Book Excerpt: 'Overcoming Dyslexia'

Nov. 12, 2003 -- 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 andphonics taught systematically and explicitly?

How are children taught to approach an unfamiliar word? Theyshould feel empowered to try to analyze and sound out an unknownword first rather than guess from the pictures or context. Illustrationsand context can be used as a second step to verify if the pronunciationseems to make sense.

Does the program also include many opportunities to practicereading, to develop fluency, to build vocabulary, to develop readingcomprehension strategies, to write, and to listen to and talk aboutstories?

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 groupsare important.Some components of reading such as vocabulary may betaught as a class activity. However, given the variability in reading skillswithin a class, other components such as basic phonologic skills and oralreading are best addressed in smaller groups. A portion of each day'sreading instruction, therefore, should be carried out in small groups. Aclass of twenty is divided into three groups of six to seven students sothat each child receives individualized attention at least once a weekas he tries to sound out words or read aloud. This grouping shouldbe flexible for each component of reading, so that a child can move inand out of a group depending on his progress and level of skillin that particular area. Children who are progressing more slowlywill benefit from smaller groups and more intensive attention tothat skill.

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

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

At Home:

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

Focus on reinforcement. School is where new learning should takeplace; home is ideal for practice and reinforcement. School helps himbuild the necessary neural models for reading; home practice strengthensand solidifies the model. Try to coordinate any home reading activitywith what your child is learning in school. The goal is to reinforce andstrengthen what he is learning. Children do best when they can focus onone procedure or approach at a time. Work in harmony with your child'steacher.

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

Sounding out smaller words. Like most other behaviors, how we readreflects the habits we develop through instruction and practice. You canplay an important role in ensuring that your child develops good readinghabits by encouraging certain behaviors. One of the most important is tolearn to sound out words and to do so early. Whenever your child comesacross a word he is unsure of, encourage him to try to sound it out. Youcan begin by asking him about the first sound. For example, if the wordis 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 andsay mat. Ask him if this sounds right to him. Does it make sense in thestory? Here he is practicing good reading habits by, first, decoding anunknown word, and then verifying that his pronunciation is accurate. Byteaching him to ask himself these questions automatically, you are alsofostering his independence as a reader and building his confidence.Speak to your child's teacher and ask what sounds and strategiesyour child is working on and what you can do to help him practice. If sheisn't able to provide any suggestions, you can ask her about some of theactivities listed below. These simple and useful strategies are relativelyeasy for you to practice with him and will help him pull apart literallyhundreds of words that he might otherwise give up on. They are alsohelpful when you are reading with your child. If he stumbles on a wordthat is dependent on one of these strategies for its pronunciation, afteryou finish a page or story you can use the troublesome word as an opportunityto 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 differencebetween words like mate and mat.

Words containing the letter c and to determine when a c is saidsoftly, as in cereal and cinder, or makes a hard sound, as in camel andclock; 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, theycan have a similar effect on reading comprehension. A recent study carriedout with seven- and eight-year-olds determined that home readinghabits were strong predictors of a child's later performance in reading.Skilled readers were read to more often by their parents and were morelikely to read with their parents and talk about books and stories withthem.

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

I like to divide reading comprehension activities into three parts:those you can do before opening the book, those that are most helpful asthe child reads, and those that help him organize his thoughts and sumup the events of the story after he finishes reading. These activities arefun but intensive. By no means should you feel obligated to go througheach one of these for each book you and your child read together. I amoffering a range of possibilities. You must decide which of these best suityou and your child. There is no one right way or one set formula to teachcomprehension skills to your child. The idea is to transfer a way of thinkingabout reading to your child. Once he has assimilated this way ofactively 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 readingwith him is that it gives you insight into his ability to comprehend whathe is reading. Below are some of the signs of a child who is having troublecomprehending what he is reading:

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

He has trouble answering the question "What was the bookabout?"

He doesn't enjoy reading.

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

He doesn't finish what he begins to read.

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

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

He can't quite come up with main ideas or summarize what hehas 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 readingprogram?

Two complementary approaches, when combined, provide up-to-datemonitoring of a child's rate of progress and his level of achievement inreading. One is called curriculum-based measurement (CBM) and relieson ongoing measurements of reading fluency (ideally, weekly; minimally,three times during a school year) using the child's classroom readingmaterials. This is meant to establish how fast he is acquiring newknowledge. The other method, which is not intended for very frequentadministration, uses standardized reading tests and assesses readingperformance periodically vis-à-vis his age-mates.

