Related topics: •  Dyslexia, Ages 3 to 6 •  Dyslexia, Ages 6 to 12

Although the term has fallen out of favor among child psychologists and other experts, dyslexia is popularly used to mean a disability in processing language. There are three types: visual (trouble recognizing printed letters or words), auditory (trouble distinguishing certain sounds or connecting sounds to letters), and "expressive writing" (trouble drawing or writing legibly or trouble proceeding from thinking a word to writing it). Your child may have any or all of these types.

Among children in US public schools, 5 percent have learning disabilities and a majority of those with disabilities receive special education for reading problems. Of those kids with reading trouble, dyslexia is the most common cause. Boys are diagnosed with dyslexia more often than girls, though some research indicates that this may be at least partially due to bias on the part of some medical professionals.

Nobody knows for sure, but most experts agree that some type of neurological dysfunction is involved. In a 1998 study at the Yale University School of Medicine, researchers mapped the brain activity of 29 dyslexic readers and 32 normal readers. For those with dyslexia, the images showed reduced activity in the part of the brain that processes language and increased activity in the area involved in the spoken word. Researchers called this "a glitch in the circuitry for reading" that makes it difficult to link printed letters and words with the sounds they represent.

Dyslexia runs in some families, which points to a genetic factor. More than a third of people diagnosed with dyslexia have a relative, often a father or uncle, who also is dyslexic.

Some healthcare professionals believe that visual dyslexics have poor central vision -- that their eyes approach the printed word at an angle, or off center. But most experts say there's no sound basis for this theory. Eye exercises don't alleviate dyslexia, though many dyslexics find it helpful to use a special "marker" card, a finger, or a pencil to keep their eyes in the right place as they read. Vision aside, this approach may work by providing another sensory link to what's seen.

Dyslexia usually shows up when a child is in elementary school. However, some kids manage to compensate for a number of years through other skills -- memory and careful listening -- so the problem doesn't surface until they get to high school. At this level, they're asked to produce much more work and it involves a lot of reading, so their struggles become apparent to others. If your child hasn't been diagnosed with dyslexia but you suspect that he has it, watch for these warning signs:

•An inability to read or comprehend reading materials. By age 12, your child should be able to read books assigned in his classes and explore key concepts, for example, by writing a book report or giving an oral presentation. As he gets older, he should be able to do increasingly sophisticated work, such as producing written reports that call for reading and organizing material from several sources.

•Difficulty in copying words or sentences. Your child may reverse letters or words (writing d instead of b , for example), and he may have poor handwriting.

•Confusion over identifying similar-looking letters and words. Your child may have trouble telling p from q , or he may read words backward (saw instead of was ).

•Consistently poor grades, particularly in language-related subjects.

•Low test scores. Your child may feel he doesn't have enough time to complete tests and quizzes, and he may get confused when teachers give directions orally. Because time pressure exacerbates his confusion, he may have a particularly hard time performing on standardized tests.

•Difficulty grasping basic mathematical concepts and solving multiple-step problems. Or your child may be able to calculate in his head but not on paper.

•Difficulty expressing complete thoughts, either in speech or in writing. Not being able to communicate well is frustrating, so your child may seem depressed or sullen.

•Problems with following through on directions. For example, your child may fail to remember that you asked him to do the dishes and clean his room before he watches any TV.

•Confusion as to time and sequence. Your child may not realize that if it's Wednesday and his book report is due Friday, that means the day after tomorrow. He may also have trouble coming home on time.

If your child's grades are clearly sliding, or if his reading, critical thinking, and listening skills seem well below those of his peers, make an appointment with the psychologist at his school. Under federal law, public schools must provide an evaluation and -- if the psychologist diagnoses a learning disability -- a treatment plan that addresses your child's needs. This won't cost you anything. Furthermore, if you disagree with the psychologist's conclusions, you also have the right to request an outside evaluation (at the school district's expense) by a qualified professional of your choice.

If you think a physical problem, such as poor hearing or vision, might be causing your child's troubles, make an appointment with your child's doctor for a physical exam.

You should also seek professional help if your child has already been diagnosed with dyslexia but his treatment plan isn't working.

