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Online Chat with Dr. Sally Shaywitz

By: Reading Rockets

Named "One of America's Top Doctors," Dr. Shaywitz is professor of pediatrics at Yale University School of Medicine and author of the bestseller Overcoming Dyslexia. On January 27, 2005, Reading Rockets hosted an online discussion with Dr. Shaywitz, who answered questions about dyslexia and other reading difficulties and responded to parents' concerns.

Many thanks to our partners LD OnLine, The Access Center, and The Partnership for Reading.

Editor's Note: Reading Rockets' moderators retain editorial control over online chats and choose the most relevant questions for our online experts, who may decline to answer certain questions.

Let's get started!

Reading Rockets (Moderator):
Welcome to today's online chat. We're thrilled to have Dr. Sally Shaywitz with us today to answer your questions about dyslexia and other reading difficulties. Be sure to sign up for your chance to win one of 15 copies of Overcoming Dyslexia.

Dr. Sally Shaywitz:

Welcome. I am delighted to join all of you to talk about reading and dyslexia. I welcome this opportunity to share the new knowledge about reading and dyslexia and tell about the practical implications of the science of reading. Let's begin.

Question from Christal, Texas:

How can a parent, who is dyslexic themselves and was never taught phonics, help their dyslexic child?

Dr. Sally Shaywitz:

You have already taken a very important step – understanding that your child has a reading problem. Help must come from the school – that is where your child spends his prime learning hours and this is where adults – teachers who have the knowledge skills – are.

Your job is to make sure that your child is taught with methods and programs they are proven to be effective, that is, that show evidence that they actually work. You can directly ask his teacher, Is there evidence this program is effective? Has this evidence been published in a scientific journal? Was it reviewed by the National Reading Panel?

You can also ask about the kinds of strategy taught to help your child read a new or unfamiliar word – most effective are strategies that teach your child to sound out the word, and not just guess it from the context.

It also important to make sure that your child's progress is frequently measured – weekly or monthly – to ensure there is progress and if not, that the program can be quickly modified. Monitoring progress throughout the year – by actually measurement – is preferable to finding out the last day of the school year that your child has not made progress during the year.

In Overcoming Dyslexia, there is much more information on how to monitor progress and what constitutes good progress.

Question from Julie, Louisiana:
I read your book shortly after my seven-year-old son was diagnosed with dyslexia last spring, and we've been remediating privately ever since. He attends a small, private school that doesn't do much for children with dyslexia. They have shown some willingness to extend test times, but have already proclaimed that they do not allow other things, such as assistive technology.

My question is this: if his remediation is successful (and it seems to be going pretty well), will he still need the same level of accommodations later on? I'm sure it's impossible to predict across the board, but I'm worrying in advance (we call it "dress rehearsal for disaster"), because he loves his school and wants to stay there. I'd be interested in any longterm studies/statistics you have on the subject.

Short Version: Does early remediation reduce the need for accommodations? And if so, how much?

Dr. Sally Shaywitz:
There is some early indications that a highly effective intervention provided early on can result in the ability to read not only accurately but fluently (rapidly) as well. There are no follow-up data on these children, nor are there, to my knowledge, data indicating that later remediations are producing fluent readers.
So, while the hope is there that early remediation will produce fluent readers, the evidence is still coming in. At this time, children who are dyslexic will generally require extra time and other accommodations as they go through school, including postsecondary. Accommodations such as extra time are vital to allowing a bright dyslexic child demonstrate their knowledge and not be penalized by slow reading.
In the future, children who are receiving new, scientifically-based effective, reading interventions, may become fluent readers and not require additional time and other accommodations. That is the hope – but we are still gathering the evidence.

Question from Cindy, Canada:
I currently teach Grade One and have come across many struggling readers. I have read the signs that are posted on this web site. During parent interviews, some parents inquire about dyslexia. I know that it is common for students to reverse letters (b, d, j, g, c) and some numbers (5, 2, 4) at this stage of development. Is this ever considered a sign for dyslexia, and at what age? One parent even said she has seen her child print upside down. This same child has some difficulty reading. What are your thoughts on this?

How are speech/language difficulties related when the child is still only 6/7 years of age?

