Dealing With Dyslexia

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Researchers are exploring new ways of helping children overcome their reading disabilities.

Angela Swift had been a special education teacher for years when her kindergarten-age son, Toby, was diagnosed with dyslexia.

Two years passed, and the special classes the school district in La Verne, Calif., provided for Toby didn't seem to be helping. By 3rd grade, he was bright enough to score A's on oral geography exams, but still couldn't read.

So Ms. Swift began to look for other answers. She soon discovered that, in the years since she had entered the field, the research on reading disabilities had multiplied. And much of it pointed to promising strategies that just might help Toby.

"I was amazed," she recalled. "How could I be around special education for 15 years and not know about this? How could my school district not know?"

Most of the new research has been supported by the National Institutes of Child Health and Human Development at the National Institutes of Health in Bethesda, Md. Since 1965, the federal agency has spearheaded a national research program on children's learning disabilities.

The studies have helped dispel some of the common myths about dyslexia and have pinpointed a possible biological origin for reading disorders.

And, perhaps most importantly, they have identified ways that educators can identify and treat reading problems early--before children fail in school. In several studies, researchers have identified strategies that can produce substantial improvements in children who are at the bottom of the list among their peers in reading.

But the work also has been controversial among educators, in part because it touches on some of the same debates on teaching reading that have divided educators nationwide. And researchers are finding, as Ms. Swift did, that schools and teacher training programs are slow to embrace the new findings.

Dyslexia, as one researcher put it, "is just a fancy name for not being able to read." The classic definition, however, is a little more rigid. It maintains that children are dyslexic or reading disabled if they are otherwise intelligent and no other cause, such as a hearing impairment, can be found for their problems.

But some researchers now believe dyslexia represents the most severe end of a continuum of reading problems. And they maintain that the old definition leaves out large numbers of children who cannot read because they are from disadvantaged homes or haven't been exposed to books, reading, and the alphabet.

'A Lot of Letters'

For that reason, estimates vary wildly on the number of children who have the problem. Some researchers put it as low as 5 percent, for example.

But Dr. Sally E. Shaywitz, a researcher at Yale University's school of medicine who has tracked 451 New Haven, Conn., schoolchildren since 1983, found that up to 20 percent of the children she studied were reading disabled.

Contrary to popular belief, people who are dyslexic do not see letters backwards or in reverse order.

G. Reid Lyon, the chief of the NICHD's child-development and behavior branch, which sponsored the disabilities-research program, said the population could be much larger--as high as 40 percent--if one includes children who cannot read because they weren't taught well or because they have had limited print exposure. But he argues that, in an age when reading ability is a must for virtually any kind of future employment, the needs of those children for remediation are no less pressing.

Contrary to popular belief, people who are dyslexic do not see letters backwards or in reverse order. The words, as Toby put it, "just look like a lot of letters."

Newer research suggests, in fact, that reading problems have very little to do with the print a child sees on a page.

Rather, these researchers say, reading disabilities may be one manifestation of a much broader problem with language itself. Severe dyslectics, for example, might also have problems recalling a specific term, with sentence structures, and with idiomatic expressions.

Dr. Shaywitz also found, in her group of 451 students, that girls were just as likely as boys to suffer from the disorder--even though their schools might not have targeted them to be in need of special help.

"The lesson here for schools is, if a girl's not making progress, not to ignore her," Dr. Shaywitz said.

Trouble With Phonemes

On one point, virtually all of the studies agree: At the heart of most poor readers' difficulties are problems distinguishing phonemes--the smallest sounds that make up speech. The word "bat," for example, is made up of three phonemes: buh--aah--tuh. The English language contains 44 such sounds in all.

"Your ear can't hear those teeny sounds. The minute I say that word to you the 'a' and the 't' fold up into the 'b' sound and become one pulse of sound," Mr. Lyon said. In normally developing readers, the ear registers those constituent sounds. With this skill in place, beginning readers can then go on to the next stage of reading: phonics, the process of linking letters to sounds.

Poor readers, on the other hand, may need to be trained in how to distinguish those small sounds. That explains in part why people with reading disabilities decode words so laboriously even though they have no trouble understanding the same words when they hear them. By the time they have finished sounding out a word, dyslectics have no energy left to understand what they have read.