Dyslexia is diagnosed when a child has poor word skills and no other developmental, emotional, or physical disorder that could be causing the problem. The diagnosis also calls for measuring the gap between the child's intelligence (IQ) and his achievements in school.

A school or other child psychologist may give your child an intelligence test such as the Wechsler Intelligence Scale for Children or the Stanford Binet Intelligence Scale. The psychologist will look at your child's academic record and evaluate his facility with words; there are specific tests to assess handwriting, reading comprehension, and other language skills, as well as tests to evaluate specific sensory processing channels -- for instance, how well your child processes what he hears.

You should know that most schools won't consider your child to have a disability unless his achievements are lagging significantly -- meaning something like two years below the average for his grade level. If your child has only a mild disability or has been painstakingly compensating for his problem, he may not be that far behind in grade-level terms, but he still needs a lot of help, both academically and personally. His abilities to process information need to be developed, and so does his confidence.

No. In fact, he may be very bright. A number of famous writers, artists, scientists, and other leaders, including Albert Einstein and Thomas Edison, had dyslexia. Former vice president Nelson Rockefeller wrote memorably about his early years as one of the "puzzle children" and credited dyslexia with forcing him to develop the "powers of concentration" he needed to become a four-time governor of New York. Mutual fund tycoon Charles Schwab has said that a blank piece of paper "was the most traumatic thing that had ever faced me in life," but he persevered, using personal computers and dictation to get his ideas across. So while dyslexia is a challenge, overcoming it brings rewards, not least of which are good study habits and an ability to work hard.

Dyslexia is a lifelong condition, but many adults with dyslexia have so thoroughly absorbed the coping strategies that it no longer constitutes a disability. Your child's dyslexia probably won't continue to pose serious obstacles once he's learned to read and write with more ease.

One part of the program should probably be group or individual sessions with a psychotherapist. When it's gone untreated, dyslexia can be frustrating, embarrassing, and even frightening for a child. Kids with dyslexia often suffer because teachers or classmates think they're lazy or stupid, and they get angry with themselves when they hear things incorrectly or can't spell words right. After years of receiving teachers' disapproval as well as poor grades, your child may have low self-esteem. He may have become rebellious or depressed. He may have fallen into the role of class clown -- or fallen in with the wrong crowd. For these reasons as well as academic ones, he'll benefit from some professional help with his self-image as well as his communication skills.

Three basic approaches can smooth the way in school: special teaching techniques in the classroom; behavioral therapy to teach good study habits, including time management; and intensive instruction, if necessary, from a therapist who specializes in reading disorders.

Many teachers aren't formally trained in managing dyslexia, but they can use techniques to direct a dyslexic child without disrupting the class. You may want to meet with your child's teachers to talk about how they can best guide and oversee his work. The school's special education administrators should contribute to this discussion and find a reading specialist to work with your child. In addition, your child can help himself by adopting certain practices. Here are a few ways both he and his teachers can facilitate the learning process:

•Write down rules, directions, and expectations. In addition to giving assignments and test instructions orally, your child's teacher can write them on the board or pass out a photocopied sheet. Your child may want to keep a small spiral-bound notebook or daily planner for noting assignments, extracurricular activities, and chores he's supposed to do at home; he could even keep a list of words he usually misspells in it. Some kids with dyslexia find it helpful to carry an expandable file folder to school for organizing all of their papers.

•Hone test-taking skills. With help from his teachers and plenty of practice, your child can improve his performance on timed tests, working on his ability to follow spoken directions and to guess judiciously when time doesn't allow for thinking questions through. (However, your child may qualify for an exemption from timed tests under the Americans With Disabilities Act. And he may be able to take the SAT without being timed. Contact the National Center for Learning Disabilities for information.)

•Use electronic devices. Dyslexia may mean your child will never win a spelling bee, but it doesn't have to mean he can't produce a fine book report. Many dyslexic students develop outstanding writing skills when they're allowed to use a computer and spell-check software. Also useful are tape recorders (to review instructions) and calculators. Typing on a keyboard or punching a calculator is a multisensory approach (touching plus seeing), so it plays to your child's strengths. Some experts suggest that dyslexic students do most of their writing on a computer or typewriter by the fourth grade.

