Complete Guide to Dyslexia

Dyslexia might best be described as an unexpected difficulty learning to read. Children with dyslexia struggle with phonology, or the recognition and manipulation of sounds in language. Dyslexia affects a child’s ability to decode words — to break them down into constituent sounds, or phonemes, and then to sound out novel words. That makes it hard to recognize words, to retrieve words, to read, to write and to spell. Some children with dyslexia just have problems quickly retrieving words.

The result is a discrepancy between ability and achievement: a child who is struggling with reading despite having the intelligence to be a much better reader. A dyslexic child isn’t lacking in intelligence, and isn’t necessarily failing in school, since some kids with dyslexia, by putting in a great deal more effort than their peers, are able to keep up with their work, at least in the first few grades. However, it often becomes impossible for them to keep up by about third grade, when they are expected to be able to read fluently — quickly, easily and automatically.

While they may learn to read and compensate for reading weakness in other ways, children do not outgrow dyslexia.

Dr. Sally Shaywitz, co-director of the Yale Center for Dyslexia and Creativity, estimates that 80 to 90 percent of children who struggle with learning disorders have dyslexia — as many as one in five children. Many dyslexic children go undiagnosed, she argues, and school failure that is attributed to environmental factors or intelligence is often undiagnosed dyslexia. Experts used to think that dyslexia was more common in boys than girls, but current research shows that it affects girls and boys equally.

A young child with dyslexia may:

• Have trouble learning simple rhymes
• Be speech delayed
• Have a hard time following directions
• Have difficulty with short words; repeat or leave out words like and, the, but
• Have trouble differentiating left from right

In school, kids with dyslexia are likely to:

• Have significant difficulty learning to read, including trouble sounding out new words and counting the number of syllables in words
• Continue to reverse letters and numbers when reading (read bear as dees, for example) after most kids have stopped doing that, around the age of 8
• Struggle with taking notes and copying down words from the board
• Have difficulty rhyming, associating sounds with letters, and sequencing and ordering sounds
• Have trouble correctly spelling even familiar words; they will often spell them phonetically (cmpt instead of camped)
• Lack fluency in reading, continuing to read slowly when other kids are speeding ahead
• Avoid reading out loud in class
• Show signs of fatigue from reading with great effort

The impact of dyslexia doesn’t stop when class ends. The disorder can also affect kids outside of school. Children with dyslexia might also:

• Have trouble understanding logos and signs
• Have difficulty learning the rules to games
• Struggle to remember multi-step directions
• Have trouble reading clocks and telling time
• Have a particularly hard time learning a new language
• Have emotional outbursts as a result of frustration

While we tend to think of dyslexia as a reading disorder, it also has an effect on a child’s social and communication skills. Since it can interfere with being able to retrieve words quickly, dyslexia can hinder a child’s ability to interact with peers in a typical way, and respond appropriately in social situations. “A dyslexic person who has word-finding difficulties can have trouble with their expressive language,” explains Scott Bezsylko, the executive director of Winston Preparatory School, which specializes in teaching kids with learning disorders. “That has a social impact, in addition to your difficulties with reading and writing, that make you feel not so good about yourself.”

Children who are dyslexic, at least until they are diagnosed, often become frustrated and ashamed at their inability to learn to read, and the implication that they are either lazy or stupid. “A lot of our work with dyslexic kids is to help them rediscover that they are smart and capable,” notes Beszylko, “because they’ve stopped believing in themselves.”

Dyslexia is diagnosed through an evaluation that determines a deficit in reading ability and rules out other possible causes for the deficit, such as hearing problems, or social, environmental or cognitive factors. Usually kids must wait until they are school-aged (or have had significant early reading instruction) to get an accurate assessment.

If you are concerned that your child is not meeting benchmarks for reading skills, you can request that your school district do an evaluation and then review the results with you. The evaluation will measure your child’s intellectual capacity and reading skills, to determine if there is an achievement gap.

If your child falls below average in skills like decoding, comprehension, word recognition, word retrieval and reading fluency, your school district should recommend a plan to help bolster those skills.

If you aren’t satisfied with the caliber of the evaluation, you are free to seek out a private evaluation by a psychologist, a neuropsychologist, a reading specialist, a speech and language therapist, an educational evaluator or a school psychologist. The professional who does the evaluation should provide you with a report explaining the results and making specific recommendations for your child.

This outside evaluation can be used to make the case to your school district for support or accommodations for your child.

Teachers can be valuable sources of information on how well your child is progressing in reading, notes Dr. Matthew Cruger, director of the Learning and Development Center at the Child Mind Institute. Teachers are familiar with benchmarks and expectations for each age, and may have test results that highlight problems. But even teachers who recognize a lag in reading skills may be reluctant to share that information with parents.

