What is Dylexia?

What is Dyslexia?

Official Definitions Defined:
If it looks like a duck, walks like a duck, it's probably a duck.
Or is testing for dyslexia really necessary?.

Official Definition #1. According to the World Federation of Neurology, dyslexia is: "a disorder manifested by difficulty in learning to read despite conventional instruction, adequate intelligence and sociocultural opportunity." (sic)

Translated into plain English, this means that if a student isn't dumb and he isn't surrounded by people who hate schools and if he goes to school and if he gets the "conventional instruction (Look-see or whole language) and if he still has problems reading, it must be that he is a dyslexic.
Official Definition #2. According to the International Dyslexia Association's Committee of Members in November, 1994, "Dyslexia is a neurologically-based, often familial, disorder which interferes with the acquisition and processing of language. Varying in degrees of severity, it is manifested by difficulties in receptive and expressive language, including phonological processing, in reading, writing, spelling, handwriting, and sometimes in arithmetic. Dyslexia is not a result of lack of motivation, sensory impairment, inadequate instructional or environmental opportunities, or other limiting conditions, but may occur together with these conditions. Although dyslexia is life-long, individuals with dyslexia frequently respond successfully to timely and appropriate intervention."

Translated into plain English, this means that dyslexia has to do with how the brain organizes what the eyes see and the ears hear. The condition is such that traditional methods of teaching reading will not work with a person with dyslexia. However, dyslexics may be taught to read and write with proper instruction. This usually involves multi-sensory approaches as used by AVKO, Orton-Gillingham, Slingerland, Spalding tutors, etc.
Official Definition #3. According to the International Dyslexia Association's Research Committee in November 1994, "Dyslexia is one of several distinct learning disabilities. It is a specific language-based disorder of constitutional origin characterized by difficulties in single word decoding, usually reflecting insufficient phonological processing abilities. These difficulties in single word decoding are often unexpected in relation to age and other cognitive and academic abilities; they are not the result of generalized developmental disability or sensory impairment. Dyslexia is manifested by variable difficulty with different forms of language, often including, in addition to problems reading, a conspicuous problem with acquiring proficiency in writing and spelling."

Translated into plain English, this means that if someone has normal intelligence but has severe problems learning to read and write despite "conventional" instruction, that person is dyslexic.
Official Definition #4. According to the U.S. Department of Health and Human Services, "Developmental dyslexia is a specific learning disability characterized by difficulty in learning to read. Some dyslexics also may have difficulty learning to write, to spell, and, sometimes, to speak or to work with numbers. We do not know for sure what causes dyslexia, but we do know that it affects children who are physically and emotionally healthy, academically capable, and who come from good home environments. In fact, many dyslexics have the advantages of excellent schools, high mental ability, and parents who are well-educated and value learning.

Translated into plain English, this means that when you can't find a reason for a child not being able to read, it must be he is dyslexic.
Official Definition #5. Dyslexia is a term that has been loosely applied to reading disabilities. Specific definitions for dyslexia vary with disciplines. Those in medicine define dyslexia as a condition resulting from neurological, maturational, and genetic causes, while those in psychology relate dyslexia on the basis of the specific reading problems evidenced and give no reference to causation. All disciplines would probably agree that dyslexia is evidenced by persons of otherwise normal intellectual capacity who have not learned to read despite exposure to adequate instruction.

Translated into plain English, this means that when you can't find a reason for a child not being able to read, it must be he is dyslexic.

How Is Dyslexia Diagnosed? Are there tests for dyslexia?

The diagnosis of dyslexia usually begins with an awareness by parents or teachers that a problem in reading exists. A physician is often the first diagnostician to explore the nature of the difficulty. The medical practitioner should investigate the cause of the reading problem by conducting a complete physical examination and obtaining a comprehensive health history. If indicated, the child should be referred for a neurological examination. If dyslexia is suspected, the physician should refer the child for further evaluation and treatment by a specialist in psycho-educational diagnosis. The major purpose of the diagnostic process is to isolate the specific difficulties associated with dyslexia and to suggest appropriate educational intervention. Usually the diagnostician will employ a battery of assessment instruments that explore the relationship of specific reading problems to the intellectual, achievement, perceptual, motoric, linguistic, and adaptive capabilities of the individual. Based on the results, an intervention plan can be implemented by a special educator or remedial reading teacher trained in specialized reading techniques. (sic)

Translated into plain English, this means that you must get an "expert" to test your child to rule out all other possible explanations for his learning disability so he can then tell you what you already know--that your child has problems learning to read with conventional methods, in other words your child is dyslexic.

Editors note: Why waste your money testing for dyslexia when you already know what you need to know and that is, your child needs help in learning to read and learning to spell.

Standard explanation of what works for dyslexics: No one remedial reading method works for all reading disabled students. Therefore it is important that the teacher have mastery of many different techniques.

Translated into plain English, this means that the experts don't really know how to teach dyslexics but they hope a teacher will use many different approaches until one that works is found. AVKO's methods (note the plural) have been successful with all the dyslexics who have come to our clinic for help.

What Are Some Of The Characteristics Of Dyslexia?

An individual is identified as dyslexic when a significant discrepancy exists between intellectual ability and reading performance without an apparent physical, emotional, or cultural cause.

Translated into plain English, this means a person may be called a dyslexic when we know that he is smart enough to be able to learn to read but we "can't" figure out why he doesn't read.

Common characteristics include, but are not limited to:

(1) family history of reading problems;

(2) a predominant occurrence in males (males to females 8:1);

(3) an average or above average IQ and, not uncommonly, a proficiency in math:

(4) no enjoyment of reading as a leisure activity;

(5) problems of letter and word reversal;

(6) developmental history of problems in coordination and left/right dominance;

(7) poor visual memory for language symbols;

(8) auditory language difficulties in word finding, fluency, meaning, or sequence;

(9) difficulty transferring information from what is heard to what is seen and vice versa. Specific reading problems associated with dyslexia include difficulty in pronouncing new words, difficulty distinguishing similarities and differences in words (no for on), and difficulty discriminating differences in letter sound (pin, pen). Other problems may include reversal of words and letters, disorganization of word order, poor reading comprehension, and difficulty applying what has been read to social or learning situations.

