Dyslexia Is Forever

From the WebMD Archives

Despite improvements in the diagnosis and management of dyslexia, many adolescents and young adults with the disorder continue to have reading problems.

Jan. 7, 2000 (Atlanta) --Despite improvements in the diagnosis and management of dyslexia, many adolescents and young adults with the disorder continue to have reading problems. The results of a long-term study, published in the December issue of the journal Pediatrics, explain how disabilities in dyslexia are persistent.

"The belief that children with dyslexia will eventually outgrow it is simply not true," says lead author Sally E. Shaywitz, MD, of Yale University. Shaywitz tells WebMD that while many bright young adults with dyslexia learn to read words accurately, they remain slow readers for a reason. "The same phonological deficit responsible for initial reading difficulties remains and accounts for persistent problems," Shaywitz tells WebMD. In other words, children who were diagnosed as dyslexic early in their school careers were still dyslexic later on, even though they may have learned to overcome it to some degree.

Dyslexia is a learning disability characterized by problems in expressing or receiving oral or written language. Difficulties may be expressed in reading, spelling, writing, speaking, or listening. According to the International Dyslexia Association, dyslexia is not the result of low intelligence. The term but describes a different kind of mind -- often gifted and productive -- that learns differently. The National Institutes of Health estimates that approximately 15% of the U.S. population are affected by learning disabilities, many with dyslexia.

For this study, children were recruited from the Connecticut Longitudinal Study, a representative group of almost 500 children entering public kindergarten in 1983. When the students reached the ninth grade, those with persistent reading disabilities were compared with average and superior readers. Each child received a comprehensive assessment of academic, language, and other cognitive skills.

Over the study period, researchers found that deficits in phonological awareness and coding continued in the dyslexic group. Phonological awareness allows people to notice, comprehend, and manipulate the individual sounds in a word. Phonological coding deficits interfere with reading rate, accuracy, and spelling. Therefore, dyslexics are not 'cured,' nor do they 'catch up,' in the development of reading skills as they progress in school.


In 1998, Shaywitz and other researchers reported in the journal Pediatric News that dyslexics have disruptions in the language system in the brain during reading. According to Shaywitz, brain imaging performed on adults showed underactivation in posterior regions of the adult brain and relative overactivation in anterior regions, providing further evidence that dyslexia is a neurobiologic disorder.

"This is the next step that we had to reach for educators to say that dyslexia is real," Shaywitz said in an interview at the time of the study. "If [brain imaging] holds true for children, [it] may someday be used to diagnose the disorder in young children before it impairs academic performance."

Shaywitz tells WebMD the next step is to "better understand the neural circuitry for reading and determine how this circuitry develops over time in poor readers."

The International Dyslexia Association says few dyslexics exhibit all the signs of the disorder. Some common signs include the following:

  • Lack of awareness of sounds in words, sound order, rhymes, or sequence of syllables.
  • Difficulty decoding words -- single word identification.
  • Difficulty encoding words -- spelling.
  • Poor sequencing of numbers or of letters in words, when read or written -- for example, b/d, sing/sign, left/felt, soiled/solid, 12/21.
  • Problems with reading comprehension.
  • Difficulty expressing thoughts in written form.
  • Delayed spoken language.
  • Imprecise or incomplete interpretation of language that is heard.
  • Difficulty in expressing thoughts verbally.
  • Confusion about directions in space or time (right and left, up and down, early and late, yesterday and tomorrow, months and days).
  • Confusion about right or left handedness.
  • Difficulty with handwriting.
  • Difficulty with mathematics -- often related to sequencing of steps or directionality or to the language of mathematics.
  • Similar problems among relatives.
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