Understanding Dyslexia

You likely know someone who struggles with reading. This shouldn’t surprise us, because reading is a complex act. It involves a wide range of processes and skills that all have to act at once, in the right way, to achieve the desired outcome of understanding a piece of text.

For several reasons, some people have difficulty reading and assembling the meaning of a text. In an age where reading is a vital life skill, this can cause significant problems.

They read slowly and haltingly, and words they read correctly in one sentence may be misread in a subsequent sentence. Reading aloud can be particularly painful. Poor spelling and trouble writing are usually included. They may have a learning disability known as dyslexia.

It’s important to point out that not all people who experience trouble reading have dyslexia. Obviously, being able to read and write well depends on adequate training. If you don’t receive this training, you will probably find it hard to read. Similarly, some kinds of brain injury or impairment may make complex tasks like reading difficult to achieve. However, when a child’s reading skills lag behind their overall ability, dyslexia may be present.

But where is it present, and why? In this article, we are going to consider:

• Where does the term “dyslexia” come from?
• What is dyslexia?
• What are the signs of dyslexia?
• How common is dyslexia?
• What is the impact of dyslexia?
• What causes dyslexia?
• What cognitive difficulties underpin reading?
• How is dyslexia diagnosed?
• Can dyslexia go undetected?
• What other conditions can occur with dyslexia?
• What can parents do to help their children?
• What is the best treatment for dyslexia?

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Where does the term “dyslexia” come from?

The term dyslexia appeared for the first time in the late 19th century. Interestingly enough, an ophthalmologist came up with the term. He was working with adults who had lost their ability to read after a stroke.

It was only in 1968 that the World Federation of Neurology met and defined dyslexia as a learning disorder in these terms:

“A disorder manifested by difficulty in learning to read despite conventional instruction, adequate intelligence, and socio-cultural opportunity. It is dependent upon fundamental cognitive disabilities which are frequently of constitutional origin.”

What is dyslexia?

Dyslexia is difficulty with words. Like all words that start with dys, it refers to a problem, deficiency, or lack. Lexia has to do with words and language. In particular, dyslexia refers to difficulty with reading and writing words.

Traditionally, scholars defined dyslexia as a discrepancy between actual reading performance and what would be expected based on the child’s intelligence. The ‘true dyslexic’ was typically a person who, despite struggling with reading, is above average in intelligence. When children are less intelligent, their reading troubles have been ascribed to their general intellectual limitations. 

Research, however, has shown that the distinction between the intellectually able dyslexic poor reader and the ‘garden-variety’ poor reader is no longer tenable. Using brain imaging scans, Tanaka et al. (2011) found no difference between the way poor readers with or without dyslexia think while reading.

The Rose Report (2009) states that dyslexia can occur across the IQ range and that poor decoding skills require the same kinds of intervention irrespective of IQ. The Rose Report defines dyslexia as follows (p. 10):  

Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling. Characteristic features of dyslexia are difficulties in phonological awareness, verbal memory and verbal processing speed. Dyslexia occurs across a range of intellectual abilities.

In their DSM-5, the American Psychiatric Association uses the term ‘Specific Learning Disorder with impairment in reading’ to describe what others call dyslexia. The DSM-5 considers dyslexia “specific” for four reasons: it is not attributable to

• an intellectual disability, generally estimated by an IQ score of 65-75;
• a global developmental delay;
• hearing or vision disorders; or
• neurological or motor disorders.

Dyslexia is best thought of as a continuum, not a distinct category, and there are no clear cut-off points. Like hypertension, it can vary in severity. The terms mild, moderate, and severe are commonly used to describe the degree:

The most common subtypes of dyslexia include dysphonetic (also called phonological or auditory), dyseidetic (also named surface and visual), and deep. Developmental dyslexia may be used to distinguish the problem in children and youth from similar difficulties experienced by persons after severe head injuries.

What are the signs of dyslexia?

The complexity of learning disabilities, in general, makes it difficult to pinpoint a discrete set of definitive signs. However, advances in dyslexia testing have enabled clinicians to link certain traits, behaviors, and deficits to the presence of this learning disorder. Here is a list of some of the more common ones:

Linguistic signs

Children tend to develop language in a predictable series of stages, and there is a correlation between a failure to reach certain landmarks and trouble reading later on. While none of these are conclusive proof of dyslexia, they are worth noting if you observe them in your child:

• Late language acquisition: Many dyslexic children exhibit a delay in language acquisition. Acquisition is the term linguists use to describe the process whereby you take on your mother tongue.

