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Dyslexia

Topic Overview

What is dyslexia?

Dyslexia is a learning disability that makes it hard to read, write, and spell. It occurs because the brain jumbles or mixes up letters and words. Children with dyslexia often have a poor memory of spoken and written words.

Having dyslexia does not mean that your or your child's ability to learn is below average. In fact, many people with dyslexia are very bright. But not being able to read well can make many areas of learning difficult.

Dyslexia is also called specific learning disability, reading disorder, and reading disability.

What causes dyslexia?

Experts don't know for sure what causes dyslexia. But it often runs in families. So it may be passed from parents to children (genetic disorder). Also, some studies have found problems with how the brain links letters and words with the sounds they make.

Dyslexia is not caused by poor vision, and people with dyslexia do not see letters and words backward.

What are the symptoms?

Signs of dyslexia in children who are too young for school include:

  • Talking later than expected.
  • Being slow to learn new words.
  • Problems rhyming.
  • Having a hard time knowing which sounds are most alike and which ones don't belong (for example, not being able to tell that "was" doesn't sound like mat, hat, or sat).
  • Problems following directions that have many steps.

After a child begins school, the signs of dyslexia include:

  • Trouble learning the alphabet.
  • Problems reading single words, such as a word on a flash card or in text they know (like a favourite book).
  • Problems linking letters with sounds.
  • Confusing small words, such as "at" and "to."
  • Reversing the shapes of written letters such as "d" for "b." For example, the child may write "dat" instead of "bat."

If your child has one of these signs, it does not mean that they have dyslexia. But if your child has several of these signs, or if you have a family history of dyslexia, you may want to speak with your family doctor or your child's teacher. They can arrange tests to check your child's reading.

How is dyslexia diagnosed?

Dyslexia and other learning problems are diagnosed by a psychologist who specializes in children and how they learn (called an educational psychologist). A diagnosis is made by an assessment process that may include:

  • Gathering information about your child’s development and their medical, family, social, and educational (school) history.
  • Tests to help them understand how your child learns, solves problems, and what their strengths and problems are with learning and understanding language.
  • Gathering information from you, your child, and your child’s teachers.

After the educational psychologist looks over all of the information they gathered, they will write a report. The report includes:

  • All the assessment information.
  • A diagnosis (if there is one).
  • Treatment recommendations for your child.
  • Ways for your family and school to support your child.

How is it treated?

Treatment uses a number of teaching methods to help your child read better. These methods include:

  • Teaching how letters are linked to sounds to make words.
  • Teaching how to divide longer words into syllables.
  • Using hands-on, fun activities to teach concepts.
  • Giving extra time for reading tasks.
  • Using audio books that your child can listen to while reading. This helps them link the letters they see to the sounds they hear.

If your child is diagnosed with dyslexia, the educational psychologist will develop a plan for your child’s support and treatment. This is called an individual program plan (IPP) or individual support plan (ISP). The educational psychologist will ask you, your child's teachers, and others at the school who they work with to take part in designing the plan. Your child will get an updated plan each year based on how well they are doing and what your child's needs are.

Medicines and counselling usually are not a part of treatment for dyslexia.

Dyslexia is lifelong and early help and support during childhood can help. Support from family, teachers, and friends is also important.

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Cause

The cause of dyslexia is not clear, although it is probably an inherited (genetic) disorder because it runs in families.

Some studies have shown that people with dyslexia have abnormalities in the functioning of the areas of the brain involved in reading and language.footnote 1

There are 3 areas of the brain that help you read:

  • an area that finds patterns in sounds and symbols
  • an area that’s involved with how fast and smooth you read
  • an area that’s involved with sounding out words and knowing how different words look

With dyslexia, each of these areas may affected making it hard to develop reading skills.

Dyslexia is not caused by:

  • poor vision
  • hearing loss
  • a lack of intelligence (how smart you are)
  • a lack of trying

People with dyslexia do not see letters and words backwards.