Dr. Sally Shaywitz:
You are asking two very important – and related – questions. There are many myths about dyslexia; one is that reversing letters and numbers is a sure sign of dyslexia. Reversing letters and numbers often occurs in young children and is not a sure sign of dyslexia. School systems and others often also think that if a child does not show reversals that child is not dyslexia. This is clearly not true. As I note in my book, Overcoming Dyslexia (pp.100-101), "There is no evidence that dyslexic children actually see letters and words backwards." So, to answer your first question, reversals are not a sign of dyslexia.

On the other hand, speech and language difficulties are often found in children and adults who are dyslexic. The primary difficulty in dyslexia is in getting to the basic sounds of spoken words; that is, for example, in appreciating that the spoken word mat has three sounds - /m/ /a/ /t/ or that if you take the /t/ sound away from the spoken work steak, the word sake remains.

So, a fundamental difficulty in children and adults who are dyslexic is a great difficulty in appreciating and in noticing or manipulating the basic sounds of spoken language. A child needs to be able to isolate these individual sounds if he or she is to take the next important step in reading – learning to attach specific sounds to each letter or letter group. Once a child has developed the appreciation that the written word has the same number and sequence of sounds as the spoken word, that child has mastered what is referred to as the Alphabetic Principle and is ready to read.

Knowledge that spoken language problems also characterize struggling readers is very important because it can help identify potential reading problems in children even before they are expected to read and can help identify struggling readers at any age. In Overcoming Dyslexia (pp. 122-127), I list the Clues – both in spoken as well as in written language – to a possible reading problem.

Reading Rockets (Moderator):

Are you enjoying the chat? Do you have any suggestions? Let us know! Click here to take a short survey. Your comments will help us make future chats even better.

Question from Rosa Hagin, New Jersey:
Dr. Shaywitz, how are you defining dyslexia?

Dr. Sally Shaywitz:
Hello Rosa;

I am honored that you are participating in this chat.

Dyslexia is an unexpected difficulty in reading – unexpected in terms of the individual seeming to have all the factors present that suggest he or she should be a good reader – intelligence, often high; motivation, often strong and exposure to reasonably effective reading instruction.

My best to you.

Question from Sheila, Ohio:
Although my 9 year old son has been in speech therapy since preschool and has an identified severe phonemic awareness deficit, I've been told that based on testing and his grades he doesn't qualify for any additional services at school. We all agree he isn't reading at grade level. I know my school district has very limited resources, and I'm told that there are many other children who need help more than he does. He is working with a private tutor (using the Wilson method) once a week, but I'm concerned it isn't enough. What more can I do? I'm afraid he'll keep falling behind and never catch up!

Thank you!!

Dr. Sally Shaywitz:
I would ensure that your child's reading fluency as well as his reading accuracy are evaluated. I am confident that from your description, he is not a fluent reader and should qualify for services based on a lack of fluency. Your concern is for your son and not how many other children need help. The school responsibility is to help each child who is struggling and he certainly appears to be struggling. You are correct, once a week, even with a good program, is totally inadequate. Go back, have his fluency evaluated and keep on fighting. You are right and fighting the most important battle - for your son's future. Don't give up!

Question from Joe:
I have read that neurologists are using MRIs to look at the brain activity of individuals with conditions including ADHD, dyslexia, etc. Do individuals with dyslexia show different brain images when reading? If so, could MRIs be used to diagnose individuals with dyslexia? How expensive are MRIs? Would this be too expensive for most people?

Dr. Sally Shaywitz:
Extraordinary progress in imaging technology now allow scientists to image a child's brain as he or she is actually reading. The technology, referred to as functional magnetic resonance imaging or fMRI, uses the same scanner as a typical MRI used to scan, for example, your knee if you have a torn ligament. The difference is that the fMRI uses special software and some adaptive hardware as well so that small changes in blood flow to different parts of the brain can be detected as a child reads. Using this technology, our research group (and others) has learned that there are three systems for reading on the left side of the brain, one in the front and two in the back of the brain.

We have also learned that in struggling readers, there appears to be less activation or a glitch in the two systems in the back of the brain. Our studies have also indicated what happens in the brain in children who compensated, to some degree, for their reading problems, and also identified the specific region called the "word form area" located in the back of the left of the brain that seems to be related to skilled or fluent reading.

