Dyslexia and Related Disorders

Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and pronouncing words. Dyslexia affects individuals throughout their lives; however, its impact can change at different stages in a person’s life. It is referred to as a learning disability because dyslexia can make it very difficult for a student to succeed academically in the typical instructional environment, and in its more severe forms, will qualify a student for special education, special accommodations, or extra support services.

The exact causes of dyslexia are still not completely clear, but anatomical and brain imagery studies show differences in the way the brain of a person with dyslexia develops and functions. Moreover, most people with dyslexia have been found to have problems with identifying the separate speech sounds within a word and/or learning how letters represent those sounds, a key factor in their reading difficulties. Dyslexia is not due to either lack of intelligence or desire to learn; with appropriate teaching methods, students with dyslexia can learn successfully.

About 13–14% of the school population nationwide has a handicapping condition that qualifies them for special education. Current studies indicate that one half of all the students who qualify for special education are classified as having a learning disability (LD) (6–7%). About 85% of those students have a primary learning disability in reading and language processing. Nevertheless, many more people— perhaps as many as 15–20% of the population as a whole—have some of the symptoms of dyslexia, including slow or inaccurate reading, poor spelling, poor writing, or mixing up similar words. Not all of these will qualify for special education, but they are likely to struggle with many aspects of academic learning and are likely to benefit from systematic, explicit, instruction in reading, writing, and language.

Dyslexia occurs in people of all backgrounds and intellectual levels. People with dyslexia can be very bright. They are often capable or even gifted in areas such as art, computer science, design, drama, electronics, math, mechanics, music, physics, sales, and sports.

In addition, dyslexia runs in families; parents with dyslexia are very likely to have children with dyslexia. For some people, their dyslexia is identified early in their lives, but for others, their dyslexia goes unidentified until they get older.

The impact that dyslexia has is different for each person and depends on the severity of the condition and the effectiveness of instruction or remediation. The core difficulty is with word recognition and reading fluency, spelling, and writing. Some individuals with dyslexia manage to learn early reading and spelling tasks, especially with excellent instruction, but later experience their most debilitating problems when more complex language skills are required, such as grammar, understanding textbook material, and writing essays.

People with dyslexia can also have problems with spoken language, even after they have been exposed to good language models in their homes and good language instruction in school. They may find it difficult to express themselves clearly or to fully comprehend what others mean when they speak. Such language problems are often difficult to recognize, but they can lead to major problems in school, in the workplace, and in relating to other people. The effects of dyslexia reach well beyond the classroom.

Dyslexia can also affect a person’s self-image. Students with dyslexia often end up feeling “dumb” and less capable than they actually are. After experiencing a great deal of stress due to academic problems, a student may become discouraged about continuing in school.

Before referring a student for a comprehensive evaluation, a school or district may choose to track a student’s progress with a brief screening test and identify whether the student is progressing at a “benchmark” level that predicts success in reading. If a student is below that benchmark (which is equivalent to about the 40th percentile nationally), the school may immediately deliver intensive and individualized supplemental reading instruction before determining whether the student needs a comprehensive evaluation that would lead to a designation of special education eligibility. Some students simply need more structured and systematic instruction to get back on track; they do not have learning disabilities. For those students and even for those with dyslexia, putting the emphasis on preventive or early intervention makes sense. There is no benefit to the child if special instruction is delayed for months while waiting for an involved testing process to occur. These practices of teaching first, and then determining who needs diagnostic testing based on response to instruction, are encouraged by federal policies known as Response to Intervention (RTI). Parents should know, however, that at any point they have the right to request a comprehensive evaluation under the IDEA law, whether or not the student is receiving instruction under an RTI model.

A comprehensive evaluation typically includes intellectual and academic achievement testing, as well as an assessment of the critical underlying language skills that are closely linked to dyslexia. These include receptive (listening) and expressive language skills, phonological skills including phonemic awareness, and also a student’s ability to rapidly name letters and numbers. A student’s ability to read lists of words in isolation, as well as words in context, should also be assessed. If a profile emerges that is characteristic of readers with dyslexia, an individualized intervention plan should be developed, which should include appropriate accommodations, such as extended time. The testing can be conducted by trained school or outside specialists. (See the Testing and Evaluation Fact Sheet for more information.)

