Dyslexia

Table of Contents

  • What is Dyslexia?
  • Prevalence
  • Etiology
  • Characteristics
  • Common Dyslexia Myths
  • Interventions and strategies
    • Structured Literacy
    • Classroom Accommodations
  • Other resources from the International Dyslexia Society
  • Assistive Technology

What is Dyslexia?

Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.

Dyslexia is included within the Individuals with Disabilities Education Act (IDEA, 2004), within “specific learning disability (SLD)”, one of the 13 disability categories. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V; American Psychiatric Association, 2013) includes dyslexia within “learning disorder.” Unfortunately, the inconsistency in terminology and the lack of one universally agreed upon definition of dyslexia has caused some confusion among special educators, administrators, and parents. However, most agree that dyslexia is a distinct type of SLD that presents in a difficulty with phonological coding (Shaywitz et al., 2004; Snowling, 2009).

(Wery and Dilibero, 2016)

For the past 60 years (more or less), dyslexia has been considered a type of learning disorder, referred to as “specific reading disability” or “specific learning disorder with impairment in reading.” It is likely that the growing interest in dyslexia today reflects a growing dissatisfaction with the present state of learning disabilities in the USA, especially as it pertains to dyslexia. It is a well-known fact that no matter what criteria are being used currently to identify specific reading disabilities/dyslexia, those practices are making little or no distinction between readers with dyslexia and garden variety poor readers. Both the dyslexia and the specific learning disabilities professionals and parents should welcome the newfound interest in dyslexia by the state and federal governments. Perhaps one of the results will be the adoption of widely accepted diagnostic criteria that will allow clinicians and assessment professionals to accurately separate individuals with dyslexia from other poor readers.

(Hammill and Allen, 2020)


Prevalence

The percentage of people with dyslexia is unknown, but it has been estimated to be as low as 5% and as high as 17% of the population. While dyslexia is more often diagnosed in boys, this is partly explained by a self-fulfilling referral bias among teachers and professionals. It has even been suggested that the condition affects men and women equally.

(Wikipedia, n.d./Dyslexia)


Etiology (causes)

The causes of dyslexia are not agreed upon, although the consensus of neuroscientists believe dyslexia is a phonological processing disorder and that dyslexics have reading difficulties because they are unable to see or hear a word, break it down to discrete sounds, and then associate each sound with letters that make up the word.

Poor working memory may be another reason why those with dyslexia have difficulties remembering new vocabulary words. Remembering verbal instructions may also be a struggle. Dyslexics who have not been given structured language instruction may grow to depend on learning individual words by memory rather than decoding words by mapping phonemes (speech sounds) to graphemes (letters and letter combinations which represent individual speech sounds).

(Wikipedia, n.d./Characteristics of dyslexia)

 


Characteristics

Dyslexia is characterized by learning difficulties that can include:

Difficulty with oral language:

  • Late in talking
  • Difficulty in pronouncing words
  • Difficulty in acquiring vocabulary or age-appropriate grammar
  • Difficulty following directions
  • Confusion in right/left, before/after, top/bottom, etc.
  • Difficulty in learning alphabet
  • Difficulty in learning nursery rhymes or songs
  • Difficulty with word retrieval or naming problems

Difficulty with reading:

  • Difficulty learning to read
  • Difficulty with phonological awareness (identifying rhyming words or counting syllables)
  • Difficulty with phonemic awareness (hearing and manipulating sounds)
  • Difficulty with auditory discrimination (distinguishing different sounds in words)
  • Difficulty in learning the sounds of letters
  • Difficulty remembering names
  • Difficulty in remembering the orders of letters
  • Misreading common words
  • Omitting common words
  • Guessing through longer words
  • Poor reading comprehension
  • Slow, laborious oral reading

Difficulty with written language:

  • Trouble organizing ideas on paper
  • Many spelling mistakes
  • Performs well on spelling tests, but continues to have spelling mistakes in daily work
  • Difficulty in proofreading

(Wikipedia, n.d./Management of Dyslexia)

Because of literacy problems, an individual with dyslexia may have difficulty with handwriting (dysgraphia). This can involve slower writing speed than average, poor handwriting characterized by irregularly formed letters, or inability to write straight on a blank paper with no guideline

(Wikipedia, n.d./Characteristics of dyslexia)

Spelling is a demanding task for all children learning to write. Some children, however, require interventions that are specifically tailored to their needs. For example, children with dyslexia, showing deficits in spelling knowledge and strategies, often fail to produce accurate spellings for words. For these children, learning to spell poses a major challenge and represents a significant barrier to the development of their ability to compose texts. Indeed, although children with dyslexia can acquire some composition skills, they struggle with those that are specifically related to written language.