The curriculum-based approach, advanced by researchers Lynn andDouglas Fuchs at Vanderbilt University, measures how well a child haslearned what he has been taught. His progress in meeting the demandsof the reading program developed for him is graphed over time, so hisgrowth or lack of growth is clearly visible. Progress in different areas ofreading-including phonics, decoding nonsense words, reading realwords, and reading passages aloud-can be measured. Earlier I discussedexpected levels of fluency at different grades. CBM can be usedto track fluency rates as an objective measure to identify if a child isresponding to a particular instructional approach and, if necessary, tomodify it. The rate of his reading growth is compared to norms that havebeen established for the amount of weekly growth expected at eachgrade level, beginning at grade one and extending through grade six. Noone has to wait for the end of the school year to learn about a child'sreading progress.A child's rate of reading growth follows a distinct pattern: (1) growthis greatest in the early school years and lessens with each succeedinggrade; (2) growth is most often at its maximum at the beginning of eachschool year and tapers off toward spring.Using oral passage reading as an example, I have listed below theexpected reading growth rates-how much (the number of words readcorrectly per minute) a child should be expected to improve each week.The important figure here is the amount of change-how many morewords per minute a child can read correctly compared to the previousweek. For each grade level, a lower number (referred to as "realistic") and a higher one (called "ambitious") are provided. The realistic numberrepresents the amount of improvement observed for a typical child. Thechild who is experiencing reading difficulties, having fallen behind, has alot 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 makea learning leap and catch up to his classmates.

Rate of Expected Weekly Reading Growth(Increase in Correct Words Read per Minute)Grade Realistic Ambitious1) 2.00 3.002) 1.50 2.003) 1.00 1.504) 0.85 1.105) 0.50 0.806) 0.30 0.65

CBM is administered in the classroom. A child reads aloud a passageat her grade level, and each week she is assessed using a passage ofequivalent difficulty. Her oral reading is timed for one minute; as shereads, her teacher follows along with a copy of the passage, using thescoring method described on page 277. The fluency score-the totalnumber of words read per minute minus the number of errors-is calculatedand charted. For example, a second grader's fluency (ambitious)rate should increase by two words each week; a fifth grader's growthshould come close to one word per week. For this approach to work, achild must be reading at least at a mid-first grade level. It is importantnot to base any judgment on one or two weeks but, rather, to observe thechild's progress over five, six, or more weeks. If she is on track, the programshould 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'sfluency in the early foundational reading skills. Accordingly, it is targetedfor children from preschool through grade three. The goal is to identifythose children who are not progressing and who may benefit from earlyintervention. DIBELS (or comparable surveillance) can benefit allbeginning readers, especially those who are at risk for a reading disabilityor who are showing early signs of struggle.

Teaching the Dyslexic Child to Read

The second approach to monitoring progress focuses on a child'sabsolute level of performance, at a fixed point in time, compared to hisage or grade peers as measured by a standardized reading test such asthe Woodcock Reading Mastery Test. These results are reported in percentilescores (for example, a nine-year-old boy who is reading at the40th percentile is superior to 40 percent of all nine-year-old boys). Theyalso may be reported as standard scores, which are adjusted so that 50percent of the children score either below or above an average score of100. This kind of standardized test is most often given at the end of theschool year. The results establish at what level a child is reading and howhe compares to other children of his own age, but they do not helpdetermine how fast he is mastering specific reading skills. Keep in mindthat both reading accuracy and reading fluency, as well as comprehension,must be assessed by these standardized measures. Otherwise, studentswho are accurate but read slowly and with great effort will beoverlooked 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 littleprogress loudly proclaims the need for a change, just as a steepupward incline proudly trumpets rapid progress. Happily, new readingprograms, like those I have recommended and those adhering to ReadingFirst requirements, routinely build in ongoing monitoring.

