Dyslexia – A Guide

Dyslexia, or developmental reading disorder, is characterized by difficulty with learning to read fluently and with accurate comprehension despite normal or above-average intelligence.

Introduction
Symptoms of dyslexia
Causes of dyslexia
Diagnosing dyslexia
Treating dyslexia
More Information

Introduction

Dyslexia should be recognised as a spectrum disorder, with symptoms ranging from very mild to very severe. In particular, people with dyslexia have difficulties with:

• phonological awareness
• verbal memory
• verbal processing speed

These terms are explained in more detail below.

Phonological awareness

Phonological awareness is thought to be a key skill in early reading and spelling development. It is the ability to identify how words are made up of smaller units of sound, known as phonemes. Changes in the sounds that make up words can lead to changes in their meaning.

So, for example, a child with a good level of phonological awareness would understand that if you change the letter ‘p’ in the word ‘pat’ to ‘s’, the word would become ‘sat’.

Verbal memory

Verbal memory is the ability to remember a sequence of verbal information for a short period of time.

For example, the ability to remember a short list such as ‘red, blue, green’, or a set of simple instructions, such as ‘put on your gloves and your hat, find the lead for the dog, and then go to the park’.

Verbal processing speed

Verbal processing speed is the time that it takes to process and recognise familiar verbal information, such as letters and digits.

For example, your verbal processing speed is the time that it takes you to look at the following numbers and letters – ‘B’, ‘B,’ ‘C’, 1’, and then realise that the information relates to the name of the television channel BBC1.

Dyslexia and intelligence

Even though dyslexia is classed as a learning difficulty, there is no connection between dyslexia and a child’s intelligence. Children of all intellectual abilities – from low to high intelligence – can be affected by dyslexia.

Similarly, a child’s difficulty with reading and spelling is not determined by their intelligence, but by how severe their dyslexia is. Children with average intelligence and mild dyslexia are likely to be more skilled at reading and writing than children with high intelligence and severe dyslexia.

How common is dyslexia?

Dyslexia is thought to be one of the most common learning difficulties. It is estimated that 4-8% of all schoolchildren in England have some degree of dyslexia.

Dyslexia appears to be more common in boys than girls. For example, it is estimated that boys are one-and-a-half to three times more likely to develop dyslexia than girls.

Dyslexia affects people of all ethnic backgrounds, although a person’s native language can play an important role. A language where there is a clear connection between how a word is written and how it sounds, and consistent rules grammatical rules, such as in Italian and Spanish, can be more straightforward for a person with mild to moderate dyslexia to cope with.

However, languages such as English, where there is often no clear connection between the written form and sound, as in words such as ‘cough’ and ‘dough’, can be more challenging for a person with dyslexia.

The cause (or causes) of dyslexia is unknown. However, many experts think that the condition is probably caused by genetic factors that affect the normal development of certain areas of the brain.

Although there is currently no cure for dyslexia, a range of educational programmes and interventions have proven effective in improving reading and writing skills in many children with the condition.

Outlook

The outlook for dyslexia is highly variable. Around 95% of children respond well to educational interventions and go on to make moderate to good progress with reading and writing.

The remaining 5% of children continue to find reading and writing difficult and will require more intensive support and long-term assistance.

It should be stressed that although children with dyslexia will face challenges on a day-to-day basis, even children who have severe dyslexia can go on to lead full and productive lives.

A different way of thinking

Some experts argue that it is incorrect to classify dyslexia as a problem with thinking, emphasising that it is just a different way of thinking that makes use of other skills.

Dyslexia

For example, most educational methods and many areas of work tend to emphasise the skills that people with dyslexia have trouble with, such as reading, writing, remembering lists and sequences, and organising and planning.

However, the skills that people with dyslexia tend to be better at, such as creative thinking, visual awareness, problem solving, and verbal communication, tend to only be emphasised in certain areas, such as the arts and the media, plus a number of scientific disciplines including physics, mathematics and computer programming.

Brain imaging studies have shown that people with dyslexia use different parts of their brain, and that they make more use of the right hemisphere, which is involved in the more creative aspects of thought.

