Dyslexia

Dyslexia

Definition

Dyslexia is a learning disability characterized by problems in reading, spelling, writing, speaking, or listening. It results from the inability to process graphic symbols. In many cases, dyslexia appears to be inherited.

Description

The word dyslexia is derived from the Greek word, dys (meaning poor or inadequate) and the word lexis (meaning words or language). Dyslexic children seem to have trouble learning early reading skills, problems hearing individual sounds in words, analyzing whole words in parts, and blending sounds into words. Letters such as "d" and "b" may be confused. Often a child with dyslexia has a problem translating language into thought (such as in listening or reading), or translating thought into language (such as in writing or speaking). Dyslexia is also referred to as developmental reading disorder (DRD).

Dyslexia is a problem involving higher (cortical) processing of symbols in the brain. Most children with dyslexia are of normal intelligence ; many have above-average intelligence. However, when a child is dyslexic, there is often an unexpected difference between achievement and aptitude. Each child with dyslexia has different strengths and weaknesses, although many have unusual talents in art, athletics, architecture, graphics, drama, music, or engineering. These special talents are often in areas that require the ability to integrate sight, spatial skills, and coordination.

Common characteristics of a child with dyslexia include problems with:

• identifying single words
• understanding sounds in words, sound order, or rhymes
• spelling
• transposing letters in words
• handwriting
• reading comprehension
• the spoken language
• understanding directions
• understanding opposites, such as up/down or early/late

Social and emotional difficulties often accompany this disorder, as children are unable to meet expectations of parents and teachers and feel frustrated at their inability to achieve their goals. They may have a negative self-image and become angry, anxious, and depressed.

Demographics

About 15–20 percent of the population of the United States has a language-based learning disability. Of students with specific learning disabilities receiving special education services, 70–80 percent have deficits in reading. With such a high incidence, there is a question as to whether this is really a difference in learning style rather than a true "disability." The condition affects males more than females, and appears in all ages, races, and income levels.

Causes and symptoms

The underlying cause of dyslexia is not known, although research suggests the condition is often inherited. In 1999, The Centre for Reading Research in Norway presented the first research to study the largest family with reading problems ever known. By studying the reading and writing abilities of close to 80 family members across four generations, the researchers reported, for the first time, that chromosome 2 can be involved in the inheritability of dyslexia. When a fault occurs on this gene, it leads to difficulties in processing written language. Previous studies have pointed out linkages of other potential dyslexia genes to chromosome 1, chromosome 15 (DYX1 gene), and to chromosome 6 (DYX2 gene). The researchers who pinpointed the localized gene on chromosome 2 (DYX3) hope that this finding will lead to earlier and more precise diagnoses of dyslexia.

Research suggests a possible link with a subtle visual problem that affects the speed with which affected people can read. Anatomical and brain imagery studies show differences in the way the brain of a dyslexic child develops and functions.

Indicators of dyslexia include:

• possible family history of learning disorders
• difficulty learning to recognize written words
• difficulty rhyming
• difficulty determining the meaning (idea content) of a single sentence
• writing or arithmetic learning problems

When to call the doctor

The doctor should be called if a child appears to have difficulty learning to read or exhibits any symptoms of dyslexia.

Diagnosis

Anyone who is suspected to have dyslexia should have a comprehensive evaluation, including medical, psychological, behavioral, hearing, vision, and intelligence testing. The test should include all areas of learning and learning processes, not only reading. Other causes of learning disabilities, such as attention deficit hyperactivity disorder (ADHD), affective disorders (e.g. depression or anxiety ), central auditory processing dysfunction, pervasive developmental disorders , and physical or sensory impairments, must be ruled out before the diagnosis of dyslexia can be confirmed. A child of any age may be evaluated for dyslexia using an age-appropriate battery of tests.

Test results are used to determine eligibility for special education services in many states as well as eligibility for programs in colleges and universities. They provide a basis for making educational recommendations, and determine the baseline for evaluation of improvement in the child's performance. In the United States, the Individuals with Disabilities Education Act (IDEA), Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) define the rights of children with dyslexia and other learning disabilities. These children are legally entitled to special services to help them overcome and accommodate their learning problems, including education programs to meet their needs. The Acts also protect people with dyslexia against unfair and illegal discrimination.

As further research pinpoints the genes responsible for some cases of dyslexia, there is a possibility that earlier testing will be established to allow for timely interventions to prevent the onset of the condition and treat it when it does occur. Unfortunately, in many schools, a child is not identified as having dyslexia until after repeated failures.

