Dyslexia

Dyslexia is said to be a neurological disorder with biochemical and genetic markers. The popular definition for many years was that it is was a disability in which a person's perception is reversed or that a dyslexic sees things backwards and, therefore may read or write backwards. However this is no longer believed to be true. Now the popular conception of dyslexia may mean reading and/or writing ability is significantly low. One approach is to compare their ability to that which would be predicted by his or her general level of intelligence, but some would say that it is not certain that intelligence should be a predictor of reading/writing ability; and also that the causes, effects and treatments of reading disabilities may be similar for all levels of intelligence.

However, as has been discovered only in the last decade, individuals may read and write perfectly and still have dyslexia (see "characteristics" below), but this is disputed. Other contradictions are also said to exist among those diagnosed with dyslexia seeming to point to the fact that dyslexia is a highly complicated disorder. Neuroscientific, psychological, and educational research has just begun scratching the surface of what dyslexia truly is.

There are alternative definitions of dyslexia and much debate over the definition of dyslexia and how best to treat it. The British Psychological Society do not describe it as a mental condition or neurological disorder:

"It is very common to try and deal with dyslexia as if it is a mental condition, with one test and one feature but that is just not the case" [1].
The BPS do not link dyslexia with intelligence in their definition:

"Dyslexia is evident when accurate fluent word reading and or spelling develops incompletely or with great difficulty. This focuses on literacy learning at the 'word level' and implies that the problem is severe and persistent despite appropriate learning opportunitity"
"Learning difficulties of a Dyslexic nature are not defined by general ability as measured by IQ, but by cognitive processes under-pinning basic literacy. Learners representing a wide range of general ability and IQ can have dyslexic problems".[2]
The term was coined in 1884 by R. Berlin [3]. People are diagnosed as dyslexic when their reading problems cannot be explained by a lack of intellectual ability, inadequate instruction, or sensory problems such as poor eyesight. Because reading is a complex mental process, dyslexia has many potential causes. From a neurophysiological perspective, dyslexia can be diagnosed by close inspection of the morphology of the brain, usually upon autopsy. Dyslexia is also associated with phonological difficulties, such as enunciation.

Debate and Controversy
There is much debate and indeed controversy over the definition, cause and treatment of dyslexia. Here is an attempt to summarize some of the viewpoints expressed on the subject. Other parts of this article will discuss the correctness or otherwise of these viewpoints.

Viewpoint 1: 'Dyslexia is simply reading difficulty, and is also easily explained and cured'
This point of view is relatively uncommon among the general public and dyslexics themselves, but is said to be very popular among the scientific community involved with education - see the #References at the bottom on this article.

Cause: This point of view contends that:
Dyslexia is primarily caused by insufficient quality of education, both in the home (such as letting young children watch TV instead of reading nursery rhymes to them) and in the classroom (such as teachers using whole language and other novel teaching schemes to the exclusion of traditional Phonics).
There may be some genetic or hereditary factors or even nutritional factors that may modify a child's desire or ability to read, but they do not cause a problem which can't be fixed with a little early extra traditional education.
Reading and writing are fundamental basic processes that almost every human is perfectly capable of, along with speech and walking. :# Some say there may be very small group (<1%) of people who really do have severe difficulties with reading that can't be solved with traditional education, but this is not relevant to the diagnosis and treatment of the ~10% of people described as dyslexic today.
Treatment: This point of view contends that:
Traditional teaching methods are the only proven methods for teaching reading.
There is no scientific evidence that novel methods such as coloured glasses or physical coordination exercises have any effect.
While some children may require more help than others, including one-to-one tuition, they will be totally cured (as opposed to having learned to live with the condition).
Dyslexia amounts to nothing more than a delay in the learning process caused by a lack of quality education in the home and classroom.
Definition This point of view contends that the definition should be:
The term dyslexia, if it is to be of any use, should simply to be defined as those who currently have difficulty reading, regardless of its speculated cause.
The threshold separating dyslexics from non-dyslexics is entirely arbitrary.

Viewpoint 2: 'Dyslexia IS a neurological/mental disorder which affects about 10%'
This is the popular point of view, at least among the general public, teachers, and dyslexics themselves, however it's now coming under sustained attack. Its primary contention is that there is more to dyslexia than Viewpoint 1 states. i.e. It's not just bad teaching, and it's inborn to about 10% of the population.
Cause: This point of view contends that:
There are a number of factors including genetics, but there is more research to be done.
Dyslexia is inevitable from birth and is not related to the quality of traditional education given.
Dyslexia cannot be cured, only treated.
Those who are successfully treated are still in some sense 'different' than non-dyslexics who are at the same reading level. Perhaps in terms of brain structure or brain activity.
Dyslexic children are different from non-dyslexics even if they are at the same reading level as them.
Treatment: This point of view contends that:
Coloured glasses, exercising the eyes, physical coordination exercises can treat dyslexia.
The testimony of a person who is dyslexic is to be believed. This includes self-analysis of brain function, or discussing the success or otherwise of treatments.
Definition: This point of view contends that the definition should be:
Dyslexia is a distinct mental condition which affects reading and writing ability. It's defined in such as way as to include about 10% of the population.

