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From Wikipedia, the free encyclopedia
Dyslexia, also known as reading disorder, is characterized by trouble with
unrelated to problems with overall . Different people are affected to varying degrees. Problems may include difficulties in
words, reading quickly, , "sounding out" words in the head, pronouncing words when reading aloud and understanding what one reads. Often these difficulties are first noticed at school. When someone who previously could read loses their ability, it is known as alexia. The difficulties are involuntary and people with this disorder have an unaffected desire to .
The cause of dyslexia is believed to involve both
and environmental factors. Some cases run in families. It often occurs in people with
(ADHD) and is associated with similar . It may begin in adulthood as the result of a , , or . The underlying mechanisms are problems within the 's language processing. Dyslexia is diagnosed through a series of tests of memory, spelling, vision, and reading skills. Dyslexia is separate from reading difficulties cau or either hearing or vision problems.
Treatment involves adjusting teaching methods to meet the person's needs. While not curing the underlying problem, it may decrease the degree of symptoms. Treatments targeting vision are not effective. Dyslexia is the most common , affecting 3–7 % however, up to 20% may have some degree of symptoms. While dyslexia is more often diagnosed in men, it has been suggested that it affects men and women equally. Dyslexia occurs in all areas of the world. Some believe that dyslexia should be best considered as a different way of learning, with both benefits and downsides.
Dyslexia is thought to have two types of cause, one related to
and another to . It is considered a , not a problem with . However,
often arise because of it. Some published definitions are purely descriptive, whereas others propose causes. The latter usually cover a variety of reading skills and deficits, and difficulties with distinct causes rather than a single condition. The
definition describes dyslexia as "difficulty with spelling, phonological processing (the manipulation of sounds), or rapid visual-verbal responding". The British Dyslexia Association definition describes dyslexia as "a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling" and is characterized by "difficulties in phonological awareness, verbal memory and verbal processing speed".
Acquired dyslexia or alexia may be caused by brain damage due to
or . Forms of alexia include , , , , and .
There is some variability in the definition of dyslexia. Some sources, such as the U.S. National Institutes of Health, define it specifically as a learning disorder. Other sources, however, define it simply as inability to read in the context of normal intelligence, and distinguish between developmental dyslexia (a learning disorder) and acquired dyslexia (loss of the ability to read caused by brain damage). , the manual of medical diagnosis used in much of the world, includes separate diagnoses for "developmental dyslexia" (81.0) and for "dyslexia and alexia" (48.0). , the manual of psychiatric diagnosis used in the United States, does not specifically define dyslexia, justifying this decision by stating that "the many definitions of dyslexia and dyscalculia meant those terms would not be useful as disorder names or in the diagnostic criteria". Instead it includes dyslexia in a category called .
In early childhood, symptoms that correlate with a later diagnosis of dyslexia include
of speech, difficulty distinguishing left from right, difficulty with direction, as well as being easily distracted by background noise. The reversal of letters or words and
are behaviors sometimes seen in people with dyslexia, but are not considered to be defining characteristics of the disorder.
Dyslexia and
(ADHD) com about 15% of people with dyslexia also have ADHD and 35% of those with ADHD have dyslexia.
School-age dyslexic children may exhibit signs of difficulty in identifying or generating rhyming words, or counting the number of syllables in words – both of which depend on . They may also show difficulty in segmenting words into individual sounds or may blend sounds when producing words, indicating reduced . Difficulties with word retrieval or naming things is also associated with dyslexia.:647 Dyslexics are commonly poor spellers, a feature sometimes called dysorthographia or , which depends on .
Problems persist into adolescence and adulthood and may accompany difficulties with summarizing stories, memorization, reading aloud, or learning foreign languages. Adult dyslexics can often read with good comprehension, though they tend to read more slowly than non-dyslexics and perform worse in
tests or when reading nonsense words – a measure of phonological awareness.
A common myth about dyslexia is that its defining feature is reading or writing letters or words backwards, but this is true of many children as they learn to read and write.