At the heart of most poor readers' difficulties are problems distinguishing phonemes—the smallest sounds that make up speech.

"If you want a quick diagnostic, give children a set of nonsense words, and the child who can't pronounce them is the child with basic reading disabilities," said Frank R. Vellutino, a professor of psychology at the University at Albany, State University of New York.

In his studies, Mr. Vellutino has been able to identify potential poor readers as early as kindergarten by asking them to pronounce nonsense words, to identify the letters of the alphabet, or to distinguish the sounds that make up words.

On the biological side of the issue, the NIH-funded studies of human brains also bolster the idea that reading disabilities stem from broader, underlying problems with language.

Dr. Albert Galaburda, of Beth Israel Deaconess Medical Center in Boston, examined autopsied brains of poor readers and found them to be fundamentally different from those of normal readers. In the disabled readers, some neurons or brain cells form out of place in the areas of the brain that control language--an abnormality that occurs before a child is born. The defect may affect the way nerve cells connect with one another later in life as well.

Classroom Studies

For disabled readers such as Toby Swift, the research that has the most direct bearing on their future has taken place in the classroom.

Mr. Vellutino and his colleagues, for example, worked with 76 poor readers from middle-class homes who otherwise showed average or above average intelligence. Beginning in 1st grade, the students were given 30 minutes a day of one-on-one tutoring in reading. They might, for example, read a new story each day and reread a familiar one; learn letter-sound relationships and useful spelling patterns, such as the ''ut'' in "nut," "but," and "rut"; and learn to recognize a few commonly used words on sight.

"The remediation was fairly balanced," Mr. Vellutino said. "We think reading is more like building a patchwork than a pyramid."

His aim was not to pinpoint what specific intervention worked best with disabled readers, but instead to see if the tutoring sessions could be used as a means of diagnosing readers most in need of help.

But those sessions helped almost all the students improve their reading. At the end of one semester, 70 percent of the children were reading in the average range. At the end of two semesters, only 15 percent of the students were still struggling--a proportion that represented 1.5 percent of the total first grade population in the schools the researchers tested.

Dyslexia is a lifetime affliction, and some researchers estimate that 4 to 5 percent of children may never learn to compensate for it.

Joseph Torgeson, a Florida State University psychology professor, undertook a similar experiment with 60 4th graders ranked among the bottom 2 percent of readers in their grade level.

The students were divided into two groups. One was taught using a program called "embedded phonics," which gave them lessons in the letter-sound relationships they had not yet mastered, as well as extensive writing practice.

The other children were taught using a method known as "auditory discrimination in depth." The program essentially teaches children to feel the sounds in words, emphasizing, for example, the shapes of their mouths and tongue positions when they pronounce an ''l'' or a ''v.''

Both groups received two hours of lessons a day. After eight weeks, both groups had moved up into the average reading range--an improvement of 1 1/2 to two grade levels. But a higher proportion in the group that was taught embedded phonics--26 percent--were still substantially impaired.

By comparison, 9 percent in the group taught by auditory-discrimination techniques still had serious reading problems.

"These gains are strikingly different than what is typically obtained in the regular resource room. Typically, kids' standard scores don't change that much," Mr. Torgeson said. "People are afraid of one-on-one instruction because it's very expensive. But our rationale is, well, you need to know what you can accomplish. Why take two years when you can do it in eight weeks?"

Larger Reading Issues

None of the strategies in the new studies worked for all students. Dyslexia is a lifetime affliction, and some researchers estimate that 4 percent to 5 percent of children may never learn to compensate for it. But the gains the studies document represent, for the most part, big improvements over typical practice.

What is more, most of the studies point to a clear strategy for teaching reading-disabled children. Regardless of the specific method used, they suggest that, at a minimum, poor readers need explicit instruction in phonemic awareness, in phonics, and in the structure of language. And they need enough practice to enable them to use those skills automatically.

The problem, the researchers say, is that schools have been moving in the opposite direction--away from phonics-based approaches and toward whole-language methods of teaching reading. The latter approach maintains that children learn to read naturally and calls for immersing them in good literature, rather than pacing them through repetitious phonics drills.