(Chapleau and Beaupre-Boivin, 2019)


Common Dyslexia Myths

As reading and writing have become increasingly crucial for success in and out of school, students with dyslexia are often at-risk for academic failure, lower reading self-efficacy (Burden, 2008), and lower self-esteem (Alexander-Passe, 2006) as well as an increased risk of dropping out of school (U.S. Dept. Of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs, 2006). Due to the potential for poor school and post-school outcomes, teachers, parents, and advocates often feel desperate to locate and employ accommodations and interventions to help students with dyslexia read.

Teachers and other practitioners need to be able to discriminate between those interventions that have been empirically shown to be effective (evidence-based practices) from those that have not. While some may conclude that an intervention that fails to produce a positive effect may not do good, but probably does not do harm, others disagree.

Inert interventions may in fact cause other forms of harm, in depriving resources (time and financial) away from those interventions that have demonstrated efficacy. That time and resource could be use on other interventions that are more likely to improve students’ reading ability. Further, the use of unsubstantiated interventions can impact the credibility of the profession, and lead to the public losing trust in special educators (Lilienfeld, Lynn, & Lohr, 2015).

Finally, the most harm may come when students who have already experienced significant struggle and academic failures related to learning to read, have yet another experience with failure when they are not able to read significantly better using a method that is not evidence based. A repeated failure experience can further damage students’ self-efficacy and academic self-esteem.

Instead, students with dyslexia need well-qualified teachers and interventionists, who can skillfully implement intensive instruction (Moats, 2009). This intensive, systematic intervention is likely to include direct multisensory instruction in the areas of phonological awareness, phonics, and fluency (Mather & Wendling, 2012; Shaywitz, 2003; Snowling & Hulme, 2012) that is both sequential and cumulative, and taught to automaticity (Moats, 2009).

(Wery and Dilibero, 2016)

Research does not suggest that specially-tailored fonts (such as Dyslexie and OpenDyslexic) help with reading. Children with dyslexia read text set in a regular font such as Times New Roman and Arial just as quickly, and they show a preference for regular fonts over specially-tailored fonts.

There is currently no evidence showing that music education significantly improves the reading skills of adolescents with dyslexia.

(Wikipedia, n.d./Dyslexia)

The dyslexia myth of “backwards reading” persists as a remnant of the visually based theories about reading (see Lilienfeld et al., 2010 for a discussion). This myth has been resistant to change likely due to the complexity of research on dyslexia coupled with a lack of venues for disseminating increasingly complicated representations of science to the public. There is also the problem that some children with dyslexia do make letter reversals in their writing, which serves to reinforce the notion of “backwards reading.” However, letter reversals are developmentally common during early literacy acquisition in typically developing children as well (Vellutino, 1979) and such reversals early in literacy acquisition (i.e., kindergarten) are unrelated to later reading abilities (i.e., grades 2,3) (Treiman et al., 2014). Long-standing lines of research have shown that children with dyslexia do not show visual-spatial weaknesses with non-linguistic stimuli, such as geometric designs (Vellutino et al., 1975a) or letters in unfamiliar orthographies (i.e., Hebrew; Vellutino et al., 1975b). This pattern indicates that it is the linguistic features of letters and words that contribute to the reversal errors, rather than a general visual-spatial processing problem. The widespread misunderstanding regarding the causal role of letter reversals in dyslexia can be understood in the context of the common logical error of inferring causation from correlation. While children with dyslexia can reverse letters, and sometimes do so beyond developmentally typical windows, letter reversals are not a cause of their reading problems.

