Correspondence (letter to the editor): Important Cofactors

The article described very competently the diagnostic evaluation and therapy of dyslexia from the perspective of child and adolescent psychiatry. In order to be able to assess the child in its entire cognitive-language learning development and not only with regard to the acquisition of written language competencies, the importance of peripheral auditory disorders, peripheral visual disorders, and auditory and visual processing and perception disorders should not be forgotten. As an example, peripheral auditory disorders —especially unilateral or minimal hearing impairments—have been confirmed to affect the quality of performance at school (1), so that the relevant diagnostic evaluation of peripheral auditory ability should be included in the diagnostic evaluation of dyslexia. Furthermore, close associations between specific language impairment and dyslexia are well known, so it seems advisable in a child with dyslexia to also test the current state of their expressive and receptive language skills development, in order to be able to include any deficits in these areas into the therapeutic concept. Finally, in case of primarily perception related spelling mistakes, diagnostic evaluation of auditory processing and perception (2) may be helpful, including performance of phonological awareness, especially as training in differentiating and identifying phonemes can have a positive effect on spelling (3), whereas, according to the current state of research, merely language-free auditory training does not yield any transfer effects for reading-spelling performance (3).