Tim has written a scenario between an Educational Psychologist and Mother after the an assessment has been completed on her son. He is explaining his report to the mother and his diagnosis.

Madam Wong: So, is my Jiang Jie dyslexic? Will he get extra time in the PSLE?

Dr Ken: I think he probably is.

Madam Wong: Well that is a relief, that explains why he has trouble at school, but what do you mean he “probably” has dyslexia?

Dr Ken: Let me try and explain.

Dyslexia is the most common disorder of development for us modern humans, and we’ve done more research on it than almost any other problem, but we’re still a long way from any final answers. To tackle the problem most psychologists and teachers have agreed to start with a “working definition” that developmental dyslexia is when a child has more than usual difficulty learning to read or spell at the word level, in spite of adequate teaching.

Once you have a working definition, you can agree which children you are looking at. Then comes the hard bit: why do some kids have difficulty learning to read and spell and not others? For those of us lucky enough to learn to read easily, we usually don’t really know how we did it. When it is harder, as it is for some boys, we have to try and dig deeper into what is going on, and even now we are really only beginning to understand how learning something as complex as reading works in the human brain.

Madam Wong: Oh! so there is a difference between boys and girls?

Dr Ken: Boys are about 3 times more likely to have dyslexia than girls in Singapore today, and that’s pretty much the same in most developed countries. Why? We aren’t sure, but maybe boys brains develop a little bit differently, or perhaps they are not quite so good at language as girls generally, or perhaps girls are a bit less vulnerable than boys to all the many things that can go slightly wrong with their development at an early age.

But maybe there are some advantages at the end of the day. Boys may still be more able to “think outside the box”, to become brilliant scientists and leading businessmen.

There are lots of famous dyslexics, not all men, but many are. And yes, dyslexics do have to work a bit harder and they do need more help, so they may need some recognition in exam accommodations that enable them to answer in a reading and writing environment without an unfair disadvantage.

Madam Wong: Ok, so what does this all mean for Jiang Jie?

Dr Ken: For some children it’s very obvious they have difficulties with reading and spelling, in Jiang Jie’s case it’s more subtle. He’s already 9 and he’s been making a lot of effort and he’s managed to get by so far, with the extra tuition you have arranged for him. But he still is quite slow to work out hard words, and remembering what order the letters go in some words is harder than average for him. I think we need to give him some more specialized help to try and give him greater fluency with reading and of course to make spelling less of a chore. However, Jiang Jie is clever in many ways, especially with shape and space problems.

Madam Wong:: So you recommend more specialised help. What does that mean?

Dr Ken: Jiang Jie has a subtle difficulty with phonology – that means hearing the individual sounds that words are made up of – the phonemes – and then working out how to change the phonemes into the correct letters in the right order. It’s made harder in his case because he struggles a bit to hold onto information as he works on it – his working memory is a bit limited, and so to remember the question he has to answer and to drag out of memory what he needs for the answer all take more effort and maybe a bit longer too for him. He also has a bit of a naming speed difficulty. So getting all the huge amount of data he has stored in his brain out quickly to work out what a word is takes just a bit longer, and so it gets muddled.

Madam Wong: But what do I need to do?

Dr Ken: You have to keep him positive, and not let him get disheartened. Finding things that he can do well at, like archery which I know he enjoys, a good diet does help, and plenty of exercise and relaxation, as well. The best way to help is to be positive and supportive and actually teach him more systematically how to remember the tricky words. Often that involves using more of his strengths in art and movement to help remember the difficult bits in words. Many kids with a profile like Jiang Jie also need help to stay organised and if you can help him to understand how to manage his time he will feel more in control of his studies. You have to find some extra money for tuition and maybe a laptop for him. And you need to help him with reading and writing practices whenever he needs you, and at the least you need to make sure he is keeping up with practice himself. It’s a really important fact that poor readers actually read only a small fraction of what good readers do. So the good readers are exposed to and learn many, many more words while they read, and the poor readers get left behind. It’s tough, and it’s called the Matthew Effect.

We need to step in to increase the amount of useful practice people like Jiang Jie are getting to try and reduce the gap between him and those students who read without any effort.

Madam Wong: What do I tell his school and his teachers?

Dr Ken:

His school can help by recognising that he has more than usual difficulty with words. They need not to make too much of spelling mistakes in his case, and pay more attention to what the ideas he’s trying to express. They need to talk positively about dyslexia, and help him work out ways of dealing with stress and giving him some help with revision and study strategies.

For example, they might teach him more about planning what to say when he has to write a composition using “Mind Maps”, and they might let him use a computer for long pieces of writing more often. If you want I can help explain this assessment report to his teachers and advise them on teaching strategies that they can use with Jiang Jie to make him more successful in the classroom and with his school work.

Madam Wong: Can you ask his teachers to give him less homework?

Dr Ken: No, his school will, I hope, be sensible and recognize in Jiang Jie’s case that he is trying hard and producing the best he can. I don’t want to give him an excuse to take it easy. But you can help him with homework – don’t do it for him, but help him by setting up a good place where he can work without distractions, at a good time (not too late). And then help him to sort things out: make sure he understands what he’s got to do, and remind him where he can get information from. Let him bang out a first go on the computer and then you can save him a lot of frustration by offering to help him get it into a sensible sequence. My guess is he has lots of good ideas, but he tends to go all over the place rather than explain the ideas clearly.

Madam Wong: You mentioned he might need specialist tuition. How will that help him?

Dr Ken: He needs to go to a good tutor, probably in a very small group with other children at about the same level, and follow a systematic programme to build up his phonological and memory skills. I doubt if we can make much direct difference to his recall speed problem – there are some programmes that claim to work, but I’m not yet convinced. But we do know that phonological and memory weaknesses can be helped, and that they do make a difference to children with dyslexia. Tuition is direct training to improve reading and spelling, but it’s done in such a way that the underlying weaknesses are addressed and compensated for. I would like him to go 3 or 4 times a week at first, but I’m afraid that’s not practical. But the government will support two sessions a week, and that works in most cases.

Madam Wong: So why did you say Jiang Jie “probably” has dyslexia?

Dr Ken: I’m sorry. I said “probably” because I’m interested in us getting a better and better scientific understanding of dyslexia and what we can do to help. There’s no such thing as certainty in science – we are always trying to find weaknesses in our theories so we can make better theories. It’s the same with dyslexia; research into the human brain is very complicated.

I am as sure as anyone can be that Jiang Jie has a genuine difficulty in learning, that he needs specialist help, and that with help his “difficulty” can become a blessing. So I am happy to describe him in my report as “dyslexic”. He needs recognition for the great- er effort he has to make, through getting extra support inside and outside school.

Madam Wong: Thanks, Dr Ken.

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This article was published in Singapore Child December 2011 and is reproduced with their permission.

This article was first published in FACETS