Dyslexia

Dyslexia
Dyslexia
Specialty	Neuropsychology, pediatrics

Dyslexia is a neurological disorder with biochemical and genetic markers. In its most common and apparent form, it is a disability in which a person's reading and/or writing ability is significantly lower than that which would be predicted by his or her general level of intelligence. However, as has been discovered only in the last decade, individuals may read and write perfectly and still have dyslexia (see "characteristics" below).

The term was coined in 1887. 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. Because reading is a complex mental process, dyslexia has many potential causes. From a neurophysiological perspective, dyslexia can be diagnosed by close inspection of the morphology of the brain, usually upon autopsy. Dyslexia is also associated with phonological difficulties, such as enunciation.

Variations and related disorders

Dyslexia is a learning disorder. Its underlying cause may be neurological in nature, but from there, the systems involved splay out into visual, language, etc. FMRI (Functional Magnetic Resonance Imaging) has been used to demonstrate differences in the dyslexic brain patterns, but much research still needs to be done to apply this information. The disorder can be partially compensated for with appropriate therapy.

In addition to the typical forms of dyslexia, there are numerous related disorders:

Semantic dyslexia
Scotopic 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.
Dyspraxia
A neurological disorder characterised by a marked difficulty in carrying out routine tasks involving balance, fine-motor control, and kinesthetic coordination.
Verbal Dyspraxia
A neurological disorder characterised 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 characterised by distorted and incorrect writing.
Dyscalculia
A neurological disorder characterised by a problem with learning fundamentals and one or more of the basic numerical skills. Often people with this disorder can understand very complex mathematical concepts and principles but have difficulty processing formulas and even basic addition and subtraction.

Facts and statistics

Between five and 15 percent of the population can be diagnosed as suffering from various degrees of dyslexia. As previously mentioned, dyslexia can be substantially compensated for with proper therapy, training and equipment.

Most researchers agree that there is a fairly even gender balance amongst dyslexics, and that the fact that it is reported more in males is because of selection factors and bias.

Dyslexia's main manifestation is a difficulty in developing reading skills in elementary school children. Those difficulties result from reduced ability to associate visual symbols with verbal sounds. While motivational factors must also be reviewed in assessing poor performance, dyslexia is considered to be an inborn trait and rarely arises from environmental factors after the brain has matured beyond its especially plastic condition during infancy.

Some have disagreed with these findings, however, and believe that while dyslexia may sometimes be inborn, it is often attributable to lack of phonics training when learning to read, and also attributed to the preponderance of the whole language system.

Physiology and treatment

Even a few weeks of intense phonological training (often involving breaking down and rearranging sounds to produce different words) can help noticeably improve reading skills. Unlike in normal adults, phonological training shows an increase in the activity in the right temporoparietal cortex.

This part of the brain works in spatial tasks and may be the main compensatory structure in phonological training. This is the sister region of the left temporoparietal cortex responsible for visual motion processing which is underactive in many dyslexics. The earlier the phonological regimen is taken on, the better the overall result. Advanced brain scans could identify children at risk of dyslexia before they can even read, although it is thought that simple tests of balance could do the same. It has also been shown that early diagnosis and treatment can almost completely eliminate the symptoms of dyslexia.

The most important thing that can be done for the child is to make sure the child is kept active. You can do this by giving them simple jobs to do around the home such as cleaning the house. This helps improve their concentration and their motivational skills.

One hypothesis for some of the symptoms of dyslexia is a lack of overall short-term memory. Typically a dyslexic will not remember your name, and will suffer an undue amount of difficulty in transcribing (for example) a phone number. These problems could be attributed to difficulty in laying down short-term memories.

