College of Health Solutions research team is aiming to change how language disorders are identified in children

In the spring of 2020, Nilam Khurana, a pediatrician at Healing Hearts Pediatrics, felt that dyslexia was severely underdiagnosed in children. After her daughter went undiagnosed, she felt a change in pediatric practices was needed.

From that desire for change, the Language and Development Screening Questionnaire (LDYSQ) was created by a team of researchers including former and current Health Solutions faculty and an extremely passionate doctoral student. The team hopes to significantly increase the number of children in the US screened for dyslexia and developmental language disorder at school entry. 

“Nilam wanted to do something about dyslexia because her child was diagnosed so late in school that it was really detrimental for her daughter, and that's the case with a lot of kids who have dyslexia,” Health Solutions Professor Shelley Gray said.

Khurana reached out to the now-former senior vice president for research at Phoenix Children’s Hospital Terry Stull. In addition to Gray, Laida Restrepo, a former assistant dean at the College of Health Solutions (now at the University of South Florida), helped to get a research project underway.

The team started by developing the questionnaire, and their main goal is for pediatricians to be at the forefront of dyslexia and developmental language disorder (DLD) screening to address the problem sooner.

“Traditionally pediatricians have not screened for dyslexia or developmental language disorder, which commonly co-occur,” Gray said. “So, at that six-year-old well-child visit, our goal is that every pediatrician in the U.S. would complete this screener with families. If the child looks like they're at risk, parents can follow up with their child’s school or another community resource for a complete evaluation.”

As part of  developing the questionnaire, the team also wants to make sure that children considered at risk receive further evaluation and if warranted, treatment. This will require working with schools and community providers to coordinate care.

How a child learns to read and understand and use oral language was key for the team to understand in developing the questionnaire.

“The precursors to learning to read are well known now. For example, two predictors are how well a child learns letter names and phonological awareness.”

According to the National Center on Improving Literacy, phonological awareness is defined as “the ability to recognize that spoken words are made up of individual sound parts”

If you or someone you know is concerned that their child may have dyslexia or developmental language disorder, the College of Health Solutions provides screening for children and has relevant information and resources, including the Child Language and Literacy Lab, which Gray founded. 

For more information, visit the Child Language and Literacy Lab.

Gray said that the team is submitting a research proposal to the National Institutes of Health hoping to get the additional funding, but is also seeking out other grants.

One of the main hopes for Gray with potential additional funding is to follow-up with families post diagnoses and to get the word out about the screening to pediatric offices.

“Hopefully we'll get this new funding, and then we'll be recruiting participants into the study,” Gray said. “We intend to do it through schools and pediatric offices.”

Another reason that the LDYSQ is so important is that it isn’t solely dealing with English-speaking children. For doctoral student R.J. Risueño, who speaks Spanish as a second language, there was always a question of: What can we do for the bilingual kids?

Risueño joined the research team after completing his master’s degree at Arizona State University. After translating the questionnaire into Spanish and getting parent’s feedback on wording, what Risueño found the most difficult is that there are little-to-no standardized measures of pre-literacy skills for bilingual children.

“That's been one struggle: how do we test for dyslexia in Spanish when we don't have these standardized… measures,” Risueño said. “And then the other problem that you're getting at is how do we account for dialectal differences?”

“That's been one struggle: how do we test for dyslexia in Spanish when we don't have these standardized… measures.,” Risueño said. “With bilingual children, language and literacy disorders are often over-identified or under-identified. They're over-identified when a school says, ‘Oh if they can't speak English they must have a language disorder’ and then they are mistakenly put into special education when they should not be there. But also they're under-identified because the school says, ‘Oh, well they haven't been in the U.S. long enough to learn English yet.’”

The team recently presented their research for the first time in July at the Symposium on the Scientific Studies of Reading in Copenhagen, Denmark. Risueño says that the team is eager to continue with the research.