Who makes the diagnosis of dysorthographia

Who has the right to say that your child is dysorthographic? The teacher? The doctor? The speech and language therapist? The question matters, because the diagnosis opens the door to remedial support and school adjustments. Here is who makes the diagnosis, how, and the role of the other professionals in this process. Knowing who does what will spare you a great deal of back and forth.

The speech and language therapist makes the diagnosis

It is the speech and language therapist who makes the diagnosis of dysorthographia. They are the specialist in disorders of spoken and written language, trained to assess and treat them. The diagnosis they make is called a speech and language diagnosis. Their expertise covers every aspect of written language.

To do this, they carry out an assessment on medical prescription. They administer standardised tests, analyse errors, compare the results with age norms and look for underlying weaknesses. These tests allow an objective and comparable evaluation.

At the end of the assessment, they write a report which concludes whether or not there is dysorthographia, specifies its form and intensity, and proposes a remedial plan. This document is the basis for all the steps that follow. See the speech and language assessment.

The role of the GP

The GP does not make the diagnosis of dysorthographia themselves, but they play an essential role. It is they who prescribe the speech and language assessment, which is required for reimbursement. Their place in the process is indispensable.

They also check that there is no other cause for the difficulties: a problem with vision, hearing, attention disorder or another health problem. A diagnosis of a specific disorder assumes these causes have been ruled out. This process of elimination is a key step.

The GP receives the speech and language therapist’s report and can, in light of all the information, confirm the medical diagnosis of a learning disorder. They may also refer you to other specialists. See the role of the GP.

What the teacher does not do

The teacher does not make a diagnosis, even though they are often the first to notice difficulties. Their role is to observe, alert parents and adapt their teaching. They know well the level expected in their class.

Their observations are nonetheless very valuable. They can describe precisely your child’s difficulties in class and compare them with those of other pupils. Their written observations can be useful for the assessment.

Be wary of labels applied too quickly, in either direction: “they’re dys” or “there’s nothing wrong, they’re just lazy”. Only an assessment can settle the matter. A label wrongly applied can do a great deal of harm. See talking to the teacher.

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Other professionals

The neuropsychologist can assess other functions, such as attention, memory or reasoning. They do not make a diagnosis of dysorthographia, but they can identify associated disorders that make it worse. Their assessment complements that of the speech and language therapist.

The psychomotor therapist and the occupational therapist assess the handwriting movement. They can diagnose dysgraphia, often associated with dysorthographia. These disorders require specific support.

In complex situations, a reference centre for learning disorders can carry out a multidisciplinary assessment, with a joint conclusion from several specialists. These centres are mainly involved in complex cases.

The diagnostic criteria

To make a diagnosis of dysorthographia, the speech and language therapist checks several criteria. The spelling difficulties must be clearly below what is expected for the child’s age, according to standardised tests. These norms allow the child to be compared with others of the same age.

They must be persistent, present for at least several months despite normal teaching and appropriate support. They must not be explained by an intellectual disability, a sensory impairment or a lack of teaching. These criteria guarantee a rigorous diagnosis.

Finally, they must have a real impact on schooling or daily life. This impact criterion is essential. See dysorthographia or simple weakness in spelling.

When can the diagnosis be made

The diagnosis of dysorthographia is rarely made before Year 2 or Year 3. Before then, errors are part of normal learning, and it is hard to distinguish a disorder from a simple delay. Allowing time to learn avoids misdiagnosis.

This does not mean you should wait to act. An assessment can be carried out earlier if the difficulties are significant, in particular to identify weaknesses in spoken language or phonological awareness. Early help is always beneficial.

Conversely, the diagnosis can be made at any age, at secondary school, at sixth form or even in adulthood. There is no age limit for a diagnosis. See at what age to diagnose.

What the diagnosis is for

The diagnosis first of all allows the difficulties to be given a name. For the child and for the parents, it is often a relief: it was neither laziness nor a lack of intelligence. This relief often changes the whole family dynamic.

It then opens the door to speech and language remedial therapy, reimbursed by the Assurance maladie, and to school adjustments through a PAP. These supports make a real difference day to day.

It also makes it possible, if needed, to put together an MDPH file for greater support, and to request adjustments in examinations. These steps are only possible with a diagnosis. See after the diagnosis.

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Questions that keep coming up

Can a teacher say that my child is dysorthographic ?

No. The teacher can identify difficulties and alert you, but they do not make a diagnosis. Only a speech and language assessment, on medical prescription, can confirm dysorthographia. Their observations nonetheless remain very useful.

Can the doctor make the diagnosis alone ?

The GP prescribes the assessment and rules out other causes, but it is the speech and language therapist who precisely evaluates spelling and makes the speech and language diagnosis. The two professionals work in complementarity.

Can a neuropsychologist diagnose dysorthographia ?

The neuropsychologist assesses other functions, such as attention or memory. The diagnosis of dysorthographia falls within the speech and language therapist’s remit. Their assessment can nonetheless be useful as a complement.