Abstract
A dyslexia diagnosis in Denmark can have significant consequences for individuals, as support is not available to others with reading difficulties. Currently, the diagnosis is given solely on the basis of an electronically administered test consisting of two tasks assessing grapheme-phoneme correspondences. To examine whether the Danish diagnostic test is sufficient to identify university students with dyslexia, we compared the performance of 239 Danish university students who reported literacy difficulties and were tested for dyslexia with the Danish diagnostic test on three word-level tests (low-frequency word reading, high-frequency word reading and spelling to dictation) with the performance of separate control groups for each test: 220, 212 and 218 students, respectively. The results showed that 61% of students labelled “not dyslexic” by the Danish diagnostic test performed significantly worse than controls on at least two out of three word-level tests. In terms of self-report of literacy difficulties, students labelled “not dyslexic” by the diagnostic test were indistinguishable from those labelled “dyslexic.” These findings suggest that the current method of diagnosing dyslexia in Denmark is too narrow and that adding a few simple tests of word reading and spelling would minimize the risk of overlooking students in need of literacy support.
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07 June 2022
A Correction to this paper has been published: https://doi.org/10.1007/s11881-022-00259-z
Notes
In Denmark, primary school refers to grades 0 through 9, usually corresponding to ages 6–16.
According to data from the Danish Ministry of Higher Education and Science, 57% of new students admitted to bachelor programs at Danish universities in 2021 were women (Uddannelses- og forskningsministeriet, 2021), and according to unpublished data from 2020–2021 from the literacy support unit at the university, approximately 70% of students seeking assessment or literacy support at Aarhus University were women.
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Acknowledgements
The authors thank colleagues and student assistants in the Literacy Counselling Team at the Counselling and Support Centre of Aarhus University for the data collection and Anne Leth Pedersen for valuable feedback on early drafts of the paper. We also thank the reviewers for their comments and questions which helped us improve the paper.
Funding
The research was funded by our respective universities.
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Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation was performed by Katrine H. Bønnerup, Helle Fredslund Ottosen and colleagues at the Counselling and Support Centre of Aarhus University under the supervision of Rauno Parrila. Data collection was performed by Katrine H. Bønnerup, Helle Fredslund Ottosen, colleagues and student assistants at the Counselling and Support Centre of Aarhus University. Analyses were performed by Ethan Weed and Helle Fredslund Ottosen. The first draft of the manuscript was written by Helle Fredslund Ottosen and Katrine H. Bønnerup, and all authors commented on and edited previous versions of the manuscript. All authors read and approved the final manuscript.
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Ethics approval
We declare that we complied with the university guidelines that were in place in 2015–2019 when we collected the data.
Consent to participate
All participants gave consent to participate in the study. The participants with literacy difficulties gave written consent, and the control participants, who completed only one task and provided no identifying information, gave oral consent.
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The research was completed while Helle Fredslund Ottosen was affiliated with the Counselling and Support Centre at Aarhus University, Denmark.
Appendices
Appendix 1 Words in spelling test, 30 items
fedtet.
flypassagererne.
uciviliserede.
transporterede.
torskerogn.
lærerne.
erhvervslivet.
konkurrence.
kontrolleret.
beskadiget.
forargede.
ingeniører.
niveauet.
blokering.
torpederede.
observation.
konklusionsafsnittet.
ordentlige.
hierarki.
nødt.
øjenkrogen.
fedt.
schæferhund.
passager.
erindrer.
fysioterapeut.
buschaufføren.
erhverv.
bevidstløshed.
forarger.
Appendix 2 Low-frequency word list, 30 items
Irrelevans.
Eksplicit.
Supplement.
Delfortolkning.
Legitim.
Negation.
Observation.
Kriterier.
Formidlende.
Efterfølgeligt.
Processering.
Argumentatorisk.
Kvalitativt.
Kompilation.
Reservoir.
Centrerede.
Karakteristika.
Subjektsprædikat.
Værdiopfattelser.
Komplementaritetsprincip.
Oligarki.
Ionisere.
Traumatisk.
Gymnasiast.
Homogeniseret.
Hermeneutik.
Epistemologi.
Apoplektisk.
Metabolisme.
Allegoriseringer.
Appendix 3 High-frequency word list, 40 items
læ ti.
dusø.
ur at.
piltør.
sætjul.
køn vin.
træ abe.
fri glo.
øje stå.
håbe huse.
løbe gave.
dyne dåse.
birk aske.
skud bold.
gladblød.
æble gråt.
kistekasse.
trøst smagt.
strøm straf.
kærlighed kedeligt.
Appendix 4 Adult Reading History Questionnaire – Revised, Danish version (English translation)
Elementary school questions
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1.
How much difficulty did you have learning to read in elementary school? (0 = none, 4 = a great deal)
-
2.
How much extra help did you need when learning to read in elementary school? (0 = no help, 4 = a great deal)
-
3.
Did you ever reverse the order of letters or numbers when you were a child? (0 = no, 4 = a great deal)
-
4.
Did you have difficulty learning letter and/or colour names when you were a child? (0 = no, 4 = a great deal)
-
5.
How would you compare your reading skill to that of others in your elementary classes? (0 = above average, 4 = below average)
-
6.
All students struggle from time to time in elementary school. In comparison to your classmates, how much did you struggle to complete your work? (0 = not at all, 4 = much more than most)
-
7.
Which of the following most nearly describes your attitude toward reading as a child? (0 = very positive, 4 = very negative)
-
8.
When you were in elementary school, how much reading did you do for pleasure? (0 = a great deal, 4 = none)
-
9.
How would you compare your reading speed in elementary school with that of your classmates? (0 = above average, 4 = below average)
-
10.
How much difficulty did you have learning to spell in elementary school? (0 = none, 4 = a great deal)
-
11.
When you were in elementary school, how many books did you read for pleasure each year? (0 = more than 10, 4 = none)
Current status questions
-
1.
How much difficulty do you currently have with reading? (0 = none, 4 = a great deal)
-
2.
Have you received extra help during your postsecondary education? (0 = no help, 4 = tutors)
-
3.
How would you compare your reading skill to that of others in your postsecondary classes? (0 = above average, 4 = below average)
-
4.
All students struggle from time to time at the postsecondary level. In comparison to your classmates, how much do your struggle to complete your work? (0 = not at all, 4 = much more than most)
-
5.
Have you experienced difficulty reading or writing in academic Danish? (0 = none, 4 = a great deal)
-
6.
What is your current attitude toward reading? (0 = very positive, 4 = very negative)
-
7.
How much reading do you do for pleasure? (0 = a great deal, 4 = none)
-
8.
How would you compare your current reading speed with that of others with the same age and education? (0 = above average, 4 = below average)
-
9.
How would you compare your current spelling to that of others with the same age and education? (0 = above average, 4 = below average)
-
10.
Do you currently reverse the order of letters or numbers when you read or write? (0 = no, 4 = a great deal)
-
11.
How many books do you read for pleasure each year? (0 = more than 10, 4 = none)
Appendix 5
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Ottosen, H.F., Bønnerup, K.H., Weed, E. et al. Identifying dyslexia at the university: assessing phonological coding is not enough. Ann. of Dyslexia 72, 147–170 (2022). https://doi.org/10.1007/s11881-021-00247-9
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DOI: https://doi.org/10.1007/s11881-021-00247-9