The Mindfulness Series: Treating the whole dyslexic patient

Dyslexia can be defined as a reading disorder that is not caused by sensory or cognitive deficits, a lack of motivation, or adequate reading instruction. There is an increasing amount of research being done in the area of mindfulness strategies being incorporated into phonological processing intervention programs. I find this topic to be a high level of interest because of the discrepancies present in the current multidisciplinary team model. As a practicing speech-language pathologist in both education and medical scopes of practice, I find it “easier” to treat reading impairments in the medical world. Yes, you read that correctly. Reading impairments are “hard” to treat in the education world! Why? Districts do not want SLPs targeting reading instruction, and instead direct all reading interventions to the primary classroom teacher.

Why is this alarming?

During my career as a speech-language pathologist, I found myself needing to leave the educational practice school setting. I wanted to provide interventions for areas I was skilled in like dyslexia, but I was prevented from doing so. Children can have IEP goals and still fall through the cracks. How can SLPs treat the whole child without targeting reading intervention? There is a gap between clinical implications when practicing in the real world of highly structured systems (e.g., school districts) and multidisciplinary planning (e.g., working with other professionals). Because reading is such a high-cognitive task that impacts multiple domains of functioning, teams typically consist of a speech-language pathologist, classroom teacher, and psychologist.

How can we bridge the gap to better serve our dyslexic students?

I found the answer to my question during a thorough literature review of evidence-based methods being used by psychologists, teachers, and SLPs. The truth is that the only way of treating the whole child is through multidisciplinary collaboration. We learn from each other as professionals, while also coordinating care by teaching our team members techniques we have learned. The problem with this methodology is the systemic issue of not having multidisciplinary planning and collaboration time built in your schedule. It is a clinical skill and duty of the job, but employers don’t want to pay you for that. So… we are back to the cycle of not having enough support from the district to support our students holistically.

During my literature review, I found research supporting that…

• mindfulness techniques aided readers on the lexical level.

• significant correlations exist between reduced reading errors and decreases in impulsivity.

• mindfulness improved sustained attention.

3 ways to incite change:

1. Hold an in-service. Free continuing education opportunities do not always have to result in contact hours that you can report to ASHA. Knowledge is power. Your clinic manager, director of rehab, or team members are more likely to respect your views if you can support evidence-based practice and research.

2. Invest in a strong support team: Whether it means advocating for your clinical practice to hire and create roles to support the workplace, or building a student internship program, you can produce meaningful change. Sometimes, more evaluating and treating SLPs on the team isn’t what the team is lacking. Non-clinical or clinical roles that focus on research and process improvement are usually what is lacking. Support in numbers creates change.

3. Have a clear and measurable vision: In practical clinical situations, we have a plan of care and measurable benchmarks to monitor progress. The same is applicable when navigating the macrostructures of a workplace (e.g., school district, hospital, etc). We need to have a plan and measurable goals for what we are trying to accomplish with that specific patient. Are we trying to improve reading fluency, phonological errors, confidence, etc? The higher-ups may not buy-in to the notion that SLPs can improve or “fix” reading, however we may be able to cite evidence in improving a specific domain in reading.