Early Signs of Dyslexia and Effective Early Intervention

 I will be speaking on the "Early Signs of Dyslexia and Effective Early Intervention" for the Dyslexia Association Hong Kong at the Hong Kong Football club on Thursday 23rd May at 7.15pm.

This will a very practical and informative talk for both parents and educational professional about this important subject.

The signs of  dyslexia can be seen from a very young age but many parents and teachers choose to "wait and see".  In the meantime children lose their confidence and the gaps widens.

There are many fun and practical ways to intervene which benefit all children.  First we need to strengthen a child's 

pre-reading skills then we need to use dyslexia interventions to help them learn to read and write.

None of these activities are harmful so why wait?

For tickets please use this link

https://www.ticketflap.com/earlysignsofdyslexiaandeffectiveearlyintervention

Visual Perception - what is it?

Visual perception is the term used to describe the way in which the brain processes visual information. There can be differences in the way that visual information is perceived, processed, organised and understood.  This is different from the idea of 20/20 vision and being long sighted or short sighted.

We assume that when we show someone information visually on an interactive white board or a page in a book or a poster that they are seeing what we are seeing.  We also assume that they will be able to readily pick out the information that they need from a visual source. For many children and adults this is not the case.

Good visual perception is important for all aspects of life. We need the ability to process visual information to make sense of the world around us. We need to be able to understand shapes, colours and distance. We use visual perception to develop our understanding of everyday concepts.  For example: to know what a cup is, we need to see many cups and remember what are the key features that make a cup, as not all cups are the same.  This understanding and visual memory will help us see that while a jug is similar to a cup it is not the same. We can mentally compare and realise that a jug has a lip for pouring that a cup does not.

Good visual perception is vital to learn to read and write. We need to distinguish letters and spaces between words. We need to remember spellings and organise words on a page.  Visual perception should be one of the first things that is checked if a child is having difficulty learning to read or write.

It is not always easy to identify children who have difficulties with visual perception.  Children usually don't realise that what they see is not what others see. It is also very hard to verbalise what we see or explain exactly what the problem is.

Some of signs to look out for are:

- difficulty remembering visually presented information
- difficulty with the order of letters and objects
- difficulty picking objects out from a busy background
- difficulty organising themselves or materials in space
- they may not realise that an object orientated differently is actually the same
- they may not notice big or small differences
- they may appear clumsy

Visual perception is complex and is made up of a number of skills. 

• Visual memory
• visual sequential memory 
• visual closure
• visual discrimination
• visual form constancy
• visual figure ground
• visual motor intergration

Children do not usually have weaknesses in all these areas,  a weakness in just 1 or 2 of them can cause significant difficulties both at school and in every day life.

www.eyecanlearn.com is a very useful website for parents that explains both visual efficiency and visual perception clearly.

If you have any concerns use should consult a behavioral optometrist who can test these areas using standardised tests. Check these websites to find a suitably qualified professional  http://www.babo.co.uk or https://www.covd.org

Over the next couple of weeks I will explain some of these areas in more detail and some strategies that can be used to help.

Have Non Verbal Learning Disorders been forgotten?

Does your child have excellent verbal skills ? Learns facts easily? Asks lots of questions?

But misunderstands social situations, takes things literally, is reluctant to explore things for themselves or is clumsy?

These could be signs of Non Verbal Learning Disorder.  Many people have not heard of this difficulty.  As its name suggests it is a difficulty with understanding and processing information that is presented visually rather than verbally.  Typically there is a big discrepancy between verbal skills which are age appropriate or even advanced and their visual perceptual skills.

The difficulty affects a number of areas including social skills as the child (or adult) can not read facial expressions or body language. They may misunderstand social situations leading to friendship issues particularly as they get older.  They may 'talk at' people and may want to share facts they are interested in but not notice when the other person has lost interest. For this reason it can easily be confused with Asperger's syndrome.

While the child can seem very knowledgeable or even precocious when they are speaking, they may miss the subtleties of language.  They may take things very literally and not understand sarcasm or figurative language.  This can then affect their reading comprehension as they may focus on the factual detail and miss the bigger picture and a character's feelings and motives.  It can also be mistaken for language disorders, like social pragmatic communication disorder.

