Dyslexia – The Hidden Handicap

Of late, a considerable amount of people have acquired awareness on Dyslexia, thanks to the movie Taare Zameen Par. As depicted in the movie, Dyslexia indeed creates complicated situations for child as well as the parents of the dyslexic child. It is a disability that was particularly difficult to identify until now and is many a times confused with intellectual disability.

Dyslexia occurs at all levels of intelligence and is not a result of low intelligence as seen even in the great personalities like Leonardo da Vinci, Thomas Alva Edison, Alexander Graham Bell, Winston Churchill, Keanu Reeves, Albert Einstein and Tom Cruise, all dyslexics. It is not a rare disability. As a matter of fact, about 10 to 15 percent of children are dyslexics.

This particular learning disability has an individual identity from disabilities of the other causes and is often considered as a gift by experts. To simplify things and delve deeper into the learning disability, we spoke to Purnima Mirchandani, B. A. in Psychology from Bombay University, B. Ed. in Special Education from S.N.D.T. University, Mumbai and M.A. in Clinical Psychology (1985) from Pune University.

Purnima Mirchandani is a Clinical Psychologist and Remedial Teacher for Dyslexia and has been working with the developmentally handicapped children since 1981 and with dyslexic children since 1986. Currently, she has a private practice testing and teaching children with learning disabilities as well as other handicaps, is working as an Honorary Consultant representing Lifetrust at the LD Centre at Nair Hospital and is the President of Maadhyam Foundation since 2007.

In an interview with her, she demystifies Dyslexia as what she calls as “the hidden handicap”, as it is. So here we have the answers to all your queries like “What is dyslexia?”, “Are dyslexics dumb?”, “Is it curable?” and all such questions.

Health Jockey (HJ): Please Define Dyslexia.

Purnima Mirchandani (PM): (Dyslexia is) basically a difficulty with written word – ‘Lex’ means word and ‘Dys’ means difficulty – difficulty with the written word – difficulty in reading, difficulty in understanding what he or she is reading and difficulty in putting down thoughts on paper. If I define it clearly – Dyslexia manifests itself as difficulties in the expressive or receptive, oral or written language and problems may emerge in reading, spelling and writing, speaking, listening or reading comprehension.

There are other difficulties also, not just Dyslexia – Dyslexia is an umbrella term that we tend to use for all the learning disabilities. Dysgraphia is another one – which is difficulty in spelling, poor handwriting and difficulty putting thoughts on paper. Because it is a processing disorder, throughout life you might have difficulties in different ways in this.

Then ofcourse there is Dyscalculia because numbers also can be an area of difficulty. Children who may have difficulties not just in numbers – they might see numbers reverse, they might not understand sequencing skills, may not understand how many things make a dozen, or how many minutes are there to an hour; and calculations of those things prove difficult to them. They may have difficulty in borrowing in a subtraction sum (mathematical exercises). Instead of borrowing they may subtract the upper number from lower number.

So Dyslexia, Dysgraphia and Dyscalculia are the three more common terms we use. Of course Dyslexia is like an umbrella term that we use to describe all these disabilities.

HJ: In what age-group does it occur?

PM: “Well, I would say it’s always present, but it can be diagnosed at the age of 7 to 8 yrs as that is when formal academic work is started. Before that you can do pre-dyslexia screening which tells you the deficit areas that can be worked on, but for diagnosis it is 7 to 8 years when you can tell in surety that there is a disability which needs to be worked on.”

HJ: Which part of the brain/sensory organs does it affect?

PM: It is the brain. In fact, a dyslexic child is one who does not have any sensory deficit – i.e. no deficit in vision or auditory. There is no one theory as to why this is caused. It has been found in many cases to be hereditary – thus it is genetic. Earlier days it was found more in boys than in girls; now, there are many girls also who have been detected to have dyslexia. It could be because of some kind of trauma during birth, or any kind of an injury to the foetus during pregnancy. It could be also because of some problems during delivery like fetal distress, anoxia (where the umbilical cord winds around the throat and the baby becomes blue in the face) etc. There is no one theory. Often it is seen that children who attain the milestone of speech later than his/her peers are dyslexic – not so much late in walking but are late in speaking.

HJ: Are there any various types and sub-types of Dyslexia?

