How is Orton-Gillingham Diagnostic and Prescriptive?


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All who are trained in Orton-Gillingham have something in common and that is that we follow this specific set of principles of the approach. These principles are the interwoven thread and commonality between everyone trained in Orton-Gillingham. 

In a previous post, I covered What does Explicit, Systematic and Sequential Teaching Look Like?

All of these principles are related back to the amazing work of Dr. Samula Orton and Anna Gillingham and what we refer to as the Ortonian Prescription.

To learn more about the Ortonian Prescription, check out Season 1, Episode 5 of the Together in Literacy Podcast: How Dr. Samuel Orton and Anna Gillingham’s Work Support Social-Emotional Learning.

Download a PDF version of this printable guide to the Orton-Gillingham Principles.

Here, I want to talk about two specific principles of the Orton-Gillingham approach; it is both diagnostic and prescriptive.

What does it mean that the Orton-Gillingham Approach is Diagnostic and Prescriptive? 

These are two incredibly important principles and also two that took me a long time to hone in my craft. It really does take time to become effective at being both diagnostic and prescriptive. 


When working with students, particularly challenged learners, being diagnostic means looking at all of the pieces of the puzzle. You may have your assessment data in place, perhaps there is an IEP in place, or you might not have any of that information available. What you do have in front of you is a challenged reader.  

What we want to do is to constantly monitor. When we have our diagnostic hat on, what are we monitoring? We are monitoring a variety of responses from our students:

  • Verbal responses
  • Non-verbal responses
  • Written responses

By being diagnostic, we are constantly checking, at multiple points throughout a lesson, whether a student is showing areas of weakness or where they’re showing areas of progress. Monitoring and looking at their verbal, non-verbal, and written responses will inform our instruction. So, as we work through a lesson, we can make adjustments as needed to our instruction. Or, we can make notes for future lessons. And this is what leads to being prescriptive.

Are you seeking an assessment for your Orton-Gillingham scope and sequence? Check out my Orton-Gillingham Diagnostic Assessment BUNDLE with scope and sequence.


Based on what we saw from a diagnostic perspective, we become prescriptive. This is where we take into account the areas where we saw challenges and weaknesses and where we saw areas of strength and progress. Then we use that information to create lesson plans that are tailored to the individual needs of that child. 

Our lesson plans are where we prove that we are prescriptive because they contain components or elements that specifically address the areas of weakness that we noticed in previous lessons. 

Anytime that there is a phonemic awareness drill, word reading, sentence reading, dictation, or any piece where you observed weakness in a previous lesson, those will be addressed and further monitored in subsequent lessons. 

We want to constantly monitor and take notes so that we can continue in that cycle. 

The Beauty of Being Both Diagnostic and Prescriptive

When we are diagnostic and prescriptive, we are always monitoring in the moment while also looking ahead at what to review in future lessons. The beauty of being both diagnostic and prescriptive is that sometimes, in the midst of a lesson, when things seem to be too challenging, we can make adjustments as needed…

  • We can change the tools you’re using.
  • We can change the strategies you’re using.
  • We can make decisions in the lesson.
  • We can cater to the individual needs of that student. 

Looking at the individual needs of learners, thinking about the materials we’re using, thinking about the pacing we have, looking at the way we introduce concepts, review concepts, and assess concepts, that is all going to help us to be a more diagnostic and prescriptive Orton-Gillingham educator. 

You can use Word List Builder to create customized and meaningful activities that are both diagnostic and prescriptive! Build your folder of words, create templates and games, and so much more!

Are you looking for professional development that will help you become a more effective structured literacy educator? The Literacy Nest has a membership for that

Building Readers for Life Academy is a monthly membership program that empowers educators AND families by diving into structured literacy and strategies for ALL learners. With BRFL Academy, you’ll learn what it takes to help EVERY student become a reader for life.

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