People with dyslexia often:

• have good verbal skills
• have good social skills
• are able to think laterally and solve problems by making unexpected connections (it is often reported that people with dyslexia can solve complex problems without being aware of how they came to the solution)
• are able to understand the ‘big picture’
• have good visual reasoning and awareness skills

Symptoms of dyslexia

The symptoms of dyslexia can differ from person to person, and each person with the condition will have a unique pattern of strengths and weaknesses.

Preschool children

In some cases, it may be possible to detect symptoms of dyslexia before a child starts school.

Possible symptoms include:

• delayed speech development in comparison with other children of the same age
• speech problems, such as not being able to pronounce long words properly and ‘jumbling’ up phrases – for example, saying ‘hecilopter’ instead of ‘helicopter’, or ‘beddy tear’ instead of ‘teddy bear’
• problems expressing themselves using spoken language, such as being unable to remember the right word to use, or putting together sentences together incorrectly
• little understanding or appreciation of rhyming words, such as ‘the cat sat on the mat’, or nursery rhymes
• difficulty with, or little interest in, learning the letters of the alphabet

Early school years

Symptoms of dyslexia in children who are 5-7 years of age include:

• problems learning the names and sounds of letters
• spelling that is unpredictable and inconsistent
• problems copying written language
• poor phonological awareness

Poor phonological awareness

Phonological awareness is the ability to recognise that words are made up of smaller units of sound (phonemes) and that changing and manipulating phonemes can create new words and meanings.

A child with poor phonological awareness may not be able correctly answer the questions below.

• What sounds do you think make up the word ‘hot’ and are these different to the sounds that make up the word ‘hat’?
• What word would you have if you changed the ‘p’ sound in ‘pot’ to a ‘h’ sound?
• How many words can you think of that rhyme with the word ‘cat’?

Word attack skills

Young children with dyslexia also have problems with ‘word attack skills’. This is the ability to make sense of unfamiliar words by looking for smaller words, or collections of letters, such as ‘ph’ or ‘ing’, that a child has previously learnt.

For example, a child with good word attack skills may read the word ‘sunbathing’ for the first time and gain a sense of the meaning of the word by breaking it down into ‘sun’, ‘bath’, and ‘ing’.

Middle school years

Symptoms of dyslexia in children who are 7-12 years of age include:

• slow reading speed
• problems with the correct spelling of words
• problems understanding and recognising new words – for example, children with dyslexia may have problems with school subjects that introduce them to technical terms, such as science subjects

Teenagers and adults

Symptoms of dyslexia in teenagers include:

• slow writing speed
• poorly organised written work which lacks expression – for example, even though an older child may be very knowledgeable about a certain subject, they may have problems expressing that knowledge in writing
• problems with reading fluency – reading fluency is the ability to read text smoothly, rapidly, and automatically, without having to use any, or little, conscious effort

Dyslexia in adults

It may be possible for someone with dyslexia to reach adulthood without the condition being properly identified. Signs that you may have dyslexia include:

• trying to avoid reading and writing whenever possible
• trying to conceal any difficulties that you have with reading and writing from other people
• poor spelling
• poor time management and organisational skills
• relying on memory and verbal skills, rather than reading or writing

Associated symptoms of dyslexia

There are a number of associated symptoms of dyslexia. While they are not directly connected to reading or writing, they can affect some people with dyslexia. They include:

• problems with number skills, such as counting, comparing two sets of numbers, or carrying out sums in their head
• poor short-term memory
• problems concentrating
• short attention span
• organisation and time management problems
• physical coordination problems – some people with dyslexia can appear unusually clumsy, and younger children can find it difficult to carry out tasks that require a degree of physical co-ordination, such as tying their shoelaces

Causes of dyslexia

There are a number of different theories about the causes of dyslexia which all tend to agree that it is a genetic condition that changes how the brain deals with information, and that it is passed on through families.

Genetics

Dyslexia is thought to be a genetic condition which means it runs in families. It is estimated that if you have dyslexia, there is a 40-60% likelihood that your child will also develop the condition.

Further evidence that dyslexia is a genetic condition is that if one identical twin is born with the condition, it is very likely that the other twin will also have it.

A number of genes that may contribute to dyslexia have been indentified by researchers, but exactly how these genes may affect the development of the brain is still uncertain.

