Book Excerpt: 'Overcoming Dyslexia'

As part of Good Morning America's "Breakthrough Dyslexia" segment, Dr. Sally Shaywitz, author of Overcoming Dyslexia: A New and Complete Science-Based Program for Overcoming Reading Problems at Any Level, shared excerpts from her book that might assist parents in finding out if their child should be evaluated for dyslexia.

The excerpts below come from selected sections of Shaywitz's, book Overcoming Dyslexia.

A Brief Checklist Concerning Your Child's Beginning Reading Program (page 209)

What method is used to teach reading?

The key questions to ask are these: Is there scientific evidence that the program is effective? You may want to ask for specific evidence, such as an article on the efficacy of the program or method in a peer-reviewed scientific journal. (Keep in mind that testimonials, no matter how moving, are not scientific evidence, nor are articles in newsletters and magazines or mentions in the media or online.)

Was the program or its methods reviewed by the National Reading Panel? If not, how does this program compare to those found effective? You want specifics.

In teaching beginning reading, are phonemic awareness and phonics taught systematically and explicitly?

How are children taught to approach an unfamiliar word? They should feel empowered to try to analyze and sound out an unknown word first rather than guess from the pictures or context. Illustrations and context can be used as a second step to verify if the pronunciation seems to make sense.

Does the program also include many opportunities to practice reading, to develop fluency, to build vocabulary, to develop reading comprehension strategies, to write, and to listen to and talk about stories?

How is instruction matched to a child's individual needs? The critical elements to look for are these:

Individualization: The size and flexibility of instructional groups are important. Some components of reading such as vocabulary may be taught as a class activity. However, given the variability in reading skills within a class, other components such as basic phonologic skills and oral reading are best addressed in smaller groups. A portion of each day's reading instruction, therefore, should be carried out in small groups. A class of twenty is divided into three groups of six to seven students so that each child receives individualized attention at least once a week as he tries to sound out words or read aloud. This grouping should be flexible for each component of reading, so that a child can move in and out of a group depending on his progress and level of skill in that particular area. Children who are progressing more slowly will benefit from smaller groups and more intensive attention to that skill.

Feedback and guidance: Learning should be active, with many teacher-child interactions. Ideally, the teacher models reading for the child and then provides feedback and guidance as the student rereads the selection aloud. This is best determined by direct observation while visiting your child's classroom.

Ongoing assessment: The child's reading skills should be assessed both by informal teacher observation and by more formal measures. As I will discuss in Chapter 19, measuring your child's progress in reading needs to be an ongoing process in order to reflect his changing needs. In the primary grades (one to three) his reading should be assessed at least three times during the school year to monitor growth, and more often if there are indications of failure to make progress.

At Home:

While a parent should not become her child's primary teacher, she can become her child's biggest helper. With a light hand, good humor, and the suggestions found here, you can help accelerate your child's progress. In most instances I strongly caution parents against setting out to teach their child all of the phonics rules or a complete reading curriculum. Teaching reading is a complex task and one that should be left to a professional. Keep in mind that your child is in class for perhaps six hours a day. You will see him after school when he is tired and less receptive to learning and when you, too, are not at your most energetic or patient. I recommend that you work with your child fifteen or twenty minutes a few evenings a week; it should remain fun and not a chore for either of you. For the most part, weekends should be left for enjoyment and not to play catch-up.

Focus on reinforcement. School is where new learning should take place; home is ideal for practice and reinforcement. School helps him build the necessary neural models for reading; home practice strengthens and solidifies the model. Try to coordinate any home reading activity with what your child is learning in school. The goal is to reinforce and strengthen what he is learning. Children do best when they can focus on one procedure or approach at a time. Work in harmony with your child's teacher.

I encourage you to reinforce selected basic skills that will make reading more understandable and ultimately more enjoyable for your child. I will give you a list of children's books that are right for him, books that he will be able to read, that he will enjoy reading, and that will stimulate him to read more. The activities are easy to do and require little more than a stack of index cards, magnetic letters, a felt marking pen, and a highlighter pen. For some of the activities I recommend colored as well as white index cards.

