Dyslexia (Reading Disorder)

The most important gateway to learning is through the eyes. The eye receives the image; then through an extended path in the brain, a concept develops in the frontal lobe. Letters become words, and words have meaning. Vision is an effective tool in learning.

A significant number of children derive no meaning from letters and words and are unable to read. “In some school districts as many as 15 percent of the students are two grades or more behind in their reading abilities.” The logical and first deduction in the minds of bewildered, distraught parents and worried teachers is that vision must be defective. Usually, the first referral of a dyslexic child is to the eye physician. For this reason a brief discussion of dyslexia is placed in this article.

Dyslexia is a complex problem. Only recently has intensive study been devoted to understanding its complexity. No one specialist is involved exclusively.

“Dyslexia is a specific inability to read well or understand printed symbols in an otherwise normal individual.” This definition deserves attention because it presents the essence of present-day interpretation for reading disorders, as offered by many authorities. Another definition is: “A difficulty in reading understanding due to a central lesion. By a central lesion we mean a neurological deficit in the area of the brain which perceives an image. The problem is one of immature development in the brain.

Secondary dysslexias (“secondary” meaning the result of or owing to) may occur from such factors as: (1) brain damage, as seen with cerebral palsy or mental retardation; (2) emotional disturbances, anxiety, depression; (3) hyperactivity with its short attention span; (4) environmental conditions: (a) limited social opportunity, cultural and economic deprivations with poor exposure to language, knowledge, and reading, (b) poor motivation, and (c) poor instruction. This outline merely suggests possibilities and is not comprehensive.

Some children are slow readers because of visual or auditory handicaps or poor health.

What is to be done a dyslexic child? How does a teacher proceed? What counseling is given a bewildered parent?

First, a diagnosis must be established. No one specialist cares to make a decision alone on a diagnosis and management. Skilled teamwork is required. A start must be made. Possibly, an established procedure has been organized in a school system or community. If not, since dyslexia is not an unusual disorder, a plan should be developed. Many disciplines are involved. The specialists on a team to evaluate the dyslexia in a child should include a pediatrician or family physician, a neurologist, a psychologist and, if necessary, a psychiatrist, an eye physician, an otologist, and the teacher. The latter may be the classroom teacher who reports on his observations and the academic performance of the child. Or, he may be form the area of special education. If problems of speech need to be considered, a specialist in this field is consulted. A school worker or school nurse may be asked to describe the home environment. This team should think and work together and know the contribution that each can bring to the diagnosis and management of the dyslexia. The parents must understand the steps which are being taken and can give invaluable information on health history and behavior.

The steps are these. Eyes are examined. A dyslexic child may suffer from a refractive error or muscle imbalance of the eyes. Rarely would a visual handicap produce dyslexia. Nevertheless, the examination must be made and necessary corrective procedures instituted. Hearing must be evaluated. A complete health examination by a pediatrician or family physician should be followed by a neurological study to determine whether an organic brain lesion exists. A child may not display any gross neurological disturbances, such as spasticity or odd behavior patterns; therefore, a careful study is indicated Potential academic achievement must be measured, Emotional maturity must be considered.

In brief, every facet of the dyslexic child’s physical, emotional mental, and environmental being must be scrutinized. This represents coordinated effort. Once the child is taken by a parent for consultation, one medical specialist, perhaps the pediatrician or eye physician or someone who is interested in dyslexia, should institute investigations and confer with all the specialists involved. He may even gather them all together for a round table discussion. Hopefully, he finally should formulate a diagnosis.

After a diagnosis is made, a schedule should be planned. All those involved in the management of the youngster at home and at school need to be familiar with the conclusions reached and suggestions for the improvement of the child and his dyslexia. One added observation in this: the team which studied the dyslexic child should continue to function and watch his progress over the years. This is a large order, but if one medical specialist is devoted to this problem, continuing interest is possible, and the results are worthwhile.

To summarize: Once a teacher recognizes a dyslexic child, early diagnosis and early treatment should be the goals. Responsibility for early detection lies primarily with the elementary teacher. A child is more likely to become a normal reader if careful remedial therapy is started in the second grade rather than a year later. Ninety percent of these children have learning disabilities to varying degrees in other areas, most commonly spelling and arithmetic. Spelling usually gives the most trouble.

Once the cause of the dyslexia for an individual child is determined and corrective health measures, e.g., glasses or hearing aid, are instituted, the final step is educational. When indicated “a good remedial therapist who is usually a teacher with special education background, learns what is needed as he works with the child and draws out of this knowledge special techniques for that child. There is no one method or one book, because there are no two children quite the same. You have to adapt the approach to what you see and feel in that child, and then move along with him.”  

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Category: Eye Disorders