Learning Differences · Video

Not All Dyslexia Looks the Same

Two children can read at exactly the same level for completely different reasons — and the reason is what decides which instruction will work.

Dr. Leah Skinner, Ed.D. | Duration 7:37 | Published October 2026

The short answer

Dyslexia is a difficulty with reading, but it is not one difficulty. In one child the breakdown is in hearing and manipulating the sounds in words. In another the sounds are fine and the problem is speed — every word gets decoded correctly and slowly, every time. In another, decoding is accurate and the sentence is gone by the end of it. All three read below grade level. All three need different instruction. That is why a reading level is a starting point and an assessment is the actual answer.

Key takeaways

A reading level says how far behind, not why

Two children at the same grade equivalent can have completely different things wrong. The level sets the urgency. The profile sets the plan.

Most dyslexia involves the sounds in words

Phonological processing — hearing, separating and manipulating the individual sounds in spoken language — is the most common point of breakdown and the best-evidenced target for instruction. It is where an assessment looks first.

Speed and accuracy are separate problems

A child can decode almost every word correctly and still be unable to read, because it takes them so long that the meaning falls apart on the way. Accuracy and fluency need measuring separately, and they respond to different instruction.

The named categories are useful shorthand, not fixed diagnoses

“Phonological”, “surface”, “double deficit” are descriptions of patterns, and the research on how cleanly they separate is genuinely mixed. What is not in dispute is that the underlying skills differ between children and can be measured.

Structured literacy is the answer in every profile — the weighting is what changes

No profile calls for a different method. Every one of them calls for explicit, systematic instruction in the code. What the assessment decides is where the hours go: more on phonological awareness, more on orthographic patterns, more on fluency, or more on holding meaning across a sentence.

Chapters

What the research actually supports

You will find lists of four, six or eight “types of dyslexia” online, and figures attached to them about how much difference the right match makes — usually presented as settled. They are not, and it is worth knowing where the solid ground is before you read anyone’s report, or any claim on this subject. Including ours.

  • The phonological and surface patterns are real, but they do not hold still. Children do group that way at a point in time. Followed over several years, the groupings were only fairly stable, and the authors concluded there was modest evidence for the distinction being valid but not for it being clinically useful on its own.Peterson, R. L., Pennington, B. F., Olson, R. K. & Wadsworth, S. J. (2014). Longitudinal stability of phonological and surface subtypes of developmental dyslexia. Scientific Studies of Reading — pmc.ncbi.nlm.nih.gov/articles/PMC4241299
  • The double deficit is a serious idea with serious challenges to it. Wolf and Bowers proposed in 1999 that slow naming speed is a second core deficit alongside phonological processing, and that children with both are the hardest to help. A later review of the whole evidence base concluded that naming speed does not hold up as a separate persistent core deficit, in part because the two are so closely correlated that they are hard to pull apart.Vukovic, R. K. & Siegel, L. S. (2006). The double-deficit hypothesis: a comprehensive analysis of the evidence. Journal of Learning Disabilities, 39(1), 25–47.
  • “Working memory dyslexia” is not a recognised category. Working memory weakness is real, it is commonly measured, and it genuinely affects whether a child can hold a sentence together while decoding it. It is not a type of dyslexia, and no classification system lists it as one.
  • What is not in dispute. The underlying skills — phonological awareness, decoding, naming speed, fluency, spelling, working memory, listening comprehension — differ between children, can be measured reliably, and point at different places to put the instructional effort. That is the finding this page rests on, and it does not require anyone to believe in six discrete types.International Dyslexia Association, Definition of Dyslexia — dyslexiaida.org/definition-of-dyslexia
  • About the figures in the video. The video cites a hundred hours of mismatched instruction producing no progress, and a twenty-two point standard score gain when the same hours are matched to the profile. Those numbers reflect clinical experience of what the difference can look like, not a published trial, and they should be read that way. The underlying claim — that instruction aimed at the wrong skill wastes a child’s year — is well supported. A specific point gain for your child is not something anyone can promise.

The patterns you will see in a report

These are descriptions, not diagnoses. Most children show some of more than one, and the point of naming them is to say where the instruction should be weighted.

Sound-based difficulty

The most common pattern. Unfamiliar words cannot be decoded, nonsense words are very hard, and the child guesses from context and pictures. Instruction is weighted heavily toward phonological awareness and explicit decoding.