Phonological processing

The most widely supported theory of how dyslexia affects reading and writing is known as the phonological processing impairment theory. In order to better understand this theory, it is useful to distinguish between how spoken language and written language is comprehended.

The ability to understand spoken language seems to be a natural capacity of the human brain. This is why children as young as three years of age can often speak and understand relatively complicated sentences.

As a result of this natural ability, when we listen to spoken language, we do not register that a word is made up of phonemes (the smallest units of sound that make up words). We only hear the word itself.

For example, when you hear the word ‘crocodile’, you hear it as a seamless whole. You do not have to break up the word into its phonemes and then reassemble them to make sense of it (which in this case, would be the sounds ‘crok’, ‘er’, ‘dyle’).

The same is not true of reading and writing. Both of these skills require the ability to first recognise the letters in a word, then using the letters to identify the phonemes, and assembling them to make sense of the word.

This ability is known as phonological processing. It is thought that people with dyslexia find phonological processing much more difficult than other people.

Dyslexia and the brain

It is thought that the reason people with dyslexia have problems with phonological processing is that some areas of their brain function in a different way than in people without the condition.

One body of research looked at three areas that are found in the left hemisphere (half) of the brain. These are known as:

• Broca’s area – which is thought to be involved in producing written words
• parietotemporal region – which is thought to be involved in analysing written words
• occipitotemproal region – which is thought to be involved in identifying written words.

Magnetic resonance imaging (MRI) scans have shown that activity levels in all three regions of the brain are much lower in people with dyslexia when they are trying to read. These low brain activity levels may contribute to their problems with phonological processing.

Another body of research has looked at an area of the brain called the cerebellum, which is located at the lower back of the brain. It is thought that the cerebellum plays an important role in helping to process language.

The cerebellum is also responsible for coordination, and your ability to estimate how much time has passed. This may explain why many people with dyslexia have problems with coordination and time management.

Again, the results of MRI scans have suggested that the cerebellum functions differently between people with dyslexia and those without the condition.

It should be emphasised that all of the areas of the brain discussed above are thought to have a high degree of ‘plasticity’. Plasticity is a term that means that an area of the brain and its function is not ‘set in stone’, but can be remodelled over time.

It may therefore be possible for people with dyslexia to use appropriate treatment to effectively ‘rewire’ areas of their brain over time and improve their phonological processing ability.

Diagnosing dyslexia

Early identification

It is thought that the earlier a child with dyslexia is diagnosed, the more effective their future treatment will be.

In practice, identifying dyslexia in younger children can be difficult for parents because the signs and symptoms of the condition are often subtle. Many children, including younger children, also develop ways to compensate for their dyslexia, such as relying on their long-term memory more than usual.

Screening programmes have been suggested for children starting school, but pilot projects proved unreliable.

Due to the importance of recognising dyslexia early, teachers in England are being given additional training and resources to help identify children whose early reading and writing abilities appear to be below the standard that would be expected at that age.

Of course, there can be many reasons why your child may have problems with reading and writing that are unrelated to dyslexia. These might include:

• vision problems, such as short-sightedness (myopia)
• impaired hearing, due to a condition such as glue ear
• other conditions, such as attention deficit and hyperactivity disorder (ADHD)

There is also the possibility that your child does not respond very well to the method of teaching that is being used.

If you, or your child’s teacher, are concerned about your child’s lack of progress in reading and writing, as a first step, you should take them to visit your GP so that they can check for any health problems.

If no health problems can be found, the next stage would be for your child to receive additional teaching and support, possibly using a different method, such as smaller group work, or one-to-one teaching. Many children, even those with mild dyslexia, will usually make good progress.

If concerns with your child’s progress still exist after having additional teaching and support, further screening and assessment is usually recommended.

Dyslexia screening

There are a number of different methods of dyslexia screening. In the simplest screening method, a child is asked a series of questions, such as:

• Do you mix up numbers such as 81 and 18?
• Do you confuse left with right?
• Do you miss out words or the endings of words?

If your child answers ‘yes’ to these and other similar questions, they may have dyslexia.

Other screening methods involve testing a number of abilities, such as your child’s understanding of grammar and their phonological processing abilities.

Although the screening process cannot confirm a diagnosis of dyslexia, it can identify children who have a high probability of having dyslexia.

