Dyslexia is not an uncommon problem among the nation's school children, though many kids are not getting the help they need to succeed, said E. Mark Mahone, a pediatric neuropsychologist at the Kennedy Krieger Institute. Proper assessments and treatment can help and can prevent secondary mental health problems from arising, said Mahone, also director of the Kennedy Krieger neuropsychology department and co-director of its Center for Innovation and Leadership in Special Education.
How common is dyslexia, and what constitutes an official diagnosis?
Dyslexia is highly prevalent. The International Dyslexia Association reports that dyslexia affects an estimated 8.5 million schoolchildren and one in six individuals nationwide.
According to the [American Psychiatric Associatio's 2013] Diagnostic and Statistical Manual of Mental Disorders, the diagnosis is made using the individual's history (development, medical, family and education) as well as psychoeducational reports of test scores and observations and response to intervention. Criteria for dyslexia include difficulties with learning as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite interventions that target those difficulties: inaccurate or slow and effortful word reading (reads single words aloud incorrectly or slowly and hesitantly, frequently guesses words, has difficulty sounding out words); or difficulty understanding the meaning of what is read (may read text accurately but not understand the sequence, relationships, inferences or deeper meanings).
Is dyslexia a reflection of intelligence or future ability to succeed?
Dyslexia is not a reflection of the child's intelligence. Like other developmental disorders, dyslexia occurs across all levels of intelligence. Children with dyslexia should be considered to have the intelligence to succeed.
How is it diagnosed, especially if the student displays signs of other mental health or learning conditions?
Dyslexia occurs along a continuum, varying in severity and presentation. In most cases, an individual's reading achievement unexpectedly falls at the low end of the normal distribution of all readers.
In practice, dyslexia is diagnosed using standardized tests of reading. Initially, tests assess single-word recognition and decoding. Also important in diagnosing dyslexia are tests of the individual's vocabulary, rapid automatized naming (how quickly one can name familiar items) and phonological awareness (the ability to break down the sounds that make up words and put them back together).
In older children, assessment of reading also includes tests of fluency (the ability to read rapidly and accurately at the same time) and comprehension (remembering what was read).
The diagnosis of dyslexia is complicated if there are other conditions present, which is often the case. Dyslexia commonly occurs with ADHD, other learning disabilities, language disorders, developmental motor coordination disorders and, especially in older children, anxiety or depression. Dyslexia is not diagnosed if the clinician believes [another disorder is] impeding the child's academic achievement.
It is critical [to] consider the whole child, not just the reading. By treating only the reading problem, we reduce the chances of positive outcomes.
How is it treated, and are students getting the resources they need?
Most individuals benefit from structured literacy instruction that focuses on phonological awareness, vocabulary development and automaticity of sound-symbol relationships.
Some students get access to these resources early in their lives. The scientific literature suggests that early and accurate identification of dyslexia and appropriate teaching of reading can often prevent the experience of failure in children. With appropriate interventions, students with dyslexia can be substantially "normalized" and secondary mental health issues averted.
Unfortunately, most students with dyslexia are not getting these interventions in a systemic or consistent manner. There are a variety of reasons for this gap, but many have to do with resources available to local school districts and the failure of training programs to fully prepare teachers to provide these interventions.
Who do you go to for help if you believe your child has dyslexia?
There are a number of excellent resources for individuals with dyslexia, their families and those who provide services.
Some of the best include:
- The International Dyslexia Association: eida.org
- The National Center for Learning Disabilities: ncld.org
- Understood.org: understood.org
- The Learning Disabilities Association of America: ldaamerica.org