Sounding out smaller words. Like most other behaviors, how we read reflects the habits we develop through instruction and practice. You can play an important role in ensuring that your child develops good reading habits by encouraging certain behaviors. One of the most important is to learn to sound out words and to do so early. Whenever your child comes across a word he is unsure of, encourage him to try to sound it out. You can begin by asking him about the first sound. For example, if the word is mat, you can say with some exaggeration, "The first letter is mmm. What is the sound of mmm?" Repeat the process with the last sound, "t," and then the middle sound, "aaaa." Once he is able to articulate "mmmm," "aaaa," "t," ask him to blend the sounds together rapidly and say mat. Ask him if this sounds right to him. Does it make sense in the story? Here he is practicing good reading habits by, first, decoding an unknown word, and then verifying that his pronunciation is accurate. By teaching him to ask himself these questions automatically, you are also fostering his independence as a reader and building his confidence. Speak to your child's teacher and ask what sounds and strategies your child is working on and what you can do to help him practice. If she isn't able to provide any suggestions, you can ask her about some of the activities listed below. These simple and useful strategies are relatively easy for you to practice with him and will help him pull apart literally hundreds of words that he might otherwise give up on. They are also helpful when you are reading with your child. If he stumbles on a word that is dependent on one of these strategies for its pronunciation, after you finish a page or story you can use the troublesome word as an opportunity to review the rule.

These strategies will allow your child to pronounce the following correctly:

Words following the silent e rule so that he knows the difference between words like mate and mat.

Words containing the letter c and to determine when a c is said softly, as in cereal and cinder, or makes a hard sound, as in camel and clock; I refer to this as the saying c's rule.

How Parents Can Nurture Reading Comprehension (pages 233)

Just as parents can have a positive effect on fluency and vocabulary, they can have a similar effect on reading comprehension. A recent study carried out with seven- and eight-year-olds determined that home reading habits were strong predictors of a child's later performance in reading. Skilled readers were read to more often by their parents and were more likely to read with their parents and talk about books and stories with them.

The basic idea is to encourage your child to be an active listener, the forerunner of an active reader. All the steps you take to accomplish this are directed toward capturing his attention and pulling him into the reading. The goal is for the words and the ideas they represent to take on meaning. And so you are continually looking for ways to connect what is happening in the pages of the book to what is familiar or meaningful to your child.

I like to divide reading comprehension activities into three parts: those you can do before opening the book, those that are most helpful as the child reads, and those that help him organize his thoughts and sum up the events of the story after he finishes reading. These activities are fun but intensive. By no means should you feel obligated to go through each one of these for each book you and your child read together. I am offering a range of possibilities. You must decide which of these best suit you and your child. There is no one right way or one set formula to teach comprehension skills to your child. The idea is to transfer a way of thinking about reading to your child. Once he has assimilated this way of actively thinking about reading, he is an independent reader.

Comprehension: The Trouble Signs (from page 246)

One of the added benefits of sitting alongside your child and reading with him is that it gives you insight into his ability to comprehend what he is reading. Below are some of the signs of a child who is having trouble comprehending what he is reading:

He doesn't seem to get much from his reading.

He has trouble answering the question "What was the book about?"

He doesn't enjoy reading.

He spends the same amount of time on easy passages as he does on difficult ones.

He doesn't finish what he begins to read.

He doesn't seem to be able to relate his reading to things he knows.

He has trouble drawing inferences from his reading; his interpretations are always extremely literal.

He can't quite come up with main ideas or summarize what he has read.

He can't distinguish important ideas from lesser ones in the text.

He has trouble making predictions.

He rarely looks back at earlier pages to check his reading.

He says reading is boring or tiring.

He avoids reading.

Answers to the Most Frequently Asked Questions (page 278)

What is the best way to monitor my child's progress in a reading program?

Two complementary approaches, when combined, provide up-to-date monitoring of a child's rate of progress and his level of achievement in reading. One is called curriculum-based measurement (CBM) and relies on ongoing measurements of reading fluency (ideally, weekly; minimally, three times during a school year) using the child's classroom reading materials. This is meant to establish how fast he is acquiring new knowledge. The other method, which is not intended for very frequent administration, uses standardized reading tests and assesses reading performance periodically vis-à-vis his age-mates.

