10.31.19

The ABC’s of Dyslexia

Can you believe that back in the 19th century, doctors blamed reading disabilities on bad eyesight, calling dyslexia “word blindness?”  Of all children identified as having a learning disability, 70-80% are primarily impaired in reading.  Children who struggle with reading can suffer from low self-esteem and may disengage from school.  Children are generally in the third grade or above when they are first identified by their schools as having reading challenges; however, reading learning disabilities diagnosed after third grade are much more difficult to remediate.   Early identification is important because the brain is much more plastic in younger children and potentially more available for the rerouting of neural circuits. Once a child falls behind he/she must make up thousands of unread words to catch up to his/her peers who are continuing to move ahead.

We now know that there are structural and functional differences in the brain of individuals with dyslexia.   For example, there is structural asymmetry in the brains of individuals with dyslexia, with the right plana (a structure behind the primary auditory cortex) being larger than the left, as well as variability in size in other brain regions (e.g., cerebellum, bilateral frontal region, corpus callosum).  There may also be abnormal cellular growth that results in dyslexia.  We also know that reading disabilities run in families.  As October represents National Dyslexia Awareness Month, we want to highlight the ABC’s of dyslexia, including basic information about dyslexia, misconceptions of this learning disability, red-flags, and information about what steps to take if you have concerns your child may have dyslexia, including evidence-based interventions.

Dyslexia Basics

The International Dyslexia Association defines dyslexia as “a language-based learning disability” and highlights the following:

  • Individuals with dyslexia have difficulty reading. The two primary challenges associated with dyslexia include:
    • Phonological processing: The ability to correctly hear, sequence, and blend speech sounds to form words and understand the connection between letters and their sounds. Early phonological problems can predict reading learning disability symptoms in first and second grade.
    • Rapid naming: The ability to automatically and reliably name letters and numbers, and to retrieve names when needed.
  • Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and even math (think word problems!)
  • As many as 15–20% of the school population demonstrate symptoms of dyslexia, including slow or inaccurate reading, poor spelling, poor writing, or mixing up similar words.
  • Dyslexia occurs in people of all backgrounds and intellectual levels.
  • People with dyslexia are often capable or even gifted in areas such as art, computer science, design, drama, electronics, math, mechanics, music, physics, sales, and sports.

The task of the early reader is to transform the alphabet symbols into linguistic symbols.  They must break the code of transforming graphemes (smallest semantically distinguishing unit in a written language) into phonemes (e.g., sounds of language).  In order to do this the beginning reader must become aware of the internal phonological structure of spoken words.  They must also be able to form and retrieve letter and word images in memory and recognize that the sequence of letters on a page represent the phonology.  They must also be able to make very quick and automatic connections between the written letter and the names of letters.  An attention span necessary for learning this information must be present. Interestingly, reading is dependent on language, but it is not a natural outgrowth of language.  In other words, language, which humans have possessed for millions of years, usually unfolds as a natural biological progression.  Reading, which humans have had for only about 4,000 years, is not a natural biological unfolding.  Reading is based on language, but it must be taught.

Common Misconceptions about Dyslexia

There are several myths about individuals with dyslexia.  A few include:

  • Myth: Writing letters and words backwards are symptoms of dyslexia.
  • Fact: Writing letters and words backwards are common in the early stages of learning to   read and write among both typically developing learners and individuals who have dyslexia.

 

  • Myth: Reading disabilities are caused by visual perception problems.
  • Fact: The current consensus based on current scientific research is that dyslexia is best characterized as a problem with language processing at the phoneme (e.g., sound) level, not a problem with visual processing.

 

  • Myth: If you just give them enough time, children will outgrow dyslexia.
  • Fact: More strong evidence shows that children with dyslexia continue to experience reading problems into adolescence and adulthood.

 

  • Myth: More boys than girls have dyslexia.
  • Fact: Longitudinal research shows that as many girls as boys are affected by dyslexia.

