Dyslexia
Teaching students with receptive and
expressive language impairments in the
oral and written language modalities
Contents
1. What is Dyslexia?
2. Identification, diagnoses and treatment
considerations?
3. What are some ways to approach treatment?
4. Answering questions…
Definition…
 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.
Research 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.
Characteristics
 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.
Question 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.
Question 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
Question 3: “Is dyslexia hereditary?”
Answer: Some forms of
dyslexia are highly
heritable.
(Excerpt of an article in the
American Journal of Psychiatry
published in December 2008
on 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.“
2005-2008 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)
2008-2010 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)
Conclusions
1.
Dyslexia is a brain-based disorder.
2.
Timing of connections have a significant affect on processing
language.
3.
White matter in the brain can be altered. The earlier this
happens the better.
4.
"Focused instruction can help underperforming brain areas to
increase their brain proficiency."
5.
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.
Early 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.
Red 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)
Directionality
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.
“My 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.
Who 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
Why 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
The 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.
Testing
 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.
Treatment Considerations
 Acquisition of letters and their sounds for reading and
writing typically mirrors developmental norms for
speech sound acquisition
 When you’re choosing materials and what to focus on
with an individual, keep this at the forefront
(See normative data chart in addendum)
Phonological Awareness
Broader  Narrower (top down)
1. Identify…
2. Use…
oral
rhymes
syllables
in spoken
words
cup, sup, tup
cupcake =
cup + cake
onsets &
rimes in
spoken
syllables
individual
phonemes
in words
spoken
cup =
c + up
cup =
c+u+p
Phonemic Awareness
 Increases word reading  increases reading
comprehension

Increases reading fluency
-through blending

Increases strategies for accurate spelling
-via segmenting
-predictable relationships
Sound Segmentation
Sentence segmentation – nursery rhymes, famous songs, etc.
(only if they can interpret information at this level)
Word segmentation
Syllable segmentation
Phoneme segmentation
1.
2.
3.
4.






“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
SLPs 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 aren’t getting it, I often go to: “How many sounds do you
hear in the letter…M?”
/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
SLPs 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




“I’m 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…
Deletion & 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-)
Deletion & 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…”
Substitutions
1.
Word substitution (the name game)



2.
3.
Syllable substitution (the other Name Game)
Phoneme substitution

4.
Alicen Lea Burke
Change “Lea” to “Fizzle”
Now change Burke to “Pop”
“Say ‘hat’. Now, change the /h/ in hat to a /s/.”
Sentence and Phrases can be addressed later
Building Strong Skills

Work on only one or two targets with individuals at
a time.

Work through a hierarchy for each target.

When they’ve 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!
Setting 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
Common 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.
Teach 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)
Hierarchical 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!
More…




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)
Management and Accommodations
 Richelle to add
Procedures for Referral at
Sunnycrest…
 If it’s speech only… refer to the SLP
 If it’s language in any form, refer to the team
 If it’s highly likely the child will not qualify and you
don’t think it’s “worth it” to refer to the team, use your
resources and talk to the parents about self-referral
for literacy assessments.
Questions you asked
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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?
Resources
 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 Sewald’s early intervention Tutorial Program
References 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
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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.
doi:10.1044/1092-4388(2009/07-0145) Accessed from:
http://www.ncbi.nlm.nih.gov/pubmed/20061325
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Mayo Clinic dyslexia information page. Mayo Clinic.
http://www.mayoclinic.com/health/dyslexia/ds00224/dsection=symptoms.
Accessed April, 2010.
NINDS dyslexia information page. National Institute of Neurological Disorders
and Stroke. http://www.ninds.nih.gov/disorders/dyslexia/dyslexia.htm. Accessed
April, 2010.
What are the signs of dyslexia? International Dyslexia Association.
http://www.interdys.org/SignsofDyslexiaCombined.htm. Accessed April, 2010.
Catts & Kamhi (2005). Language and Reading Disabilities. (Ed. 2). Boston, MA:
Pearson, Inc.