexia while they are in their early reading years. The law also requires schools to provide “interventions” (help) to students identified through the screening.

OSPI offers a Fact Sheet about the screening in multiple languages. It includes the reason for the screening, who gives the screening, the skills that are screened, the process, and information about dyslexia.

What happens if the screening shows indicators (signs) of dyslexia?

The law requires the school to:

  • Notify the student’s family of the identified indicators and areas of weakness
  • Share with the family the school’s plan for multitiered systems of support to provide supports and interventions (help with reading)
  • The notice should include resources and information about dyslexia for the family’s use.
  • Update families regularly on the student’s progress

How can families tell if a student has trouble, or may have trouble with reading and language? Families can look for these signs in children who are toddlers and pre-kindergarten:

  • Trouble learning simple rhymes
  • Speech delays
  • following direction
  • Difficulty reading short words or leave them out
  • Trouble understanding the difference between left and right
    -Child Mind Institute Parent Guide to Dyslexia.

Screening happens in kindergarten through grade 2. If a student is already older than that, families can check for these signs of reading and language difficulty at home.

Understood.org states: “Dyslexia can also cause trouble with spelling, speaking, and writing. So, signs can show up in a few areas, not just in reading.” Understood.org lists these signs for students older than grade 2: Signs a Student May Have Dyslexia (handout)

The Washington Office of Superintendent of Public Instruction (OSPI) offers a Family and Caregiver Discussion Guide that may help when families are planning to speak to their child’s teacher or school administrators about their student’s reading difficulties, behavior, or other concerns.

What happens if the screening shows a student has signs of dyslexia, or if families or teachers notice signs and want a student to get help?

The school puts multi-tiered systems of support (MTSS) into action. “Multi-tiered systems” usually means beginning reading help as part of regular classroom reading instruction. If a student’s reading difficulties continue, the student may get more intensive instruction in smaller groups, and perhaps move up to intensive one-on-one time with a reading instructor. For any of these levels, the reading instruction must be “evidence-based” methods which means the methods have been tested and shown to be useful in helping with reading difficulties.

This guide for schools from OSPI has details about MTSS.

These more intensive levels of reading help may work very well. Not every reading difficulty is due to dyslexia, and not every person with dyslexia has the same level or type of reading difficulty.

At any point during these interventions, families or teachers may see a student is not making progress and ask that the student be evaluated for special education to see if the student qualifies for an Individualized Education Program (IEP). An IEP can provide Specially Designed Instruction (SDI), which means instruction will be based on the student’s unique needs and provide extra instructional time, assistive technology, and other supports.

The federal law that provides special education eligibility and funding is called the Individuals with Disabilities Education Act (IDEA). According to the IDEA, Dyslexia is a Specific Learning Disability. Specific Learning Disability is a category of eligibility for an Individualized Education Program (IEP). IDEA states that students have the right to a Free, Appropriate Public Education (FAPE), and the IEP is a key factor in a student having FAPE.

What types of help can a student get with reading and literacy?

Multi-tiered systems of support (MTSS) use instruction methods that have been proven to work for many students, starting with help in the general (regular) classroom. If a student doesn’t make progress that way, the student may join a smaller group for that gives each student more time with a teacher or reading specialist and even move on to one-to-one instruction with a reading specialist. These options are available to any student who shows signs of dyslexia or reading difficulty. OSPI offers Dyslexia Guidance (for schools): Implementing MTSS for Literacy with more specific information.


IEP: Students can get Specially Designed Instruction (SDI) based on their unique needs, such as particular areas of language and literacy where they have difficulties. Reading programs offered by the school can be included in an IEP. IEPs can include accommodations, which may include texts and instructions in audio format, text-to-speech/speech to text software, recording oral answers to assignment or test questions, access to distraction-free location for reading, allowing extra time to complete work or tests, and many more. Accommodations for Students with Dyslexia by the International Dyslexia Association lists many other options.

