When Massachusetts passed a law last year requiring school districts to screen for dyslexia, Nadine Gaab, an associate professor of pediatrics at the Boston Children’s Hospital and Harvard Medical School, was glad the state was taking a proactive approach to prevent early reading difficulties. 

But in the professional development sessions she provides for teachers in the area, she didn’t see nearly the same enthusiasm. 

Gaab could “see on their faces that they weren’t as happy as I was,” she says. They told her, “We weren’t trained to screen,” and if a screening showed that a kindergartner did show signs of the learning disorder, they didn’t always know what to do next. 

That’s why she wanted to provide educators with a screening instrument children can administer themselves, and one that provides strategies to help children when they miss key early literacy milestones in areas such as vocabulary, oral listening comprehension and phonological awareness.

The Boston Children’s Hospital Early Literacy Screening System is a 20-minute, game-based, adaptive app being piloted in 40 schools in nine states. The project also recently received a $50,000 prize as part of the Solve Challenge Finals, a competition for tech entrepreneurs held by the Massachusetts Institute of Technology.

“We’re really trying to move from a deficit model to a preventive model,” Gaab says. “We have that in medicine. People are trying to screen for high cholesterol and help people at risk so they never develop heart disease.”

Technology is also making other types of screening in early childhood more accessible to families and early educators and linking them with further resources if needed. 

Recent attention to the struggles of parents whose children aren’t learning to read suggest schools often fail to diagnose dyslexia and that teachers lack knowledge on how to address students’ needs.

Twenty-one states have a statute or policy related to screening for dyslexia, according to a September 2018 report by the Education Commission of the States — and like Massachusetts, some have taken action in recent years.

Gaab notes, however, the typical one-on-one model of adult-administered screening is time-consuming, often takes place after a child has repeatedly failed to learn to read and when the “window for more effective intervention has closed.”

Understanding the 'pre-reading brain'

Before the Ringgold School District in New Eagle, Pennsylvania, began using the screener with incoming kindergartners at the district’s two elementary schools, teachers would use the Dynamic Indicators of Basic Early Literacy Skills, a widely used diagnostic test that focuses on reading fluency but has also been criticized for being too narrow.

“Working with Dr. Gaab and her team has given us better insight into the cognitive neurosciences and pre-reading brain,” says Superintendent Megan Marie Van Fossan. 

District leaders are also designing a professional learning program to help teachers implement interventions targeting specific early literacy skills. 

“It truly has shifted how we think about reading instruction,” she adds. 

The next steps, Gaab says, are to make the app available to parents, to introduce the use of the screener among programs serving preschoolers, and to encourage pediatricians to incorporate it into check-ups for 4- or 5-year-olds. 

Gaab and her colleagues have been advocating for physicians to take a larger role in screening for dyslexia, and a 2013 research article suggests cooperation between the medical and education fields is necessary in order for more children to be identified with the disorder.

Initially, Gaab says, they didn’t receive a very warm reception from pediatricians.

“But when you start telling them the implications for mental health and low self-esteem,” she adds, “then they are a little more open to that idea.”