 Motor and visual spatial skills are affected making the child seem clumsy and uncoordinated.  Their handwriting and drawings will be messy.  Their lack of focus and careless work can lead to a diagnosis of ADHD.

At the heart of Non Verbal Learning Disorder is the difficulty in noticing and understanding patterns, particularly visual patterns.  They can also have difficulties with abstract reasoning, maths concepts and organisational skills.  It is like having the building blocks but not being able to put them together to make a building.  Children can have good decoding and spelling skills, have difficulties with reading comprehension.  They may be able to learn maths facts and some methods by rote but not understand maths concepts or be able to solve problems. Verbally they can seem very able to but this is not translated into their school work.  This can be puzzling for both teachers and parents and frustrating for the child.

While Non Verbal Learning Disorder is not longer listed in the Diagnostic and Statistical Manual of Mental Disorder (DSM-5), there is still a lot information available about this difficulty. Prior the changes diagnosis, as a lot of work had been done to raise awareness of Non Verbal Learning Disorders as a Specific Learning Difficulty.  As an Inclusion Coordinator, I recognise many of the signs in the children I work with and still consider it to be important in understanding and supporting children effectively.

With all this confusion why bother labeling?
Understanding what is really causing the difficulties a child is experiencing both helps the child understand themselves and will unlock the right interventions. Interventions for children with ADHD or Asperger's syndrome may not be effective in helping children with Non Verbal Learning Disorder.
For more information look at
https://childmind.org/search/?fwp_term=nonverbal%20learning%20disorder
and
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/nonverbal-learning-disabilities/

Parents and teachers need to focus on clear communication.  Patterns and connections between concepts need to be taught explicitly, children need to be told the main idea or concept directly. Adults need to verbalise what is represented visually to help the child to make sense of the visual material. Talking through the steps needed to solve a problem can help children know how to approach a problem solving task.  Support needs to be given for transitions between activities or for new situations.  Social skills groups and interventions which help the children to understand and practice social skills in a safe environment are important.  They need adult support to analyse situations and understand what is really happening and how they misunderstood or misread the situation.  Occupational therapy can also be beneficial in addressing the visual spatial difficulties, poor motor skills.

As a parent of a child with Nonverbal Learning Disorder, Rondalyn Varney Whitney has written an excellent book documenting the journey she took in understanding her son and gives practical advice to support parents and teachers.

Understanding Slow Processing - how to function in a world that values speed

 Do you ask your child questions and wait a long time for them to respond? 

Do you get frustrated that when you are in a hurry to leave the house and your child is always slow to find their shoes and put them on? 

Does a simple homework task that should have been finished by dinner drag on for the whole evening?

Does your child panic in timed tasks and spend more time watching the clock than doing the task?

All of these could be signs of slow processing.  It is not that the child can't do the task they just can't do it quickly.

Children with slow processing are often misunderstood and their real difficulties overlooked. Often their slowness is misinterpreted for not knowing or not being very bright. Many teachers still equate speed with brightness. They will regard the children who give the quickest answers as the brightest in the class.  In doing this they overlook the fact that many deep thinkers do so slowly. Many bright and gifted children are misjudged and given inappropriate work because teachers can not see past their slowness. They may not be given extension work because they do not complete routine tasks well in the time given.

Maths, in particular, is an area where the teacher's desire for quick answers is misguided. Of course we want children to be familiar with their number bonds and time tables and not have count and calculate every time they need them. However not being able to give an immediate answer does not mean the a child does not know their number facts. Maths has many facets and we want to develop reasoning and problem solving skills as well a calculation skills. Those who are quick at maths may not be the best mathematicians. My son has known his times tables since he was 5 and learnt them almost instantly. However if he is put on the spot and asked a times table question there will always be a time delay. If you judged his maths ability on this you would completely miss his deep understanding of maths and ability to make links between concepts and solve complex problems.

In writing tasks teachers often seem to value speed above content. If two children complete a task to a similar standard the teacher is likely to praise the child who finished first.  A child with slow processing may have written an excellent start to a story but the fact they have not finished their story will always be a problem. Sometimes the teacher will barely acknowledge the quality and effort that has gone into the writing they have done but just focus on the fact it is not finished. The child may also be wrongly accused of being lazy and not trying hard enough. Part of the problem is that the school day is divided in 30 minute to 1 hour slots and a certain amount of content has to be covered in each lesson. Teachers are constantly under pressure to cover the curriculum and this leaves little scope for extending a lesson and allowing more time for tasks when a student needs it.

