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Dyslexia
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Dyslexia is an impairment in your brain's ability to translate written images received from your eyes into meaningful language. Also called specific reading disability, dyslexia is the most common learning disability in children.
Dyslexia usually occurs in children with normal vision and normal intelligence. Children with dyslexia usually have normal speech, but may have difficulty interpreting spoken language and writing.
Children with dyslexia need individualized tutoring, and treatment for dyslexia often involves a multisensory education program. Emotional support of your child on your part also plays an important role.
Symptoms
Dyslexia symptoms can be difficult to recognize before your child enters school, but some early clues may indicate a problem. Once your child reaches school age, your child's teacher may be first to notice a problem.
Before school
Signs and symptoms that a young child may be at risk of dyslexia include:
- Late talking
- Adding new words slowly
- Difficulty rhyming
School age
Once your child is in school, dyslexia symptoms may become more apparent, including:
- Reading at a level well below the expected level for the age of your child
- Problems processing and understanding what he or she hears
- Difficulty comprehending rapid instructions
- Trouble following more than one command at a time
- Problems remembering the sequence of things
- Difficulty seeing (and occasionally hearing) similarities and differences in letters and words
- An inability to sound out the pronunciation of an unfamiliar word
- Seeing letters or words in reverse (b for d or saw for was) — although seeing words or letters in reverse is common for children younger than 8 who don't have dyslexia, children with dyslexia will continue to see reversals past that age
- Difficulty spelling
- Trouble learning a foreign language
When to see a doctor
Dyslexia is characterized by a delay in the age at which your child begins to read. Most children are ready to learn reading by kindergarten or first grade, but children with dyslexia often can't grasp the basics of reading by that time. Talk with your doctor if your child's reading achievement level falls below what's expected for his or her age or if you notice other signs or symptoms of dyslexia.
Causes
A learning disability is a condition that produces a gap between someone's ability and his or her performance. Most people with dyslexia are of average or above-average intelligence, but read at levels significantly lower than expected. Other types of learning disabilities include attention difficulties, an inability to perform well at writing skills and an inability to perform well at math skills.
The cause of dyslexia seems to be a malfunction in certain areas of the brain concerned with language. The condition frequently runs in families.
Complications
Your child's inability to read well may not affect achievement in other school subjects, such as arithmetic. However, because reading is a skill basic to most other school subjects, a child who has dyslexia is at a great disadvantage in most classes and may have trouble learning.
Left untreated, dyslexia may lead to low self-esteem, behavioral problems, anxiety, delinquency, aggression, and withdrawal or alienation from friends, parents and teachers. The degree to which these problems develop may relate to the severity of the condition.
Preparing for your appointment
You'll probably first bring up your concerns with your child's pediatrician or family doctor. You may then be referred to specialists, such as an eye doctor (ophthalmologist) or a doctor who specializes in brain and nervous system disorders (neurologist) to ensure that another problem isn't at the root of your child's reading difficulty. Additionally, you'll likely be referred to a reading specialist who can help identify and treat dyslexia.
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
- Write down any symptoms that your child is experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of any medications, as well as any vitamins or supplements, that your child is taking.
- Ask a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor.
Preparing a list of questions ahead of time can help you make the most of your appointment. For dyslexia, some basic questions to ask your doctor include:
- Why is my child having difficulty reading and understanding?
- What kinds of tests does he or she need?
- Can dyslexia be treated?
- Are there any alternatives to the primary approach that you're suggesting?
- How quickly will we see progress?
- Are there any brochures or other printed material that I can take home with me? Can you recommend any Web sites?
- Will my other children have dyslexia too?
- What kind of help can I expect from my child's school for dyslexia?
What to expect from your doctor
Your doctor will likely have a number of questions for you as well, such as:
- When did you first notice that your child was having trouble reading? Did a teacher bring it to your attention?
- At what age did your child start talking?
- Have you noticed if he or she writes any letters or words in reverse?
- Have you tried any reading interventions? If so, which ones?
- Have you noticed any behavioral or social skill changes associated with your child's reading difficulty?
- Has your child had any vision problems?
