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A New and Complete Science-Based Program for Reading Problems at Any Level

Written by Sally Shaywitz, M.D.Author Alerts:  Random House will alert you to new works by Sally Shaywitz, M.D.

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On Sale: December 24, 2008
Pages: 432 | ISBN: 978-0-307-55889-3
Published by : Vintage Knopf
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Synopsis|Excerpt

Synopsis

FOR EVERYONE WHO STRUGGLES TO READ!
Clear, practical, science-based information and advice for successful results

One in five American children has trouble reading. But they are not stupid or lazy. In Overcoming Dyslexia, Dr. Sally Shaywitz, codirector of the Yale Center for the Study of Learning and Attention and a leader in the new research into how the brain works, offers the latest information about reading problems and proven, practical techniques that, along with hard work and the right help, can enable anyone to overcome them. Here are the tools that parents and teachers need to help the dyslexic child, age by age, grade by grade, step by step.

--What dyslexia is and why some intelligent, gifted people read slowly and painfully
--How to identify dyslexia in preschoolers, schoolchildren, young adults, and adults
--How to find the best school and how to work productively with your child’s teacher
--Exercises to help children use the parts of the brain that control reading
--A 20-minute nightly home program to enhance reading
--The 150 most common problem words–a list that can give your child a head start
--Ways to raise and preserve a child’s self-esteem aqnd reveal his strengths
--Stories of successful men and women who are dyslexic

Excerpt

I now want to gather together all the clues that combined will serve as an early-warning system for recognizing dyslexia. The clues will help you answer the question: Should my son or daughter (or I) be evaluated for dyslexia?

No one wants to be an “alarmist” and put her child through an evaluation for trivial or transient bumps along the road to reading. Evaluations can take time, and those carried out privately can be expensive. But I think we have to remind ourselves that our children are precious, oneof-a-kind individuals and have only one life to live. If we elect not to evaluate a child and that child later proves to have dyslexia, we cannot give those lost years back to him. The human brain is resilient, but there is no question that early intervention and treatment bring about more positive change at a faster pace than an intervention provided to an older child. And then there is the erosion of self-esteem that accrues over the years as a child struggles to read.

Childhood is a time for learning. A child who delays breaking the phonetic code will miss much of the reading practice that is essential to building fluency and vocabulary; as a consequence, he will fall further and further behind in acquiring comprehension skills and knowledge of the world around him. To see this happen to a child is sad, all the more because it is preventable.

Joseph Torgesen, a reading researcher at Florida State University who has carried out many of the critical studies on intervention, has this to say about the need to identify children early on and the cost of waiting: To the extent that we allow children to fall seriously behind at any point during early elementary school, we are moving to a “remedial” rather than a “preventive” model of intervention. Once children fall behind in the growth of critical word reading skills, it may require very intensive interventions to bring them back up to adequate levels of reading accuracy, and reading fluency may be even more difficult to restore because of the large amount of reading practice that is lost by children each month and year that they remain poor readers.

Most parents and teachers delay evaluating a child with reading difficulties because they believe the problems are just temporary, that they wll be outgrown. This is simply not true. Reading poblems are notoutgrown, they are persistent. As the participants in the Connecticut Longitudinal Study have demonstrated, at least three out of four children who read poorly in third grade continue to have reading problems in high school and beyond. What may seem to be tolerable and overlooked in a third grader certainly won’t be in a high schooler or young adult. Without identification and proven interventions, virtually all children who have reading difficulties early on will still struggle with reading when they are adults.

Luckily, parents can play an active role in the early identification of a reading problem. All that is required is an observant parent who knows what she is looking for and who is willing to spend time with her child listening to him speak and read.

The specific signs of dyslexia, both weaknesses and strengths, in any one individual will vary according to the age and educational level of that person. The five-year-old who can’t quite learn his letters becomes the six-year-old who can’t match sounds to letters and the fourteen-year-old who dreads reading out loud and the twenty-four-year-old who reads excruciatingly slowly. The threads persist throughout a person’s life. The key is knowing how to recognize them at different periods during development. Therefore, I have gathered the clues together to provide three distinct portraits of dyslexia: first, in early childhood from preschool through first grade; next, in school-age children from second grade on; and, last, in young adults and adults.

