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This paper provides an in-depth discussion of dyslexia. It defines dyslexia, lists signs and symptoms of the disability, and explains the relationship between dyslexia, Attention-Deficit/Hyperactivity Disorder, and social/emotional problems. This paper explains the three theories of dyslexia - the phonological theory, the magnocellular theory, and the cerrebellar theory. It then goes on to explain present research concerning the three theories of developmental dyslexia, with a special focus placed on the phonological theory. It explains why a phonological deficit is such a debilitating condition in reading and outlines deep dyslexia, surface dyslexia, and difficulties that accompany each. Furthermore, this paper discusses various strategies and methods that teachers can use to help dyslexic children learn in the classroom setting and beyond. This discussion of methods places an emphasis on the multisensory approach to teaching, and it explains why this method is beneficial for children with dyslexia. Also, the discussion of methods touches on techniques to help children whose problem with reading stems from a vision problem relating to binocular stability.
Developmental dyslexia, a condition characterized by a discrepancy between a person's intelligence and reading ability, is the most common of all learning disabilities, affecting eighty percent of all those identified as learning disabled (Shaywitz, 1998). The International Dyslexia Association defines dyslexia as
A specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. (Heward, 2009)
Late talking, difficulty rhyming, and adding new words slowly are all signs and symptoms that a young child may be at risk for dyslexia (Mayo Clinic Staff, 2010). In school age children, signs of dyslexia may be more apparent and likely include the following: reading well below the expected level, problems processing and understanding what is heard, trouble following more than one command at a time, difficulty comprehending rapid instructions, problems remembering the sequence of things, difficulty seeing similarities and differences in letters and words, an inability to sound out an unfamiliar word, seeing words or letters in reverse, trouble learning a foreign language, and difficulty spelling (Mayo Clinic Staff, 2010).
Because the two conditions often coexist, there is often confusion between dyslexia and Attention-Deficit/Hyperactivity Disorder (AD/HD) (Dakin & Erenberg, 2008). An estimated thirty percent of individuals with dyslexia also have AD/HD, a condition characterized by inattention, distractibility, hyperactivity, and impulsivity (Dakin & Erenberg, 2008). Although the two conditions are decidedly different, individuals with AD/HD have characteristics similar to those with dyslexia (Dakin & Erenberg, 2008). First of all, both have trouble reading fluently. However, unlike individuals with dyslexia who have trouble reading words, individuals with AD/HD may skip over punctuation, leave off endings, or loose their place (Dakin & Erenberg, 2008). Second, both those with dyslexia and AD/HD may have trouble writing (Dakin & Erenberg, 2008). Dyslexics have trouble with spelling, grammar, proofreading, and organization, while AD/HD writers have trouble with proofreading and organization (Dakin & Erenberg, 2008). Lastly, students with either AD/HD or dyslexia may be underachieving in school, despite being bright (Dakin & Erenberg, 2008). Because of these shared characteristics, it is important for teachers and medical professionals to accurately distinguish between AD/HD and dyslexia in order to best meet the needs of each and every child.
There are many social and emotional problems related to dyslexia (Ryan, 2004). According to the research of Samuel T. Orton, dyslexics do not develop emotional problems until they begin learning to read (Ryan, 2004). The frustration associated with reading grows over time as dyslexics' peers continue to surpass them in reading (Ryan, 2004). Along with frustration, dyslexics experience many other emotions as a result of their troubles with reading (Ryan, 2004). First of all, dyslexics experience anxiety as they anticipate failure at school and with homework (Ryan, 2004). This anxiety may lead dyslexics to be fearful of other new situations as well (Ryan, 2004). Second, dyslexics experience anger as a result of their frustrations in school (Ryan, 2004). Third, dyslexics' self-image is extremely vulnerable due to anxiety (Ryan, 2004). The pressure to succeed and be like fellow classmates contributes to feelings of inferiority that are damaging to dyslexics' self-images (Ryan, 2004). Lastly, depression is the most extreme emotional issue that dyslexics may face (Ryan, 2004). Listening to children's feelings and helping them set realistic goals for themselves may help those struggling with depression (Ryan, 2004). Also, emphasizing that the process is more important than the product is important in helping dyslexic children cope with feelings of inferiority that may lead to depression (Ryan, 2004).