Tests and diagnosis
Dyslexia diagnosis involves an evaluation of medical, cognitive, sensory-processing, educational and psychological factors. Your doctor may ask about your child's developmental and medical history as well as your family medical history.
Your doctor may also suggest that your child undergo:
- Vision, hearing and neurological evaluations. These evaluations can help determine whether another disorder may be causing or contributing to your child's poor reading ability.
- A psychological assessment. This can help determine whether social problems, anxiety or depression may be limiting your child's abilities.
- An evaluation of educational skills. Your child may take a set of educational tests and have the process and quality of his or her reading skills analyzed by an expert.
Treatments and drugs
There's no known way to correct the underlying brain malfunction that causes dyslexia. Dyslexia treatment is through remedial education, and the sooner intervention begins, the better it generally is for your child. Psychological testing will help your child's teachers develop a suitable remedial teaching program.
Multisensory approach
Teachers may use techniques involving hearing, vision and touch to improve reading skills. Helping a child use several senses to learn — for example, by listening to a taped lesson and tracing with a finger the shape of the letters used and the words spoken — can help him or her process the information.
A reading specialist will focus on five key areas necessary for effective reading:
- Phonemic awareness — phonemes are the smallest sounds in spoken words
- Phonic recognition
- Oral reading ability
- Building a vocabulary
- Reading comprehension
You can help your child learn by reading to him or her often and helping your child pronounce letters and spell out words. If your child learns best by hearing new information first, listen to books on tape with him or her and then read the same story in written form together.
If your child has a severe reading disability, tutoring may need to occur more frequently, and progress may be slower. A child with severe dyslexia may never be able to read well and may need training for vocations that don't require strong reading skills. However, with determination, children and adults with dyslexia can learn to do many things, and a number of famous people have succeeded despite their dyslexia. Children with milder forms of dyslexia often eventually learn to read well enough to succeed in school.
Coping and support
Emotional support and opportunities for achievement in activities that don't involve reading are important for children with dyslexia.
If your child has dyslexia:
- Be supportive. Having difficulty learning to read may affect your child's self-esteem. Be sure to provide love and to support his or her talents and strengths.
- Talk to your child. Explain to your child what dyslexia is and that it's not a failure on his or her part. The better your child understands this, the more likely he or she will cope with and compensate for this learning disability.
- Take steps at home to make it easier for your child to study. Provide a clean, quiet, organized place for your child to study, and designate a study time. Also, make sure your child gets enough rest, good nutrition and family support — through outings and activities — to provide a better environment in which he or she can learn.
- Work with your child's school. Talk with teachers frequently to make sure your child is able to stay on track. Be sure your child gets extra time for tests that require reading, if needed. Ask your child's teacher if it would help your child to record the day's lessons to playback later. If available, tutoring sessions with a reading-disorders specialist can be very helpful for many children with dyslexia.
You may also want to consider joining a support group to stay in contact with parents who face similar learning disabilities in their children. Belonging to a support group can provide you with both good information and emotional support. Check with your doctor or your child's reading specialist to find out if there are any support groups in your area.
- Lyon GR. Specific language and learning disabilities. In: Kliegman RM. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.; Saunders Elsevier: 2007. http://www.mdconsult.com/das/book/body/142934465-3/0/1608/82.html?printing=true. Accessed June 11, 2009.
- NINDS dyslexia information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dyslexia/dyslexia.htm. Accessed June 11, 2009.
- Learning disabilities. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec19/ch299/ch299d.html. Accessed June 11, 2009.
- Dyslexia. National Center for Learning Disabilities. http://www.ncld.org/index.php?option=content&task=view&id=454. Accessed June 11, 2009.
- What are the signs of dyslexia? International Dyslexia Association. http://www.interdys.org/SignsofDyslexiaCombined.htm. Accessed June 11, 2009.
- Grizzle KL. Developmental dyslexia. Pediatric Clinics of North America. 2007;54:507.
- Hamilton SS. Interventions for children with reading difficulty. http://www.uptodate.com/home/index.html. Accessed May 22, 2009.