Do the benefits of scientifically based programs last? Do the childrenbecome independent skilled readers?Fluency is the critical marker for permanency. A fluent reader hasformed permanent and perfect models of words in his automatic wordform system for reading. The children most likely to develop fluency followingan intervention are the boys and girls who receive proven earlyintervention and, optimally, prevention services in kindergarten or firstgrade. For children who are already experiencing reading problems,improvements are most likely to be maintained following the evidencebasedprograms I have recommended that are taught by a knowledgeableteacher, attended for a sufficient period of time, and providedwith greater intensity (in an individual or small group setting). Moreintense interventions mean more exposure to print and more opportunitiesto practice reading words, the critical prerequisites to developingfluency.

When should a reading program be discontinued?In general, when a child is just gaining momentum in reading is the timefor an all-out push and never the time for an abrupt halt.Simply teaching a child how to sound out words without providinghim with practice in applying this skill to reading will likely result in achild who can sound out some words but has difficulty reading the manynew words he comes across as he progresses in his studies. He will notbe a fluent reader, and reading will remain effortful. Left alone, he willavoid reading. So this is the time to maintain the same level of intensityand quality of instruction while targeting fluency as well.To repeat: A child should not be removed from an effective readingprogram until he is able to read words and passages fluently at his gradelevel. Fortunately, standardized tests such as the Test of Word ReadingEfficiency (TOWRE) now make it possible to assess a child's efficiencyin reading individual words, while other tests such as the Gray OralReading Tests-4 (GORT-4) measure his ability to read passages fluentlyaloud (see Chapter 13). The GORT-4 provides a standardized assessmentof a child's oral reading accuracy, rate, and comprehension. A childmay read isolated words efficiently but still struggle to read words whenthey are connected together in a passage-a much more demandingtask. Request the results of your child's performance on both of thesetests and discuss them with appropriate teachers before making anydecision to remove him from a special reading program.

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

Yes, and in general, public school programs for children with readingdisability are failures. As it was for Sam, the designation special educationper se is insufficient. Parents of a reading-disabled child must carefullyexamine the specifics of their child's reading intervention.Special-education programs tend to stabilize the degree of readingfailure rather than close the gap between a dyslexic student and his classmates.The evidence is overwhelming. One study that examined children'sreading before and after they spent three years in a resource roomas part of special education found no changes in word reading scores relativeto their peers and a significant decline in their performance onmeasures of reading comprehension. Findings from another studyechoed these results; fourth and fifth graders receiving special educationshowed virtually no change in their rate of reading growth compared totheir rate of growth when attending regular classes previously. It is notsurprising to learn, therefore, that researchers observing the daily activitiesin resource rooms confirmed that the reading programs the childrenwere receiving lacked essential elements found in effective interventions,such as intensity and small size (groups were from five to nineteenchildren). Furthermore, there was minimal individualization eventhough the children varied widely in their reading skills. To make mattersworse, since such children are pulled out of their regular classroominstruction, they often miss the language arts teaching taking place intheir absence. The result is that the most needy students tend to receivethe least reading and language instruction.Studies examining "inclusion classrooms," where children receivespecial reading help within their own regular classes, show similar findings:Children demonstrate little change in their reading ability relativeto their classmates. On the other hand, studies show that childrenreceiving the new scientifically based programs made large and lastingreading gains, far surpassing their previous rate of growth. With theimplementation of the Reading First legislation, I am optimistic that farfewer children will require special education and those who do will benefitfrom the scientifically based programs that I have recommended.

How does my dyslexic child best learn content? What can I tell histeacher to facilitate his learning?A dyslexic student's route to learning is through meaning; meaning providesa framework for remembering. More than for others, he must fullyunderstand a topic; rote memory does not work well for him. Focus onconcepts and real-life examples and experiences, and provide manyopportunities for practice. In this top-down, big-picture approach, teachideas first, establish categories for different groups of facts, and point outconnections within and between categories. Look for opportunities forhands-on experiences; encourage visualization of concepts and factsmentioned in texts or during class discussions. Keep in mind that thoughit may take longer to acquire, knowledge gained through meaning ismuch more enduring than that obtained through rote memorization.Motivation is critical to learning and can be strengthened by adheringto a few simple principles: First, any child, and particularly one whois 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 achoice about assignments-which book he will read or what topic he willreport on. Third, he needs some recognition of how hard he is workingas well as tangible evidence that all his effort makes a difference; this cancome in the form of improvement on a graph of his fluency rates orreceiving 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 littleas fifteen to twenty minutes each evening reading aloud to him; thiscan be either a story or a chapter of a book. Hey! Listen to This: Storiesto Read Aloud, edited by Jim Trelease, includes a particularly enjoyablecollection of stories for children aged five to nine (grades kindergarten tofour). Read All About It! by the same author is intended for preteens andteens. Listening to stories will help a child retain his interest in readingand in books, and will expose him to the vocabulary and ideas he wouldbe getting himself if he were reading. Keep in mind that a dyslexic child'sability to understand what he hears is often years ahead of his ability toread.

