Understanding Dyslexia Better

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Aoccdrngig to rscheearch at an Elingsh uinervtisy, it deosn't mttaer in waht oredr the ltteers in a wrod are, olny taht the frist and lsat ltteres are at the rghit pcleas. The rset can be a toatle mses and you can sitll raed it wouthit a porbelm. This is bcuseae we do not raed ervey lterer by ilstef, but the wrod as a wlohe.

When Words Collide: Understanding Dyslexia and its Promising New Treatments

By David North. This article appears courtesy of The Long Island Press. All rights reserved.

"What do letters have to do with words?"

This provocative quote, more of a challenge than a question, is posed by Merrill Loechner of Levittown. She was diagnosed as dyslexic at 19.

Imagine trying to read this article one word at a time, struggling to get to the end of a sentence, then forgetting what you just read. Imagine the frustration of not being able to trust your senses, as letters and words move and dance about. All the time. These are just two examples of challenges faced each day by many children and adults coping with dyslexia.

Up to 15 percent of the U.S. population has significant difficulty learning to read, according to the National Institutes of Health. People are born with dyslexia, and often, other family members have the disability. The National Center for Learning Disabilities estimates that almost 2.9 million school-aged children-5 percent of those in public schools-are classified as having specific learning disabilities and receive some kind of special education support.

Loechner says that as a child, she coped with her condition by learning to recognize words by their shape: "Letters make up words, but those words stand alone." She insisted, as do many children, that her mother read the same stories over and over (The Cat in the Hat, for example), and claims that the repetition helped her associate the sounds of the words she was hearing with the shapes on the pages. As a precocious grade-schooler, she says she was reading and enjoying novels by Agatha Christie, who coincidentally had a learning disability associated with dyslexia: dysgraphia, the inability to write legibly. Christie managed the condition by dictating her manuscripts to a typist.

Loechner managed to read and write well enough not to draw attention and concern from her parents and teachers. She says that she arrived as a student at Island Trees Elementary School already reading, so her condition went largely unrecognized.

"No one ever told me to 'sound out' a word," Loechner recalls. Her academic challenge was mathematics (dyscalculia).

"One can get by interpolating words and letters," she says, "but numbers require precision." She describes viewing numbers as one might see those popping Powerball numbers on the television Lotto drawings. Loechner admits that when she was a girl in the '70s and '80s, society may have given her a pass for her weakness at math. She was called out on her condition when a teacher reviewed a college placement test.

"He says, 'You have a good vocabulary, poorly executed,' typical of a high-functioning dyslexic," she tells the Press.

The Dyslexic World
Dysgraphia and dyscalculia are just two of dozens of related symptoms under the umbrella of dyslexia, according to Dr. Harold Levinson, a psychiatrist and neurologist in Great Neck. Others include dysphasia (impaired speech and verbal comprehension), attention deficit disorder (ADD) and hyperactivity disorders.

"In most cases, a person may reverse a 'D' or a 'B', or reverse 'saw' for 'was'," Levinson says, adding that in those cases, people understand words, and compensate by using context. More serious conditions will find people struggling to keep track of words in a line, or they'll skip words or whole lines.

"Sometimes letters will wiggle, or they'll take on words one letter at a time; by the time they finish the word, they've forgotten what preceded it. Some can be distracted by sounds; some are light-sensitive, too," Levinson explains.

Imagine having letters moving, or tunneling-then also strobing and flickering under fluorescent lighting!

Some children battling dyslexia will become distracted, frustrated and angry.

"It's no question many dysfunctional mechanisms are also coupled with anxiety," Levinson explains. These many conditions, and difficulty with memory and context, can diminish confidence and lead to questions about a person's intelligence. "The delay in processing information can derail the whole learning process," says Levinson. That's terribly unfair, considering the amount of brainpower and adaptation required for coping with dyslexia.

Intelligence is not an issue for Loechner, who is now a marketing manager for a laboratory products company in Connecticut.

Her intellectual capacity is verified by her being a (literally) card-carrying member of the high-IQ society, Mensa. Her experiences, including her apparent success in learning to use a "whole-word recognition" process, are not regarded as typical; but she did adapt and was regarded as a gifted reader. Another well-known dyslexic was Albert Einstein. Dyslexia certainly doesn't hamper creativity either, as demonstrated by dyslexic actors Cher, Harrison Ford, the late River Phoenix and Sylvester Stallone.

Why Tommy Can't Read
The Martins (their names have been changed) of Lynbrook describe helping their now 8-year-old son Tommy navigate the educational system.

"In preschool he had some trouble with his alphabet, and with numbers," explains Mrs. Martin. "We thought it was a visual problem, but the teachers said he was OK, and about equal in development with the others."

When asked if their son had attempted whole-word recognition, as Loechner did, the Martins say their son showed little or no interest in books.

"We would read to him, and he seemed to enjoy listening, and he could tell us about the stories, but he'd never pick up a book and bring it to us; he wouldn't initiate it [a reading session]."

In first grade, Tommy seemed to do well with the concept of phonics.