What Factors Contribute To Dyslexia?

Ocular Problems

Several reliable studies (Helveston 1969; Blika 1982; Keys 1982; Hiatt 1984) have found that dyslexic individuals have no greater incidence of eye problems than do individuals with normal reading ability. Such parameters as visual acuity, stereo acuity, ocular alignment and motility, fusion status (break point amplitude), and refractive error have not been shown to be significantly different in poor versus normal readers. Individuals with reading problems should, however, have a careful eye examination as part of an overall medical examination. There is no scientific evidence that visual training (including eye muscle exercises, ocular tracking or pursuit exercises, or glasses with bifocals or prisms) leads to significant improvement in the performance of dyslexic individuals.

Translated into plain English, this means a dyslexic should have his eyes checked, but improved vision doesn't help that much in learning to read.

Language Problems

According to Mattis (1978), the primary contributing factor to dyslexia is an auditory language deficit. Approximately 86% of the individuals identified as dyslexic evidence an auditory language disorder that prevents the individual from linking the spoken form of a word with its written equivalent. In light of this, any individual with reading problems should have a careful evaluation of his or her language capabilities and where indicated, appropriate speech and language intervention should be provided.

Translated into plain English, this means hearing and speaking are related to reading.

Visuo-Spatial-Motor Problems

In contrast to language problems, visuo-spatial-motor factors of dyslexia appear less frequently (Robinson and Schwartz 1973). Approximately 5% of the individuals identified as dyslexic have a visuo-spatial-motor problem that interferes with sequential organization, scanning, and the perception of temporal and spatial cues. Although visuo-spatial-motor confusion is common in young children who are just learning to read, these problems do not tend to account for severe and persistent reading difficulties unless the child has missed so much basic reading instruction that he cannot get caught up. Assessment of visual, spatial, and motor capacities should be included in the diagnosis of any coordination or orientation disorder; however, there is no scientific evidence that interventions such as neurological and sensory organizational training, laterality training, dominance training, balance beam, or reflex inhibition will significantly accelerate reading performance.

Translated into plain English, this means that some dyslexics have problems visualizing things, problems with hand-eye coordination, muscle control, sense of time and space. This should be assessed but treatment of any of these problems won't be of much help.

Other Factors

The importance of general intelligence in learning to read has been examined and shown to be a critical factor in both reading and language abilities. Investigations of the role of dominance in handedness, eyedness, and mixed laterality have produced no consistent conclusions. Studies investigating low birth weight, EEG abnormalities, temperamental attributes, attention deficit disorders, birth order, food additives, and chemical allergies have yielded mixed results. What is clear is that a wide range of factors can be associated with reading difficulties but that these factors work differently in different children.

Translated into plain English, this means that the experts don't really know or agree about what causes dyslexia or how to treat it.

There is no simple formula for diagnosing and treating a dyslexic child. Each one requires his or her own individual program.

If you would like to find out how Don McCabe, a dyslexic himself, was enabled to read and what it was that enabled him to discover how to teach other dyslexics to read and write, see To Teach a Dyslexic.

Yet another definition submitted via e-mail

DYSLEXIA: A NATURAL PHENOMENON

Abstract

Social institutions and their rules often originated from capricious decisions. For education, western text book design has never been questioned as to its possible bias against some children's perceptual organizational strategies. Text book design with its "Z" encoding often conflicts with the a priori "S" encoding and decoding paradigms found in natural perception. Orthography is another flawed social tool replete with anachronistic distractions. These factors results in social and perceptual rule conflicts inhibiting children's (or adult's) attempts to decode and encode English alphanumeric signs and symbols. These conflicts are often misinterpreted or ridiculed by the educational culture leading to the child's impaired performance (but not learning) sometimes termed dyslexia denoting a class of impaired people without reading and writing skills due to some brain disorder. Experts often refer to the reversal of numbers and letters as indicators of dyslexia. However, reversals are part of natural perception and we deal with them everyday, and ignore them as part of our perceptual background. This paper suggests that persistent reversals are aligned with confusing perceptual, pedagogic and orthographic rules rather than brain impaired reading and writing skills. What is troublesome is that many labeled dyslexics become "cured," often on their own, and end up becoming authors, scholars, scientists, etc. This suggests that environmental forces such as negative reinforcement found within the educational community are factors delaying lexic development.

Dyslexia Redefined

Dyslexia is buzz word with intolerable ambiguity. Among others, dyslexia is generally defined as the reversal of letters and numbers due to some brain disorder. However, in this paper dyslexia is defined as the left-to-right reversal of letters and numbers due to confusing perceptual codifying rules in conflict with arbitrary textbook designs further complicated by English orthography and dysfunctional institutional behaviors. It should become clear that the left-to-right reversal of alphanumeric symbols is a natural, evolutionary, rule-governed form of perception. By dysfunctional institutional behavior, I maintain that the confused left-to-right reversal process is often reinforced by emotional trauma, shame, negative attitudes, unfounded beliefs, low self-esteem, etc., tacitly or overtly given off by the school culture that places the student in a state of perpetual confusion. I will also suggest that the child’s traumatized state of confusion could itself limit the development of his brain's functionality. By orthography, I mean the present state of English spelling that is the very essence of sociodyslexia because of the chaos in phonemic and graphemic rules. The dysfunctional state of English orthography is a deficit transferred to the student. It is indefensible to hold that there is an intuitive connection in such examples as the long i: tie, by, bye, high, and hi to name a few. Only etymologists understand their origins and interconnectedness. Words are tools of communication, and like any tool, they need to be adapted to their user or be discarded. No one in their right mind would use bent hammers or ancient computers and be efficient and effective in today’s world, yet we refuse to change our awkward orthographic tools opting for spell checkers and wasted dictionary time, all the while insisting our children should adapt to these anachronisms rather than making the tool adapt to the user's needs. Texts that indiscriminately mix orthographic variations without proper historical linguistic training produce a stumbling phonetic interpretation in dyslexic (rule confused) children and adults. A child's attention span cannot handle the drudgery and repeated failures and quickly turns her attention to more important things such as daydreaming. An adult can handle it, and this is a possible explanation for sudden recovery of lexic ability. Clearly, such a person is ideal for designing dyslexic's text books. By natural, I mean preexisting organic processes and their rules that are the referents to our observations and their symbolic expressions.

