So I first blogged about dyslexia way back in May 2019, because I had been asked to write about it several times by different people over time… It took me a long time to get around to it because the truth was that I actually had very little knowledge about the topic.
So as per request from blog followers, I am going to try to answer some specific questions today.
- Where does a paediatrician start?
- How to help kids cope
- How to advocate for our kids
“Where does a paediatrician start when a child presents with a Specific Learning Disability?”
I think the best starting point is making sure that one actually understands what the term(s) really mean(s).
The terms “dyslexia,” “dysgraphia” and “dyscalculia” are quite commonly misunderstood. It doesn’t help at all that the diagnostic terms have all changed (as they tend to do every now and then) just to add to the confusion. Most commonly people seem to think that dyslexia is where people get their letters and/or numbers back to front. This can be a feature of dyslexia but is by no means a proper explanation of the condition.
So today I want to have a little chat about what dyslexia (and the other Specific Learning Disabilities) IS and then, give you some practical strategies to support a little person who has a specific learning disability like this.
Dyslexia a learning disability where children (or adults) have difficulties with written language. They have trouble with recognition of letters and their sounds (and how these relate to each other) and also how to blend these sounds together. This skill is called “phonological awareness” or “phonology.” As a result, children with dyslexia struggle with reading and spelling (and then subsequently this can affect their abilities and confidence in other subjects) even though they are typically bright or at least have normal problem solving skills (that is, they have normal intelligence). The “new” DSM-5 diagnostic term for dyslexia is “Specific Learning Disability in reading” and the new term for dysgraphia is “Specific Learning Disability in writing.” On the numeracy side of things, the new term for dyscalculia is “Specific Learning Disability in numeracy.”
As long as kids with Specific Learning Disabilities are appropriately understood and supported, they can conquer their learning difficulties and lead potentially very successful lives!
Specific Learning Disabilities often first presents itself when a child starts school because this is when they are expected to learn to read and perform mathematical tasks. It can be difficult to diagnose because the difficulties might masquerade as (and are often associated with) any one of a number of other conditions like,
- ADHD (Attention Deficit Hyperactivity Disorder) – children with dyslexia find literacy based school work really hard and as a result it is hard for them to sustain attention for long periods of time. This might make it look like they have an attention-deficit when they actually don’t
- Anxiety – if children with dyslexia are not properly supported in the learning environment then they can develop anxiety towards school work, and/or seem disengaged or disinterested in learning
- ODD (Oppositional Defiant Disorder) – again, when children are inadequately understood and supported with their school work, they may appear to have traits of oppositional defiant disorder. It is so hard for them to do the work, that they feel it is impossible and pointless trying.
- Intellectual disability – children who have dyslexia can sometimes be mistakenly be labelled as lazy or dumb, when the truth is that they can (and do) thrive with the right kind of support. They may be thought to have a broader learning problem, because sometimes children who have dyslexia can also have troubles with numbers (eg telling time, counting money) – more about this later.
With a child with learning difficulties, where do we start?
If you suspect your child has a learning problem, then there are a number of places/people that you can seek help from.
- Your class teacher, school guidance officer, school deputy principal/principal: these professionals are often some of the first to realise that there may be further investigations warranted into your child’s learning difficulties; your child might be able to be referred internally to an Education Queensland Speech Pathologist that can perform formal testing.
- Your GP: your GP can point you in the right direction of professionals that are specifically trained to help your child and perform the needed assessments
- Your paediatrician: will look at your child as a whole and determine if there are any medical conditions that need ruling out (hence if any investigations are needed) and also let you know what assessments will be needed and who can do them
- Educational psychologist/neuropsychologist: these professionals are often trained to do cognitive and sometimes also specific dyslexia testing to help define the nature of your child’s learning problem
- Paediatric speech pathologist – can perform the appropriate speech and language assessments to test both verbal and written language abilities and can help with ongoing therapy
As a developmental paediatrician, this a basic outline of how I approach a child who has learning difficulties:
- History taking
- Collateral information gathering – report cards, observations and concerns from teacher
- Cognitive testing (IQ testing) – needs to be completed for formal diagnosis because by definition, children who have a specific learning disability, have NORMAL intelligence
- Speech and language testing – is done to determine if the child has a SPECIFIC learning disability (eg reading or writing) or if their difficulties are part of a broader speech and language impairment. By definition, children who have SLD have normal oral speech/language skills
- Formulation of the whole picture – pulling together all of the results from the different assessments into an individual learning profile for the child.
