The Phenomena Associated With Dyslexia - Literature review Example

Running Head: Understanding Dyslexia Development of Learning Patterns, Learning Disabilities, Dyslexia and Methods to Rectify: Literature Review [Writer’s Name] [Institute’s Name] Development of Learning Patterns, Learning Disabilities, Dyslexia and Methods to Rectify: Literature Review TABLE OF CONTENTS Abstract………………………………………………………………………………………3 Introduction…………………………………………………………………………………..4 What is dyslexia……………………………………………………………............................6 Genetic preponderance to dyslexia and its co-occurrence…………………............................8 Compensatory mechanisms used by dyslexic patients………………………………………..8 Anatomical variations found in brains of dyslexic patients…………………………………...9 Visual disturbances found in dyslexic patients………………………………………………10 Auditory differences in dyslexic patients…………………………………………………….11 Reading difficulties found in dyslexic patients………………………………………………12 The influence of music on the development of the brain…………………………………….13 Methods to identify children with learning difficulties………………………………………14 Response to intervention or RTI model……………………………………………………...15 Instructional treatments for children…………………………………………………………15 Does nutritional supplementation have a role in preventing learning disorders……………..16 Educational strategies in managing children with dyslexia………………………………….16 Conclusion…………………………………………………………………………………....17 References……………………………………………………………………………………18 ABSTRACT: Dyslexia remains one of the most common learning disabilities, which can cause problems in reading and writing. The children affected with this condition show difficulty in learning and give poor results academically. Most of the time these results are inconsistent with the mental caliber of the child, and this may cause frustration to the child as well. Many techniques have been introduced during the recent years regarding treating these conditions, but most of them revolve around intensive reading and guidance. Most of these therapies are successful enough and help students perform better. More research however, is required about how dyslexia develops and what is the pathophysiology associated with it. DEVELOPMENT OF LEARNING PATTERNS, LEARNING DISABILITIES, DYSLEXIA AND METHODS TO RECTIFY: LITERATURE REVIEW. As the mental faculties of an infant develop with age, there are a series of patterns and methods through which he learns to process the information he is presented with. All of his senses are important in creating the accurate picture of his surroundings and in creating adequate responses accordingly. Cognitive and affective developments ensue, with visual and auditory recognition patterns. It is the same time that the brain of the child is developing itself to effectively modify itself with the information it is being presented with. In the normal child, these milestones of mental as well as physical development are carried out at specific ages and time frames, signaling correct processing in the brain development. However, in children with learning difficulties, there may be many problems in the developmental pattern and in achieving the milestones. A child’s brain may not be accurately receiving the various sensory stimuli, or the brain may be inadequate to correctly interpret the information presented to it. In both the cases, the net result with different variations is a deviance from the normal learning patterns observable in a child. The most helpful tool in identifying these problems is the delayed milestones, or a slow speed of child in speaking, learning, or physically developing. The child may not be able to interpret the information presented to him as accurately as a normal child. The school and home are therefore the most likely places where any of such changes can be observed. A child may be a slow learner, or may not be able to give proper concentration to the subject matter. He or she may display reading, phonation and spelling difficulties, and may show a poor academic record. Such children may in turn be marginalized due to their weaknesses, and complex psychological issues may develop. These changes can leave a very strong mark, and reversing the effects of these events may not be completely successful. Therefore the correct and timely identification of these problems is the only way that children with learning disabilities can be treated successfully. The complications with learning difficulties are not only medical, but affect the person psychologically as well, and may affect his or her social communication with the peers and family. There are long term educational, social and economic implications, and the entire family is affected and involved in the rehabilitation of these children. (AAP, 1998) The treatment of such conditions are very varied and therefore, subjected to the need of the child according to his problem. Two current methods are however widely being used by practitioners world wide. First is to provide early comprehensive educational, psychological and medical assessment. Second is to provide educational remediation with the