My child seems to be very smart, can she still have a reading problem?

Yes, we know that many bright children have trouble learning to read. Such children who have an unexpected difficulty in learning to read are referred to as dyslexic. Children who are dyslexic have the intelligence, motivation, and schooling considered to be necessary for reading and yet still have difficulty. These children have a problem getting to the sound structure of spoken and written words. As a result they have a problem sounding out words. At the same time, these children may have strong abilities in reasoning, in understanding and in knowing the meaning of words. It is this pattern of a problem in decoding in contrast to strong thinking and reasoning skills that makes dyslexia so frustrating. It is important that even bright children be evaluated for any signs of a reading problem, because they are often overlooked and can be greatly helped by early identification. Even gifted children can have dyslexia.

What happens to gifted reading disabled children as they get older?

Parents often worry about the future for their gifted child with reading problems. Children with dyslexia can become anything they want to be as long as they are allowed to access and use their often excellent thinking skills. To do this, it is critical that they be given accommodations as they go on in school. The most important accommodations include:

• extra time for examinations, including standardized tests and assignment completion
• notetakers or allowance to record class lectures
• access to books on tape
• tutors to “talk through” and review the content of reading material
• alternatives to multiple choice tests (e.g. reports or orally administered tests)
• the use of lap-top computers with spelling checkers.

The use of books on tape is particularly important for bright young dyslexic readers to insure that they will be exposed to all the richness of literature that they might otherwise miss, and to gain knowledge of current events and content areas. Many students have told me how much these accommodations have meant to them. Students often consider these resources a life-line.

What occupations or professions can children with dyslexia dare to dream about?

We have learned that children with dyslexia can become lawyers, doctors, architects, writers, business leaders, teachers or journalists. Children who are dyslexic should be encouraged to follow their abilities and their dreams and should not be prematurely discouraged or tracked into less desirable occupations. Having strong intelligence, motivation, support from home and school, together with accommodations opens the door to whatever future that child dreams about. A famous physician-surgeon told me that he had struggled with reading so much that he was advised to transfer to a vocational program for carpentry. It was fortunate that a caring and capable teacher discovered his abilities in middle school and worked with him for hours and hours each week to teach him to read. He remains a slow but accurate reader today.

Do we know what happens within the brain during reading?

Tremendous progress has been made in understanding how the brain reads. As a result of advances in technology, we can now see what is happening in the brain as someone reads. A technology called functional magnetic resonance imaging (fMRI) uses an MRI scanner to view the working brain. It uses the same kind of scanner that takes an image of your knee if you tear a ligament. There is no radiation or injection involved because it uses magnetism instead. Using this technology, we are able to compare brain activation patterns in good and in poor readers and have found important differences in the wiring. Good readers activated a large neural circuit in the back of the brain. Poor readers underactivated this same circuit. In contrast, poor readers seem to overactivate an area in front of the brain. We believe that this pattern (relative underactivation in the back of the brain and relative overactivation in the front of the brain) may be a neural signature for dyslexia.

Why are differences in imaging patterns important to know about for parents and teachers?

Often dyslexic readers are blamed for not trying hard enough or for not being motivated. Up until now they had nothing, no hard evidence, to show that their problem was real. Now, children can point to these brain images and say, “Look, this reading problem is real, it has a neural basis.”

Can I take my child to get an fMRI to diagnose his reading problem?

Not yet, imaging is still used only for research and not for diagnosis. However, it is highly likely that within several years, brain imaging will be used for earlier and more precise diagnosis of a reading problem. In the future, brain imaging may also tell us how effective a reading program is for a particular child. We may be able to look at brain imaging patterns before and after a reading intervention to see if they have improved. What a wonderful future to look forward to!

Dr. Sally Shaywitz, Professor of Pediatrics and Dr. Bennett Shaywitz, Chief of Child Neurology and Professor of Pediatrics and Neurology at Yale University, are Co-Directors of the Yale Center for the Study of Learning and Attention. They are both clinicians who care for patients with reading difficulties and neuroscientists who study the neural basis of reading and reading disability. Drs. Shaywitz will be the guest speaker at the Schwab Foundation for Learning’s Spring educational program. For more information on this program, please call 1-800-230-0988.

Additional resources the authors suggest the following materials:

Resources: Dyslexia. Shaywitz, S. E. (November 1996). Scientific American, volume 275; pages 98-104. http://www.sciam.com/1196issue/1196shaywitz.html

Unlocking Learning Disabilities: The Neurological Basis. Shaywitz, S. E. and Shaywitz, B.A. in Learning Disabilities: Lifelong Issues. Edited by Shirley C. Cramer and William Ellis (1996). Baltimore: Paul H. Brookes Publishing Co. Pages 255-260.

Dyslexia. Current Concepts. Shaywitz, S.E. in New England Journal of Medicine, January 29, 1998. 338:307-312. The article can be ordered from the publisher at http://www.nejm.org/content/1998/0338/0005/0307.asp

Imaging Information on the Internet, http://info.med.yale.edu/pediat/pedineur/ Click on Research, go to Bennett A. Shaywitz Recent Publications, click on Functional Disruption in the Organization in the Brain for Dyslexia.