All About Dyslexia

You have probably heard of the term “dyslexia,” and you may have seen an increased focus on reading instruction in schools in recent years. Yet along with this increased awareness of how children acquire reading skills, we continue to see confusion about the nature of dyslexia and reading difficulties. 

What is Dyslexia?

Although there are various definitions of dyslexia, according to Dyslexia Canada, it can be defined as a specific learning disorder (LD) in reading [1]. Those with dyslexia tend to have trouble reading accurately and fluently and may have trouble with reading comprehension, spelling, and writing [1]. In addition, the International Dyslexia Association states that dyslexia is characterized by difficulties with accurate or fluent word recognition as well as poor spelling and decoding [2]. Such difficulties may be a result from a deficit in the phonological component of language and is unexpected for children with average cognitive abilities and those who receive effective classroom instruction [2]. 

How is Dyslexia Different from a Specific Learning Disorder in Reading?

The DSM-5-TR is the current manual used by psychologists, psychiatrists and physicians to diagnose a wide range of neuropsychological conditions. The DSM is regularly updated and during these updates sometimes the terminology used by medical professionals changes. Dyslexia first appeared as a diagnosable condition in the 1980 edition of the DSM-III [3]. Since then, the term has disappeared and reappeared several times, more recently being replaced with the term “Specific Learning Disorder with impairment in reading” [4]. 

Although dyslexia can be used as an alternative term for a pattern of learning difficulties (i.e., problems with accurate or fluent word recognition, poor decoding, and poor spelling specifically) [4], it is often not used as it does not encompass a wide range of learning difficulties. For example, if a child has a Specific Learning Disorder with impairment in word reading accuracy, reading rate, and reading comprehension, the term dyslexia does not accurately reflect the child’s challenges, as dyslexia does not include difficulties with reading comprehension. Therefore, a Specific Learning Disorder with impairment in reading is often the preferred term for a child with these specific challenges. Given that learning is complex and individuals may experience challenges in many areas of learning, the term dyslexia is not always used as it is not reflective of the various challenges one may have with learning. 

Causes & Symptoms of Dyslexia

Research suggests that Dyslexia is neurobiological - brain imaging studies show differences in the way the brain develops and functions in regards to language and literacy [2]. Dyslexia can be both hereditary [1, 5] and influenced by environmental factors [5]. If a parent has dyslexia, their children have 40-60% increased risk of developing the disorder [6]. 

Signs and symptoms of dyslexia may include having trouble decoding words, which includes matching letters to their letter sounds and sounding out words quickly and fluently, as opposed to guessing what the word may be [7]. Those with dyslexia may also experience challenges with phonemic awareness, which is the ability to recognize that words are made up of individual sounds, or phonemes [7]. Individuals with dyslexia also have trouble reading fluently; even though they may eventually master a large vocabulary of sight words, they may still struggle to read longer text and need more time than their peers [8]. It is important to note that dyslexia affects everyone differently and symptoms may vary slightly between individuals. Additionally, children may struggle to build their reading skill for other reasons, such as environmental factors, vision or hearing problems, or inadequate reading instruction. All reading challenges are not necessarily indicative of dyslexia. 

Facts Versus Myths About Dyslexia

The following are common myths and facts about dyslexia [9]:

What are Effective Strategies for Dyslexia?

The National Panel of Reading suggests that phonological instruction (i.e., recognize and manipulate spoken parts of words, such as identifying words that rhyme) and phonemic awareness (i.e., noticing, thinking about, and being aware of sounds in words) can be helpful in preventing and treating dyslexia [10]. A meta-analysis found that phonemic awareness instruction for children who are suspected of having a reading LD had a medium effect on composite and segmentation (i.e., identifying individual sounds in words) and a small effect on blending (i.e., the ability to join to join speech sounds together to make words), first sound identification, and deletion (i.e., helps develop phonemic awareness by having students manipulate spoken words by deleting a phoneme) [11]. The effects of this instruction were the strongest for those in kindergarten and grade one, however, positive outcomes were also found for older children as well [11]. Researchers also suggest that graphemes (i.e., units in writing that correspond to a single sound, for example, “man” contains three graphemes “m,” “a”, and “n”) should be incorporated into phonemic awareness instruction [11] and that phonological awareness training should be accompanied by high-quality reading interventions [10]. 

Another meta-analysis examined studies that included students in kindergarten to grade five with dyslexia or those who were at risk for dyslexia [12]. Results indicate that targeted reading interventions can improve word reading and spelling, more so than reading comprehension [12]. Importantly, more frequent intervention was found to be more effective. In addition, the effects of interventions that were delivered earlier (i.e., kindergarten to grade two) were not found to be statistically significantly larger than interventions delivered in grade three to grade five [12]. However, studies that included students in grade three through grade five were found to have smaller effects than those with students in kindergarten to grade two [12], which suggests that the earlier the intervention is delivered, the more effective it may be [11, 12].

One study has found that music training may help those with dyslexia [13]. Specifically, these researchers suggest that music training may help improve phonological awareness and reading in children who have dyslexia [13]. Importantly, it has been suggested that by enhancing temporal processing and rhythmic skills, music may become a potential tool in early intervention programs [13]. 

Dyslexia does not go away on its own and it can’t be “outgrown.” Children with dyslexia need proper, explicit instruction in order to show measurable improvements in their reading skills [14]. Sometimes this intervention can be provided by general or specialist teachers at school and other times it may be beneficial to work with a trained tutor or reading specialist outside of the school day. 