appropriate psychological and medical treatment. The concept of provision of eye remedies of various kinds such as eye exercises is not recommended. What is recommended however is that the pediatrician must be able to clearly distinguish between actual eye problems and other learning disabilities. (AAP, 1998) It is important to understand that a good development of the mind and body requires stimulation and activation of both the body as well as the brain. Playing is among the most important parts of the development of children. (Burdette and Whitaker, 2005)There are many researches that claim that children who carry out physical activity are better able to concentrate and focus on various activities, and consequently are able to perform better in school. Playing is essential in the development of sensory-motor integration, and helps in improving memory. Playing helps in carrying out many mental activities as well, such as decision making, curiosity, discovery, recognition of safety and danger factors etc. Problem solving is another area which develops as children play. Such children are less likely to feel anxiety, depression, and aggression and sleep problems. Therefore physical activity and interaction is as important in the well being of a child as is mental development. And these two factors contribute towards each other in achieving good social well being. (Burdette and Whitaker, 2005) Children with mental and physical impairments such as children with Down’s syndrome are likely to feel frustration due to lack of expression. In such patients the lack of physical experience also makes them slow down in their development. It is these physical impairments that may contribute towards a child’s slow progress. On the other hand, having a physical impairment does not necessarily mean that a child will be slow. Lack of appendage in a normally functioning child will not cause any difference in the way he perceives the world, or how he performs academically. Similarly, blind or deaf children are also able to perform as effectively as normal children. These examples relate to the interconnection as well as the independence of these factors from each other and how they help in improving outcomes with regards to a child’s well being. (Burdette and Whitaker, 2005) WHAT IS DYSLEXIA The statements about dyslexia and its nature have varied with time as understanding of it developed. It has been given various names during this time such as congenital work blindness, at a time when it was considered a purely visual disorder. Now research has replaced this concept claiming that it is essentially a verbal deficit and part of language disorders. The main problem in such cases is the inability of the dyslexic child to process rapid temporal i.e. visual and auditory information compared to normal children. The visual information storage time is longer where as visual information transfer is slower. The decrease in the processing efficiency consequently affects the child’s eye, hand and vocal responses, labeling a child as “slow” or a “low achiever”. (Ram-Tsur, 2006) Developmental dyslexia is a condition where by an individual displays difficulties in reading while showing all signs of normal IQ and intelligence. In this regard, the reading and writing skills of the person do not seem in accordance with the mental level that he or she displays. A neurobehavioral disorder in nature, it affects the population in varying rates and may be prevalent from 5% to 17.5%. While the cases have been seen in boys, there is now evidence that the girls may also be affected with the same frequency. But this is yet to be researched. (Shaywitz, 1998) Other problems in dyslexia include left right directional confusion, mirror reversals of the letters and words, difficulty in remembering sequences of words and numbers, tables etc., and poor short term memory. It is important to identify the situation correctly as dyslexia symptoms may be found in other conditions as well such as attention deficit hyperactivity disorder and dyspraxia. (Stordy, 2000) Because of lower academic achievements, such people may have a very low self esteem, and may be labeled to be” lazy, unmotivated, or of low intelligence” (Narayanan and Xiong, 2003) The problem with dyslexia is that even if it is recognized at early ages, the child may have crossed the age of five already. The dyslexic patients’ difficulties with reading are usually identified at about nine years of age. At school level, it means the child would be 9 years of age at the time. This delay may make the recovery process longer. Diagnostic features would require estimating whether the problem is persistent or not. Even in adults, while conscious effect may improve the quality of reading, the problems may remain. A history of problems in wording and pronunciation with history of reading difficulties is usually the most helpful indicator for learning disabilities. (Shaywitz, 1998) GENETIC PREPONDERENCE TO DYSLEXIA AND ITS CO-OCCURANCE The strong family tendency of developing dyslexia is very common, often with other forms of language disturbances as well. This