The NIH researchers argue that learning to decode and sound out words may be the gateway that children must first cross if they are to read at higher levels.

Whole-language proponents attempt to teach phonics as well, but they embed those lessons in the context of the stories children read.

"The problem in teaching reading is that we go from one extreme to another," Mr. Vellutino said. ''We need a diverse set of strategies and a balanced approach to reading instruction."

Given the large proportions of students with reading problems, the researchers have suggested, why not teach all children to read using methods that incorporate phonics and phonemic awareness with rich, engaging stories and writing?

Broader Application Questions

As Mr. Lyon and other researchers have lobbied for such an approach with policymakers around the country, they have also gained some critics from within the education research community.

Richard L. Allington, an education professor and the chairman of the reading department at SUNY-Albany, said they may be overreaching by trying to apply findings drawn from poor readers to the regular classroom.

Besides, Mr. Allington noted, many of the improvements the NIH researchers have documented have come on tasks measuring students' ability to read nonsense words or on phonological-awareness tasks, rather than more sophisticated stages of reading.

"They don't have reliable results on real-word reading, fluency, and comprehension," he said. "The last time I looked no one had targeted children with disabilities' primary need as being able to pronounce nonwords."

The NIH researchers, for their part, argue that learning to decode and sound out words may be the gateway that children must first cross if they are to read at higher levels.

Gerald Coles, an educational psychologist in Ithaca, N.Y., and the author of a forthcoming book on literacy, says the NIH studies may also be exaggerating the extent of reading problems across the nation.

Because one-fifth of the children in the sample Dr. Shaywitz studied were dyslexic, that doesn't mean the same proportion exists in the general population, he said.

MRI Technology Applied

"I think the overwhelming number of children identified as learning disabled or as dyslexic have problems that come primarily from instruction or pressures that don't allow families to provide the early literacy experiences they need," Mr. Coles said.

The NIH-supported research program has yet to have the last word on the subject. Studies begun this fall are using magnetic resonance imaging to look into the brains of children who are poor readers--both before and after they have undergone tutoring.

Previous studies using the technique, which is harmless, have already suggested that the metabolic activity that takes place in the brain as a poor reader tries to read is different from that of able readers. Now, researchers are looking to see whether successful reading interventions can change those brain-activity patterns.

Researchers are looking to see whether successful reading interventions can change those brain-activity patterns.

Meanwhile, Ms. Swift continues to wrangle with her school district over how to introduce some of the new research findings into her son's education. Her uphill battle may not be unusual.

Louisa C. Moats, a clinical assistant professor of pediatrics at the University of Texas-Houston Health Science Center whose work is also being funded by the NIH, reviewed four of the most popular textbooks used in reading education courses for aspiring teachers.

"None of the texts contained accurate information about phonology and its role in reading development, and none of them explained with depth or clarity why many children have trouble learning to read or what to do about it," Ms. Moats told a congressional committee this year.

Similarly, among the hundreds of teachers she has surveyed informally, fewer than 10 percent could name major contributors to the field of reading research.

"It was astonishing to me the ignorance of the field about this," Ms. Moats said in an interview.

Disappointing Goals

At the Swift family's expense, Toby received private tutoring last year through the same auditory-discrimination program used in Mr. Torgeson's study. Ms. Swift says the lessons helped.

After the Swifts argued with school officials, the district spent more than $6,000 to train several teachers and classroom assistants--including Toby's teacher--in the techniques of the auditory-discrimination-in-depth program.

Cathy Shehan, the coordinator of special education services in the Bonita Unified School District, where Toby is a student, said the district has also formed a committee to explore other techniques for helping struggling readers and to set up a reading curriculum for special education students.

The district balked, however, at the Swifts' request to continue Toby's tutoring over the summer.

For now, 10-year-old Toby, who has also been formally identified as gifted, will get his auditory-discrimination-in-depth lessons at school five days a week. But Ms. Swift is concerned that the half-hour lessons provide too little, too late.

She says that in the 8th grade special education class she teaches, she knows that most of the children are there because they cannot read.

"I have a very bright little boy," Ms. Swift says, "and if I'm not careful he'll be lost to the education system."

Vol. 17, Issue 12, Page 24-26

Published in Print: November 12, 1997, as Dealing With Dyslexia
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