Pattern-based difficulty

Decoding works, letter by letter, every time — including for words the child has met a hundred times. Spelling is phonetic rather than conventional. Instruction is weighted toward orthographic patterns and building automatic recognition.

Speed difficulty

Phonological skills test as intact and reading is still very slow. These children are sometimes told they are not really dyslexic, because accuracy looks acceptable in isolation. Instruction keeps the code teaching and adds structured work on fluency.

Both sounds and speed

Weakness in phonological processing and in naming speed together. This is typically the hardest profile to move and needs the most instruction, most often — which is worth knowing at the start rather than discovering a year in.

Comprehension that collapses across a sentence

Decoding is accurate but by the end of a long sentence the beginning is gone. Working memory is usually the constraint. Instruction keeps the decoding work and adds explicit strategies for holding and recovering meaning.

More than one thing at once

Very common, and not a separate category — dyslexia alongside ADHD, dysgraphia or dyscalculia. It matters because the plan has to account for all of it: a child who cannot stay in the lesson cannot benefit from the lesson, however well the reading instruction is targeted.

What a comprehensive assessment measures

  1. Phonological awareness. Hearing, separating and manipulating sounds in spoken words, with no letters involved. The first place to look, and a weakness here explains most of what appears further down the report.
  2. Decoding, including nonsense words. Invented words cannot be recognised from memory, so they test decoding itself rather than vocabulary. A large gap between real-word and nonsense-word reading is one of the clearest signals there is.
  3. Rapid automatized naming. How quickly a child can name a sequence of familiar letters, digits or colours. It is the measure that separates a child who is slow from a child who is inaccurate.
  4. Reading fluency. Accuracy and rate together, in connected text. This is where a child who decodes correctly but at enormous cost becomes visible.
  5. Spelling and written expression. Spelling often shows the gap more clearly than reading does, because there is nothing to guess from.
  6. Reading comprehension against listening comprehension. The gap between what a child understands when they read it and when they hear it is one of the most informative numbers in the report.
  7. Working memory and oral language. To establish what is intact as well as what is not — and because a strong oral vocabulary alongside weak decoding is the classic profile of a bright child who has been missed.

A report that stops at scores has stopped too early. The part that decides whether the assessment was worth doing is the set of instructional recommendations — what a teacher or tutor should actually do differently on Monday.

Screener, school evaluation, comprehensive assessment

Three different tools answering three different questions. Families are often given one and told it covers all three.

A screener asks: should we look closer?

A few minutes, a handful of early skills, a yes or a no. It is designed to sort children into “look closer” and “carry on”, and that is the whole job. It is not a diagnosis and it does not say what is wrong.

A school evaluation asks: does this child qualify for services?

It is free, it is thorough, and it is built to answer an eligibility question under the law. It is also the only route to an IEP, which is why it is worth requesting whatever else you do.

A comprehensive assessment asks: what exactly is breaking down, and what instruction addresses it?

Different question, different answer. It measures the profile in detail and produces instructional recommendations rather than an eligibility finding — and the report is yours.

If you can only do one, start with the school evaluation.

It costs nothing and it is the only path to services. A comprehensive assessment is worth adding when you need the detail an eligibility decision does not require, when the findings do not match what you see, or when you want answers sooner.

What to do once you have the report

  1. Find the subtest table, not the summary. Composite scores average several measures together, so a real weakness can disappear into an unremarkable overall number. The pattern is in the individual subtests.
  2. Ask which scores sit furthest below your child's own average. Not below the national average — below their own. That comparison is what identifies the profile and it is a question an assessor can answer in one sentence.
  3. Check the recommendations name a programme and a frequency. “Structured literacy instruction” is a category. You want the programme, the minutes per week and who is qualified to deliver it.
  4. Take it to the school. The district has to consider a private evaluation that meets its criteria. It does not have to agree with it, but it does have to look at it, and a detailed report changes the conversation in an eligibility meeting.
  5. Keep the baseline. Whatever happens next, those scores are the number you will measure the next year against. Without them nobody can tell you whether the instruction worked.

Questions parents ask

What are the different types of dyslexia?

