COLLEGE OF PUBLIC HEALTH

DEPARTMENT OF SPEECH THERAPY

SPTH203

FALL SEMESTER

2018-2019

 Topic: Dyslexia

 Instructor: Ms. Rosie Abou Nassar

 Student: Fatima Ezzeddine and Zeina Yassine.

 Date Submit: 9 January 2019.

Table of Contents

1. Introduction:......................................................................................................................................3
 Definition of Specific Learning difficulties:.................................................................................3
 Definition and symptoms of:.........................................................................................................3
a. Dyslexia:.....................................................................................................................................3
b. Dysorthography:........................................................................................................................3
c. Dyscalculia:................................................................................................................................3
2. Diagnostic Criteria:...........................................................................................................................4
3. Assessment of Dyslexia:.....................................................................................................................4
3.1 Assessing oral language:............................................................................................................4
3.2 Assessing pre-requisites skills...................................................................................................4
Assessing reading skills:........................................................................................................................4
a. Assessing orthography:.............................................................................................................5
3.3 Assessing reading comprehension skills:..................................................................................5
4. Intervention:......................................................................................................................................5
a. Intervention of phonological awareness:......................................................................................5
b. Intervention of sequencing:...........................................................................................................6
c. Reading intervention:....................................................................................................................6
d. Intervention of reading comprehension:......................................................................................6
e. Intervention of writing skills:.......................................................................................................6
5. Role of SLP:.......................................................................................................................................7
6. Conclusion:.........................................................................................................................................7
7. References:.........................................................................................................................................8

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1. Introduction:
 Definition of Specific Learning difficulties:
Specific learning difficulties are demonstrated in a particular difficulty in learning to read, write
and spell or manipulate numbers. Specific Learning Disabilities are Dyslexia, Dysorthography,
and Dyscalculia.
 Definition and symptoms of:
a.Dyslexia:
- According to the international dyslexia association, dyslexia is a specific learning disability
that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent
word recognition and by poor spelling and decoding abilities. These difficulties typically result
from a deficit in the phonological component of language.
- Symptoms: Dyslexia is an evolutive disorder. It should be studied according to age groups.
Three stages will be described:
- 6 to 8 years - 8 to 12 years - Above 12
 6 to 8:
o Persistence of confusions: letters with visual and auditory similarities.
o Permutation of letters specially in consonant clusters.
o Reversion of syllables.
o Addition and omission of letters.
o Dictation limited to isolated letters.
o Anxiety regarding written language.
 8 to 12:
o skipping lines in reading.
o Hesitation, blocking
o Irregular debit
o Omissions, Additions, Inversions
o Perseverations
o Copying difficulties
o Telegraphic written expression: not capable to express himself with writing
 12 years and above:
o The dyslexic child at this age is a teenager with a past of failures, difficulties and
difference.
o They are psychologically suffering and that factor should be taken into consideration.

b. Dysorthography:
Dysorthography is a “specific dysgraphic disorder of spelling which accompanies dyslexia by a
direct consequence of the phonological disorder”.
c.Dyscalculia:

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 Dyscalculia is a difficulty in learning or comprehending arithmetic, such as difficulty in
understanding numbers, learning how to manipulate numbers, and learning facts in
mathematics”.
2. Diagnostic Criteria:
A. Difficulties learning and using academic skills, as indicated by the presence of at least one of
the following symptoms that have persisted for at least 6 months, despite the provision of
interventions that target those difficulties:
1. Inaccurate or slow and effortful word reading (e.g., reads single words aloud incorrectly or
slowly and hesitantly, frequently guesses words, has difficulty sounding out words).
2. Difficulty understanding the meaning of what is read (e.g., may read text accurately but not
understand the sequence, relationships, inferences, or deeper meanings of what is read).
3. Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants).
4. Difficulties with written expression (e.g., makes multiple grammatical or punctuation errors
within sentences; written expression of ideas lacks clarity).
5. Difficulties mastering number sense, number facts, or calculation (e.g., has poor
understanding of numbers, and relationships; counts on fingers to add single-digit numbers
instead of recalling the math fact as peers do).
6. Difficulties with mathematical reasoning (e.g., has severe difficulty applying mathematical
concepts, facts, or procedures to solve quantitative problems).
B. The affected academic skills are substantially and quantifiably below those expected for the
individual’s chronological age, and cause significant interference with academic or
occupational performance, or with activities of daily living.
C. The learning difficulties begin during school-age years but may not become fully manifest until
the demands for those affected academic skills exceed the individual’s limited capacities
D. The learning difficulties are not better accounted for by intellectual disabilities, uncorrected
visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack
of proficiency in the language of academic instruction, or inadequate educational instruction.
3. Assessment of Dyslexia:
3.1 Assessing oral language:
- A reciprocal relation exists between the development of oral language and learning to read. A
delay or disorder in OL development may lead to problems with the development of literacy.
This is why a well targeted oral language assessment should be administrated
3.2 Assessing pre-requisites skills
- Short-term memory: It can be assessed by recalling items (variation of the length) that are
presented visually (pictures/objects) or auditory: words and digits in serial orders.
- Working memory is assessed by recalling digits/visual items in the opposite order.
- Phonological and phonemic awareness: identification, counting, blending and manipulation
of syllables must be assessed. Tasks are administrated from simple to complex (phonemes,
syllables, rimes) during the assessment.
- Also, other assessment tests are used to assess visual and auditory discrimination,
attention and long term memory in addition to rhythm.

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 - Assessing reading and orthography skills
Assessing reading skills:
- Three different components or subskills are included in reading: word recognition, decoding
and comprehension.
- A reading assessment is undertaken using the following tests :
 A standardized single word reading test;
 A standardized text reading test;
 A test of non-word reading;
 A test of alphabet knowledge.
 Assessing word recognition: It is also referred to as lexical processing. It is the ability to
recognize words quickly and accurately.
 Assessing decoding skills: decoding consists of a number of subskills: the ability to
divide a word into phonemes; the use of grapheme-phoneme conversion; blending the
speech sounds and identifying the correct word and its meaning. These components can
be evaluated via:
 Letter naming: It is evaluated by asking the child to name the letter and it’s sound.
 Non-word reading: It is used to determine how readers decode new and unknown
words.
 Assessing reading fluency: Reading accuracy testing should be completed by reading
speed. Poor readers may learn to read accurately but they remain dysfluent with a slow
reading rate.
 Reading text: It enables us to observe reading accuracy and comprehension.
a. Assessing orthography:
- Dictating syllables example: /ba:/ /mu:/ /k/ /t/ …
- Isolated words /sijjara/ /Xaru:f/ /du:la:b/ /ʕɑșfu:r/
- Pseudowords /fab/ /ʕarmi/ /du:lem/ /talkam/ /Xanʃu:f/
- Text or paragraph
- Free writing (to observe fluency (number of words produced in a specified time period),
Vocabulary and lexical diversity, Word choice, and Use of multisyllabic words).
3.3 Assessing reading comprehension skills:
- Assessing reading comprehension can be administrated by two types of tests: tests with
question-answer format and tests which use a multiple choice or closed type procedure.
- It can include sentences comprehension or text comprehension.