The curriculum-based approach, advanced by researchers Lynn and Douglas Fuchs at Vanderbilt University, measures how well a child has learned what he has been taught. His progress in meeting the demands of the reading program developed for him is graphed over time, so his growth or lack of growth is clearly visible. Progress in different areas of reading-including phonics, decoding nonsense words, reading real words, and reading passages aloud-can be measured. Earlier I discussed expected levels of fluency at different grades. CBM can be used to track fluency rates as an objective measure to identify if a child is responding to a particular instructional approach and, if necessary, to modify it. The rate of his reading growth is compared to norms that have been established for the amount of weekly growth expected at each grade level, beginning at grade one and extending through grade six. No one has to wait for the end of the school year to learn about a child's reading progress. A child's rate of reading growth follows a distinct pattern: (1) growth is greatest in the early school years and lessens with each succeeding grade; (2) growth is most often at its maximum at the beginning of each school year and tapers off toward spring. Using oral passage reading as an example, I have listed below the expected reading growth rates-how much (the number of words read correctly per minute) a child should be expected to improve each week. The important figure here is the amount of change-how many more words per minute a child can read correctly compared to the previous week. For each grade level, a lower number (referred to as "realistic") and a higher one (called "ambitious") are provided. The realistic number represents the amount of improvement observed for a typical child. The child who is experiencing reading difficulties, having fallen behind, has a lot more ground to cover, so he must make faster progress than his classmates. His goal is to achieve the ambitious rate of growth if he is to make a learning leap and catch up to his classmates.

Rate of Expected Weekly Reading Growth (Increase in Correct Words Read per Minute) Grade Realistic Ambitious 1) 2.00 3.00 2) 1.50 2.00 3) 1.00 1.50 4) 0.85 1.10 5) 0.50 0.80 6) 0.30 0.65

CBM is administered in the classroom. A child reads aloud a passage at her grade level, and each week she is assessed using a passage of equivalent difficulty. Her oral reading is timed for one minute; as she reads, her teacher follows along with a copy of the passage, using the scoring method described on page 277. The fluency score-the total number of words read per minute minus the number of errors-is calculated and charted. For example, a second grader's fluency (ambitious) rate should increase by two words each week; a fifth grader's growth should come close to one word per week. For this approach to work, a child must be reading at least at a mid-first grade level. It is important not to base any judgment on one or two weeks but, rather, to observe the child's progress over five, six, or more weeks. If she is on track, the program should be continued. If the observed reading growth is below the "ambitious" rate, however, the program needs to be modified. DIBELS (see Chapter 15) is extremely useful for assessing a child's fluency in the early foundational reading skills. Accordingly, it is targeted for children from preschool through grade three. The goal is to identify those children who are not progressing and who may benefit from early intervention. DIBELS (or comparable surveillance) can benefit all beginning readers, especially those who are at risk for a reading disability or who are showing early signs of struggle.

Teaching the Dyslexic Child to Read

The second approach to monitoring progress focuses on a child's absolute level of performance, at a fixed point in time, compared to his age or grade peers as measured by a standardized reading test such as the Woodcock Reading Mastery Test. These results are reported in percentile scores (for example, a nine-year-old boy who is reading at the 40th percentile is superior to 40 percent of all nine-year-old boys). They also may be reported as standard scores, which are adjusted so that 50 percent of the children score either below or above an average score of 100. This kind of standardized test is most often given at the end of the school year. The results establish at what level a child is reading and how he compares to other children of his own age, but they do not help determine how fast he is mastering specific reading skills. Keep in mind that both reading accuracy and reading fluency, as well as comprehension, must be assessed by these standardized measures. Otherwise, students who are accurate but read slowly and with great effort will be overlooked and not receive the required help. All children do not respond in exactly the same manner to a program. Most important is the trajectory. A relatively flat line indicating little progress loudly proclaims the need for a change, just as a steep upward incline proudly trumpets rapid progress. Happily, new reading programs, like those I have recommended and those adhering to Reading First requirements, routinely build in ongoing monitoring.

Do the benefits of scientifically based programs last? Do the children become independent skilled readers? Fluency is the critical marker for permanency. A fluent reader has formed permanent and perfect models of words in his automatic word form system for reading. The children most likely to develop fluency following an intervention are the boys and girls who receive proven early intervention and, optimally, prevention services in kindergarten or first grade. For children who are already experiencing reading problems, improvements are most likely to be maintained following the evidencebased programs I have recommended that are taught by a knowledgeable teacher, attended for a sufficient period of time, and provided with greater intensity (in an individual or small group setting). More intense interventions mean more exposure to print and more opportunities to practice reading words, the critical prerequisites to developing fluency.