Symptoms

Signs of dyslexia vary depending on age. If your child has one or two of the signs, it does not mean that they have dyslexia, but having several of the signs listed below may mean that your child should be tested.

Preschool

A preschool-age child may:

  • Talk later than most children.
  • Have more difficulty than other children pronouncing words. For example, the child may read aloud "mawn lower" instead of "lawn mower."
  • Be slow to add new vocabulary words and be unable to recall the right word.
  • Have trouble learning the alphabet, numbers, days of the week, colours, shapes, how to spell, and how to write their name.
  • Have difficulty reciting common nursery rhymes or rhyming words. For example, the child may not be able to think of words that rhyme with the word "boy," such as "joy" or "toy."
  • Be slow to develop fine motor skills. For example, your child may take longer than others of the same age to learn how to hold a pencil in the writing position, use buttons and zippers, and brush their teeth.
  • Have difficulty separating sounds in words and blending sounds to make words.

Kindergarten through grade 4

Children in kindergarten through fourth grade may:

  • Have difficulty reading single words that are not surrounded by other words.
  • Be slow to learn the connection between letters and sounds.
  • Confuse small words such as "at" and "to," or "does" and "goes."
  • Have trouble rhyming words.
  • Make consistent reading and spelling errors, including:
    • Letter reversals such as "d" for "b."
    • Inversions such as "m" and "w" and "u" and "n."
    • Guessing words based on the first letters.
    • Substitutions such as "house" and "home." Or substitutions within a word such as "sat" and "set" or "pat" and "mat".
    • Adding or taking away letters in words, such as "mate" to "mat" or "though", "through", and "thought".

Grades 5 through 8

Children in fifth through eighth grade may:

  • Read at a lower level than expected for their grade.
  • Read at a slower rate than expected.
  • Reverse letter sequence such as "soiled" for "solid," "left" for "felt."
  • Have trouble rhyming words.
  • Be slow to recognize and learn prefixes, suffixes, root words, and other reading and spelling strategies.
  • Have trouble remembering and understanding what they read.
  • Be able to read a word right in one place and wrong in another place within the same text.
  • May mispronounce the same words, such as saying "frustrated" instead of "frustrated".
  • Have difficulty spelling, and they may spell the same word differently on the same page.
  • Avoid reading aloud.
  • Make more mistakes when reading aloud compared to others in their grade.
  • Have trouble with word problems in math, or math related words (such as hundredth and tenth).
  • Write with difficulty or have illegible handwriting. Their pencil grip may be awkward, fist-like, or tight.
  • Avoid writing.
  • Use lower than expected levels of vocabulary in their writing.
  • Have trouble organizing writing.
  • Have slow or poor recall of facts.

High school and university

Students in high school and university may:

  • Read very slowly with many inaccuracies.
  • Continue to spell incorrectly, or frequently spell the same word differently in a single piece of writing.
  • Avoid courses or tests that require large amounts of reading and writing, and procrastinate on reading and writing tasks.
  • Have trouble taking notes in class.
  • Have trouble following instructions.
  • Have trouble preparing summaries and outlines for classes.
  • Have trouble doing assignments with more than one step or long-term projects.
  • Have trouble managing their time.
  • Have trouble studying from large amounts of written information.
  • Work intensely on reading and writing tasks.
  • Have poor memory skills and complete assigned work more slowly than others.
  • Have an inadequate vocabulary and be unable to store much information from reading.