Most excitedly, our recent studies, supported by the results of other investigators as well, demonstrate that the brain is highly malleable and under the influence of effective reading instruction – can change and resemble that of a good reader. Basically, this means that teaching matters – making it all the more important to ensure that each child receives reading instruction that has been proven to work – referred to as "evidence-based" reading instruction. Parents, teachers and we as a nation, should settle for no less. For anyone interested in more information and brain images, I refer you to chapters 6 & 7 of Overcoming Dyslexia. Similarly, the notion of evidence-based education is discussed in detail in my book.

At this time, the use of functional imaging, fMRI, is limited to research. Clincial judgments about reading and reading disability are made on the basis of a child's history, observations of how he or she reads and test results. To be explicit, MRI's or any other imaging modality, is not currently recommended for use in the diagnosis of a reading problem.

Reading Rockets (Moderator):
Don't forget to sign up for your chance to win one of 15 copies of Overcoming Dyslexia.

Question from Joe:
What characteristics should we look for in pre-school children who would be at risk for dyslexia?

Dr. Sally Shaywitz:
The most important clues in a preschool child are:

  • A family history of reading problems
  • Delayed speech
  • Lack of appreciation and enjoyment of rhymes – e.g., not appreciating the rhymes in a Dr. Seuss book
  • Not being able to recite rhymes by age 3
  • Continuation of baby talk
  • Trouble pronouncing words
  • Trouble learning the alphabet – (not the alphabet song, but knowing the individual names of the letters of the alphabet)

It is important to keep in mind that you are looking for a pattern of these clues – ones that keeping occurring often. Not knowing a rhyme or a the name of a letter once or twice is not what we are looking for. A pattern that occurs over and over again is what to look for.

Question from Colleen, New York:
What's the best plan for a preschooler with dyslexia entering kindergarten? What should I ask the school to do right from the start?

Dr. Sally Shaywitz:
Beginning kindergarten is an important to ensure that an at-risk child receives the right help. The critical areas are: assessment, instruction and monitoring. The child's language and phonological and readiness skills should be assessed. Next, there are now available several evidence-based, developmentally appropriate reading readiness programs available; they generally stress teaching child about the sounds of spoken language, how letters represent these sounds and introduce a child to early reading skills.

Vocabulary and listening to stories as well as early writing are introduced. The elements should be provided in a systematic and explicit fashion; dyslexic children do not learn by osmosis. Simply surrounding a child with books is insufficient, he or she must be taught explicitly.

Finally, they should be continuously monitored; there are instruments now available that all up-to-the-minute frequent monitoring of reading progress. And you, as a parent, should continuously ask to ensure that the reading instruction is based on evidence of efficacy and that your child's progress is being carefully monitored and that if she or he is not making progress, modifications are quickly made. Catching a reading problem early and doing the right things can ensure a bright future for your child. Good luck.

Question from Kelly:
What is your perception regarding the "readiness" debate as it relates to early childhood education? Should early childhood education be mostly "play" oriented? Is direct instruction appropriate? If so when and how much?

Dr. Sally Shaywitz:
Your question is a very important one. Early childhood experiences provide the basic foundation or groundwork for getting ready to read. Language – appreciation of the sounds of spoken words, vocabulary – what words mean, and listening to stories and hearing about the world around are all key elements to getting ready to read. Learning about the sounds and letters of the alphabet, about words and their meaning and the world are all important and can and should be part of a child's early childhood experiences and education. Clearly, any experience should be provided in an age appropriate manner – each of the elements I noted above can be provided effectively in an enjoyable and fun manner.

Question from Patrice, Massachusetts:
Can you speak a little about the difference between a learning disability and a reading disability?

Dr. Sally Shaywitz:
Learning disability is a much broader term; reading disability is one form of a learning disability, there are, for example, also math disability and other types of disabilities. It is important to appreciate that of all the learning disabilities, reading disability is by far and away the most common, accounting for about 80%+ of all learning disabilities.

Question from Lori, Atlanta:
How do you recommend handling parents that may be in denial that their child has dyslexia, and in turn, once they find out that they do have dyslexia, they don't necessarily do anything about it?

