Dyslexia

A specific learning difficulty, which presents without any global cognitive deficit, dyslexia can cause problems with spelling, reading and writing in varying degrees.

Although it’s a lifelong condition, there is lots of support available to help overcome the challenges that those affected encounter both during education and their working life.

General features

Dyslexia is typically identified as a child is beginning to learn to read and write at school, and the general features presented at any age typically involve some or all of the following:

Slow reading and writing

Difficulty in getting the letters arranged in the right order

Letters may often be back to front

Poor spelling

Marked difference in comprehension between verbal and written instructions

Difficulty in following a string of instructions

Problems with organisation and planning

Although dyslexia is considered to be a learning disability, there is no associated loss of intellectual function as in global learning disabilities. Those affected by dyslexia may have excellent skills in alternative areas such as problem solving and creativity.

Children
It can be possible to identify dyslexia in younger, preschool children too. The following features can indicate that they may be affected by dyslexia:

A delay in speech development

Problems with pronouncing longer words and mixing up letters which occur in phrases, such as “beddy tear” (teddy bear) or “hecilopter” (helicopter)

Difficulties using expressive language due to an inability to construct sentences or recall the words they need

Apathy towards rhyming words, nursery rhymes or word patterns

Slowness or difficulty in learning the alphabet

It’s important to recognise that although the above symptoms can be indicative of dyslexia, it may not necessarily be the case as every child will learn at a different rate.

Children in primary school may exhibit the following signs:

Inconsistent spelling

Difficulty in learning sequences, such as months of the year

Errors when reading aloud

Able to answer questions verbally but not in writing

Illegible handwriting

Difficulty in copying written work

Transposing letters within a word

Difficulty differentiating left from right

Extremely tired after school

Low self esteem or confidence

Poor “word attack” skills

Word attack skills are defined as the ability to read an unfamiliar word by breaking it down into groups which are known. For example, the word “sunbathing” could be split into three collections of letters which should be more familiar: “sun”, “bath” and “ing”. Children with dyslexia will find it very difficult to do this.

Older teenagers and adults

Although older children and adults may suffer from some of the symptoms of dyslexia mentioned above, it may also be evident from the following:

Difficulty with revision
Problems remembering sequences such as pin numbers
Inability to meet deadlines
Difficulties planning long pieces of written work such as reports, essays or letters
Tendency to avoid reading and writing wherever possible
Written work which doesn’t adequately represent the level of knowledge the individual has

Phonological awareness ability

Every word is made up of small groups of sound, phonemes, and these combine to create meaningful words. By alternating the phonemes it is possible to change the meaning, thus creating a new word.

Individuals with poor awareness of phonemes would find it difficult to answer questions about the specific sounds contained within a word, or compare it to other words. Rhyming words may also be difficult for them to think of.

Poor phonological awareness is a common feature of dyslexia.

Aetiology and epidemiology

Anyone can be affected by dyslexia but it’s believed that there is a familial tendency to inherit the disorder. Current research indicates that there may be a gene which determines how parts of the brain develop, thus affecting the ability to use and interpret the written word.

Around 10% of the population are affected by dyslexia, which equates to around 6.3 million people in the UK. The condition may occur in isolation or it may be associated with other difficulties such as dyspraxia, dyscalculia or attention deficit disorder.

Diagnosis

In many cases the teachers may be one of the first to identify the possibility of dyslexia but if not, this should be the place to raise concerns, or the SENCO, the special needs coordinator for the school.

In some cases additional support may be requested from either an educational psychologist or a specialist dyslexia teacher.

Children should also be taken to the GP to rule out any other underlying condition. Both hearing and visual defects can present in a very similar way to dyslexia. ADHD is another condition which may make it seem as if your child has difficulties with managing the written word.

Associated conditions

Attention Deficit (Hyperactivity) Disorder

This condition can make it very difficult for the individual to maintain their concentration as well as challenges with prioritising tasks and moving from one activity to another.

