בס"ד
Dyslexia –
Prognosis and Treatment
Written By: Shirit Badichi
028661544
August 2006
8 Rav Asi st., Bnei Braq
03-6168679
Contents
Introduction
Foreword
Chapter One
What is Dyslexia?
Definitions of Dyslexia
Variations and Related Disorders
Symptoms of Dyslexia
Characterisitics of Dyslexia
Chapter Two
Early Identification
Diagnostic Tests For Early Identification
Benefits of Early Diagnosis for Remediation
Early Warning Signs that May Predict Learning Difficulties
Family History and Genetic Evidence
Speech and Language
Sequencing
Auditory Sequential Memory Difficulties
Motor Skills
Gross Motor Skills
Laterality
Chapter Three
The Eyes Significance and Importance in the Dyslexia Debate
Chapter Four
Teaching Reading
Teachign Reading to Dyslexic Pupils
Conclusion
Bibliography
Foreword
I have been teaching in the second grade dor 15 years. Almost every year there is at least one student in my class who has a big difficulty in reading (sometimes in writing as well). Students that do not know how to read get tutored in the afternoon and are sent to resource room at school twice or three times a week. Some of these students eventually learn to read, however there are others who are not able to read at the end of the year. These students are usually diagnosed as dyslexic. These youngsters can be healthy, energetic and many of them are highly intelligent. Parents and family members do not understand and many accuse them of not paying attention, not concentrating, or just being lazy. These students are made to feel second-class citizens because they may simply be unable to follow instructions which for others seem easy.
It is hard for me as a teacher to see the students’ deep pain and the suffering for being mentally abused for not knowing how to read. I decided to write this research paper in order to understand: What is dyslexia? What are its symptoms? And How can the Education System help dyslexic students learn how to read?
In view of these questions I have designed the following paper:
Chapter One a) explains what is dyslexia, and gives differnet definitions for dyslexia. B) what are the symptoms and characteristics of dyslexia.
Chapter Two talks about the importance of early identification of dyslexia, and the symptoms od dyslexia at early age.
Chapter Three explores the subtypes of dyslexia and discusses if there is a cure for dyslexia by eye treatment.
Chapter Four discusses differnet teaching methods, and how to teach dyslexic students how to read.
Acknowledgements
I wish to thank HaKadosh Baruch Hu for enabling me to accomplish this research paper. I hope that this research paper will aid other teachers to understand and help dyslexic students learn how to read.
I would like to thank Mrs. Gavrielle Ben Shmuel for reading through the manuscript. I appreciate her guidance and professional suggestions.
Special thanks to Mrs. Menucha Kunsman who I admire. I have been priviliged to take part in her English courses in Beit Hamore. I have enjoyed her courses very much and gained much knowledge.
A tremendous amount of gratefulness to my dear parents for encouraging me in writing this paper and for helping me find information about dyslexia.
To my devoted husband I feel an immeasurable amount of sincere gratitude for enabling me to spend much time n writing this research paper. Without his help it could not have been completed.
Introduction
When children first attend school their teachers and parents are keen to ensure that their reading and writing skills develop at the expected level. It soon becomes clear that children learn at different pace, but some children fall noticably behind their peers.
Although educationalists try to avoid labelling children it is extremely distressing for all concerned when a child, who may be bright in many other ways, is failing to learn to read.
There may be many reasons for the child’s difficulty with reading, one of which is Dyslexia. If a child is dyslexic, it is important that this is identified and addressed as soon as possible. In the past, parents concerns may have been brushed aside with observations such as “boys often develop later than girls” or that the child lacked concentration. The child may also have shown signs of behavioral problems which were sometimes given as explanations for his lack of progress.
People who are dyslexic require recognition and teaching to help them overcome learning difficulties. Dyslexia occurs throughout the world in all environments, and does not respect class boundaries. It can causr a great deal of anxiety and friction when an “otherwise bright child” is still unable to read despite many attempts of teaching the skills using a variety of methods. Therefore it is imperative that dyslexia is detected at the earliest possible age, then managed in a manner which will allow the child to grow and develop in order to reach his or her true potential in life.
Chapter One
What is Dyslexia?
Dyslexia is a condition which causes difficulty with reading, writing and spelling. Like many medical and scientific terms it is derived from the Greek. The prefix “dys” means difficulty or malfucntion, and the root-word lexis means language. The literal translation is “difficulty with words”. It implies that the problem is not simply with reading, but includes spelling, writing and other aspects of language (Thompson, 1990).
People are diagnosed as dyslexic when their reading problems cannot be explained by a lack of intellectual ability, inadequate instruction, or sensory problems such as poor eyesight.
Although it can be caused by brain damage, (usually reffered to as “Alexia” in this case), the majority of Dyslexics show no evidence of brain trauma. There are two forms of dyslexia. Developmental dyslexia appears to be present from birth, and acuired dyslexia is the result of brain trauma. It is believed that developmental dyslexia is the result of developmental differneces in the brain. Many studies have shown that often there are other family members who show and have shown similar difficulties, which suggests a genetic or developmental cause of the condition. Dyslexia, as a condition, can can show a pronounced difference between individuals from childhood but can continue throughout a person’s life. Nor is it restricted to one sex. Maly dyslexics, however, may show different symptoms from females. Native language may also affect the symptoms and severity of dyslexia.
