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Reading the signs: diagnosing dyslexia

My nine-year-old daughter's math and science skills are terrific, but she can't seem to grasp the basics of reading and writing. Her teachers suspect she may have dyslexia. What exactly is dyslexia?

Learning disabilities, of which dyslexia is one type, can be incredibly frustrating. A diagnosis of a learning disability is not the same as being diagnosed with the flu or measles; rather, there is a wide range of potential symptoms and possible causes. Dyslexia refers specifically to developmental reading disorder. It's quite widespread, and affects between 2 and 8 percent of the elementary school-age population.

According to Steven Parker, M.D., an associate professor of pediatrics at Boston University School of Medicine and director of developmental and behavioral pediatrics at Boston Medical Center, dyslexia is characterized by an inability to distinguish or separate the sounds in spoken words. Further, some people cannot identify certain words based on sounding out the individual letters, and others are unable to form images or ideas related to new words. When the brain is unable to store an image related to a new word, then the word won't be recognized when it appears repeatedly. Dyslexia most often manifests itself in an inability to read, to write, or to retain information after reading it.

In order to diagnose dyslexia, clinicians use a group of diagnostic tools. "They combine observation testing to rule out vision or hearing problems," says Parker. "It's very important to eliminate other possible causes of reading problems before diagnosing dyslexia."

Parker notes that parents are usually the first to notice obvious delays in children's development. "There are so many firsts that parents are keyed to look for, and when these developmental milestones don't happen, parents may seek help," he says. But often, lagging academic skills such as reading and writing are noticed early on in the classroom, not at home. "When teachers pick up on struggling students, they can involve parents and get help," Parker says.

Treating dyslexia and other academic developmental disorders can involve in-school special education classes or extracurricular sessions with learning specialists. Most school systems offer special education classes. Children in special education classes may need help with only one or two subjects, and otherwise eat, play, and participate in after-school activities with the rest of their classmates.

According to Parker, planning a remedial program begins with identifying what the child is capable of doing. Special education teachers or learning specialists should have professional certification, and should be able to explain their goals for a teaching program in terms that parents can understand. "Parents should also be involved in their child's program as much as possible," says Parker. "They need to learn how to approach homework assignments, and what methods of learning will be most helpful for their children."

Frequently, special education teachers use an individualized, skill-based approach with dyslexic children. This builds on the child's strengths, and allows for several different methods of teaching children how to read and write. "Instead of merely using phonetics to sound out a word, children may be asked to say, write, and spell each new word," says Parker. Also, children may need to use other senses, such as sight and touch, to enhance the learning process. "If you're teaching a child the word red, you may reinforce that by using red objects," he adds.

It is unclear what causes learning disabilities such as dyslexia, but, Parker says, there is a great deal of study surrounding the causes of learning disabilities. For some years, learning problems were thought to result from a single neurological defect, but new evidence seems to show that learning disabilities have more to do with how the brain brings information together.

Regardless of cause, Parker stresses that the most important thing is for children to get the help they need, feel supported, and use well the skills they have while building on the skills that are problematic.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on dyslexia or other health matters, call 617-638-6767.

21 September 2001
Boston University
Office of University Relations