Universal Screener for Dyslexia and Reading Difficulties in PDF/DOC format, complete with:

Universal Screener for Dyslexia and Reading Difficulties in PDF/DOC format, complete with:

• Key skill areas assessed

• Scoring guide

• RTI Tier suggestions based on results

• Observational notes

• Action steps

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📄 UNIVERSAL SCREENER FOR DYSLEXIA & READING DIFFICULTIES

Student Name: _____________________
Grade: _______
Date: _______________
School: ___________________________
Administered By: ___________________

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SECTION 1: PHONEMIC AWARENESS

Skill	Task Example	Score (✓/✗)	Notes
Rhyming	Say 2 words that rhyme with “cat”	___ /2
Phoneme Isolation	“What is the first sound in ‘dog’?”	___ /2
Phoneme Blending	Blend sounds /s/ /u/ /n/ → “sun”	___ /2
Phoneme Segmentation	Segment “fish” → /f/ /i/ /sh/	___ /2
Phoneme Manipulation	Change /m/ in “mat” to /s/ → “sat”	___ /2

Total (out of 10): _______
Proficiency:

• 8–10: At or above grade level

• 5–7: Monitor (Tier 1 support)

• 0–4: At risk (Tier 2–3 intervention)

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SECTION 2: RAPID AUTOMATIZED NAMING (RAN)

Task	Time Taken	Errors
Letters (a, s, m, t, r – repeated in a 5x5 grid)	___________	______
Numbers (2, 4, 7, 9, 5 – repeated in 5x5 grid)	___________	______
Colors or Objects (optional K-1)	___________	______

Observations: _________________________________
Concerns if:

• Significantly slower than peers

• 3 errors

• Difficulty maintaining flow

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SECTION 3: DECODING / PHONICS

Skill	Task	Score (✓/✗)
Letter-Sound Correspondence	Show 10 letters; ask sound	___ /10
CVC Word Reading	e.g., “mat,” “pin,” “dog”	___ /5
Digraphs	e.g., “ch,” “sh,” “th” words	___ /5
Blends	e.g., “slip,” “trap”	___ /5
Silent-e / VCe Words	e.g., “cake,” “bike”	___ /5

Total (out of 30): _______
Benchmarks:

• 25–30: Mastery

• 15–24: Developing

• <15: Intensive support needed

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SECTION 4: ORAL READING FLUENCY (GRADES 1+)

• Use a grade-level passage (100–200 words)

• One-minute timed read

• Count WPM (words per minute) and accuracy

WPM: __________
Accuracy (%): _______%
Expression/Prosody (1–4): _____
Fluency Norms by Grade:

• 1st: 30–60 WPM

• 2nd: 70–100 WPM

• 3rd: 85–115 WPM

• 4th: 100–140 WPM

• 5th+: 120–160 WPM

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SECTION 5: SPELLING INVENTORY

Word	Correct/Incorrect	Error Type (phonetic, visual, omission, etc.)
1. hat	___
2. flip	___
3. shop	___
4. cake	___
5. train	___
6. swim	___
7. jump	___
8. night	___
9. red	___
10. bed	___

Total: ___ /10
If <7/10: Consider phonics/spelling intervention (OG, Wilson, etc.)

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OBSERVATIONAL CHECKLIST

Behavior	Observed?
Reverses letters (b/d, p/q)	☐
Struggles with left-to-right tracking	☐
Avoids reading or gets frustrated	☐
Difficulty with rhyming	☐
Poor spelling or phonetic approximations	☐
Family history of reading difficulties	☐
Difficulty copying from board	☐

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RTI INTERVENTION SUGGESTIONS

Tier 1: Universal Instruction (80–85%)

• High-quality core reading instruction

• Multisensory phonics and fluency practice

• Progress monitoring every 6 weeks

Tier 2: Targeted Small Group (10–15%)

• 30 minutes/day, 3–5x/week

• Structured OG-based phonics program

• Decoding/encoding, blending, and fluency

• Monitor every 2–4 weeks

Tier 3: Intensive Intervention (5–10%)

• 1:1 or 1:2 explicit reading intervention

• Daily 45–60 minutes

• Structured Literacy (Orton-Gillingham, Barton, Wilson)

• Consider referral for psychoeducational eval

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NEXT STEPS

☐ Schedule parent conference
☐ Begin RTI Tier ___ support
☐ Refer for dyslexia screening
☐ Provide classroom accommodations
☐ Monitor with DIBELS / Acadience / EasyCBM

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✅ SCREENING SUMMARY

Risk for Dyslexia: ☐ Low ☐ Moderate ☐ High
Recommended Tier: ☐ 1 ☐ 2 ☐ 3
Follow-Up Date: _______________

Screener Notes/Recommendations:

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