Are there any simple, more general strategies that a dyslexic child canuse to help himself in his reading?The most helpful overall strategy teaches a child what to do when hecomes across an unknown or difficult word. As mentioned earlier, he istaught to look at the letters making up the word. In practice the child isencouraged to sound out as much of the word as he can, and then a littlelater he is taught to find a word that sounds like it and also makes sensein the context of the sentence. A teacher plays an important role in transferringthis skill to the disabled reader. She first guides the child to readby blending the sounds or by analogy to a word he already knows, andthen checking if its meaning is correct. With time and practice the childbecomes increasingly independent in his ability to try out differentstrategies and to monitor his own reading. Once his support is takenaway, it is always wise to make frequent checks to ensure that the child iscontinuing to apply his newly learned strategies.For a struggling reader who cannot decipher many of the words on aline, the tendency is to lose one's place and end up on another line readingsomething that makes little sense. A child's simple habit of runninghis finger across the line of print as he reads keeps him from skippingwords or lines. In general, for finger pointing to be effective, a childmust 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-edgedobject.

What is the best approach to summer vacation time? Should adyslexic child receive reading tutoring, or should he be allowed tohave an entirely stress-free period?Dyslexic children are at high risk for losing reading skills that are notcontinually practiced. They have not yet established permanent neuralmodels of words, and so their word models remain fragile and unstableand may dissipate over a summer of disuse. I recommend that childrenreceive some tutoring over the summer or read aloud regularly with aparent. If a child is severely behind, he should receive substantial tutoring(two hours, two to three mornings a week) in basic skills for muchbut not all of the summer. Local schools and universities often sponsorsummer reading clinics that are worth looking into. Other readers whoare more advanced but not yet fluent benefit greatly from practicingreading aloud. Reading aloud from books on a summer reading list andgetting a jump-start on tackling the books to be read in the fall term areoften extremely helpful. Before the spring term ends, try to obtain areading list for next year's classes. Summer is a good time to order bookson tape or to scan (digitize) books to be read when school resumes in thefall (see Chapter 23). But by all means allow your child to have some funduring the summer. Do not make school a never-ending year-roundexperience; having fun and spending time doing what he enjoys and isgood 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 ofdyslexia. And in the next chapter I will discuss the kinds of successfulapproaches and programs that help adults of all ages who have readingdifficulties.

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

Finally, don't patronize a child or lessen his expectations. Alwaystreat him as a person with many dimensions, not simply as a person whohas a reading problem. Let his strengths and not his weaknesses definehim as a person.

Dyslexics think differently (page 366). They are intuitive and excel at problemsolving, seeing the big picture, and simplifying. They feast on visualizing,abstract thinking, and thinking out of the box. They are poor rotereciters but inspired visionaries. Adult dyslexics are tough: Having struggled,they are used to adversity; hard work and perseverance now comenaturally. Having experienced failure, they are fearless, undaunted bysetbacks. Repetition and practice are a way of life. Each person I'vefocused on was rescued by a special person-a parent or a teacher-whosaw the raw talent and nurtured it in the midst of all the naysayers. Thefeeling of hope was sustained by the taste of success in sports, the arts,or some other activity. Yes, the symptoms of dyslexia persist, but theyneedn't interfere with success.Success is waiting for your child, and now you know what to do tohelp him achieve it. You don't have to rely on chance. You know how toidentify a problem early and how to get the right help to ensure that it isyour child's strengths and not the misperceptions of others that ultimatelydefine him. You know what is possible and how to nourish it:Children blossom with reward and praise, and flourish because of highexpectations. Above all you must maintain your belief in your child, provideunconditional support for him, and hold true to a vision of hisfuture. The rewards will be great.Today, each dyslexic child is free to develop his talents and to pursuehis 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.