The Unity of Perception

Before examining my premise in detail, there are some general points that must be understood by the reader that helps explain my point of view. First, if you examine your own perceptions and their general operations, you take for granted the veracity of their organization and content. Your perceptions are organized for you in a stable way. Provided you are not on LSD, mentally ill, or wearing prisms for glasses, percepts of things and people are not just floating around, upside down, backwards or transposed in some psychotic Alice-in-Wonderland nightmare. Yet, children are treated as dysfunctional or different by the educational culture when they inconsistently invert reproductions of number and letters. This has a profound impact on the child’s self-esteem and his future academic performance. The combination of dyslexia (rule confusion), low self-esteem, and English orthography is a toxic brew that affects mind, body and soul; in effect, the child’s personality begins to shut down. However, the child’s only failure is to thrive in a hostile, competitive environment.

Analogous Experiences

There is another aspect of perception that the reader might consider. Many readers have driven cars in Europe or Europeans in the US. The experience is to drive in the opposite lane with an opposite steering wheel, yet we quickly adapt to the situation. Our perceptual operations take over and very little instruction or mediation is required once we have oriented ourselves with the rules. When we make an error, are we dyslexic? By my definition, the answer is affirmative. We have simply confused one set of rules with another. If any reader has backed-up a trailer with the aid of mirrors, the operation is relatively simple if one keeps the rules for reversing in mind. If one does this often, then the process becomes automatic.

Left-to-Right and Right-to-Left Processing

The final observation is crucial. Clearly, dyslexia has something to do with the confusion of left and right. This has something to do with the mechanics of reading and writing and the way our culture expects books and their alphanumeric symbols to be organized and presented to an authority figure. There is a natural basis that overlaps this process. As you realize, your perception of a vista is to scan it back and forth. This scanning operation is generally made in a winding pattern. Above all, we do not often process in a typewriter fashion going from left-to-right then returning to the left automatically. This is unnatural because it is perceptually inefficient and even dangerous to our very survival. The left-to-right processing prejudice is grossly inefficient and defies our perceptual operations. However, the western culture has perpetuated the idea that we must read and write from left to right in a "Z" pattern, and that this is the only way to decode or encode symbols. Yet other cultures go from right to left, top to bottom, etc, and the pattern is clearly relative to that society.

Perceptual Rules

Allow me to show you that you are dyslexic in your decoding and encoding of English linguistic symbols. By encoding, I mean writing and by decoding I mean reading. Have someone dictate a passage to you and write down what you hear. But, rather than process your writing in the left-to-right prejudice, continue writing on the next line backwards from right-to-left in an inverted "s" style. At this point, you should become dyslexic in a confusion of rules. (Note, you must do the exercise to grasp the point.) Which way do you go? How should the letters and numbers face? To clear things up, I have a sample of each form:

(Left-to-Right) Jack and Jill went up the hill

(Right-to-Left) ¬

_____________.

(See AVKO's note at the end.)

The question is Why can’t you continue in this way? You are encoding in reverse. You have discovered that there are clear rules and you applied them. The answer is social bias prevents us from adopting reversing. We decode in reverse all the time. We can decode everything from cards, signs, faces, phrases, etc. With practice, it becomes easier to both encode and decode. Because some people are better at it is no reason to discriminate against them. In short, you can read and write in reverse much like backing up a trailer using a mirror. Moreover, it is natural and rule-governed. The problem arises when one does not realize this and inconsistently applies the two sets of rules. The problem becomes compounded in children while they are establishing encoding and decoding operations, they are simultaneously confronted with English orthography. In dyslexic (rule confused) children, this is truly an Alice-in-Wonderland experience.

Negative Reinforcement

Finally, everyone understands the positive power of the Pygmalion Effect, but there is its opposite I term the Dyslexia Effect whereby educational institutions view the dyslexic child as different or worse. It is shocking when the child realizes that he is impaired or in playground terms, a retard. But is the child really defective or is the culture that views the child as such projecting its voodoo upon these children. It has long been documented that suggestions of impending doom on naive individuals often resulted in death. If some suggestion can result in powerful physical events, positive or negative, it is plausible that a child can be traumatized. This experience often shapes the outlook and esteem of the child in negative ways that are continually reinforced by the system and the parent’s knee-jerk reactions to the judgments of others regarding their child’s awkward performance. Institutions often refer to brain scan technology to make their case that one subnormal brain is structurally different from another normal brain. I suggest that the images are often misinterpreted. Are the dyslexic brain images the cause or the residue of academic treatment of the child? Many children change overnight once they learn they are different. And what is the norm? The bland educational performances of Einstein, Darwin, et. al., or the judgments of their forgotten teachers? The issue is no longer one of nature, but nurture. Let me be clear: I am suggesting that the effect is immediate and enduring. It is an educational lobotomy that radically and immediately results in an impaired learner. It is acquired dyslexia. Why is this? Because the child is now on his own, intellectually and socially isolated, with strategies that no longer work, devoid of inroads into the academic culture, without a compass or map, and forced to reinvent himself if he is to thrive. An this takes time. It is no accident that these children exhibit similar survival traits. Like a computer programming loop, their neurological pathways could well be in a transfixed spin while they look for new successful strategies. Meanwhile, as pedagogic inflexibility marches on, they fall down, or are left behind, or pushed aside.

