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Diagnosis: Dyslexia

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What research has shown about what works in treating reading disabilities

Illustration by Jana Christy

New scientific research shows best practice for teaching children with learning disorders how to read

Becka Treister has had difficulty reading for as long as she can remember. "I would move the letters around in my head," she said. "We would do these reading circles when we were learning how to read, and I just never got it."

Treister was lucky. Her problem was identified early on as dyslexia, and her parents enrolled her, in second grade, at McGlannan School in Kendall, a school that provides one-on-one learning for children with dyslexia and other learning problems. An individualized education offers huge advantages to kids with dyslexia and other learning problems, but it comes at a steep price: The tuition at McGlannan exceeds $19,000 per year.

For Treister, the school did its job. Today she is 17 and a senior at Gulliver Preparatory School with hopes of attending the University of North Carolina to study journalism. But she still bears the scars of years of being unable to learn to read as easily as her peers. "When I see some of the kids I used to go to school with, they say 'You are the girl who couldn't read,'" she says.

What Exactly is Dyslexia?

Dyslexia is a language-based learning disability. The term encompasses a variety of symptoms, but generally, a dyslexic person has trouble learning to read. Dyslexics are usually intelligent, and their struggle to read is often mistaken for laziness. In addition to trouble reading, dyslexics may also have difficulty with other language skills, such as spelling, writing and speaking.

Dyslexia is common; it affects about one in five children. It cuts across all backgrounds and intellectual levels and tends to run in families. People who are dyslexic are often gifted in other areas that do not require strong language skills, such as art, computer science, design, drama, math and sports.

A diagnosis of dyslexia does not doom a student to a life of failure; after all, dyslexia didn't stop Thomas Edison, Tom Cruise, Jay Leno, Agatha Christie, Walt Disney or Whoopi Goldberg from achieving success.

The diagnosis of dyslexia can be difficult, and a formal evaluation by an expert is necessary. Although some children are diagnosed earlier, most kids who struggle to read are not identified as dyslexics until third grade or later, according to Sally Shaywitz, M.D., a Yale University neuroscientist and co-director of the Yale Center for the Study of Learning and Attention. Shaywitz is the author of a recent book, Overcoming Dyslexia (Alfred A. Knopf; April 2003) that discusses the latest research.

"The earlier children are identified, the better it is," said Shaywitz. "You can get them help so they can join their classmates on the right track to reading rather than lagging behind." As time goes on, it gets harder for kids to catch up, Shaywitz said, and that usually causes damage to a child's self-esteem.

Shaywitz's research has shattered many myths about dyslexia. The most common one is that dyslexics see words or letters backward. That's just not true; in fact, normal kids routinely write letters backwards when they are learning to read and write. Instead, Shaywitz says that dyslexics are unable to break words down into their constituent phonemes - the sounds that are spoken. For example, to be able to read, a child has to be able to break the word "man" down into three individual sounds: mmm, aah and nnn. But dyslexics can't. They hear a blur of sounds and can't identify the individual sounds that make up a word.

"You learn to read by learning how the letters represent the sounds," Shaywitz said. "But if you haven't gotten the sounds, you don't have the Velcro to stick the letters onto."

Another myth shattered by Shaywitz's research is that kids grow out of reading problems. In fact, the opposite is true. A child who still has difficulty reading by third grade will have difficulty the rest of his life, Shaywitz said. That's why it's so important that kids be identified as dyslexics as early as possible, so they can start receiving proper remedial instruction. It's incumbent upon parents to learn to identify the early warning signs.

Improving the Skills of a Dyslexic Child

Unfortunately, owing to the large number of students in public school classes, teachers might not always pick up reading problems in a young child. "Even when you notice something, you have to go through a lot of paperwork in the school system to get them tested," says Denise Tamayo, founder of The ELLES School in Lake Worth, a school that accommodates children with specific learning disabilities.

Tamayo, who previously was a special education teacher in the public schools, said that even when a child enters a special education program, he or she is likely to be put into a varying exceptionalities class with children of differing special needs. "On paper, the school board looks like it can accommodate their needs, but the numbers are so great that individualized instruction is very rare," she said.

Like most schools for kids with learning disabilities, The ELLES School has small class sizes - six to eight in a class. Teachers work with students to help them "decode" words, to learn the sounds associated with each letter. "We use a lot of auditory processing awareness activities and visual memory exercises," Tamayo says.

She uses the Orton-Gillingham-based method of instruction at her school, which incorporates a multisensory approach to reading. That allows a child to use all of his or her senses to learn to read - - visual, auditory, kinesthetic and tactile - - and enhances both memory and learning.

McGlannan School uses a multisensory approach as well, says Carole Repensek, Ed.D., assistant director. Repensek, who is also the president of the Florida branch of the International Dyslexia Association, says there are a number of less conventional "treatments" for dyslexics that are being touted as cures, such as balance therapy and visual therapy. "It's just not supported by science," she said. "We support anything we do by science."

Shaywitz agrees. "The data that I've seen to date [for those programs] doesn't meet the high level that has been set for scientifically based reading research," she said. "It could be that the studies of the future will tell us different information, but the studies that have been published so far don't really meet that level."

So what does work for dyslexics? Shaywitz said that the programs that work teach five key elements:

• Phonemic awareness, or the ability to identify the individual sounds of words
• Phonics, or the way that letters represent sounds
• Fluency, or the ability to read accurately and rapidly, with good inflection
• Vocabulary, since children with the largest vocabularies are often stronger readers
"These five key elements need to be taught systematically and explicitly," Shaywitz said. "That's really important."

Choosing A Reading Program

Once a child has been diagnosed with dyslexia, parents face a choice. How do you find the best reading program for your child? If your child is enrolled in a public school, do you keep him or her there and rely on the school's exceptional student education program, or transfer him to a private school?

Shaywitz says that a typical public school special education program does little to help a dyslexic child. She said that public schools are slow to identify reading problems, provide too little instruction and rarely have teachers that are experts in reading problems. She recommends that parents consider alternatives to a public school education if the school has provided a special reading program but the child is still lagging behind.

Private schools are not always appropriate, either. Although they have smaller classes, the quality of private schools varies, and without an effective reading program, students might fail to improve even at a private school.

If you decide that a private education is appropriate for your dyslexic child, make sure that it has a quality reading program. If you decide on a specialized school for kids with reading disabilities, make sure that it uses a program that is scientifically based, Shaywitz recommends.

Here are some tips for finding the appropriate educational setting for your child:

• Talk to many people about the school you are considering. That includes parents of students who attend the school or have graduated, as well as students, teachers and administrators.
• Visit the school. Observe the students to see if they are happy. Are the teachers and administrators open and friendly? Do they welcome questions?
• Review the school's mission statement to learn more about its policies, goals and historical record of success.
• Observe classes in session.
• Learn as much as you can about the school's curriculum and reading program.
• Check out the credentials of the faculty. Are they reading specialists or generalists?
• Ask what extracurricular activities are offered.

Most important, if you think your child has a reading problem, don't ignore it. Don't accuse your child of laziness or believe that if you just give him a little more time, he will grow out of it. If it is dyslexia, he won't.

"A parent's first reaction is to deny that there is a problem," says Lisa Treister, a resident of Coconut Grove and Becka's mom. "This is a very typical response, but a harmful one. Parents need to put these feelings aside and seek professional help if their gut is telling them that things aren't exactly right. Learning differences don't go away."

Robyn A. Friedman is a freelance writer and mother. She lives in Boca Raton.

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