Dyslexia

 

 

 

Dyslexia

 

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Dyslexia

 

What is Dyslexia?

 

The term dyslexia has become part of the common lexicon.  From comedians telling jokes to celebrities telling all, people toss the word around with regularity.  While public awareness of disabilities is a positive thing, misunderstandings and myths abound.

 Many people are under the impression that dyslexia is a specific type of reading disorder. Dyslexia is the medical term for reading disability. Other learning disabilities have alternative medical terminology as well, although these are less well known.  Dysgraphia refers to writing disabilities, dyscalculia to math disabilities, etc.  The word “dyslexia” is defined as:  reading difficulty.  That is all that the word means.  It is the broad term that encompasses all types of reading problems.  Yet, many people ascribe a set of specific symptoms to this word. 

            The most entrenched myth is that dyslexics see words, letters/numbers backwards.  Direct research has shown that this is simply not the case.  What research has discovered is that children who demonstrate persistent “reversals” typically have rapid naming problems.  Their difficulty is not in how they perceive information, but in their ability to rapidly, automatically recall or name it.  Rapid naming is a cognitive ability affecting a child’s ability to efficiently retrieve information from long-term memory stores.  Consider that commonly reversed letters and words are highly similar (p,b,d and saw/was). Children who have inefficiently stored this information in memory have difficulty rapidly determining the proper symbol/word association.  If children actually perceived visual information backwards, they would make these error types on all words, not to mention the problems they would have maneuvering around their environment.  Young children commonly make reversals as they are learning and just beginning to store this information in long-term memory.  This is a normal part of development.  In her book, Overcoming Dyslexia, author Sally Shaywitz, one of the leading researchers into reading disabilities states, “Reversals are irrelevant to the diagnosis of dyslexia”. In her research, 88% of dyslexics demonstrate auditorily based, phonological processing deficits. Phonological processing refers to the ability to perceive and manipulate the sounds that make up language. It is these deficits that are primarily, but not exclusively symptomatic of reading disabilities.

            The educational field places dyslexia within the category “learning disabilities”.  In order to diagnose a reading disability (or dyslexia) the criterion for a learning disability must be met.  This involves a battery of assessments that measure cognitive processing and achievement.  Learning disabilities are neurologically based disorders.  As such, a cognitive deficit that can be directly related to an achievement deficit must be identified.  It must also be determined that poor achievement is not primarily due to other handicapping conditions, poor environment, or lack of appropriate instruction.  In the case of reading disabilities, deficits in reading skills, reading comprehension and/or reading fluency must be established.  It is the cognitive processing deficit that defines the reading disability and suggests the course of instruction.  It is also the presence of a cognitive processing deficit that separates learning disabled readers from remedial readers. Remedial readers are those children who learn normally (without the impact of a cognitive deficit), but at a slower rate, or who are delayed due to environmental factors, such as lack of access to instruction. Remedial readers typically make steady progress with reading materials common to the regular classroom, while disabled readers need specialized instruction and/or materials.

            Identifying processing deficits and their impact on reading is a complex process that can be highly individualized.  There are, however, some generalities.

 

• Deficits in reading skills:  
• The primary cause of reading skill deficits is phonological processing deficits and this is the most common form of reading disability. Phonological processing deficits can involve phonemic awareness and phonological memory/short-term auditory memory. In these cases, readers have a difficult time perceiving, discriminating and/or retaining the sound units that make up words.  Direct instruction in phonemic awareness and phonics is commonly prescribed.  For those children with short auditory memory spans, direct phonics is recommended, but with a focus on phonogram chunks to reduce the amount of information to be held in memory. 
• Some reading skills deficits are caused by poor visual recognition. This can slow the acquisition of a strong fund of sight words.  For this type of deficit, speeded word work and drill is typically prescribed for the most frequently occurring words. Overlearning phonics skills is taught in parallel so that the child can utilize a rapid decoding process to assist in poor recognition.
• Deficits in reading comprehension: 
• One typical cause of reading comprehension problems is deficits in verbal/language processing.  Tests of verbal comprehension, vocabulary and semantic reasoning are used to measure this possibility.  Instruction typically involves word knowledge building, direct instruction in reading comprehension strategies and use of vocabulary controlled materials. 
• Another common cause of poor comprehension is a slow rate of reading fluency. In this case, a processing deficit for fluency would be diagnosed (see below) and the comprehension problems would be considered secondary. In this case, the fluency is addressed through specific training.
• Deficits in reading fluency:
• Areas of cognitive deficit that affect this area include slow processing speed and/or cognitive fluency, which include problems with word retrieval and rapid naming.  Children can improve their word finding abilities with phonetic clues. As such, it is often recommended that children engage in strong phonics programs so that their decoding becomes automatic and gives them a tool to assist their retrieval.  Repeat reading and choral reading can improve children’s reading rate.  Speeded word work can also improve their performance. 
• There is also some evidence that some visually based problems may contribute, although there is debate as to whether these problems are due to cognitive processing weaknesses or vice versa.  These include poor visual tracking/scanning and visual convergence problems.  This appears to be a current and somewhat controversial finding however.  An eye examination is required for a learning disability diagnosis; however, the type of screening usually completed by the school nurse will not suffice.  If visual issues are suspected, a thorough eye exam by an optometrist is suggested.  Corrective lenses are often prescribed, but programming as described above has been successful in many cases, with or without the use of lenses.
• Of course, poor reading skills are a factor to be considered in diagnosing fluency problems.  In this case, the fluency problem is secondary to the reading difficulty.  The reading skill deficits are addressed with plenty of opportunity for fluency training using materials at low, easy levels.

 

Children with reading disabilities can and do improve with good, appropriate instruction. Few disabled readers however, achieve the ease and fluency of nondisabled readers.  Even very successful adults tell of their continuing struggle with some aspects of reading.  Learning disabilities tend to be lifelong, but through good instruction we can teach children the skills and strategies they need to become successful, reading adults.

 

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