The problems displayed by individuals with dyslexia involve difficulties in acquiring and using written language. It is a myth that individuals with dyslexia “read backwards,” although spelling can look quite jumbled at times because students have trouble remembering letter symbols for sounds and forming memories for words. Other problems experienced by people with dyslexia include the following:

• Learning to speak
• Learning letters and their sounds
• Organizing written and spoken language
• Memorizing number facts
• Reading quickly enough to comprehend
• Persisting with and comprehending longer reading assignments
• Spelling
• Learning a foreign language
• Correctly doing math operations

Not all students who have difficulties with these skills have dyslexia. Formal testing of reading, language, and writing skills is the only way to confirm a diagnosis of suspected dyslexia.

Dyslexia is a lifelong condition. With proper help, many people with dyslexia can learn to read and write well. Early identification and treatment is the key to helping individuals with dyslexia achieve in school and in life. Most people with dyslexia need help from a teacher, tutor, or therapist specially trained in using a multisensory, structured language approach. It is important for these individuals to be taught by a systematic and explicit method that involves several senses (hearing, seeing, touching) at the same time. Many individuals with dyslexia need one-on-one help so that they can move forward at their own pace. In addition, students with dyslexia often need a great deal of structured practice and immediate, corrective feedback to develop automatic word recognition skills. For students with dyslexia, it is helpful if their outside academic therapists work closely with classroom teachers.

Schools can implement academic accommodations and modifications to help students with dyslexia succeed. For example, a student with dyslexia can be given extra time to complete tasks, help with taking notes, and work assignments that are modified appropriately. Teachers can give taped tests or allow students with dyslexia to use alternative means of assessment.

Students can benefit from listening to books on tape and using text reading and word processing computer programs. Students may also need help with emotional issues that sometimes arise as a consequence of difficulties in school. Mental health specialists can help students cope with their struggles.

The Individuals with Disabilities Education Act 2004 (IDEA), Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act (ADA) define the rights of students with dyslexia and other specific learning disabilities. These individuals are legally entitled to special services to help them overcome and accommodate their learning problems. Such services include education programs designed to meet the needs of these students. The Acts also protect people with dyslexia against unfair and illegal discrimination.

*The previous information was taken from the TEA Dyslexia Handbook.

Suggested Readings

Moats, L. C.,  & Dakin, K. E. (2008). Basic facts about dyslexia and other reading problems. Baltimore: The International Dyslexia Association.

Shaywitz, S. (2003). Overcoming dyslexia: A new and complete science-based program for reading problems at any level. New York: Knopf.

The International Dyslexia Association (IDA) thanks Louisa C. Moats, Ed.D., and Karen E. Dakin, M.Ed., for their assistance in the preparation of this fact sheet.

© Copyright 2017. The International Dyslexia Association (IDA).

Dysgraphia is a Greek word. The base word graph refers both to the hand’s function in writing and to the letters formed by the hand. The prefix dys indicates that there is impairment. Graph refers to producing letterforms by hand. The suffix ia refers to having a condition. Thus, dysgraphia is the condition of impaired letter writing by hand, that is, disabled handwriting. Impaired handwriting can interfere with learning to spell words in writing and speed of writing text. Children with dysgraphia may have only impaired handwriting, only impaired spelling (without reading problems), or both impaired handwriting and impaired spelling.

Research to date has shown orthographic coding in working memory is related to handwriting and is often impaired in dysgraphia. Orthographic coding refers to the ability to store written words in working memory while the letters in the word are analyzed or the ability to create permanent memory of written words linked to their pronunciation and meaning. Children with dysgraphia do not have primary developmental motor disorder, another cause of poor handwriting, but may have difficulty planning sequential finger movements such as the touching of the thumb to successive fingers on the same hand without visual feedback. Children with dysgraphia may have difficulty with both orthographic coding and planning sequential finger movements.

Children with impaired handwriting may also have attention-deficit disorder (ADHD)–inattentive, hyperactive, or combined inattentive and hyperactive subtypes. Children with this kind of dysgraphia may respond to a combination of explicit handwriting instruction plus stimulant medication, but appropriate diagnosis of ADHD by a qualified professional and monitoring of response to both instruction and medication are needed.

Dysgraphia may occur alone or with dyslexia (impaired reading disability) or with oral and written language learning disability (OWL LD, also referred to as selective language impairment, SLI).

Dyslexia is a disorder that includes poor word reading, word decoding, oral reading fluency, and spelling. Children with dyslexia may have impaired orthographic and phonological coding, rapid automatic naming and focused, switching, and/or sustained attention.