tendency is very high in boys as compared to girls, with chances of acquiring it as high as 50%. The presentation of dyslexia in different ages can be variable. For example, an infant may have difficulties in speech production, and therefore may be late at starting to speak. He or she may also show grammatical errors while speaking. Phonological problems, reading difficulties and spellings are often affected in such children. (Snowling, 1996) COMPENSATORY MECHANISMS USED BY DYSLEXIC PATIENTS Many of the dyslexic children in the early ages are unable to understand and therefore compensate for their learning disabilities. However researches have shown that as these children grow in age, they start various compensatory mechanisms that help them in competitive learning environments such as high school and college. It is to bear in mind that these students have high mental faculties, and apart from reading problems are very bright. (Reis, McGuire and Neu, 2000) These children in many cases are gifted with extraordinary intelligence, which may mask their problem with reading and writing. And this sole fact can be a very strong cause of frustration. Many of the students may not even be aware of their problem, and therefore may continue with this pattern of learning. Lack of learning proper compensatory strategies directly affects their performance levels, and therefore their future outcomes in life. Such children and students however, display persistence and individual interests of extraordinary kind. Self efficacy is enhanced, as well as meta cognition ability. (Reis, McGuire and Neu, 2000) This however, is also a bane for the students who can easily grasp complex ideas, but have difficulty in segmenting the information. It is these persistent traits that students rely on as they study in college, focusing more on their gifts rather than on their weaknesses. (Reis, McGuire and Neu, 2000) Compensatory steps for such children and adults may include study and cognitive strategies, compensatory supports in the form of tape recorders and computer programs, and environmental accommodations, such as creating test taking environments with more time and less distracting elements. (Reis, McGuire and Neu, 2000) Repetition and other verbal tasks can be very much learned through these techniques which may help students achieve desired results. Many of these programs are now part of various universities, which are working towards helping such gifted students perform well. Understanding the individual needs of the person with learning disabilities is the first step towards creating a program that will result in good prognosis. (Reis, McGuire and Neu, 2000) ANATOMICAL VARIATIONS FOUND IN BRAINS OF DYSLEXIC PATIENTS It is now established that the anatomical configuration of the dyslexic patients’ brains is very different from normal brain topography, which shows that there are underlying anatomical faults contributing to this learning difficulty. Among the various brain regions affected are included the inferior frontal gyrus, cerebellum, insula, caudate, corpus callosum, left temporal lobe and the thalamus. There is increased incidence of “duplication of the left Heschl’s gyrus, extreme leftward asymmetry of the planum temporale and parietale, small right cerebellar anterior lobes, and leftward cerebral asymmetry” (Eckert et al, 2003) the anatomical variations are different in different age groups, probably due to the compensatory mechanisms or the development of some areas in response to various therapeutic processes. However, even age is unlikely to cause such dramatic changes in the size or volume of a particular brain area. In children however, most of the original anatomical problems can be visualized. For example, studying brains fo dyslexic children has shown that they demonstrate smaller brain volumes than controls, there is no duplication of the Heschl’s gyrus nor any extreme leftward asymmetry of the PT or the planum parietale. The children will have phonological decoding deficits which are not consistent with their IQ. The children at this time are unable to comprehend passages when compared to college dyslexic students. In such children the cerebellum is affected indirectly, which in turn can lead to downstream effects on other regions of the brain. Frontal lobe dysfunction is also a strong feature found in dyslexic children. This area is theorized to regulate the motor articulatory feedback. The person may be unable to associate the position of the articulators with speech sounds. Due to this the defects seen in speech of the children are grapheme to phoneme conversion difficulties. (Eckert et al, 2003) The frontal cerebellar network becomes activated during fluency tasks, in consonant vowel and linguistic working memory tasks. (Eckert et al, 2003) THE VISUAL DISTURBANCES FOUND IN DYSLEXIC PATIENTS The role of ocular defects in children with dyslexia remains a topic of debate. There are controversial researches that claim differences in the “mean saccadic reaction time, stability of fixation, and number of aggression movements on non orthographic