clues: shaywitz (2006)

Re: Dyslexia, Diagnosis; Clues
Fr: Sally Shaywitz, MD* (2006). Overcoming dyslexia: A new and complete science-based program for reading problems at any level. NY: Vintage Books, pp. 29-30, 122-127, 132.

[*Dr. Shaywitz is Professor of Pediatrics at the Yale University School of Medicine, codirector of the Yale Center for the Study of Learning and Attention, and member of the National Reading Panel and the Institute of Medicine of the Academy of Sciences.]

• Definition

Dyslexia is “a reading difficulty in a child or adult who otherwise has good intelligence, strong motivation, and adequate learning” (p. 132).

It is defined by the International Dyslexia Association (2002) as “a specific learning disability that is neurobiological in origin. 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.” (p. 132)

• Prevalence Rate

“The Connecticut study [longitudinal, begun in 1983 by Yale University] indicates that reading disability affects approximately one child in five.” (p. 30) It is “estimated to comprise at least 80 percent of all learning disabilities….” (p. 29)

• Clues to Dyslexia

A. Early Childhood (pp. 122-123)

“The earliest clues involve most spoken language. The very first clue to a language (and reading) problem may be delayed language. Once the child begins to speak, look for the following problems:

The Preschool Years

-- Trouble learning common nursery rhymes such as “Jack and Jill” and “Humpty Dumpty”
-- A lack of appreciation of rhymes
-- Mispronounced words; persistent baby talk
-- Difficulty in learning (and remembering) names of letters
-- Failure to know the letters in his own name

Kindergarten and Grade I

¬-- Failure to understand that words come apart; for example, that batboy can be pulled apart into bat and boy, and later on, that the word bat can be broken down still further and sounded out as “b” “aaa” “t”
-- Inability to learn to associate letters with sounds, such as being unable to connect the letter b with the “b” sound
-- Reading errors that show no connection to the sounds of the letters; for example, the word big is read as goat
-- The inability to read common one-syllable words or to sound out even the simplest of words, such as mat, cat, hop, nap
-- Complaints about how hard reading is, or running and hiding when it is time to read
-- A history of reading problems in parents or siblings

In addition to the problems of speaking and reading, you should be looking for these indications of strengths in higher-level thinking processes: [122/123]

-- Curiosity
-- A great imagination
-- The ability to figure things out
-- Eager embrace of new ideas
-- Getting the gist of things
-- A good understanding of new concepts
-- Surprising maturity
--- A large vocabulary for the age group
-- Enjoyment in solving puzzles
-- Talent at building models
-- Excellent comprehension of stories read or told to him

B. From Grade II On (pp. 123-125)

Problems in Speaking

-- Mispronunciation of long, unfamiliar, or complicated words; the fracturing of words – leaving out parts of words or confusing the order of the parts of words; for example, aluminum becomes amulium
-- Speech that is not fluent – pausing or hesitating often when speaking, lots of um’s during speech, no glibness [fluency]
-- The use of imprecise language, such as vague references to stuff or things instead of the proper name of an object
-- Not being able to find the exact word, such as confusing words that sound alike: saying tornado instead of volcano, substituting lotion for ocean, or humanity for humidity
-- The need for time to summon an oral response or the inability to come up with a verbal response quickly when questioned
-- Difficulty in remembering isolated pieces of verbal information (rote memory) – trouble remembering dates, names, telephone numbers, random lists

