Title: Dyslexia
1Dyslexia
- Teaching students with receptive and expressive
language impairments in the oral and written
language modalities
2Contents
- 1. What is Dyslexia?
- 2. Identification, diagnoses and treatment
considerations? - 3. What are some ways to approach treatment?
- 4. Answering questions
3Definition
- Dyslexia is defined by the National Institution
of Health (NIH) as a brain-based type of
learning disability that specifically impairs a
person's ability to read. - In general, most individuals with dyslexia
- Typically read at levels significantly lower than
expected despite having normal intelligence. - Dyslexia is often referred to as a language based
learning disability. - Individuals with dyslexia usually have difficulty
with either receptive oral language skills,
expressive oral language skills, reading,
spelling, or written expression.
4Research Based Facts
- Dyslexia is the most researched of all learning
disabilities. - Dyslexia affects at least 1 out of every 5
children in the United States. - Dyslexia affects as many boys as girls.
- Dyslexia is the leading cause of reading failure
and school dropouts in our nation. - Reading failure is the most commonly shared
characteristic of juvenile justice offenders.
5Characteristics
- It is characterized by difficulties with accurate
and/or fluent word recognition, and by poor
spelling and decoding abilities. - These difficulties typically result from a
deficit in the phonological component of language
that is often unexpected in relation to other
cognitive abilities and the provision of
effective classroom instruction. - Secondary consequences may include problems in
reading comprehension and reduced reading
experience that can impede growth of vocabulary
and background knowledge.
6Question 1 Can you be a little or a lot
dyslexic?
- Dyslexia varies in degrees of severity.
- The prognosis depends on the
- severity
- specific patterns of strengths and weaknesses
- appropriateness of the intervention
- It is not a result of lack of motivation, sensory
impairment, inadequate instruction, environmental
opportunities, low intelligence, or other
limiting conditions. It is a condition which is
neurologically based and often appears in
families. - Occasionally, dyslexia can be misdiagnosed when
vision deficits are involved.
7Question 2 Is it spectrumish?
- This question leads to the discussion of
emotional/behavioral consequences of reading
deficits. - Other disorders that may co-occur include
- Attention deficit disorders
- Autism spectrum disorders
- Auditory processing deficits
- Seizure disorder
- Children with Language Learning Differences
(multilingual backgrounds) may also have dyslexia - Others
8Question 3 Is dyslexia hereditary?
- Answer Some forms of dyslexia are highly
heritable. -
- (Excerpt of an article in the American Journal
of Psychiatrypublished in December 2008on
www.ajp.psychiatryonline.org)
- Dyslexia Susceptibility Gene
- The results of this study both support the
role of K1AA0319 in the development of dyslexia
and suggest that this gene influence reading
ability in the general population. Moreover, the
data implicate the three-SNP haplotype and its
tagging SNP rs2143340 as genetic risk factors for
poor reading performance.
92005-2008 Research Highlights
- Dyslexic children use nearly five times the
brain area as normal children while performing a
simple language task (2005) (e.g., Detour to MP)
- Dyslexia may be caused by disorganized,
meandering tracts of nerve fibers in the brain
making it difficult to integrate the information
needed for rapid, automatic reading. (2007) - Key areas for language and working memory
involved in reading are connected differently in
dyslexics (2007) - Intensive remedial instruction resulted in an
increase in brain activity in several cortical
regions associated with reading, and that gains
became further solidified during the year
following instruction (2008) - Once the children with dyslexia received an
intense and specialized instructional program,
their patterns of functional brain connectivity
normalized. (2008)
102008-2010 Research Highlights
- Preschool predictors of reading and writing
difficulties were identified in two contexts a
delayed ability to detect and process voices, and
slow naming of familiar, visually presented
objects (2008) - A moderate and stable relationship was found in
phenotypes between 4-year speech and language
scores and reading at 7, 9, and 10 years (2009) - Results support the notion that letter-speech
sound integration is an emergent reading skill
that develops inadequately in dyslexic readers,
presumably as a result of a deviant interactive
specialization of neural systems for processing
auditory and visual linguistic inputs. (2010)
11Conclusions
- Dyslexia is a brain-based disorder.
