Dyslexia

Overview

Dyslexia is a learning disorder that involves difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words (decoding). Also called a reading disability, dyslexia is a result of individual differences in areas of the brain that process language.

Dyslexia is not due to problems with intelligence, hearing or vision. Most children with dyslexia can succeed in school with tutoring or a specialized education program. Emotional support also plays an important role.

Though there's no cure for dyslexia, early assessment and intervention result in the best outcome. Sometimes dyslexia goes undiagnosed for years and isn't recognized until adulthood, but it's never too late to seek help.

Symptoms

Signs of dyslexia 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. Severity varies, but the condition often becomes apparent as a child starts learning to read.

Before school

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

Late talking
Learning new words slowly
Problems forming words correctly, such as reversing sounds in words or confusing words that sound alike
Problems remembering or naming letters, numbers and colors
Difficulty learning nursery rhymes or playing rhyming games

School age

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

Reading well below the expected level for age
Problems processing and understanding what is heard
Difficulty finding the right word or forming answers to questions
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
Spending an unusually long time completing tasks that involve reading or writing
Avoiding activities that involve reading

Teens and adults

Dyslexia signs in teens and adults are a lot like those in children. Some common dyslexia symptoms in teens and adults include:

Difficulty reading, including reading aloud
Slow and labor-intensive reading and writing
Problems spelling
Avoiding activities that involve reading
Mispronouncing names or words, or problems retrieving words
Spending an unusually long time completing tasks that involve reading or writing
Difficulty summarizing a story
Trouble learning a foreign language
Difficulty doing math word problems

When to see a doctor

Though most children are ready to learn reading by kindergarten or first grade, children with dyslexia often have trouble learning to read by that time. Talk with your health care provider if your child's reading level is below what's expected for your child's age or if you notice other signs of dyslexia.

When dyslexia goes undiagnosed and untreated, childhood reading difficulties continue into adulthood.

Causes

Dyslexia results from individual differences in the parts of the brain that enable reading. It tends to run in families. Dyslexia appears to be linked to certain genes that affect how the brain processes reading and language.

Risk factors

A family history of dyslexia or other reading or learning disabilities increases the risk of having dyslexia.

Complications

Dyslexia can lead to several 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 children from reaching their potential as they grow up. This can have negative long-term educational, social and economic impacts.

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

Diagnosis

There's no single test that can diagnose dyslexia. A number of factors are considered, such as:

Your child's development, educational issues and medical history. The health care provider will likely ask you questions about these areas. Also, the provider will want to know about any conditions that run in the family, including dyslexia or any other type of learning disability.
Questionnaires. The provider may have your child, caregivers or teachers complete questionnaires. 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 difficulty reading.
Psychological evaluation. The provider may ask you and your child questions to better understand your child's mental health. This can help determine whether social problems, anxiety or depression may be limiting your child's abilities.
Tests for 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.

Treatment

There's no known way to correct the underlying brain differences that cause dyslexia. However, early detection and evaluation to determine specific needs and appropriate treatment can improve success. In many cases, treatment can help children become competent readers.

Educational techniques

Dyslexia is treated using specific educational approaches and techniques, and the sooner the intervention begins, the better. Evaluations of your child's reading skills, other academic skills and mental health will help your child's teachers develop an individual 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 in processing the information.

Treatment focuses on helping your child:

Learn to recognize and use the smallest sounds that make up words (phonemes)
Understand that letters and strings of letters represent these sounds and words (phonics)
Understand what is read (comprehension)
Read aloud to build reading accuracy, speed and expression (fluency)
Build a vocabulary of recognized and understood words

If available, tutoring sessions with a reading specialist can be helpful for many children with dyslexia. 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 structured, written plan that outlines your child's needs and how the school will help your child succeed. This is called an Individualized Education Plan (IEP).

Early treatment

Children with dyslexia who get extra help in kindergarten or first grade often improve their reading skills enough to succeed in grade 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 a child can learn skills that improve reading and develop strategies to improve school performance and quality of life.

What parents can do

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

Address the problem early. If you suspect that your child has dyslexia, talk to your child's health care provider. Early intervention can improve success.
Read aloud with your child. It's best if you start when your child is young, but it's never too late to start. Introducing books as a toy to babies encourages fun, learning and social interaction with caregivers. Read stories to your child. Also, 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 the teacher about how the school will help your child succeed. You are your child's best advocate.
Encourage reading time. Set aside time each day to read with your child. To improve reading skills, a child must practice reading. Encourage your child to read as skills develop. Also have your child read aloud to you.
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 be enjoyable.

What adults with dyslexia can do

Success in employment can be difficult for adults who have 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

Academic problems don't necessarily mean a person with dyslexia can't succeed. Capable students with dyslexia can be highly successful 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.

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. Offer encouragement by praising your child's talents and strengths. Talk to the school staff so they can provide the services and support that your child needs to succeed.
Talk to your child. Explain to your child what dyslexia is and that it's not a personal failure. Understanding this can help your child better 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.
Limit screen time. Limit electronic screen time each day and use the extra time for reading practice.
Stay in contact with your child's teachers. Talk with teachers frequently to make sure your child can stay on track. If needed, be sure your child gets extra time for tests that require reading. 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 health care provider or your child's reading specialist if there are any support groups in your area.

Preparing for an appointment

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

Specialist, such as an eye doctor (ophthalmologist or optometrist)
Health care professional trained to evaluate hearing (audiologist)
Specialist in brain and nervous system disorders (neurologist)
Specialist in the central nervous system and behavior (neuropsychologist)
Specialist in children's development and behavior (developmental and behavioral pediatrician)

You may want to ask a family member or friend to come along, if possible, for support and to help you remember information.

Bringing school records is especially helpful for the evaluation done by health care providers. These records can include your child's IEP or 504 Plan, report cards, written communications from school noting concerns, and a limited number of your child's work samples.

Here's some information to help you prepare for your appointment:

What you can do

Before your appointment, make a list of:

Any symptoms your child is experiencing and the ages when symptoms were first noticed, including any symptoms that may seem unrelated to the reason for the appointment
Key personal information, including any major stresses or recent life changes
Any medications, vitamins, herbs or other supplements that your child is taking, including the dosages
Questions to ask the health care provider to help you make the most of your appointment

Questions to ask may include:

What do you think is the cause of my child's difficulty with reading?
Are there other diagnoses that can be associated with or confused with dyslexia?
What kinds of tests does my child need?
Should my child see a specialist?
How is dyslexia treated?
How quickly will we see progress?
Should other family members be tested for dyslexia?
What sources of assistance or support do you recommend?
Are there any brochures or other printed materials that I can have? Can you recommend any websites?
Are there any local educational resources for dyslexia?

Feel free to ask other questions during your appointment.

What to expect from your doctor

The health care provider is likely to ask you a number of questions, 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?

Be ready to answer questions to make the most of your appointment time.