Treatment

Dyslexia is a life-long condition, but with proper intervention, a child can learn to read and/or write well. When a child is diagnosed with dyslexia, the parents should find out from the school or the diagnostician exactly what the problem is, what method of teaching is recommended, and why a particular method is suggested.

The primary focus of treatment is aimed at solving the specific learning problem of each affected child. Most often, this may include modifying teaching methods and the educational environment, since traditional educational methods will not always be effective with a dyslexic child. An Individual Education Plan (IEP) should be created for each child, reflecting his or her specific requirements. Special education services may include specialist help by an instructor specifically trained to teach dyslexic students through individualized tutoring or special day classes. It is important to teach these students using all the senses—hearing, touching, writing, and speaking—through a multi-sensory program.

People with dyslexia need a structured language program, with direct instruction in the letter-sound system. Teachers must provide the rules governing written language. Most experts agree that the teacher should emphasize the association between simple phonetic units with letters or letter groups, rather than an approach that stresses memorizing whole words.

To assist with associated social and emotional difficulties, teachers must use strategies that will help the child find success in academics and personal relationships. Such strategies include rewarding efforts and not just the results, helping the child set realistic goals, and encouraging the child to do volunteer work that requires empathy and a social conscience (for example, a child with dyslexia who does well in science or math could serve as a peer tutor in those subjects or could tutor a younger child with dyslexia). Psychological counseling may also be helpful.

Prognosis

There is a great deal of variation among different people with dyslexia, producing different symptoms and degrees of severity. The prognosis depends on the severity of the disability, but is usually good if the condition is diagnosed early, the intervention used is effective and appropriate for the specific child, and if the child has a strong self-image and supportive family, friends, and teachers. However, difficulties with reading may persist throughout adulthood, which may result in occupational problems in certain careers. However, many successful people, such as Erin Brockovich and Whoopi Goldberg, have dyslexia.

Prevention

Since learning disorders often run in families, affected families should try to recognize learning disability problems early. For families without a previous history of learning disabilities, an intervention can begin as early as preschool or kindergarten if teachers detect early signs.

Parental concerns

There are many resources available to aid parents in helping their children. For example, the International Dyslexia Association (<http://interdys.org>) provides extensive information for parents, teachers, and children. Parents are encouraged to utilize these resources to ensure their child's success in school and in interactions with their peers and later as working adults. They must also guard against feeling that the child is lazy or not trying hard. Instead, they should provide a supportive and loving environment.

Dyslexia may have an impact upon the child's family. Non-dyslexic siblings may be jealous of the attention, time, and money the dyslexic child receives from the parents. Since dyslexia runs in families, one or both parents may have had similar school problems. The child's problems may bring back feelings of frustration and failure for parents, which may interfere with their parenting skills.

KEY TERMS

Individualized educational plan (IEP) —A detailed description of the educational goals, assessment methods, behavioral management plan, and educational performance of a student requiring special education services.

Learning disorders —Academic difficulties experienced by children and adults of average to above-average intelligence that involve reading, writing, and/or mathematics, and which significantly interfere with academic achievement or daily living.

Spatial skills —The ability to locate objects in a three-dimensional world using sight or touch.

See also Language delay; Language disorders.

Resources

BOOKS

Reid, Gavin.Dyslexia—A Complete Guide for Parents. Hoboken, NJ: John Wiley & Sons, 2004.

Shaywitz, Sally. Overcoming Dyslexia: A New and Complete Science-Based Program for Overcoming Reading Problems at Any Level. New York: Knopf, 2003.

Stowe, Cynthia. How to Reach and Teach Children with Dyslexia: A Parent and Teacher Guide to Helping Students of All Ages Academically, Socially, and Emotionally. San Francisco, CA: Jossey-Bass, 2002.

ORGANIZATIONS

International Dyslexia Association. Suite 382, Chester Bldg., 8600 LaSalle Rd., Ste. 382, Baltimore, MD 21286-2044. (800) ABC-D123 or (410) 296-0232. <http://interdys.org/index.jsp/bibcit.composed>

Learning Disabilities Association. 4156 Library Rd., Pittsburgh, PA 15234-1349. (412) 341-1515; Fax: (412) 344-0224. <www.ldanatl.org>

Judith Sims Beth A. Kapes