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Neuropathology of Dyslexia


Dannette Bourne

on 17 January 2014

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Transcript of Neuropathology of Dyslexia

Defining Dyslexia When you read, you begin with ABC
Identifying Dyslexia What can we do as Educators & Parents to Assist and Support these Children? Do-Re-Mi:
The Neuropathology of Dyslexia Understanding Dyslexia
& Tools for Teachers “Dys” = difficulty; “Lexia” = words
According to the Yale Center for Dyslexia and Creativity, dyslexia is characterized by:
"...an unexpected difficulty in reading in children and adults who otherwise possess the intelligence and motivation considered necessary for accurate and fluent reading."
These students often demonstrate difficulty with alphabet, reading, writing, and spelling in spite of conventional teaching methods, and adequate sociocultural opportunities. Overview MISCONCEPTION
INSPECTION A common misconception:
People with dyslexia only struggle with reading and writing

This is false...
This learning disability impacts many aspects of learning - including math.
Apart from education - a person's life, health, and career are affected as well. Fonts & Dyslexia What is Dyslexie? Dyslexie is a font that was developed by a graphic designer, Christian Boer
Boer also has Dyslexia.
Research was done on this typeface and it’s proven that dyslexics will make fewer errors than with regular fonts.
Dyslexie is available to get on your computer
This facilitates reading and writing emails Following a Timetable Quotes from students Reading Aloud Quotes from students Font Types to Help Dyslexia Standard:
Comic Sans
Century Gothic
Trebuchet Thomas Edison
Pablo Picaso
Edgar Allan Poe
Jim Carrey References Note: dyslexia cannot be
treated with medication Retrieved from www.dyslexiaassociation.ca/english/celebrities-authors.shtml Let's Start at the Very Beginning... You gotta know how the brain works Temporal Lobe Functions Auditory Processing (interpretation of sound-NOT "hearing")
Some Long-term Memory
Also: Emotion & Learning What the Little Brain does... I mean:
Functions of the Cerebellum Movement
Equilibrium The Occipital Lobe Visual Processing
Recognizing objects
Interpreting visual stimuli The Parietal Lobe Orientation
Integrates & processes sensory information sent from the thalamus (sight, taste, touch, sound) to various parts of the body Learning
Regulation of automatic functions and rote memory movements:
Touch typing
Tying shoelaces A Very Good Place to Start Cells of the brain So much to cover..
Where should we begin? ...but how do neurons help us learn?? Synaptogenesis continues throughout the lifetime
Dendrites sprout in response to instruction
Novelty seeking
Classical (association)
Operant (reward / punishment)
Verbal Learning Frontal Lobes ... aka... Central Command Personality
Executive Functions
Emotional Restraint (This literally is not in place until
your mid-20s... You're welcome.. I've just
explained adolescence!) I've made dendritic connections
(in other words.. I've taught this lesson...)
But why won't they remember it??? We've covered "normal" brains...
What about dyslexic ones? ...hence: "learning" doesn't necessarily mean
long-term retention, consolidation
or generalization First, let's define: dyslexia... When reading: Broca's Area
speech production, phoneme articulation
helps in "sounding out words"
Frontal Eye Field
involved in eye movements when reading
Primary Motor Area
controls movement of the mouth to say the words when reading aloud When reading... Phonological processing
Perceives and identifies phonemes (individual units of language)
Attaching sounds & letters
Lexical memory for words When reading Processing the visual form of letters (i.e. "hey... two sticks leaning together in a point with one between them like a ladder = A!") When reading... Sensory feedback to mouth for clear articulation when reading aloud Neural differences in
dyslexic brains Students with dyslexia often have articulation disorders, or poor speech. Study:
fMRI while engaged in word rhyming task
Typical children:
Recruit left dorsolateral prefrontal cortex (DLPFC)
DLPFC plays critical roles:
Phonological awareness for spoken language
Etiology of dyslexia Kovelman, et al. (2011) Thick band of nerve fibers that connects the left and right hemispheres
Transfers motor, sensory, and cognitive information between the brain hemispheres. Study:
In dyslexic students, the corpus callosum is shorter than typically developed students
Fails to undergo comparable myelination of normal readers during early reading acquisition von Plessen, et al. (2002) Frontal Lobe It's not just flipping letters... Dysphonetic or "Auditory dyslexia"
discriminating between individual sounds
remembering individual sounds or sequences of sounds
phonological segmentation
phonological blending
poor sight word recognition (no phonetic cues to help memory) There are 3 types! (At least) Surface Dyslexia aka "my kid flips letters"
Most common and easiest to identify
Confusing of similar letters (b/d/p/q), numbers (8/3), or even words (on/no).
Slow fluency rate when reading
Inverting letters when writing (left/felt)
May spell words as they sound (rite/right)
Poor reading comprehension
Poor/slow handwriting Mixed
Hardest to identify and remediate
Students display characteristics of both dysphonetic and surface dyslexia Decreased in size compared to typically developed brains

