October is Dyslexia Awareness Month. Dyslexia is an often misunderstood learning disability. It is considered a specific disability that affects one’s ability to read; however, with the right instruction, almost all individuals with dyslexia learn to read.
Previous viewpoints, that are now outdated and inaccurate, considered Dyslexia a visual deficit. Research using fMRI studies has revealed that Dyslexia is actually based in different neural networks involved in phonological processing, associated with language. The brain regions responsible for reading, located within the left hemisphere, specifically the temporal and parietal regions, develop differently than those without Dyslexia. Thus, it is a neurological disorder and is considered to be genetic. This disorder affects 10 to 20 percent of children and has a tremendous impact on one’s academic and emotional functioning as well as future success.
To better understand Dyslexia, one must examine the act of reading. Reading is a complicated task yet for those who have not struggled it is an automatic and often seemingly effortless one. In order for an individual to be a fluent, automatic reader, two foundational skills must be in place. First, an individual must have an appreciation of phonics and be able to distinguish and appreciate phonemes. Phonemes are the sound structure which constitutes language. Next, an individual must be able to quickly and accurately perceive and identify abstract geometric symbols, i.e. letters. Mastery of these core skills results in an automatic association between a sound and its associated symbol within specific brain structures. Now, automatic reading begins and individuals begin to recognize letter groups, which allows for whole word reading. Fluent, automatic reading refers to the ability to read without undue cognitive effort.
The majority of individuals with Dyslexia show a primary deficit with phonological awareness. A minority of people show an isolated difficulty with symbol identification, termed orthographic Dyslexia. Some people struggle in both areas, which is described as “double dyslexia.”
There are different signs of Dyslexia at differing ages and early identification is key. Dyslexia can be formally identified with 92 percent accuracy as early as 5.5 years of age; however, signs of Dyslexia are observed as early as preschool. For instance, the preschooler may experience problems finding specific words when communicating, struggle to learn nursery rhymes or have difficulty learning to write his/her name. During Kindergarten through 2nd grade, the student may display difficulty learning letter names and sounds, letter reversals may be observed (e.g., b, d, p, q), and he/she may struggle with learning to spell. The 3rd to 5th grade years often result in a student who reads common words incorrectly, has trouble sounding out words and may confuse or omit words. Older children, tweens to teens, may read slowly compared to peers, misspell words to such a degree that the computer software does not recognize the intended word and avoid reading. The gap between the child’s reading level and actual grade begins to widen as early on as Kindergarten.
Studies have shown that when children are not reading at grade level by the end of 3rd grade, they are highly unlikely to catch up, and unfortunately, are at increased risk of failure to graduate from high school.1 This is often called the “3rd Grade Wall.” Third grade is a key year in academics. The approach changes from learning to read to reading to learn. Students struggling with reading often experience the greatest challenges this year as the demands increase. No longer are the books basic text (e.g., “See Sally run”) but now the student is required to read chapter books and books with facts. Fluency or speed of reading also must increase.
Unfortunately, there often is a wait-and-see approach to reading. There’s the hope that with the next academic year reading will “click” for the student. This approach fails our students. The interventions to address the challenges of Dyslexia are most effective when implemented during the early academic years. Beyond just the academic struggles, students who are not accurately diagnosed and receive treatment are at increased risk for self-esteem issues and even affective distress (e.g., anxiety or depression).
So, how does one know whether their child has Dyslexia? There are several avenues to a diagnosis. First, the educational system can provide a psycho-educational evaluation that is free of cost to the family when the student meets certain criteria for evaluation. This evaluation examines the child’s intellectual functioning and academic achievement to assess for weaknesses in reading, but does not provide a formal diagnosis. If a weakness in core reading skills is found, services can be implemented within the academic setting.
Neuropsychologists are often called upon to complete a comprehensive evaluation that also includes assessment of intellectual functioning and academic achievement, but delves further into cognitive functioning. This approach allows for a broader understanding of a child’s cognitive strengths and weaknesses to better inform the family and school of the diagnosis and the best approaches to treatment and accommodations. Such an approach also assesses for co-morbid diagnoses (e.g., the presence of disorders commonly occurring with Dyslexia) that also affect learning, such as Attention-Deficit/Hyperactivity Disorder (ADHD). Speech and language pathologists also conduct evaluations to assess language skills.
Once the child has received a diagnosis, interventions need to be implemented. There are several intervention programs available. Evidence-based – those which are based on current research findings – result in the greatest gains. These specific programs use a systematic, multi-sensory, and intensive approach to remediating core reading skills, phonemes and symbol recognition.
While October is Dyslexia Awareness Month, this is a reading disorder that affects many of our children and adults throughout a lifetime if it is not properly diagnosed early on. For additional information, please consult the following resources or reach out to our office:
Overcoming Dyslexia by Sally Shaywitz
International Dyslexia Association – https://dyslexiaida.org/
Orton-Gillingham Academy – https://www.ortonacademy.org/
Decoding Dyslexia NJ http://decodingdyslexianj.org/
The Children’s Dyslexia Center of New Jersey – http://mlcnj.org/
- Fiester, L. (2010). Early Warning! Why Reading by the End of Third Grade Matters. A KIDS COUNT Special Report. Baltimore: The Annie E. Casey Foundation, p. 7.