If you can afford it, you will get far more detailed information from a private neuropsych than from either the school or children's. There is also likely a wait, so I would schedule now and you can always cancel if your concerns resolve.

What is her phonemic awareness like? How does she score on dibels? That's more relevant to possible dyslexia than letter reversals.

I’d tackle the anxiety first, which is a psychiatric only eval. Once you’ve got that managed you can better look for educational concerns. I’d wait for an expensive neuropsych.

Also, you might want to start addressing the anxiety. Our kid was diagnosed by a pediatric psychiatrist.

Could go either way on this. If you wait another year when she’s reading/writing they’d be able to know more about those skills. On the other hand if she’s not on track to grow those skills it’s good to test now.

If you are in the DC area, there are a few places that take insurance- Children’s and KKI come to mind. You could get on the waitlists now, since it’s not urgent.

7 is a perfectly good age to test. School gets progressively harder. Dyslexia and many other learning/neurological differences are able to be diagnosed at that age.

My son is not even 5 and we already know he has some learning differences. For now he sees a developmental pediatrician and is doing suggested therapies, but fully intend to do a neuropsych when he’s 6-7.

I think this is a good time to test. She's been in school long enough that the results will be reliable, and it's before gaps get too big and harder to remediate.

Unfortunately, it's hard to get coverage for a neuropsych unless there is a medical disorder. It will likely end up being OOP.

I am not sure when and how best (or if) to go about getting testing for my DD to see if there are any underlying causes for her poor performance.

Background on DD:
DD is 7 and just completed 1st grade. Her NNAT was ~10th percentile and her iready scores have been ~15th percentile. In math we think she is closer to average than her scores show. However, in reading she is behind despite a full year of pull outs, reading every night, etc. We have not been able to get a clear sense on her abilities relative to her peers in reading (reading specialist and teacher say two different things both below average just how far below in question)
She does have extremely very high anxiety around all Drs and Dentist appointments. To the point where getting any diagnosis or opinion from them is impossible. Although, our dentist did ask if she was nerotypical. She also demonstrates some rigidity about the way things are done or how people should play and pretend. She very rarely is able to entertain herself, even as a toddler. Aside from the above she seems to be very nerotypical to me but obviously the school performance is concerning.

My question is do I wait a little longer to see if she catches up before pursuing testing? (We did try to go through the schools but because she isnt a disruption in class and letter confusion is still normal they won't pursue testing). If we should pursue testing any advice on how to figure out if any will be covered by insurance or Drs recommendation who still work with insurances (everything I've found implies they dont work with insurance and its all OOP). Thanks in advance