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This review uses a levels-of-analysis framework to summarize the current understanding of developmental dyslexia's etiology, brain bases, neuropsychology, and social context

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doi: 10.1146/annurev-clinpsy-032814-112842.

Affiliation

¹ Department of Rehabilitation Medicine, Children's Hospital Colorado, Aurora, Colorado 80045; email: robin.peterson@childrenscolorado.org.

doi: 10.1146/annurev-clinpsy-032814-112842.

Affiliation

¹ Department of Rehabilitation Medicine, Children's Hospital Colorado, Aurora, Colorado 80045; email: robin.peterson@childrenscolorado.org.

Abstract

This review uses a levels-of-analysis framework to summarize the current understanding of developmental dyslexia's etiology, brain bases, neuropsychology, and social context. Dyslexia is caused by multiple genetic and environmental risk factors as well as their interplay. Several candidate genes have been identified in the past decade. At the brain level, dyslexia is associated with aberrant structure and function, particularly in left hemisphere reading/language networks. The neurocognitive influences on dyslexia are also multifactorial and involve phonological processing deficits as well as weaknesses in other oral language skills and processing speed. We address contextual issues such as how dyslexia manifests across languages and social classes as well as what treatments are best supported. Throughout the review, we highlight exciting new research that cuts across levels of analysis. Such work promises eventually to provide a comprehensive explanation of the disorder as well as its prevention and remediation.

Keywords: etiology; genetics; language; neuropsychology; reading disability.

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national center for biotechnology information

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This review uses a levels-of-analysis framework to summarize the current understanding of developmental dyslexia's etiology, brain bases, neuropsychology, and social context. Dyslexia is caused by multiple genetic and environmental risk factors as well as their interplay. Several candidate genes hav ...

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Brain Scans Show Dyslexics Read Better with Alternative Strategies

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Brain Scans Show Dyslexics Read Better with Alternative Strategies

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Scientists studying the brain have found that dyslexic adults who become capable readers use different neural pathways than nondyslexics

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Dyslexia the Gift | Davis Dyslexia Association International

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Brain Scans Show Dyslexics Read Better with Alternative Strategies | Dyslexia the Gift

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Research shows that dyslexic readers use different neural pathways than typical readers, improving through use of right brain regions.

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Rita Pierson, a teacher for 40 years, once heard a colleague say, "They don't pay me to like the kids." Her response: "Kids don't learn from people they don't like.'" A rousing call to educators to believe in their students and actually connect with them on a real, human, personal level.

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Rosa demystifies the dyslexic mind. She will be demonstrating that we can learn a thing or two from these “seemly broken brains”, and revive our perception of dyslexia Rosa's mission is to bring evidence-based strategies to the classroom.

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What is dyscalculia?
Why is it so rarely diagnosed?
Why diagnosis matters

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Signs of dyscalculia, also known as a math learning disability or math disorder, can be hard to spot. Shutterstock

You've probably heard of dyslexia, but have you heard of dyscalculia before? Maybe not, given that children with dyscalculia - or mathematical learning difficulties - are less likely to be diagnosed.

In fact, research shows that children with dyslexia are more than a hundred times more likely to receive a diagnosis and educational support than children with dyscalculia. This is despite the fact that dyslexia and dyscalculia are expected to be equally common.

This is worrying, given that research shows low numeracy might affect people's life chances more negatively than low literacy. Indeed, there is a strong link between numeracy and educational success, income, mental and physical health and even chances of arrest and incarceration.

What is dyscalculia?

Dyscalculia is defined as a condition that involves long-term, severe difficulties with mathematics - which cause significant problems with academic or occupational performance, or with daily activities.

Some typical signs of dyscalculia that parents might notice are using finger counting - even for simple arithmetic - struggling to retrieve number facts from memory (such as times tables), and struggling to learn new procedures.

Dyscalculic children might also have trouble using calendars and clocks, they might struggle with recalling the order of past events, and with following sequential instructions.

