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THE LEARNING DISORDER CALLED DYSLEXIA
by Ernest J. Bordini, Ph.D., Licensed Psychologist
previously published in Gainesville Parents Magazine
all rights reserved
Dyslexia
is a term for a brain based difficulty in reading now simply called a
“Reading Disorder.” It is one of many disorders referred to as Learning
Disorders in the DSM-V, a manual often used for diagnosis. The DSM-5
indicates a Learning Disorder exists when a score on an individually
administered achievement test of reading, writing, or mathematics is
substantially below expectations for age, schooling, and level of
intelligence.
Dyslexia is a relatively common disorder (2-10%)
and is likely hereditary in many cases. Perinatal injuries, medical
disorders, lead poisoning, fetal alcohol syndrome, and chromosomal
abnormalities have also been associated with learning disorders. Reading
disorders are more common in males (3-4 males : 1 female).
Learning
disorders typically do not resolve. Many children with learning
disorders will experience difficulties which will pose challenges
throughout their academic and occupational careers. The impact on
achievement, motivation in school, peer relationships, and self -esteem
is often significant.
DSM-V reports that the dropout rate for
children with learning disorders is 1.5 times the average. Adults with
Learning Disorders often experience social and occupational
difficulties.
Reading disorders are likely due to very subtle
brain difficulties in processing visual and/or auditory material.
Children may have difficulties with the visual and scanning aspects of
reading. They may have difficulty in the phonological or “sounding out”
aspects of reading. Children with combinations of both or multiple
difficulties often exhibit the most severe reading difficulties.
Reading
is a complex process. In order to read well, one must quickly be able
to appreciate the small differences which distinguish letters. The
reader must then automatically scan and translate groups of these visual
images (graphemes) into their auditory representations (phonemes).
These phonemes then need to be efficiently blended into words. Then the
words need to be recognized and understood. Visual clues indicating
where words and sentences start and stop must be processed. Rules of
grammar must also be understood for accurate comprehension.
Many
children with reading difficulties are identified early through the
school system. Teachers are often good at recognizing what is typical at
a given age. Brighter children may 'power' their way through early
reading demands using their intelligence to assist their reading. Many
children are referred for further diagnostic testing when large
differences between skills are seen on standardized group tests
conducted by schools.
Many if not most children with reading
disorders will also exhibit writing difficulties. For some children
reading and writing difficulties may be part of a general language
disorder. These children may be very good at putting puzzles together,
building things or drawing but my not be very verbally communicative.
Some children with reading difficulties may also have attention
problems. This may compound the reading difficulty by reducing
frustration tolerance, the ability to pay attention for
sufficient periods of time, and the ability to sit still and focus.
The
diagnosis of a learning disorder entitles the child to special
services. Special services are geared to provide a 'f free and
appropriate education in the least restrictive environment. Special
resource class and a modified curriculum are often available. Some
children require accommodations. In later grades and college some of
these children may qualify to have tests read to them, extra time for
reading assignments, or " be able to utilize books on tape.
The
school system and government establish criteria which are used to
qualify a child. A difference of at least 1 to 11 standard deviations
(usually about 15 points on the most common tests) between an IQ score
and a reading score is usually required.
Diagnosis requires
individual administration of a standard IQ tests such as the Wechsler or
Stanford-Binet. Individual administration of achievement tests such as
the Wechsler or Woodcock Johnson Achievement tests are also necessary.
Evaluations are performed by a licensed psychologist or school
psychologists. Parents may obtain their own independent evaluation and
to have this information considered in the determination by the school.
Accurate
diagnosis is essential for an effective treatment plan. Appropriate
testing is often time consuming. Unfortunately, insurers often do not
provide for private diagnostic or treatment services for these
neurodevelopmental disorders. Services are often denied since they am
“educational in nature.” Evaluators vary in experience and costs are
often determined by how limited or comprehensive the testing is.
Educators, family physicians, and pediatricians often can provide the
names of psychologists who have expertise in providing these
evaluations.
Once diagnosis is made, an Individual Education Plan
(IEP) is created for the child. The IEP is subject to approval by the
parents. This may involve extra assistance and instruction by a learning
specialist, speech and language therapy if necessary, use of a resource
class, or in more severe cases full-time placement in a resource class.
Schools systems often have a description of rights and accommodations
for learning disabled and ADHD students available through their
Exceptional Student Education departments.
Children with greater
verbal than visual strengths may benefit more from phonological reading
approaches. Children with visual processing strengths may benefit from
'sight' reading approaches.
Multidisciplinary programs often
involve intensive individual assessment, therapy, individual and small
group instruction. Area multidisciplinary programs include the
Ross-Mercer Clinic at the University of Florida and the Morris
Development Center in Gainesville. AGC Therapy Centers also offers
multidisciplinary approaches for learning disorders. Some children with
milder reading difficulties can be aided by programs in the region
catering to their particular needs.
Dr. Mel Levine, pediatrician
with interests in learning disability has authored excellent books for
professional, teachers, and students. Dr. Levine has stressed the
importance of early help for learning disorders while establishing
islands of competence. He recommended creating areas of expertise by
encouraging and developing the child's natural strengths and interests.
These islands can help bolster self-esteem and reduce frustration when
tackling a developmental new tasks.
References:
American Psychology Association, Diagnostic and Statistical Manual of Mental Disorders - Fourth Edtion. 1994
Levine,
Melvin Education Care System for Understanding and Helping at Home and
in School, Educators Publishing Source Cambridge, Mass 1994
Ernest
J. Bordini, Ph.D. is a Licensed Psychologist and the Executive Director
of Clinical Psychology Associates of North Central Florida |