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of a language directly impacts how difficult learning to read the language is.:266 English and French have comparatively "deep"
within the
, with complex structures employing spelling patterns on several levels: letter-sound correspondence, syllables, and .:421 Languages such as Spanish, Italian and Finnish have mostly alphabetic orthographies, which primarily employ letter-sound correspondence – so-called shallow orthographies – which for dyslexics makes them easier to learn.:266
writing systems, such as , have extensive symbol use, and pose problems for dyslexic learners.
Dyslexia is often accompanied by several learning disabilities, but it is unclear whether they share underlying neurological causes. These associated disabilities include:
– A disorder which primarily expresses itself through difficulties with writing or typing, but in some cases through difficulties associated with
and direction- or sequence-oriented processes such as tying knots or carrying out repetitive tasks. In dyslexia, dysgraphia is often multifactorial, due to impaired letter-writing automaticity, organizational and elaborative difficulties, and impaired visual word forming which makes it more difficult to retrieve the visual picture of words required for spelling.
– A significant degree of
has been reported between ADHD and reading disorders such as dyslexia. ADHD occurs in 12–24% of all individuals with dyslexia.
– A listening disability that affects the ability to process auditory information. This can lead to problems with
and auditory . Many people with dyslexia have auditory processing problems, and may develop their own
to compensate for this type of deficit. Some research indicates that auditory processing skills could be the primary shortfall in dyslexia.
– A neurological condition characterized by marked difficulty in carrying out routine tasks involving balance, fine-,
coordination, difficulty in the use of speech sounds, problems with , and organization.
Inferior parietal lobule – ( superior view animation)some dyslexics demonstrate less electrical activation in this area.
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Researchers have been trying to find the neurobiological basis of dyslexia since the condition was first identified in 1881. For example, some have tried to associate the common problem among dyslexics of not being able to see letters clearly to abnormal development of their visual nerve cells.
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techniques such as
(PET) have shown a correlation between both functional and structural differences in the brains of children with reading difficulties. Some dyslexics show less electrical activation in parts of the left hemisphere of the brain involved with reading, such as the , , and the middle and . Over the past decade, brain activation studies using PET to study language have produced a breakthrough in the understanding of the neural basis of language. Neural bases for the visual
and for auditory verbal
components have been proposed, with some implication that the observed neural manifestation of developmental dyslexia is task-specific (i.e. functional rather than structural). fMRIs in dyslexics have provided important data which point to the interactive role of the
and cerebral cortex as well as other brain structures.
The cerebellar theory of dyslexia proposes that impairment of cerebellum-controlled muscle movement affects the formation of words by the tongue and facial muscles, resulting in the
problems that are characteristic of some dyslexics. The cerebellum is also involved in the
of some tasks, such as reading. The fact that some dyslexic children have motor task and balance impairments has been used as evidence for a cerebellar role in their reading difficulties. However, the cerebellar theory is not supported by controlled research studies.
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Research into potential genetic causes of dyslexia has its roots in post- examination of the brains of people with dyslexia. Observed anatomical differences in the
of such brains include microscopic
malformations known as , more rarely,
micro-malformations, and . The previously cited studies and others suggest that abnormal cortical development presumed to occur before or during the sixth month of
brain development was the cause of the abnormalities. Abnormal cell formations in dyslexics have also been reported in non-language cerebral and subcortical brain structures. Several genes have been associated with dyslexia, including
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The contribution of gene–environment interaction to reading disability has been intensely studied using , which estimate the proportion of variance associated with a person's environment and the proportion associated with their genes. Studies examining the influence of environmental factors such as parental education and teacher quality have determined that genetics have greater influence in supportive, rather than less optimal, environments. However, more optimal conditions may just allow those genetic risk factors to account for more of the variance in outcome because the environmental risk factors have been minimized. As environment plays a large role in learning and memory, it is likely that
modifications play an important role in reading ability.
and measures of
in the human periphery are used to study
however, both types of study have many limitations in the extrapolation of results for application to the human brain.