The patterns most often described are phonological (difficulty with the sounds in words), surface or orthographic (accurate but slow, because familiar words never become automatic), a combination of weak phonological processing and slow naming speed, sometimes called a double deficit, and profiles where comprehension collapses because working memory cannot hold the sentence together. It is worth knowing that these are descriptions of patterns rather than fixed diagnostic categories, and the research on how cleanly they separate is mixed. What matters practically is which underlying skills are weak in your child, because that is what decides where the instruction is aimed.

Does it matter which type of dyslexia my child has?

It matters for the weighting, not for the method. Every profile needs structured literacy — explicit, systematic instruction in the relationship between sounds and letters. What the profile changes is where the hours go: a child whose phonological processing is weak needs far more time there, while a child whose decoding is accurate but desperately slow needs the same code instruction plus structured fluency work. Instruction aimed at the average struggling reader is aimed at nobody in particular, which is the practical reason the assessment is worth doing.

What can be mistaken for dyslexia?

Several things, which is why a measured assessment beats a checklist. ADHD can produce inattentive reading that looks like a decoding problem. Slow processing speed can look like dyslexia on a timed task and nothing like it on an untimed one. Uncorrected vision or hearing difficulties, a language delay, and simply having missed a lot of instruction can all produce a child who is behind in reading. An assessment separates these because it measures the components rather than the outcome.

Are there mild forms of dyslexia?

Yes — reading difficulty sits on a continuum, and where a line is drawn is partly a matter of where the cut-off is set. Mild cases are missed constantly, particularly in bright children who compensate well enough to look average while working several times harder than their classmates to get there. A child performing at expectation and exhausted by it is a common profile and a real one.

How is a comprehensive assessment different from the school's?

They answer different questions. A school evaluation establishes whether a child qualifies for special education services, which is a legal determination and the only route to an IEP. A comprehensive assessment is built to identify which specific skills have broken down and what instruction addresses them, and it produces recommendations rather than an eligibility finding. Many families do both, and if you can only do one, start with the free school evaluation.

What happens in a comprehensive assessment?

Four parts: a parent interview covering history and what you see at home, a standardised testing battery of roughly two and a half to three hours across phonological processing, decoding, naming speed, fluency, spelling, comprehension and oral language, a review of school records and any previous reports, and a written report delivered in a consultation where it is explained rather than handed over. The report should include instructional recommendations, not only scores.

