Can speech therapy help with dyslexia?

Speech therapy can help with some of the skills that dyslexia affects, but it is not the best-supported treatment for the reading and spelling problem itself. The strongest controlled evidence favors systematic phonics teaching. A speech-language pathologist can work on sound skills, and that work is worth doing when the sound skills are part of the difficulty, but ask how the therapy will improve reading. For the wider picture, see our guide to speech to text for dyslexia and dysgraphia, part of our accessibility and health guides.

Speech therapy targets the sound skills that dyslexia affects

Dyslexia is defined by difficulty with word-level reading and spelling. A 2018 review says those difficulties are in turn caused by phonological deficits, which concern the sound structure of words ¹. Speech therapy addresses sound structure directly, so it is a reasonable place to look for help.

The same review summarizes the evidence that children with dyslexia, on average, perform poorly on phonological tasks, including phoneme awareness, word and nonword repetition, and word retrieval ². A speech-language pathologist can assess those skills and train them. That is the part of the work most closely tied to dyslexia.

These are group averages on specific tasks. They do not show that a particular person has dyslexia, and they do not show that a particular therapy will change reading. For the speaking side of the question, see does dyslexia affect speaking.

The strongest controlled evidence is for phonics, not for speech therapy as a service

The most useful evidence we found on treatment comes from a 2014 meta-analysis of randomized controlled trials of reading treatments for children and adolescents with reading disabilities. It included 49 comparisons of experimental and control groups ³. Phonics instruction was the only approach whose effect on reading and spelling was statistically confirmed ⁴.

That result is a clear signal. If you have to choose where to put effort and money, a program of systematic phonics teaching has the strongest support for the reading and spelling problem. Speech therapy is not a substitute for that teaching.

We did not find a controlled trial of speech therapy as a separate program for dyslexia, in the sources we checked. So the honest answer is not that speech therapy does nothing. It is that the controlled evidence for reading gains is for phonics, and the evidence for speech therapy as a whole is not established for dyslexia.

It depends on whether the problem is in speech, reading or both

The right service depends on where the difficulty sits. These are the cases we see most often, and each calls for a different first step.

• Mainly reading and spelling. The usual first step is a reading and spelling assessment and a structured literacy plan, such as phonics teaching. Speech therapy may be a useful addition if sound skills are weak, but it should not replace reading instruction.
• Mainly word retrieval. If the problem is finding words quickly, a speech-language assessment can measure it directly. Ask whether the assessment covers word retrieval and phonological skills, not only how sounds are pronounced.
• Mainly speech sounds. If the difficulty is pronouncing sounds, that is a separate problem from dyslexia, and it is the kind of difficulty speech therapy is designed to treat.
• Both. Many children and adults have more than one difficulty. Our question on dysgraphia and dyslexia covers how writing and reading difficulties overlap.

What to ask a speech-language pathologist before you start

A good plan can answer these questions. If it cannot, that is a reason to look elsewhere.

1. Which skills will you train? Ask for the specific sound skills, such as phoneme awareness, and how they connect to reading.
2. How will you measure progress? Ask for a baseline and repeat measures of reading and spelling, not only of speech.
3. How does the therapy connect to reading instruction? A plan that stands apart from reading teaching is harder to judge against reading gains.
4. What happens if reading does not improve? Ask when the plan will be reviewed and what the next step will be.

For a school-age child, ask the school which plan applies and whether the speech-language services are part of an Individualized Education Program. For more on accommodations, see our guide to speech to text for students with disabilities.

Use dictation and read-back while the therapy runs

Speech therapy takes time, and writing does not have to wait for it. Dictation lets you compose without choosing the spelling of every word. Read-back, where the software reads your text aloud, helps you catch words you did not mean to write. Our guide to speech to text for dyslexia explains the routine, and the question on text to speech or speech to text for dyslexia explains how to choose between them.

Dictation does not treat dyslexia. It works around the spelling step while you build the reading and spelling skills that the therapy and the phonics teaching are meant to strengthen. Keep both going, and measure both, so you can see which one is changing your results.