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The dual-route theory of
aloud was first described in the early 1970s. This theory suggests that two separate mental mechanisms, or cognitive routes, are involved in reading aloud. One mechanism is the lexical route, which is the process whereby skilled readers can recognize known words by sight alone, through a "dictionary" lookup procedure. The other mechanism is the nonlexical or sublexical route, which is the process whereby the reader can "sound out" a written word. This is done by identifying the word's constituent parts (letters, , ) and applying knowledge of how these parts are associated with each other, for example, how a string of neighboring letters sound together. The dual-route system could explain the different rates of dyslexia occurrence between different languages (e.g. the Spanish language dependence on phonological rules accounts for the fact that Spanish-speaking children show a higher level of performance in non-word reading, when compared to English-speakers).
Dyslexia disorder is not caused by
in fact, it appears to involve the combined effects of several genes. Studying the cognitive problems associated with other disorders helps to better understand the genotype-phenotype link of dyslexia. Neurophysiological and imaging procedures are being used to ascertain phenotypic characteristics in dyslexics, thus identifying the effects of certain genes.
There are tests that can indicate with high probability whether a person is a dyslexic. If diagnostic testing indicates that a person may be dyslexic, such tests are often followed up with a full diagnostic assessment to determine the extent and nature of the disorder. Tests can be administered by a teacher or computer. Some test results indicate how to carry out teaching strategies.
Central dyslexias include , , , and . -10 reclassified the previous distinction between dyslexia (315.02 in ICD-9) and alexia (315.01 in ICD-9) into a single classification as R48.0. The terms are applied to developmental dyslexia and inherited dyslexia along with developmental aphasia and inherited alexia, which are considered synonymous.
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In surface dyslexia, words with regular pronunciations (highly consistent with their spelling, e.g. mint) are read more accurately than words with irregular pronunciation, such as colonel. Difficulty distinguishing
is a diagnostic used for some forms of surface dyslexia. This disorder is usually accompanied by surface agraphia and fluent aphasia. Acquired surface dyslexia arises when a previously literate person experiences brain damage, which results in pronunciation errors that indicate impairment of the lexical route.
Broca's area – (lateral view) dyslexics overuse this area which is associated with speech
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In phonological dyslexia, sufferers can read familiar words but have difficulty with unfamiliar words, such as invented pseudo-words. Phonological dyslexia is associated with lesions in the parts of the brain supplied with blood by the . The superior temporal lobe is often also involved. Furthermore, dyslexics compensate by overusing a front-brain region called , which is associated with aspects of language and speech. The Lindamood Phoneme Sequencing Program (LiPS) is used to treat phonological dyslexia. This system is based on a three-way sensory feedback process, using auditory, visual, and oral skills to learn to recognize words and word patterns. Case studies with a total of three patients found a significant improvement in spelling and reading ability after using LiPS.
Individuals with deep dyslexia experience both semantic paralexia (para-dyslexia) and phonological dyslexia, which causes the person to read a word and then say a related meaning instead of the denoted meaning. Deep alexia is associated with clear phonological processing impairments. Deep dyslexia is caused by widespread damage to the brain that often includes the left hemisphere. The "continuum" hypothesis claims that deep dyslexia develops from phonological dyslexia.
Peripheral dyslexias have been described as affecting the visual analysis of letters as a result of brain injury. , a visual field loss on the left/right side of the vertical midline, is associated with this condition.
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Pure, or phonologically-based, dyslexia, also known as agnosic dyslexia, dyslexia without agraphia, and pure word blindness, is dyslexia due to difficulty in recognizing written sequences of letters (such as words), or sometimes even letters. It is considered '"pure" because it is not accompanied by other significant language-related impairments. Pure dyslexia does not affect speech, handwriting style, language or comprehension impairments. Pure dyslexia is caused by lesions on the . The VWFA is composed of the left
and is activated during reading. A lesion in the VWFA stops transmission between the
and the left . It can also be caused by a lesion involving the left
or the . It is usually accompanied by a
in the right side of the visual field. Multiple oral re-reading (MOR) is a treatment for pure dyslexia. It is considered a top-down processing technique in which affected individuals read and reread texts a predetermined number of times or until reading speed or accuracy improves a predetermined amount.
Hemianopic dyslexia is commonly considered to derive from
loss due to damage to the . Sufferers may complain of abnormally slow reading but are able to read individual words normally. This is the most common form of peripheral alexia, and the form with the best evidence of effective treatments.