If you are concerned about your child, your school or your local educational authority (LEA) should be able to arrange a screening test for them.

If you are an adult and you require a dyslexia screening test, a number of dyslexia charities provide them, but you may have to pay a fee.

Dyslexia assessment

A dyslexia assessment involves a more complex and rigorous series of tests which are designed to confirm a diagnosis of dyslexia, while assessing a child’s particular strengths and weaknesses when it comes to learning and intellectual ability.

A dyslexia assessment needs to be carried out by a trained specialist, often either by a teacher with expertise in teaching children with dyslexia, or an educational psychologist (a psychologist who specialises in helping people with learning difficulties).

There are a number of different assessment methods, but they all involve the child taking part in a series of tests. The tests are not simply limited to their reading and writing abilities, but also examine other skills including:

• language development
• vocabulary
• the ability to reason logically
• memory
• the speed with which they can process visual and auditory (hearing) information

Dyslexia can usually be confidently diagnosed if a child’s reading and writing skills are poor, but their other abilities, such as their understanding of logic, or their verbal skills, are unaffected.

Once an assessment of your child’s abilities has been conducted, you should receive a report outlining their strengths and weaknesses. Understanding what your child is good at and enjoys is an important step in developing an educational plan that can begin to tackle their weaknesses.

Your LEA will usually provide funding for the assessment of your child. Adults may have to pay a fee for an assessment, which can range from between £200-£400.

Treating dyslexia

While there is currently no cure for dyslexia, there are a range of specialist interventions and treatments that can help children with dyslexia with their reading and writing abilities. The amount and type of intervention that they will need will depend on the severity of their condition.

Most children with dyslexia will only need to miss a few hours of their regular classes each week in order to receive specialist, one-to-one teaching, or teaching in small groups. A minority of children with dyslexia may need to be transferred to a specialist school. Many specialist schools charge a fee, although financial support may be available from your Local Educational Authority (LEA).

Educational intervention – early years

Research has found that early educational interventions, ideally before a child reaches seven or eight years of age, are an effective way of achieving long-term improvements in their reading and writing.

A wide range of educational interventions and programmes are currently available. For example, a recent report looking at effective ways to improve literacy in children with reading and writing difficulties found that there are currently 60 types of interventions and programmes currently being used in England.

With so many different programmes available, it can often be confusing for parents when deciding which ones would be most beneficial for their child.

There is a large body of good quality evidence that interventions that focus on improving phonological skills (the ability to identify and process sounds) are the most effective way of improving reading and writing. These types of educational interventions are often referred to as phonics. Phonics is a system that is widely used to teach all children to read and write, not just those with dyslexia.

Phonics – core elements

Phonics focuses on six core elements:

• phonemic awareness
• phonics instruction
• spelling and writing instruction
• fluency instruction
• vocabulary instruction
• comprehension instruction

These are explained in more detail below.

Phonemic awareness

Phonemic awareness teaches children how to recognise and identify phonemes (sounds) in spoken words. For example, it helps a child to recognise that even very short words, such as ‘hat’ are actually made up of three phonemes ‘h’, ‘a’, and ‘t’.

Another important part of phonemic awareness involves understanding that you can manipulate phonemes to change words, such as changing the ‘h’ to a ‘c’ to create the word cat.

Phonics instruction

Phonics instruction teaches children how to sound out printed words by recognising the written letters that correspond to spoken phonemes. Letters that correspond to phonemes are known as graphemes.

Phonics also teaches children how to decode multisyllabic words, such as ‘crocodile’ and apply previous learned rules so that they have a better understanding of new words.

Spelling and writing instruction

Spelling and writing instruction encourages children to combine letters and graphemes in order to create words and then, over time, to use the words to create more complex sentences.

luency instruction

Fluency instruction provides children with practice in reading words accurately. The goal is for a  child to be able to read with a good level of accuracy and speed.

This is important because if a child spends a lot of time trying to focus on reading individual words, it is easy to lose track of the text as a whole, and they may not properly understand what they are reading.

Vocabulary instruction

Vocabulary instruction teaches children to recognise the words they are reading while building and understanding new words.