Viewpoint 3: 'The term dyslexia is essentially useless and should now be made obsolete to avoid confusion'
Definition: This point of view contends that:
The current popular definition used by the general public ('Dyslexia IS a neurological/mental disorder') is entirely incorrect and useless. The definition used by the scientific community is totally different and therefore the term just breeds confusion. There may be a group (perhaps less than 1% of the population, not 10%) who have reading difficulties untreatable by traditional education, but we should not use the term 'dyslexia' for their condition, because it will cause confusion. New terms should be created for any verifiable conditions.

Variations and related disorders
Dyslexia is a learning disorder. Its underlying cause may be neurological in nature, but from there, the systems involved play out into visual, language, etc. FMRI (Functional Magnetic Resonance Imaging) has been used to demonstrate differences in the dyslexic brain patterns, but much research still needs to be done to apply this information.

In addition to the typical forms of dyslexia, there are numerous related disorders:

Auditory Processing Disorder is the cause of the phonological problems that many dyslexics experience, and causes problems in the auditory memory or working memory and this can cause some memory issues.
Semantic dyslexia - a form of dyslexia characterized by an inability to properly attach words to their meanings in reading and/or in speech.
Scotopic sensitivity syndrome - a form of dyslexia which makes it very difficult for a person to read black text on white paper, particularly when the paper is slightly shiny.
Dyspraxia - a neurological disorder characterised by a marked difficulty in carrying out routine tasks involving balance, fine-motor control, and kinesthetic coordination.
Verbal Dyspraxia - a neurological disorder characterised by marked difficulty in the use of speech sounds, which is the result of an immaturity in the speech production area of the brain.
Dysgraphia - a neurological disorder characterised by distorted and incorrect writing.
Dyscalculia - a neurological disorder characterised by a problem with learning fundamentals and one or more of the basic numerical skills. Often people with this disorder can understand very complex mathematical concepts and principles but have difficulty processing formulas and even basic addition and subtraction.

Facts and statistics
Between 5 and 15 percent of the population can be diagnosed as suffering from various degrees of dyslexia. As previously mentioned, dyslexia can be substantially compensated for with proper therapy, training and equipment.

Most researchers agree that there is a fairly even gender balance amongst dyslexics, and that the fact that it is reported more in males is because of selection factors and bias.

Dyslexia's main manifestation is a difficulty in developing reading skills in elementary school children. Those difficulties result from reduced ability to associate visual symbols with verbal sounds. While motivational factors must also be reviewed in assessing poor performance, dyslexia is considered to be an inborn trait and rarely arises from environmental factors after the brain has matured beyond its especially plastic condition during infancy.

Some have disagreed with these findings, however, and believe that while dyslexia may sometimes be inborn, it is often attributable to lack of phonics training when learning to read, and also attributed to the preponderance of the whole language system.

Physiology and treatment
Only traditional educational remedial techniques have any record of improving the reading ability of those diagnosed with dyslexia [4]. There is no evidence that coloured lenses, any visual training, or similar proposed treatments are of any use. Anecdotal reports of success can be explained by other factors.

Even a few weeks of intense phonological training (often involving breaking down and rearranging sounds to produce different words) can help noticeably improve reading skills. The earlier the phonological regimen is taken on, the better the overall result. Advanced brain scans could identify children at risk of dyslexia before they can even read, although it is thought that simple tests of balance could do the same. It has also been shown that early diagnosis and treatment can almost completely eliminate the dyslexic symptoms from some of the underlying causes. It is claimed that many of the underlying causes of dyslexia are of a genetic nature and that there are no cures, only strategies to work around the causes of a persons dyslexia, however these two claims are disputed.

It had been falsely believed that keeping your child active, perhaps by giving them housework, or performing physical exercises, would help with dyslexia. However, this is false (Wilsher 2002 - Dyslexia, Volume 8, Number 2, April/June 2002, pp. 116-117(2)). There is no scientific evidence in support of this theory.

One hypothesis for some of the symptoms of an underlying cause of dyslexia is a lack of overall short-term memory. Typically a dyslexic will not remember your name, and will suffer an undue amount of difficulty in transcribing (for example) a phone number. These problems could be attributed to the short term memory having to run the coping strategies needed to overcome a range of issues caused by the underlying causes of dyslexia.

Researchers studying the brains of dyslexics have found that during reading tasks, dyslexics show reduced activity in the left inferior parietal cortex. It is anecdotally claimed that it is not that uncommon for dyslexics who have trained themselves to cope with their affliction, to develop uncannily efficient visual memories which aid in reading and comprehending large quantities of information much faster than is typical. Commonly dyslexics show 10 times more brain activity when reading. Sometimes, depending of the type and extent, also writing, listening and speaking. However, increased brain activity is not necessarily a sign of better processing. Conversely, some dyslexics may show a natural dislike of reading and, in consequence, compensate by developing unique verbal communication skills, inter-personal expertise, and leadership skills - however these possible outcomes are the same for people who have no difficulty reading. Different people adopt different strategies for living with the same affliction. It is said that this may be because there may be different underlying causes of their dyslexia.