Problems in Reading

-- Very slow progress in acquiring reading skills
-- The lack of strategy to read new words
-- Trouble reading unknown (new, unfamiliar) words that must be sounded out; making wild stabs or guesses at reading a word; failure to systematically sound out words
-- The inability to read small “function” words such as that, an, in [123/124]
-- Stumbling on reading multisyllable words, or the failure to come close to sounding out the full word
-- Omitting parts of words when reading; the failure to decode parts within a words, as if someone had chewed a hole in the middle of the word, such as conible for convertible
-- A terrific fear of reading out lout; the avoidance of oral reading
-- Oral reading filled with substitution, omissions, and mispronunciations
-- Oral reading that is choppy and labored, not smooth or fluent
-- Oral reading that lacks inflection and sounds like the reading of a foreign language
-- A reliance on context to discern the meaning of what is read
-- A better ability to understand words in context than to read isolated single words
-- Disproportionately poor performance on multiple choice tests
-- The inability to finish tests on time
-- The substitution of words with the same meaning for words in the test he can’t pronounce, such as car for automobile
-- Disastrous spelling, with words not resembling true spelling; some spellings may be missed by spell check
-- Trouble reading mathematics word problems
-- Reading that is very slow and tiring
-- Homework that never seems to end, or with parents often recruited as readers
-- Messy handwriting despite what may be an excellent facility at word processing – nimble [= quick in movement] fingers
-- Extreme difficulty learning a foreign language
-- A lack of enjoyment of reading, and the avoidance of reading books or eve a sentence
-- The avoidance of reading for pleasure, which seems too exhausting
-- Reading whose accuracy improves over time, though it continues to lack fluency and is laborious
-- Lowered self-esteem, with pain that is not always visible to others
-- A history of reading, spelling, and foreign language problems in family members

In addition to signs of a phonologic weakness, there are signs of strengths in higher-level thinking processes: [124/125]

-- Excellent thinking skills: conceptualization, reasoning, imagination, abstraction
-- Learning that is accomplished best through meaning rather than rote memorization
-- Ability to get the “big picture”
-- A high level of understanding of what is read to him
-- The ability to read and to understand at a high level of overlearned (that is, highly practiced) words in a special area of interest; for example, if his hobby is restoring cares, he may be able to read auto mechanics magazines
-- Improvement as an area of interest becomes more specialized and focused, when he develops a miniature vocabulary that he can read
-- A surprisingly sophisticated listening vocabulary
-- Excellence in areas not dependent on reading, such as math, computers, and visual arts, or excellence in more conceptual (versus factoid-driven) subjects such as philosophy, biology, social studies, neuroscience, and creative writing

C. Young Adults and Adults (pp. 125-126)

Problems in Speaking

-- Persistence of earlier oral language difficulties
-- The mispronunciation of the names of people and places, and tripping over parts of words
-- Difficulty remembering names of people and places and the confusion of names that sound alike
-- A struggle to retrieve words: “It was on the tip of my tongue”
-- Lack of glibness, especially if put on the spot
-- Spoken vocabulary that is smaller than listening vocabulary, and hesitation to say aloud words that might be mispronounced

Problems in Reading

-- A childhood history of reading and spelling difficulties
-- Word reading becomes more accurate over time but continues to require great effort
-- Lack of fluency [125/126]
-- Embarrassment caused by oral reading: the avoidance of Bible study groups, reading at Passover seders, or delivering a written speech
-- Trouble reading and pronouncing uncommon, strange, or unique words such as people’s names, street or location names, food dishes on a menu (often resorting to asking the waiter about the special of the day or resorting to saying, “I’ll have what he’s having,” to avoid the embarrassment of not being able to read the menu)
-- Persistent reading problems
-- The substitution of made-up words during reading for words that cannot be pronounced – for example, metropolitan becomes mitan – and a failure to recognize the word metropolitan when it is seen again or heard in a lecture the next day
-- Extreme fatigue from reading
-- Slow reading of most materials: books, manuals, subtitles in foreign films
-- Penalized by multiple-choice tests
-- Unusually long hours spent reading school or work-related materials
-- Frequent sacrifice of social life for studying
-- A preference for books with figures, charts, or graphics
-- A preference for books with fewer words per page or with lots of white showing on a page
-- Disinclination to read for pleasure
-- Spelling that remains disastrous and a preference for less complicated words in writing that are easier to spell
-- Particularly poor performance on rote clerical tasks

D. Sings of Strength in Higher-Level Thinking Processes (pp. 126-127)

-- The maintenance of strengths noted in the school-age period
-- A high learning capability
-- A noticeable improvement when given additional time on multiple-choice examinations
-- Noticeable excellence when focused on a highly specialized area such a medicine, law, public policy, finance, architecture, or basic science
-- Excellence in writing if content and not spelling is important
-- A noticeable articulateness in the expression of ideas and feelings [126/127]
-- Exceptional empathy and warmth, and feeling for others
-- Success in areas not dependent on rote memory
-- A talent for high-level conceptualization and the ability to come up with original insights
-- Big-picture thinking
-- Inclination to think out of the box
-- A noticeable resilience and ability to adapt