Dr. Sally Shaywitz:
All parents want the best for their child. Some parents become so frightened and they panic and deny the problem. I have written Overcoming Dyslexia to empower such parents to understand the nature of the problem and that there is now good help available. Once parents appreciate this, they feel empowered to become "champions" for their children and make a difference in ensuring that they receive effective help. Once parents understand what to do and why and know that they can make a difference, they will do anything to improve their child's life.

Question from Diana:
Per school my daughter is not dyslexic but she is 11 years old and though she has memorized more words her ability to decode unfamiliar words, effectively use blending and reading speed continue to be below her grade level and peers even though she gets good grades. What tests can we have a professional do to determine what is the problem since the school wont retest her?

Dr. Sally Shaywitz:
Very often bright children are penalized and fall between the cracks; that is, although they do not learn the necessary strategies for reading, they are able to memorize enough words to avoid detection. Your daughter appears to fit into this category. The problem is that as your daughter progresses in school, she will be faced with many, many more new words, many long, technical or unfamiliar words and with many rare words – the bottom line is that memory no longer is adequate to know all of these words.

Your daughter should be tested. In Overcoming Dyslexia I describe in some detail the types of testing and rationale for testing. Basically, her ability to read words accurately and fluently and to comprehend words are essential components of a test battery. You should ensure that her fluency – ability to read rapidly as well as accurately – are tested (this is often overlooked). Tests of her ability to get to the sounds of spoken words are also important as are measures of her vocabulary. This could serve as the core of a test battery, other tests can be added, depending on her individual history and pattern.

She should be tested. If on the basis of her testing, in addition to her history and observations of how she reads aloud, she is not a fluent reader, she should get help soon. She can be helped and the help should not be delayed.

You should also keep in mind that your daughter may be helped by the accommodation of extra time if she is a slow reader.

Reading Rockets (Moderator):

Click here to learn more about Target the Problem, an upcoming feature from Reading Rockets that provides information about the different types of reading difficulties a child may experience.

Question from Wendy from Richmond VA:
I am a Special Education teacher and work with a number of dyslexic students whose accuracy is improving faster than their fluency. Will some dyslexic students always have poor fluency? Are we expecting them to be as fluent as the non-dyslexic?

Dr. Sally Shaywitz:
Yours is an excellent question; teachers are commonly finding that they are able to remediate a child's accuracy, but that the child continues to lack fluency. As I discuss in Overcoming Dyslexia there are specific strategies to help improve fluency; for example, as reported by the National Reading Panel, repeated oral reading with feedback and guidance, is an effective strategy.

However, we still do not have the answers to your last questions. A few studies of young children have shown improvements in fluency – but we not yet know if this will be lasting. Fluency is a critical issue and the National Institute of Child Health and Human Development is devoting much effort to better understanding the nature of fluency and how to improve fluency for all children.

Finally, we do know that children who are not fluent fail to show activation of an area in the back of the left side of the brain called the word form area. Recently, we have been able to demonstrate that effective reading instructions brings about some improvement in fluency and in increasing brain activation in the word form area. A very hopeful finding, but an early one. We still need to learn much more and we are.

Question from Ronda, Oregon:
After reading your book, "Overcoming Dyslexia," I was encouraged to find so many programs that are effective with these students. Can you explain why it is taking so long for the use of these programs to become widespread in the public school system? I'm especially frustrated by our teacher training programs that are not preparing our teachers to use these Orton-Gillingham-based methods. What can we do to help initiate change?

Dr. Sally Shaywitz:
It is both amazing and inexcusable that it is taking so long for effective programs to be used in schools. I think part of the problem is that schools and educators are not aware of the great leap forward that has occurred where there is not rigorous science to help guide reading instruction.

We not have the potential to be in an era of evidence-based effective reading instruction where evidence that a program has proven to be effective with comparable groups of students is the standard used in selecting programs. For our children's futures, we must step away from using philosophy or preconceived beliefs or anecdotal information guide how we teach children to read. Children are only 7 or 8 years old once in their lives and deserve all the opportunities that reading brings with it.

A major step to improvement is to improve how our colleges of education teach teachers about reading. We must insist that curriculums there reflect up-to-date science. Within schools, parents and teachers must ask about and, indeed, demand that their students be taught by methods proven to be effective. In "Overcoming Dyslexia" I provide specific questions parents can ask teachers and schools about their child's reading program to insure that it is evidence-based and effective.