Section 504 Plan: Section 504 plans don’t include Specially Designed Instruction. They do include accommodations.

The National Center on Improving Literacy has information on when a Section 504 plan may make sense for a student with reading difficulties or dyslexia. They note that Section 504 Plans, which fall under Section 504 of the Rehabilitation Act of 1973, do not provide for Specially Designed Instruction. If a student’s reading has improved without an IEP by receiving multitiered systems of support, a Section 504 plan may offer Assistive Technology options, spelling checks, extended time on assignments and testing and other accommodations.

PAVE has articles and a video with more information about special education, IEPs, and Section 504 plans.

Interventions (help with reading) are schoolwide

Not all students who need reading support will need IEPs or a Section 504 Plan. The Revised Code of Washington (RCW 320.260) requires schools to support literacy through “evidence-based multi-tiered” programming. That means schools provide different levels of support for all students who need help, whether or not the student has an IEP or Section 504 Plan.

Some schools have reading programs funded by Title 1, which is part of a federal law called Every Student Succeeds Act (ESSA). Title 1 is funded to close opportunity gaps related to poverty and other measures.  

TIP: Ask about all options for reading support at your school. If a student with an IEP participates in a schoolwide reading program, then the IEP can list that program as part of the student’s services.

Dyslexia can be identified and helped without a diagnosis

Students do not need a diagnosis of dyslexia to be evaluated (tested) for special education eligibility. If the family has concerns, they can ask the school to evaluate the student. Requests should be in writing. PAVE provides a sample letter to help families request an educational evaluation.

Here’s a sentence to include in the evaluation request letter:

“I need my child tested for a specific learning disability. I believe there is a problem with reading that is disability related.”

TIP: When a student’s need for reading help qualifies for an IEP, there are important things that families need to know about how IEPs work, what the goals are for the student’s reading abilities, what type of reading help will be given, where the Specially Designed Instruction will take place, and what the parent’s and student’s roles and responsibilities are when their student has an IEP. These are the basics:

  • IEP Eligibility is based on a student’s needs
  • Specially Designed Instruction (SDI) serves the identified needs
  • The IEP tracks learning progress with specific goals in each area of SDI

What options do families have if they disagree with a school’s decisions about their student’s reading supports or other decisions?

  • If a student has not been screened for signs of dyslexia and the family has concerns, a first step is to meet with the student’s teacher. This article by the International Dyslexia Association offers specific steps families can take.
  • Families can request an evaluation to see if the student qualifies for an IEP or a Section 504 Plan.
  • If families disagree with the evaluation, they can request an Independent Educational Evaluation (IEE) from a provider outside the school. This article from PAVE gives steps and a sample letter to request and IEE: Evaluations Part 2: Next Steps if the School Says ‘No’
  • If the student has an IEP, this article gives specific steps to follow: Parents as Team Partners: Options When You Don’t Agree with the School.
  • For students with a Section 504 Plan, OSPI recommends:
    “The Section 504 coordinator in each district makes sure students with disabilities receive the accommodations they need and respond to allegations of discrimination based on disability. [Section 504 coordinators are members of a school’s Section 504 team which develops 504 Plans to accommodate a child’s needs]. A discussion with your school principal, or Section 504 coordinator at the school district, is often the best step to address your concerns or disagreements about Section 504 and work toward a solution. Share what happened and let the principal or coordinator know what they can do to help resolve the problem. If you cannot resolve the concern or disagreement this way, you can file a complaint.”

What else to know:

Keep in mind that families and schools don’t need to use the term dyslexia at all. They can talk about a student’s learning disability in reading, writing, or math in broader terms such as “Specific Learning Disability.” Under the Individuals with Disabilities Education Act (IDEA), dyslexia is a Specific Learning Disability that qualifies a student for special education.

Specific Learning Disability is defined by the Washington Administrative Code (WAC 392-172A-01035):
“Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia, that adversely affects a student’s educational performance.”