Reversal and Genus

Mozart conversed in reverse and played music upside down, if the movie is correct. Leonardo wrote in reverse. We all recognize the genius in these activities. Police and scientists think in reverse to solve the mysteries of crime or the universe and this is considered the apex of intelligence ( to think from effect to cause) because it is difficult. At times, we drive, walk, think and perceive in reverse. We reverse our VCRs, records, games and it is, at most, annoying. Above all, we don't fall apart in a confused state of bewilderment. We understand exactly what is going on. But, when some children seem to not care which way they encode or decode alphanumeric symbols, we look to brain scan technology, special remedial programs, psychologists, neurologists, new drugs, brain waves, and so on, in a desperate search to repair the damaged child. So, is it genius or idiocy? Because most people cannot reverse these symbols or refuse to do so, is it then a failure of the child or of the culture to recognize and deal with a natural event and quite possibly an indicator of genus? This is not to say that some severe forms of organic displacement are or will be better explained though brain scans or some methodology yet to come, but I am skeptical of these tools in determining the potentials of students with the labels such as different. This is unregulated social engineering involved in another experiment on defenseless children with negative results. What may be more important to the success of these children rest not with different colored glasses, missing genes, brain scans, new drugs, etc., but the special attention and support they are now receiving.

Teacher Fluency

Teachers must become fluent or comfortable in the right-to-left phonemic-graphemic process and begin to see it as an a priori component of perception. In this way, a social stigma is not transferred onto the child. We deal with reversals everyday yet we do not believe ourselves dyslexic. Think of it like this: ancient Arab mapmakers represented their world opposite that of Western mapmakers. To interpret their maps, westerners must turn them over because of our habitual orientation of viewing the world with north on top. Westerners would be considered dyslexic cartographers in their culture. In fact there is no correct orientation, just the force of our habits solidifying into prejudices of "right" or "wrong." Children can be taught to identify which direction they are processing from, i.e., right-left or left-right style and learn not to mix them. Children and parents can then appreciate the fact that reversing is a natural event in everyone, but there are rules to keep in mind. Various reversing games can be constructed around guidelines. Therein, orthography must be managed to avoid confusion and historical linguistics presented to explain English orthography’s dyslexic mysteries. Teachers should avoid diphthongs, triphthongs, and opt for isomorphic forms during this critical period.

Upside Down

A more difficult "error" to explain, if it even exists, is the encoding of alphanumeric symbols upside-down and backwards. However, there is a rule guiding this process and it is in itself another natural phenomenon. Again, the reader might adopt the epoche of phenomenology, suspending judgment, and imagine the open architecture of the child’s mind. In this exercise, simply write the words in the same fashion as above. Instead of going to the next line, write on the bottom of the line.

Summary

If you imagine writing on an endless straight line, your perspective would be beyond imagination to view the line in its entirety. Therefore, we must delimit our written symbolic communications in the forms of books, screens, etc. The choice of how to delimit lines is an accidental one, yet the child does fully not realize it. The child’s imagination can fold the lines in any number of weaves and so too the symbols encoded on it. Perception has no preference. Imagination does not care. Intelligence can decode it. Every time the line folds, rules are generated. The child has an open imagination about such matters. Only the society takes a position on the correctness of the decoder’s or encoder's perceptual orientation.

The Perceptual Origins of Rule Confusion

Books are designed to be read in a zigzag or continual "Z" eye movement. Writing follows the same format. The zigzag was a convention adopted long ago, but is it a natural component to optimal decoding perceptions? Confirm this for yourself: perform zigzag eye movements for a time and test your capacity to decode your environment under this paradigm. It gives me a great headache and nausea. So, we realize that all is not optimal with texts, but children do not. Children follow natural perceptual paradigms and the closest to texts are those of the horizon or trails, paths, roads, etc. These do not follow the zigzag, but the continual "S" pattern. Viewed from the perspective of the horizon, the line does not go straight into space, but falls off in the mist, or if the person turns around, the line forms some continuum that must meet where one began the view. This point is assumed to continually exist as the person turns. Abstractly stated, we are dealing with a line that forms a circle with the child in the center. (The inner figures are reflections as on water.) The western zigzag is formed by the boundary of the texts, and the natural analogy is might be to view exposed layers in the side of a hill cut in half where the eye meets space and returns to the edge to view the next layer. The "S" or snake motion is more common and essential to human survival as in following something descending a trail or road. Obviously, the child is acutely aware of facial details and their subtle changes. In this case, the face indicates the direction the person (and reflection) is traveling. The perceptual paradigm for the trail is the winding "S" from top to bottom while the "Z" forms the text book from top to bottom:

It is perceptually correct to see people facing opposite directions yet traveling in the same direction, namely, up or down. This is where Western logic locks into an immediate contradiction in that objects moving in opposite directions on the same line cannot be moving in the same direction without stipulating post facto caveats to explain the phenomenon away. Axiological judgments as to the correctness or incorrectness become issues. Organic necessity or logic simply twists the line or tube as in the intestines, and things move along. Nature does not care about our social fixations of "right" or "wrong," rather, what is effective. The "Z" is that of right and wrong, while the "S" is effective. These rules are often in conflict. It seems that boys and men more are adept at spatial orientation than some girls and women, and this would go with essential survival skills in hunting, tracking, and finding one’s way over the past 500,000 years. The details encountered in social skills clearly favor female epistemology. The transference of details from faces to letters is an ontogenetic step away:

Again, the feminine epistemology would favor this transition while spatial orientation would favor the boys. The "dyslexic" problem is socially generated when the entire structure comes into view:

The child is simply following the logic of the twisting trail. On his pad, the trail has no curved lines, so the encoding looks like this to the authority figure:

This is not to say that the child can start at any direction in the process or hold onto a pattern for awhile for it a social preference to start at the top left line. Again, the text book or written paper is in a descent like that of a descending trail.

Confirmation

Confirmation of this perceptual model should be found in children who continue to write on the back of the page whereby they follow the line to the end, turn the page over, and continue to write. This would correspond to the downward trail that continues on (behind the hill) rather than winds down. At this point the child exhibits mediation: the anticipation that something will emerge at a later time is established. Since the pressure is on the child to perform, so the child simply continues, not by changing his perspective, but by turning the imaginative mountain. I have no idea if this behavior exists, but if it does, I believe it confirms this model.
Ó Copyright, Jack Ferguson, Jan. 2001

email: scancode@wireweb.net

Editor's note: Did you notice the misspelling of "pail" as pale when you read:

(Left-to-Right) Jack and Jill went up the hill

(Right-to-Left) ¬
Even experts in dyslexia can misspell!