• Difficulty with rhyme: A child with dyslexia may find it difficult to answer a question like: “can you think of a word that rhymes with hot?”

Problems with literacy

Once a child completes the process of acquiring their first language (usually around the age of 5), literacy is introduced through elementary schooling. The child must begin to learn to interpret written text. For this to happen, several other mental processes must be effortless and routine.

• Learning sound-symbol relationships: A persistent difficulty in linking letter symbols to sounds can be an early indicator of dyslexia. Some children routinely give the wrong sound for a given letter symbol, even frequent ones.

• Difficulty blending: In English, and many other languages, each character in a written word represents one phoneme or sound. To successfully deal with a word, a beginning reader must “blend” the individual sounds represented by the various symbols: the sequence t – a – p must become a single sound: “tap.” Dyslexia can make it difficult for the young reader to do this.

• Difficulty segmenting: Just as they may struggle to blend sounds into words, people with dyslexia often do not readily do the opposite task of breaking words into separate sound segments.

• Reading for comprehension: Effective reading involves more than accurate decoding of text. The reader must understand what the text is saying. People with dyslexia might have significant difficulty with reading comprehension.

Behavioral signs

In addition to language and literacy skills, a child’s behavior and non-verbal abilities can provide information about future reading outcomes.

• Retaining heard information: Dyslexic children often fail to follow verbal instructions, which can easily be mistaken for defiance or a deficit in hearing.

• Motor skills: There appears to be a high correlation between dyslexia and difficulties with motor skills. These are the skills we recruit to do things like sit and balance (gross motor) or hold and manipulate paper and pencils (fine motor).

How common is dyslexia?

Determining exactly how many people have dyslexia is tricky. This is because the definition of this learning disability is not precise in the way that many other disorders are. What unifies all people with dyslexia is that they find it difficult to read effectively for understanding.

While it’s hard to arrive at a concrete figure, dyslexia seems to affect a large number of people. Most estimates place the number at between 4 and 12 percent of the population. According to the International Dyslexia Association, at least one in every ten otherwise able people has serious dyslexia problems.

What is the impact of dyslexia?

Poor reading skills cast a dark shadow. Extensive evidence suggests that learning to read is directly linked to a young child’s self-concept and mental well-being and that children with hampered reading skills fare poorly academically.

As the poor achiever’s hope for a fulfilling and productive life begins to diminish, they may start contributing to the overall number of school dropouts, single parents, and juvenile delinquents.

Reading failure increases the risk of depression as well as suicidality. Fuller-Thomson et al. (2018) concluded that people with specific learning disabilities had 46 percent higher odds of having ever attempted suicide in comparison with their peers without a learning disorder.

Strong reading skills, on the other hand, have been tied to many personal, social, and economic benefits.

What causes dyslexia?

Some research suggests that dyslexia has a neurobiological basis. This means that its cause is in the brain.

In a meta-analysis of functional neuroimaging studies of dyslexia, Martin et al. (2016) list studies in which differences between groups with and without dyslexia were found in specific brain regions. The most consistent findings concerned the left occipitotemporal cortex, which includes the so-called visual word form area (VWFA), though critical for reading.

The left inferior parietal lobule came in a close second in the meta-analysis study. This part of the human brain is involved in word analysis, grapheme-to-phoneme conversion, and general phonological and semantic processing.

A neurological basis goes some way in explaining why some children fail to achieve despite having adequate training and support. It also provides a way to make sense of the common occurrence of dyslexia within families (DeFries & Alarcón, 1996).

It should, however, be noted that brain differences do not equal brain disorders (Protopapas & Parrila, 2018). Some studies suggest that the cause-effect relationship is reversed, and that anatomical brain differences are not the cause of reading difficulties but the consequence (Krafnick et al., 2014). It should also be noted that the brain is plastic, which means that it is constantly changing due to learning and experience.

Although some causes of dyslexia have a biological or genetic origin, and environmental factors play an important role, intervention needs to be guided by the cognitive difficulties that underpin reading failure, say Elliott and Grigorenko (2014).