Comprehension instruction

Comprehension instruction teaches children to monitor their own understanding while they read. They are encouraged to ask questions if they notice gaps in their understanding, while also linking what they are reading to information they have previously learned.

Phonics – important features

There is also a large body of good quality evidence to indicate that the most effective methods of teaching phonics to children with dyslexia contain a number of important features. These are explained below.

Structure

Teaching needs to be highly structured, with development made in small steps, building logically on what has been learnt before.

Multi-sensory

Children with dyslexia learn better when they can use as many different senses as possible. An example of multi-sensory teaching is where a child is taught to see the letter ‘a’, say its name and sound, and write it in the air (all at the same time).

Reinforcement

Skills should be reinforced through regular practice because children with dyslexia often have to ‘overlearn’ skills that they have already mastered. This helps to improve their automatic recognition of the correct phonemes, letters, and rules in reading and writing.

Skill teaching

Early interventions in children with dyslexia should focus on the development of useful skills that can be transferred to other areas. Trying to teach children to learn and retain big chunks of information instead could place, arguably unnecessary, pressure on their memory.

Metacognition

Metacognition is a word that essentially means ‘thinking about the way you think’. In practice, metacognition involves encouraging children to recognise that there are several different learning methods and approaches available to them, and then thinking about which ones would be best for them to use in different circumstances.

Breaking down emotional barriers

Another important feature of any educational intervention is to recognise that many children with dyslexia can develop emotional barriers that can make learning more difficult such as:

• anxiety
• frustration
• low confidence

Therefore, it is important to break down these barriers through encouragement, empathy, and fostering the child’s self-esteem.

Older children

Many older children with dyslexia feel much more comfortable working with a computer than with an exercise book. This may be because a computer uses a visual environment which corresponds more closely to their method of thinking.

Word processing programmes can also be very useful because they have a spellchecker, and an auto-correct facility that can help to highlight any mistakes in your child’s writing.

Most web browsers, and word processing software also have ‘text-to-speech’ functions, or available ‘plug-ins’, where the computer reads the text as it appears on the screen.

Speech recognition software can also be used to translate what a person is saying into written text. This type of software can be useful for children with dyslexia because their language abilities are often much better than their writing skills. The software can take a considerable amount of time and effort to use before it can be used with speed, but some children may find that the effort is eventually worthwhile.

There are also many educational interactive software applications which may provide your child with a more engaging way of learning a subject, rather than simply reading from a textbook.

Adults

Much of the advice and techniques that are used to help children with dyslexia are also relevant for adults. Making use of technology, such as word processors and electronic organisers, can help you with your writing and to organise your daily activities.

The best way to learn something is to use a multi-sensory approach. For example, you could use a digital recorder to record a lecture, and then listen to it as you read your notes. It is also recommended that you break large tasks and activities down into smaller steps.

If you need to draw up a plan, or make notes about a certain topic, you may find it useful to create a ‘mind map’, rather than writing a list. Mind maps are diagrams that use images and keywords to create a visual representation of a subject or plan.

You should let your employer know that you have dyslexia because they are required by law to make reasonable adjustments to the workplace in order to assist you.

Examples of reasonable adjustments include:

• providing you with assistance technology, such as voice-recognition software
• allowing you extra time for tasks that you find particularly difficult
• providing you with information in formats that you find accessible

Helping your child

As a parent, you may want to help your children with their reading, but you may be unsure about the best way to do it. Below is some advice that you may find useful.

• Read to your child – this will improve their vocabulary, listening skills, and it will encourage their interest in books.
• Share reading – you both read some of the book and then discuss what is happening, or what might happen.
• ‘Overlearning’ – you may get bored of reading your child’s favourite book over and over again, but repetition will reinforce their understanding and build familiarity with the text.
• Silent reading – children need the chance to read alone in order to encourage their independence and fluency.
• Make reading fun – reading should be a pleasure, not a chore. Use books that are about subjects your child is interested in, and ensure that reading takes place in a relaxed and conformable environment.

More Information

Dyslexia –  Wikipedia https://en.wikipedia.org/wiki/Dyslexia

British Dyslexia Association – The British Dyslexia Association (BDA) is a national charity and their vision is that of a dyslexia friendly society that enables dyslexic people of all ages to reach their full potential.

Dyslexia Action – a national charity that improves lives through education