Dyslexia

Your child may be under a lot of stress if she’s experiencing symptoms of dyslexia—and that means you’re feeling a strain, too. Every parent wants to see their child do well at school and build a healthy level of self-confidence. Because dyslexia affects reading—a skill that’s essential to learning—kids with dyslexia face challenges in the classroom that can sometimes affect how they see themselves overall. 

However, there’s a lot to feel reassured about: dyslexia is a common disorder, and it doesn’t have the stigma attached to it that it did years ago. Most importantly, dyslexia can improve tremendously if they right intervention is chosen.

It’s natural to want to learn as much as possible about dyslexia so you have a better sense of what’s ahead for you and your child. Read on for a snapshot of the condition.

What is dyslexia, exactly?
Dyslexia is a neurological condition that interferes with the acquisition and processing of language and print. Specifically, it’s a reading problem that results from the inability to translate letters into their corresponding sounds—and conversely, to relate sounds to their corresponding letters.

A child with dyslexia can have difficulties with many aspects of language, including reading, writing and phonological processing (sounding out words). In some cases, dyslexia can also cause problems with arithmetic. 

Are there different types of dyslexia?
Dyslexia can manifest itself in different ways. It is common for children with dyslexia to experience one or several of the following challenges:

• problems with the auditory side of language (the way sounds are translated into different symbols)
• difficulty recognizing letters
• struggling to link multiple words together (even if individual words can be read without a problem)  
• difficulty with language comprehension (for example, taking a long time to process words; by the time the end of a sentence or paragraph is reached, the beginning has been forgotten) 

What’s the difference between developmental dyslexia and acquired dyslexia?
Nearly all the patients we see at Children’s have developmental dyslexia, meaning that  it develops within the first years of life  or some markers may even be present at birth.

However, some children (and adults, too) develop dyslexia as a result of a stroke, car accident or other type of trauma. This is called acquired dyslexia, and it is fairly rare. A child with this type of dyslexia will come to Children’s Department of Neurology for treatment.

Causes

What causes dyslexia?

Unfortunately, no one knows exactly what causes a child todevelop dyslexia. There is evidence to suggest that the disorder is inherited in a lot of children, meaning it runs in families. 

However, just because a parent has dyslexia—or even both parents—it doesn’t mean their child will necessarily be dyslexic. There have been cases, for instance, where three siblings in a large family have dyslexia, but two other siblings do not. There are also families, where one child has dyslexia but no other family member is affected. Researchers are still working to pinpoint the genetic mechanisms behind dyslexia.

 A very small percentage of people with dyslexia have what’s called the acquired form of the condition. This means they developed the disorder later in life. Acquired dyslexia can be caused by a stroke, brain injury or other type of trauma. Neurologists can help to treat this type of dyslexia.

Signs and symptoms

What are the symptoms of dyslexia?

Dyslexia symptoms can vary from child to child, but will usually include one or more of the following: 

• problems with rhyming
• challenges recognizing letters
• difficulty recognizing that two words—“garbage” and “gorilla,” for example—start with the same sound or letter
• struggling to repeat nonsense words and phrases, like “SpongeBob SquarePants”
• problems with comprehension (for example, taking so long to process words that, by the time the end of a sentence or paragraph is reached, the beginning has been forgotten)
• difficulty with fluency of language (some children can read individual words without a problem, but have problems linking many words together)

In addition to these symptoms, children with dyslexia may feel frustrated or embarrassed at school because certain lessons and assignments are hard for them.

Questions to ask your doctor 

You and your family play an essential role in your child’s treatment for dyslexia. It’s important that you share your observations and ideas with your child’s treating clinician, and that you have all the information you need to fully understand the treatment team’s explanations and recommendations.

You’ve probably thought of many questions to ask about your child’s dyslexia and treatment plan. It’s often very helpful to jot down your thoughts and questions ahead of time and bring them with you, along with a notebook, to your first appointment. That way, you’ll have all of your questions in front of you and can make notes to take home with you. 

(If your child is old enough, encourage her to bring her own set of questions to the appointment, too!)

 Some initial questions for your doctor might include:

• How did you arrive at this diagnosis?
• Are there any other conditions my child might have instead of, or in addition to, dyslexia?
• Does my child need further testing?
• How can I help my child at home?
• How should I talk to my child about his dyslexia?
• How can I help my child build a healthy self-image?
• What should I tell my child’s teachers about his dyslexia?
• How can I best work with the school going forward?
• Do you feel my child needs to see a dyslexia specialist outside of school?
• What should I tell my child’s siblings, other family members and classmates about his dyslexia?
• Do I need to make any other changes to my child’s home and school routines?
• What products—such as computer-based programs—do you recommend trying?
• Can you point me to other educational and support service resources in my area? What about online?

FAQ

Q: Is there a cure for dyslexia?
A: Unfortunately, no. There is no pill or “quick fix” for dyslexia. Children’s clinicians usually explain to parents that the brain is akin to a muscle, in the sense that it can be trained to operate differently (and more efficiently).

Just as we can go to the gym to train our bodies, it is possible to train the mind and minimize the effects of dyslexia. Parents, teachers and other caregivers can play a major role in helping kids with dyslexia “train their brains.” Although dyslexia often is a lifelong condition, it is also a condition that can be greatly mitigated with the right treatment.

