Dyslexia interventions

Some teaching is geared to specific reading skill areas, such as phonetic decoding; whereas other approaches are more comprehensive in scope, combining techniques to address basic skills along with strategies to improve comprehension and literary appreciation. Many programs are multisensory in design, meaning that instruction includes visual, auditory, and kinesthetic or tactile elements; as it is generally believed that such forms of instruction are more effective for dyslexic learners.^[1]

Research findings for academic interventions in a Latin alphabet writing system

There is little empirical or quantitative research supporting the use of any particular program for reading instruction when used with dyslexic children.^[2][3]

In 2007 the researchers Joseph Torgesen and Richard Wagner have shown that, when teaching children with reading disabilities, programs including systematic and explicit instruction in phoneme awareness and grapheme-phoneme correspondence are far more successful than programs that do not. ^[4]

Academic remediations

With appropriate instruction, dyslexics can become skilled readers. Appropriate remedial instruction includes using:

• Direct, explicit and comprehensive instruction in the structure of language
• A systematic sequence for teaching individual skills
• Structured information from the simple to the complex
• Simultaneous multisensory approaches, including combinations of visual, auditory, and kinesthetic modalities
• Interaction between student and teacher during instruction of new skills
• Reinforcement throughout the day of newly learned skills
• Integrated spelling and handwriting instruction sequence with reading instruction, so that they are mutually reinforcing
• Extended practice for each skill until the student overlearns the skill (see Overlearning and Automaticity)
• Ongoing review of previously learned skills
• Careful pacing to avoid information overload
• Intensive instruction until reading, spelling and writing skills are at grade level.
• Repeated reading to help develop fluency and reading rate^[5]
• Paired reading to help develop fluency and enhance comprehension.

Classroom accommodations

Although there are no treatments or quick cures for dyslexia there are many techniques that can be used to assist dyslexic students in the classroom while reading skills are being remediated. These include such things as:

• Oral testing
• Untimed tests
• Audiobooks
• Eliminate or reduce spelling tests
• Minimizing the need to read out loud ^[6]
• Allow students to record the Teacher explaining homework (for example on a Dictaphone) to ensure an accurate account of the homework is made.
• Accept dictated homework
• Reduce homework load
• Grade on content, not spelling nor handwriting
• Reduce copying tasks
• Avoid or reduce essay tests
• Providing teacher handouts to supplement the notes taken
• Using materials that are not visually overcrowded
• To increase motivation, giving assignments in areas in which the student has a strong interest, for example, sports stories, biographies of inventors or rock musicians, or fiction about teenage issues.^[7]
• Use an appropriate layout, including a larger font size, larger line spacing (1.5) and a clear font - sans-serif fonts are usually recommended.^[8]
• Some dyslexic people are sensitive to the colour of the paper and may find off-white, pale green or pale purple paper can make reading easier.
• Using appropriate font type and size. It is suggested that Sassoon and Comic Sans may be the easiest to read; Times New Roman may be one of the most difficult to read. The font should not be too small. There are several fonts and typefaces designed for dyslexia including Gill Dyslexic,^[9] Read Regular,^[10] Lexia Readable, Sylexiad,^[11] OpenDyslexic,^[12] and Dyslexie.^[13] (Latin writing system only). However, although dyslexics may prefer some of these special fonts, there is no evidence that any of the fonts nominally designed for dyslexics helps them read more easily or better, and some make false claims.^[14]

Recent developments

Accessible publishing works to make reading easier for all who struggle with the standard one-size-fits-all method of book publishing. Accessible publishing works with publishers and Print on Demand technology which allows the reader to choose how the books will be published. Available format variations include choosing the font size (from 11 point font through to 28 point font), whether the font is bold, italic or regular, and choosing the amount of line spacing.^[15] There are also a variety of special fonts being developed for dyslexia, eye tracking problems and other conditions.^[16] Although some individuals with dyslexia report improved ease of reading with different fonts, these reports are anecdotal; there is little empirical evidence to support the use of "dyslexia fonts". Accessible publishers, such as ReadHowYouWant, also work to make books available in Braille, e-books, audiobooks and DAISY.

New formats such as streamline text^[17] have been developed that help dyslexic people to track (move from one line to the next) more fluently. These work by adding 'sign-posts' into the text to show where to go next.

Context & phonetic spell checkers and grammar checkers combined with text-to-speech and other assistive technologies aimed for help with dyslexia, such as Ghotit Dyslexia software,^[18] aim to make writing easier.^[19]

Teachers are also using audiobooks as a way of teaching textbooks in an engaging way to those with dyslexia. In the UK, one of the biggest charities is Listening Books, which offers members a streaming service over the internet. An Australian company, ReadHowYouWant is working to make all published books available in audiobook form.^[20] In the United States, the nonprofit Learning Ally offers the world's largest library of human-narrated audio textbooks, and a second organization, Bookshare, offers a wide selection of synthetic-read audiobooks. These audiobooks work well for individuals who have word reading accuracy and fluency difficulties (i.e. dyslexics).