Researchers studying the brains of dyslexics have found that during reading tasks, dyslexics show reduced activity in the left inferior parietal cortex. It is not that uncommon for dyslexics who have trained themselves to cope with their affliction, to develop uncannily efficient visual memories which aid in reading and comprehending large quantities of information much faster than is typical. Commonly dyslexics show 10 times more brain activity when reading. Sometimes, depending of the type and extent, also writing, listening and speaking. Conversely, some dyslexics may show a natural dislike of reading and, in consequence, compensate by developing unique verbal communication skills, inter-personal expertise, and leadership skills. Different people adopt different strategies for living with the same affliction.

A popular hypothesis for the reading difficulties experienced by dyslexics is strabismus, which is difficulty in bringing both eyes into focus on the same point. Such problems explain why dyslexics often confuse the sequence of written letters or numbers, as the end of the word is literally being seen first by one eye, then the beginning of the word is seen by the other eye. Studies in which young children are taught reading skills while wearing an eyepatch have shown very promising results. This is based upon the theory that, because children benefit more from learning to read than being confocal, the former should take precedence over the latter.

In 1979, anatomical differences in the brain of a young dyslexic were documented. Albert Galaburda of Harvard Medical School noticed that language centers in dyslexic brains showed microscopic flaws known as ectopias and microgyria. Both affect the normal six-layer structure of the cortex. An ectopia is a collection of neurons that have pushed up from lower cortical layers into the outermost one. A microgyrus is an area of cortex that includes only four layers instead of six.

These flaws affect connectivity and functionality of the cortex in critical areas related to sound and visual processing. These and similar structural abnormalities may be the basis of the inevitable and hard to overcome difficulty in reading.

Several genetic regions on chromosomes 1 and 6 have been found that might be linked to dyslexia. In all likelihood, dyslexia is a conglomeration of disorders that all affect similar and associated areas of the cortex. With time, science is likely to identify and classify all individual suborders with benefits to our understanding of how low-level genetic flaws can affect the wiring of the brain and enhance or reduce a particular component of human mental capacity.

Some studies have concluded that speakers of languages whose orthography has a strong correspondence between letter and sound (e.g. Korean and Italian) have a much lower incidence of dyslexia than speakers of languages where the letter is less closely linked to the sound (e.g. English and French). (Source: http://www-tech.mit.edu/V121/N12/shorts2_12.12w.html )

Whether models of dyslexia are correct or not, the main lesson of dyslexia is that minor genetic changes affecting the layering of the cortex in a minor area of the brain may impose limitations on the overall intellectual function. At the same time, dyslexia shows that the brain exhibits a strong ability to compensate for its acquired limitations, and intense training can often result in miraculous turnabouts.

Characteristics

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 inconsistency. Symptoms increase dramatically with confusion, time pressure, emotional stress, or poor health.

General

Appears to be bright, seemingly highly intelligent, and articulate but unable to read, write, or spell at grade level.
Isn't "behind enough" or "bad enough" to be helped in the school setting.
Possibly High in IQ or average or below average, yet may not test well academically; tests well orally, but not written. see Functional illiteracy
Feels dumb; has poor self-esteem; hides or covers up weaknesses with ingenious compensatory strategies; easily frustrated and emotional about school reading or testing.
Perhaps talented in either 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."
Learns best through hands-on experience, demonstrations, experimentation, observation, and visual aids.

Vision, reading, and spelling

Complains of dizziness, headaches or stomach aches while reading.
Confused by letters, numbers, words, sequences, or verbal explanations.
Reading or writing shows repetitions, additions, transpositions, omissions, substitutions, and reversals in letters, numbers and/or words.
Complains of feeling or seeing non-existent movement while reading, writing, or copying.
Seems to have difficulty with vision, yet eye exams don't reveal a problem.
Extremely keen sighted and observant, or lacks depth perception and peripheral vision.
Reads and rereads with little comprehension.
Spells phonetically and inconsistently

Hearing and speech

Has extended hearing; hears things not said or apparent to others; easily distracted by sounds.
Difficulty putting thoughts into words; speaks in halting phrases; leaves sentences incomplete; stutters under stress; mispronounces long words, or transposes phrases, words, and syllables when speaking.