Clues to Dyslexia in Early Childhood

The earliest clues involve mostly 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 First Grade

• 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” “aaaa” 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:
• 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

Clues to Dyslexia From Second Grade On

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
• 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 a 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
• 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 word, as if someone had chewed a hole in the middle of the word, such as conible for convertible
• A terrific fear of reading out loud; the avoidance of oral reading
• Oral reading filled with substitutions, 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 text 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 fingers
• Extreme difficulty learning a foreign language
• A lack of enjoyment in reading, and the avoidance of reading books or even 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:
• 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 overlearned (that is, highly practiced) words in a special area of interest; for example, if his hobby is restoring cars, 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

Clues to Dyslexia in Young Adults and Adults

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

Should My Child Be Evaluated for Dyslexia?
• 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 f 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

Signs of Strengths in Higher-Level Thinking Processes
• 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 as 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
• 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

These clues across the life span offer a portrait of dyslexia. Examine them carefully, think about them, and determine if any of these clues fit your child, you, or someone else you are close to. Look for clues in the weaknesses and strengths. Identifying the weaknesses makes it possible to spot dyslexia in children before they are expected to read and in adults after they have developed some degree of reading accuracy but are continuing to show the remnants of earlier problems, reading slowly and with great effort.

If you think you or your child has some of these problems, it is important to note how frequent they are and how many there are. You don’t need to worry about isolated clues or ones that appear very rarely. For you to be concerned, the symptoms must be persistent; anyone can mispronounce a word now and then, or confuse similar-sounding words occasionally. What you are looking for is a persistent pattern–the occurrence of a number of these symptoms over a prolonged period of time. That represents a likelihood of dyslexia.


From the Hardcover edition.
Sally Shaywitz, M.D.|Author Q&A

About Sally Shaywitz, M.D.

Sally Shaywitz, M.D. - Overcoming Dyslexia
Sally Shaywitz, MD, is Professor of Pediatrics at the Yale University School of Medicine and codirector of the Yale Center for the Study of Learning and Attention. A member of the National Reading Panel and the Institute of Medicine of the Academy of Sciences, and chosen as one of America’s Top Doctors by Castle Connolly, she lectures regularly throughout the country and has appeared on CNN, Good Morning America and The Today Show.

Author Q&A

A Conversation with Sally Shaywitz, M.D.

Q: What is dyslexia?

A: Dyslexia refers to a difficulty in learning to read in a person who has good intelligence, strong motivation, and who has received appropriate teaching. Logic says such a child or adult should have learned to read and yet he or she has not. And so dyslexia represents a paradox, particularly in our society where reading ability is often taken as a proxy for intelligence and it is assumed that if you are a good reader you are also highly intelligent and if you struggle to read you must not be so smart. Dyslexia violates that assumption because people who are dyslexic are both highly intelligent and struggle to read. It is exciting is that scientists now understand exactly why otherwise smart children and adults can have trouble reading and know how to help them. There are now highly effective methods for diagnosing and treating children and adults with dyslexia at all levels and all ages.

Q: How many Americans are affected by dyslexia?

A: There are no obvious or visible physical signs of dyslexia, and as a result it often goes undetected and its true prevalence is often underestimated. In our studies where we tested every child in a randomly selected population, we discovered that dyslexia is a very common problem, affecting at least one child in five. In addition to the 20% of children and adults identified with reading problems, another large number (perhaps an additional 20%) experience reading difficulties which are not severe enough to be readily identified but can still cause problems.

Q: Does your research in Overcoming Dyslexia have implications for the entire population (i.e. people who have trouble reading but might not be diagnosed as dyslexic)?

A: Absolutely. That is one of the main reasons I wrote the book. There are so many people who can be helped if they only recognized the nature of their reading difficulty. Many people struggle and don’t realize that they have a reading problem. In Overcoming Dyslexia I provide a concise list of both the problems and unique strengths characterizing people who are dyslexic and describe how to recognize dyslexia in young children, in school-aged boys and girls, and in older children and adults. From experience with my patients I know what a relief it is to finally understand what has been troubling you for so many years. And the best part is that there are now highly effective, scientifically-proven methods and programs for teaching reading.

Q: What are the most common misconceptions about people who are dyslexic?

A: Perhaps the most common myth about dyslexia is that people who are dyslexic see words backward (“dog” as “god” or “was” as “saw”). This assumption is wrong. Another myth is that children outgrow reading problems. They don’t. This means that it is imperative that dyslexia be detected early and treated seriously. A third myth is that dyslexia affects only (or mostly) boys. In a study published in 1990 in the Journal of the American Medical Association, we demonstrated that dyslexia affects comparable numbers of boys and girls. A fourth myth holds that people who struggle to read are not very smart. On the contrary, some of the very brightest boys and girls struggle to read. Dyslexia occurs at all levels of intelligence, average, above average, and highly gifted. The writer John Irving and the financier Charles Schwab are both dyslexic and I have included their stories in Overcoming Dyslexia not only because they dispel myths about dyslexia but also because they provide wonderful examples of how boys and girls who struggle can become highly successful men and women. A fifth myth is that dyslexia only occurs in languages that use the alphabet and so it does not occur in countries like China and Japan whose languages are logographic (based on characters or pictures). Studies have shown that reading problems are as prevalent in these countries as they are in the United States and that struggling readers in China and Japan tend to make the same types of phonologic or sound-based errors as do their counterparts speaking English or other alphabetic languages.