OWL LD (SLI) is impaired language (morphology–word parts that mark meaning and grammar; syntax–structures for ordering words and understanding word functions; finding words in memory, and/or making inferences that go beyond what is stated in text). These disorders affect spoken as well as written language. Children with these language disorders may also exhibit the same writing and reading and related disorders as children with dysgraphia or dyslexia.

Without diagnosis, children may not receive early intervention or specialized instruction in all the relevant skills that are interfering with their learning of written language. Considering that many schools do not have systematic instructional programs in handwriting and spelling, it is important to assess whether children need explicit, systematic instruction in handwriting and spelling in addition to word reading and decoding. Many schools offer accommodations in testing and teaching to students with dysgraphia, but these students also need ongoing, explicit instruction in handwriting, spelling, and composition. It is also important to determine if a child with dysgraphia may also have dyslexia and require special help with reading or OWL LD (SLI) and need special help with oral as well as written language.

Initially, children with impaired handwriting benefit from activities that support learning to form letters:

• playing with clay to strengthen hand muscles;
• keeping lines within mazes to develop motor control;
• connecting dots or dashes to create complete letter forms;
• tracing letters with index finger or eraser end of pencil;
• imitating the teacher modeling sequential strokes in letter formation; and
• copying letters from models.

Subsequently, once children learn to form legible letters, they benefit from instruction that helps them develop automatic letter writing, using the following steps to practice each of the 26 letters of the alphabet in a different order daily:

• studying numbered arrow cues that provide a consistent plan for letter formation
• covering the letter with a 3 x 5 card and imaging the letter in the mind’s eye
• writing the letter from memory after interval that increases in duration over the handwriting lessons
• writing letters from dictation (spoken name to letter form).

In addition, to developing handwriting speed, they benefit from writing letters during composing daily for 5 to 10 minutes on a teacher-provided topic.

Students benefit from explicit instruction in spelling throughout K-12:

• initially in high frequency Anglo-Saxon words;
• subsequently in coordinating the phonological, orthographic, and morphological processes relevant for the spelling of longer, more complex, less frequent words; and
• at all grade levels in the most common and important words used for the different academic domains of the curriculum.

Throughout K -12, students benefit from strategies for composing:

• planning, generating, reviewing/evaluating, and revising
• compositions of different genre including narrative, informational, compare and contrast, and persuasive
• self-regulation strategies for managing the complex executive functions involved in composing.

Some children do make reversals (reversing direction letter faces along a vertical axis), inversions (flipping letters along a horizontal axis so that the letter is upside down), or transpositions (sequence of letters in a word is out of order). These errors are symptoms rather than causes of handwriting problems. The automatic letter writing instruction described earlier has been shown to reduce reversals, which are less likely to occur when retrieval of letters from memory and production of letters have become automatic.

If children have both handwriting and spelling problems, the kinds of handwriting instruction described earlier should be included along with the spelling instruction.

In general, no. Although federal law specifies written expression as one of the areas in which students with learning disabilities may be affected, it does not clearly identify the transcription problems that are the causal factors in dysgraphia–impaired handwriting and/or spelling–for impaired written expression of ideas. Some of the tests used to assess written expression are not scored for handwriting or spelling problems and mask the nature of the disability in dysgraphia. Content or ideas may not be impaired. All too often, the poor writing or failure to complete writing assignments in a timely fashion or at all is misattributed to lack of motivation, laziness, or other issues unrelated to the real culprit–dysgraphia. Children who are twice exceptional–gifted and dysgraphic–are especially under-diagnosed and underserved. Teachers mistakenly assume that if a student is bright and cannot write it is because the student is not trying.

Yes. See Barnett, Henderson, Scheib, and Schulz (2007), Berninger (2007a), Milone (2007), and Slingerland assessment below for assessing handwriting problems associated with dysgraphia. Also, see Berninger (2007b) and Berninger, O’Donnell, and Holdnack (2008) for using these tests and other evidence-based assessment procedures in early identification, prevention, and diagnosis for linking assessment results to evidence-based handwriting and spelling instruction (also see Troia, 2008).

In summary, dysgraphia is a specific learning disability that can be diagnosed and treated. Children with dysgraphia usually have other problems such as difficulty with written expression. It is important that a thorough assessment of handwriting and related skill areas be carried out in order to plan specialized instruction in all deficient skills that may be interfering with a student’s learning of written language. For example, a student may need instruction in both handwriting and oral language skills to improve written expression. Although early intervention is, of course, desirable, it is never too late during the school-age years to intervene to improve a student’s deficient skills and provide appropriate accommodations.

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