(Anderson, Sarlo, Pearlstein and McGrath, 2020)

According to the American Academy of Pediatrics, vision problems do not cause dyslexia. “Scientific evidence does not support the efficacy of eye exercises, behavioral/perceptual vision therapy, training glasses, or special tinted filters or lenses in improving the long-term educational performance in these complex pediatric neurocognitive conditions.”(pg. e849).   (Handler and Fierson, 2011)


Interventions and strategies

Most teaching is geared to remediating specific areas of weakness, such as addressing difficulties with phonetic decoding by providing phonics-based tutoring. Some teaching is geared to specific reading skill areas, such as phonetic decoding; whereas other approaches are more comprehensive in scope, combining techniques to address basic skills along with strategies to improve comprehension and literary appreciation. Many programs are multisensory in design, meaning that instruction includes visual, auditory, and kinesthetic or tactile elements; as it is generally believed that such forms of instruction are more effective for dyslexic learners. Despite claims of some programs to be “research based”, there is very little empirical or quantitative research supporting the use of any particular approach to reading instruction as compared to another when used with dyslexic children.

Torgesen (2004) emphasized the importance of explicit instruction for remediation as well as the need for intensity that is completely different from regular classroom instruction. To make gains in reading, students need highly structured, sequential interactive activities and close monitoring, directly connecting the known with the new, with sufficient time for practice of new skills to build automaticity and fluency. The size of the instructional group is also important, ideally between 1:1 and 1:3.

(Wikipedia, n.d./Management of Dyslexia)

Dyslexic children require special instruction for word analysis and spelling from an early age. The prognosis, generally speaking, is positive for individuals who are identified in childhood and receive support from friends and family. The New York educational system (NYED) indicates “a daily uninterrupted 90-minute block of instruction in reading”, furthermore “instruction in phonemic awareness, phonics, vocabulary development, reading fluency” so as to improve the individual’s reading ability.

(Wikipedia, n.d./Dyslexia)

Academic Remediation

Early identification and treatment is key to helping individuals with dyslexia achieve in academic and life. Appropriate remedial instruction is a structured literacy approach:

  • Structured Literacy: Effective Instruction for Students with Dyslexia and Related Reading Difficulties
    • Phonology – is the study of sound structure in the spoken word. These skills included rhyming, counting words in a spoken sentence, and clapping syllables in spike words. The ability to segment words into their compound sounds, phonemes.
    • Sound-Symbol Association – awareness of phonemes of spoken language, the learner must map the phonemes to symbols (printed letters). This skill must be taught in two directions: visual to auditory (reading) and auditory to visual (spelling).
    • Syllable Instruction – a syllable is a unit or written language with one vowel sound. Instructions must include the 6 basic syllable types in English (closed, vowel-consonant-e, open, consonant-le, r-controlled, and vowel pair).
    • Morphology – morpheme is the smallest unit of meaning in any language. The study of base words, roots, prefixes, and suffixes.
    • Syntax – set of principles that dictate sequence and function of words in sentences. This concept includes grammar, sentence variation, and mechanics of language.
    • Semantics – aspect of language with focus on meaning.
    • Systematic – an organization of material that follows a logical pattern of the language
    • Cumulative – the steps of teaching is based on previous concepts.
    • Explicit Instruction – requires the deliberate teaching of all concepts with student-teacher interactions.

Classroom Accommodations (UDL) 

Although there are no treatments or quick cures for dyslexia there are many techniques that can be used to assist dyslexic students in the classroom while reading skills are being remediated. These include such things as:

  • Accommodations for Students with Dyslexia
    • Oral testing
    • Untimed tests
    • Audiobooks
    • Eliminate or reduce spelling tests
    • Minimizing the need to read out loud
    • Allow students to record the Teacher explaining homework to ensure an accurate account of the homework is done.
    • Accept dictated homework
    • Reduce homework load
    • Grade on content, not spelling nor handwriting
    • Reduce copying tasks
    • Avoid or reduce essay tests
    • Providing teacher handouts to supplement the notes taken
    • Using materials that are not visually overcrowded
    • To increase motivation, giving assignments in areas in which the student has a strong interest, for example, sports stories, biographies of inventors or rock musicians, or fiction about teenage issues.
    • Use an appropriate layout, including a larger font size, larger line spacing (1.5) and a clear font – sans-serif fonts are usually recommended.
    • Using appropriate font size. Research does not suggest that the use of specially tailored fonts helps with dyslexia.
  • Notice how these accommodations align with the 3 Principles of Universal Design for Learning (UDL).