Adults

Adults with dyslexia may:

  • Hide reading problems.
  • Spell poorly or rely on others to spell for them.
  • Use technology to help them spell, such as spell check or voice-to-text features.
  • Avoid writing or not be able to write at all.
  • Be very competent in oral language, but unable to write at the same level.
  • Rely on memory rather than on reading information.
  • Have trouble with understanding large amounts of text or text above their reading level.
  • Have trouble in social settings, such as not understanding sarcasm (when someone says something they don’t actually mean) or someone’s tone of voice, body language, or expressions of their face.
  • Have spatial thinking skills. Examples of professionals who need spatial thinking abilities include engineers, architects, designers, artists and craftspeople, mathematicians, physicists, physicians (especially orthopedic surgeons, surgeons), and dentists.
  • Often work in a job that is well below their intellectual capacities and are more likely to not have a job or full-time work.
  • Have difficulty with planning and organization.
  • Be entrepreneurs, although lowered reading skills may result in difficulty maintaining a successful business.

What Increases Your Risk

A person is more likely to have dyslexia if their parent or sibling has it. Also, a person is more likely to be diagnosed with dyslexia if they had a speech or language delay as a child.

When to Call the Doctor

If your child struggles with language, reading, and sounding out words, you may want to have your child checked for dyslexia. You can also speak with your child's pediatrician, teacher, school psychologist, or school counsellor if you believe your child's reading or other language skills are not advancing compared to other children their age.

If you have dyslexia and are concerned that your child may have some of the signs of dyslexia, you may want to talk to your doctor or to school personnel because your child is at increased risk for having dyslexia.

Examinations and Tests

A single test can't diagnose dyslexia. Rather, your doctor or a school professional (such as a school psychologist or reading specialist) will ask you what signs of dyslexia you and your child's teachers have seen. They will ask your child questions too. Your child may also be referred to an educational psychologist for an assessment. You can also contact a private educational psychologist.

Reading tests and other types of assessments may be done to help find out more about your child's skills. For example, tests may include those that focus on your child's learning style, language and problem-solving skills, and intelligence quotient (IQ).

It takes a team to gather information about your child and your concerns. School professionals or learning specialists in your area will assess academic skills and abilities. Your child's doctor can assess your child's general health and cognitive development. A complete medical, behavioural, educational, and social history may be taken to rule out other conditions (such as a brain injury) that can also interfere with the ability to read or memorize words.

It must be clear that your child doesn't have another problem that could cause him or her to struggle with reading, such as a condition that affects cognitive development.

Dyslexia is only diagnosed when:

  • There is evidence of a severe reading problem.
  • The problem is not due to below-average intelligence, a visual or hearing deficit or other physical conditions, or a lack of educational opportunity.

To qualify for special education assistance, your child may need to take tests to show that he or she needs special help with his or her language and math skills.

Treatment Overview

Treatment for dyslexia consists of using educational tools to enhance the ability to read. Medicines and counselling usually aren't used to treat dyslexia. An important part of treatment is educating yourself about the condition. The earlier dyslexia is recognized and addressed, the better. Starting treatment when a child is young can improve reading and may even lessen reading problems in the first years of school.footnote 2 But reading will likely not ever be easy for a person with dyslexia.

There are many programs to help children develop their reading and writing skills (called structured literacy intervention). They all follow several rules or methods that include:

  • Teaching how to make better connections between letters and sounds and how to sound out words with more than one syllable.
  • Not expecting children to learn these concepts and skills through their school work and assignments alone.
  • Teaching easier concepts and skills before harder ones and harder reading tasks.
  • Using hands-on, fun activities to teach concepts.

When a child has been diagnosed with dyslexia, public school personnel may create a personal plan for them. This plan is called an individual program plan (IPP) or an individual support plan (ISP). The first step in developing an IPP or ISP for your child, is talking with your child's school to create a support team made up of you, the teacher, and other school personnel, including school counsellors, education teachers, and the school psychologist.

Your child's personalized plan will detail specific challenges, appropriate teaching methods, and goals and objectives for the academic year. It is evaluated at least once a year, with changes made based on your child's progress. Parents have the right to take part in designing their child’s IPP or ISP and giving feedback on the plan.