The state’s definition of learning disability excludes “learning problems that are primarily the result of visual, hearing, or motor disabilities, of intellectual disability, of emotional disturbance, or of environmental, cultural, or economic disadvantage.”

Here’s a handout on Accommodations and Modifications for Students with Dyslexia.

Resources

From PAVE:

Special Education is a Service, Not a Place
Student Rights, IEP, Section 504 and More (video)
Steps to Read, Understand, and Develop an Initial IEP
Supporting literacy: Text-to-Speech and IEP goal setting for students with learning disabilities
IEP Tips: Evaluation, Present Levels, SMART goals
Section 504: A Plan for Equity, Access and Accommodations
Evaluations Part 2: Next Steps if the School Says ‘No’
There’s more: just type “Special Education,” “IEP” or “504” in the search bar

From OSPI:

Family and Caregiver Discussion Guide with Educators and Schools
Understand Literacy Screening: Parents and Families
Available in ខ្មែរ (Khmer), 한국인(Korean), ਪੰਜਾਬੀ (Punjabi), Русский (Russian), Soomaali (Somali), Español (Spanish), Filipino/Tagalog, 中國人(Traditional Chinese), and Tiếng Việt (Vietnamese)
Best Practices for Supporting Grades 3 and Above
Section 504 & Students with Disabilities (web page)
Dyslexia Guidance (for schools): Implementing MTSS for Literacy

Dyslexia awareness is promoted by the National Center on Improving Literacy (NCIL), which provides resources designed to support families, teachers, and policy makers. On its website, the agency includes state-specific information, recommends screening tools and interventions and provides research data about early intervention.

The International Dyslexia Association has many detailed resources for families.

Quick Look: How to Prepare for a Virtual Meeting

Posted on by Nicol Walsh

Schools and families continue to meet virtually to discuss special education services during the closures related to the coronavirus pandemic. Here are tips to help family members prepare for remote meetings to discuss a student’s Individualized Education Program (IEP), a Section 504 Plan, evaluation for special education services or something else related to a special education student’s needs and learning program.

For more comprehensive information, see PAVE’s article, “IEP on Pause? How to Support Continuous Learning with School Buildings Closed.”

  • Determine a regular communication plan with the school. That might include email, telephone, text, web-based meetings, U.S. mail, packet delivery by school bus…  whatever works for regularly checking in.   
  • Family caregivers can request meetings. PAVE provides a template to formalize the request: Sample Letter to Request an IEP Meeting. Included with the letter template is detail about who is required to attend IEP meetings, and those requirements have not changed.
  • The Special Education Continuous Learning Plan is provided by the Office of Superintendent of Public Instruction (OSPI) to support but not replace the IEP during the national crisis caused by the coronavirus pandemic. Included in the form is a sample meeting agenda.
  • Consider confidentiality and privacy issues. Ask school staff to describe how privacy and confidentiality are protected through a suggested meeting platform, and make sure to have any passwords or PINs ready to use when you log in or call into a meeting.
  • Before a meeting, ask to sign any necessary paperwork or releases to have special education records sent electronically via email. Special education records can include meeting notifications, IEP or Section 504 documents, assessments, progress reports, Prior Written Notices that describe meetings and planned actions, or other materials that contribute to the program review and goals.  
  • Review records before the meeting and write down questions to ask during the meeting. PAVE provides a Parent Handout Form or, for self-advocates, a Student Handout Form, that can help organize concerns and questions. Another version of a Parent Input Form is provided by the Washington Office of Superintendent of Public Instruction (OSPI).
  • Carefully review goals, services, accommodations, modifications and consider how they might apply or need to be adjusted for current circumstances. Think creatively and prepare to collaborate and request expertise from school staff. Pay special attention to the present levels of academic achievement and functional performance. These present levels statements, within the first pages of the IEP document, describe how the student is doing and where there are challenges. Wrightslaw.com provides tools specifically to support parents in reviewing IEP present levels in preparation for a meeting during COVID-19.
  • Consider whether the student will attend the meeting. A student who is 14 or older is invited as part of the state’s Pathways to Graduation planning. PAVE provides an article: Attention Students: Lead your own IEP meetings and take charge of your future.
  • Communicate early—before the scheduled meeting—to request updates about progress, a student’s present levels of performance, or other concerns. If family caregivers build a handout for the meeting, that can be submitted ahead of time to ensure that this information is part of the agenda.
  • Family members can request a practice session to test the technology. Part of that training might include practice sharing the screen to make sure everyone will be able to view important documents during the formal meeting.
  • As with in-person meetings, family participants can invite support people. A friend or family member might be able to attend and take notes.
  • Refer to parent and/or student input forms to stay on topic and ensure that all concerns and questions are addressed.
  • When the meeting ends, family participants can ask for a copy of the program recommendations page.
  • After the IEP meeting, the school provides a Prior Written Notice (PWN) to the family participants to review meeting notes and any decisions, agreements, or disagreements. Ask when and how the PWN will be provided. Family participants have the right to request amendments or corrections to the PWN.
  • Be sure to leave with a clear action plan. Here are key questions to ask and record:
    • What will happen?
    • Who is responsible?
    • When will the actions happen? Are there timelines?
    • How will we communicate for follow through?
  • As with any meeting, any unresolved issues can be addressed in a follow-up meeting.

