Page 94-101: Dyslexia

Part 2 - Disorders Demystified

Page 94-101: Dyslexia

Dyslexia

Dyslexia is a specific learning difficulty affecting the skills involved in reading, writing and spelling. It is often described as a specific learning ‘difference’ because people with dyslexia usually have a combination of abilities and difficulties that affect their learning process. It is described as ‘specific’ because it only impacts on certain areas of development, rather than being a general learning difference that has an impact on all areas.

Most definitions of dyslexia agree that individuals have marked difficulties with word reading, decoding and spelling, that are inconsistent with other aspects of their development, including their general learning ability. It is described as a continuum and there is no cut off point for diagnosis.

Characteristic features of dyslexia are difficulties in phonological awareness (ability to attend to, discriminate, remember and manipulate sounds), verbal memory and verbal processing speed. It is described as a difficulty processing and remembering information that is seen and heard, affecting learning and particularly the acquisition of literacy skills.

Dyslexia can range in severity and, while there are common areas of strength and difficulty associated with the diagnosis, every individual is likely to present differently. Difficulties with reading, writing and spelling may be accompanied by difficulty with number work, short term memory, organisation and sequencing skills. It is not unusual for dyslexia to co-occur with other specific learning differences such as Autism Spectrum Disorder (ASD), Attention Deficit Disorder (ADD), Dyscalculia (difficulty with numeracy, arithmetic and mathematical concepts) or DLD. Children with hearing impairment, visual impairment or head injury may experience reading, writing and spelling difficulties as a result of their underlying condition, but would not be considered to have dyslexia.

The exact cause of dyslexia is unknown, but research indicates that the difficulty stems from physiological differences in the brain that result in information being processed differently. It is not caused by poor parenting, poor education or lack of ability. It is thought to be genetic in origin, as it often runs in families.

Prevalence

It is estimated that up to 1 in 10 people in the UK has some degree of dyslexia, which rises to 15% when co-occurrence with other conditions is included. This means that it is the most common specific learning difficulty, affecting between 6.6 and 9.9 million people in the UK and between 800,000 and 1.3 million young people in education. Dyslexia affects individuals throughout their childhood and into adulthood, but its impact can change at different stages in a person’s life.

Myth Busting

Speech and Language Myth Busting Icon

Does dyslexia only affect a child’s ability to read and write?

The ability to read, write and spell are the main areas affected by dyslexia, however it also typically impacts on other areas of development including memory, coordination and organisation. It is important that children’s strengths and areas of difficulty are identified, so that appropriate support strategies can be put in place.

Do children only receive a diagnosis of dyslexia if they have average or above average intelligence?

Previously it was believed that dyslexia only occurred in children who had average or above average intelligence levels. This was possibly due to the fact that it is more easily detected in these children. It is now understood that dyslexia occurs independently of a child’s level of intelligence, meaning that children with dyslexia can vary in terms of their general learning ability. It is the disparity between the child’s areas of ability and difficulty that is thought to indicate dyslexia. It is referred to as a learning difficulty because it affects the child’s ability to develop literacy skills and therefore their ability to succeed academically.

What to look for

The signs and symptoms of dyslexia vary from person to person, with each individual having a unique pattern of strengths and weaknesses that affect their ability to learn.

It is recommended that a cluster of areas of chronic difficulty, in contrast to areas of ability, may be suggestive of dyslexia. This could mean that a child presents with poor or inconsistent spelling, slow reading and writing and difficulty understanding information that is written. Then in contrast they may have a better understanding of information that is given verbally and have strengths in other areas such as creative, visual and problem-solving skills.

Indicators of dyslexia

To identify children at risk of dyslexia, who would benefit from further assessment, it is recommended that an indicator checklist of difficulties is used. The following are indicators that may be suggestive of dyslexia, but it is important to remember that not all children will experience all of the difficulties.