PM: We normally categorise it as Learning Disability (LD) but generally a Dyslexic child would also have Dysgraphia and most of them have Dyscalculia. Earlier fewer kids with Dyscalculia were being found, but now there are more cases of dyscalculia. So dyscalculia also is very much part of the whole syndrome.

But talking about sub-types, I would say there are some visual learners, and some who are auditory learners. Like the types here:

Visual dyslexia – this is not a difficulty with vision, but difficulty with visual perception. They exhibit reversals in reading and writing, difficulty with sequencing skills, problems in interpreting and recalling visual images. For example, they might see b for d, p for q, 6 for 9.

Auditory dyslexia – this is not a difficulty in hearing but difficulty in interpreting what he/she has heard. So children who are dyslexics have no auditory or visual disability; but they have difficulty in processing of one or both of the i.e. visual perception and auditory perception.

HJ: What are the symptoms of Dyslexia?

PM: It is not a disease to have symptoms. There are certain pointers which we get (that help identify dyslexia) – which is in reading and writing comprehension, following the text with fingers, losing place while reading, reading in a monotonous voice; of course like I said ‘b’ and ‘d’ is a very clear cut immediate way of finding out.

Again you must remember ‘b’ and ‘d’ is a very clear cut and immediate way to find out only after the age of 8. Because very often non-dyslexic children have this ‘b’ and ‘d’ error at a younger age, but once their brain matures, they do not make these errors. A dyslexic child often makes these errors unless they are corrected through remedial measures. You shouldn’t misinterpret a ‘b’ and ‘d’ error in isolation and think that the child is dyslexic if he/she is making that error, because many many kids go through this reversal. If only it persists beyond the age of 8 then it should be a cause of concern.

Then again there are pointers like reading monotonously, not able to blend the words together – may read the words in bits n pieces instead of as one word together. Or substituting words like ‘bed’ for ‘bad’, missing out letters in the middle of a word, for example instead of ‘remember’ they say ‘rember’; or instead of ‘traveller’ they say ‘traver’ or missing out the ‘e’ at the end of the word or omitting in the end like the ‘s’ or ‘ed’ or ‘ing’.

They may have difficulty in orthography – i.e. being able to even phonetically say this letter stands for this sound. Letter identification in severe cases is also an area of concern. Then spelling words by how they hear it and not actually how it should be spelt. For example: ‘busy’ – instead of writing ‘b u s y’ they write ‘bizzy’; ‘sight’ as site, bizarre spellings sometimes, inversions – e.g. ‘was’ written as ‘saw’ and ‘how’ as ‘who’, not using punctuation marks or capitalization, running words one into the other and not being able to organizing thoughts on paper. Then directional confusion in ‘left and right’- they may know their own left and right but they can’t tell you which is your left and which is your right hand. Also there is difficulty in sequencing, even sequencing thoughts in their mind may not be clear. Some may excel in drawing and some may have difficulty with drawing. So again it’s not just one thing; each child is unique!

HJ: How are the learning capabilities of a dyslexic child different from that of normal child?

PM: They take longer to learn, but if given the right remedial help at an early age it will be much easier for them to learn; but they will always face difficulty – it will never disappear.

HJ: Is Dyslexia curable?

PM: No. It is not a disease so it cannot be cured. It is a difficulty which can be helped to overcome with remedial education. It will never disappear because the same spelling error will come time and again but the child will learn to correct it along the way. Certain things can be totally corrected and certain things will keep recurring again and again, especially under stress but the child will learn ways to overcome it with different ways.

HJ: What are the various treatments for it?

PM: No treatments because, again as I said, it is not a disease. It is a learning disability so the treatment is remedial education.

To know the kind of remedial education, assessment is very important because once you know the area the child is having difficulty in you can give the remedial help accordingly. Looking at the strengths and weakness of the child and trying different techniques for teaching would help formulate the remedial program for each child differently. The focus should be on using ‘Multi-Sensory Techniques’ which is using more than one sense – the visual, the auditory, the kinesthetic and the tactile, all four senses. Build up on all these skills. If the child is a visual learner, use those visual skills to make him learn. If he is auditory leaner, use those skills, so use those strengths and work on those.

Use flash cards, contouring, paired reading, mind-mapping, highlighting, using mnemonics, para-phrasing, making flip cards – all these are different methods that are used to teach.

Dyslexia – The Hidden Handicap will continue with Part II.