Q: At what age can signs of dyslexia first be detected? What are the early warning signs?

A: Today, most children who struggle to read are not recognized until third grade, though some are identified earlier. Many more go undetected until much later. Some are not identified until they are adults. Scientists have discovered that almost all cases of dyslexia reflect a problem in getting to the basic sounds of words. Children who are dyslexic are unable to attend to the individual sounds (called phonemes) making up all words. For example, the word “bat” has three phonemes -- b - aaaa - t. It is important for children to be able to detect the individual sounds making up a spoken word because that is how they go about solving the reading puzzle.

In Overcoming Dyslexia I review, step-by-step, how children learn to read and which signs tell a parent that a child is not on track for becoming a reader. The earliest clues can come from listening to a child’s spoken language; a mild delay in learning to talk or a difficulty learning words that rhyme are often very early indicators of a possible reading problem. A little later, difficulty learning the names of the letters of the alphabet and then the sounds of the letters may be signs of an imminent reading difficulty. But once these vulnerabilites are identified there are now scientifically proven early reading programs that bring a child up to speed and allow her to catch up to and keep pace with her classmates.

Q: What is the most important thing a parent can do to help her dyslexic child?

A: A knowledgeable and proactive parent is often the critical factor responsible for transforming an unhappy struggling reader into a happy, proficient one. A parent plays a determining role in ensuring that her child: 1.) is accurately and promptly diagnosed; 2.) is provided reading programs that are scientifically proven to work; and 3.) develops a lasting positive sense of himself. The critical factor, is the child’s sense he can succeed. I believe it is essential to find the time to develop and nurture a child’s strengths, — in athletics, drama, whatever — to view himself as a competent individual.

Q: Are the public schools adequately meeting the needs of children with dyslexia? Are these children better off in private school?

A: Public schools are not doing a very good job of teaching children with dyslexia to become skilled readers. First, many, many children who are struggling to read are going undetected for long periods of time, typically not being identified until third grade or later. This is unfortunate since we know how to identify children very early on. Second, there is growing evidence that most special education programs are not doing their job. A gap in reading exists between dyslexic children and their classmates. To be successful, a reading program must help the child to make even more progress than his classmates so that he can close the gap and keep up with his classmates who are continuing to make progress. In Overcoming Dyslexia, I guide parents on how to determine if a program is effective and provide the names of specific reading programs that have been proven to work. I also provide parents with a systematic list of questions to ask in evaluating and selecting a school for their dyslexic child.

Q: If your preschooler’s birthday is close to the cutoff to start school, should you delay sending him to school for a year to give him more time to develop?

A: Research studies have shown that delaying kindergarten entry for a year does not help a child scholastically or emotionally. The idea of a “maturation lag” is not supported by science. To the contrary, research has shown that if a child seems to be behind, it is critical that he receive help as soon as possible.

Q: What are the elements of an effective reading program?

A: In 1998, in response to urgent demands from parents and teachers, Congress mandated that a National Reading Panel comprised of the top scientists, reading researchers, educators as well as parents be appointed to evaluate the effectiveness of different methods and programs to teach children to read. I served on the Panel.

The most effective reading programs provide instruction in teaching children to notice the sounds of spoken words. The letters comprising words represent a code and the first step of teaching reading is to help children break the code; they do this by learning how to attach letters to the sounds they hear in spoken words. This approach allows a child to sound out most words. Some words can’t be sounded out (for example, “though” or “she” or “your”) and children are taught to memorize these words. Sounding out words allows a child to have a strategy to read new words, words he has never before seen. Just relying on memorization can work for a while, but once a child is in third grade or higher, his memory bank simply runs out of space and he is at a loss when he comes across new or more complicated words. It is also important that the developing reader learns to read words fluently; this means he reads a word accurately and quickly. This skill, fluency, is critical if a child is to become a really good reader, one who enjoys reading and who looks forward to reading for pleasure and for information. In my book, I say what parents can do at home in the evening with their child to develop fluency and what specific programs are most effective. Developing your child’s fluency only takes ten or twenty minutes of your and your child’s time in the evening. Building a child’s vocabulary and comprehension skills round out an effective reading program.

Q: How can you distinguish between a child who is struggling to read because of dyslexia and one who has difficulties because of some other problem (i.e., a different learning disability or an emotional problem)?