In 1979, anatomical differences in the brain of a young dyslexic were documented. Albert Galaburda of Harvard Medical School noticed that the language center in a dyslexic brain showed microscopic flaws known as ectopias and microgyria. Both affect the normal six-layer structure of the cortex. An ectopia is a collection of neurons that have pushed up from lower cortical layers into the outermost one. A microgyrus is an area of cortex that includes only four layers instead of six. However, this may well have nothing to do with dyslexia - it was only a study of one brain, not a scientically controlled study of a large number of brains. Also, changes in brain structure do not tell us anything about the root cause or possible treatments - it could be genetic, or the brain structure could simply be a result of a combination of insufficient education along with the actions of the dyslexic, causing the brain to develop in a particular way. The causes and effects of dyslexia are difficult to disentangle.

These flaws affect connectivity and functionality of the cortex in critical areas related to sound and visual processing. These and similar structural abnormalities may be the basis of the inevitable and hard to overcome difficulty in reading.

Several genetic regions on chromosomes 1 and 6 have been found that might be linked to dyslexia. In all likelihood, dyslexia is a conglomeration of disorders that all affect similar and associated areas of the cortex. With time, science is likely to identify and classify all individual suborders with benefits to our understanding of how low-level genetic flaws can affect the wiring of the brain and enhance or reduce a particular component of human mental capacity.

Some studies have concluded that speakers of languages whose orthography has a strong correspondence between letter and sound (e.g. Korean and Italian) have a much lower incidence of dyslexia than speakers of languages where the letter is less closely linked to the sound (e.g. English and French). (Whether models of dyslexia are correct or not, the main lesson of dyslexia is that minor genetic changes affecting the layering of the cortex in a minor area of the brain may impose limitations on the overall intellectual function. At the same time, dyslexia shows that the brain exhibits a strong ability to compensate for its acquired limitations, and intense training can often result in miraculous turnabouts.

Characteristics
Most dyslexics will exhibit about 10 of the following traits and behaviors. These characteristics can vary from day-to-day or minute-to-minute. The most consistent thing about dyslexics is their inconsistency. Symptoms increase dramatically with confusion, time pressure, emotional stress, or poor health. This may vary according to which of the suggested underlying causes of dyslexia affect the individual dyslexic.

The following list of traits and behaviours is very long (35 at the moment) and they are all very general so it's quite likely that most of the population, dyslexic or not, would complain of 10 of the following traits and behaviours so this list should be treated with caution.

General
Appears to be bright, seemingly highly intelligent, and articulate but unable to read, write, or spell at grade level.
Isn't "behind enough" or "bad enough" to be helped in the school setting.
Feels dumb; has poor self-esteem; hides or covers up weaknesses with ingenious compensatory strategies; easily frustrated and emotional about school reading or testing.
Perhaps talented in either art, drama, music, sports, mechanics, story-telling, sales, business, designing, building, or engineering.
Seems to "Zone out" or daydream often; gets lost easily or loses track of time.
Difficulty sustaining attention; seems "hyper" or "daydreamer."
Learns best through hands-on experience, demonstrations, experimentation, observation, and visual aids.

Vision, reading, and spelling
There is no scientific evidence that a relationship exists between reading failure and perceptual ability or that visual training provides effective treatment. [5].

Hearing and speech
Has extended hearing; hears things not said or apparent to others; easily distracted by sounds.
Difficulty putting thoughts into words; speaks in halting phrases; leaves sentences incomplete; stutters under stress; mispronounces long words, or transposes phrases, words, and syllables when speaking.

Writing and motor skills
Trouble with writing or copying; pencil grip is unusual; handwriting varies or is illegible.
Clumsy, uncoordinated, poor at ball or team sports; difficulties with fine and/or gross motor skills and tasks; prone to motion-sickness.
Can be ambidextrous, and often confuses left/right, over/under.

Maths and time management
Has difficulty telling time, managing time, learning sequenced information or tasks, or being on time.
Shows dependence on finger counting and other tricks when doing math; knows answers, but can't do it on paper.
Can count, but has difficulty counting objects and dealing with money.
Can do arithmetic, but fails word problems; when doing maths must see the big picture before the detail.

Memory and cognition
Excellent long-term memory for experiences, locations, and faces.
Poor memory for sequences, facts and information that have not been experienced.
Thinks primarily with images and feeling, not sounds or words (little internal dialogue)

Behavior, health, development and personality
Extremely disorderly or compulsively orderly.
Can be class clown, trouble-maker, or too quiet.
Had unusually early or late developmental stages (talking, crawling, walking, tying shoes).
Prone to ear infections; sensitive to foods, additives, and chemical products.
Can be an extra deep or light sleeper; bedwetting beyond appropriate age.
Unusually high or low tolerance for pain.
Strong sense of justice; emotionally sensitive; strives for perfection.