- Timing of connections have a significant affect
on processing language. - White matter in the brain can be altered. The
earlier this happens the better. - "Focused instruction can help underperforming
brain areas to increase their brain
proficiency." - Both genetic and environmental factors contribute
to the relationship between early language skills
and reading, whereas genetic factors play a
dominant role in the relationship between early
speech and reading.
12Early Intervention Begins in Preschool
- Individuals with dyslexia respond successfully to
timely and appropriate intervention. - Children as young as 4 1/2 can be diagnosed with
dyslexia. - Dyslexia is identifiable, with 92 accuracy, at
ages 5 1/2 to 6 1/2.
13Red Flags
- Begins with
- Poor expressive receptive language skills
- Poor listening, processing organizational
skills - Lack of print knowledge
- Poor phonological awareness skills
- But, often, it is spelling that separates kids
with dyslexia from kids who struggle with reading
for some other reason. - (See a list of additional red flags in the
addendum)
14Directionality
- Most dyslexic children and adults have
significant directionality confusion. - Left-Right confusion
- Even adults have to use whatever tricks their
mother or teacher taught them to tell left from
right. It never becomes rapid and automatic. - A common saying in household with dyslexic people
is, "It's on the left. The other left." - That's why they are b-d confused. One points to
the left and one points to the right. - They will often start math problems on the wrong
side, or want to carry a number the wrong way.
(e.g., Hannah) - Up-Down confusion
- Some children with dyslexia are also up-down
confused. They confuse b-p or d-q, n-u, and m-w.
15My kid reverses. Is he dyslexic?
- Confusion about directionality words
- First-last, before-after, next-previous,
over-under - Yesterday-tomorrow (directionality in time)
- North, South, East, West confusion
- Adults with dyslexia get lost a lot when driving
around, even in cities where they've lived for
many years - Often have difficulty reading or understanding
maps.
16Who can identify and diagnose?
- Anyone can identify a child with dyslexia
- Knowledgeable
- Informed
- Who can provide a diagnosis? Washington State DOH
indicates only licensed and trained - Physicians
- Psychologists
- Speech-language pathologists
17Why test for dyslexia?
- Why is an evaluation important?
- better understand the problem
- determine eligibility for special education
services in various states - also determine eligibility for programs in
colleges and universities - provide a basis for making educational
recommendations - determine the baseline from which remediation
programs will be evaluated
18The Numbers
- Very few children with dyslexia are in the
special education system. Only 1 in 10 will be
eligible for an IEP (when tested in second or
third grade) under the category of Learning
Disability (LD). - That means 9 out of 10 may "fall through the
cracks." Although the parents and the teacher
know there's something different about the child,
the child does not qualify for special education
services, and most will no longer get help from
the reading specialist after first or second
grade. - Dyslexia is not rare. It is the most common
reason a child will struggle first with spelling,
then with written expression, and eventually "hit
the wall" in reading development by third grade.
19Testing
- Individuals may be tested for dyslexia at any
age. - Tests which are selected will vary according to
the age of the individual. - Young children may be tested for phonological
processing, receptive and expressive language
abilities, and the ability to make sound/symbol
associations. - When problems are found in these areas
remediation can begin immediately. A diagnosis of
dyslexia need not be made in order to offer early
intervention in reading instruction.
20Treatment Considerations
- Acquisition of letters and their sounds for
reading and writing typically mirrors
developmental norms for speech sound acquisition - When youre choosing materials and what to focus
on with an individual, keep this at the forefront - (See normative data chart in addendum)
-
21Phonological Awareness
- Broader ? Narrower (top down)
- Identify
- Use
syllables in spoken words
onsets rimes in spoken syllables
individual phonemes in words spoken
oral rhymes
cup, sup, tup
cupcake cup cake
cup c up
cup c u p
22Phonemic Awareness
- Increases word reading ? increases reading
comprehension - Increases reading fluency
- -through blending
- Increases strategies for accurate spelling
- -via segmenting
- -predictable relationships
23Sound Segmentation
- Sentence segmentation nursery rhymes, famous
songs, etc. (only if they can interpret
information at this level) - Word segmentation
- Syllable segmentation
- Phoneme segmentation
- Count how many sounds you hear in the word
boat. Remember to sound them out! not, How
many sounds are there? - b-o-t boat
- What sound does letter B say? Or B says /b/ but
help them distinguish between the name of the
letter and the actual sound it makes. The answer
is not bee, it is /b/. - How many sounds do you hear in B? (2?, 1?) vs.