– Early Years

Family history of dyslexia or literacy difficulties
History of language delay or slow speech development
Difficulty learning nursery rhymes
Difficulty keeping simple rhythm
Muddling words when speaking, e.g. saying “cubumber” for ‘cucumber’
Difficulty sitting still and listening to stories, or likes listening to stories but shows no interest in letters or words
Difficulty carrying out instructions with more than two steps

– Primary School

Difficulty learning the names and sounds of letters, and confusion with letters that look similar
Unpredictable and inconsistent spelling, e.g. putting letters and figures the wrong way round or confusing the order of letters in words
Slow speed of processing, and therefore slow reading and writing
Visual disturbances when reading, e.g. letters and words seeming to move around
Understanding information better when spoken, but having difficulty when it is written
Answering questions well orally, but having difficulty writing the answer down
Difficulty carrying out a sequence of instructions
Struggling to learn sequences, such as the alphabet or days of the week
Poor handwriting and messy work with words crossed out and spellings tried several times
Little or no expression when reading and poor comprehension
Having difficulty following the main point of a story when reading and difficulty picking out key information from text

– Secondary School

Avoiding reading or writing whenever possible
Words are omitted, repeated or added when reading aloud, affecting comprehension and making reading hesitant or laboured
Difficulty recognising familiar words and difficulty using dictionaries, encyclopaedias etc.
Difficulty remembering lists of instructions, places, times, dates, basic number sets and formulae
Difficulty processing information at speed, for example mental arithmetic
Difficulty saying multisyllabic words clearly
Poor organisation and planning of written work, with some individuals writing very little or, conversely, writing a lot but losing the main thread
Difficulty with punctuation and/or grammar
Difficulty taking notes in lessons
Poor handwriting with badly formed letters or neat handwriting that is written very slowly, which can mean that very little written work is produced
Difficulty with organisation of homework and finding tasks difficult to complete on time
Presenting as disorganised and forgetful
Excessively tired, due to the amount of concentration and effort required

It is worth noting that some of the indicators above could indicate other difficulties, such as DLD or language disorder.

Impact of dyslexia

The impact of dyslexia is different for each person, depending on the severity of their condition. The following may be affected for individuals with dyslexia:

Low attainment – Dyslexia can result in children having difficulty accessing the curriculum and making academic progress, as literacy skills underpin most, if not all, learning within school. Young people with dyslexia have been found to be twice as likely to fail to pass English and Maths at GCSE. This is also reflected in the fact that only 5% of students at university have dyslexia, compared to 10-15% of people in society with the condition.
Social communication skills – Dyslexia can affect a child’s ability to retrieve words quickly, produce words clearly when speaking and to organise and sequence their thoughts and ideas. This means that they often find it difficult to express themselves successfully within conversation and this can impact on their ability to develop and maintain successful relationships.
Mental health difficulties – Children with dyslexia often become frustrated with, or ashamed of, their difficulties within the classroom and see the gap between them and their peers increasing. This can lead to significant mental health difficulties including depression and anxiety. Research has shown that young people with dyslexia and/or literacy difficulties report higher levels of mental health difficulties.
Behaviour difficulties – A student with dyslexia is three and a half times more likely to be permanently excluded, due to not having the skills to engage effectively with the curriculum. The rates of young people with dyslexia within the youth offending system are estimated to be between 31 and 51%. Poor literacy skills significantly impact on an individual’s life choices and ability to engage with professional life.

Strategies

Speech and Language Strategies Icon

Dyslexia is a lifelong problem that presents challenges for pupils on a daily basis. By understanding the typical areas of strength and difficulty children with dyslexia have, teachers can successfully facilitate pupils’ learning. It is generally recommended that support for children with dyslexia is met within the classroom through high quality teaching strategies and differentiated learning materials. With appropriate support, children with dyslexia can be included in mainstream school and can be successful.

Many of the general strategies for supporting children with SLCN will be very applicable for children with dyslexia, in particular for supporting their weaker verbal memory and processing. Here are some specific strategies that have been found to be effective in supporting children with dyslexia in the classroom:

Top Tip

Speech and Language Top Tip Icon

For reading tasks, present a small amount of text to focus on, rather than a whole book or page.