Dyslexia and Vision: Let’s Clear the Air

It is important to note that although vision problems can interfere with the learning process, vision problems are not the primary cause of dyslexia or learning problems [15, 16]. According to the American Academy of Pediatrics “convergence insufficiency and poor accommodation, both of which are uncommon in children, can interfere with the physical act of reading but not with decoding. Thus, treatment of these disorders can make reading more comfortable and may allow reading for longer periods of time but does not directly improve decoding or comprehension” [15]. Vision therapy may help individuals with convergence insufficiency, however, it is not an appropriate method to improve reading [15, 16]. Currently, there is no evidence in support of the effectiveness of eye exercises, behavioral vision therapy, or tinted filters or lenses in improving long-term educational performance in these more complex cases [15, 16]. Provided that there is a lack of scientific evidence, such exercises are not recommended [15, 16]. 

Children who exhibit signs of dyslexia should be referred for educational, psychological, neuropsychological, and/or medical assessments [15, 16]. It is important to have your pediatrician and family physicians perform periodic eye and vision screenings on your child(ren) and to refer those who do not pass screening to experienced ophthalmologists [15, 16]. Additionally, children who are suspected of having an LD or who are diagnosed with an LD in which vision may play a role should be referred to an ophthalmologist, as routine pediatric vision screening is not designed to detect near-vision problems [15].Ophthalmologists should identify and treat significant ocular or visual disorders present [15, 16]. 

Conclusion

Reading is incredibly important in various areas of life, as it helps us in our ability to communicate verbally and through written language. Reading is an essential skill we use everyday to read books, signs, documents, emails, text messages, and so much more. Thus, supporting children in their reading early on is vital to set them up for success in the future. However, every child is different and learns in different ways. Some strategies may work well to help support and improve reading, while other strategies may not be as effective. See what works best for you and your family in supporting your child’s reading!

If you are concerned about your child’s learning or challenges with reading or writing, we would be happy to talk with you about a psychoeducational assessment to accurately pinpoint their reading difficulties and recommend strategies to support their reading development. Please don’t hesitate to email us at info@highpointpsychology.com.

References

[1] Dyslexia Canada. (n.d). Dyslexia Basics. Retrieved from https://dyslexiacanada.org/en/dyslexia-basics

[2] International Dyslexia Association. (2024). Definition of Dyslexia. Retrieved from https://dyslexiaida.org/definition-of-dyslexia/

[3] American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.).

[4] American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th Edition Text Revision DSM-5-TR). Washington, DC: Author.

[5] Fletcher, J. M., Lyon, G. R., Fuchs, L. S., & Barnes, M. A. (2019). Learning disabilities: From identification to intervention (2nd ed.). Guilford Press.

[6] Schumacher J, Hoffmann P, Schmäl C, Schulte-Körne G, Nöthen MM. (2007). Genetics of dyslexia: the evolving landscape. Journal of Medical Genetics. 44(5), 289-97.  

[7] The Understood Team. (n.d). What is Dyslexia? Understood. Retrieved from https://www.understood.org/en/articles/what-is-dyslexia#Dyslexia_signs_and_symptoms

[8] Shaywitz, S. (2003). Overcoming dyslexia: A new and complete science-based program for reading problems at any level.

[9] Morin, A. (n.d). 7 Common myths about dyslexia. Understood. Retrieved from https://www.understood.org/en/articles/common-myths-about-dyslexia-reading-issues

[10] National Reading Panel (U.S.) & National Institute of Child Health and Human Development (U.S.). (2000). Report of the National Reading Panel: Teaching children to read : an evidence-based assessment of the scientific research literature on reading and its implications for reading instruction, https://www.nichd.nih.gov/sites/default/files/publications/pubs/nrp/Documents/report.pdf

[11] Rehfeld, D. M., Kirkpatrick, M., O'Guinn, N., & Renbarger, R. (2022). A Meta-Analysis of Phonemic Awareness Instruction Provided to Children Suspected of Having a Reading Disability. Language, speech, and hearing services in schools, 53(4), 1177–1201. https://doi.org/10.1044/2022_LSHSS-21-00160

[12] Hall, C., Dahl‐Leonard, K., Cho, E., Solari, E. J., Capin, P., Conner, C. L., Henry, A. R., Cook, L., Hayes, L., Vargas, I., Richmond, C. L., & Kehoe, K. F. (2023). Forty years of reading intervention research for elementary students with or at risk for dyslexia: A systematic review and Meta‐Analysis. Reading Research Quarterly, 58(2), 285-312. https://doi.org/10.1002/rrq.477

[13] Flaugnacco, E., Lopez, L., Terribili, C., Montico, M., Zoia, S., & Schön, D. (2015). Music Training Increases Phonological Awareness and Reading Skills in Developmental Dyslexia: A Randomized Control Trial. PloS one, 10(9), e0138715. https://doi.org/10.1371/journal.pone.0138715

[14] Johnston, V. (2019). Dyslexia: What reading teachers need to know. The Reading Teacher, 73(3), 339-346

[15] American Academy of Pediatrics, Section on Ophthalmology, Council on Children with Disabilities, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, & American Association of Certified Orthoptists (2009). Joint statement--Learning disabilities, dyslexia, and vision. Pediatrics, 124(2), 837–844. https://doi.org/10.1542/peds.2009-1445

[16] American Academy of Ophthalmology. (2014). Joint statement: Learning disabilities, dyslexia, and vision. Retrieved from https://www.aao.org/education/clinical-statement/joint-statement-learning-disabilities-dyslexia-vis

Blog post written by Kassandra Burk, Carmen Gietz, and Dr. Andrea Stelnicki.

The information contained in this blog post is based on a narrative review of available literature. Some studies may have been unintentionally omitted. You are advised to speak with a healthcare professional to determine if the information is appropriate to your specific circumstances.