Individuals with dyslexia require more practice to master skills in their areas of deficit. In the circumstances where typically developing children need 30 to 60 hours training, the number of hours that has resulted in optimistic conclusions concerning the remediation of dyslexia is between 80 and 100 hours, or less if the intervention is started sufficiently early. Only approximately 20% of adults with early reading difficulties have acquired fluent reading skills in adulthood.^[21]

Functional MRI (fMRI) studies have shown neurological changes in dyslexic children and adults who have used phonological interventions, with improved performance on tests of phonemic awareness and text decoding.^[22][23] fMRI studies have also shown changes in the brain and spelling improvement of dyslexic children taught spelling phonetically in an orthographic manner.^[24]

A recent study has shown that the usage of a FM system drives neural plasticity in children with dyslexia.^[25] A FM system is a personal assistive listening device, consisting of a wireless microphone worn by the teacher, and a wireless receiver similar to a Bluetooth receiver worn on the ears by the pupil. Measurements of the brain’s response to speech sounds showed that the children who wore the device for one year responded more consistently to the very soft and rapidly changing elements of sounds that help distinguish one consonant from another (cat, bat, pat etc.). That improved stability was linked with reading improvement based on standardized measures of readability – which, as a long-term benefit, points to brain plasticity.

References

1. Henry, M.K. (1998). "Structured, sequential, multisensory teaching: the Orton legacy". Annals of Dyslexia 48: 3–26. doi:10.1007/s11881-998-0002-9. ISSN 0736-9387. Retrieved 2007-08-02.
2. "Orton-Gillingham and Orton-Gillingham Based Reading Instruction: A Review of the Literature -- Ritchey and Goeke 40 (3): 171 -- The Journal of Special Education".
3. Connor, C.M.D.; Morrison, F.J.; Fishman, B.J.; Schatschneider, C.; Underwood, P. (2007-01-26). "THE EARLY YEARS: Algorithm-Guided Individualized Reading Instruction". Science 315 (5811): 464–5. doi:10.1126/science.1134513. PMID 17255498. Retrieved 2007-08-02.
4. Wolf, Maryanne (2007). Proust and the Squid. HarperCollins publishers. p. 175. ISBN 978-0-06-018639-5.
5. Uhry, Joanna Kellogg and Diana Brewster Clark (2004). Dyslexia: theory and practice of instruction. Pro-ed publishers. pp. 88-89. ISBN 1-4164-0115-6.
6. Reid, Gavin. Dyslexia 2nd edition. New York: Continuum International.(2007).Pages 41-95
7. http://www.allkindsofminds.org
8. Dyslexia Style guide from the British Dyslexia Association
9. Gill Dyslexic
10. Read Regular typeface
11. Sylexiad
12. OpenDyslexic
13. Dyslexie font
15. http://www.readhowyouwant.com/Format/index.aspx
16. Garner, Dwight (2008-05-20). "Making Reading Easier". The New York Times. Retrieved 2010-05-01.
17. What is streamline text? Archived December 2, 2013, at the Wayback Machine.
18. "Ghotit Dyslexia Software for People with Learning Disabilities". Ghotit.com. Retrieved 12 June 2012.
19. http://speedchange.blogspot.com/2008/02/ghotit.html
20. http://www.readhowyouwant.com/Technology/overview.aspx
21. Lyytinen, Heikki, Erskine, Jane, Aro, Mikko, Richardson, Ulla (2007). "Reading and reading disorders". In Hoff, Erika. Blackwell Handbook of Language Development. Blackwell. pp. 454–474. ISBN 978-1-4051-3253-4.
22. Eden, Guinevere; Jones, Karen M.; Cappell, Katherine; Gareau, Lynn; Wood, Frank B.; Zeffiro, Thomas A.; Dietz, Nicole A.E.; Agnew, John A.; Flowers, D. Lynn (2004-10-28). "Neural Changes following Remediation in Adult Developmental Dyslexia (Clinical Study)". Neuron 44 (3): 411–422. doi:10.1016/j.neuron.2004.10.019. PMID 15504323. Retrieved 2010-05-01.
23. Shaywitz, B.; Shaywitz, S.; Blachman, B.; Pugh, K.R.; Fulbright, R.; Skudlarski, P.; Others, (2004). "Development of left occipitotemporal systems for skilled reading following a phonologically based intervention in children" (PDF). Biological Psychiatry 55 (9): 926–933. doi:10.1016/j.biopsych.2003.12.019. PMID 15110736.
24. Dahms, Joel. (2006). "Spelling Out Dyslexia". Northwest Science & Technology.
25. Hornickel J, Zecker S, Bradlow A, Kraus N, (2012). "Assistive listening devices drive neuroplasticity in children with dyslexia". [PNAS]. doi:10.1073/pnas.1206628109.