August 2, 2002 Children's Reading Disability Attributed To Brain Impairment

Children who are poor readers appear to have a disruption in the part of their brain involved in reading phonetically, according to a sophisticated brain imaging study funded by the National Institute of Child Health and Human Development (NICHD). The study also found that children who read poorly but who do not receive any extra help or training eventually compensate for their disability by using other parts of the brain as backup systems for the impaired brain regions. Although most of these children eventually do learn to read, they never do so with the same fluency as do good readers. This is probably because the "backup" brain systems they use when reading apparently cannot process printed information as easily as can the brain systems primarily involved in reading.

The researchers, led by Bennett Shaywitz, M.D., of the Yale University School of Medicine, published their results in the July Biological Psychiatry. "This study shows us the physical basis of why some children have difficulty reading," said Duane Alexander, M.D., Director of the NICHD. "We are now in a position to observe the brain changes that take place when poor readers receive the training that allows them to become proficient readers. In turn, this knowledge may allow us to design even more effective therapies to help poor readers overcome their disability."

In the study, the researchers used a technology known as functional magnetic resonance imaging (fMRI), which produced computer-generated images of the brain while the children were reading. With fMRI, the team demonstrated differences in brain images between children with dyslexia and non-reading impaired control children. The disruption in the brain systems for reading was evident when the children performed phonologic tasks, that is, tasks that required knowing the sound structure of words. Written English is a kind of code-letters or combinations of letters stand for the individual sounds within words. The reading impaired children had difficulty with tasks that required
interpretation of this code. Dr. Shaywitz noted that the current study with children confirmed the researchers' earlier finding with adults that people with dyslexia have an impairment in the brain regions involved with reading words phonetically. And like adults with dyslexia, they use an alternate brain region as a backup system when reading. [The earlier study is described at: http://www.nichd.nih.gov/new/releases/dyslexianews.cfm.] "The study shows some very important findings," Dr. Shaywitz said. "First it identifies neural pathways for reading in good readers while showing a disruption of these pathways in children who are dyslexic (Fig 1). " Second, Dr. Shaywitz explained, the study identifies a region for skilled reading in the the brain area known as the left occipito-temporal region (Fig. 2). Better readers are more likely to activate this region than are poor readers. Third, the study shows areas of compensatory systems in the front and the right side of the brain in dyslexic children who are older (Fig.3). These three images can be found at http://www.nichd.nih.gov. The researchers tested the ability of children to
rhyme nonsense words, for example, asking them: "Do [LEAT] and [JETE] rhyme?" The children were also asked to determine the category of real words-- "Are [CORN] and [RICE] in the same category?" These tasks require children to use phonology, that is, their knowledge of the sound structure of words, which is very difficult for dyslexic readers. Shaywitz and his collaborators used fMRI to study 144 children ranging in age from 7 to 18 years, 70 dyslexic readers (21 girls, 49 boys) and 74 nonimpaired readers (31 girls, 43 boys ). "Our findings show that the impairment in the brains of children with reading disability persists into adulthood," said another author of the study, G. Reid Lyon, Chief of NICHD's Child Development and Behavior Branch. "The findings provide compelling evidence that children with reading disabilities need to receive educational services to help them overcome their disabilities." Dr. Lyon added that NICHD-funded research has shown that such services should have a firm foundation in phonological awareness. Before most poor readers can learn to read successfully, he said, they need to learn that spoken words can be broken apart into smaller segments called phonemes. Next, they usually require training in phonics-"mapping" phonemes to the printed words on a page. Once children have mastered these steps, they can then receive training to help them read fluently, and to comprehend what they read. ### The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site, http://www.nichd.nih.gov, or from the NICHD Clearinghouse, 1-800-370-2943; E-mail NICHDClearinghouse@mail.nih.gov.

FOR IMMEDIATE RELEASE Monday, April 19, 2004

Imaging Study Reveals Brain Function of Poor Readers Can Improve

A brain imaging study has shown that, after they overcome their reading disability, the brains of formerly poor readers begin to function like the brains of good readers, showing increased activity in a part of the brain that recognizes words. The study appears in the May 1 Biological Psychiatry and was funded by the National Institute of Child Health and Human Development (NICHD), one of the National Institutes of Health. "These images show that effective reading instruction not only improves reading ability, but actually changes the brain's functioning so that it can perform reading tasks more efficiently," said Duane Alexander, M.D., Director of the NICHD. The research team was led by Bennett Shaywitz, M.D., and Sally Shaywitz, M.D, of Yale University, in New Haven, Connecticut. Other authors of the study were from Syracuse University, in Syracuse, New York; Vanderbilt University, in Nashville, Tennessee; and the NICHD.

According to Dr. Sally Shaywitz, the results show that "Teaching matters and good teaching can change the brain in a way that has the potential to benefit struggling readers." Along with testing the children's reading ability, the researchers used functional magnetic resonance imaging (fMRI), a sophisticated brain imaging technology, to
observe the children's brain functioning as they read.

In all, 77 children between the ages of 6 and about 9 and 1⁄2 took part in the study. Of these, 49 had difficulty reading, and 29 children were good readers. Of the 49 poor readers, 12 received the standard instruction in reading that was available through their school systems. The remaining 37 were enrolled in an intensive reading program based on instruction in phonemic awareness and phonics.

In the study, the 37 poor readers in the intensive reading program outpaced the 12 poor readers in the standard instruction groups, making strong gains in three measures
of reading skill: accuracy, fluency, and comprehension. These gains were still apparent when the children were tested again a year later. Moreover, fMRI scans showed that the brains of the 37 formerly poor readers began functioning like the brains of good readers. Specifically, the poor readers showed increased activity in an area of the brain that recognizes words instantly without first having to decipher them. The intensive reading program the 37 children took had strong components in phonemic awareness and phonics. Phonemic awareness refers to the ability to identify phonemes, the individual sounds that make up spoken words. The word "bag," for example, is made up of three such elemental units of speech, which can be represented as bbb, aaa, and ggg. The brain strings together the 40 phonemes making up the English language to produce hundreds and thousands of words. In speech, this process is unconscious and automatic.