Comparing dyslexic to non-dyslexic peers
age-matched, reading ability-matched
n=30, right-handed, native English speakers, 8-12 years of age.
fMRI scans indicate reduced bilateral parietotemporal cortex during word-rhyming task Same study:
Dyslexic students demonstrated significantly less activation on tasks in right occipitotemporal cortex
Additional study:
n=144, right-handed students (70 dyslexic / 74 typical)
Students did real word and pseudoword decoding
Posterior brain regions were disrupted for dyslexic students
Reading skill positively correlated with activation of left occipitotemporal region Hoeft, et al. (2006) Hoeft, et al. (2006) Habib (2000) Parieotemporal Lobes Occipital Lobe Parietal Lobe Temporal Lobe I'll address these together because they keep coming up in the research together. The parieotemporal lobes work closely together when reading! Shawitz et a. (2002) Etiology
Dyslexia is inheritable
This is why your medical/family history is very important!
Cause is biological
Neural commonalities in students with dyslexia:
Underutilized left hemisphere
(We know that reading and language comes from the left hemisphere of the brain!!)
Therefore, they must overuse their right hemisphere for reading and spelling
Slow transmission between hemispheres Dyslexia only affects boys There are no clues to dyslexia before a child enters school People with dyslexia cannot read Smart people cannot be dyslexic If those letters are not flipping, then it's not dyslexia! If you're a good student, then you cannot be dyslexic http://dyslexia.yale.edu/Myths.html Comorbidity Arrowsmith-Young, B. (2012). The woman who changed her brain: And other inspiring stories of pioneering brain transformation. New York City: Free Press.
Berninger, V. W., & Richards, T. L. (2002). Brain literacy for educators and psychologists. Amsterdan: Academic Press.
Eide, B., & Eide, F. (2011). The dyslexic advantage: Unlocking the hidden potential of the dyslexic brain. New York: Hudson Street Press.
Feifer, S.G., Toffalo, D.A. (n.d.). Checklist for dyslexic behaviors. [Class handout]. School of Education, La Sierra University, Riverside, CA.
Hoeft, F., Hernandez, A., McMillon, G., Taylor-Hill, H., Martindale, J. I., Meyler, A., Keller, T. A., Siok, W. T., Deutsch, G. K., Just, M. A., Whitfield-Gabrieli, S., & Gabrieli, J. D. (2006). Neural basis of dyslexia: A comparison between dyslexic and nondyslexic children equated for reading ability. The Journal of Neuroscience, 26(42), 10700-10708.
Kovelman, I., Norton, E. S., Christodoulou, J. A., Gaab, N., Lieberman, D. A., Triantafyllou, C., Wolf, M., Whitfield-Gabrieli, S., & Gabrieli, J. D. (2011). Brain basis of phonological awareness for spoken language in children and its disruption in dyslexia. Oxford University Press, 754-764.
National Center for Learning Disabilities (2001). The dyslexia t: An essential resource provided by the National Center for Learning Disabilities. Retrieved from http://www.ncld.org/
M. H. (2000). The neurological basis of developmental dyslexia: An overview and working hypothesis. Oxford University Press, 123, 2373-2399.
Shaywitz, B. A., Shaywitz, S. E., Pugh, K. R., Mencl, W. E., Fulbright, R. K., Skudlarski, P., Constable, R. T., Marchione, K. E., Fletcher, J. M., Lyon, G. R., & Gore, J. C. (2002). Disruption of posterior brain systems for reading in children with developmental dyslexia. Society of Biological Psychiatry, 101-110.
Shaywitz, B. A., Skudlarski, P., Holahan, J. M., Marchione, K. E., Constable, R. T., Fullbright, R. K., Zelterman, D., Lacadie, C., & Shaywitz, S. E. (2007). Age-related changes in reading systems of dyslexic children. American Neurological Association, 61, 363-370.
Shaywitz, S. E., Mody, M., & Shaywitz, B. A. (2006). Neural mechanisms in dyslexia. Association for Psychological Science, 15, 278-281.
Sousa, D. A. (2001). How the special needs brain learns. Thousand Oaks, Calif: Corwin Press.
Von Plessen, K., Lundervold, A., Duta, N., Heiervang, E., Klauschen, F., Smievoll, A. I., Ersland, L., & Hugdahl, K. (2002). Less developed corpus callosum in dyslexic subjects--a structural MRI study. Neuropsychologia, 40, 1035-1044.
Wicks-Nelson, R., & Israel, A. C. (2003). Language and learning disorders. In Behavior disorders of childhood. Upper Saddle River, N.J: Prentice Hall.
The Yale Center for Dyslexia & Creativity (2013). Myths & truths about dyslexia. Retrieved May 21, 2013, from http://dyslexia.yale.edu/Myths.html Wicks-Nelson, R., Israel, A.C. (2003) Dysphonetic or "Auditory dyslexia"
Maintains a strong preference for leisure and academic activities that involve minimal listening skills
Can comprehend more efficiently when material is read silently rather than orally
Has difficulty recalling everyday words in conversation
Takes wild guesses recalling everyday words in conversation
Has extreme difficulty blending letter sounds
Makes many spoonerisms (i.e., "You hissed classed today" for "You missed class today")
Does not follow oral directions well
Substitutes vowels, such as spelling the word "bit" for "bed" Keep in mind
the 3 types! Surface Dyslexia aka "my kid flips letters"
Uses finger to maintain place when reading
Has difficulty copying information from the board
Uses capital letters with indiscretion (e.g. dAd)
Often fails to notice changes in the environment
Difficult time with directions
Often gives the correct letters, but in the wrong sequence (e.g. "teh" for "the")
Has difficulty describing visual characteristics of familiar people and places
Has difficulty copying figures & signs in math
Expressive vocalization during "silent reading"
Omits words (and lines of words) when reading
Has a better memory for what is said rather than what was read Mixed
Is rigid and inflexible
Makes frequent negative comments regarding reading tasks
Has a low frustration tolerance (especially during reading activities)
Is highly distractible
Seems unaware of nonverbal social cues (e.g., gestures, tone of voice)
Has difficulty making friends often due to blunt and insensitive remarks
Has not benefitted from instruction via typical basal reading programs Signs & Symptoms
by Age Preschool
Difficulty recognizing letters
Language delays
Trouble with rhyming
Difficulty with sounds of letters
History of dyslexia or other learning disabilities in family Early Elementary
Difficulty reading single words (especially without visual cues/context)
Difficulty with pseudowords
Slow fluency
Poor spelling
Generally good math computation skills
Difficulty with directions Later elementary & middle school
As math begins involving language (word problems, algebra), greater math difficulties
Large reading assignments difficult
Reading comprehension difficulties Dyscalculia
Problems with numerical calculations
We see an increase in dyscalculia with the introduction of letters and words:
word problems
algebra (all of a sudden, math is letters??) Along with dyscalculia, students identified with dyslexia are often identified as having other specific learning disabilities including:
Attention Deficit/Hyperactivity Disorder
Asperger's and other Autism Spectrum Disorders
There is an overlap of certain aspects of one difficulty with another Dysgraphia Sister disorder to dyslexia.
Inefficiency at handwriting
slow copying
inconsistent letter formation
mixtures of letters & styles
poor legibility Laterality