So, what exactly causes this "word blindness," as Pringle Morgan, who first described the debilitating condition in 1896, called dyslexia (Stein & Talcott, 1999)? There are three leading theories of developmental dyslexia - the phonological theory, the magnocellular (auditory and visual) theory, and the cerebellar theory (Ramus et al., 2003).
The phonological theory states that dyslexia is caused by an impairment in the representation, storage, and retrieval of speech sounds (Ramus et al., 2003). In other words, a dyslexic has difficulties retrieving the sounds necessary in making the grapheme-phoneme correspondences that learning to read an alphabetic system requires (Ramus et al., 2003). In fact, the most sensitive measure of reading problems in dyslexia is the inability to read phonologically nonsense words, which directly relates to dyslexics' inability to map speech sounds to the written word (Shaywitz et al., 1998). Further support for this theory lies in the fact that dyslexics do, indeed, perform poorly on tasks requiring phonological awareness such as segmenting and manipulating speech sounds (Ramus et al., 2003). Although the results of many studies have pointed toward the phonological theory of dyslexia, it should be noted that the theory contains a weakness in its inability to explain the sensory and motor disorders that are also present in many dyslexics (Ramus et al., 2003).
The magnocellular theory can be broken into two general parts - the rapid auditory processing theory and the visual theory. The rapid auditory processing theory states that an auditory deficit, which lies in the faulty perception of short or rapidly varying sounds, is the direct cause of the development of a phonological deficit (Ramus et al., 2003). So, this theory postulates that a phonemic awareness deficit is still present in dyslexics, but it is not the origin of dyslexics' difficulties with reading. The visual theory states that a visual impairment causes difficulties with the processing of letters and words on a page of text (Ramus et al., 2003). It suggests that the magnocellular pathway is disrupted in dyslexics, causing abnormal binocular control and visuospatial attention (Ramus et al., 2003). Like the rapid auditory processing theory, the visual theory does not discount the possibility of a phonological deficit; rather, it emphasizes a visual deficit in some dyslexic individuals (Ramus et al., 2003). Overall, the magnocellular theory attempts to integrate the findings of the various other theories into one simplified version (Ramus et al., 2003).
Many other studies have shown that faulty visual perceptions may be the primary cause of dyslexics' reading problems (Stein & Talcott, 1999). These studies have revealed that dyslexics do not have stable binocular control, which causes the eyes to lag behind a target and constantly play "catch up" as they fall behind (Stein & Talcott, 1999). This lack of binocular stability could explain the complaints of many dyslexics, such as words and letters moving around on the page, words moving off the paper, and letters appearing to cross over one another and merge together (Stein & Talcott, 1999). Naturally, if a faulty visual perception caused the previously mentioned phenomenon to occur, reading would be a very challenging endeavor. For one, sight-reading would be a difficult undertaking; it would prove nearly impossible to memorize the correct arrangement of letters in a word (Stein & Talcott, 1999). Also, reading phonetically would be a challenge, especially in the early stages of learning to read when readers must match each individual grapheme with its corresponding phoneme (Stein & Talcott, 1999). The visual confusion dyslexics face would make it difficult to follow the letters across a word (Stein & Talcott, 1999).
The cerebellar theory is the third leading theory of developmental dyslexia. It claims that dyslexics' cerebellums, the part of the brain at the back of the skull, are mildly dysfunctional (Ramus et al., 2003). The cerebellum is the area of the brain that is partially responsible for motor control, speech articulation, and the automatization of over learned tasks such as driving, typing, and reading (Ramus et al., 2003). The poor performance of dyslexics in many motor tasks, in dual tasks demonstrating impaired automatization of balance, and in time-estimation supports the cerebellar theory (Ramus et al., 2003). However, the cerebellar theory fails to explain the absence of sensory and motor disorders in some dyslexics (Ramus et al., 2003).