Shutterstock

Research shows that developmental disorders very often occur together. So if your child has autism, ADHD or dyslexia, then they could also have dyscalculia. Our recent research investigated the links between dyscalculia and other developmental disorders in primary school children, and we found that among the children we identified as potentially dyscalculic, 81% already had another diagnosis.

We also found the number of boys and girls with dyscalculia to be the same. This differs from other conditions that are more common among boys. In our study, twice as many boys than girls had a diagnosis of dyslexia.

Why is it so rarely diagnosed?

Primary schools in the UK test pupils using standardised, curriculum-based tests every year, starting from grade three. When a child performs at or below a certain cut-off, and their performance does not substantially improve after receiving specialist support for six months, they should receive a diagnosis of dyscalculia. But despite this, dyscalculia is almost never diagnosed - it appears to be a very rare condition.

This could mean that because practitioners do not have experience of working with children with a diagnosis of dyscalculia, they might feel less confident in identifying a new case.

Former diagnostic criteria for dyscalculia included the requirement that mathematics skills should be well below the person's level of intelligence. This requirement has been now dropped, but practitioners might still expect an unexplained difficulty with mathematics, without any other issues.

There is also no official guidance on how dyscalculic learners can be best supported. And because a dyscalculia diagnosis is very rare, it is also difficult to recruit individuals with dyscalculia for research studies - which is essential for testing and developing intervention methods.

Another issue is that when children already have another diagnosis - such as ADHD - this might be considered the main target of intervention. This means that any learning difficulties might be seen as a consequence of the primary problems. And there can also be a general tendency to view mathematics as a difficult and burdensome subject that is "not for everybody".

Why diagnosis matters

Early diagnosis is particularly important, because missing the basics of mathematics makes it difficult for learners to follow subsequent topics. This can lead to frustration and negative attitudes towards mathematics, as well as school subjects in general.

Officially diagnosing children might also lead to faster changes in government policies. Once dyscalculic learners appear in official statistics, it is more likely that support will be offered. It was only in 2009 that the Rose report on dyslexia was published, which called for the availability of special training for teachers to support children with dyslexia. This initiative has been a huge success, and it is likely that the same result would be possible for dyscalculia.

What all this shows is that when it comes to dyscalculia, more needs to be done to help children who are struggling. So if you're a parent worried about your child, it is important to raise this with your child's school and seek specialist educational psychology support.

Obtaining an official diagnosis might take a long time. But you can help your child by practising some basic concepts and procedures with them. This can be done by manipulating everyday objects, such as beads or tokens, or playing simple number games. You can also play board games with a dice - which can help to demonstrate basic number concepts.

These activities might be especially helpful for younger children, but can also help to build confidence in the case of older pupils. Computer based maths programs can also be used for repeated practice of arithmetic. As with literacy, it is important that you don't see your child's maths learning as solely the responsibility of schools.

Dyscalculia, similar to dyslexia, is a life-long condition, which continues to affect people beyond their school years. It cannot and should not be ignored. And a better awareness of the condition in parents, teachers and society generally could offer great improvements in the prospects of dyscalculic learners.

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Dyscalculia: 'maths dyslexia' or why so many children struggle with numbers

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You've probably heard of dyslexia, but have you heard of dyscalculia before? Maybe not, given that children with dyscalculia - or mathematical learning difficulties - are less likely to be diagnosed. In fact, research shows that children with dyslexia are more than a hundred times more likely to receive a diagnosis and educational support than children with dyscalculia.

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It's not an easy thing, learning to read and write. Discover what it takes to build important literacy skills, and how you can help your children grow as readers, writers, and thinkers!

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Helping educators unlock the power of students who learn differently.

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Mindsets and practices to better reach students with learning and attention issues

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1 in 5 students have learning and attention issues. An extensive literature review of empirical studies revealed three critical mindsets and eight key practices that can improve outcomes for students with learning and attention issues — and all students.

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- What is dyslexia?
- social and emotional impacts of dyslexia
- How is diagnosed
- Emotional support

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Children each learn and develop at their own pace, and reading is no different from other skill building. It's common for kids to find reading challenging at one point or another. But if learning to read becomes an ongoing struggle that leaves a child falling behind their peers, it's possible that they have a learning disorder known as dyslexia.