 

Common Red Flags of Individuals with Potential Dyslexia:

Preschool:

  • Difficulties learning automatic sequences like the alphabet, numbers up to 20, name, date of birth.
  • Challenges with phonological awareness or the awareness that words are composed of sounds and that there is a pattern to sounds, some words sound alike (like rhyming words) and some do not. Challenges playing with sounds and enjoying nursery rhymes.
  • Speech and language development difficulties– does the child tend to confuse words that sound alike, does the child have trouble retrieving the name of things.

Kindergarten: 

  • Often teachers and parents complain that the child cannot seem to learn to identify letters, numbers, and simple sight words. They may seem to recognize letters after a drill, but then cannot hold onto the connections between the written symbol and the name of the letters.
  • In other instances they may recognize letters after much drill, but cannot make the connections between written single letters and blends with their sounds.
  • They often also cannot write the letters of the alphabet from memory by mid-year, though they may be able to copy them adequately if given a model from which to write.

First grade:

  • Same complaints as above, but because of problems recognizing letters or making letter-sound symbol connections, they cannot sound out simple words and/or recognize these words consistently.
  • Difficulties seeing patterns in words.
  • Cannot recognize words even though they have seen them over and over again.
  • While other children are already reading short passages, these children are stuck trying to figure out every word.
  • The child may be having trouble with number facts.
  • By the end of first grade, a child should not be reversing letters and numbers anymore except if they are in a rush.

Second and Third Grade:

  • Lack of progression in reading/spelling skills as expected, their reading is very hesitant and not fluent, they can’t learn spelling patterns, etc.
  • Because the child cannot decode words normally, their reading comprehension suffers. Also, since they can’t spell, their expressive writing also suffers.
  • The child is not retaining math facts (e.g., multiplication tables)

Fourth and Fifth Grade:

  • Problems acquiring knowledge. While the child in the lower grades is expected to learn to read, they are now expected to know how to read to learn.  That is, they acquire information through reading.
  • The child now develops other academic problems since reading is tied into most, if not all, subjects. Word problems in math require reading.  Science requires the learning of difficult and unfamiliar terminology.  Social studies requires reading and writing.

Middle School:

  • Academic Failure. The amount of reading and writing doubles and triples; all subjects require automatic and efficient reading ability.
  • Avoidance of academic activities. The student may avoid homework, especially if it involves writing.  The student avoids any reading unless it is forced on them.  The student may have an aversion to attending school.

High School:

  • The student cannot keep up with the volume of writing assignments and homework because they read and write slowly.
  • A foreign language is very challenging to learn.
  • Science terms in biology and chemistry are hard to remember and write.
  • They may perform poorly on standardized tests.
  • Retrieval and retention become major problems when studying for exams.

 

 

Have Concerns about Your Child?

If you have concerns about your child demonstrating signs of dyslexia, you can express your concerns to your child’s teacher and request that the school conduct an evaluation.  Alternatively, you can also seek an independent evaluation with a clinical psychologist/neuropsychologist who specializes in such assessments.  Results of such evaluations are critical to document the presence of any learning disability and can be therefore used to determine eligibility for an Individual Education Plan (IEP) at your child’s public school.  Note that results of evaluations are also extremely helpful for children attending private schools in order for the school to put in place needed interventions and accommodations.

Structured Literacy-Effective Reading Instruction

We are often asked what the best reading programs are for individuals with dyslexia.  We know that structured literacy reading instruction is essential.  Such programming integrates listening, speaking, reading and writing and emphasizes the structure of language across the speech sound system (phonology), the writing system (orthography), the structure of sentences (syntax), the meaningful parts of words (morphology), the relationships among words (semantics), and the organization of spoken and written discourse.

Key components to evidence-based reading instruction include the following:

  • Explicit – concepts are taught using direct teaching of the content or skill to be learned, using clear and unambiguous language.
  • Systematic – the elements of the language are taught sequentially with intensive practice and continual feedback.
  • Cumulative – lessons build on previous knowledge, moving from simple concepts to more difficult concepts.
  • Multisensory– lessons engage the learner in visual, auditory, kinesthetic and tactile responses (often at same time)

If your child qualifies for an IEP it will be important for you to ask the school whether the reading intervention being offered is evidence-based and provided by a trained special educator who has had training in the specific program.

To learn more about what individuals with dyslexia experience, check out the following information about Mark Williamson, an adult artist with dyslexia.