Question from Ellen, Connecticut:
Do all dyslexic children have a weakness in the phonological area?
Dr. Sally Shaywitz:
Ellen, that is a very good question. Our work with other researchers, especially Robin Morris and Jack Fletcher, on examining subtypes of reading problems has demonstrated that a phonological weakness is present in 90% of all struggling readers. Phonological problems may be associated with problems in other areas such as memory as well. A small group of children may demonstrate problems in rate alone and not in phonology. These results are for young children; we are now working on an adolescent study to see if the same is true for this group of older children.

Reading Rockets (Moderator):

If you like this chat and want to find out about future chats from Reading Rockets, sign up to receive email updates.

Question from Tara, Tennessee:
What can we all do to make sure that students with dyslexia get the accommodations they need to demonstrate what they know and to continue their learning?
Dr. Sally Shaywitz:
Accommodations are essential for a dyslexic reader. Brain imaging studies demonstrate that the fast pathways for fluent reading do not develop in dyslexic readers. As a result, such a reader must rely on slower pathways that allow him or her to read accurately, but not rapidly.

Unfortunately, accommodations are greatly misunderstood. We must all work to ensure that the nature and rationale and the necessity for accommodations are understand. We should not accept the flawed logic that if a person is doing relatively well in school he does not require accommodations. Dyslexics may do very well in school as a result of accommodations and this should not be used as an excuse to deny accommodations.

I devoted a very informative chapter, Chapter 23, in Overcoming Dyslexia to address just about every aspect of and answer the most common questions asked about accommodations. We should all read it and work hard to ensure that this critical information is disseminated and that schools and testing agencies decisions reflect scientific knowledge about dyslexia and not outdated myths.

I cannot emphasize how important accommodations are – virtually a life line – for dyslexics. Now that we understand the scientific necessity for accommodations, we must ensure that each student receives the accommodations he or she needs.

Question from Margery:
I'm a special education teacher in a primary school. Your at home suggestions are excellent. How do you temper overzealous parents to not attempt "everything" at once. I find that parents are inappropriately over-doing the work at home and ultimately hurting their child's self-esteem and progress.

Dr. Sally Shaywitz:
An important question. At times, parents who care so much worry that they must fill in every moment of a child's day and evening fixing the problem. While this laudable, my experience with highly successful adults who are dyslexic indicates that a recurring theme is that these folks were greatly benefited from finding and pursuing an activity in which they could find success and a sense of mastery. It doesn't matter what the acclivity is – basketball, piano playing, skateboarding, drawing, rock collecting, soccer, doll collections – as long it brings a sense of satisfaction to the child.

To address this question, in my book Overcoming Dyslexia I included a very important chapter, Protecting and Nourishing Your Chid's Soul, to help parents find ways of supporting and developing their child's self-esteem. I thought this issue so important that I also included an Epilogue, giving examples of well-respected, highly successful people who were dyslexic and how they succeeded. Invariably, they had an interest that helped sustain their self-esteem: for the writer, John Irving, it was a love of, and success in, wrestling; for writer Stephen Cannell, it was football; for financier Charles Schwab, it was golf – each had something that they enjoyed and in which they could experience success.

Question from Lisa, Kentucky:
I have an 8 year old boy who has is in 2nd grade. He is really struggling with reading. He is at most at a high kindergarten reading level. At school he gets 1 hour of additional help outside the classroom. We also have had him privately tutored for awhile, but we are not seeing any progress. We are considering holding him back in school. We are also looking into additional help for this summer. Do you think that a child with dyslexia should be held back in school?

Dr. Sally Shaywitz:
The evidence suggests that simply holding a child back is not helpful. If a child is falling behind, he needs help – he requires reading instruction that is proven to be effective and it needs to be delivered to him intensely (small group) and frequently (60-90 minutes/daily). Of course, progress should be frequently and consistently monitored.

Repetition of the same program that failed him in one year will not likely do any better a second time around. You must ensure that he is tested and receives reading intervention that is proven to be effective and he receives it intensively and frequently.

Reading Rockets (Moderator):

Are you interested in learning more about helping children learn to read? Sign up for Reading Rockets News, a free monthly newsletter featuring news and information on how young children learn to read, why so many struggle, and how caring adults like you can help.

