You can tell if your toddler will have this reading disability years before he starts school.
"Bright" doesn't begin to describe 10-year-old Olivia Mott. The artistic fifth-grader from Cheshire, Connecticut, has an amazing memory -- she can recall details of a conversation she heard months ago or exactly what someone was wearing at the time. However, the thing that Olivia was most excited about last year was finishing Judy Blume's Tales of a Fourth Grade Nothing. Back in first grade, while her classmates were breezing through picture books she was stumped by even the most common sight words. She was diagnosed with dyslexia, the learning disability that prevents children from reading and spelling with ease and accuracy. With the help of daily lessons with reading specialists and twice-weekly sessions with a free tutor at a nearby Masonic Learning Center, "Olivia is now reading at grade level," says her mom, Sarah. "I can't believe how far she's come."
As many as one in five kids has some degree of dyslexia, making it the most common learning disability -- and young children often show the first signs of it early on when they're starting to speak. Sadly, though, many of these kids will never get diagnosed. In keeping with the recent trend of emphasizing learning "differences" rather than disabilities, school psychologists and trained testers often hesitate to use the label. "There are children who have all the signs of dyslexia but are identified by schools as simply 'struggling' or 'impaired' readers, and as a result they don't get the special help they need," says Maryanne Wolf, Ed.D., director of the Center for Reading and Language Research at Tufts University, in Medford, Massachusetts.
A decade or two ago, a child who had trouble reading might have been written off as slow and unmotivated. But today, experts know that kids with dyslexia are often gifted analytical thinkers -- famous dyslexics include Albert Einstein, Leonardo da Vinci, and Charles Schwab -- and that with early diagnosis and intensive instruction, they can become more capable readers than anyone might have imagined.
A Different Way of Thinking
To help a child who may have dyslexia, parents might first have to set aside some preconceived notions about the disorder. "Dyslexia is one of those problems that many people think they know a lot about, but their ideas are often based on notions that are no longer valid," says Sally Shaywitz, M.D., codirector of The Yale Center for Dyslexia & Creativity with her husband, Bennett Shaywitz, M.D. For instance, everyone's heard that kids with dyslexia see letters in mirror image and confuse "b" and "d" -- even though studies disproved this in the late 1990s. And people often think it's a problem mostly for boys. In fact, girls are just as likely to have dyslexia, even though boys are diagnosed three or four times more often. (Boys may be more likely to act up in class and thus be scrutinized for "problems.")
People with dyslexia actually view text the same way others do, but they have trouble activating the parts of the brain that retrieve the sounds in spoken words and synthesize letters and sounds. This difficulty processing language begins even before a child reaches reading age. When most toddlers hear a nursery rhyme like "Hey, Diddle Diddle," they enjoy the repetition of sounds and may try to mimic them and come up with their own rendition. But when a child born with dyslexia listens to rhymes, she may not perceive the sound patterns at all. By kindergarten, the same children who picked up on rhymes will be able to pull apart the sounds in spoken words, known as phonemes, and match each to a letter. Soon, they'll see a word like cat, and realize it can be decoded by breaking it into sounds ("k," "aaaa," and "t"). A dyslexic classmate will struggle to associate letters with sounds, much less be able to blend them together to read words.
Scientists have proven that dyslexia is a real brain disorder by using functional magnetic resonance imaging (fMRI), a scanning device that shows where blood flows through a person's brain. When skilled readers look at words projected on a video screen, the left side of the back of their brain -- the area where words' letters, sounds, and meanings are integrated and rapidly recalled -- is bright with activity. But in fMRIs of people with dyslexia, these typical reading circuits are mostly dark and other areas are activated. The fact that people who have dyslexia use alternative pathways on both sides of the brain in order to read may explain why they're often also creative, out-of-the-box thinkers even though they struggle with some language-based tasks, says Dr. Wolf. "Their brain has the ability to look at problems in a different way."
Brain scans have also shown that when children with dyslexia start receiving specialized instruction by age 6 or 7, they are able to activate the part of their brain that helps them read words more accurately, says Dr. Shaywitz, author of Overcoming Dyslexia. This allows them to read the same books as their classmates, although they may always need more time to finish. While current programs can help a child become a more accurate and comfortable reader, they can't "cure" his dyslexia.
Key Steps to Take
Acknowledging that your child has a chronic learning disability can be scary. "However, now that we know how to help children with dyslexia, we've found that getting a diagnosis actually empowers kids and parents," says Dr. Shaywitz. Experts advise these strategies for every age.
Be on the lookout for early signs in your toddler or preschooler. Family history is a big predictor: Up to one half of kids with a parent or a sibling with dyslexia also have it. Early speech delays (such as not saying first words by 15 months) and difficulty pronouncing or getting words out once a child is talking may mean he's having word-retrieval problems that might be associated with reading issues later. However, the inability to appreciate rhymes is a key early sign of dyslexia, says Dr. Shaywitz. If your toddler doesn't seem to play with and repeat the rhyming sounds he hears in Mother Goose or Dr. Seuss, pay attention to whether he has problems learning letters and letter sounds as he moves into preschool.
