Dyslexia: A disorder every parent should know about

DEFINITION

Dyslexia is a learning disorder characterized by difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words. Also called specific reading disability, dyslexia is a common learning disability in children.

Dyslexia occurs in children with normal vision and intelligence. Sometimes dyslexia goes undiagnosed for years and isn't recognized until adulthood.

There's no cure for dyslexia. It's a lifelong condition caused by inherited traits that affect how your brain works. However, most children with dyslexia can succeed in school with tutoring or a specialized education program. Emotional support 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 the first to notice a problem. The condition often becomes apparent as a child starts learning to read.

Before school

Signs and symptoms that a young child may be at risk of dyslexia include:

• Late talking
• Learning new words slowly
• Difficulty learning nursery rhymes
• Difficulty playing rhyming games

School age

Once your child is in school, dyslexia signs and symptoms may become more apparent, including:

• Reading well below the expected level for your child's age
• Problems processing and understanding what he or she hears
• Difficulty comprehending rapid instructions
• Problems remembering the sequence of things
• Difficulty seeing (and occasionally hearing) similarities and differences in letters and words
• Inability to sound out the pronunciation of an unfamiliar word
• Difficulty spelling
• Trouble learning a foreign language

Teens and adults

Dyslexia symptoms in teens and adults are similar to those in children. Though early intervention is beneficial for dyslexia treatment, it's never too late to seek help. Some common dyslexia symptoms in teens and adults include:

• Difficulty reading, including reading aloud
• Trouble understanding jokes or expressions that have a meaning not easily understood from the specific words (idioms), such as "piece of cake" meaning "easy"
• Difficulty with time management
• Difficulty summarizing a story
• Trouble learning a foreign language
• Difficulty memorizing
• Difficulty doing math problems

When to see a doctor

Dyslexia is characterized by a delay in the age at which a 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 level is below what's expected for his or her age or if you notice other signs or symptoms of dyslexia. When dyslexia goes undiagnosed and untreated, childhood reading difficulties continue into adulthood.

CAUSES

Dyslexia has been linked to certain genes that control how the brain develops. It appears to be an inherited condition — it tends to run in families.

These inherited traits appear to affect parts of the brain concerned with language, interfering with the ability to convert written letters and words into speech.

RISK FACTORS

Dyslexia risk factors include:

• A family history of dyslexia
• Individual differences in the parts of the brain that enable reading

COMPLICATIONS

Dyslexia can lead to a number of problems, including:

• Trouble learning. Because reading is a skill basic to most other school subjects, a child with dyslexia is at a disadvantage in most classes and may have trouble keeping up with peers.
• Social problems. Left untreated, dyslexia may lead to low self-esteem, behavior problems, anxiety, aggression, and withdrawal from friends, parents and teachers.
• Problems as adults. The inability to read and comprehend can prevent a child from reaching his or her potential as the child grows up. This can have long-term educational, social and economic consequences.

Children who have dyslexia are at increased risk of having attention-deficit/hyperactivity disorder (ADHD), and vice versa. ADHD can cause difficulty sustaining attention as well as hyperactivity and impulsive behavior, which can make dyslexia harder to treat.

PREPARING FOR YOUR APPOINTMENT

You may first bring up your concerns with your child's pediatrician or family doctor. To ensure that another problem isn't at the root of your child's reading difficulties, the doctor may refer your child to:

• A specialist, such as an eye doctor (ophthalmologist)
• A health care professional trained to evaluate hearing loss (audiologist)
• A doctor who specializes in brain and nervous system disorders (neurologist)

What you can do

To prepare for your appointment:

• Make a list of any symptoms that your child is experiencing, including any that may seem unrelated to the reason for the appointment.
• Prepare key personal information, including any major stresses or recent life changes.
• Make a list of any medications, vitamins or other supplements your child is taking, including the dosages.
• Ask a family member or friend along, if possible, for support and to help you remember information.
• Make a list of questions to ask your doctor to 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?
• Should my child see a specialist?
• Can dyslexia be treated?
• Are there other diagnoses that can be associated with or confused with dyslexia?
• 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 materials that I can have? Can you recommend any websites?
• Will my other children have dyslexia, too?
• What kind of help for dyslexia can I expect from my child's school?

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?
• How is your child doing academically in the classroom?
• At what age did your child start talking?
• Have you tried any reading interventions? If so, which ones?
• Have you noticed any behavior problems or social difficulties you suspect may be linked to your child's trouble reading?
• Has your child had any vision problems?
• Can you describe your child's diet, including caffeine and sugar consumption?

