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Ask Susan: Orthographic Dyslexia — Symptoms, Causes, Intervention

Good day Susan

My son’s phonological awareness is average to low-average, but his rapid recall is very low. We would like information about the approach and how it supports children with more of an orthographic type of dyslexia.


Dear Phillipa

Before answering your questions, and for the benefit of other readers, I will first explain what orthographic dyslexia is. Orthographic dyslexia, also called surface dyslexia, dyseidetic dyslexia or visual dyslexia, is a subtype of dyslexia that refers to children who struggle with reading because they can’t recognize words by sight.

Reading by sight is an important skill for a couple of reasons. One is that some words have tricky spellings. Words like one, said, whose and people can’t be sounded out — readers need to memorize them. The other reason has to do with reading fluency. To be able to read quickly and accurately, kids need to recognize many common words at a glance — without sounding them out.


The most common symptom of orthographic dyslexia is thus a very limited sight vocabulary; few words are instantly recognized from their whole configuration — they need to be sounded out laboriously, as though being seen for the first time. Children with orthographic dyslexia will also have difficulty learning irregular words that can’t be sounded out.

Other reading and spelling patterns associated with orthographic dyslexia include:

  • Confusion with letters that differ in orientation (b-d, p-q), or with words that can be dynamically reversed (was-saw).
  • Losing one’s place because one doesn’t instantly recognize what had already been read.
  • Omitting letters and words because they weren’t visually noted.
  • Difficulty recalling the shape of a letter when writing.
  • Spells phonetically but not bizarrely (laf-laugh; bisnis-business).
  • Can spell difficult phonetic words but not simple irregular words.

Most problems can only be solved if one knows what causes the problem. A disease such as scurvy claimed the lives of thousands of seamen during long sea voyages. The disease was cured fairly quickly once the cause was discovered, viz. a Vitamin C deficiency. A viable point of departure would therefore be to ask the question, “What is the cause(s) of dyslexia?” In your son’s case, one would like to be more specific and ask, “What is the cause(s) of orthographic dyslexia?”


It should be noted that two separate regions of the brain are involved in reading: one in sounding out words, and the other in seeing words as pictures — which is what sight reading is all about.

Neuroscientists at Georgetown University Medical Center (2016) concluded that skilled readers can recognize words at lightning-fast speed when they read because the words have been placed in a sort of visual dictionary. This part of the brain is known as the visual word form area (VWFA) and functions separately from an area that processes the sounds of written words.

Glezer and her coauthors tested word recognition in 27 volunteers in two different experiments using fMRI. They were able to see that words that were different, but sound the same — like ‘hare’ and ‘hair’ — activate different neurons, akin to accessing different entries in a dictionary’s catalog. If the sounds of the word influenced this part of the brain we would expect to see that they activate the same or similar neurons, but this was not the case — ‘hair’ and ‘hare’ looked just as different as ‘hair’ and ‘soup’. Also, the researchers found a different distinct region that was sensitive to the sounds, where ‘hair’ and ‘hare’ did look the same. The researchers thus showed that the brain has regions that specialize in doing each of the components of reading: one region is doing the visual piece and the other is doing the sound piece. The part of the brain that does not work well then in the case of a child with orthographic dyslexia, is most likely the region that is doing the visual piece, i.e. the VWFA.

Skills required in sight-reading

Although some causes of dyslexia have a genetic origin (Kere, 2014), and environmental factors play an important role (Stein, 2018), cognition mediates brain-behavior relationships and therefore offers a sufficient level of explanation for the development of principled interventions. We thus need to understand the cognitive difficulties that underpin reading failure, regardless of whether their origin is constitutional or environmental (Elliott & Grigorenko, 2014). To understand what causes orthographic dyslexia we thus need to focus on the cognitive skills that must be acquired first, before one can become good at recognizing words by sight.

While auditory processing skills and auditory memory are foundational to learning phonics, visual processing skills (such as spatial relations and form discrimination), visual memory, visual-spatial memory, and rapid recall are foundational to sight-reading. Rapid recall refers to the speed with which the names of symbols (letters, numbers, colors, or pictured objects) can be retrieved from long-term memory (De Jong & van der Leij, 2003). This process is often termed rapid automatized naming (RAN), and people with dyslexia typically score poorer on RAN assessments than normal readers (Elliott & Grigorenko, 2014).


The good news is that weaknesses in cognitive skills can be attacked head-on; it is possible to strengthen these mental skills through training and practice. Edublox’s Development Tutor aims at strengthening underlying cognitive skills including visual processing skills, visual memory, visual-spatial memory, and rapid recall. In addition, a child with orthographic dyslexia will also need application in the form of reading and spelling exercises. This can best be accomplished by Edublox’s live tutoring services. Our live tutoring program is based on the proven Orton Gillingham approach but simultaneously aims at developing the brain’s visual word form area, mentioned above.

Watch this playlist and experience how Edublox training and tutoring help turn dyslexia around. One of the students is a third-grade student who was diagnosed with orthographic dyslexia.

Key takeaways




De Jong, P. F., & van der Leij, A. (2003). Developmental changes in the manifestation of a phonological deficit in dyslexic children learning to read a regular orthography. Journal of Educational Psychology, 95(1), 22-40.

Elliott, J. G., & Grigorenko, E. L. (2014). The dyslexia debate. Cambridge: Cambridge University Press.

Georgetown University Medical Center (2016, June 9). In the brain, one area sees familiar words as pictures, another sounds out words. Retrieved July 15, 2019 from https://bit.ly/2XLzNHd

Kere, J. (2014). The molecular genetics and neurobiology of developmental dyslexia as model of a complex phenotype. Biochemical and Biophysical Research Communications, 452(2), 236-243.

Stein, J. (2018). The magnocellular theory of developmental dyslexia. In T. Lachmann, & T. Weis (Eds.). Reading and dyslexia (pp. 97-128). Cham, Switzerland: Springer.

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More about Susan

Susan is an educational specialist in the field of learning problems and dyslexia and has a B.A. Honors in Psychology and B.D. degree. Early in her professional career, Susan was instrumental in training over 3,000 teachers and tutors, providing them with the foundational and practical understanding to facilitate cognitive development amongst children who struggle to read and write. With over 30 years of research to her name, Susan conceptualized the Edublox teaching and learning methods that have helped thousands of children who were struggling academically to read, learn and achieve. In 2007, Susan opened the first Edublox reading and learning clinic and now there are 40 Edublox clinics internationally. Her proudest moments are when she sees a child who had severe learning difficulties come top of their class after one or two years at Edublox. Susan always takes time to collect the ‘hero’ stories of learners whose self-esteem is lifted as their marks improve.