Ramus et al. conducted a number of tests to determine which of the leading theories of dyslexia proved to be most correct. To test the phonological theory, subjects were put through various tests including automatic picture naming, automatic digit naming, and non-word repetition (Ramus et al., 2003). To test the magnocelluar theory, subjects were put through auditory and visual perception tests (Ramus et al., 2003). The tests of auditory perception included an audiological screening, phonemic categorization, and temporal order judgment of short and long sounds (Ramus et al., 2003). Visual perception tests included measures of visual acuity, speed discrimination, and motion detection (Ramus et al., 2003). To test the cerebellar theory, subjects were put through tests measuring balance, coordination, and timing, all which involve the use of the cerebellum (Ramus et al., 2003). The results of the study showed support of the phonological theory of dyslexia and stated that although a significant number of dyslexics suffer from additional visual, auditory, or motor disorders, the phonological deficit can arise independently (Ramus et al., 2003).
If the phonological theory of dyslexia is, indeed, the most plausible theory of dyslexia, the following question is raised: why is the ability to hear sounds in spoken words such an integral part of a process, reading, that doesn't even require using our ears? Stein and Talcott (1999) answer this question in their article "Impaired Neuronal timing in Developmental Dyslexia - The Magnocellular Hypothesis." According to Stein and Talcott (1999), when reading familiar words, it is not necessary for readers to use phonological analysis at all. Such words are in readers' sight vocabularies, and readers can take meaning from the word without breaking it down into sounds and syllables (Stein & Talcott, 1999). Readers are free to use the visual semantic route to reading (Stein & Talcott, 1999). However, when reading unfamiliar words that are not yet part of readers' sight vocabularies, readers must translate each letter into its corresponding phoneme, a process requiring phonemic awareness (Stein & Talcott, 1999). During this process, readers must use the auditory/phonological route to reading (Stein & Talcott, 1999). In dyslexics, the reading problem, according to Stein and Talcott, can occur in either the ability to sight-read or in the ability to read unknown words phonetically.
If the reading problem arises in dyslexics' ability to sight read, Stein and Talcott (1999) refer to the condition as surface dyslexia. Such dyslexics rely entirely upon their ability to read words phonetically (Stein & Talcott, 1999). So, these dyslexics can read regular words and even nonsense words that follow standard phonetic rules with ease (Stein & Talcott, 1999). However, surfaces dyslexics' problems arise when they come across a word such as "ache" because the word does not follow standard phonetic rules (Stein & Talcott, 1999). Also, Stein and Talcott (1999) note that surface dyslexics tend to make spelling errors by spelling words phonetically; they refer to such errors as "phonetic regularization errors."
Contrary to surface dyslexia, deep dyslexia occurs when readers rely totally on the visual semantic route to reading, applying no knowledge of phonetic generalizations (Stein & Talcott, 1999). Deep dyslexics may encounter many different problems when reading. First of all, they tend to make visual errors such as producing words that are similar to the correct word but with incorrect letters or letters in the wrong order (Stein & Talcott, 1999). For example, deep dyslexics might misread the word "bind" as "blind" or "bond." Another reading error deep dyslexics tend to make is producing a word with a similar meaning that is totally unrelated phonetically and visually to the correct word (Stein & Talcott, 1999). For example, deep dyslexics might read the word "ship" as "boat." Deep dyslexics are not capable of reading nonsense words because of their inability to read words phonetically (Stein & Talcott, 1999).
It should be noted that most dyslexics do not fall neatly into the surface dyslexic or deep dyslexic category; many dyslexics make both visual and phonological errors, with one error or the other predominating (Stein & Talcott, 1999).
Because of the multitude of problems that dyslexic children will face in the classroom, it is absolutely imperative that educators are equipped with the knowledge to effectively teach such students. Phonemic awareness, phonic recognition, oral reading ability, vocabulary, and reading comprehension are all areas that a reading specialist and regular education teacher should target in order to teach dyslexic children to read (Mayo Clinic Staff, 2010).
Dyslexic children with severe reading disabilities may need to frequently see a personal tutor, and in extreme cases, dyslexics may never be able to read or write well (Mayo Clinic Staff, 2010). In such situations, dyslexics should be trained for jobs that do not require reading skills (Mayo Clinic Staff, 2010). Dyslexics with milder reading disabilities may be able to learn to
read well enough to succeed in the classroom (Mayo Clinic Staff, 2010). With such mild to moderate cases of dyslexia, a multisensory teaching method is often the most effective way to teach reading (Bradford, 2008).