What cognitive difficulties underpin reading?

Di dunia kini kita, tiap orang harus dapat membaca….

Unless one has first learned to speak Bahasa Indonesia, there is no way that one would be able to read the above Indonesian sentence. This shows that language is at the very bottom of the reading ladder. Cognitive skills comprise the second. Below are examples: 

• Phonological awareness is a listening skill that includes the ability to distinguish units of speech, such as rhymes, syllables in words, and individual phonemes in syllables.

• Rapid automatized naming (RAN) refers to the speed with which one can retrieve the names of symbols (letters, numbers, colors, or pictured objects) from long-term memory.

• Processing speed can be defined as how long it takes to get stuff done. Dyslexia is linked to slow processing speed.

• Auditory working memory refers to the ability to temporarily hold several facts or thoughts in memory while solving a problem or performing a task. You use this workspace in your brain when mentally adding or subtracting two or more numbers.
  
  An important and consistent finding is that working memory problems interfere with reading comprehension.

• Visual memory involves the ability to store and retrieve previously experienced visual sensations and perceptions when the stimuli that originally evoked them are no longer present.
  
  Strong visual memory is a critical skill for word recognition. Skilled readers can recognize words at a lightning-fast speed when they read because the words have been placed in the brain’s visual word form area.

• Sequential memory requires items to be recalled in a specific order. Visual sequential memory is the ability to remember things seen in sequence, while auditory sequential memory is the ability to remember things heard in sequence.

• Logical thinking is the process in which one uses reasoning consistently to reach a conclusion.
  
  The relationship between logical thinking and reading comprehension is well-established in the literature. It has been said, “there is no reading without reasoning,” and even that reading is reasoning.
  

How is dyslexia diagnosed?

A comprehensive evaluation is required to make a diagnosis of dyslexia. This evaluation looks at a child’s ability to read, in addition to other factors such as general academic ability and family background. Typically, a large amount of information is required, and the person administering the evaluation or assessment will take the child through a series of tests.

This thoroughness is necessary because one needs to rule out other possibilities.

Can dyslexia go undetected?

Sometimes, specific learning disabilities like dyslexia can be hard to detect. Some children evade a diagnosis because they have exceptional abilities and can therefore mask their dyslexia. They feature in the literature as “twice exceptional” cases because they are above average in ability and intelligence while living with a reading disability.

What other conditions can occur with dyslexia?

As various fields of study converged on the problem of dyslexia, experts began to discover relationships between dyslexia and other conditions. Some of these are:

• Children who struggle to concentrate, resist impulses, or complete tasks may have Attention Deficit Hyperactivity Disorder (ADHD).

• The term dyscalculia describes a learning disorder that affects a student’s ability to learn or retain math skills.

• The term dysgraphia describes a variety of difficulties with writing. In young children, these include problems with holding a pencil, forming letters, and spelling words correctly.

• Dyspraxia refers to difficulty with coordination and movement.

What can parents do to help their children?

What is the best treatment for dyslexia?

The best treatment for dyslexia combines cognitive skills training with the teaching of decoding and reading fluency, and the development of orthographic mapping.

Decoding is key to learning to read and involves taking apart the sounds in words (segmenting) and blending sounds. Reading fluency is the ability to read with speed, accuracy, and proper expression. The process of orthographic mapping involves the brain linking the three forms of a word — its sounds, spelling, and meaning — and storing them together in long-term memory. It allows for instant word recognition, fluent reading, and accurate spelling.

Edublox Online Tutor is an online platform that houses a range of products and services to improve various aspects of learning. Our programs include Development Tutor, Reading Tutor, and Live Tutor. Live Tutor, combined with Development Tutor, is recommended for students with mild to severe dyslexia and targets:

• cognitive skills;
• decoding and reading fluency; and
• orthographic mapping.
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Watch our playlist of customer reviews and see how Edublox training and tutoring can help turn dyslexia around.

Book a free consultation to discuss your child’s learning needs.

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Authored by Susan du Plessis (B.A. Hons Psychology; B.D.), an educational specialist with 30+ years experience in learning disabilities, and Dylan Arslanian (B.A. Hons Linguistics, Cambridge DELTA).
Medically reviewed by Dr. Zelda Strydom (MBChB).

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