Beginning in the 1970s, NICHD-funded researchers learned that developing a conscious awareness of the smaller sounds in words was essential to mastering the next step in learning to read, phonics. Phonics refers to the ability to match spoken phonemes to the individual letters of the alphabet that represent them. Once children master phonics, the NICHD-funded studies showed, they could make sense of words they haven't seen before, without first having to memorize them. Further NICHD-supported research found that instruction in phonemic awareness was an essential part of a comprehensive program in reading instruction that could help most poor readers overcome their disability.

In the 1990s, the Shaywitzes had used fMRI to learn that reading ability resides in the brain's left half, or hemisphere. Within the hemisphere, three brain regions work together to control reading. In the left front of the brain, one area recognizes phonemes. Further back, another brain area "maps" phonemes to the letters that represent them. Still another brain area serves as a kind of long-term storage system. Once a word is learned, this brain region recognizes it automatically, without first having to decipher it phonetically.

Poor readers, the researchers had learned in the earlier studies, have difficulty accessing this automatic recognition center. Instead, they rely almost exclusively on the phoneme center and the mapping center. Each time poor readers see a word, they must puzzle over it, as if they were seeing it for the first time.

In the current study, the researchers discovered that, as the 37 poor readers progressed through their instruction program, their brains began to function more like the brains of good readers. Specifically, the brains of these children showed increased activation in the automatic recognition center.

"This study represents the fruition of decades of NICHD-supported reading research," said G. Reid Lyon, Ph.D, Chief of NICHD's Child Development and Behavior Branch.

"The findings show that the brain systems involved in reading respond to effective reading instruction." The NICHD is part of the National Institutes of Health (NIH), the biomedical research arm of the federal government. NIH is an agency of the U.S. Department of Health and Human Services. The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site, http://www.nichd.nih.gov, or from the NICHD Information Resource Center, 1-800-370-2943; e-mail NICHDInformationResourceCenter@mail.nih.gov.

AVKO Editorial Comment: Should anyone be surprised that there are changes in the brain as the result of learning?

Redefining Literacy Learning About Learning to Read:
A Conversation with Sally Shaywitz and Marcia D'Arcangelo

Unlike speaking, reading is not an instinctive human ability. New imaging techniques now allow researchers to see how our neurocircuitry uses the brain's language system to both speak and read. Neuroscientist and professor of pediatrics at Yale University School of Medicine, Sally Shaywitz, along with her husband, Bennett Shaywitz, is codirector of the Yale Center for the Study of Learning and Attention. For 30 years, she has focused on understanding the brain mechanisms involved in reading. While developing "The Brain and Reading" video series, Marcia D'Arcangelo interviewed Dr. Shaywitz about her life's work. We hear how advances in brain imaging technology let us see the brain at work. Because we wonder whether new discoveries can inform our instructional practice, learning about how the brain works is of great interest to educators today. Educators have always been interested in the brain, but we scientists haven't had the ability to bring issues relating to the brain to education. But now, we can actually look at the working brain and examine what happens when a child tries to learn. These matters are very germane to what teachers need to know.

What do we really know about how the brain learns to read?

We know that whereas speaking is natural, reading is not. Children do not automatically read. They have to learn how to do it. Through tens of thousands of years of evolution, men and women have developed the abilities to speak, to hear, and to listen. Every society has some form of spoken language. Put a baby in a speaking environment and that child will learn to speak. We don't have to teach children how to talk. As Stephen Pinker says, language is instinctive. But reading isn't. Reading is a recent development. Not every society reads. There isn't a little reading center in the brain. Humans haven't evolved that way. The neurocircuitry isn't set up to allow us to read. But humans do have the capacity to read. Over time, we have learned to use our neurocircuitry to read. The brain system that lends itself to reading is the language system. To read, a child has to use this wonderful, enriched, and robust language system to somehow get meaning from print. To do that, a child has to somehow transcode that print into language.

Are you saying that in order to read, we have to adapt, or train, our brain to perform in ways it wasn't naturally designed to work?

In essence, yes. We acquire the ability to do many things that we aren't born knowing how to do. Children have to develop the awareness that words are made up of sounds. And that print represents these sounds,or phonemes. For example, the word bat really has three phonemes, b, a, and t, so children have to develop this awareness. And then they have to develop the understanding that the letters on the page——the b, the a, and the t——represent these units of sound. When children reach this level of awareness, they're ready to learn to read. For some children, it's easy; for others, it's very difficult.

You and your group at Yale have used functional magnetic resonance imaging (fMRI) technology to analyze how the brain learns to read. Have you discovered why it is easy for some and difficult for others?

In one study, we examined very disabled readers and compared them with good readers. We found a difference in the brain activation patterns of the two groups when the task made increasing demands to break up words into their underlying phonologic structure or sound pattern. This is very exciting and extraordinarily important. One, it shows the functional organization of the brain for reading. Two, it shows what happens when people have trouble reading. And three, it shows when the problem occurs. Knowing all of this supports the view that reading is biologically based and lends substantial support to the phonologic hypothesis of how we read and why some people can't read.

Why is it important to understand that reading is biologically based?

We often blame children, particularly bright children who have trouble reading, for not being motivated enough or for not trying hard enough. As if somehow, it's their fault. But if we have evaluated the children, we know that they're trying hard, more than anyone can imagine. But they have nothing to show for it. Before, we could hypothesize that the child was very bright but had a real biologic difficulty making him or her unable to read. Now, we can look at an imaging pattern and say, "Aha, this is a real problem; this is as real as a broken arm that you might look at on X-ray."

Can we look at brain imaging patterns and tell which children will have trouble reading?

This technology has been an extraordinary advance, but I don't want to mislead people. We can't use it yet to diagnose an individual. Someone cannot get into the scanner and say, "Aha, I have an image, and I can have a diagnosis." But I have no doubt about the potential for this technology to diagnose people early and more precisely and then to actually examine the effects of interventions.

What difference, specifically, did you see in the brain patterns of good and poor readers?

