When learning to read goes wrong!

When one search for pictures on reading you are bombarded with all the happy-faced kids reading away. Sadly, that is not true for all children. The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) indicates that 5-15% of children will suffer from a specific learning disorder such as dyslexia and others. However, many more will develop poor reading skills due other factors, including, but not limited to:

• auditory or auditory perceptual deficits
• visual or visual perceptual deficits
• lack of teaching, poor teaching or inappropriate teaching methods
• poor motivation to learn, often due to anxiety, depression or many other reasons
• poor socio-economic background
• limited access to books, writing material and/or a care giver that reads to the child
• complexity of the language
• the medium of instruction being different from the child's native language or limited exposure to the medium of instruction before formal schooling
• below average intelligence
• any combination of the above

Some of the easiest, but very important aspects to rule out when your child struggle to learn to read is to:

• have his eyes tested
• have his ears tested

Parents often tell me their child's ears and eyes are fine. The child have never complained about not being able to hear or see properly. However, a child growing up with a slight visual or hearing impairment might think the world is meant to look or sound the way they see or hear it. I sure did and my hearing impairment was only diagnosed at university. 

Let's start with dyslexia first:

• It is a disproportionate difficulty in learning to read.
• It occurs in 5-10% of children.
• It is neurologically based. Several genes contribute to the development of dyslexia.
• It often is  hereditary.  Siblings of a child with dyslexia have a 50% chance to develop dyslexia too, and parents with dyslexia are more likely to have children with dyslexia.

The presentation of dyslexia is  varied:

• Most children with dyslexia have phonological difficulties. They struggle to process phonemes or speech sounds. Consequently linking phonemes and graphemes is a struggle. This later leads to comprehension problems.
• In rare cases children with dyslexia have a left-right confusion and spatial difficulties. This leads to the extensive spatial reversals of letters, e.g. "m" as "w", "b" as "d". Even can lead to mistakes in ordering of letters in  words e.g. "snail" is read as "nails". It also leads to the inversion of word order in a sentence. 
• Some children with dyslexia have difficulties with foundational sensory-perception, namely auditory and/or visual perception.
• Some children struggle to automatise the link between visual information and speech. For this reason rapid automised naming tests are often used in assessment batteries when dyslexia is suspected.

Before I carry on, here is  a warning: Mirror writing, writing in the wrong direction  and  reversals (e.g. B and d) are a normal phase for all children learning to write. It only becomes a warning sign if it is persistent beyond grade 2 or 3. 

Professor Stanislas Dehaene make a compelling case  for dyslexia being a joint deficit in the visual and speech circuits, namely deficits in invariant visual recognition and phonological processing. 

The following has been found in neuroscience research using brain scans"

• An under-activation  in the phonological speech circuits, which explains the high frequency of difficulties processing of phonological information among children with dyslexia. 
• The bigger the under-activation in the word form area or letterbox the more severe the reading impairment. This is an impairment of invariant letter recognition. 
• Hyper-activation of Broca's area and right temporo-parietal areas
• Greater gray matter density in the left middle temporal gyrus leads to reduced reading speed. 

For me the most interesting of all the brain research was the finding of out of place neurons  in children with dyslexia.  During pregnancy neurons travel from where they are formed near the ventricles (inner spaces of the brain) to the cortex (outer layer of the brain). In children with dyslexia ectopias (misplacement of neurons) occur in the layers of the cortex in both areas processing speech and the word form area (letterbox). This leads to an impairment in the connections pf these neurons. A thin fibre bundle under the left temporo-parietal area is impaired in people with dyslexia. This leads to a disconnection in the information flow. 

Reading this you might think it is all gloom and doom for those children suffering from dyslexia. This is not the case. Understanding the science of reading, also helps us come up with programmes and simple solutions that assist these children. Probably the most exciting news is that simple teaching techniques that can be implemented in a regular classroom seem to assist children with dyslexia and those with just a moderate to slight reading difficulty. Some children of course needs more intensive interventions. 

I want to invite readers that are familiar with programmes designed to help learners with dyslexia or reading difficulties to post information about their programmes, tips for parents etc. 

References

Dehaene, S. (2009). Reading in the brain. The new science of how we read. New York: Penguin Books. 

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