- Making the assessment results and formulation/learning profile available to the school in order for them to create an educational support plan/individualised educational plan for the child.
How to help kids with Specific Learning Disabilities cope with their disability?
I have covered this question in a past blog article (with a slightly different spin and more on the topic of SLD in reading than SLD generally) and you can find it here.
Despite many people being aware of “dyslexia” being a learning condition, I think that because it is generally poorly understood, there seems a resultant lack of good resources to help children who have this issue. In addition to this, it is important to note that each individual with a Specific Learning Disability is just that – an individual. These kids are NOT all the same, and one of the most important steps in supporting them is to understand their own specific learning profile and strengths and weaknesses. This way, the learning support can be tailored to their needs for maximum effect.
Children with Specific Learning Disabilities still have many strengths that can include good oral skills, comprehension and good visual spatial awareness. Like ALL children, they need the opportunity to succeed to feel motivated and happy – so finding their talent (eg sport, music, art, maths, drama, cooking, astronomy – whatever!) and allowing them to pursue this is really very important. Also allowing them to feel success and make progress with their literacy/numeracy skills keeps them engaged and motivated, which is why it is crucial for parents and teachers to understand the child’s disability in order to adequately and appropriately support it.
So I have done a lot of reading and compiled a big list of things that I think may be helpful in a practical sense for children with dyslexia both at home (for parents to use) and in the classroom (for teachers and teacher’s aides). NOT ALL OF THESE STRATEGIES AND TOOLS WILL HELP EVERY CHILD with dyslexia. They are not a bad point to start though.
GENERAL STRATEGIES FOR KIDS WHO STRUGGLE WITH LITERACY-BASED TASKS
- Break tasks down into small easily remembered pieces of information.
- If visual memory is poor, copying must be kept to a minimum. Notes or handouts are far more useful.
- Seat the child fairly near the class teacher so that the teacher is available to help if necessary, or he can be supported by a well-motivated and sympathetic classmate.
- Build rest breaks into the day to allow the child to regroup and recharge. See my article on supporting attention and concentration in children right here.
- Praise and reward EFFORT as much as academic achievement. Reminding children that giving things a go is just as important as getting things right.
- Assistive technology and tools: it is really incredible the number and quality of assistive technology tools that are out there these days to help with writing and reading.
- Spell checkers: The dyslexic learner types in a word how they think it’s spelled, often phonetically, and the spell checker will return a correctly spelled match. This helps the child strengthen their confidence in both writing and spelling and commit correct spellings to memory.
- Line Readers: A line reader magnifies and highlights the portion of text over which it is placed. This helps dyslexic readers move through a book or worksheet and keep their place easier, especially if they experience ‘swimming’ words: the surrounding sea of text will be less distracting.
- Coloured keyboard: keyboards with coloured overlays and larger letters make typing more accessible to dyslexic students.
- “Text-to-speech” or “Voice-to-text” (dictation) software when reading and writing.
- Teachers meet with parents (and parents meet with teachers) regularly to discuss progress and which strategies that have been used at home/school have been the most successful for the child.
- It is really important that reading should involve repetition and introduce new words slowly. This allows the child to develop confidence and self-esteem when reading.
- Get the student to read a book at their current level of ability. Constantly challenging them with books that are above them, will instantly demotivate and disengage them. Motivation is far better when demands are not too high, and the child can actually enjoy the book. If he/she has to labour over every word he will forget the meaning of what he is reading.
- If the child HAS to read aloud to the class, perhaps send some pre-selected reading material home to be practised first the night before. This will mean the child can read with some confidence with their peers. In the particularly anxious child, save “reading aloud” for a quiet time with the class teacher/teacher’s aide or classroom helper.