Q: How common is it for a child to have attention-deficit hyperactivity disorder (ADHD) as well as dyslexia?
A: As many as 40-50 percent of children who have ADHD also have dyslexia or another learning disorder. 

Q: My child has started feeling uncomfortable around her peers, as well as in the classroom. Is this common in kids with dyslexia?
A: Absolutely. People who are unfamiliar with dyslexia—and this includes other children—sometimes falsely assume that a dyslexic child is “lazy” or has a low level of intelligence. This can make things very difficult and stressful for the child, as it can lead to teasing, bullying and a sense of being “left out” or “different.”  (Compounding the issue is the fact that having a reading problem can also be damaging to the child’s own view of himself and his sense of self-worth.)

You can serve as your child’s advocate at school, at home and in the community. Your treating clinician will help you determine the best way to approach your child’s teachers, and can advise you on how to talk about his dyslexia with classmates, siblings and other family members. Remember—and remind your child—that kids with dyslexia can do anything other kids can. They’re equally capable of building good friendships, taking on leadership roles and excelling in many academic subjects, sports and hobbies.

Q: How does dyslexia affect IQ?
A: It doesn’t! Some people mistakenly think that a child with a reading problem must not be intelligent. Yet the fact is, many children with dyslexia have average to above-average intelligence. 

Q: Does my child’s school have an obligation to help him tackle his dyslexia?
A: Yes. If your child has been diagnosed with dyslexia, his school is obligated to develop an Independent Education Plan (IEP) to help him reach his full academic potential.

However, keep in mind that some schools have more resources and access to specialty services than others—so the extent of what your child’s school can do will depend on a number of factors. Your treating clinician can advise you about the right questions to ask the school and where to go for additional guidance.

Q: What can an Individualized Education Plan (IEP) do for my child?
A: Once a child is diagnosed with dyslexia, his parents and educators will work together to develop an IEP that’s designed to help him reach his full potential at school. 

An IEP gives your child access to many types of assistance throughout his school career, such as:

• additional time to take tests and complete assignments
• one-on-one tutoring with a reading specialist
• videotaping or audio-recording lessons (lessening or eliminating the need to take written notes)

Q: How do I start the process of establishing an IEP for my child?
A: Before moving forward with creating an IEP, you first need to provide documentation of your child’s formal diagnosis by a licensed health care professional. (It’s possible that, even with a formal diagnosis from a clinician, your child’s school might want to conduct some additional tests to confirm the diagnosis and determine how they can best assist.)

Q: Will my child’s insurance plan cover her treatment for dyslexia?
A: The answer depends on your specific insurance provider and plan. Ultimately, federal law mandates that it is the responsibility of schools—not health care professionals—to treat children with learning disabilities like dyslexia. For this reason, health insurance companies sometimes won’t cover medical assessments and treatments for dyslexia.

However, it is extremely common for dyslexia to go hand-in-hand with other conditions like attention-deficit hyperactivity disorder (ADHD) that typically are covered by health insurance. Many kids who come to Children’s Hospital Boston for ADHD are subsequently found to have dyslexia, too. Usually, such “dual diagnoses” are covered by insurance—but you should always contact your provider directly to learn the specific details of your child’s coverage, and to ask any questions you may have.

Q: How can I help my child overcome self-esteem problems relating to his dyslexia?
A: It’s vital to consistently support your child by praising him for his intellectual curiosity, intelligence and participation in discussions. Use compliments like, “you are really smart” and “you really know a lot.” Remind him of two important things: one, that having a reading problem doesn’t make him any less intelligent—and two, that with practice, he can train his brain to make reading easier.

Q: Could I have done something to prevent my child’s dyslexia?
A: It is not possible to prevent dyslexia; nothing you did—or didn’t do—before your child was born or during his formative years could have caused him to develop this reading problem.

While dyslexia can’t be prevented, it can be treated with a great degree of success if caught early and addressed properly. Here at Children’s Hospital Boston, we’re working on ways of detecting dyslexia symptoms before kids even start to read. Learn more about this research.

Q: What complications can result from untreated dyslexia?
A: If a child’s dyslexia goes undiagnosed and untreated, she’s likely to:

• struggle in school

• become easily frustrated

• develop low self-esteem

• fail to reach her full academic and personal potential

In addition, research has demonstrated that kids with untreated dyslexia are at a greater risk of:

• dropping out of school

• ending up in the juvenile justice system

• not pursuing higher education

For all of these reasons, it’s essential that a child who shows possible signs of dyslexia receives a prompt evaluation and diagnosis from a qualified health care professional.

Q: If my child has dyslexia, should I be worried about his overall health and well-being?
A: While every child’s situation is different, it’s true that kids with dyslexia are under increased stress at times—so you should always be vigilant and aware of changes in your child’s mood, self-confidence and behavior. Some children with dyslexia also have attention-deficit hyperactivity disorder (ADHD) or other developmental disorders, so it’s crucial to get a thorough assessment and diagnosis from a pediatric specialist with expertise in treating learning disabilities.

All children with dyslexia will go through periods where they may feel anxious, frustrated, sad and even angry. Parental encouragement is essential to helping a child through these difficult times. Here at Children’s Hospital Boston, our expert child and adolescent psychologists, social workers and counselors and other mental and behavioral health professionals are available to help you provide your child with the full spectrum of support he needs.