– Supporting reading, writing and spelling

Create opportunities for children to be exposed to texts without relying on reading, e.g. using audiobooks, in order to develop their vocabulary, understanding and use of complex grammar and world knowledge. Help children to find books that match their interests and expand their world knowledge.
Develop rhythm and rhyme skills at an early age using nursery rhymes. Continue to develop this with older children using poetry and rap, e.g. rap battles.
Develop children’s phonological awareness skills to improve ability to decode words when reading and encode them when spelling, e.g. breaking words into syllables and blending syllables together, breaking words into individual sounds, identifying sounds in words and manipulating sounds in words.
Draw attention to patterns in words, such as irregular spelling patterns (thought/bought), prefixes, suffixes, rules for plurals and other word endings. Use highlighters to identify parts of words.
Use mind maps to show how words relate to each other in word families, e.g. cook, cooking, cookery, cooker.
Use alternatives to writing for tasks where children don’t have to write, e.g. children can respond verbally, record answers using dictaphones or draw.
Make use of technology to support writing, such as word processors. It is recommended that young people with dyslexia are able to use laptops/tablets in all classes.
When developing writing skills, try using pencil grips or ergonomic pens. Ensure that children are sitting comfortably with their feet on the floor. A slanted writing surface can support some children.
When marking work, correct only words that have been explicitly taught or use a colour coding marking system for known and new words, to support children’s motivation to correct errors.

– Supporting verbal memory and processing of information

Limit the amount of reading and copying from the board that children need to do, for example by giving copies of notes.
Use visual support throughout lessons, for example introducing vocabulary with visual support, e.g. pictures, mind maps.
Simplify written instructions or information in tasks to include key information or highlight key pieces of information.

– Supporting organisation

Develop pupils’ ability to take notes and identify key information using visual strategies such as mind maps or graphic organisers. This can help pupils to understand the links between key words and concepts and any related information.
Visually display reminders about what pupils need to do, for example where they can find things in the classroom, useful vocabulary, how to ask for help and what the finished task should look like.
Demonstrate how to use visual and practical aids, for example writing frames and planning formats.

When to refer

If you have concerns about the literacy skills of a child you are supporting it is recommended that you speak to the school SENCo. The SENCo may decide to carry out a screening test or use a checklist to find out more about a child’s areas of strength and difficulty in order to see how they can be best supported in the classroom. If a child continues to have difficulties, despite extra support and strategies within the classroom, they may need further in-depth assessment to determine whether they have dyslexia.

Children can only be diagnosed through a diagnostic assessment carried out by a certified dyslexia assessor. Currently, children must be aged 7 or over for an assessment to be carried out. These assessments can either be requested by the school or parents can arrange and pay for an assessment privately. It is important that children at risk of dyslexia are assessed in order for them to receive the diagnosis as appropriate. This will ensure that appropriate interventions are in place, including exam access arrangements.

Link to spoken language skills
Dyslexia is primarily a difficulty with understanding and using written language (reading and writing), but some children with dyslexia also have difficulties with their understanding and use of spoken language. These difficulties vary considerably for individuals with dyslexia, with many children having good verbal language skills. As speech and language skills and literacy skills interact with and impact on each other, it can sometimes be difficult to identify the cause and maintaining factors of difficulties in these areas.

Current evidence suggests that dyslexia and DLD (specific learning difficulty in relation to understanding and/or using spoken language) are two distinct disorders that frequently co-occur. This means that some children with dyslexia will also have a diagnosis of DLD, with significant difficulties in both spoken and written language.

Some children with dyslexia may present with relatively weak oral language skills as a result of their difficulties in relation to literacy and therefore they would not meet the criteria for a diagnosis of DLD. They have difficulties because vocabulary, complex grammar and general world knowledge are developed, to a large extent, through reading. Children with dyslexia are therefore at risk for poorer language development due to reduced reading experience affecting both their spoken and written language skills.

There is also a large body of research linking early speech and language difficulties to later literacy difficulties. Children need to be able to understand spoken language before they will be able to read written language, and they need to be able to use words, phrases and sentences, before they will be able to write them. This means that for some children, their underlying speech and language needs are the cause of their literacy difficulties. For these children, identifying their speech, language and communication needs as early as possible is important to ensure that strategies are put in place to develop their language skills, which will in turn support development of their literacy skills.

Top Tip

Speech and Language Top Tip Icon

If a child in your care has literacy difficulties, always check their understanding of language has been assessed.

Role of SaLT

Children’s literacy difficulties are supported by school staff and children with dyslexia will only need to be seen by a SaLT if they present with speech sound difficulties or difficulty understanding and using spoken language, in addition to their difficulties with written language. Using a language screen, such as the Language Link assessment, will identify whether any children with dyslexia (or other literacy problems) have difficulties with understanding spoken language so that the correct support can be put in place for them. This will support their underlying language difficulties and then also their ability to develop literacy skills. If you are concerned about a child’s speech, language and communication skills, it is recommended that you discuss them with your local SaLT.