If you seek special education assistance for your child, it's handy to keep copies of:

It’s important to remember that children do not learn at the same rate. Children with dyslexia have their own strengths and areas for growth. They will also learn skills at their own pace. Because their reading and writing skills are below the level of others in their grade, it’s important that they get ongoing help and support.

Schools can offer support and use teaching technology to help students with dyslexia succeed. This may include:

  • Giving extra time to complete tasks.
  • Help with note taking.
  • Adapted assignments.
  • Digital and online reading and writing tools and apps.
  • Online books that are available to read and listen to.

Depending on the severity of your child's dyslexia, you may want to have a teacher's aide or tutor available to help your child with schoolwork.

If school staff members suggest that your child be held back a grade (grade retention), talk to your doctor or another professional about your options. Grade retention may not help your child any better than other methods.

It is important to know that dyslexia is a lifelong condition. Even though early treatment during childhood can help, your child will likely always have to make an extra effort to read and write.

Ongoing Concerns

Each child with dyslexia has a different set of abilities and areas for growth, which can range from mild to severe. A child's academic future lies in a combination of several things: the severity of dyslexia, their strengths, the treatment plan and how often it's adapted to their needs, support of family and school professionals, family resources, motivation to learn, and any associated disability, such as attention deficit hyperactivity disorder (ADHD).

Up to half of children with specific learning disabilities have other impairments that interfere with their schooling.footnote 4Disabilities often associated with dyslexia include ADHD, behavioural or memory problems, and difficulty using problem-solving skills to achieve a goal.

Studies that have followed children with dyslexia from kindergarten through high school show that most learn to read accurately, although they usually read at a slow rate, aren't completely fluent readers, and have trouble with spelling. So many teens with dyslexia may need some assistance and support in the classroom.

Extra time to finish classroom assignments or tests is often needed by all children with dyslexia. Children with dyslexia also may need help managing their schedules, organizing work, and completing multiple assignments and long-term projects, especially when they reach junior or senior high.

It's also helpful to work with them to find the right kinds of learning tools and apps, such as:

  • Text-reading tools and text in a digital format.
  • Speech-to-text tools so they can dictate ideas.
  • Spell-check, text prediction, and grammar check.
  • Books in audio or digital format.
  • Access to lecture notes.
  • Scheduling apps to help breakdown tasks, plan, and organize their time.

Parents can effectively support their child if they understand dyslexia and how to deal with their child's special needs. Having dyslexia can lead to poor self-esteem, depression, anxiety, frustration, or behavioural problems in some children, which can hinder their reading progress. If you think your child has self-esteem problems related to dyslexia, counselling may help.

Will your child learn to read and succeed at school?

Children with dyslexia have many capabilities and strengths, although reading will probably continue to be a challenge throughout life. The earlier dyslexia is recognized and addressed, the greater the chance that your child will learn to read at their highest possible level.

Encouraging and supporting your child while staying involved in his or her education are other key factors. As they get older, help your child learn how to ask for help when they need it to prepare them to be adult learners. Helping children with coping strategies as they advance in school will also help. Although extra effort and dedication are required, often children with dyslexia are able to contend with this challenge and succeed in academics and other areas.

Helping Your Child

Parents can make a big difference in improving the reading skills of a child diagnosed with dyslexia. Because you are most aware of your child's strengths and weaknesses, you can focus on learning strategies that will work best for them. With young children, playing alphabet games and reading rhyming books, for example, while offering support and encouragement, might greatly improve reading skills. Staying involved with your child's education throughout the school years will be a key part of your child's success.

You can be a positive force in your child's education. Following is a list of ways parents can help their young children with dyslexia develop reading skills and feel good about themselves.