tasks” (Ram-Tsur, 2006) Studies carried out on the eye movements of dyslexic children have shown variable presentations. For example, such children may show ocular motor disability during the reading tasks, but may not do so when it came to symbol recognition. In other cases, it was a vice versa situation, and some in combination. The saccadinic eye movements are usually defected. Such patients may not be able to completely cope with the rapid processing of the visual information they receive as well as the generation of sequences of saccades. (Ram-Tsur, 2006) Two theories try to explain the increased latency. One theory suggests that delayed processing time during perceptual stage is the main reason for increased latency, while the other theory states that dyslexic patients may take longer time to program and execute the saccadic movement. Still other theories claim that this problem may be due to combination of both factors mentioned above. These theories are supported by the fact that defects in the magno cells projecting to area V5 may lead to dysfunction in motion processing. Which theory is the actual fact in the delayed saccadic sequence remains to be determined. (Ram-Tsur, 2006) AUDITORY DIFFERENCES IN DYSLEXIC PATIENTS The role of auditory impairment in learning difficulties among dyslexic patients is a very critical aspect of understanding the pathology. Although having normal intelligence and motivational patterns with regards to sensory acuity and education acquisition, the reading abilities of these children are markedly below their own IQ levels. Visual differences in the interpretation skills of these children have been known for some time now, but the role of auditory pathways in this regard is still under study. Such children may display disturbances in sound perception. Visual studies of the brain have shown that dyslexics display marked left-right hemisphere asymmetry. Again these patients show smaller left than right MGN neurons, that is large sized neurons. Compared to controls the number of MGN neurons may be less. The left hemisphere is known for the fast temporal auditory transitions that are necessary for language understanding. (Galaburda et al, 1994) anatomical differences in the development of the left sided auditory centers may be a contributing factor in the problems with learning. The magnocellular theory is among the most popular and debated theories in the dyslexic patients. The mango cells show increased sensitivity to high temporal frequencies and to visual changes. Among the other theories introduced is the fast temporal deficit hypothesis. This theory claims that dyslexic patients have basic sequential sensory processing defects, which may not be dependant on the magno cells exclusively. The supporters of this theory claim that it explains the slow reactions of the patients to rapid sequential auditory and visual stimuli. (Ram-Tsur, 2006) The cerebellar deficit hypothesis claims that the deficits of dyslexia are many, along side core phonological difficulties. This explains the poor motor control in such people such as “automatization, time estimation, and speeded performances” (Ram-Tsur, 2006) READING DIFFICULTIES FOUND IN DYSLEXIC PATIENTS There is reason to believe that the phonological skills of the dyslexic children are very contributory to their reading problems. In such children there is very poor phonological awareness, and produce sounds in graphemes. Such children have difficulty in processing stop consonants, indicating temporal processing deficits. Early interventions are usually the best method to prevent such problems from progressing and help in their rectification in early stages. The reading skills are seen to improve once the patient is given interventions regarding phonation. (Shankarnarayan and Maruthy, 2007) The reading process is a very complex process involving two main sets of functioning. These include visual perception and linguistic processes. Along side, the temporal processing of the content is also carried out. (Shaywitz, 1998) The complexity of the whole process can be broken down into the lower level of comprehension and the higher level of processing. In the lower level, the identification of the distinct phonological voices is carried out. It is here that phenomes are recognized and processed and the presence of individual phenomes in words is recognized. The analysis at this level is to identify each phenome, process it and then join it with the other phenomes in a word to process the true sound and consequently the meaning of the word. Phonological awareness is the first step in the reading and learning process, where the child learns to read words piecemeal by identifying and then combining individual phenomes. A person who has deficits in phonologic awareness is likely to have these problems in adult age as well. Dyslexic patients for example may not be able to dissociate the different words into its phenomic form, which may cause confusion in their interpretation, and thereby in reading them. In such cases, the higher processing centers may well be unaffected; however the initial