Writing and motor skills

Trouble with writing or copying; pencil grip is unusual; handwriting varies or is illegible.
Clumsy, uncoordinated, poor at ball or team sports; difficulties with fine and/or gross motor skills and tasks; prone to motion-sickness.
Can be ambidextrous, and often confuses left/right, over/under.

Maths and time management

Has difficulty telling time, managing time, learning sequenced information or tasks, or being on time.
Computing maths shows dependence on finger counting and other tricks; knows answers, but can't do it on paper.
Can count, but has difficulty counting objects and dealing with money.
Can do arithmetic, but fails word problems; when doing maths must see the big picture before the details.

Memory and cognition

Excellent long-term memory for experiences, locations, and faces.
Poor memory for sequences, facts and information that have not been experienced.
Thinks primarily with images and feeling, not sounds or words (little internal dialogue).

Behavior, health, development and personality

Extremely disorderly or compulsively orderly.
Can be class clown, trouble-maker, or too quiet.
Had unusually early or late developmental stages (talking, crawling, walking, tying shoes).
Prone to ear infections; sensitive to foods, additives, and chemical products.
Can be an extra deep or light sleeper; bedwetting beyond appropriate age.
Unusually high or low tolerance for pain.
Strong sense of justice; emotionally sensitive; strives for perfection.

Public support

In the United States, Canada and in the United Kingdom, some people say that there is a lack of adequate support and a general lack of interest in the learning disabilities of children in public schools. This has recently led to legal action by private parties against public schools in the United States and state schools in the United Kingdom.

Some charitable organizations like the Scottish Rite Foundation have undertaken the task of testing for dyslexia and making training classes and materials available for teachers and students. [1] [2] [3]

In English law, the failure of schools to diagnose and provide remedial help for dyslexia became grounds for personal injury litigation in 1999 following a House of Lords decision in the case of Pamela Phelps. Students with dyslexia in Higher Education may receive support funded via the Disabled Students Allowance. Support can take the form of IT equipment (software and hardware) as well as personal assistance, also known as non-medical helper support. Dyslexic students will also be entitled to special provision in examinations such as additional time to allow them to read and comprehend exam questions.

The British Disability Discrimination Act also covers dyslexia.

"In some cases, people have 'coping strategies' which cease to work in certain circumstances (for example, where someone who stutters or has dyslexia is placed under stress). If it is possible that a person's ability to manage the effects of the impairment will break down so that these effects will sometimes occur, this possibility must be taken into account when assessing the effects of the impairment." — Paragraph A8, Guidance to the Definitions of Disability

Many doctors and teachers diagnose students with Attention Deficit Disorder rather than dyslexia. Of all the conditions that can mimic, mask or co-exist with ADD, dyslexia is probably the most well known. It is also one of the most misunderstood. Dyslexia is a learning disability that affects 17-20% of school age children according to the Department of Health, Education and Welfare. Like ADD, the dyslexic mind functions differently than others. Dyslexic children, like ADD children, tend to be above average intelligence, if not gifted. But they have specific difficulties with words. They have difficulty recalling words, even words they are familiar with. They also have difficulty with sequencing. Letters and syllables can become inverted (like "aminal") as can entire words. ("Come here over.") The child may have trouble distinguishing between the letters "b," "d," "q" and "p."

Tests for Dyslexia

If you have dyslexia, reading up on the subject is probably very hard. If you had trouble understanding this article, you most likely have dyslexia.

Bibliography

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Gross-Glenn, K., and Rothenberg, S., Evidence for Deficit in Interhemispheric Transfer of Information in Dyslexic Boys, International Journal of Neuroscience, vol 24, 1984.
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Horowitz, B., Rumsey, J.M. and Donohue, B.C., Functional Connectivity of the Angular Gyrus in Normal Reading and Dyslexia, Proceedings of the National Academy of Sciences, vol 95, July 21, 1998
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Snowling, M.J. (2000). Dyslexia. Blackwell Publishing: ISBN 0631205748

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