Dyslexia is most commonly associated with trouble learning to read. It affects a child's ability to recognize and manipulate the sounds in language. Kids with dyslexia have a hard time decoding new words, or breaking them down into manageable chunks they can then sound out. This causes difficulty with reading, writing and spelling. They may compensate by memorizing words, but they'll have trouble recognizing new words and may be slow in retrieving even familiar ones.

Dyslexia is not a reflection of a child's intelligence - in fact it's defined as a gap between a student's ability and achievement. Some youngsters with dyslexia are able to keep up with their peers with extra effort at least for the first few grades. But by the third grade or so, when they need to be able to read quickly and fluently in order to keep up with their work, they run into trouble.

With help and strategies for compensating for their weakness in decoding, students with dyslexia can learn to read and thrive academically. But dyslexia is not something one grows out of.

How common is dyslexia?

It is estimated that as many as one in five kids has dyslexia, and that 80 to 90 percent of kids with learning disorders have it. Sally Shaywitz, MD, co-director of the Yale Center for Dyslexia and Creativity, notes that many children go undiagnosed as struggles in school are incorrectly attributed to intelligence, level of effort or environmental factors.

Although experts used to say that dyslexia occurred more often in boys than in girls, current research indicates that it affects boys and girls equally.

A young person with dyslexia may:

Struggle with learning even simple rhymes

Have a speech delay

Have trouble following directions

Repeat or omit short words such as and, the, but

Find it difficult to tell left from right

In school, children with dyslexia are likely to:

Have difficulty sounding out new words

Lack fluency compared to other children their age

Reverse letters and numbers when reading (read saw as was, for example)

Find it difficult to take notes and copy down words from the board

Struggle with rhyming, associating sounds with letters, and sequencing and ordering sounds

Stumble and have difficulty spelling even common words; frequently they will spell them phonetically (hrbr instead of harbor)

Avoid being called on to read out loud in front of classmates

Become tired or frustrated from reading

Dyslexia affects children outside of school as well. Kids with dyslexia may also:

Find it difficult to decode logos and signs

Struggle when trying to learn the rules to games

Have difficulty keeping track of multi-step directions

Struggle with getting the hang of telling time

Find it especially challenging to learn another language

Become incredibly frustrated, which can effect their mood and emotional stability

Social and emotional impacts of dyslexia

Dyslexia affects a lot more than reading - it can also impact a child socially. "A dyslexic person who has word-finding difficulties can have trouble with their expressive language," says Scott Bezsylko, the executive director of Winston Preparatory School, which specializes in teaching kids with learning disorders. "That has a social impact, in addition to your difficulties with reading and writing, that make you feel not so good about yourself."

Kids with dyslexia - particularly those who have yet to be diagnosed - often suffer from low self-esteem because they worry that there is something wrong with them, and are often accused of not trying hard enough to learn to read. "A lot of our work with dyslexic kids is to help them rediscover that they are smart and capable," notes Beszylko, "because they've stopped believing in themselves."

How is dyslexia diagnosed?

If your child isn't meeting expectations for reading, as parents you can ask the school district to perform an evaluation and share the results with you. The evaluation will test your child's intellectual capacity and reading skills, to see if there is an achievement gap. It should also rule out other potential causes like environmental factors or hearing impairment.

The school should then make recommendations on how they can support your child and maximize her learning.

If you are unhappy with the quality of the evaluation, you can also secure a private evaluation by a psychologist, a neuropsychologist, a reading specialist, a speech and language therapist, an educational evaluator or a school psychologist. This external evaluation can also be used to advocate for your child and get the accommodations and services she might need.

When should a child be evaluated?

Dyslexia can begin to reveal itself at a young age, and there are preschool evaluations that look at the child's awareness of the sounds that make up words, and ability at word retrieval. However, Matthew Cruger, PhD, a clinical neuropsychologist at the Child Mind Institute, suggests waiting until kids are at least six years old and have had some formal instruction in reading to seek out a formal evaluation.