  • Read to your child. Find time to read to your child every day. Point to the words as you read. Draw attention to words that you run across in daily life, such as traffic signs, billboards, notices, and labels.
  • Be a good reading role model. Show your child how important reading is to daily life. Make books, magazines, and other reading materials available for your child to explore and enjoy independently.
  • Focus on the sounds within words (phonemes). Play rhyming games, sing songs that emphasize rhyme and alliteration, play word games, sound out letters, and point out similarities in words.
  • Work on spelling. Point out new words, play spelling games, and encourage your child to write.
  • Help with time and planning. Hang up simple charts, clocks, and calendars, so your child can visualize time and plan for the future.
  • Share in the joy of reading. Find books that your child can read but that you will also enjoy. Sit together, take turns reading, and encourage discussion. Revisiting words that cause trouble for your child and rereading stories are powerful tools to reinforce learning.
  • Read, read, read. Read to and with your child. This can help make a positive difference in learning basic reading skills.

Children who have dyslexia may need emotional support for the many challenges they face. Following is a list of ways parents can offer encouragement.

  • Learn about dyslexia. Information about dyslexia can help you better understand and assist your child.
  • Teach through your child's areas of strength. For example, if your child understands more when listening, let him or her learn new information by listening to an audio book or watching a DVD. If possible, follow up with the same story in written form.
  • Respect and challenge your child's natural intelligence. Most children with dyslexia have average or above-average intelligence that can be challenged by parents who encourage their intellectual growth.
  • Talk openly about dyslexia. Be honest with your child about what dyslexia is. Explain it in understandable and age-appropriate examples and terms while offering unconditional love and support.
  • Teach your child to persevere. You can model, through good-humoured acceptance of your own mistakes, that mistakes can help you find solutions. Teach them that it is OK to ask for help, and we all need help sometimes.
  • Recognize your child's limitations. There may be some things your child will always struggle with. Let your child know this is OK. Help your child find ways to use their strengths to do tasks they struggle with.
  • Don't become a homework tyrant. Expecting perfection and squabbling with your child over homework will create an unhealthy relationship and emphasize your child's failures.
  • Talk about people with dyslexia. This can help young people see others with the same learning challenges be successful and encourage them to keep trying.

Other Treatments

Vision problems can interfere with the process of reading, but vision problems don't cause dyslexia. Some people may claim that vision therapies (such as covering one eye or using coloured lenses) help treat dyslexia. But there hasn't been strong evidence to support this claim.footnote 5, footnote 6

There are many reading programs available and many are online. These programs can help children master the skills they need to develop their reading and spelling skills. Some advertised reading programs that promise success in teaching phonics and reading for children who have dyslexia should be viewed with caution. Before you invest in these programs, request research that documents their claims, and talk to school personnel and doctors.

References

Citations

  1. Reiff MI, Stein MT (2011). Learning problems. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 327–331. New York: McGraw-Hill.
  2. Shaywitz SE, et al. (2006). Dyslexia (specific reading disability). In FD Burg et al., eds., Current Pediatric Therapy, 18th ed., pp. 1244–1247. Philadelphia: Saunders Elsevier.
  3. National Institute of Child Health and Human Development (2000). Report of the National Reading Panel. Teaching Children to Read: An Evidence-Based Assessment of the Scientific Research Literature on Reading and Its Implications for Reading Instruction. Available online: http://www.nationalreadingpanel.org/publications/summary.htm.
  4. Shapiro B, et al. (2007). Specific learning disabilities. In ML Batshaw et al., eds., Children with Disabilities, 6th ed., chap. 25, pp. 367–385. Baltimore: Paul H. Brookes Publishing.
  5. American Academy of Pediatrics (2011). Joint technical report—Learning disabilities, dyslexia, and vision. Pediatrics, 127(3): e818–e856.
  6. Canadian Ophthalmological Society (2004). Policy statements and guidelines: Learning disabilities, dyslexia, and vision. Available online: http://www.eyesite.ca/english/program-and-services/policy-statements-guidelines/learning-disabilities.htm.

Credits

Adaptation Date: 8/18/2021

Adapted By: Alberta Health Services

Adaptation Reviewed By: Alberta Health Services

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