The good news about living with reading difficulties is that they can be corrected through instruction and technological innovation. With direct, explicit, and thorough instruction, almost any child with a reading disorder can overcome it to a significant degree. When this instruction is combined with the right technological devices, those with dyslexia can further compensate for residual issues such as reading speed and comprehension. This article will show you how to detect reading disorders such as dyslexia and find ways to deal with them effectively.
1Understand spoken language and reading before attempting to understand reading failure or dyslexia.
- Spoken language is a "river of sound", in which one sound (or phoneme) blends sometimes seamlessly into the next.
- In order to acquire reading, a child must have grasped the concept that words are made up of smaller sounds (phonemic awareness) and that those sounds can be represented by symbols (the alphabetic principle).
- Reading, at its most fundamental, is the ability to accurately and effortlessly associate symbols (letters) with the sounds of language (phonemes). This is called "decoding". Once decoding skills are in place, the process of comprehension -- understanding what is read -- can begin.
- Written language, and its corollary, reading, has only been around for a few thousand years. The expectation of universal literacy is even more recent -- perhaps a hundred years. Therefore, it is no surprise that normal neurological variation gives some people difficulty in learning to read.
- Reading requires the brain to both "unglue" sounds (phonemic awareness), and to rapidly and accurately recall associations between sounds, symbol, and meaning.
- Some people who struggle to learn to read have difficulty with phonemic awareness.
- A second group have difficulty with accurate, effortless recall (often called rapid automatic naming, or RAN).
- A third group may have difficulty with both, which is called the "double deficit hypothesis".
2Know what dyslexia is and is not:
- According to the International Dyslexia Association Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede the growth of vocabulary and background knowledge.
- Learning to read is not a function of intelligence or innate cognitive ability. People with mild intellectual disability (formerly known as mental retardation) can be taught to read accurately and fluently.
- Difficulties in learning to read are not due to "seeing words or letters backwards". According to the cognitive neuroscientist Stanislas Dehaene, almost children go through a phase of letter reversal and confusion of letters of similar shape such as b, d, p, and q. Explicit, direct and intensive teaching of the sounds of language, and how they are represented by letter forms, will eliminate these confusions. Persons older than eight who still have these confusions and reversals have suffered inadequate or confusion instruction.
- Difficulties in learning to read are not due to visual processing problems. See The Joint Statement on Learning Disabilities, Dyslexia, and Vision from the American Academy of Pediatrics; Colored lenses or overlays, vision training (special glasses or exercises) and movement therapy will not help children or adults overcome reading difficulties or dyslexia.
3Beginning in infancy and every year thereafter, make sure that your child's hearing and vision are within normal ranges. A child who has difficulty not only with hearing, but processing the meaning of sounds (auditory processing) will struggle later with reading. Likewise, vision should be evaluated not just for acuity (the "20/20 part) but for the ability of the eyes to work together (visual processing). A child with auditory processing difficulties might be referred to an audiologist or a speech-language pathologist. A child with visual processing difficulties might be referred to a pediatric ophthalmologist (an M.D. who specializes in children's eye disorders).
4Before beginning school, be aware of some of the signs that may indicate that your child is at risk of having difficulty with reading:
- The most important is a significant speech delay.
- Children with chronic ear infections may also later struggle with reading.
- Repeatedly mixing up syllables or sounds in multi-syllable words (example consistently saying "brolloki" for broccoli, even after correction).
- Difficulty in reliably telling left from right after about age seven.
- Difficulty with memorization (such as learning the home address, phone number, or the alphabet).
- Motor or automatic sequencing difficulties, such as difficulty in learning to tie shoes.
- An inability to play rhyming games, or to produce words that rhyme.
5Once in school, be aware of your child's expected progress in literacy. It used to be thought that dyslexia could not be detected before the child had had three to four years of school (third grade, or about age eight in the United States). This is often referred to as the "waiting to fail" model, and it is wrong. Interventions (more teaching, one-on-one tutoring) should begin as early as the difficulty is detected. Children who struggle in school for years are at a tremendous disadvantage. Children can, and should be, screened for both phonemic awareness and rapid automatic naming, beginning in the first quarter of kindergarten. Parents need to ask their child's school if these screening assessments are given, and if not, why not. If the school refuses to provide these assessments, parents should seek out an educational therapist or other health professional who can provide the screenings.
6Be aware of the difference between "screening assessments", progress monitoring" and "diagnostic assessments". Screening assessments tend to be quite short, and are designed to distinguish children who may be at risk or already having difficulty. "Progress monitoring" is also short and administered often to test children's mastery of what has been taught. Diagnostic assessments are a much more thorough, and can take several hours. They are designed to evaluate all areas of a person's intellectual and academic functioning (modified for the person's expected academic achievement).