Problems can include a person’s difficulty with reading and writingm poor short-term memory for sequences, (e.g. numbers and math), and a “confused use of their hands” (for example ambidextrous people often show signs of dyslexia). In addition, occasionaly males will ahow a slower sevelopment of language skills in the early part of their lives. Dyslexias include the inability to name letters, to read words or sentences, or to recognize words directly even though they can be sounded out. Dyslexia is not limited to reversing the order of lwtters in reading or writing, as is often implied in popular culture; it may, for instance, include unexpected spelling mistakes (including phonetic spelling in English) and unusual syntax, and may be associated with dyscalcutia. Most theories focus on non-primary areas in the frontal lobe and the temporal lobe. (4) Studies have linked several forms of dyslexia to genetic markers. (5,6,7)
The term dyslexia was coined in 1884 by R. Berlin (8). Dyslexia was originally defines as a difficulty with reading and writing that could not be explained by general intelligence. One diagnostic approach is to compare their ability in areas such as reading and writing to that which would be predicted by his or her general level of intelligence. Although a variety of modern methods exist to diagnose and assist dyslexics, the causes and nature od the disease remain largely unknown.
Definitions of Dyslexia
The Research Group on Developmental Dyslexia of the World Federation of Neurology produced a definition of Specific Developmental Dyslexia as: “A disorder manifested by difficulty in learning to read despite conventional instruction, adequate intelligence and sociocultural opportunity. It depends on fundamental cognitive disabilities, which are frequently constitutional in origin.”
There have been many criticisms of these fefinitions because of their use of exclusionary criteria.
The Education for All Handicapped Children Act (Public Law 94-142) in 1968 stated: “The term specific learning disability means a disorder in one or more basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfected ability to listen, speak, write, spell or do mathematical calculations. The term includes such conditions as perceptual handicap, brain injury, minimal dysfunction, Dyslexia and developmental aphasia.
Such terms do not include children who have learning disabilities which are primarily the result of visual, hearing or motor handicaps, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage.”
Source: US Office of Education (1977): 65083.
The Orton Dyslexia Society’s definition (1994): “Dyslexia is one of several distinct learning disabilities. It is a specific language-based disorder of constitutional origin characterized by diffictulties in single word decoding, usually reflecting insufficient phonological processing. These difficulties in single word decoding are often unexpected in relation to age and other cognitive and academic abilities. They are not the result of generalized developmental disability or sensory impairment. Dyslexia is manifested by variable difficulty with different forms of language, often including in addition to problems with reading, a conspicuous problem with acquiring proficiency in writing and spelling”. (The Orton Dyslexia Society Research Committee. April, 1994)
Source: Reid Lyon G. (1995). Toward a Definition of Dyslexia. Annals of dyslexia 45:9
BDA definition of dyslexia (1996):
Dyslexia is a complex neurological condition which is constitutional in origin. The symptoms may affect many areas of learning and function, and may be described as a specific difficulty in reading, spelling and written language. One or more of these areas may be affected: Numeracy, notational skills (music), motor function and organizational skills may also be involved. However, it is particularly related to mastering written language, although oral language may be affected to some degree.”
Source: Crisfield J. (ed) (1996) The Dyslexia Handbook, BDA Reading
Canadian Government
The Government of Canada’s Health Portal links its description to the BC Healthguide website ( using their definition:
“Dyslexia is defined here with a difficulty with the alphabet reading, writing and spelling in spite of normal to above average intelligence, conventional teaching, and adequate sociocultural opportunity. Dyslexia is thought to be genetic and hereditary. Dyslexia is not caused by poor vision. Dyslexia is diagnosed following psychological and educational tests that determine language and other academic abilities, IQ and problems-solving skills, and is only diagnosed if the reading disability is not a result of another condition.”
The British Dyslexia Association
“Dyslexia is a difference in the brain area that deals with language. It affects the underlying skills that are needed for learning to read, write and spell. Brain imaging techniques show that dyslexic people process information differently.”
Variations and Related Disorders
Dyslexia is a learning disorder. Its underlying cause may be neurological in nature, but from there, the systems involved play out into visual, language, etc. FMRI (Functional Magnetic Resonance Imaging) has been used to demonstrate differences in the dyslexic brain patterns, but much research to be done to apply this information.
In addition to the typical forms of Dyslexia, there are numerous related disorders:
- Auditory Processing Disorder is the cause of the phonological problems that many dyslexics experience, and causes problems in the auditory memory or working mwmory and auditory sequencing issues. Many with Auditory Processing issues develop visual learning coping strategies, and benefit from a Whole Language approach to reading, and using multi-colored or multi-formatted text.
- Semantic Dyslexia – a form of dyslexia characterized by an inability to properly attach words to their meanings in reading and/or in speech.