To learn more, PAVE provides a six-minute overview of IEP basics and a 30-minute training video about special education.   

Adolescent Health Care Act Provides Options for Families Seeking Mental Health and Substance Use Help for Young People Resistant to Treatment

Posted on by Nicol Walsh

A Brief Overview

  • The Adolescent Behavioral Health Care Access Act, passed into law by the Washington Legislature in 2019, gives parents and providers more leverage in treating a young person who won’t or can’t independently seek medical help for mental illness and/or substance use disorder.
  • The Washington State Health Care Authority (HCA) in March 2020 launched several website links with information about the new law, which includes an option for Family Initiated Treatment (FIT).
  • The Washington State Hospital Association on July 9, 2019, provided a slide presentation describing the law’s history and its primary features.
  • A place to connect with other families concerned about adolescent mental healthcare access in Washington State is a group called Youth Behavioral Healthcare Advocates (YBHA-WA) on Facebook. Included on the page are handouts that summarize key aspects of the new law. 

Full Article

Getting mental health help for a youth in crisis can be complicated, frustrating and frightening.

Mental Health America ranks states based on the incidence of mental illness and access to services. The agency’s 2020 rankings list Washington in the 43rd position, based on various measures that indicate a higher prevalence of mental illness and lower rates of access to care.

Often a barrier to treatment is the youth, who may not be able to see a problem or want to get professional help. Parents often struggle to navigate systems that must balance a young person’s autonomy with concern that they may not be able to make good decisions because of their development, specific illness circumstances or symptoms that impact the brain.

In Washington State, the age of medical consent is 13. That means that a person 13-17 years old can independently seek medical treatment, without the consent or knowledge of parents.

Age of consent laws also have meant that Washington youth could say no to mental health or substance use treatment, regardless of whether parents and providers agreed that such treatment was necessary to protect the safety and well-being of the adolescent.

A law passed by the Washington legislature in 2019 gives parents and providers more leverage when a young person is struggling with a mental illness or substance use disorder and won’t independently engage with treatment. The law does not limit an adolescent’s ability to initiate treatment on their own.

A January 8, 2020, article in Crosscut profiles several families impacted by the new law. “Until the new law,” the article states, “parents often were shut out of their teenager’s care and treatment plans and couldn’t push a teen toward necessary outpatient or inpatient care without their consent.”

The Adolescent Behavioral Health Care Access Act enables parents/caregivers to bring a child for inpatient or outpatient treatment without requiring consent from the child, ages 13-17. The law includes elements introduced by the state Senate and House of Representatives, which originally titled the bill as HB 1874.