processing defects cause complications in its further processing. (Shaywitz, 1998) The higher phonological functions involve comprehension, general intelligence and reasoning, vocabulary and syntax. There are higher orders cognitive abilities involved in the higher phonological functions. In a dyslexic patient, not only will the medical evaluation consist of identifying the reading pattern of a person, but also the various factors that may contribute to the reading skills, such as educational level, IQ, age etc. (Shaywitz, 1998) THE INFLUENCE OF MUSIC ON THE DEVELOPMENT OF THE BRAIN Music is a highly different form of sound recognition involving combinations and patterns. The recognition of music may start very early in an infant’s life, although a true musical sense requires a constant training regarding the various sounds. The significance of music in the various learning patterns became understood fairly recently, and now it is established that music and learning music leads to many changes in the functioning patterns of the brain. While for an inexperienced or untrained mind, the synchronization may not be developed, in the musician’s head; there is a continuous “change in the number of the neurons involved, the timing of synchronization, and the number and strength of excitatory and synaptic connections”. (Fujioka et al, 2006)In simple words, the auditory system is highly enhanced with the exposure to music, and the primary auditory cortex is able to identify and appreciate complex sound patterns with more efficiency. (Fujioka et al, 2006) During the time of infancy to adulthood, there are many changes that take place regarding auditory perception and functioning. This is a very long time, and it may take up to 20 years for a child to develop his or her auditory evoked potential or AEP and auditory evoked magnetic field or AEF. There are many components to AEP and AEF, and these take various time frames to develop themselves at different rates. (Fujioka et al, 2006) Musical training in any form can lead to faster development of the auditory processes of the brain, and cause significant changes in the perceptive ability of children, especially the morphological “changes in the late components of the AEF in children between 4 to 6 years within 1 year ((Fujioka et al, 2006). Music training and lessons researches have shown that it can affect the working memory capacity of the children, provide increased perseverance quality in them and increases their ability to maintain constant focus. Such children show neural patterns that are highly responsive to various forms of music, but not to noise stimuli, showing increased ability to identify certain voice patterns. (Fujioka et al, 2006) METHODS TO IDENTIFY CHILDREN WITH LEARNING DIFFICULTIES There are many ways through which children with learning difficulties can be recognized and early recognition is now becoming part of the school and educational systems in order to prevent any complications. The many categories of defining a child with learning disabilities include language development and its phonation related awareness, perceptual motor abilities, and the length and span of attention that is inconsistent for a child at a particular age. (Coleman et al, 2006) Such children show problems with their academic achievements. There are many of such programs and interventions that are present. A few of them will be discussed below. RESPONSE TO INTERVENTION OR RTI MODEL This model is more of a preventive device in nature, and aims to identify children with learning difficulties in early ages. The aim of early identification is to rectify the problem immediately, with minimal complications for the future regarding social as well as academic life. this model is made of three parts of the intervention, “the use of multiple tiers of increasingly intense interventions, a problem solving approach to identify and evaluate instructional strategies, and integrated data collection and assessment system to monitor student progress and guide decisions at every level” (Coleman et al, 2006) This system claims that parents and teachers are in the best position to identify that the child may be experiencing learning difficulties, and therefore, must be informed of the important signs that may show tendency or development of these problems. This removes the purely clinical aspect of the diagnosing protocol, but instead relies on the information that is gathered by the child’s most close observers, the parents and the teachers. Based on their comments, the doctor may be able to identify and conduct various diagnostic procedures. This can help in early detection and may save much time and energy for all parties in trying to rectify the complication. The teacher by assessing the development and progress of the child increases the intensity of the tiers that are part of the program designed for the child. Such interventions continue to show positive outcomes for children with disabilities. (Coleman et al, 2006) INSTRUCTIONAL TREATMENTS FOR CHILDREN Studies have shown that instructional treatments of dyslexic children improve their