Attention Deficit (Hyperactivity) Disorder can manifest with the following symptoms:

Restlessness
Lack of attention
Impulsive
Inappropriate behaviour
Aggressive (unintentionally)
No filter on speech
Unpredictable
Excessive interruptions

When there is no hyperactivity, the condition presents with:

Poor listening skills
Difficulty staying focused (may appear dreamlike)
Easily distracted
Forgetting what they are doing

Around half of individuals with Attention Deficit (Hyperactivity) Disorder will additionally have the related condition of dyspraxia.

Autism (including Asperger’s Syndrome)

A type of lifelong disability which can manifest in a variety of ways, individuals diagnosed as having an Autistic Spectrum Disorder (ASD) can either have the condition in isolation or in combination with other learning disorders.

Individuals with ASD find it difficult to relate to and communicate with the world surrounding them. Rigid thinking, an obsession with routine and unusual behaviours are all key symptoms.

Aspergers is a type of autism which typically relates to individuals who function on the higher end of the spectrum. Although they may still feel uncomfortable in social situations, individuals with Aspergers are generally able to mask their difficulties to a greater degree and have a good insight into their condition.

Dyscalculia

In individuals with dyscalculia even basic numeracy can be challenging tricky and there is significant difficulty in processing number concepts.

Dyscalculia is a type of specific learning difficulty which can affect the way in which information is retrieved, stored and processed. This can cause problems with organisation, sequencing, perception of time, memory and processing.

Some of the most common signs of dyscalculia are:

Telling the time
Comprehending quantity
Comprehending money and prices
Learning anything to do with numbers and associated procedures

Dyspraxia

When fine and gross motor function is affected, the impairment is known as dyspraxia and extends to the timing, organisation and planning of movement. The disorder may not be evident when isolated or single movements are performed, but when complex or co-ordinated movement is required, or when there’s a timed aspect, the difficulties may become visible.

Known sometimes as Development Co-Ordination Disorder (DCD), the range of symptoms are wide, from relatively mild to extensive where many aspects of daily life and functions are affected.

Research suggests that just over half of all children who have dyslexia will also suffer from dyspraxia. The condition may be detected from the following signs:

Slow or hesitant movements
A lack of confidence in their ability to try new skills
Problems with art and writing
Difficulties with movements such as catching, throwing, running, bat and ball games, riding a bike, jumping and generally balancing
Problem solving tasks such as jigsaws, mathematical puzzles and for younger children, sorting games may be more difficult

For adults, there may be difficulty in learning to drive, self-care, cooking and DIY. Just over half of all individuals who have dyslexia will also suffer from dyspraxia.

Emotional Behavioural Disorder (EBD)

In some cases the emotional reactions and behaviour are very different to the normal range, and this can impact both on their own learning and also that of their peers.

EBD can sometimes manifest due to undiagnosed specific learning disorders like dyslexia so checking for underlying causes is vital.

Visual stress
Stark contrasts, strong patterns or bright lights can cause considerable distress in some individuals, which can also lead to difficulties in looking at a printed page. It is sometimes referred to as:

Meares-Irlen Syndrome
Visual Discomfort
Visual Stress

Visual stress doesn’t cause dyslexia but can be found equally in those with and without dyslexia. Coloured filters and lenses can reduce the problems that individuals have.

Getting assessed as a child

If any underlying causes have been eliminated, and the child is still not progressing as expected, despite additional support, it may be necessary to request a formal assessment.

A meeting with the SENCO is the first step in the process, and via this person, a referral to the local authority’s educational psychologist can be requested. This can also be requested privately and an appropriate professional can be sourced through the dyslexia charities or organisation in the UK.
The process typically involves seeking information from both the parent and the school in the form of a questionnaire, about the child’s abilities and limitations and areas where they require support.

This is then viewed in tandem with the results from an assessment. The assessment typically takes place within an educational environment where a series of tests may be carried out. These tests are designed to check the following:

Vocabulary
Language development
Reading ability
Writing ability
Memory
Reasoning
Speed of processing auditory and visual information
Organisation
Approaches to learning

Following the assessment a report will be produced which outlines the results, and highlights both the strengths and weaknesses identified. The report will also make recommendations to help in those areas where the child is finding it difficult.

