Dyslexia in children: causes, symptoms, diagnosis, treatment

Dyslexia is a general term that describes primary reading disorders. Diagnostics includes examination of intellectual abilities, academic performance, speech development, state of health, as well as psychological examination. Treatment of dyslexia is primarily aimed at correcting the learning process, including learning to recognize words and their components.

There is no generally accepted definition of the term "dyslexia", so its prevalence is unknown. According to estimates of a number of researchers, 15% of children attending general schools receive special correction for reading problems, while half of them may have constant reading disorders. Dyslexia is more often detected among boys, but sex is not a proven risk factor for dyslexia.

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The cause and pathophysiology of dyslexia

Problems with phonological process cause violation of recognition, combination, memorization and analysis of sounds. With dyslexia, there can be a violation of both writing and understanding written speech, which is often limited in the future to problems with auditory memory, speech formation, the name of objects, or the search for suitable words. Also, the main violations of verbal speech are often noted.

There is a tendency toward family dyslexia. Children from families with an anamnesis of reading disabilities or developmental disorders of school skills are at higher risk. Since changes in the brain of people suffering from dyslexia have been identified, experts believe that dyslexia is primarily a consequence of cortical dysfunction due to congenital anomalies in the development of the nervous system. Assume the role of violations of the integration or interaction of specific functions of the brain. Most scientists agree that dyslexia is associated with the left hemisphere and disorders in the areas of the brain responsible for speech perception (the Wernicke zone) and speech speech (the Broca region), as well as with disruption of the connection between these areas through an arc-shaped beam. Dysfunctions or defects in the area of the angular gyrus, middle occipital region, and the right hemisphere cause problems with word recognition. The inability to learn the rules for the formation of words when reading a printed text is often regarded as part of dyslexia. Such children may have difficulty in determining the root in the word or gender of the word, as well as in determining which letters in the word are followed.

Problems with reading, other than dyslexia, are usually caused by difficulties in understanding speech or low cognitive abilities. Visual-perceptual problems and abnormal eye movements do not belong to dyslexia. At the same time, these problems can further influence the study of words.

Symptoms of dyslexia

Dyslexia can manifest as a delay in speech development, difficulty in articulation and difficulty with memorizing the names of letters, numbers and colors. Children with problems in the phonological process often have difficulty with the combination of sounds, rhyming words, determining the position of letters in words, and also dividing words into spoken parts. They can reverse the order of sounds in words. The delay or hesitation in the choice of words, the replacement of words or the naming of letters and pictures with a similar configuration is often an early indication. Violations of short-term auditory memory and auditory consistency are common.

Less than 20% of children with dyslexia have problems with meeting the vision required for reading. Nevertheless, some confuse letters and words with a similar configuration, or they have difficulties with the visual choice or definition of patterns of sounds and their combinations (associations of sounds and symbols) in words. There may be a permutation of characters or their incorrect perception, most often associated with difficulties in remembering and restoring in memory, so that children forget or confuse the names of letters and words with a similar structure; so d becomes b, m becomes w, h becomes n, was becomes saw, on becomes on. However, this can be the norm in a child under 8 years old.

Diagnosis of dyslexia

In most children, violations are not detected before entering kindergarten or school, where they begin learning the symbols. It is necessary to examine children with a delay in passive or active speech that do not catch up with peers by the end of the first stage of instruction, or if children at any level of instruction are not read at the level expected from their verbal or intellectual abilities. Often the best diagnostic feature is the child's inability to respond to traditional or typical reading approaches at the first stage of training, although a wide variability in reading skills can be observed in children at this level. For diagnosis, confirmation of problems with phonological processing is necessary.

Children who are suspected of having dyslexia should undergo a survey of reading skills, level of speech development, hearing, cognitive abilities and psychological examination to identify functional characteristics and preferred forms of learning. Such a survey can be conducted at the request of the teacher or parents of the child on the basis of the Education for Persons with Disabilities Act (IDEA), a special US educational law. The results of the survey then allow us to determine the most effective approaches to teaching the child.

Evaluation of the understanding of the text in reading is aimed at determining the recognition and analysis of words, speech control, understanding of read and heard speech, as well as the level of understanding of vocabulary and the process of reading.

Evaluation of the pronunciation, language and perception of the text by ear allows you to evaluate spoken language and the violation of the perception of phonemes (sound elements) of spoken language. Also, the function of active and passive speech is evaluated. Cognitive abilities (attention, memory, justification) are also examined.

Psychological examination is aimed at identifying emotional aspects, which can intensify reading disorders. It is necessary to collect a complete family history, including the presence of mental disorders and emotional disorders in the family.

The doctor should make sure that the child has normal vision and hearing, either by screening or by sending the child to test hearing and vision. A neurological examination can help identify secondary signs (eg, neuropsychiatric immaturity or minor neurological disorders) and exclude other problems (eg, seizures).

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Treatment of dyslexia

Despite the fact that dyslexia remains a problem throughout life, many children develop functional reading skills. Nevertheless, some children never reach a sufficient level of literacy.

Treatment consists of correction of the learning process, including direct and indirect learning of word recognition and the skills of highlighting word components. Direct learning involves the use of special phonetic methods apart from teaching reading. Indirect training involves the integration of the use of special phonetic methods into reading programs. Can be used as approaches that include learning to read in whole words or expressions, and approaches that use the hierarchy of acquiring skills from studying sound units to whole words, and then sentences. Then, it is recommended to use approaches with influence on several senses, including the study of whole words and the integration of visual, auditory and tactile sensations for learning sounds, words and sentences.

Learning the skills of separating the components of words includes the skills of mixing sounds to form words, dividing words into parts, determining the location of sound in a word. The skills of highlighting components for understanding the text during reading include defining the main idea, answering questions, highlighting facts and details, and reading with conclusions. It is useful for many children to use a computer in order to help them select words in the text or to perceive words when reading written language.

Other methods of treatment (eg, optometric training, perceptual training, training for the development of visual-auditory integration) and drug therapy have unproven efficacy, and their use is not recommended.