Question from Robin, New York:
Has there been any significant research on how dyslexia affects the mathematical reasoning centers of the brain?

Dr. Sally Shaywitz:
There is no evidence yet; however, we are currently carrying such research with children who have either reading or math problems, both or neither. Such studies including brain imaging and we would be very interested in hearing from parents or teachers of children with math problems who are interested in participating in this study. Please call 203-785-4641 for more information.

Question from Bette Butterick, Louisiana:
What is a non-threatening approach to use to convince teachers that multisensory teaching is beneficial for all in the classroom, not just the students who have dyslexia?

Dr. Sally Shaywitz:
Teachers want to help all their students. It is important to help them appreciate that reading and reading problems occur along the same continuum – like hypertension and obesity, reading and struggling reading occur along the same path – differing only in degrees. Furthermore, NAEP results show that almost 40% of children are not reading at basic levels of proficiency. The point is that there are substantial numbers of children – many, many in each class room who are struggling to read. Aside from a small group of children who might learn to read irrespective of method used, most require the best instruction we have available, otherwise large numbers are at risk for a reading disability. This means we must use proven methods of instructions.

Reading Rockets (Moderator):

Don't forget to sign up for your chance to win one of 15 copies of Overcoming Dyslexia.

Question from Karen, Phoenix:
Can you recommend a reading routine for parents with dyslexic children?

Dr. Sally Shaywitz:
Parents of a dyslexic child can be their child's biggest helper. I think the best way to help is to work with your child to improve his or her ability to read fluently – rapidly, as well as accurately.

To do this means sitting down with your child, selecting a book to read together that is easy and interesting to the child and for you to read aloud (a passage or a page) to your child and then have your child read the same passage back to you. If he or she has made errors, correct them gently, and have the reread the passage. The practice of repeated oral reading with feedback and guidance allows the brain to practice and build and re-enforce the circuits necessary for fluent reading. You can also use poems or pretend you are acting out a play – plays require reading aloud and rereading, an excellent vehicle to practice fluency.

There are also commercial programs beginning to become available.

Parents are also have a critical role in ensuring that their child maintains his sense of self-esteem. How parents may help their struggling reading is further discussed in my book, Overcoming Dyslexia.

Question from Diane, Ohio:
How has your book helped to raise awareness of dyslexia, current research, and the need for research based intervention for dyslexics? Please share some personal experiences.

Dr. Sally Shaywitz:
Thank you for your question. I wrote Overcoming Dyslexia as a labor of love to pass along in an understandable way all that has been learned about dyslexia and to tell how this exciting new information can be used in a very practical sense to help overcome dyslexia. Since my book was published, I have been gratified by an outpouring of thank-you's for helping parents, teachers and dyslexic men and women better understand how you can be smart and still struggle to read and for showing how success is possible.

There is still much work to be done. I am taken by the powerful effect dyslexia has on those who have it, have to live with it or who have a loved who is dyslexic. I want all my readers to know that I support you and will continue to do all in my power to ensure that each child and dyslexic has a bright future to look forward to. Let's all work together to ensure that science works to help all who are dyslexic. I hope to speak to you again soon. Keep in mind that many, many very intelligent men and women are dyslexic and successful. My goal is to remove the stigma from dyslexia so that everyone knows that it is real and often signifies a person who is unusually creative and empathic.

Dr. Sally Shaywitz:

Thank you for your thoughtful questions. I regret that there was not enough time to answer all your important questions. To help answer remaining questions, I refer you to my book, Overcoming Dyslexia, published by Knopf. In it you will find just about everything you may want to know about the science of reading and its implications for helping to identify and to teach struggling readers. The book is available at all bookstores and on amazon.com. Again, thank you for sharing this time with me.

Reading Rockets (Moderator):

We're sorry, but that's all we have time for today. You sent in many wonderful questions. – more than Dr. Shaywitz could answer personally during this hour.

Thanks to our partners, LD OnLine, The Access Center, and The Partnership for Reading for making today's chat possible. And a very special thanks to Dr. Shaywitz for taking the time to be with us today.

Before you go, please take a moment to take a short survey about today's chat. Your comments will help us make future chats even better.

Reading Rockets (2005)

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