Solving the Dyslexia Paradox

By Eve Kessler, Esq.

AT A GLANCE

For children with dyslexia, the optimal time frame for addressing reading deficits is before most children are diagnosed • This may become more possible as new tools are being developed to identify at-risk kids when treatment can be most effective


The development of basic reading skills is one of the primary goals of elementary school, yet many students are not meeting that goal. According to the 2019 Nation’s Report Card (results from the largest nationally representative continuing assessment of educational performance) a shocking 64 percent of fourth-graders are reading below grade level.

One cause of reading difficulties is developmental dyslexia, a specific learning disability that affects 10 to 12 percent of children nationwide.

Kids with dyslexia are as bright as their non-dyslexic peers and just as motivated to learn. They are not challenged by sensory or motor deficits or by lack of educational opportunities. Nevertheless, no matter how hard they try, they have difficulty with reading and spelling.

The causes of dyslexia are not fully understood, though some studies point to a genetic component that impacts early brain development and reading-related neurological processes.

What is certain is that dyslexia is hereditary, occurring in 40 to 60 percent of individuals with an affected first-degree relative and in 68 percent of identical twins. It appears in all economic and ethnic groups. And it is a life-long disorder: children will never outgrow their dyslexia and, without special instruction in reading and phonological awareness, they will not be able to read at grade level.

Implications of Dyslexia

Not being able to read at grade level has tremendous implications for how kids see themselves as overall learners and how motivated they are. If not addressed appropriately, early literacy deficits worsen as students move up in school, resulting in long-lasting negative impacts on vocabulary development, reading comprehension, and academic performance, while also contributing to low self-esteem, depression, anxiety, and feelings of shame, inadequacy, and helplessness.

When children continue to fail at early reading, they commonly grow discouraged, often begin to dislike reading, and end up reading significantly less than their more adept classmates. Research shows that children in the 10th percentile may read fewer words in an entire year outside of school than students in the 90th percentile read in just three days.

A significant 70 percent of kids who are below-average readers in first grade still struggle to read in eighth grade. As they age, students with untreated reading disabilities are less likely to complete high school or pursue higher education, dropping out of school at twice the rate of their non-dyslexic peers. They are at an increased risk for entering the juvenile justice system and of being unemployed or underemployed, with over 90 percent of working adults with reading disabilities earning less than $50,000 per year.

The Dyslexia Paradox 

Early and individualized intervention is key for students at-risk for dyslexia. The most effective timeframe for intervention is from pre-K through first grade. Typically, however, dyslexia is not even diagnosed until second or third grade, after a child has demonstrated significant difficulty learning to read and after the window for “most-effective” interventions has closed.

Dr. Nadine Gaab, an Associate Professor of Pediatrics at Harvard Medical School and a researcher in the field of reading development, has labeled this the dyslexia paradox. The optimal solution is to replace the existing “wait to fail” approach with a support model that includes comprehensive early risk screenings and evidence-based responses to those screenings within the general education environment.

When “at risk” beginning readers receive intensive, appropriate instruction, up to 92 percent will be able to read in the average range.

Recent advances in pediatric neuroimaging have helped researchers investigate brain structure and function in children before they begin formal reading instruction, enabling them to predict the risk of dyslexia earlier than ever before. Notably, Dr. Gaab warns that none of the predictions will matter if the subsequent evidence-based interventions don’t target the specifically identified deficits.

Dr. Gaab’s laboratories have compiled a comprehensive, constantly updated list of available evaluations (“screeners”) for dyslexia risk and early literacy milestones, which is accessible at https://bit.ly/2T1TKrm. Her labs have also integrated existing predictive dyslexia assessments into a mobile platform and an early dyslexia-screening app, which will identify children at risk for developing dyslexia and other neurological learning disabilities. The app will provide evidence-based, personalized and transformational support through an easily accessible platform, offering a list of resources, teaching solutions, and intervention programs for children at-risk. For more information, see www.bostonearlyliteracyscreener.com.

This article is based on the presentation Solving the Dyslexia Paradox: The Importance of Brain Development, Early Identification, and Intervention, by Dr. Nadine Gaab, Associate Professor of Pediatrics at the Boston Children’s Hospital, Harvard Medical School, and a member of the faculty at the Harvard Graduate School of Education. Eve Kessler, Esq., a former criminal appellate attorney with The Legal Aid Society, NYC, is Executive Director of SPED*NET, Special Education Network of Wilton (CT), and a Contributing Editor of Smart Kids.

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