reading outcomes significantly. Aylward et al (2003) in their study claimed that prior to instructional treatment, the children with dyslexia showed less activation in the left middle and inferior frontal gyri, right superior frontal gyrus, left middle and inferior temporal gyri and bilateral superior parietal regions of phenome mapping, as per MRI scans. The results after the treatment were increased reading accuracy and ability with more activation of the brain, resembling closely to the controls selected. The study was a strong support to changes that are seen in the brain after comprehensive reading instructional programs, and help to reduce learning problems of dyslexic patients. (Aylward et al, 2003) DOES NUTRITIONAL SUPPLEMENTATION HAVE A ROLE IN PREVENTING LEARNING DISORDERS Current research is actively looking for role of various nutritional substances in the prevention of learning disabilities in children. Long chain polyunsaturated fatty acids are now being given to fetuses, premature infants and full term infants, in order to help reduce the incidence of development of learning disabilities. Researches have shown that such supplementation in children especially boys improved their mathematical ability and academic achievement levels. However the effect of such supplements on dyslexic patients remains to be studied and until any further researches come out, it is still an area of research. (Stordy, 2000) EDUCATIONAL STRATEGIES IN MANAGING CHILDREN WITH DYSLEXIA Teaching methods regarding children with learning disabilities have been undergoing many trends. While initially, even the mild forms of children displaying learning difficulties were excluded, now there is more of an “inclusive” trend. (Westwood, 2003) Experts now believe that such children should not be segregated and should be taught in classrooms with normal children. With more interest in educating teachers about various kinds of disabilities and how to teach them, there are more integrated methods of teachning such children without excluding them. There are many factors however, that can make this inclusion decision successful for such children. Strong support of the teachers and superiors is essential to make such programs work. The teaching staff must be trained in understanding the needs of these children and help them accordingly with patience. The role of parents in this is also very crucial, who need to provide the children with the necessary support and encouragement. Paraprofessional aid, along with regular training programs can ensure that such children are better integrated in to the system and able to perform well in their class rooms. (Westwood, 2003) CONCLUSION: Dyslexia is among the most common learning abilities identified in children, which can seriously affect their performance in academic settings. There are many theories that attempt to understand and explain the phenomena associated with dyslexia, however, more research in the area is needed. Regardless of the pathophysiology, there is a very strong component of social problems that these children may face. With lack of understanding about their condition, such children may be considered slow and unmotivated to learn. This can lead to various behavioral problems in children who may not be able to understand as to why they cannot perform well or read and write well. The schools and parents are the primary persons who can recognize the initial signs of learning disorders, and therefore they must be educated properly about identifying these situations. Early identification and various instructional trainings have shown remarkable improvement in the way children read and write. Since these children may be other wise intelligent or even remarkably gifted, it is important that all teaching institutes at various levels help such children and students by providing help. Currently except for interventions, no other treatment is available. It is important to increase awareness about these difficulties in children and to create programs and implement policies that are able to rectify these children’s difficulties. REFERENCES American Academy of Pediatrics, 1998. 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Evidence for Ocular Motor Deficits in Developmental Dyslexia: Application of the Double Step Paradigm. Investigative Ophthalmology and Visual Science 2006: 47, 4401-4409 Vanaja Chittinahalli Shankarnarayan and Sandeep Maruthy, 2007. Mismatch Negativity in Children with Dyslexia Speaking Indian Languages. Behavioral and Brain Functions 2007, 3: 36 Sally E Shaywitz, 1998. Dyslexia. The New England Journal of Medicine Vol. 338 No. 5 pp 307-312 Margaret J Snowling, 1996. Editorial, Dyslexia: A Hundred Years On. BMJ 1996:313:1096-1097 B Jacqueline Stordy, 2000. Dark Adaptation, Motor Skills, Docosahexaenoic Acid and Dyslexia. American Journal of Clinical Nutrition Vol. 71, No. 1, 323S-326S, January 2000 Peter Westwood, 2003. Commonsense Methods for Children with Special Educational Needs: Strategies for the Regular Classroom -4th Edition. Published by RoutledgeFalmer, New York, Publication Year, 2003. Read More