- Scotopix Sensitivity Syndrome – a form of dyslexia which makes it very difficult for a person to read black text on white paper, particularly when the paper is slightly shiny. Contrary to how it seems to be defined, this is not an optical problem. It is a problem with how the nervous system encodes and decodes visual information. For many dyslexics color overlays which are matte on one side and glossy on the other help reduce the scotopic effects. Some dyslexics wear glasses which have a color tint to them which also help with the condition. In the scientific community the uses and why these filters work are debated.
- Dyspraxia – a neurological disorder characterized by a marked difficulty in carrying out routine tasks involving balance, fine-motor control, and kinesthetic coordination. Which is most common among dyslexics who also have an attention deficit disorder.
- Verbal Dyspraxia – a neurological disorder characterized by marked difficulty in the use of speech sounds, which is the result of an immaturity in the speech production area of the brain.
- Dysgraphia - a neurological disorder characterized by a problem with learning fundamentals and one or more of the basic numeral skills. Often people with this disorder can understand very complex mathematical concepts and principles but have difficulty processing formulas and even basic addition and substraction.
Symptoms of Dyslexia
Dyslexia is perhaps best characterized as a syndrome, with a wide range of symptoms. It is a much broader issue than simply a “specific reading retardation”. Often pupils do not have the same cluster of symptoms and this can make diagnosis difficult. Naidoo’s (1979) findings showed that we did not find a single, common pattern which typifies all these children. There is unevenness and variability in their performance. They do not constantly make the same mistakes when reading or writing or spelling. They have good and bad days. Their errors are often compounded by tiredness, stress, or illness. Miles and Miles (1974) commented that it is important, therefore, to look out for inconsistencies of dyslexia.
Mashland (1989) said that differneces appear to relate to the location and extent of the primary neurological dysfunction at the root of dyslexia. The medical fraternity has learned much about dyslexia, particularly with the developments in neuro-imaging and genetic studies and much is now known about the function of different parts of the brain.
Characteristics of Dyslexia
Some educationalists take issue with the use of medical terminology to describe the symptoms of dyslexia, but the following terms are useful characteristics of dyslexia:
- Congenital – people are born with it.
- Genetic – inherited and runs in families, more males than females.
- Constitutional – theie is a neurological basis.
- Problems with phonological awareness – difficulties with letter sounds when reading and spelling and writing.
- Problems with language – such as verbal naming or word retrieval or pronunciation.
- Problems with short term memory – which particularly affect auditory sequential memory (such as for the repetition of digits) or visual sequential memory (such as used in coding skills).
It would be unusual for an individual to have all these difficulties. Usually he would have a cluster of symptoms. The prognosis depends on individual strengths and weaknesses, on the individual strategies, on the degree of the dyslexia, on when the diagnosis was made and on appropriate tuition.
Ronald D. Davis places the argument that most dyslexics will exhibit about 10 of the following traits and behaviors. These characteristics can vary from day to day or minute to minute. The most consistent thing about dyslexics is their inconcistency. Symptoms increase dramatically with confusion, time pressure, emotional stress, or poor health. This may vary according to which of the suggested underlying causes of dyslexia affect the individual dyslexic. (12)
- Appears bright, highly intelligent, and articulate but unable to read, write or spell at grade level.
- High in IQ, yet may not test well academically; tests well orally but not written.
- Labelled lazy, dumb, careless, immature, “not trying hard enough” or “behavioral problem”.
- Isn’t “behind enough” or “bad enough” to be helped in the school setting.
- Feels dumb; has poor self-esteem; hides or covers up weaknesses with ingenious compensatory strategies; easily frustrated and emotional about school reading or testing.
- Learns best through hands-on experience, demonstrations, experimentation, observation, and visual aids.
- Talented in art, drama, music, sports, mechanics, story-telling, sales, business, designing, building, or engineering.
- Seems to “zone out” or daydream often; gets lost easily or loses track of time.
- Difficulty sustaining attention; seems “hyper” or daydreamer.
Early Identification
A number of researchers now claim that it is possible to identify areas of weakness and difficulty from around the age of three to four years, who may indicate children who will experience problems when they begin to learn to read. The researchers Bradely and Bryant (1983) substantiate those claims: “The performance of the pre-schoolers on this phonological (sounding out) awareness task was found to be a good predictor of their reading and spelling ability over three years later. Bryant (1985) advanced the debate when he stated that “there is no point in anyone trying to prevent children ever becoming dyslexic without having a precise way of detecting which child among a group of three or four years old is likely to do much worse at learning to read [...] The problem is however that no such measure exists.”
Diagnostic tests for early identification
There are two diagnostic tests for early screening: The Dyslexia Early Screening Test and the Cognitive Profiling System.
Dyslexia Early Screening Test (DEST)
Nicolson and Fawcett, 1995 set a test which could be administered by the pupils own teacher or a schol health professional who could test at pupils on entry to school, in the same way that children have routine sight and hearing tests. The features of this test are:
- It is suitable for children aged 4.6 to 6.5 years.
- It consists of ten simple sub-tests which allow the tester to check for strengths and weaknesses.
- It is a pencil and paper test which means all schools can use it.
- It takes about 30 minutes per pupil to administer.
- It is modestly priced.
- It can be administered by teachers and health care professionals with no previous experience of psychological testing.
The Cognitive Profiling System