Decoding the Mysteries of Dyslexia
The squiggles on the page might be hieroglyphs for all the sense they make to the first-grader. So where is her key to translate them into English?
For a child with dyslexia, it's precisely that decoding that can be the worst part of reading. How do the letters make sounds and how do you put the sounds together into words?
"Many children with dyslexia can gather the context from pictures when they start to read," says Karen Mason, MD, a developmental-behavioral pediatrician in the Division of Developmental and Behavioral Pediatrics at Cincinnati Children's Hospital Medical Center. "But when they have to get more information from the words, their parents start to notice that it takes so much energy for these children to unscramble each word."
Diagnosing the Disorder
The life-long problem of dyslexia is often diagnosed when a child enters first or second grade; physicians often see a second wave of children in the fourth grade. The problem affects boys and girls equally, but dyslexia does run in families.
"Grandpa may not have been diagnosed, but the family remembers he had problems with reading," Dr. Mason says.
The cause is not clear, but scientists are beginning to explore an anatomical abnormality. "We know that in the cortex of the brains of children with dyslexia, there are clusters of nerve cells that are not present in children who don't have dyslexia," says Dr. Mason. "We suspect these clusters are 'pruned' during normal development, though we don't know how or why. We don't have enough information yet to know whether these clusters cause or contribute to dyslexia."
Problems with reading do not necessarily mean a child doesn't comprehend the message. "Often if you read them the passage, they can answer all the questions about it."
To make an early diagnosis, Dr. Mason gives the child IQ and oral reading tests. Another test tracks children's understanding of what they read. Then they are challenged to read individual words and pseudo words, such as "pog," which mimic the patterns of English but have no meaning.
"Understanding declines from listening, to reading whole words, to the pseudo words, because a child doesn't have the ability to rely on any memory," she explains.
Learning to Manage Dyslexia
After the problem is identified, parents and teachers usually begin intensive phonetic teaching, such as the Orton-Gillingham or Lindemood-Bell systems. Special education instructors can teach the child techniques to use in reading, and then use those techniques in the classroom as the child catches up.
"Children can understand and learn age-appropriate material, but not if they have to read it themselves," Dr. Mason notes. Math skills are usually not affected until word problems are introduced.
Most students stay in mainstream classes with special education. Many parents arrange for a tutor's help over the summer.
"I tell parents that there will never be a time when their child will not be dyslexic, and reading may never be fluent or easy for them. It can take these children two or three times longer to read a passage than other students. That's when textbooks on tape can help in high school and college."
And career success is well within reach for these children, she says. "Children with dyslexia often excel at jobs where they learn and use the material. They might be a car mechanic or even a physician – they would do fine."