When should a reading program be discontinued? In general, when a child is just gaining momentum in reading is the time for an all-out push and never the time for an abrupt halt. Simply teaching a child how to sound out words without providing him with practice in applying this skill to reading will likely result in a child who can sound out some words but has difficulty reading the many new words he comes across as he progresses in his studies. He will not be a fluent reader, and reading will remain effortful. Left alone, he will avoid reading. So this is the time to maintain the same level of intensity and quality of instruction while targeting fluency as well. To repeat: A child should not be removed from an effective reading program until he is able to read words and passages fluently at his grade level. Fortunately, standardized tests such as the Test of Word Reading Efficiency (TOWRE) now make it possible to assess a child's efficiency in reading individual words, while other tests such as the Gray Oral Reading Tests-4 (GORT-4) measure his ability to read passages fluently aloud (see Chapter 13). The GORT-4 provides a standardized assessment of a child's oral reading accuracy, rate, and comprehension. A child may read isolated words efficiently but still struggle to read words when they are connected together in a passage-a much more demanding task. Request the results of your child's performance on both of these tests and discuss them with appropriate teachers before making any decision to remove him from a special reading program.

Has anyone evaluated the effectiveness of public school programs generally used to teach reading to dyslexic students?

Yes, and in general, public school programs for children with reading disability are failures. As it was for Sam, the designation special education per se is insufficient. Parents of a reading-disabled child must carefully examine the specifics of their child's reading intervention. Special-education programs tend to stabilize the degree of reading failure rather than close the gap between a dyslexic student and his classmates. The evidence is overwhelming. One study that examined children's reading before and after they spent three years in a resource room as part of special education found no changes in word reading scores relative to their peers and a significant decline in their performance on measures of reading comprehension. Findings from another study echoed these results; fourth and fifth graders receiving special education showed virtually no change in their rate of reading growth compared to their rate of growth when attending regular classes previously. It is not surprising to learn, therefore, that researchers observing the daily activities in resource rooms confirmed that the reading programs the children were receiving lacked essential elements found in effective interventions, such as intensity and small size (groups were from five to nineteen children). Furthermore, there was minimal individualization even though the children varied widely in their reading skills. To make matters worse, since such children are pulled out of their regular classroom instruction, they often miss the language arts teaching taking place in their absence. The result is that the most needy students tend to receive the least reading and language instruction. Studies examining "inclusion classrooms," where children receive special reading help within their own regular classes, show similar findings: Children demonstrate little change in their reading ability relative to their classmates. On the other hand, studies show that children receiving the new scientifically based programs made large and lasting reading gains, far surpassing their previous rate of growth. With the implementation of the Reading First legislation, I am optimistic that far fewer children will require special education and those who do will benefit from the scientifically based programs that I have recommended.

How does my dyslexic child best learn content? What can I tell his teacher to facilitate his learning? A dyslexic student's route to learning is through meaning; meaning provides a framework for remembering. More than for others, he must fully understand a topic; rote memory does not work well for him. Focus on concepts and real-life examples and experiences, and provide many opportunities for practice. In this top-down, big-picture approach, teach ideas first, establish categories for different groups of facts, and point out connections within and between categories. Look for opportunities for hands-on experiences; encourage visualization of concepts and facts mentioned in texts or during class discussions. Keep in mind that though it may take longer to acquire, knowledge gained through meaning is much more enduring than that obtained through rote memorization. Motivation is critical to learning and can be strengthened by adhering to a few simple principles: First, any child, and particularly one who is dyslexic, needs to know that his teacher cares about him. Second, motivation is increased by a child's having a sense of control, such as a choice about assignments-which book he will read or what topic he will report on. Third, he needs some recognition of how hard he is working as well as tangible evidence that all his effort makes a difference; this can come in the form of improvement on a graph of his fluency rates or receiving a grade on the content of his written work rather than its form.

What books or stories can I read to a dyslexic child? While a child is still struggling with reading, it helps to spend even as little as fifteen to twenty minutes each evening reading aloud to him; this can be either a story or a chapter of a book. Hey! Listen to This: Stories to Read Aloud, edited by Jim Trelease, includes a particularly enjoyable collection of stories for children aged five to nine (grades kindergarten to four). Read All About It! by the same author is intended for preteens and teens. Listening to stories will help a child retain his interest in reading and in books, and will expose him to the vocabulary and ideas he would be getting himself if he were reading. Keep in mind that a dyslexic child's ability to understand what he hears is often years ahead of his ability to read.

