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Dyslexia


 

Dyslexia

Reading and Writing Disability

by Kenneth Lyen

Definition

Dyslexia is a developmental disorder affecting normal, intelligent persons so that they have difficulty understanding spoken or written language despite adequate education and sociocultural opportunities.

Epidemiology

Depending on the criteria used for diagnosis, dyslexia appears to occur in 8 per cent of the general population, and affects boys about six times more frequently than girls. Dyslexia tends to run in families. A parent, sibling, uncle or grandparent may have experienced similar difficulty learning to read and spell.

Historical

The term dyslexia refers to difficulty with language. Taken from the Greek dys, meaning "insufficient", and lexis, meaning "words", people with dyslexia may have problems with reading, spelling, understanding spoken words or expressing themselves orally or in writing.

In 1877, Kussmaul described a condition which he called "word blindness". Ten years later, in 1887, Professor Berlin first used the term "dyslexia".

In 1920, Dr. Samuel Orton in the USA noted that a high proportion of children with reading problems were producing mirror writing. In the 1960s, Professor Tim Miles undertook assessments and research in children with Dyslexia in Bangor, Wales. In 1994, US scientists linked its occurrence in families to a region on chromosome number 6.

Gifted Dyslexics

Many people with dyslexia are talented in areas of art, drama, mathematics and sports, yet they may have difficulty remembering things or organizing themselves. A dyslexic mind has been described as a different kind of mind, often gifted and productive, that learns differently.

In their book The Gift of Dyslexia, Ronald Davis and Eldon Braun postulated that many great geniuses such as Leonardo da Vinci, Albert Einstein, Thomas Edison, Alexander Graham Bell, Walt Disney, and Winston Churchill were dyslexic. Each one of these people was labeled as an intellectually-slow child, but later made accomplishments that altered our world.

While dyslexia is not a prerequisite to becoming a genius, it does boost the self-esteem of dyslexics to know their minds work in the same way as those of great geniuses. It is also important for them to know that having a problem with reading, writing, spelling or maths does not mean they are stupid. Below are some basic abilities that many dyslexics share:

- They use all their senses and think multi-dimensionally.

- They think in pictures rather than words.

- They are highly imaginative.

If allowed to flourish without being suppressed by their educational system, dyslexics may achieve a high level of creativity. For Albert Einstein it was in the field of physics; for Thomas Edison and Alexander Graham Bell it was in inventing things; for Walt Disney and Leonardo da Vinci it was in art.

Cultural Context

Dyslexia is uncommon in languages that use ideograms, such as Chinese. It is interesting that in the case of the Japanese language which uses a mixture of ideograms borrowed from the Chinese (kanji) and a phonetic alphabet (hiragana and katakana), dyslexia is only manifested in hiragana and katakana. It has sometimes been said that dyslexia is a man-made disease, arising from the way that spoken language has become represented by phonetic alphabets. Some have argued that we do not need to regard it as an abnormality, nor should we overemphasize the importance of correct spelling, because in our modern age of computers, spelling can be automatically corrected by spelling checkers, and there are computer programs that allow dictated words to appear as written script.

Causes

Earlier theories postulated that dyslexia was due to faulty visual scanning of the letters within a word. Too rapid a sweep of the eyes during reading might either result in an alphabet being omitted totally or cause the sequence of letters within a word to be jumbled up. Indeed, special tinted lenses were recommended to help remedy this problem. Unfortunately, research has not supported the claims that these tinted lenses help.

It has also been suggested that dyslexia is a problem in the conversion of visual images into auditory messages. There is nothing wrong with hearing, but when the eye sees a letter such as b, d and p, the auditory centers of the brain cannot process them correctly. In support of this theory, slowing down the alphabets presented to the reader just a fraction of a second seems to dramatically improve reading skills. However, this theory does not adequately explain the mirror-writing.

Lyen postulates that dyslexia is due to a defect in the storage and/or retrieval of small packets of visual information in the brain’s memory banks. Normally, the lens in our eyes inverts every image it sees, and this is stored in the brain. When the information is retrieved, the brain has to interpret the upside-down and left-to-right images and convert them back for our mind to "read". This is analogous to having another "lens" in the mind which turns the images upright again. A fault in the initial storage, or in the recall of these small bits of information (alphabets or numbers), can explain the spelling mistakes, the poor handwriting, and the occasional mirror-writing. Slowing down the information presented to the brain may potentially help, at least in part, correct the storage or retrieval problem. It can explain the apparent paradox why dyslexics have difficulty remembering small symbols (alphabets and numbers), but have no difficulty remembering the larger canvas of pictures. They seem to be the opposite of the autistic person who remembers the detailed trees rather than the entire wood. Interestingly both dyslexic and autistic persons are best taught using visual images, the dyslexic will also derive much benefit from teaching methods that stimulate the other senses, such as auditory and tactile.

Lack of oxygen, trauma or infection can damage those parts of the brain causing dyslexia. About half the affected children come from families with histories of dyslexia or related disorders. Thus, a genetic predisposition to problems in that part of the brain can be expected.

Diagnosis

The diagnosis of dyslexia is usually suspected when parents or teachers notice that the child has a problem in reading or writing. A doctor may be consulted, a comprehensive medical history taken, and a thorough examination carried out, including a neurological and developmental assessment. If dyslexia is a strong possibility, the doctor should refer the child for further evaluation by an educational psychologist.