"He knew his consonant sounds, but he had trouble reading," says Mrs. Martin, describing the problem as more than just reversing 'Ds' and 'Bs'. "He'd also get 'Zs' and 'Ss' backwards and many numbers, all except 1, 0 and 8 [symmetrical shapes]." The couple took their son to Hofstra University for testing.

"We were told he was learning disabled, but weren't given any specifics," says his mother. "In fact, we were told the phonics I taught him confused him!"

When their son entered the second grade, another teacher suggested testing, this time through the Lynbrook School District. Those tests included copying shapes (to evaluate his visual-motor function), matching shapes to test his perception, and a visual-memory procedure (similar to the game "Concentration"). There was also a reading component.

"If he was read to, he'd remember and test very well," says Mr. Martin. "But if he read himself, his 'time' was below average and he tested poorly. Smart people compensate; he did very well in some things, so he averaged out to 'average.'" The Martins were also told he was too young for a diagnosis of dyslexia. Ironically, they later concluded they had waited too long.

Their son stayed in regular classes with some support.

"But at age 8, he started becoming anxious about comparisons with other kids," recalls Mrs. Martin. "A classmate scolded him-'You can't read!'" Tommy continued with occupational therapy and a phonics program, but wasn't making progress. A friend told Mrs. Martin about a nephew diagnosed with dyslexia, who appeared to be making progress working with Levinson.

"We saw his book, Smart But Feeling Dumb, and we finally felt someone knew what we were experiencing," says Mr. Martin. "[Our son] absorbs vocabulary and can use it, sometimes eloquently, but otherwise he had all this information in his head, but he couldn't get it out."

Dr. Readgood
Levinson began his research on dyslexia while working for the Bureau of Reading Services for the board of education in New York City. His experiences working with hundreds of children from a wide range of ethnic, social and economic backgrounds called into question the traditional concepts of dyslexia. Some medical minds had theorized that dyslexia was the result of damage to portions of the brain, or the result of emotional problems; perhaps parents pushed their children too hard.

"In order for a theory to work, it has to address all cases," says Levinson. "Many students were quite bright, and aside from their symptoms, quite happy." Where he found no evidence of "brain trouble," he frequently found motor coordination problems; children were accident-prone, or had trouble skipping, or holding crayons, and, as expected, had difficulty keeping their place on the printed page. His observations led him to another theory.

As part of his testing regimen, Levinson applied a standard neurological exam, described as similar to a field sobriety test. He found that 75 percent of the patients he tested had significantly impaired balance and coordination. "Astronauts cope with a condition called 'space dyslexia,'" he explains. "It's addressed with anti-motion-sickness medications."

Levinson says that for patients previously indicated as balance/coordination impaired, as many as 85 percent showed improvement when prescribed medication to stabilize the inner ear. As an added benefit, patients reported a decline in their anxiety.

Comparing current research about dyslexia with historic advances in the perception of medical conditions, Levinson says, "Years ago, before diabetes was understood, patients and doctors would try to address each symptom-vision, heart, circulation-then we found it was one condition, an insulin condition." There are many conditions under the umbrella of learning disorders, and Levinson says there is no one solution for the range of conditions encompassed in that diagnosis. He admits that the possible link between ear infections, mononucleosi, and other balance-related conditions to dyslexia is not completely understood. But think about it: If you were whirled about and dizzy, could you read this article?

Seeing Things Clearly
Levinson's theories are controversial, just not at the Martin home. The Martins say that after five months of treatment on meclizine, an antivertigo drug, their son is showing improvement. Mrs. Martin says, "He's doing much better and it was the best autumn we had for his allergies in years."
"It's so sad so many kids aren't being diagnosed, when they could be getting help," says Mr. Martin. "Especially at [Tommy's] age, when they're learning how to learn. For now, he's getting the basics; later, he'll be evaluated on content-how he applies what he's learning."

Current technology is also reason for optimism.

"If he had to have this condition, this is the time," says Mr. Martin, who cites indexed and reviewable CD-ROMs, computer spell check and assisted technologies on the horizon, such as voice-recognition systems and word-prediction programs. "[Tommy] wants to go to college, he's set on it; he wants to be a zookeeper at the Sydney Zoo. He loves the hands-on aspects of science: If he can hear it, and touch it, he'll absorb it. He understands concepts about triangular bridge-construction, biology, botany, cells, DNA, photosynthesis...he was even confident enough to correct a teacher about reptiles having scales, not skin." Their son continues to receive help through occupational therapy and with phonics.

Back on the whole-word recognition front, Loechner is also enthusiastic about the role computers play in improving her situation.

"Spell check lets me use my entire vocabulary," she says, "not just words I can 'draw.' But I have to have my copy reviewed to be sure the correctly spelled word is the correct word !" Text style is an issue too, even in romance. At dating websites, she finds writing in all caps creates words in unfamiliar shapes, while messages in all lower case makes the suitor appear "dumb and lazy." Mister Right must know how to use a shift key.

By David North. This article appears courtesy of The Long Island Press. All rights reserved.

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