A: The hallmark of dyslexia is an unexpected reading difficulty in a child who seems to have all the equipment (intelligence, verbal skills, motivation) necessary to become a reader. In such children we expect to see difficulties getting to the sounds of words, and at the same time, strengths in other areas of language such as the ability to understand what she hears (as opposed to what she reads). The diagnosis of dyslexia is made mostly by the history as well as by observing the child read and analyzing his performance on tests of reading and language. Older children and adults who are dyslexic demonstrate a lack of fluency, that is they read slowly and with great effort. This is in contrast to others, who with the same degree of education, read not only accurately but quickly and effortlessly. And so, slow reading, requiring extra time on tests, and finding reading extremely tiring are the hallmarks of dyslexia in a bright young adult. It is exceedingly rare that an emotional problem is responsible for a reading difficulty; more likely, unidentified and untreated dyslexia gives rise to frustration and anxiety.

Q: Can you outgrow dyslexia?

A: Dyslexia is not outgrown. Children who are dyslexic grow into adults who are dyslexic. They may learn how to read words accurately, but they do not develop into skilled readers who read quickly and who enjoy reading. However, the good news is that a struggling reader can be transformed into one who reads fluently and who looks forward to reading. The key is identifying the problem, the earlier the better. As I discuss in Overcoming Dyslexia, rigorous research studies have now absolutely demonstrated that all children can be helped to become better readers.

Q: Is there help for adults with dyslexia?

A: Adults with dyslexia can become better readers. I devote an entire chapter to adults with dyslexia, presenting programs and strategies that can help the youngest or oldest adult who is dyslexic become a better reader.

Q: You note that there are actually some benefits to being dyslexic. Please explain.

A: I conceptualize dyslexia as a weakness (in getting to the sounds of language) surrounded by a sea of strengths (conceptualizing, thinking out of the box, seeing the big picture). Dyslexics think in new and original ways. As I explain in Overcoming Dyslexia, revolutionary brain imaging technology shows dyslexics use different pathways; for reading, this presents a problem, for thinking creatively, I believe, this presents an extraordinary opportunity. Some of our greatest and most talented writers are also dyslexic (John Irving, Wendy Wasserstein, Stephen J. Cannell, John Grisham, Richard Ford.) In Overcoming Dyslexia, you will read about Nobel Laureates and some of our most creative scientists and physicians who are also dyslexic.

Q: Was there a common thread to the experiences of these very accomplished people?

A: These all had two things in common: first, few would have predicted their ultimate success; second, in each instance there was someone — a parent, a teacher, a coach — who truly believed in him and who helped him to develop a passionate interest in an area in which he could find success. For writer John Irving, it was his wrestling coach; for playwright Wendy Wasserstein and novelist Stephen J. Cannell, it was a college professor who saw beyond the spelling errors and slow reading to recognize and to encourage true talent. In Chapter 22, “Protecting and Nourishing Your Child’s Soul,” I provide specific steps that a parent can take to ensure that her child’s self-image is protected.

Q: What is the role of accommodations such as extra time for a dyslexic reader?

A: I devote an entire chapter to accommodations because they are frequently misunderstood and yet are essential if a child is to be judged by his strengths and not his weakness. Timed, multiple choice standardized tests represent a major barrier to the pathway to success for highly qualified, hard-working students who are dyslexic. After reading the accommodations chapter in Overcoming Dyslexia, including what new brain imaging studies reveal about the dyslexic’s absolute physiologic need for extra time, there will no longer be any doubt about the critical need for such accommodations for young men and women who are dyslexic. As I write in the book, the dyslexic’s need for extra time is as fundamental as is the diabetic’s need for insulin.

Q: What is the most important message you want your book to send?

A: Today, in 2003, the future for each dyslexic child and adult should be filled with hope. I am exhilarated by the extraordinary progress scientists have made in understanding dyslexia. I want people to know that it is possible to identify dyslexia early and accurately, to diagnose dyslexia precisely in older students and adults, to provide highly effective treatments that lead to skilled reading. Today, we know more about dyslexia than about most other problems in medicine — we have to get that news out.


From the Hardcover edition.

Praise

Praise

“In this gem of a book, Dr. Sally Shaywitz uses her voice, her images, her brain–and yes, her heart–to shine a piercing and clarifying light on what we so inadequately call ‘dyslexia.’ What is more, she shows how almost everyone can overcome it.” —Daniel D. Federman, M.D.,

“Fascinating. . . . Shaywitz has illuminated the inner workings of dyslexic minds.” —Time

“An important book.... For the first time, scientists are understanding how the brain works...in the act of reading. Front and center now is Sally Shaywitz.” –The Baltimore Sun


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