Dyslexia

Signs of dyslexia by age

Preschool

• late talking or mispronouncing words for longer than peers
• difficulty learning nursery rhymes or recognizing rhyming words
• trouble learning the alphabet, letter names and letter sounds
• difficulty remembering names of colors, shapes or numbers quickly

Early school years

• difficulty linking letters to sounds
• trouble sounding out simple words like "cat" or "map"
• guessing words from pictures or first letters
• reading aloud slowly and with many errors
• spelling words as they sound and inconsistently
• complaints that reading is hard, avoidance of reading

Older children and teenagers

• slow, effortful reading and poor reading comprehension because energy goes on decoding
• trouble with spelling and written expression
• difficulty learning a foreign language
• needing extra time for tests
• difficulty pronouncing unfamiliar or long words

Adults

• reading slowly, rereading text to understand it
• avoiding reading aloud
• frequent spelling errors
• strengths often in reasoning, creativity, verbal discussion and big-picture thinking

What causes dyslexia

Dyslexia is neurobiological. Brain imaging shows differences in how left-hemisphere language networks process written words. Genetics play a large role: a child with a parent or sibling with dyslexia has a much higher chance of having it. Dyslexia is not caused by vision problems, laziness, or low intelligence, and reversing letters such as b and d is common in all young children and not a defining sign.

Conditions that often occur with dyslexia

• ADHD, in about a quarter to a third of people with dyslexia
• dysgraphia, difficulty with handwriting and written expression
• dyscalculia, difficulty with numbers
• developmental language disorder
• developmental coordination disorder
• anxiety and low self-esteem

Diagnosis

There is no single test. A comprehensive evaluation, usually by a school psychologist, educational psychologist, neuropsychologist or trained specialist, assesses:

• phonological awareness and phonological memory
• rapid naming
• word reading and decoding of made-up words
• reading fluency and comprehension
• spelling and written expression
• oral language and vocabulary
• general cognitive ability

Hearing and vision should be checked to rule out other causes. In the US, schools must evaluate children suspected of a learning disability at no cost to families, under the Individuals with Disabilities Education Act (IDEA). Formal diagnosis may be listed as a specific learning disorder with impairment in reading.

Treatment and support

Structured literacy instruction

The most effective approach is explicit, systematic, multisensory teaching of:

• phonological awareness (hearing and manipulating sounds)
• phonics (letter-sound links)
• spelling patterns and word structure
• reading fluency practice
• vocabulary and comprehension strategies

Programs based on Orton-Gillingham principles are widely used. Instruction works best when started early, delivered frequently in small groups or one to one, and continued long enough.

Accommodations

• extra time on tests
• audiobooks and text-to-speech software
• speech-to-text for writing
• oral exams or reduced copying from the board
• grading content rather than spelling
• an Individualized Education Program (IEP) or 504 plan in US schools

At home

• read aloud together daily and discuss stories
• play rhyming, sound and word games
• encourage audiobooks to build vocabulary and enjoyment
• praise effort and celebrate strengths outside reading

What does not work

Vision therapy, colored lenses or overlays, special fonts alone and brain-training games have not been shown to treat dyslexia.

Outlook

Dyslexia is lifelong, but with effective teaching most children learn to read accurately, though reading may remain slower. Many people with dyslexia go on to university and successful careers. Early identification protects self-esteem and reduces school difficulties.

Frequently asked questions

What are the early signs of dyslexia?

Early signs include late talking, difficulty learning rhymes, trouble learning letter names and sounds, and difficulty sounding out simple words in kindergarten or first grade. A family history of reading difficulties increases the likelihood.

Can dyslexia be cured?

Dyslexia is a lifelong difference, not a disease, so it is not cured. However, structured literacy teaching helps most people learn to read and spell much better, and accommodations and technology allow them to work around remaining difficulties.

How is dyslexia tested?

A psychologist or trained specialist uses standardized tests of phonological skills, word reading, fluency, spelling, language and cognitive ability. Vision and hearing are checked first. In the US, public schools must evaluate children suspected of learning disabilities at no cost.

Can adults be diagnosed with dyslexia?

Yes. Many adults were never assessed as children. An adult assessment by a psychologist can confirm dyslexia and support accommodations at college or work, such as extra time, assistive software and alternative formats.