Authors: Elise H. de Bree, Madelon van den Boer, Boukje M. Toering, Peter F. de Jong.

Article: A stitch in time…: Comparing late-identified, late-emerging and early-identified dyslexia.

Publication: Dyslexia (Wiley). First published: 18 May 2022 2022 | DOI: 10.1002/dys.1712

[Full Text] [PubMed]


When dyslexia is diagnosed late, the question is whether this is due to late-emerging (LE) or late-identified (LI) problems. In a random selection of dyslexia-diagnosis case files we distinguished early-diagnosed (Grade 1–3, n = 116) and late-diagnosed (Grade 4–6) dyslexia. The late-diagnosed files were divided into LE (n = 54) and LI dyslexia (n = 45). The LE group consisted of children whose national-curriculum literacy outcomes did not warrant referral for dyslexia diagnosis in Grades 1–2; the LI group of children whose literacy outcomes did, but who were referred for diagnostic assessment after Grade 3. At the time of diagnosis, the percentage of poor performers on word-level literacy measures generally did not differ between the groups. Only the LE group contained fewer poor performers than the early-diagnosed and LI group on some word-reading measures. All groups showed similar distributions of phonological difficulties. There were no indications of compensation through vocabulary, memory or IQ in either late-diagnosed group. Our diagnosis-based study confirms and extends previous research-based studies on LE dyslexia. Moreover, it shows that LI dyslexia exists, which can be regarded as the existence of instructional casualties. The findings speak to issues of identification, diagnosis and compensation and call for further efforts to improve the early identification of dyslexia.

Key messages


  • Ideally, severe and persistent word-level reading difficulties (dyslexia) are detected as early as possible.
  • Our findings confirm findings that late-emerging dyslexia exists, meaning that the severe and persistent poor performance surface later.
  • We also found that late-identified dyslexia exists, meaning that children were referred later than their reading outcomes warranted.
  • The late-emerging and late-identified groups do not show evidence of compensation of literacy abilities.
  • Efforts should be made to avoid such instructional casualties (late-identified dyslexia) and to support the school literacy curriculum.

Tagged as: diagnosis, late-emerging dyslexia, and late-identified dyslexia


de Bree, E. H., van den Boer, M., Toering, B. M., & de Jong, P. F. (2022). A stitch in time…: Comparing late-identified, late-emerging and early-identified dyslexia. Dyslexia, 1– 17.

Excerpts from Full Text / Notes:

At the end of Grade 1, the LI group resembled the early-diagnosed group in word-level literacy, the selection criterion, but also in text reading and reading comprehension. As reading comprehension can be argued to largely reflect word-reading ability at this early phase of literacy instruction, the reading comprehension findings match those of the poor word reading skills of the groups. At the time of the diagnosis, word reading and spelling deficits were also similar in both groups. In contrast, the LE group contained fewer children with word reading accuracy and speed deficits at the time of diagnosis.


With respect to the LE group, our findings do not agree easily with the assumption that dyslexia is late-emerging due to the presence of protective factors in the late-dyslexia group. Although the LE group showed less severe word reading difficulties at the time of diagnosis on some measures, they did not show outspoken strengths in phonology or other cognitive abilities…. our LE group does not have a distinct poor early literacy profile, making the eventual dyslexia of these children difficult to predict. Possibly, the transition from accuracy to fluency is most difficult for this group of children.
In sum, our diagnosis-based study confirms and extends the findings of previous research-based studies that dyslexia can be late-emerging. This calls for more attention to the way dyslexia surfaces across the lifespan and the required support. Our findings also indicate that instructional casualties occur, as a substantial number of children in this study were identified late with dyslexia. The literacy outcomes of these children resemble those of early-diagnosed children and are poorer than those of children with LE dyslexia. The findings thus call for further attention to shaping and supporting the literacy curriculum at schools. This proverbial stitch in time should prevent late identification from occurring as well as optimize general literacy instruction

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