The diagnosis needs to be confirmed, specific problems associated with dyslexia should be identified and appropriate educational intervention recommended. The educational psychologist will conduct a series of assessments, an IQ test and a check for the reading level. From these results, a plan for intervention can be suggested. Remedial reading is usually taught by a specially-trained teacher. No two dyslexics respond in the same way to any one remedial reading program. Hence, it is important for the teacher to be able to select the most appropriate program for that particular student.

The diagnosis can be confirmed when one finds a discrepancy between intellectual ability and reading performance. The latter should not be accompanied by apparent physical, emotional or cultural problems. Specific findings in dyslexics include difficulty pronouncing new words, difficulty distinguishing words ("cat" for "tac"), and difficulty discriminating sounds ("ball", "bill"). Other dyslexics may reverse the order of letters in a word or the words in a sentence. They may also have difficulty understanding what they have read. Few dyslexics exhibit all the signs of the disorder. Their problems in language processing distinguish them as a group. Common findings in their history include, but are not limited to:

Learning Style

- Has late speech development

- Appears intelligent and can speak well, but is unable to read, write or spell as expected for that age.

- Often labeled as lazy, careless, or "dumb".

- Despite an above-average or even high IQ, they may fare badly in academic examinations.

- Have low self-esteem.

- Talented in arts, music, architecture, engineering and many other fields.

- Daydreams a lot.

- May have attention deficit or hyperactive behavior.

- Scores higher marks on oral than on written tests.

- Learns best using visual aids or hands-on practicals.

Undiagnosed Dyslexia

Teachers often place great store by a student’s correct spelling, tidy handwriting and reading prowess. When confronted with a child with spelling mistakes, poor handwriting, and faulty reading, they may mistakenly label the dyslexic child as slow, inattentive, or lazy. Such a pupil may lose his own self-esteem, become a rebel or a school dropout. Luckily some adult dyslexics succeed in life despite being functionally illiterate because their skills in other areas compensate for this disability. Often, they develop intricate subterfuges to hide their "shameful" secret.

What Factors Contribute to Dyslexia?

Ocular Problems

Studies have shown that dyslexic individuals have no higher incidence of eye problems than to normal reading individuals. There is no difference between dyslexics and normal readers in visual acuity, stereo vision, alignment and movement of the eyes, fusion status (break point amplitude) and refractive errors.

Nevertheless, I would recommend that children with reading problems should have their vision checked carefully. There is no scientific evidence that wearing tinted lenses or prisms, or doing eye exercises will improve the reading performance of dyslexics.

Auditory Language Deficit

According to this theory, the main problem in dyslexia is an auditory language deficit. Approximately 86 per cent of the individuals identified as dyslexic show an auditory language disorder that interferes with the linkage between the spoken word and its written equivalent.

Visual-Spatial-Motor Problems

This is the ability to coordinate visual signals and motor skills. In contrast to language problems, visual-spatial-motor factors appear less commonly in dyslexia. It is estimated that about 5 per cent of dyslexic individuals have a visual-spatial-motor problem that interferes with sequential organization, scanning and the perception of temporal and spatial cues. Although visual-spatial-motor confusion is found in young children just beginning to read, these problems persist in dyslexic persons.

There is no scientific evidence that interventions such as neurological and sensory organizational training, laterality training, dominance training, balance beam or reflex inhibition will improve reading skills.

Other Factors

General intelligence is critically important in determining a person’s reading and language abilities. The role of dominant handedness, eyedness and mixed laterality has not been conclusively proven. The contribution of low birth weight, brainwave (EEG) abnormalities, attention deficit disorders, food additives, and chemical allergies is also uncertain.

Treatment

There are three main approaches to dealing with dyslexia.

Developmental Approach

The developmental approach is based on the tenet that dyslexic children may have delayed development of the language center of the brain. Hence, treatment is just an increasing of conventional methods of instruction.

Remedial Approach

The remedial approach focuses on the child’s weaknesses and tries to correct them. Unfortunately, the gains tend to be short-term and, after a few years, there is no advantage when compared to untreated controls.

Auditory Training

This is based on the hypothesis that dyslexia is due to an inability to decode spoken words, so that dyslexics have problems handling phonemes (the basic building blocks of language), especially consonants like b, d and p. The hearing is all right, but the auditory center in the brain is unable to process certain sounds. Dyslexic children can be helped if sounds are engineered by making consonants louder, by stretching vowel sounds, and by spacing words farther apart.

Nowadays, there is a preference for a multisensory approach, involving all of the child’s senses; listening to the sounds of words and letters; seeing how a letter or word looks; and feeling the movements of the lips or actually writing the letter or words.

Prognosis

The outlook for dyslexic children is variable. Generally, there is a tendency for dyslexia to improve with time. Remedial programs tend to accelerate the improvement. If the family and school teachers are supportive and build up the child’s self-confidence, the chances of success can be enhanced. Early diagnosis and intervention also improve the outlook.

Conclusions

Dyslexia is a fascinating disorder and only now is the cause and treatment beginning to be understood. There is great promise that the use of computer-assisted auditory training may help affected people overcome their disability. The author suggests that further research should be done on bilingual individuals who are conversant with alphabetic and ideographic scripts such as English and Chinese. With the aid of computers, the shape, size, color, overlap and rate of delivery of each constituent of a word can be dissected out to provide further clues as to how our eyes and mind recognize and interpret words.

[This article first appeared in Rainbow Dreams (2002).]