- Try some multisensory approaches to spelling and writing:
- Writing words and sentences with tactile materials, e.g. glitter glue, sand, pasta, LEGO, or beads
- Physical activities to practice spelling, e.g. hopscotch or jump-rope – the children spell out words when they jump to each square or over the rope. Students work in pairs and take turns to dictate words and spell them.
- Scavenger hunts for letters and words– split students into teams and give them a word. Next, write letters onto sticky notes and hide them around the classroom. The teams must find the letters to construct the assigned word and then glue them together on a poster by cutting out the letters
- There are many potential reasons for poor handwriting at any age. These can include poor motor control, low tone, badly formed letters, speed etc. Encourage the children to study their writing and to critique their own work. I have read that a cursive joined style is most helpful to children with dyslexic problems.
- Pin up a reference chart in the classroom to serve as a reminder for the cursive script in upper and lower case.
- If handwriting practice is needed it is essential to use words that present no problem to the dyslexic child in terms of meaning or spelling.
- Improvement in handwriting skills can improve self-confidence, which in turn reflects favourably throughout a pupil’s work.
Copying from the blackboard/whiteboard
- Try using a different colour chalk (or whiteboard pen) for each line of written information on the board.
- Ensure that the writing is well spaced.
- Leave the writing on the blackboard long enough to ensure the child doesn’t rush, or that the work is not erased from the board before the child has finished copying.
- It is estimated that approximately 90% of children with dyslexia will have difficulties with at least some areas of maths. Maths problems often involve language and interpretation and this can impact on a child’s ability to demonstrate their true skills (an isolated learning difficulty in performing mathematical calculations is known as “dyscalculia” – but that will be a blog for another day).
- General mathematical terminology words need to be clearly understood before they can be used in calculations, e.g. add, plus, sum of, increase and total, all describe a single mathematical process.
- Other related difficulties could be with visual/perceptual skills, directional confusion, sequencing, word skills and memory. Dyslexic students may have special difficulties with aspects of maths that require many steps or place a heavy load on the short-term memory, e.g. long division or algebra.
- As with neurotypical children, teaching them to check their answers by asking, “is this answer possible/sensible or just silly?” can be very helpful
- Help and encourage children to talk their way through each step of the problem. Many children find this very helpful.
- Teach the child how to use a times table square and encourage them to say his workings out aloud as they use it.
- Children with dyslexia might benefit from being able to use a calculator to check their answers as a way of “proof reading” their work.
- Put the decimal point in a different colour. It helps visual perception with the dyslexic child.
- Check that the child has correctly written down what the homework is. If you are worried about the accuracy of their copying, then a printed version of the homework glued into their homework book for the parent to check at home can be helpful.
- Email parents about daily classroom activities (so we are not JUST relying on the child to relay the information). i.e. music, P. E. swimming, show-and-tell etc.
- Make a daily check list for the child to refer to in the evening. Encourage a daily routine to help develop the child’s own self-reliance and responsibilities.
- Like most children with learning difficulties, a dyslexic child is generally more tired at the end of the day than his peers because everything requires more thought and effort and tasks take longer. Only set homework that will be of real benefit to the child.
- Modify homework to adjust for ability but be tactful/discreet. Children’s self-esteem can really suffer if it is being constantly pointed out that they are different or less able than their peers.
- Phone a friend: Help the child to write the phone number of a couple of (conscientious) friends in the front of their homework book. Then, if there is any doubt over homework, they can ring up and check, rather than worry or spend time doing the wrong work.
- Set a limit on time spent on homework, as often a dyslexic child will take a lot longer to produce the same work that another child with good literacy skills may produce easily.
Supporting attention and concentration (see my other article on this topic: http://www.kids-health.guru/helping-attention-and-concentration/ )
- Keep instructions and language simple
- Use single step instructions
- Allowing children to work with headphones on to minimise distracting noise
- Get the child to repeat back what has been asked of them
- Use visual aids in the classroom to help with routines and timetables
- Give children a checklist of jobs to do to stick on their desk and refer to
- Encourage good organisational skills by using folders and dividers to keep work easily accessible and in an orderly fashion, or different exercise books with a subject identifying picture on the front.
- Break tasks down into smaller chunks that are easier to remember.