But Dr. Shaywitz notes that as soon as a gap between intelligence and reading skills is apparent - and evidence shows it can be seen in first grade - it's a good idea to get help. Schools sometimes encourage parents to wait until the third grade to see if their child truly needs an intervention, but Dr. Shaywitz argues that the earlier intervention is important not only to help kids catch up but to boost their fragile self-image, which is damaged by continuing struggle in school and comparisons with peers.

How to help kids with dyslexia

A dyslexia diagnosis does not mean your child will never learn to read. Dr. Cruger says there are a number of programs that can help, which might include these features:

Multi-sensory instruction in decoding skills

Repetition and review of skills

Intensity of intervention - that is, more than being pulled out of class once a week for extra help

Small group or individual instruction

Teaching decoding skills

Drilling sight words

Teaching comprehension strategies, to help kids derive meaning from what they're reading

Reading programs that been shown to help kids with dyslexia include:

Dr. Cruger points out that traditional tutoring may actually be counter-productive for a child with dyslexia, particularly if it is not a positive experience. "If the child hates the experience of reading help, it's not helpful," Dr. Cruger notes. "And it's not treating the source of the problem, the decoding weakness."

Instead, Dr. Cruger emphasizes that one of the most important ways to help kids with dyslexia is to make them more comfortable reading. This can be done in part by celebrating even small victories and accomplishments, while focusing less on correcting their errors.

Accommodations for kids with dyslexia

Kids with demonstrated dyslexia are eligible for accommodations in school. "Dyslexia robs a person of time," Dr. Shaywitz explains, "and accommodations give the time back to her." Accommodations may include:

Extra time on tests

A quiet space to work

The option to record lectures

The option to give verbal, rather than written, answers (when appropriate)

Elimination of oral reading in class

Exemption from foreign language learning

Other ways to support a child with dyslexia

One of the best ways to support a child with dyslexia - or any child who is struggling - is to encourage those activities that they like and feel good at, whether it is music, joining a sports team or anything else that helps build her confidence.

To help reinforce that dyslexia is not a marker of intelligence, it can also be helpful to talk about successful people - like Whoopi Goldberg and Steven Spielberg - who have also been diagnosed with dyslexia.

Other things that may help your child with dyslexia include:

Listening to audio books as an alternative to reading

Typing on a computer or tablet instead of writing

Apps that can make learning fun by turning decoding into a game

Using a ruler to help kids read in a straight line, which can help keep them focused

Emotional support

Dyslexia can result in frustration, embarrassment, avoidance and low self-esteem as a result of difficulties performing tasks that seem to come naturally to others. Demystifying the learning disorder with your child can help him develop the tools - and resilience - necessary to manage it, both in school and in social circumstances. Some things you can do to help include:

Discuss the specific challenges that result from dyslexia: "You know how you have a hard time reading signs or copying notes from the board? That's dyslexia."

Acknowledge their effort and celebrate hard work, even if there are still mistakes: "I know how difficult that reading homework was. I am so proud of how hard you tried."

Help them recognize their strengths: "You showed such great sportsmanship and teamwork in the soccer game the other night, and that was a great goal you scored!"

Combat negative self-talk: If your child starts saying things like, "I'm just stupid," don't ignore it. Instead, check out these ideas for helping kids who are too hard on themselves.

Frequently Asked Questions

How does dyslexia work?

How common is dyslexia?

What helps students with dyslexia?

What are the signs of dyslexia?

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Understanding Dyslexia - Child Mind Institute

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Find out how to recognize dyslexia, the most common learning disability. The Child Mind Institute on how to help kids who have trouble learning to read.

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Symptoms
Diagnosis
Managing dyslexia
Types of dyslexia

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Dyslexia is a learning difficulty that impairs a person's ability to read and write.

Dyslexia involves the ways that the brain processes graphic symbols and the sounds of words. It commonly affects word recognition, spelling, and the ability to match letters to sounds.

While it is a neurological condition, dyslexia has no relation to intelligence.

Dyslexia is common. Some experts believe that 5-10% of people have it, while some others estimate that the prevalence is 17%.

Receiving a diagnosis, guidance, and support from an early age can help reduce the impact of the condition.