A multisensory method involves using techniques including hearing, vision, and touch to improve reading skills (Mayo Clinic Staff, 2010). This method is different from traditional teaching methods that usually involve only sight or hearing (Bradford, 2008). In such traditional methods, teachers may ask children to perform visually by reading information out of a book or off of the board or by looking at diagrams and pictures; teachers ask the children to use hearing by listening to what they are saying (Bradford, 2008). The multisensory method combines the traditional uses of sight and hearing with touch and movement (Bradford, 2008). For example, to help children learn the letters "b" and "d" many teachers provide letters made out of sandpaper that the children can run their fingers over (Bradford, 2008). This experience provides the children's brain with a tactile memory to hold on to (Bradford, 2008). Another multisensory method used to teach the sometimes confusing letters "b" and "d" is to show children the word "bed." Then, draw a bed over the letters, making the upright part of the "b" the headboard and the upright part of the "d" the footboard. This helps give children a strong visual memory to remember each letter by (Bradford, 2008). Also, children can connect their middle finger and thumb on each hand to make the word "bed" without the "e" in the middle. This provides a tactile and kinetic memory for the children (Bradford, 2008). The combination of all the previous experiences makes for a strong multisensory learning experience that has proven successful for many dyslexic children by involving more than one area of the brain in learning things that may be difficult to remember (Bradford, 2008).
Another effective way to help students with dyslexia involves those whose vision may be the primary cause of their reading difficulties. With these students, the simplest way of helping them is to increase the size of the print and the separation of the letters on typed papers (Stein & Talcott, 1999). Doing so decreases the chance of eye movements merging or transposing letters and causing reading difficulty (Stein & Talcott, 1999). A second way to help children whose main problems with reading are visual is to have them read with one eye (Stein & Talcott, 1999). This method stabilizes the readers' binocular control and eliminates double vision, which causes readers to merge and transpose letters (Stein & Talcott, 1999). According to Stein and Talcott (1999), the rate of reading more than doubled for children whose binocular stability was improved using this method.
There are many other strategies teachers can use to help dyslexic children with reading, organization, and homework. To help dyslexic children with reading, teachers should never ask them to read books that are beyond their level of reading (Hodge, 2000). Children's motivation for reading will be much higher if enjoying the book is actually possible (Hodge, 2000). Also, teachers should not ask dyslexic children to read out loud in front of the class; instead, teachers can listen to students read one-on-one (Hodge, 2000). Above all, teachers should keep in mind that reading should be fun, not burdensome, for students (Hodge, 2000). For dyslexic students who have trouble with organization, there are many strategies available to help them. Approaches to help students organize time, materials, and information include the following: providing a quiet, uncluttered homework space, an alarm clock, and texts that students can mark with a highlighter, instructing students in study skills, and giving students a personal scheduler ("Accommodations," 2010). When it comes to homework for dyslexic students, teachers should remember that dyslexic students are generally more tired than their peers by the end of the school day, so teachers should only give homework that will really be beneficial for dyslexic children (Hodge, 2000). Also, if teachers choose to give less demanding homework to dyslexic students than to the rest of the class, they should use tact so as not to damage dyslexic children's self-esteem (Hodge, 2000).
When testing dyslexic students, teachers should keep in mind several things. First of all, matching, fill-in-the-blank, and short answer formats are all appropriate forms of testing for dyslexics (Houck, 2007). For fill-in-the-blank tests, teachers should provide a word bank; oftentimes, dyslexic children know the answer, but they cannot retrieve it mentally without a list to choose from (Houck, 2007). Multiple-choice tests are not an appropriate form of testing dyslexic children because the amount of reading required on such a test can be overwhelming (Houck, 2007). If a teacher must give a multiple-choice test, it is best to give it orally (Houck, 2007). Also in regards to testing dyslexic children, teachers should eliminate or reduce spelling tests (Houck, 2007). Another option is only grading a few words on a class spelling test or accepting a spelling test conducted by a dyslexia tutor for a grade (Houck, 2007). Finally, untimed tests will help give dyslexics time to fully read the questions and express answers (Houck, 2007).
Although dyslexics will face many challenges in life, especially in the school setting, they are by no means eternally incompetent. In fact, many talented, powerful people in history are now thought to have probably been dyslexic. The impressive list includes Albert Einstein, Winston Churchill, and Alexander the Great (Stein & Talcott, 1999). With the successes of these dyslexics in mind, educators and dyslexics alike should have hope for a bright future.