Support for students with dyslexia in Irish higher education institutions is coordinated in a traditional medical model approach to disability provision; students must produce diagnostic evidence to register with their Disability Service. However, recently, approaches to supporting diverse students aligned more closely to the social model of disability have entered the sector through the increased provision of mainstream student services and the introduction of Universal Design for Learning (UDL). This presents a challenge to the traditional dyslexia support role of Disability Service staff. This study explored this evolving role through two sequential research phases: 1) an online questionnaire circulated to Disability Service staff nationally (n=43); and 2) a multi-site case study of three Disability Services involving both staff (n=10) and students (n=12) with dyslexia. The findings indicate that both staff and students hold nuanced perspectives of dyslexia beyond the parameters of a medical model understanding. Aspects of Disability Service provision were seen as performing well at meeting the needs of students, particularly exam accommodations, assistive technology, permission to record lectures, and lecturer liaison. However, stigma, a strive for independence, and a lack of awareness of supports were provided as the key reasons why some students may choose not to register for support. Disability Service staff are extending their traditional role by providing some supports to students with undiagnosed dyslexic-type difficulties. They are also playing an active role in introducing UDL to their institutions through collaborative cross-departmental initiatives. A number of UDL-aligned innovations were perceived by students as being particularly impactful: recorded lectures; alternative assessment options; and high-quality feedback. There was insufficient evidence to support mainstream services as being adequate for students with dyslexia. Based on these findings, a new system of support for students with dyslexic-type difficulties is proposed that synthesises beneficial aspects of the traditional medical model provision with beneficial social model approaches.