Passage of the law was a win for the Children’s Mental Health Work Group, which studied and reviewed recommendations from a stakeholder advisory group authorized by the 2018 legislature. The final version of the law included input from family members, youth, clinicians, hospital staff and many others who met dozens of times. A June 13, 2019, slide presentation available online provides additional history and detail about the work group and its recommendations: Family Initiated Treatment and Engaging Families in Treatment of Youth. The webinar with sound is available on YouTube.

The 2020 legislature is considering amendments to the law, and the Children’s Mental Health Work Group continues to meet to consider proposals to clarify provisions that relate to residential treatment and referrals for Wraparound with Intensive Services (WISe).

“Parent” is broadly defined

The 2019 law expands the definition of parent to include a wide range of family caregivers, guardians and others who have authority to initiate treatment. The Revised Code of Washington (RCW 9A.72.085) provides standards for “subscribing to an unsworn statement” that can apply to a caregiver initiating treatment. 

Note that parents retain the right to make medical decisions for children younger than 13, and adults 18 and older are responsible for medical decision-making if there is no guardianship.

A substantive change with the 2019 law is that providers may share mental health information with parents without an adolescent’s consent, if the provider determines that information sharing with family is in the best interests of the adolescent patient. A list of information-sharing guidelines is included below.

How Family-Initiated Treatment Works

If a parent/caregiver believes that an adolescent requires mental health or substance use disorder treatment, the adult can escort the young person to an inpatient or outpatient treatment facility even if the adolescent doesn’t readily agree to go.

A provider will assess the adolescent and consider information from the family to determine whether treatment is medically necessary. An adolescent’s refusal to engage with the provider cannot be the sole basis for refusing to treat.

An inpatient facility can detain the adolescent under Family-Initiated Treatment (FIT) if medically necessary. Note: another option could be detention under the Involuntary Treatment Act (ITA), if the adolescent is determined to be gravely disabled or at imminent risk of self-harm or harm to others.

If medical necessity is found by an outpatient provider, a counselor is limited to 12 sessions over 3 months to attempt to work with the adolescent. If the young person still refuses to engage with treatment, then the period of Family-Initiated Treatment with that provider ends.

State laws continue to encourage autonomy for young people, but family engagement is encouraged. According to the Revised Code of Washington (RCW 71.34.010):

 “Mental health and chemical dependency professionals shall guard against needless hospitalization and deprivations of liberty, enable treatment decisions to be made in response to clinical needs in accordance with sound professional judgment, and encourage the use of voluntary services. Mental health and chemical dependency professionals shall, whenever clinically appropriate, offer less restrictive alternatives to inpatient treatment. Additionally, all mental health care and treatment providers shall assure that minors’ parents are given an opportunity to participate in the treatment decisions for their minor children.”

Guidance for Information Sharing

Federal law, 42 CFR Part 2, restricts information sharing related to substance use, and clinicians cannot share that information without a patient’s written consent, regardless of whether the substance use co-occurs with mental illness.

Providers have discretion in determining what information about mental health diagnoses and treatment is clinically appropriate to share with parents of an adolescent 13-17. A provider retains discretion in withholding information from family/caregivers to protect an adolescent’s well-being. In general, the Adolescent Behavioral Healthcare Access Act encourages sharing information to support collaboration between the clinical setting and home. Specifically, providers and families are encouraged to discuss:

  • Diagnosis
  • Treatment Plan and Progress
  • Recommended medications, including risks, benefits, side effects, typical efficacy, dosages and schedule
  • Education about the child’s mental health condition
  • Referrals to community resources
  • Coaching on parenting or behavioral management strategies
  • Crisis prevention planning and safety planning

Information about state laws related to Behavioral Health Services for Minors is available through the Washington State Legislature website under RCW 71.34.

Information about child and youth behavioral health services in Washington State is available from the Health Care Authority (HCA).