Are there any simple, more general strategies that a dyslexic child can use to help himself in his reading? The most helpful overall strategy teaches a child what to do when he comes across an unknown or difficult word. As mentioned earlier, he is taught to look at the letters making up the word. In practice the child is encouraged to sound out as much of the word as he can, and then a little later he is taught to find a word that sounds like it and also makes sense in the context of the sentence. A teacher plays an important role in transferring this skill to the disabled reader. She first guides the child to read by blending the sounds or by analogy to a word he already knows, and then checking if its meaning is correct. With time and practice the child becomes increasingly independent in his ability to try out different strategies and to monitor his own reading. Once his support is taken away, it is always wise to make frequent checks to ensure that the child is continuing to apply his newly learned strategies. For a struggling reader who cannot decipher many of the words on a line, the tendency is to lose one's place and end up on another line reading something that makes little sense. A child's simple habit of running his finger across the line of print as he reads keeps him from skipping words or lines. In general, for finger pointing to be effective, a child must be able to at least sound out the initial letter(s) as he reads aloud. When the child is older, he can use a ruler or other straight-edged object.

What is the best approach to summer vacation time? Should a dyslexic child receive reading tutoring, or should he be allowed to have an entirely stress-free period? Dyslexic children are at high risk for losing reading skills that are not continually practiced. They have not yet established permanent neural models of words, and so their word models remain fragile and unstable and may dissipate over a summer of disuse. I recommend that children receive some tutoring over the summer or read aloud regularly with a parent. If a child is severely behind, he should receive substantial tutoring (two hours, two to three mornings a week) in basic skills for much but not all of the summer. Local schools and universities often sponsor summer reading clinics that are worth looking into. Other readers who are more advanced but not yet fluent benefit greatly from practicing reading aloud. Reading aloud from books on a summer reading list and getting a jump-start on tackling the books to be read in the fall term are often extremely helpful. Before the spring term ends, try to obtain a reading list for next year's classes. Summer is a good time to order books on tape or to scan (digitize) books to be read when school resumes in the fall (see Chapter 23). But by all means allow your child to have some fun during the summer. Do not make school a never-ending year-round experience; having fun and spending time doing what he enjoys and is good at is essential, too. Children and teenagers are not the only ones who struggle to read. Adults who are out of school still experience the consequences of dyslexia. And in the next chapter I will discuss the kinds of successful approaches and programs that help adults of all ages who have reading difficulties.

How you as a parent view your child is very important (page 313). If you feel that a diagnosis of dyslexia means that his future is doomed, he will come to feel that way, too. Having a diagnosis of dyslexia should not preclude a child from pursuing his dreams. Given adequate intelligence, skill, persistence, and support, a child who is dyslexic can pursue virtually any area that interests him. Men and women who are dyslexic have distinguished themselves in every area imaginable, including areas that the uninformed might not believe are possible for a person who is dyslexic: writing, law, medicine, science, and poetry. Children who are dyslexic should not be reflexively shunted onto a path of nonacademic ambition unless that is clearly their preference; they should at least be helped to understand that they have a much fuller range of options. Many parents of children who are dyslexic have experienced reading problems themselves. If you have, tell your child about them and about how you felt when you were growing up. Allow him to see that people whom he admires are not perfect and are able to succeed in life.

Finally, don't patronize a child or lessen his expectations. Always treat him as a person with many dimensions, not simply as a person who has a reading problem. Let his strengths and not his weaknesses define him as a person.

Dyslexics think differently (page 366). They are intuitive and excel at problem solving, seeing the big picture, and simplifying. They feast on visualizing, abstract thinking, and thinking out of the box. They are poor rote reciters but inspired visionaries. Adult dyslexics are tough: Having struggled, they are used to adversity; hard work and perseverance now come naturally. Having experienced failure, they are fearless, undaunted by setbacks. Repetition and practice are a way of life. Each person I've focused on was rescued by a special person-a parent or a teacher-who saw the raw talent and nurtured it in the midst of all the naysayers. The feeling of hope was sustained by the taste of success in sports, the arts, or some other activity. Yes, the symptoms of dyslexia persist, but they needn't interfere with success. Success is waiting for your child, and now you know what to do to help him achieve it. You don't have to rely on chance. You know how to identify a problem early and how to get the right help to ensure that it is your child's strengths and not the misperceptions of others that ultimately define him. You know what is possible and how to nourish it: Children blossom with reward and praise, and flourish because of high expectations. Above all you must maintain your belief in your child, provide unconditional support for him, and hold true to a vision of his future. The rewards will be great. Today, each dyslexic child is free to develop his talents and to pursue his dreams-and to know he will succeed. Dyslexia can be overcome.

Excerpted from Overcoming Dyslexia by Sally Shaywitz, M.D. Copyright© 2003 by Sally Shaywitz, M.D.. Excerpted by permission of Knopf, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.