This article will take a close look at dyslexia's causes, symptoms, and management in children and adults.

Dyslexia affects the way that the brain processes written materials, making it more difficult to recognize, spell, and decode words.

The effects of dyslexia vary from person to person. People with the condition generally have trouble reading quickly and reading without making mistakes. They may also have trouble understanding what they read.

Dyslexia is a neurological issue, and it can run in families. It is not the result of poor teaching, instruction, or upbringing.

While it can be challenging, almost everyone with dyslexia can learn to read if they receive the right instruction.

Throughout early 2018, 33 legislative bills relating to dyslexia were introduced in the United States. This reflects the fact that government organizations are recognizing the need for early intervention to support children with dyslexia.

People with dyslexia are most likely to receive a diagnosis as children or young adults.

Adults who receive this diagnosis have usually had the condition their whole lives. However, a person can acquire dyslexia because of a brain injury.

If a parent, guardian, or teacher suspects that a young person has dyslexia, they should ask about a professional evaluation. The school may be able to help. An early diagnosis is more likely to lead to effective management.

Receiving a dyslexia diagnosis may open the door to more support for the child or adolescent. They may become eligible for special education services, support programs, and services in colleges and universities.

According to the International Dyslexia Association, diagnostic evaluations often cover the following areas:

background information, including family history and early development

intelligence

oral language skills

word recognition

fluency skills

reading comprehension

vocabulary knowledge

decoding, or the ability to read new words using letter-sound knowledge

phonological processing, or how the brain processes the sounds of words

During the assessment, the examiner will aim to rule out other conditions that can have similar symptoms. Examples include vision problems, hearing impairment, a lack of instruction, and social and economic factors.

People can show symptoms of dyslexia at any age, but they tend to appear during childhood.

Dyslexia can cause challenges that involve:

Reaching development milestones

Children with dyslexia may learn to crawl, walk, talk, and ride a bicycle later than their peers.
Learning to speak
A child with dyslexia may take longer to learn to speak. They may also mispronounce words, find rhyming challenging, and appear not to distinguish between different word sounds.
Learning to read
This difficulty can present as early as in preschool. A child may find it difficult to match letters to sounds, and they may have trouble recognizing the sounds in words.

Dyslexia symptoms can also arise when young people start learning more complex skills. For example, the condition can cause difficulty with:

grammar

reading comprehension

reading fluency

sentence structure

in-depth writing

Caregivers and teachers may notice that a child is reluctant to read - they may avoid situations that require it.
Learning to write
On paper, a person with dyslexia may reverse numbers and letters without realizing it.

Also, some children with dyslexia do not follow expected patterns of learning progression. For example, they may learn to spell a word and completely forget the next day.
Processing sounds
If a word has more than two syllables, processing the sounds can become much more challenging. For example, in the word "unfortunately," a person with dyslexia may be able to process the sounds "un" and "ly," but not those in between.
Sets of data
Children with dyslexia may take longer to learn the letters of the alphabet and how to pronounce them. They may also have trouble remembering the days of the week, months of the year, colors, and some arithmetic tables.
Coordination
A person with dyslexia may be less coordinated than their peers. For example, catching a ball may be difficult, and they may confuse left and right.

Reduced hand-eye coordination can also be a symptom of other, similar neurological conditions, including dyspraxia.
Concentration
People with dyslexia often find it hard to concentrate. This may be because, after a few minutes of struggling to read or write, they feel mentally exhausted.

Also, compared with the general population, a higher number of children with dyslexia also have attention deficit hyperactivity disorder ( ADHD).

According to some estimates, 30% of those with dyslexia also have ADHD, compared with 3-5% of the general school population experiencing both conditions.
The sequence of ideas
A person with dyslexia may express ideas in a sequence that, to their peers, seems illogical or unconnected.
Autoimmune conditions
People with dyslexia are more likely to develop autoimmune conditions, such as seasonal allergies, asthma, and eczema.

There is no cure for dyslexia, but a range of approaches can help make daily tasks much easier.