TESTS AND DIAGNOSIS

There's no one test that can diagnose dyslexia. Your child's doctor will consider a number of factors, such as:

• Your child's development, educational issues and medical history. Your doctor will likely ask you questions about these areas. The doctor will likely also want to know about any conditions that run in your child's family, including whether any family members have a learning disability.
• Your child's home life. The doctor may ask for a description of your family and home life, including who lives at home and whether there are any problems at home.
• Questionnaires. Your child's doctor may have your child, family members or teachers answer written questions. Your child may be asked to take tests to identify reading and language abilities.
• Vision, hearing and brain (neurological) tests. These can help determine whether another disorder may be causing or adding to your child's poor reading ability.
• Psychological testing. The doctor may ask you or your child questions to better understand your child's psychological state. This can help determine whether social problems, anxiety or depression may be limiting your child's abilities.
• Testing reading and other academic skills. Your child may take a set of educational tests and have the process and quality of reading skills analyzed by a reading expert.

TREATMENTS AND DRUGS

There's no known way to correct the underlying brain abnormality that causes dyslexia — dyslexia is a lifelong problem. However, early detection and evaluation to determine specific needs and appropriate treatment can improve success.

Educational techniques

Dyslexia is treated using specific educational approaches and techniques, and the sooner the intervention begins, the better. Psychological testing will help your child's teachers develop a suitable teaching program.

Teachers may use techniques involving hearing, vision and touch to improve reading skills. Helping a child use several senses to learn — for example, 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.

If available, tutoring sessions with a reading specialist can be very helpful for many children with dyslexia. A reading specialist will focus on helping your child:

• Learn to recognize the smallest sounds that make up words (phonemes)
• Understand that letters and strings of letters represent these sounds
• Comprehend what he or she is reading
• Read aloud
• Build a vocabulary

If your child has a severe reading disability, tutoring may need to occur more frequently, and progress may be slower.

Individual education plan

In the United States, schools have a legal obligation to take steps to help children diagnosed with dyslexia with their learning problems. Talk to your child's teacher about setting up a meeting to create a plan that outlines your child's needs and how the school will help him or her succeed. This is called an Individualized Education Plan (IEP). To receive help, your child may need a structured, written plan.

Children with dyslexia who get extra help in kindergarten or first grade often improve their reading skills enough to succeed in elementary school and high school.

Children who don't get help until later grades may have more difficulty learning the skills needed to read well. They're likely to lag behind academically and may never be able to catch up. A child with severe dyslexia may never have an easy time reading,  but he or she can learn skills that improve reading.

Academic problems don't necessarily mean a person with dyslexia can't succeed. Students with dyslexia can be highly capable, given the right resources. Many people with dyslexia are creative and bright, and may be gifted in math, science or the arts. Some even have successful writing careers.

What parents can do

You play a key role in helping your child succeed. Take these steps:

• Address the problem early. If you suspect your child has dyslexia, talk to your child's doctor. Early intervention can improve success.
• Read aloud to your child. It's best if you start when your child is 6 months old or even younger. Try listening to recorded books with your child. When your child is old enough, read the stories together after your child hears them.
• Work with your child's school. Talk to your child's teacher about how the school will help him or her succeed. You are your child's best advocate.
• Encourage reading time. To improve reading skills, a child must practice reading. Encourage reading of print materials.
• Set an example for reading. Designate a time each day to read something of your own while your child reads — this sets an example and supports your child. Show your child that reading can provide enjoyment.

What adults with dyslexia can do

Success in employment can be difficult for adults struggling with dyslexia. To help achieve your goals:

• Seek evaluation and instructional help with reading and writing, regardless of your age
• Ask about additional training and reasonable accommodations from your employer or academic institution under the Americans with Disabilities Act

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. Trouble learning to read may affect your child's self-esteem. Be sure to express your love and support. Encourage your child by praising his or her talents and strengths.
• Talk to your child. Explain to your child what dyslexia is and that it's not a personal failure. The better your child understands this, the better he or she will be able to cope with having a learning disability.
• Take steps to help your child learn at home. Provide a clean, quiet, organized place for your child to study, and designate a study time. Also, make sure your child gets enough rest and eats regular, healthy meals.
• Stay in contact with your child's teachers. Talk with teachers frequently to make sure your child is able to stay on track. Be sure he or she gets extra time for tests that require reading, if needed. Ask the teacher if it would help your child to record the day's lessons to play back later.
• Join a support group. This can help you stay in contact with parents whose children face similar learning disabilities. Support groups can provide useful information and emotional support. Ask your doctor or your child's reading specialist if there are any support groups in your area. Or search reputable sites on the Internet for dyslexia or reading disability support groups.