So what is slow processing and how should we be supporting these learners?
For those familiar with IQ testing, processing speed is one of the 4 areas tested alongside verbal skills, non-verbal or visual perception and working memory. It is an important aspect of the child's learning profile and explains how a child may approach school work and everyday tasks. However it seems to be an area people know little about. Processing speed is the speed at which we can take in information presented visually or verbally and make sense of it or use it.  It is not related to overall intelligence.  It is perfectly possible to have high verbal or perceptual reasoning score but a low processing score.  Slow processing can be part of a learning difficulty like dyslexia, ADHD or auditory processing disorder. There are 3 aspects of processing - visual processing, verbal processing and the ability to respond with a quick motor response - child may have difficulty in one area or a combination of these. This can mean a child's response may vary from task to task.  This can be confusing for adults dealing with the child and can lead people to think that there is a lack of effort or motivation from the child. A child can be slow to answer verbal questions even if they know the answer. They may have difficulty with multi-step instructions and tasks, although they could do each step in isolation. They may be slow to complete written assignments particularly if there several parts. They may need to read information more than once before understanding and answering comprehension questions. They may have difficulty taking notes and become overwhelmed if there is too much information given at once.

There is an assumption that when we say something it should be immediately understood and acted upon. We do this a lot as parents and teachers and get frustrated when the child doesn't respond quickly to our instructions or questions.  Similarly when information is presented visually in a textbook, on a poster or on an interactive whiteboard it is assumed that everyone can process and make use of the information quickly and easily.  

Many adults do not realise that a child can struggle to process information at speed, but they may actually have a good understanding if they were given more time. If a child does not respond quickly to something there is an assumption that their understanding shaky or they need more practice. Sometimes a teacher may lower their academic expectations of a child because they think they are struggling with concepts that in fact they understand well.

What can you do to help?

If you are concerned about your child's processing speed you should seek professional help from an Educational Psychologist who can carry out an educational evaluation.  This will help everyone to understand your child's strengths and weaknesses better.

Make sure the teachers are aware if your child has slow processing speed and openly discuss what allowances can be made.

At School - advice for teachers
Allow more time to answer verbal questions - either ask the question and say that you will come back to the child in a few minutes or ask the question but then avoid direct eye contact or looking impatient while they are formulating their answer. If necessary check a child's understanding privately when the rest of the class are not listening.

Break tasks into small achievable steps and give praise when each part is completed. For example ask the child to complete the opening paragraph of the story rather than the whole story. Alternatively scribe for the child to quickly get down their ideas and then ask them to focus on the end of the story. Value the quality of the work rather than the quantity.

Avoid 'busy' pages of information and questions. Cut them up and present one part at a time. Provide a paper copy of any information displayed on the board.

Use checklists to show the steps involved in a longer writing task or maths questions.

Allow time for children to re-read texts before answering questions and encourage then to do so.

When possible avoid using timers, or time a task without drawing attention to it.

Set a realistic target for the child to complete in a lesson rather than letting them feel they have not finished or have failed.

Whenever possible allow extra time for tasks. Allow the child to complete one task while other children complete two.

Continue to present tasks that match their actual ability. For example let the child complete the most challenging parts of the lesson first, don't always keep the extension tasks for those who have finished the initial task.

At home - advice for parents
Plan out with your child how and when homework tasks will be completed. Allow at least double the time you think is necessary for each step.

Occasionally practice timed tasks but make the task fully achievable in the time given. Set a small target and slowly increase over weeks and months.

When going out make sure your child knows what they are expected to do before leaving. Ask them to repeat back to you what they need to do and prompt them in plenty of time to get ready. Provide visual checklists if necessary.

Talk to your child openly about their difficulties and reassure them that they can get things done and are capable they just have to give themselves enough time. Encourage your child discuss any frustrations at school and follow up with the class teacher if appropriate.

Draw attention to what they are good at and give examples of tasks that are better done slowly and carefully.  Discuss jobs that require a slow and careful approach.