Dyslexia affects each person differently, and most people find ways to accommodate their learning differences and thrive.

Receiving a diagnosis and support early in life can have long-term benefits. Managing dyslexia in children may involve:

An evaluation of individual needs: This helps teachers develop a targeted program for the child.

Adapted learning tools: Children with dyslexia may benefit from learning tools that tap into their senses, such as touch, vision, and hearing.

Guidance and support: Counseling can help minimize any effects on self-esteem. Other forms of support may involve, for example, granting extra time on exams.

Ongoing evaluation: Adults with dyslexia may benefit from help with developing evolving coping strategies and identifying areas in which they would benefit from more support.

It can also help to adapt any working or learning space. Find some homework station ideas here.

The Yale Center for Dyslexia and Creativity offers tips for studying with dyslexia. They include:

employing time management strategies such as breaking up projects into smaller pieces and drafting an outline before starting a task

using tools such as flash cards and text-to-voice technology

organizing notes visually, using highlighters or a color-coding system

working in a quiet, clear space - with earplugs or noise-canceling headphones if necessary - and keeping distractions to a minimum

Researchers are unsure why some people develop dyslexia.

There appears to be a genetic link, because dyslexia runs in families. Some researchers have associated changes in the DCDC2 gene with reading problems and dyslexia.

While the vast majority of people with dyslexia have it from birth, it is possible to acquire it, usually due to a brain injury or stroke.

A person's native language can influence their experience of the condition. It may, for example, be easier for a person with mild-to-moderate dyslexia to learn a language with clear connections between the written form and its sounds and with consistent grammar rules - such as Italian or Spanish.

Languages with words that have unclear connections between the written forms and their sounds - such as "cough" and "dough" in English - can be more challenging for a person with dyslexia.

The symptoms of dyslexia change with age. Below, learn how the condition presents at different stages of life.

Before children enter school, they may show:

delayed speech and vocabulary development

difficulties in forming and choosing words, for example, by mixing up words with similar sounds

problems retaining information, such as numbers, the alphabet, and the names of colors

When children are school-aged, they may:

have a low reading level for their age group

have difficulties processing information and remembering sequences

have trouble processing the sounds of unfamiliar words

take longer with reading and writing

avoid tasks that involve reading

Teens and adults may:

have difficulty reading aloud

take longer to read and write

have trouble with spelling

mispronounce words

have trouble recalling words for particular objects or topics

have difficulties learning another language, memorizing text, and doing math

find it hard to summarize a story

Read more about dyslexia symptoms by age and dyslexia in adults here.

There are currently no official diagnostic "types" of dyslexia, though researchers are looking into the groups of symptoms that some people experience.

Overall, identifying an individual's specific challenges can help them get the right support. Some people experience:

Phonological dyslexia: Also known as dysphonetic or auditory dyslexia, this involves having difficulty breaking down words into smaller units, making it hard to match sounds with their written form.

Surface dyslexia:Also called dyseidetic or visual dyslexia, this involves having trouble recognizing words by sight, making words hard to learn and remember.

Rapid naming deficit: This involves having trouble naming a letter or number when the person sees it.

Double deficit dyslexia: This involves having difficulty isolating the sounds to name letters and numbers.

Sometimes people also refer to "directional dyslexia," meaning that they have difficulty telling left from right. This is a common feature of the condition.

If a person has difficulty with numbers and math, specifically, the medical term for this dyscalculia. It sometimes occurs with dyslexia or independently.

Dyslexia is a learning difference that creates challenges to reading and writing.

Though there is no cure for dyslexia, many approaches and tools can help facilitate everyday activities.

Everyone with dyslexia experiences the condition differently, but with the right support, people with the condition can excel like people without it. Read some personal success stories from The Yale Center for Dyslexia and Creativity here.

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Dyslexia: Symptoms, treatment, and types

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Dyslexia is a learning difficulty that impairs a person's ability to read and write. Dyslexia involves the ways that the brain processes graphic symbols and the sounds of words. It commonly affects word recognition, spelling, and the ability to match letters to sounds. While it is a neurological condition, dyslexia has no relation to intelligence.