When you suspect a problem, have her evaluated as soon as possible. In kindergarten, a child with dyslexia will have trouble recognizing the sounds within spoken words and associating letters with their sounds. She'll also struggle to break words into phonemes; you might try testing this by giving her a simple word and asking her to identify the sounds within it. Kids who have dyslexia also fail to recognize common sight words, but not always. "Kids may memorize certain words but not know how to decode new ones," says Dr. Shaywitz. If your kindergartner or first-grader is dealing with any of these issues, make a formal request (in writing, to the school principal) that she be tested for dyslexia. If your child is homeschooled or attends a private school that doesn't offer special-education services, you can make the request of your local public school, which is legally responsible to provide evaluations for all children in its zoning area.
Early on, before a child is expected to read, language specialists can assess her spoken-language skills that are the foundation of learning to read. Later, a psychologist should give your child a comprehensive assessment that includes her medical and developmental history, oral language abilities, phonemic awareness, and, depending on her age, reading and writing skills. If you have trouble getting your child evaluated within a month or two, or you're told that your child doesn't qualify for services when you have a strong feeling that she does have dyslexia, contact your state's branch of the Learning Disabilities Association of America (ldanatl.org) for guidance.
If your child is diagnosed with dyslexia, start an intensive tutoring program right away. Public schools should provide an Individual Education Program (IEP) for children with dyslexia. Formulated by the evaluating psychologist, teachers, and parents, the IEP is a road map for providing extra help for a child. It should include individual or small-group sessions four to five times a week with a reading specialist. (Private schools don't have to create IEPs, but many do.)
When your child is placed in a special reading program, ask what techniques the specialist uses. Most dyslexia experts prefer methods that have been scientifically studied, such as Orton-Gillingham (orton-gillingham.com). Dr. Wolf has launched a program called Rave-O, which is based on a five-year National Institute for Child Health and Human Development intervention research project. Other programs, such as Wilson Fundations (fundations.com) and Rowland Reading Foundation's Superkids Reading Program (rowlandreading.org), are designed for kids around kindergarten age. All of these programs focus on the individual sounds that make up words, and often include tools that engage more than one sense (such as moveable letter tiles) to provide a child with multiple cues for learning.
Consider additional tutoring if your school's special-education program falls short. There are many options to choose from, and also a lot of misleading information out there, says Dr. Shaywitz, so inquire about a program's success rate. "It's important to do your homework and find the program that best suits your child." Ask your pediatrician for referrals, and ask potential tutors if they partner with insurance companies. Masonic Learning Centers (childrensdyslexiacenters.org), like the one Olivia has gone to, provide free, high-quality tutoring to children with dyslexia in 15 states, although waiting lists can be long. Because dyslexia is a language disorder and not a visual problem, experts say there is no evidence that doing vision exercises or wearing special training glasses with colored lenses can benefit kids -- even though there are companies that sell them.
Insist on accommodations for a child who reads very slowly or has trouble retrieving words when speaking. Even when they learn to decode words accurately, most children with dyslexia still have trouble with articulating their thoughts and reading quickly and easily. This can make oral presentations and written tests unnecessarily difficult -- and embarrassing. Part of advocating for your child will be pressing the principal and teaching staff for accommodations that will be particularly helpful for your child, such as not being called upon to read aloud, having extra time on quizzes, and being allowed to dictate homework answers to you. When calling on her to answer a question, the teacher could also ask her to choose between two answers -- so that she can show that she knows the right answer even if it's tough for her to come up with the right words.
Keep your kid's spirits up. Dr. Shaywitz strongly believes that parents should tell their child that he has dyslexia as soon as he's been diagnosed. Letting him know that there's an explanation for the problems he's having in school will reduce his anxiety. For a young child, keep your explanation simple -- you could say something like, "you have trouble hearing small sounds in words," while also pointing out some of the things that he can do well. And tell him that dyslexia is something that lots of smart and cool people have. (Dr. Shaywitz says you might mention actor Orlando Bloom, Captain Underpants creator Dav Pikey, and Percy Jackson, the fictional hero of The Lightning Thief series, who was based on author Rick Riordan's son, who has dyslexia.)
Sarah Mott has seen Olivia's confidence improve tremendously since she found out she has dyslexia. "Before she was diagnosed, Olivia was an angel in the classroom but a terror at home," she says. "It was as if she wanted to hold it together in front of other kids, but then at home she'd break down. After she started intervention, we saw a huge difference in how she felt about herself." Once, when a classmate started teasing her that she had dyslexia and couldn't read, Olivia put a hand on her hip and said proudly, "I have dyslexia, and I can read!"
Originally published in the December 2011 issue of Parents magazine.
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