(Wikipedia, n.d./Management of Dyslexia)


Assistive Technologies

Accessible publishing works to make reading easier for all who struggle with the standard one-size-fits-all method of book publishing. Accessible publishing works with publishers and Print on Demand technology which allows the reader to choose how the books will be published. Available format variations include choosing the font size (from 11 point font through to 28 point font), whether the font is bold, italic or regular, and choosing the amount of line spacing.  Accessible publishers, such as ReadHowYouWant, also work to make books available in Braillee-booksaudiobooks and DAISY.

New formats such as streamline text have been developed that help dyslexic people to track (move from one line to the next) more fluently. These work by adding ‘sign-posts’ into the text to show where to go next.

Teachers are also using audiobooks as a way of teaching textbooks in an engaging way to those with dyslexia. In the United States, the nonprofit Learning Ally offers the world’s largest library of human-narrated audio textbooks, and a second organization, Bookshare, offers a wide selection of synthetic-read audiobooks. These audiobooks work well for individuals who have word reading accuracy and fluency difficulties (i.e. dyslexics).

Individuals with dyslexia require more practice to master skills in their areas of deficit. In the circumstances where typically developing children need 30 to 60 hours training, the number of hours that has resulted in optimistic conclusions concerning the remediation of dyslexia is between 80 and 100 hours, or less if the intervention is started sufficiently early.

A recent study has shown that the usage of an FM system drives neural plasticity in children with dyslexia. An FM system is a personal assistive listening device, consisting of a wireless microphone worn by the teacher, and a wireless receiver similar to a Bluetooth receiver worn on the ears by the pupil. Measurements of the brain’s response to speech sounds showed that the children who wore the device for one year responded more consistently to the very soft and rapidly changing elements of sounds that help distinguish one consonant from another (cat, bat, pat etc.). That improved stability was linked with reading improvement based on standardized measures of readability – which, as a long-term benefit, points to brain plasticity.

(Wikipedia, n.d./Management of Dyslexia)

Note: In much of the research you will see the terms dyslexic and dyslexic children. This is not the people first language we strive for in the field of special education.


References

Anderson A, Sarlo GL, Pearlstein H and McGrath LM (2020) A Review of Online Dyslexia Learning Modules. Front. Educ. 5:118. doi: 10.3389/feduc.2020.00118.  https://www.frontiersin.org/articles/10.3389/feduc.2020.00118/full This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

Chapleau, N., Beaupré-Boivin, K., Interventions to Support the Development of Spelling Knowledge and Strategies for Children with Dyslexia, Education, Vol. 9 No. 1, 2019, pp. 1-8. doi: 10.5923/j.edu.20190901.01. This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/

Hammill, D.D., Allen, E.A. A Revised Discrepancy Method for Identifying Dyslexia. J Pediatr Neuropsychol 6, 27–43 (2020). https://doi.org/10.1007/s40817-020-00079-2  https://link.springer.com/article/10.1007/s40817-020-00079-2#citeas This article is licensed under a Creative Commons Attribution 4.0 International License

Handler, S.M., MD, Fierson, W.M.,MD; Learning Disabilities, Dyslexia, and Vision from the American Academy of Pediatrics Joint Technical Report (Pediatrics, March 2011, Vol. 127, Issue 3) pgs. 818-849

Wery, J.J., Diliberto, J.A. The effect of a specialized dyslexia font, OpenDyslexic, on reading rate and accuracy. Ann. of Dyslexia 67, 114–127 (2017). https://doi.org/10.1007/s11881-016-0127-1This is an open access article distributed under the terms of the Creative Commons CC BY license

Wikipedia, (n.d.) Dyslexia From https://en.wikipedia.org/wiki/Dyslexia

Wikipedia, (n.d.) Characteristics of dyslexia. From https://en.wikipedia.org/wiki/Characteristics_of_dyslexia

Wikipedia, (n.d.) Management of Dyslexia From https://en.wikipedia.org/wiki/Management_of_dyslexia