7Know how dyslexia is diagnosed. There is no one test for dyslexia. A battery of interviews and tests should be included, with elements adjusted for the child's age and educational history. Only a qualified professional (a licensed clinical psychologist or a licensed school psychologist) can perform all the tests listed below and certify a diagnosis. Other professions can perform valid evaluations, but parents may wish to obtain an evaluation by a qualified professional. A complete assessment (often called a psychoeducational evaluation) would include:
- A thorough history, including the child's medical records, assessment of physical and mental development since infancy, a review of the child's behavioral history, an exploration of the family's history including any other family members who may have struggled with language or literacy, and the child's academic exposure.
- An age-appropriate measure of general intellectual functioning (this is sometimes called an IQ test). Subtests may cover some of the elements following.
- An evaluation of the child's visual system,including visual processing and visual motor integration
- An evaluation of the child's auditory system, including auditory processing.
- An evaluation of the child's memory, reasoning abilities, and executive functioning
- An evaluation of the child's expressive and receptive oral language, including evaluation of phonological processing
- Age-appropriate educational tests to determine level of functioning in basic skills areas of reading, spelling, written language, and math
- After about the middle of second grade,testing in reading and writing should include the following measures:
- single word decoding of both real and nonsense words,
- oral and silent reading in context (evaluate rate, fluency, comprehension and accuracy),
- reading comprehension,
- dictated spelling test,
- written expression: sentence writing as well as story or essay writing,
- A classroom observation, and a review of the language arts curriculum for the school-aged child to assess remediation programs which have been tried.
- A written analysis and interpretation of the pattern of strengths and weaknesses that the test battery results reveal.
8Work out a plan once you have the results. Once a full evaluation and diagnosis is in place, a plan for remediation and accommodation can be devised and put in place. In the United States, children with a diagnosis of dyslexia have significant educational rights under the Individuals with Disabilities Education Act (IDEA), which requires that individuals with disabilities have an Individual Education Plan (IEP).
- Dyslexia is not a visual disorder. Colored lenses or overlays, vision training (special glasses or exercises) and movement therapy will not help. See Learning Disabilities, Dyslexia, and Vision
- Some of the features of dyslexia can make the mastery of early math difficult, such as the rapid, accurate recall of math facts.
- There are two other academic disorders, dyscalculia and dysgraphia, which may or may not affect a person with dyslexia.
- Dyscalculia is a term referring to a wide range of life-long learning disabilities involving math. There is no single form of math disability, and difficulties vary from person to person and affect people differently in school and throughout life.
- Dysgraphia, or disorder of written expression. Dysgraphia is a learning disability that affects writing abilities. It can manifest itself as difficulties with spelling, poor handwriting and trouble putting thoughts on paper. Because writing requires a complex set of motor and information processing skills, saying a student has dysgraphia is not sufficient. A student with disorders in written expression will benefit from specific accommodations in the learning environment, as well as additional practice learning the skills required to be an accomplished writer.
- Both children and adults with dyslexia may benefit from hearing material as they read it. There are several ways to acquire spoken versions of written texts. Recordings for the Blind and Dyslexic (RFBD) makes many works, including textbooks, available for a modest fee. Many educational institutions use Kurzweil devices to provide a computer-generated voice version of texts available to qualified students. The Intel Reader is a hand-held device that scans text and converts text into computer-generated language.
- Voice-to-text technology can simplify the writing process. One common program is Dragon Naturally Speaking.
Sources and Citations
- The International Dyslexia Association, http://www.interdys.org/
- The British Dyslexia Association, http://www.bdadyslexia.org.uk/
- What is Reading? by Sebastian Wren, online at Reading Rockets http://www.readingrockets.org/articles/404
- The Development of Phonological Skills, by Louisa Cook Moats and Carol Tolman http://www.readingrockets.org/articles/28759
- Children of the Code http://www.childrenofthecode.org/
- Differences in Family Language Learning: Dr. Todd Risley http://www.childrenofthecode.org/interviews/risley.htm
- National Institute on Deafness and Other Communication Disorders: Speech and Language Developmental Milestones http://www.nidcd.nih.gov/health/voice/pages/speechandlanguage.aspx
- Association of Educational Therapists (AET) www.aetonline.org/
- Stanislaus Dehaene, Reading in the Brain
- http://www.ldaamerica.org/ Learning Disabilities Association of America
- http://www.ninds.nih.gov/ National Institute of Neurological Disorders and Stroke