Bright Futures

Disabilities that affect reading

Different cultures have different names for objects. Think about a book. In French, we’d call this object “un livre.” In Spanish, “el libro.” In Japanese, a “hon.” These are different words from different cultures for the same object.

Word blindness. Strephosymbolia. Specific learning disorder with impairment in reading. Specific learning disability. Dyslexia. These are all ways that different groups of professionals and concerned parents describe the condition of a person who has significant difficulty reading. The names change, but the child, and the deficits, remain the same.

According to Arizona statute, “dyslexia” is a specific learning disorder. Like most people with significant reading problems, those with dyslexia struggle with spelling and accurate and/or fluent word recognition. They have trouble with phonics, which is key to understanding and decoding the sounds in a word. Many of these children have average cognitive abilities and receive adequate classroom instruction, so their reading problems are unexpected.

Dyslexia itself is not an eligibility category under federal law (Individuals with Disabilities Education Act, or IDEA). However, if your child with dyslexia requires special education and related services to access and make progress in the general education curriculum because of the specific learning disability, they would be eligible to receive services through an individualized education program (IEP). These definitions show that reading problems are language-based and not visual problems. Although early readers may confuse the letter/sound combinations of “b” and “d” or may read “was” as “saw,” these errors are not the result of seeing letters backward. These children can copy the letters and words correctly, but they struggle to name the letters or words.

Causes of learning disorders

A recent article by Jack Fletcher and others, published in American Psychologist, states that learning disorders are due to specific cognitive deficits related to brain function and genetics. The causes of significant reading problems are multiple, complex and not fully understood.

While reading problems tend to run in families, a large number of genes are involved, each producing a small effect. Multiple brain regions also are affected. Many scientists think that a “neural signature” for reading problems indicates that systems at the upper back of the left side of the brain aren’t working properly. These systems are used to “sound out” new words. There are also problems in another system, lower on the left side of the brain, that allows a child to recognize words right away and access their meaning. In addition, the parts of the brain directing attention are less active.

Processes for reading

Different cultures accomplish the task of reading in different ways. Reading from left to right. Reading from right to left. Reading vertically. Turning a sequence of papers bound together. Unrolling a scroll. These are ways that different cultures engage in the process of reading.

Different “cultures” of professions use different methods to determine who has a significant reading problem, such as:

• Close observation and clinical judgment
• Psycho-educational testing to reveal deficits in underlying processes, and sometimes “severe ability-achievement discrepancies”
• An uneven pattern of strengths and weaknesses
• Response to intervention

Unfortunately, given this variety, different “cultures” might come to different conclusions when each applies their own method to the same child. That’s one reason estimates of how many children have reading disorders vary so much, ranging from 5–17%. About 40% of individuals with word reading disorders also struggle with reading comprehension. 

Once your child is identified with a specific learning disability in reading, they can access special education through an individualized education program (IEP). After that begins, there is rarely any benefit from having another evaluation to learn if your child has dyslexia. Interventions designed for word reading problems are no different from those used for dyslexia, except that in Arizona, dyslexia may not qualify a child for special education.

Intervention for reading disorders

Reading skills are continuous. They don’t show two vastly different groups of people: those with reading problems and those without. 

Reading deficits are long lasting, not merely delays, especially if you don’t get help for your child. It may seem ironic that children with reading disorders are thrust into an alphabet soup. MDTs (multidisciplinary evaluation teams), LREs (least restrictive environments) and IEPs come to those with reading problems.

If a school determines your child has a specific learning disability, your child is likely to be eligible for free special education services. This will include expert instruction in small group settings. It could offer accommodations that recognize your child's cognitive challenges. Early intervention (prior to third grade) is most effective.

Fletcher and his colleagues identify some elements of effective intervention for struggling readers:

• Teach phonics clearly in a program that includes sight-word recognition, spelling, fluency, vocabulary knowledge and comprehension.
• Firmly establish connections between sounds and symbols:
  • Include cumulative review so that previously taught patterns become automatic.
  • Ensure that learning transfers from reading single words to competence in reading text by repeated exposure to words and word patterns in text.
• Use simple and direct language. Most students with learning disabilities have language deficits. All interventions must use short sentences and explain things simply and clearly.
• Extend duration and time on-task. For students with moderate problems, this may mean 40 minutes daily for 30 weeks and, for students who do not respond, two hours per day for 12 weeks.
• Monitor progress routinely. This helps teachers know when and how to make adjustments.
• See the word, say the word, write the word, use the word in text.
• Engage learners in reading at their actual reading level (not necessarily their grade level).

If your child continues to struggle, you may look for other ways to help. However, as Fletcher and colleagues point out, parents should be wary of any intervention that doesn’t provide these key elements. Programs that have little scientific support include those that focus on slowing down the speed of processing words, teaching working memory skills using computer games or teaching only cognitive processes.

As a parent, don’t let the school wait for your child to fail before taking action and getting your child the help they need. Also, beware of programs that don’t have research proving they are effective. Here are examples of controversial treatments that don’t have proven results:

• Auditory integration training, which involves repeatedly listening to certain sounds in order to learn to distinguish those sounds and pair them with meaning
• Optometric visual training, used to teach a child how to control their eyes and improve visual skills
• Tinted lenses or plastic overlays to filter out certain light waves and make words stand out
• Sensory integration therapy, used primarily to help children on the autism spectrum learn to use all their senses together to understand what behavior is expected and how they should respond
• Cerebellar-vestibular treatment to cure motion sickness and vertigo, which some believe can cause dyslexia and hinder the eye tracking needed for reading
• Dietary treatments encouraging a child to eat foods rich in healthy fats, fatty acids, iron and zinc, as well as recommending certain vitamin supplements
• Balanced literacy, which combines teacher-led instruction (guided reading and writing) with a child’s independent learning by studying words and reading alone

Working toward successful outcomes

There are many programs designed to help struggling readers. However, most experts agree that the specific program is less important than how it is delivered. Intervention should begin in the very early grades, and it should be explicit, individualized, intensive and increase time on task. This approach generally improves a child’s ability to recognize words and improve reading comprehension. This method could work well for your child.

Even with those improvements, reading fluency can lag behind. So, as a parent, you should help build your child’s resiliency. Model a growth mindset to teach your child that learning can be fun and positive results come from hard work and dedication. Your efforts at home – combined with the right intervention methods – will prepare your child to meet whatever challenges they may face in the future.