Marking completed work:
- Mark creative writing based on CONTENT rather than grammar/spelling. Give credit for effort as well as achievement to give the pupil a better chance of getting a balanced mark. Creative writing should be marked on context.
- Use positive comments even when marking mistakes and modify corrections to be appropriate to the child’s ability level.
- Use pencil or black pen to correct work. Children are easily disheartened by having work returned covered in red crosses, when inevitably, they’ve tried just as hard or harder than their peers to produce the work.
- Only request that the child rewrite a piece of work if it is going to be displayed.
Educational computer programs and apps for the classroom:
I have taken these examples from www.dyslexic.com (ref 2) and a few websites that offer games designed for dyslexic students that can be incorporated into whole class lessons.
- nessy.com – this site offers a range of PC games that help learners understand the sounds that make up words (phonetics). Their colourful, cartoony style is appealing and engaging to kids.
- dyslexiagames.com – The workbooks available here are full of puzzles, 3D drawings, and reading activities, tailored to dyslexic learners’ strength: visual thinking.
- Simplex Spelling– If you have iPads in your classroom,the apps in the Simplex Spelling series are an excellent choice. They help build up students’ understanding of phonics and how words are constructed. The series placed 3rd in the 2012 Best App Ever Awards – Best Elementary Student App.
Additionally, in the photo gallery above there is an image I found here that lists a whole HOST of educational apps designed for kids who have learning disabilities. My disclaimer is that I have NOT gone and road-tested these apps at all… it just seemed like a great free resource, and when I shared it a few months ago on my FB page, it was shared almost 200 times. I have included it again for posterity.
- Find and nurture your child’s strengths – whatever they are.
- Diversify their talents, give them opportunities to have and experience success and mastery in things they enjoy and are good at! Dancing, playing sports, running, martial arts, singing, astronomy, art, playing an instrument – whatever!!! This will build their self-esteem, self-confidence and resilience!!
- Read stories to your child every day. Every child should have the pleasure of accessing stories and books even if they cannot decode them fully. Audio tapes can be of great benefit for the enjoyment and enhancement of vocabulary.
- Take turns reading to each other – this gives the child an opportunity to practise, whilst also giving them frequent breaks.
- Celebrate successes!
- Allow the child to read to you at home books that are an appropriate level to their ability. Talk to their classroom teacher, borrow from the school library and find cheap books of an appropriate level on eBay or Amazon!
- Set a limit on time spent on homework, as often a dyslexic child will take a lot longer to produce the same work that another child with good literacy skills may produce easily
- Encourage your child to have a regular routine with homework – it will help them feel more independent by developing their self-reliance and sense of responsibility.
- Writing words and sentences with tactile materials, e.g. glitter glue, sand, pasta, LEGO, or beads
- Set the homework area up to help support the child’s attention and concentration
- Turn the TV/radio off
- Break work up into manageable chunks/steps
- Ensure the child is not too hot/too cold, has had something to eat, has been to the toilet
- Build in movement/rest breaks
- Advocate/request for your child to have a modified homework load if you feel they are struggling to complete what is generally expected
- Praise your child for effort (as well as achievement)
Finally, how do we advocate for our children in an education system that expects exactly what they can’t cope with/what they aren’t capable of?
This is a tricky question. I honestly do believe that the vast majority of our educators/schools have our children’s best interests at heart, but it is a bit like the health system where we are pressed for resources, time and money, and the SYSTEM is not geared towards helping every child with their special needs.
Arming yourself with FACTUAL information, strategies and knowledge goes a long way. I feel that every parent has the obligation to “be THAT parent” that advocates for what they truly believe their child needs. You just have to be prepared that the school system may not always be able to meet your request and that you might need to think laterally around how you can achieve what you need to another way. Understand that not everything costs money, and sometimes a simple, free strategy or intervention might be just as effective (or even more so) than an expensive one, and if you don’t try it, you’ll never know.
Meet with the school. Present your requests. Try different strategies at home.
Get the testing done. Talk to your friendly neighbourhood developmental paediatrician.
Negotiate a learning plan. Help your child conquer the world.
I hope this has helped. And as always, I ask a little favour – that you LIKE, COMMENT and SHARE this article to help me to help as many parents as possible!
Until next time – happy learning!