Teachers often are focused on solving reading problems, but identifying or diagnosing a condition like dyslexia is out of the scope of their training. Therefore, in many settings, they are even formally forbidden to suggest that parents explore an evaluation for dyslexia.

Dr. Cruger also notes that if a child isn’t meeting benchmarks, parents should assess how much support there is for reading at home: How often do you read to and with your child? Are there books available that suit his reading level? Is reading treated as a fun and important part of your family life?

Some signs of dyslexia are evident in preschool-age children. Preschool evaluations can focus on phonological awareness and word retrieval. However, Dr. Cruger recommends waiting until children are around six years old to pursue an evaluation, when they have received formal reading instruction. If at that point a child is still struggling to recognize rhymes, common letter clusters or simple words, she should be checked out.

It’s typical for parents to be told, when kids are struggling in first or second grade, that no intervention is necessary until the third grade, when kids are expected to be fluent readers. But Dr. Shaywitz points to research that shows that for children who are dyslexic, the gap between intelligence and reading ability is already clear in first grade, and the sooner children get help the easier it is for them to close the gap.

Dr. Shaywitz argues that a diagnosis that identifies a child’s strengths as well as weaknesses can be a big boost to a child’s self-image, since in first grade kids are already comparing themselves to their peers and worrying that there’s something wrong with them. A diagnosis also opens the door to help and accommodations that can make a huge difference.

Fortunately, there are evidence-based supports to help children with dyslexia improve their reading skills. A program appropriate to a child with dyslexia might include these features, says Dr. Cruger:

• Multi-sensory instruction in decoding skills
• Repetition and review of skills
• Intensity of intervention—that is, more than being pulled out of class once a week for extra help
• Small group or individual instruction
• Teaching phonological skills
• Drilling sight words
• Teaching comprehension strategies, to help kids derive meaning from what they’re reading

Dr. Cruger adds that an important part of supporting kids with dyslexia is finding ways to decrease their discomfort about reading, and to make learning to read enjoyable, not humiliating. That means minimizing the amount of time you spend correcting the child, and maximizing encouragement of even small gains.

Reading programs that have been shown to be effective for kids with dyslexia include:

• The Wilson Method
• The Orton-Gillingham Approach
• Preventing Academic Failure (PAF)
• The Lindamood-Bell Program
• RAVE-O

What doesn’t help? Simple tutoring in a conventional learning center that is not focused on remediation, or building missing skills, can backfire if it’s an unpleasant experience. Practicing reading helps typical readers get better, but can be a source of distress for dyslexic readers. “If the child hates the experience of reading help, it’s not helpful,” Dr. Cruger notes. “And it’s not treating the source of the problem, the phonological weakness.”

Children who have dyslexia are entitled to accommodations that enable them to learn — and demonstrate their learning — despite their reading challenges. Dr. Shaywitz notes that students with dyslexia often have to fight to get extra time on things like tests, but they shouldn’t. “Dyslexia robs a person of time,” she says, “and accommodations give the time back to her.” Accommodations can include:

• Extra time on tests
• A quiet space to work
• The option to record lectures
• The option to give verbal, rather than written, answers (when appropriate)
• Elimination of oral reading in class
• Exemption from foreign language learning

For any child who is struggling, it is particularly important to encourage the things he enjoys and excels at, so that he feels confident in some areas. This could be sports, theater, art, science, debate team or anything else that makes him feel good at something.

Sharing stories of successful individuals with dyslexia might also help reinforce that it has nothing to do with intelligence.

Supportive tools and technology can help your child navigate difficult problems:

• Audio books can be a great alternative to reading
• Typing on a computer or tablet instead of writing
• Apps that can help make learning fun by turning phonological awareness into a game
• Old-fashioned rulers can help kids with dyslexia read in a straight line, which might help keep them focused

 Like most learning disabilities, dyslexia often has hidden costs. If your child has dyslexia he may feel frustrated or embarrassed if asked to do things — like reading out loud — that are difficult for him, especially during class or when other students are present. But the problems can often go beyond school. Dyslexia’s impact on day-to-day activities — playing board games, following directions or even reading clocks accurately — can cause kids to feel self-conscious and avoidant.

Helping your child understand her learning disorder can give her the tools she needs to manage her dyslexia — both academically and emotionally.

• Talk to her about the difficulties dyslexia can cause and be specific: “You know how you have a hard time reading signs, or copying notes from the board? That’s dyslexia.”
• Acknowledge her struggles and praise hard work — even if the results aren’t perfect: “I understand how challenging that reading assignment was. I was so proud of how hard you worked on it.”
• Help her identify specific strengths: “That drawing you made of our family had such vivid colors and details. You’re a great artist.”
• Combat negative self-talk: If your child starts saying things like “I’m just stupid,” don’t ignore it. Instead, check out these ideas for helping kids who are too hard on themselves.