The extent of the difficulties identified will determine what happens next. Those with substantial difficulties will be given a specific action plan, known as an “Individual Education Plan” (IEP). Every term the IEP will be reviewed.

Very occasionally, if a child is not making progress with their IEP, or they have additional difficulties a fuller assessment may be requested. Following this, a more comprehensive education plan could be issued, known as an Educational Healthcare Plan (EHC). These are legally binding and are formal documents which are reviewed annually.

Assessment in adults

Adults who believe they may have dyslexia but have not been diagnosed can obtain support, help and advice from a dyslexia group, such as the British Dyslexia Association or Dyslexia Action.

In some cases, colleges or employers may be willing to contribute to covering the cost of any assessment. However, this is not a legal obligation and approaches will vary depending on the organisation.

Ongoing management

Dyslexia is a condition which is lifelong but early support and intervention can be key to helping an individual manage the most effectively.

The majority of children diagnosed with dyslexia will be able to manage in a mainstream school with additional support; in rare cases a move to a specialist school will be required.

There are a number of different approaches which may be adopted within an educational setting, including smaller teaching groups (typically taken by a teaching assistant) or one-to-one sessions with a teacher who specialises in dyslexia.

A focus on phonological sounds (see above) is key and this practiced over an extended period of time as part of a structured programme, with small, measured steps, can be very successful.

A multi-sensory approach can also help to promote learning. An example of this could be to read the letter “b”, say the name out loud while simultaneously tracing the shape of it in the air.

The role of the parent and the home

Support from parents or guardians is key to helping children with dyslexia and it’s important that the home environment is as supportive as the educational one.

Parents are encouraged to adopt the following methods:

Reading out loud to their children. This has a dual effect, not only improving vocabulary and comprehension but also stimulating a passion for books and reading
Discuss what’s happening. When reading together, pause and discuss what is happening in the story
Repetition. Reading the same story repeatedly might seem tedious but this repetition can be a major asset in reinforcing learning
Encourage solo reading. As well as reading together, children should be encouraged to read on their own too; this helps them become more fluent and also independent in their literacy
Ensure reading is fun! It’s essential to emphasise the pleasures associated with reading, rather than forcing them on the child as an arduous task to be endured. Making sure that each reading session takes place somewhere comfortable and relaxing is key to creating positive connections.

For older children, technology may play more of an integral role; this may be for a number of different reasons.

Firstly, because the visual learning environment is different on a computer compared to a text or exercise book, many children with dyslexia find a computer is much easier for them to use.

Those using word processing programmes have the added benefit of the spell check facility, which can help them to overcome any difficulties with spelling or grammar.

But technology can offer far more than this. Applications which provide a more interactive experience are now available, along with software that can translate verbal sounds and sentences into text. Many pieces of software also contain the function to do the reverse: reading aloud any written word.

Treatment for adults

Adults with dyslexia can benefit from many of the approaches described above, particularly the use of technology to improve organisation and planning.

There are many devices which can help to overcome daily difficulties such as electronic organisers and word processors. Multi sensory approaches can be useful for adults too as can breaking activities up into smaller steps.

By law, employers are required to make reasonable adjustments to the working environment to help accommodate any disability, and this includes dyslexia. Some of the ways it might be considered reasonable for an employer to adjust the workplace includes providing special software, allowing you extra time to complete certain tasks and giving you instructions in a way which is more accessible.

Why is treatment important?

Although dyslexia manifests as difficulties with writing and reading, the impact of it can be far-reaching, particularly in new situations or at times of stress. This can extend to having problems with speech and finding the right words, or recalling key information such as telephone numbers.

Dyslexia can also cause impairment of the short-term memory, slowing down processing. For many people, this can lead to greater frustration than problems with reading and writing, and can make it difficult to follow conversations or to express an opinion.

The condition presents differently in every individual with symptoms ranging to very mild to severe. With appropriate help and early treatment, many individuals with dyslexia can manage their condition effectively with the help of self-coping mechanisms.