4.Intervention:
Once a diagnosis of dyslexia has been made, therapy should begin as soon as possible. First, we
will consider interventions of prerequisites of reading, writing and spelling that need to work
together for these activities to be effective.
a.Intervention of phonological awareness:
Training phonological awareness is necessary to develop grapheme-phoneme conversion. The
objectives are set from simple to complex: Syllables, rimes and finally phonemes:

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 - Syllables: syllables segmentation and count, syllables identification (initial, final and
median), syllables manipulation.
- Rimes: Judge if two words are rhyming, find a rhyming word, find the intruder (a word that
doesn’t rhyme) etc.
- Phonemic awareness:
 Phonemic discrimination: suppress auditory confusion while using kinesthetic and visual
aid.
 Phonemic awareness (words with CV then CCV): identification and categorization,
phonemic segmentation, phonemic count, phonemic
addition/suppression/substitution/inversion.
b. Intervention of sequencing:
Activities like chronological events(e.g. recalling a sequence of events, knowing the days of
the week, dressing in sequence) can be used in intervention of sequencing.
c.Reading intervention:
In reading intervention SLP should work on global or analytical strategies in reading
depending on the child’s difficulties.
- For global strategy SLP work on visual difficulties including visual attention, visual
discrimination, and visual memory. Then she/he works on quick recognition of words
(visually similar lists of words, two lists etc.)
- For analytic strategy she/he can use phonetic and gestural method, graphic representation
of the mouth movement, sensory-motor methods etc.), isolated letters, contextual
graphemes, visual and auditory confusions. He/she starts with simple syllables: CV-VC
then complex syllables CVC-CCV; non-sense words (length), and regular words
(meaning).
d. Intervention of reading comprehension:
Depending on the child level, the objectives are ranged from simple to complex: Words,
sentences, segments of texts. Many types of exercises can be performed:
 Asking questions alternatively.
 Semantic categories, intruders, definitions etc.
 Put the paragraphs of a text in the correct order, find titles etc.
 Anticipation exercises.
e.Intervention of writing skills:
Our objectives should mainly be providing strategies to help the child resolve his difficulties
on the orthographical level and develop the capacity to anticipate the correct orthographic form
of the words before writing them. Progression to achieve this objective include:
 Sound-letter correspondence (in RW)
 Complex and contextual graphemes
 Automating to write spontaneously more complex words
 Frequent words (grammatical and lexical)
 Understand the composition of words: prefix, suffix
 Group the words into lexical fields: farm, farmer etc.
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  Grammatical orthography and Syntax
5.Role of SLP:
SLPs have a main role with dyslexic children:
- Prevention
- Assessment and Identification
- Follow up
- Collaboration with other parents, specialists (psychomotor therapist, psychologist etc.) and
schools
6.Conclusion:
Dyslexia is a learning disability in which an individual affects his/her ability to read, write, and
spell. It can affect any person, although is usually received genetically. A child can be diagnosed
with dyslexia at a young age, even during pre-school and kindergarten years.

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7.References:
 https://dyslexiaida.org/definition-of-dyslexia/
 https://www.pisd.us/apps/pages/index.jsp?uREC_ID=244041&type=d&pREC_ID=564302
 https://www.pensareoltre.org/index.php/en/disorders/dyslexia/disturbi/43-dysorthography
 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data
/file/324573/DFE_Departmental_Report_2006.pdf
 https://www.understood.org/en/learning-attention-issues/child-learning-
disabilities/dysgraphia/understanding-dysgraphia
 https://speech-language-therapy.com/pdf/stackhouseETAL2006.pdf
 https://www.researchgate.net/publication/248448250_Gardner_J_Ed_2006_Assessment_and
_learning_2006_London_Sage
 https://www.scirp.org/(S(czeh2tfqyw2orz553k1w0r45))/reference/ReferencesPapers.aspx?
ReferenceID=1374106
 https://www.understood.org/en/learning-attention-issues/child-learning-
disabilities/dyslexia/different-types-of-dyslexia
 https://pubs.asha.org/doi/10.1044/2018_LSHSS-DYSLC-18-0049
 https://blog.asha.org/2018/03/12/the-speech-language-pathologists-role-in-diagnosing-
dyslexia/
 http://dyslexiahelp.umich.edu/parents/living-with-dyslexia/school/classroom/role-speech-
language-pathologist
 http://dyslexiahelp.umich.edu/parents/learn-about-dyslexia/dyslexia-intervention