Full transcript

Transcript
00:06 Hello and welcome. I’m so glad you’re here. I know that if you’re watching this, you’re on a really personal journey to understand your child’s learning. And my hope today is to just create a little space of clarity and honestly a lot of hope for you. We’re going to dive into why understanding
00:22 your child’s specific type of dyslexia is probably the single most important step you can take to help them truly, truly thrive. This quote, “Wow, it just gets right to the heart of everything, doesn’t it? I know that feeling so well, sitting in that evaluation, your heart
00:37 just pounding and then you walk out with a single word, dyslexia.” But what are you supposed to do with that? As the author says, I know because I sat in that chair, too. A label can feel like an ending, but a profile, oh, a profile is a beginning. And this is the
00:53 fundamental difference right here. A label just confirms that there’s a challenge. A profile is your road map. It literally maps out the beautiful, unique landscape of your child’s mind, showing you their strengths and the exact places they need support, so you
01:08 know precisely which path to take. It’s what turns all that confusion into a clear, actionable plan. Okay, so this is the thing that most parents are never told and it’s so important. Dyslexia isn’t just one thing. It’s not a monolith. It shows up in a bunch of
01:25 different ways because it can be caused by different little breakdowns in the brain’s reading system. And that means that two kids, both with that same dyslexia label, might need completely different kinds of help. You know, this research really puts it into perspective. The stakes are so high. If
01:43 you don’t know exactly what the underlying issue is, you can’t pick the right tools to fix it, you’re just guessing. And when it comes to our kids and their confidence and their future, guessing just isn’t an option. And that guessing, it has a real cost. This isn’t
01:58 just a theory. The research has actually put a number on it. And it’s a number that represents so much time and so much effort and so much hope. 100 hours.
02:10 Just let that sink in for a minute. That’s basically a full school year of intervention sessions. A whole year of your child showing up trying their best.
02:18 A year of you rearranging your life to get them there. All of that energy poured into a program that wasn’t matched to their specific profile. And the result of all that work, no meaningful progress. It’s just heartbreaking. Can you imagine the frustration for your child who is trying
02:36 so, so hard but just not getting anywhere? And the weight on you as a parent watching them struggle. That lost time, it’s so much more than just a number. But here’s the hopeful part.
02:49 Now, let’s look at the same 100 hours, same amazing kid, same dedicated family. The only thing we’re changing is that the intervention is now precisely, perfectly matched to their unique learning profile. And the impact, a documented 22-point jump in their standard score. I mean, that’s not just
03:06 progress. That is life-changing. That is the difference between feeling stuck and left behind and confidently moving right into the average range with their peers.
03:15 It’s the same amount of effort, just finally aimed at the right target. This is what happens when we stop guessing and start knowing. So, how do we find that target? It all starts with understanding these different profiles.
03:28 We’re going to walk through the six main subtypes now. And please don’t let this feel overwhelming. My real hope is that maybe, just maybe, you’ll see your child in one of these descriptions and it will feel like a light bulb turning on. Okay, first up is the phonological profile. This
03:44 is what many of us think of as classic dyslexia. It’s a child who really struggles to hear and work with the individual sounds in words. You know, like hearing the P sound in spin. Then you have the surface or orthographic profile. This kid might be pretty good
03:58 at sounding out new words, but they read so slowly because their brain doesn’t store those tricky, irregular words like said or friend as pictures. You can already see how they need totally different kinds of practice. Right?
04:10 Next, we have what’s called the double-deficit profile. This is when a child has trouble with both the sound processing we just talked about and something called rapid naming, which is just how quickly their brain can name things like colors or letters. Then there’s the RAN, or rapid naming profile
04:25 all on its own. These kids are often really accurate readers, but they are just so slow. Reading never becomes automatic for them. And then there’s a working memory profile. This is the child who might read every single word in a paragraph perfectly, but by the
04:40 time they get to the end, they’ve forgotten how it started, so they have no idea what it was about. And finally, you have the mixed profile, which is when a child has a few of these challenges at once, often alongside something like ADHD. Each one of these needs such a unique tailored plan. So,
04:56 now you’re probably thinking, “Okay, this is great, but how in the world do I find out which profile my child has?” This is where it’s so important to talk about having the right tool for the job, because not all evaluations are the same. Not even close. This slide really
05:11 says it all. A typical school evaluation is designed to answer one question, and one question only. Does this child check enough boxes to qualify for services?
05:21 It’s really about eligibility. But a deep assessment, its entire purpose is to tell you what to do. It’s the difference between a gatekeeper and a guide. A deep assessment is the tool that actually builds that road map we’ve been talking about. It goes way beyond
05:36 just a simple reading score. It looks under the hood of the car, so to speak, to figure out why things aren’t running smoothly. It finds the root cause so we can create a truly personalized plan.
05:47 And as you can see, it looks at all these different puzzle pieces. It measures sound processing and naming speed and decoding all separately. This is how you get that complete three-dimensional picture of your child’s brain, identifying not just their challenges, but their amazing
06:02 strengths, too. So, let’s bring this all home. When you have this information, it truly changes everything. It’s the thing that moves your family from a place of confusion and frustration to a place of empowerment with a clear, hopeful path forward. I want you to just take a
06:17 breath and really let this one sink in. Hearing that word dyslexia can feel so heavy. It can feel like the end of something, but it’s not. It’s the beginning of a new chapter, a better, more informed one. It’s the starting gun that says, “Okay, we know what we’re
06:35 aiming at now. Let’s go.” When it all comes down to it, this is the truth. Your child’s unique profile is everything. It’s the key that unlocks the door to an intervention that is tailor-made for them. An intervention that finally honors all of their hard work and lets them see the incredible
06:51 progress they so, so deserve. This journey can feel so big and overwhelming, I know. But it does not have to be a journey of guesswork. You can have a map. You can have real answers. You can know with confidence exactly what to do next to help your child unlock their incredible potential.
07:10 You are their fiercest advocate and you can absolutely do this.
LS

About the author

Dr. Leah Skinner, Ed.D.

Founder, READ Learning Center

Dr. Leah Skinner is a Certified Dyslexia Therapist with a Doctor of Education in Reading, Literacy and Assessment and a Master of Education with a specialization in dyslexia. She has more than twenty years of experience in structured literacy, dyslexia intervention and educational advocacy, and founded READ Learning Center and READ Academy of Sacramento.

This video is based on the full article, Identifying Dyslexia by Subtype.

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