•Look for creative ways to do assignments. Kids with dyslexia are often capable of sophisticated work if they're given some freedom in how they go about it. Instead of writing a report on the California gold rush, for example, your youngster may prefer to dress up like a miner and talk about what life was like for the fortune-seeking forty-niners. As long as he works on his reading and writing at other times, both you and his teachers should encourage such imaginative leaps.

•Lower the bar. If your child has a severe disability, his teachers shouldn't expect him to read every chapter they assign -- he'd never have time for anything else. They should allow him to get books on tape. Furthermore, they should let him take long tests orally or "chunked" (one section one day, another the next). Schools sometimes don't cooperate in these matters, so you and your child may have to stand up for his rights.

•Emphasize the importance of reading. Even if your child finds it hard, tiring, and time-consuming, he needs to understand its value. Make sure he doesn't use dyslexia as an excuse to give up on this life skill.

•Contact organizations. The International Dyslexia Association and the National Center for Learning Disabilities can give you up-to-date information and referrals to support groups and other resource links.

•Read up on dyslexia. The Misunderstood Child, by Larry B. Silver, MD, and Learning to Learn, by Carolyn Olivier and Rosemary F. Bowler, are both good starting points for parents. The Survival Guide for Kids with LD (Learning Differences), by Gary Fisher and Rhoda Cummings, is a great book to read with your child; it has an upbeat perspective and offers lots of confidence-building tactics.

•Give your child role models. Talk to your child about well-known dyslexic people who not only coped with the problem but left it far behind them. General George Patton was a visual dyslexic, for instance, but he got through West Point by committing every lecture, speech, and command to memory. Or maybe there's an adult your child knows -- a family friend, perhaps -- who is dyslexic and could talk to him about how dyslexia doesn't have to cramp his life. It can be a challenge to which he responds creatively.

•Keep your home orderly and as structured as possible. You can write rules and specific directions (put dirty clothes in the hamper, buy milk and apples at the grocery store, be home by eight) on colorful poster boards and tack them up where he'll see them. Put up lots of calendars and clocks: Dyslexic youngsters need constant reminders of time to keep them on track. Your child should wear a watch, make a habit of writing his plans on a calendar, and use charts to track his progress on complicated projects, such as an entry in the school science fair.

•Don't discipline your child unfairly. Watch out for situations in which his dyslexia may be to blame -- when he doesn't follow your instructions precisely, for instance. But don't let him use dyslexia as an excuse to misbehave, either. Establish rules, and help him follow them, as you would any child.

Be straightforward: Say that he's physically fine but he has a learning disorder that makes it difficult for him to read, write, and remember instructions. He may actually find his diagnosis a relief: It means he isn't getting poor grades because he's lazy or stupid. Depending on his emotional maturity, you may want to discuss the possible causes of dyslexia or the latest research -- or encourage him to learn more about dyslexia himself. Do your best to inform your child without scaring or confusing him. Help him realize that his dyslexia is not his fault, it's just something he needs to factor into the learning process -- a challenge rather than an obstacle.

Be sure to tell him also that you love him. Self-esteem is critical to overcoming dyslexia. Your child may already be anxious or depressed about doing poorly in school. Assure him that his worth as a person has nothing to do with how long he takes to read a book or do mathematical calculations.

Talk to your child about what's ahead. Discuss your expectations and hopes -- and his. Make sure he knows that he can excel so long as he works hard. Be candid about the moments of frustration and disappointment that he'll endure: Homework may take more time, tests may be more difficult, and doing his chores may take more commitment and concentration. But tell him that he'll have the full support of everyone who loves him and that you'll do everything you can to help him reach his goals.

-- Beatrice Motamedi is a freelance health writer specializing in children's and parenting issues. She has written or edited for Hippocrates magazine, Time Inc. Health, BabyCenter, Consumer Health Interactive, and many other publications.

References

First published August 16, 1999
Last updated June 21, 2007
Copyright © 1999 Consumer Health Interactive

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