Good readers had a pattern of activation in the back of the brain, the system that includes the occipital region, which is activated by the visual features of the letters; the angular gyrus where print is transcoded into language; and Wernicke's region, the area of the brain that accesses meaning. This posterior area is strongly activated in good readers, but we saw relative under- activation in poor readers. As we asked good readers to do more and more phonologic processing——to look at single letters and tell whether they rhyme and then to look at and sound out words that they had never seen before——we could see an increase in activation in these areas. But when poor readers performed these same phonological tasks, they really didn't increase the activation in the back of the brain. There was a significant difference. What made it even more interesting was that there were differences in the front of the brain as well. When good readers read, an area in the front of the brain called the inferior frontal gyrus, or Broca's area, was activated. When poor readers read, that area was even more strongly activated.

What does this pattern of relative underactivation and overactivation in poor readers tell you?

We've interpreted this to mean that in going from print, from seeing letters, to language——which is the task of reading——poor readers have incredible difficulty. The relative increase in activation in the front of the brain reflects their effort. Sometimes when people can't read, they sub-vocalize. They say the word under their breath. This may represent additional effort to pronounce the word accurately. It's incredible that we found this difference in the angular gyrus, the area that helps transcode one precept——say, the visual——to another, the linguistic. This makes sense given what we know about the cognitive process of reading, going from print to language. Clearly, we have a lot to learn, but now all investigators who have worked hard to understand reading and the brain have a place to focus future research. We can go to the next level of trying to understand the neural mechanisms that lie under reading and reading impairment.

In other words, the brain systems of poor readers process incoming print information differently from the way that the systems of good readers do.

Yes, there really is a difference in brain activation patterns between good and poor readers. We see the difference when people carry out phonologically based tasks. And that tells us that the area of difficulty—— the functional disruption——in poor readers relates to phonologic analysis. This suggests that we focus on phonologic awareness when trying to prevent or remediate the difficulty in poor reading.

After poor readers master the reading process, do their brain activation patterns change, or are patterns of activation similar all their lives?

That's an important question that our research group at Yale is collaborating with investigators at Syracuse University (Anita Blachman) to address. Children who are poor readers are receiving a highly focused, phonologically based intervention, and they are imaged both before and after the intervention. We expect to have the results of this study within a few years.

Are the results you discovered with brain imaging consistent with what you find when you study readers cognitively?

They are. For example, a number of years ago we studied more than 300 children, most of whom were poor readers. When we examined these children on a range of tasks, the one that most significantly differentiated good readers from poor readers assessed phonemic awareness. For example, we asked children to say a word and remove a phoneme: "Can you say 'Germany' without 'ma'?" To do that, they have to segment that spoken word and pull out a part. Children who had difficulty with this phonologic processing task were also the poorest readers. One of the strongest predictors of who will be good readers is their phonemic awareness. The evidence we have that this is brain based converges nicely with behavioral information.

What are the implications of these studies for teaching reading?

Pretty strong evidence supports a phonologic model of reading. People have to be aware, clearly, that it's a complex issue. We want children to be able to read the word on the page. But we must also remember that we want them to read the word on the page to get to the meaning and the richness of the literature and the language. But if they don't know how to read the individual words, what can we do? The most comprehensive reading program explicitly teaches about the sounds of language. It teaches children that words can be broken up into these smaller units of language, that the letters represent these units of language——phonics. But we also want to teach children about language and to build their vocabulary. We want them to have a knowledge base. We want them to practice reading and to read for meaning. So we want a balanced program. Although phonics is more important for some children than for others, all children can benefit from being taught directly how to break up spoken words into smaller units and how letters represent sounds.

You mentioned that children must practice reading. What is it about how the brain functions that makes practice important?

Think of brain pathways as circuits. The more we use them, the more they become reinforced. It's very important for children to read often. But if children can't read well, they're not going to want to read. But if we can give poor readers a sound foundation so that they know and can decode a group of words, they will have the phonologic skills to sound out words they've never seen before and will be encouraged to read. Once children know how to decode words, we want them to become fluent and automatic and be able to see words and read them without struggling. Only then will they have the resources left to enjoy what the word means and to think about the multiple meanings of what they're reading.

Can you give an example of how being taught directly about language can be more important for some children than for others?

We get very concerned about poor readers who are dyslexic, who have difficulties in phonology but have strong skills in reasoning, understanding, and comprehending. Their isolated skill in phonology is lacking, but all the other skills and understandings are there. These children often have wonderful vocabularies. Imagine their frustration. They see a word in print but can't read it. Then someone says, "Oh, you don't know that?" But when they hear the word, they know it very well. It is important to identify these children as early as possible and to give them the help they need in the most intense, direct way possible. Back in 1985, Becoming a Nation of Readers suggested that teaching phonics is not a useful practice after the early grades. Yet we have many children in the upper grades, including high school, who read poorly.

Do children outgrow the need for direct phonics instruction?

We know that brain systems are plastic, flexible, and responsive, but we have to give children the right substrate in terms of how we teach them. Children who have a biologically based difficulty can learn, but we have to present instruction in a more direct, more intense way over a longer duration. We should also clarify that today's research-based interventions are not our mother's phonics. Today's programs, for example, research-based interventions supported by the National Institute of Child Health and Human Development (NICHD), are balanced, comprehensive programs that include phonologic awareness, phonics, literature, vocabulary, fluency, and comprehension-strategy components.

Have your studies revealed any differences between boys' and girls' ability to learn to read?

We've examined this issue in several ways. We started the Connecticut Longitudinal Study in 1983, when we identified a random group of more than 400 five-year-old boys and girls about to enter kindergarten. We didn't select these children because they had reading problems. The only criterion was that they attended public school in Connecticut. We're still following over 90 percent of these children, who are now in their early 20s. We've tested them in reading and arithmetic every year. When we compare the boys' and the girls' reading scores, we don't see differences. That surprised us because the literature suggests that boys may have more problems. So, for all the children in our study, we asked their schools, "Has this child been identified as having a reading problem?" We found that four times as many boys as girls were identified as having a reading problem. When we examined our data for an explanation, we found that teachers seemed to be using behavioral criteria. They saw that Johnny was a little more fidgety in class, a little more disruptive, so they selected little boys for further evaluation; little girls who were just sitting very nicely, very politely, but not reading, might not be identified.