In neglect dyslexia, some letters, most commonly those at the beginning or left side of a word, are skipped or misread during reading. This alexia is associated with right parietal lesions. The use of prism glasses has been shown to substantially mitigate this condition.
People with attentional dyslexia complain of letter-crowding or migration, sometimes blending elements of two words into one. Sufferers read better when words are presented in isolation rather than flanked by other words and letters. Using a large magnifying glass may help mitigate this condition by reducing the effects of flanki however, no trials of this or indeed any other therapy for left parietal syndromes have been published as of 2014.
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An example of OpenDyslexic typeface, which is used to mitigate common reading errors due to dyslexia.
Through the use of compensation strategies, therapy and educational support, dyslexic individuals can learn to read and write. There are techniques and technical aids which help to manage or conceal symptoms of the disorder. Removing stress and anxiety alone can sometimes improve written comprehension. For
with alphabet-writing systems, the fundamental aim is to increase a child's awareness of correspondences between
(letters) and
(sounds), and to relate these to reading and spelling by teaching how sounds blend into words. It has been found that reinforced collateral training focused on reading and spelling yields longer-lasting gains than oral phonological training alone. Early intervention – that done while the language areas of the brain are still developing – is the most successful in reducing the long-term impacts of dyslexia. There is some evidence that the use of specially-tailored fonts may mitigate the effects of dyslexia. These fonts, which include , , and , were created based on the idea that many of the letters of the
are visually similar and may therefore confuse dyslexics. Dyslexie and OpenDyslexic both put emphasis on making each letter more distinctive in order to be more easily identified. Font design can have an effect on reading, reading time, and the perception of legibility of all readers, not only those with dyslexia.
There have been many studies conducted regarding intervention in dyslexia. Among these studies one meta-analysis found that there was functional activation as a result.
Dyslexic children require special instruction for word analysis and spelling from an early age. However, there are fonts that can help dyslexics better understand writing. The prognosis, generally speaking, is positive for individuals who are identified in childhood and receive support from friends and family.
Map showing predominant forms of writing systems by country and what their characters represent:
   (consonants and vowels)
   (only consonants)
   (family-related syllables)
  
   (isolated syllables)
The percentage of people with dyslexia is unknown, but it has been estimated to be as low as 5% and as high as 17% of the population. While it is diagnosed more often in males, some believe that it affects males and females equally.
There are different definitions of dyslexia used throughout the world, but despite significant differences in writing systems, dyslexia occurs in different populations. Dyslexia is not limited to difficulty in converting letters to sounds, and Chinese dyslexics may have difficulty converting
into their meanings. The Chinese vocabulary uses logographic, monographic, non-alphabet writing where one character can represent an individual phoneme.
The phonological-processing hypothesis attempts to explain why dyslexia occurs in a wide variety of languages. Furthermore, the relationship between phonological capacity and reading appears to be influenced by orthography.
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Dyslexia was identified by
in 1881, but the term dyslexia was coined in 1887 by , an
in . He used the term to refer to the case of a young boy who had a severe impairment in learning to read and write, despite showing typical intelligence and physical abilities in all other respects. In 1896, W. Pringle Morgan, a British physician from , published a description of a reading-specific learning disorder in a report to the
titled "Congenital Word Blindness". The distinction between phonological and surface types of dyslexia is only descriptive, and without any etiological assumption as to the underlying brain mechanisms. However, studies have alluded to potential differences due to variation in performance.
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The majority of currently available dyslexia research relates to , and especially to . However, substantial research is also available regarding dyslexics who speak Arabic, Chinese, Hebrew or other languages.
As is the case with any disorder, society often makes an assessment based on incomplete information. Before the 1980s, dyslexia was thought to be a consequence of education, rather than a basic disability. As a result, society often misjudges those with the disorder. There is also sometimes a workplace stigma and negative attitude towards those with dyslexia. If a dyslexic's instructors lack the necessary training to support a child with the condition, there is often a negative effect on the student's learning participation. There is no evidence demonstrating that the use of music education is effective in improving dyslexic adolescents' reading skills.
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