Dyslexic but everyone is different

While there are key characteristics of dyslexia, every person with dyslexia has a slightly different cluster of difficulties.  This is why individual intervention and support is most effective.

Anyone who works with dyslexic students or parents who have more than one child with dyslexia will tell you that there are different types of dyslexia.  While cumulative, systematic multi-sensory teaching benefits all dyslexic students, there are different materials and approaches which can be used depending on the type of dyslexia.  In any intervention, it makes sense to utilise a child’s strengths and work on improving areas of weakness.

Different websites and authors explain these differences in their own way and use different terminology. Some choose to split the main areas of difficulty while others group certain difficulties together. This can be confusing and is perhaps unnecessarily complicated.  Nessy.com have an ebook that lists different types of difficulties and explains how each person with dyslexia has a different combination.  Other websites mention 4, 7 or even 12 types of dyslexia.

In essence, there are 3 main types of dyslexia.   Nearly all dyslexics struggle with working memory however some have more visual perceptual difficulties and some have more auditory processing difficulties and some have equal difficulties in both areas. In addition, all of these groups may have slow processing (this may be identified as rapid naming deficit) and motor skills difficulties (this may include dysgraphia or dyspraxia).

1.    Those dyslexics who have more difficulty with processing auditory information but have strong visual skills have dysphonetic dyslexia (it is also called phonological dyslexia.) This group also includes double deficit dyslexia which is children with difficulties with phonological awareness and rapid naming. 

These are the children who muddle words that sound similar like ‘bag’ and ‘back’ or ‘rag’and ‘rug’. They will have trouble identifying all the sounds in a word when they try to segment a word for spelling. They will try to use their visual memory and could spell chased as ‘cashed’ or farmer as ‘framer’. They often miss sounds or syllables or suffixes from longer words like ‘epty’ for empty, 'swim' for swimming.  These children will have trouble reading names or sounding out polysyllabic words. They can often say the sounds in a word but have trouble blending them together and they may swap over the order of the letters.

When the child starts to learn to read they may initially do quite well as they use their strong visual skills to learn key sight vocabulary and use picture cues to decipher simple texts. However, their decoding skills do not develop in the same way.  If the school uses a scheme that is based on introducing sight vocabulary a little at a time, with predictable sentence structure like Oxford Reading Tree then the child will appear to be learning read. However, as texts become more varied, complex and less predictable they will have no skills to work out new words. Suddenly, the teacher and/or the parents will realise the child has reading difficulties. If the school uses a phonic based scheme like Read Write Inc then these reading difficulties will be evident earlier.

 

These children benefit from using flip books to generate words families and colour coding letter patterns.

These children also tend to be good at maths as they recognise patterns and so do not rely on working memory for number bonds and times tables. or calculation methods 

 2. Other dyslexics struggle more with visual perception and are said to have dyseidetic dyslexia (this may also be called surface dyslexia or visual dyslexia.) These children often struggle with Maths as well as reading and writing. They find it hard to visualise maths concepts and develop a concept of number. They do not notice visual patterns and rely on their weak working memory skills to try to remember number facts and calculation methods.

These are the children who struggle to learn irregular high frequency which make up so much of our early reading (in more transparent languages these children would have fewer difficulties.) If the school uses a phonic based reading scheme these children will learn to decode simple 3 or 4 letter words but it will be noticeable that they will sound out words again and again. They do not commit words to memory. In their writing, high frequency words are spelt phonetically like ‘becos’ and ‘sed’ and they may reverse letters and words. They may also substitute visually similar letters like i and j or t and f. These difficulties are considered normal in the early stages of writing. However, as other children begin to master letter formation and key vocabulary these errors will persist. 

These children need to make words with magnetic letters and play games with these words. Verbalising what is tricky about a word is helpful in learning spellings, as are mnemonics.

 3. Some dyslexics have both visual and auditory difficulties.  These tend to be the child who are noticed early on and are most readily identified as dyslexic by teachers and parents. They struggle to develop reading and writing skills at all in a normal school context as they cannot use stronger skills to compensate. It is vital that these children receive structured, culmulative, multisensory support as soon as possible to overcome their difficulties. Lots of hands on and interactive activities are needed to make words memorable.