Recently, haven't you found some brain-based gender differences in the ways that men and women read?

We found something rather remarkable. We examined brain activation patterns in men and women as they were sounding out nonsense words. We gave them two printed nonsense words and asked, "Do these two words rhyme?" Men activated an area on the left side of their brain, the inferior frontal gyrus, or Broca's area. When women did the same task, they indeed activated the left inferior frontal gyrus. But they activated the right as well. Equally interesting was that there was no difference in how quickly and accurately men and women could sound out nonsense words. This tells us that men and women can get the same result by perhaps using different routes.

Are different mental challenges involved in learning to read and reading to learn?

The so-called simple view states that reading has two major components: identifying the single word——decoding—— and comprehending——understanding what we read. We now are able to examine the process of decoding in terms of brain organization. Comprehension is a lot more complicated. Obviously, to comprehend a printed word, we first have to decode it. But more is involved. We are studying that now.

What part of the brain is involved with processing meaning?

We speak of "this area of the brain" or "that area of the brain," but it's important to know that the brain is connected and that there are brain systems. These brain systems are forever communicating with one another. So even though for ease of communication we speak of specific areas, what we really have are networks that are communicating with one another constantly. Having said that, I will note that an area of the brain that particularly has to do with meaning is Wernicke's area, in the temporal lobe of the brain. The temporal lobes are located on each side of the brain just behind the ears. Teachers often find that some students can read and not understand a word whereas others can understand everything but have trouble decoding words.

How are those problems different?

Some children, particularly as they get older, reach a high level of accuracy in identifying words, but still have difficulty becoming fluent or automatic in their reading. They're very slow readers. And reading takes a great deal of energy. But those children or young adults can understand what they read. It just takes a lot out of them. It's very much an energy-consuming process. Other children may read words rapidly but may not get the meaning. Children with a serious problem called hyperlexia can decode very well, but they can't comprehend. It's the inverse of dyslexia. Dyslexic children have the lower-level phonologic deficit, but intact higher-order skills that allow them to comprehend at high levels. Children with hyperlexia have terrific phonologic skills but can't comprehend. Hyperlexia is a relatively rare disorder, and affected children often experience other difficulties as well. For all we know about the nature of reading, many misconceptions still exist about reading difficulties—— dyslexia, for example. One common misconception about dyslexia is that people see letters and words backward. That is unfortunate because I've seen many people for whom the diagnosis of dyslexia was delayed because they did not manifest reversal. People with dyslexia have no problem copying letters and words, and they don't copy words backward. They may make some reversals in writing but no more than other children do. They have difficulty naming things because dyslexia is a language difficulty, not a problem with visual perception. These children can copy the word correctly. For example, they can copy w-a-s for was and say the letters correctly. But when we ask them what word they copied, they say, "saw." So it's not a question of having the visual, perceptual skills but of what they do with a word on the page.

How do we bring the print to language?

Again, the brain mechanism of going from print to language is phonologically based. We have to transcode the print. We have to appreciate that the print stands for words that can be broken into smaller phonologic units and that the grapheme, the letter or the letter groups, represents these bits of language. When we look at print, we activate areas in the back of the brain that have to do with vision, convert the print to language by using areas farther forward in the brain that have to do with transcoding, and then use areas of the brain that get to the meaning of language. The important thing to remember is that although for ease of communication the system is described as linear, in fact, information is transmitted bidirectionally and in parallel. Educators are vitally interested in information that can help them teach reading. Many middle school and high school teachers, in particular, haven't been taught how to teach reading. I find it curious that teachers are often blamed for their students' poor reading. Of all the people to whom I lecture, the largest group, the most committed group, is teachers. They're the ones who want to know, "What do we know about reading? What can I take back to my classroom?" We haven't been able to provide teachers until recently with a knowledge base of what reading is all about. But fortunately, we——and when I say "we," I mean the whole scientific community that studies reading— —now really understand the reading process from both cognitive and behavioral perspectives and, increasingly, from neurobiological perspectives. This evidence supports the fact that reading is part of language. To read, we have to break up spoken words into smaller units, understand that letters represent sounds, have a knowledge base, have a vocabulary, and have the motivation and enjoyment. Teachers now have a template, a scientifically based template, to guide them in how they teach reading. If they use this approach, they can actually make a difference.

Sally Shaywitz is Professor of Pediatrics at the Yale Child Study Center and at Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510 (e-mail: sally.shaywitz@yale.edu). Marcia D'Arcangelo is a Producer on ASCD's Professional Development team (e-mail: mdarcang@ascd.org).

A Standard Recommended Method of Testing for Dyslexia
(AVKO considers this expensive and really non-productive but we have this here so that you can see what it entails)

A rather extensive testing battery is completed. The cognitive portion is usually done by a psychologist. It is necessary to establish the approximate IQ to rule out mental retardation among other things. Two common tests that are used are the Benet and WISC to determine IQ. Then some type of achievement test is completed. The Woodcock-Johnson Achievement Battery is often used. This permits comparison of standard scores. The usual criteria are a standard deviation (15 points) between IQ and achievement or sometimes irregularities in subscores. If evidence warrants, language processing tests, figure ground discrimination type testing, and visual-motor type testing. In addition, for public school placement in a L.D. program, the place where dyslexic students are served in public schools, a social history, a medical history, a psychological eval, and an educational eval are required.

The psychological and educational evaluations are basically covered in the above testing that may be completed within the school system or by outside sources. A psychologist usually does the cognitive testing. The educational testing may be done by an educational specialist or guidance counselor. There also has to be a classroom observation and a review of all other educational data. A school social worker should do the social history. A medical doctor should do the medical examination. Then all the results are reviewed by a team that includes the parents, the school administration, the evaluators, the classroom teacher, the social worker, and a medical representative. The goal is to prove that the problem is not emotional, mental, social, or medical before educational placement can be completed.