By age 7-8, children should have preferred side of the body.
They should consistently use the same hand, foot, and eye for major tasks
They should be on the same side of the body
Students without this have a "weak lateral base"
this negatively affects their perceptual organization
strengthening a unilateral preference can assist in remediating reversed or misread letters or words Observe
The earlier students are screened & identified, the greater the chance of remediation
Note the age-inappropriate symptoms Refer
Refer the student to your counselor or school psychologist for observation and/or assessment
Many school psychologists feel uncomfortable qualifying students for Special Education Services under dyslexia
Don't say "my son has dyslexia!"... say "my child has difficulty reading" and note symptoms (e.g. difficulty sounding out words, poor reading comprehension, etc) Certain fonts can be fatiguing for students to read:
Fonts with serifs
Swirly fonts
Font smaller than 12 pt. Intervene
To remediate letter reversals, write frequently confused letters on your child's back, fingertips, or her palms while he looks away utilizing a pencil or stylus to write with. When letters are easily recognized, spell whole words to work on visualization strategies for reading and spelling.
To accommodate for visual strain, fatigue and inattention, allow text to be no smaller than 12pt font. The increase in letter size may trick the student's mind into perceiving written text easier. Compulsory list of famous people with dyslexia Bill Gates
John F. Kennedy
Albert Einstein
Muhammed Ali Minimizing multiple choice options may improve problem-solving efficiency and lessen visual stimulation
Provide a naturally lit or incandescent space for extended reading times.
Colored notepaper may also improve visual contrast making the figure-ground perceivable.
Consider using writing paper with raised lines to assist in giving sensory feedback while writing
Use chunking strategies to teach how to spell new sight words or vocabulary. It is easier to remember phonetic segments than whole sight words.
Have student's practice reading aloud with an adult
Consider extended time on quizzes, exams, and homework assignments This is by no means the end or a comprehensive presentation of dyslexia...

but this is the end of THIS presentation!
Questions? Comments? For Download:
Read Regular (www.readregular.com)
Myriad Pro
(www.opendyslexic.org) When you sing, you begin with Do-Re-Mi Dannette Bourne
EDCI 655 & 711
Dr. Linda Caviness
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