DYSLEXIA

What is it?

A common assumption about dyslexia is that it is characterized by reading words in reversed order, i.e., "was" looks like "saw." While this type of problem can be associated with dyslexia, the disorder cannot be explained simply as seeing letters backwards. Dyslexia is marked by difficulties making the basic connection between symbols (letters) and their sounds.

When most children learn to read, they use typical "decoding" skills: recognizing letters on sight and learning the sound each letter makes. Then they begin to figure out (decode) what the letters will look and sound like when they are put together to form words. For people with dyslexia, the decoding process may be a challenge for several reasons. They may be unable to differentiate between certain sounds (such as "p" and "b"), or they may see the letters spaced incorrectly, like this:

• Thew ord sare notsp aced cor rect ly
• Thewordsareallpushedtogether

Who gets it?

The cause of dyslexia is not known. Learning disabilities are generally thought to be a result of subtle miscues in the organization of the brain. The messages the brain is sending seem to get jumbled up or confused. People with dyslexia may be able to hear and see perfectly well, but what they hear and see looks different and sounds different than it would to most people. The miscues that cause dyslexia are thought to be present at birth and influenced to some degree by heredity. Approximately five to ten percent of school-age children have some type of learning disability.

What tests will the GP weant to do?

Schools, community-based psychologists, and many hospitals (including duPont Hospital for Children) offer testing of children who appear to be at risk for a learning disability. Candidates for testing including children with at least normal intelligence who are not doing as well in school as predicted by standard intelligence tests. The comprehensive evaluation for a learning disability involves a series of cognitive, linguistic, social/emotional, and academic tests. Once a diagnosis is made, a treatment plan can be developed. Treatment, or helping the child find ways to learn, requires the close cooperation of parents and teachers and may also involve reading therapists or tutors.

What is the treatment?

There is no cure but compensatory strategies provide ways for the child to get around the effects of dyslexia. They include audiotaping lectures or texts, using flashcards to learn new things, positioning the child in the front of the classroom to better observe his teacher, and using a computer with spelling and grammar checks.

Remediation is a method of teaching that allows the child to get the information he needs in a way that he can learn. There are three components to remediation:

1. Teaching small units
2. "Over-teaching"
3. Multi-sensory presentation

By presenting small units of information, the child can better concentrate on and master difficult material a little bit at a time. For example, word families are introduced, such as the "at" family - cat, fat, mat, etc. The child learns to think about the sounds of the letters and the shape his mouth makes saying those sounds. The information is taught in a meaningful context several times, more so than would seem necessary. The over-teaching component is important. The repetition helps the dyslexic student, who tends to "lose" information quickly.

As the child is saying and reading the words, he is tracing them as well - getting the "feel" of the words. Visual displays are included with verbal instructions. Hearing, saying, seeing, and touching the learned material provides multisensory reinforcement. It is sometimes difficult to determine a dyslexic child's precise area of deficit. Multi-sensory presentation teaches to all the senses in hopes that faster learning is accomplished. It's extremely helpful for parents to learn and practice these techniques at home as well.