Can a child with Selective Mutism be diagnosed with dyslexia if they cannot speak during the assessment?
This is a question that parents and professionals ask frequently.
Unfortunately, the answer is no—not if the child is unable to complete the spoken components that are essential to a valid dyslexia assessment.
Unlike autism, where diagnosis is based on a comprehensive clinical picture gathered from multiple sources, dyslexia assessment requires evidence of specific literacy and phonological processing skills. Some of these skills can only be measured through spoken responses.
Although many parts of a dyslexia assessment can and should be adapted to reduce communicative demands, there comes a point where further adaptation would change what is being assessed. At that stage, the assessment is no longer measuring the underlying construct required for a formal diagnosis.
This does not mean the child does not have dyslexia.
It means that there is insufficient valid evidence to make a formal diagnosis because the child’s selective mutism has prevented access to essential parts of the assessment.
A responsible assessor should therefore avoid saying either:
- “The child does not have dyslexia.”
or
- “The child definitely has dyslexia.”
Instead, the conclusion should be that a formal diagnosis cannot currently be confirmed because the assessment could not be completed validly.
Where there is strong evidence suggesting dyslexia, the assessor should clearly document these concerns, explain why a diagnosis cannot yet be made, recommend appropriate literacy support based on the child’s needs, and consider reassessment if and when valid access to the remaining assessment components becomes possible.
The important message for families is this:
A lack of diagnosis is not the same as a lack of difficulty.
by Libby Hill, Speech and Language Therapist
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