How many sounds does letter be make/say? (1? 2?) - Help the students identify and catalog how many
sounds certain letters make and in what
combinations (e.g., What letters spell /i/ or
/ai/?) - Continue teaching letter names vs. sounds letters
make for CV, CVC, CVCV, CCVC, and CVCC words
24SLPs building strong phonemic awareness skills
- Identifying sounds
- Start with counting the number they hear in a CVC
word, then contrast with CV or VC - If they arent getting it, I often go to How
many sounds do you hear in the letterM? - /m/ or e-m /k/ or k-ay
- Do for first, middle and last sounds within words
(e.g., Tell me the first sound you hear in cat)
/k/ - Isolating sounds
- (e.g., Say cat without saying at) /k/
- Try manipulables (pompoms, colored squares, etc.)
for support take away to increase the demand
25SLPs building strong phonemic awareness skills
- Categorization of sounds
- Choppers (ch, j), poppers (t, d, k, g), air
sounds (s, f, v, sh, zh), lip sounds (m, p,
b, w), tongue sounds (l, r) - Blending sounds
- Im going to tell you some sounds that make a
word. What word can you make with these? - /a/-/t/ at
- Onsets/rimes
- CV, CVC, CVCe, CVCV, CCVC, CVCC, CVCVC and so on
26Deletion Addition
- Sentence level (when they are reading sentences)
- Try working with adjectives and adverbs (e.g.,
He ran softly and quickly.) - Phrase level (when they are reading phrases)
- Name Game Mad Libs, fill in the blank (e.g.,
auditory closure tasks), wacky words (combine 2
juxtaposed words in a silly phrase) - Word level TYPICALLY, I START HERE
- Syllables
- Compound words (cowboy, cupcake, pigpen)
- Try using affixes (-er, pre-, re-)
27Deletion Addition
- Phoneme deletion (initial, medial, final
positions and consonant clusters) - Say cup with out saying /k/.
- Say tired without saying /d/.
- Phoneme addition
- Incorporate morphology instruction (-s, -es,
-ing, -ed) - Add /s/ to the beginning of top it becomes
- Add /t/ to the end of goes, it becomes
28Substitutions
- Word substitution (the name game)
- Alicen Lea Burke
- Change Lea to Fizzle
- Now change Burke to Pop
- Syllable substitution (the other Name Game)
- Phoneme substitution
- Say hat. Now, change the /h/ in hat to a /s/.
- Sentence and Phrases can be addressed later
29Building Strong Skills
- Work on only one or two targets with individuals
at a time. - Work through a hierarchy for each target.
- When theyve mastered all the domains, you should
be able to have them mix 2 domains, 3, and then
all in any order. They will not achieve
independence until they effectively master
multiple targets at once. - Language use/presentation is key to helping them
understand!
30Setting Them Up for Success Through Specific
Language Use
- The obscurity of the letter name and the sounds
letters make - What sound does B make? vs. What sound does
letter B say? - Bee or /b/?
- Letter B says, /b/.
- How many sounds are there in the word bush?
How many sounds do you hear in the word bush? - b-u-sh bu-sh b-u-s-h
31Common Errors
- When confusion of letter name vs. phonemes heard
is not corrected at the sound level, it will
continue to confound the young reader and writer
at higher linguistic levels. (e.g., fractions) - Compensatory strategies adopted by the student
- Using knowledge about the context of the content
to guess - Using reasoning skills to guess more accurately
- Searching their environment for clues
- Guessing (random or methodical)
- Consequence Students often start off behind in
spelling and later in reading comprehension and
fluency.
32Teach Awareness Strategies
- Start out teaching rhyming with long, familiar
words instead of short ones (e.g., peanutbutter) - Vowel pacing board with explicit teaching
- Provide tactile cues if needed when segmenting
- Consonants vs. vowels identification
- Chart sound families (use like a dictionary)
- Chart word families as they progress through
levels - Chart common letter sequences within words,
affixes in English (e.g., ng, str)
33Hierarchical Support Systems (e.g., Words Their
Way)
- Use a hierarchy of support to ensure success.
- Explicit teaching
- Identification
- Matching
- Sorting
- Sequencing
- Fill in the blank
- Independent
- Give consistent, intermittent positive feedback!
34More
- Student to identify and chart hard words are
there trends? - Visualizing Does it look funny?
- Choral reading (let students lead?)
- Keep a vocabulary list of new words define them
on 3X5s for early study habits and games (e.g., - Arrange by letter/sound
- Arrange by category
- Parts-of-a-whole
- Sound segmentation
- Include gross motor movement during reading and
spelling - Involve the cerebellum! Use jump rope, Chinese
jump rope, Mother May I, Simon Says, word
pop-ups, sound pop-ups, four square, hopscotch,
Hullaballoo)
35Management and Accommodations
36Procedures for Referral at Sunnycrest
- If its speech only refer to the SLP
- If its language in any form, refer to the team
- If its highly likely the child will not qualify
and you dont think its worth it to refer to
the team, use your resources and talk to the
parents about self-referral for literacy
assessments.
37Questions you asked
- Is it hereditary?
- Is it spectrumish?
- Can you be a little or a lot dyslexic?
- What are the red flags that we should be looking
for? - "My kid reverses b/d or some other letters and
numbers. Does that mean they are dyslexic?" "My
kid will be reading words like "was" and say
"saw" instead. Do they have dyslexia?" - When are children typically diagnosed with
dyslexia? - Is there a window of opportunity for
intervention, or can it be addressed at any age? - Can it be confused with other disabilities or can
a professional confidently diagnose it? - Where can they be tested?
- What can teachers do to help a student with
dyslexia that is not succeeding in the regular
ed. classroom, but does not qualify for special
ed. services? - Are there research based interventions that work
for everyone? - What resources are available from the Lake
Stevens School District for the classroom teacher
to aid in the teaching of a dyslexic child? What
can we do in the classroom to provide help? - Are there good resources out there that we can
let parents know about?
38Resources
- Seattle/King County
- Hearing Speech and Deafness Center (HSDC),
Seattle Branch (Noreen Bucknum, MA, CCC-SLP) - UW and possibly WSU run summer literacy camps
- Commercial programs
- Snohomish
- SLPs, SPED teachers in LSSD
- Local research based programs
- Language to Literacy Program, provided at HSDC
(BSHC) - Julie Sewalds early intervention Tutorial
Program
39References and Citations
- Keller Just (2009). Altering cortical
connectivity Remediation-induced changes in the
white matter of poor readers. Accessed from
http//www.ncbi.nlm.nih.gov/pubmed/20005820 - Bright Solutions for Dyslexia, Inc.
http//www.dys-add.com/symptoms.html. Accessed
April, 2010. - Marshall Messaoud-Galusi (2010). Disorders of
language and literacy Special issue. Accessed
from http//www.ncbi.nlm.nih.gov/pubmed/20306622 - Blau, V., Reithler, J., van Atteveldt, N.
Seitz, J., et al. (2010) Deviant processing of
letters and speech sounds as proximate cause of
reading failure A functional magnetic resonance
imaging study of dyslexic children Journal of
Speech, Language, and Hearing Research Vol.53
311-332 April 2010. doi10.1044/1092-4388(2009/07-
0145) Accessed from http//www.ncbi.nlm.nih.gov/p
ubmed/20061325 - Mayo Clinic dyslexia information page. Mayo
Clinic. http//www.mayoclinic.com/health/dyslexia/
ds00224/dsectionsymptoms. Accessed April, 2010. - NINDS dyslexia information page. National
Institute of Neurological Disorders and Stroke.
http//www.ninds.nih.gov/disorders/dyslexia/dyslex
ia.htm. Accessed April, 2010. - What are the signs of dyslexia? International
Dyslexia Association. http//www.interdys.org/Sign
sofDyslexiaCombined.htm. Accessed April, 2010. - Catts Kamhi (2005). Language and Reading
Disabilities. (Ed. 2). Boston, MA Pearson, Inc.