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Assistive Technologies for Students with Dyslexia: A Systematic Literature

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 Assistive technologies for students with dyslexia:
A systematic Literature Review.

C. Smith1,* and M.J. Hattingh2[0000-0003-1121-8892]

1 University of Pretoria, Private Bag X20, Hatfield, 0028
2 University of Pretoria, Private Bag X20, Hatfield, 0028
marie.hattingh@up.ac.za

Abstract. The goal of this research review is to identify assistive technologies

available to support students with dyslexia. The study reports on how accessible
these technologies are, as well as the impact these technologies can have on the
students if they are adopted. The main focus of the review lies on identifying
assistive technologies that can help students with dyslexia but investigation is
also done into the surrounding and closely related topics of accessibility, ac-
ceptance and impact of the technology as well as trying to understand some as-
pects of the dyslexia disability to better understand how the technologies can aid
these students and help to rehabilitate them. Based on information gathered from
previous research, the study tries to find a weak spot in the field of assistive tech-
nologies and tries to determine how it can be bettered.

Keywords: Systematic literature review, Learning disabilities, Learn-

ing aids, Dyslexia.

1 Introduction
Dyslexia is a neurobehavioral disorder that very commonly affects children with rates
up to 17.5% [1]. More research and observations made from The National Institute of
Child Health and Human Development (NICHD), indicates that 17% to 20% of the
United States population has some form of a reading disability, which means that one
out of five children in the United States struggles with this problem and will most likely
keep struggling with it through their teenage and young adult lives [2]. Dyslexia is a
disorder where the person affected struggles with seemingly normal actions like word
recognition, spelling and formulating sentences [3]. Since dyslexia is a problem that
individuals have with language and phonological processing [1], [4] students really
struggled in the past without technology to help them to overcome their disabilities and
learn to move past it. With the world becoming more technological each day, people
with learning disabilities have gotten the chance to utilize these new emerging technol-
ogies to help and assist them with their studying and progression in the academic system
[5]. Diagnosis of the condition is happening more frequently, since new technology
becomes available that helps to identify students with dyslexia traits and tendencies,
like the use of EEG signal patterns[6]. The technological aids that these students require
2

can get complex and can include different special hardware and software assistance [7].
Students with learning disabilities have always struggled to obtain access to the needed
aids and technology, and even with institutions providing more resources in recent
times, there are still students in many demographics that cannot obtain access to these
needed aids [8]. In this literature review the focus will be on dyslexia and the technol-
ogy that can be used to assist students with the disorder rather than learning disabilities
in general, which will allow narrowing the research field down and producing better
quality results on one specific topic in the overwhelmingly large field.

2 Research Method
The research question to be answered by this study is: What technologies are available
to assist students with dyslexia? The following search terms were used: (“dyslexia” and
“technology”) OR (“dyslexia” and “learning” and “technology”) OR (“assistive” and
“technology”) OR (“dyslexia” and “assistive” and “technology”)
The selection criteria include a set of inclusion criteria and exclusion criteria that
was pre-defined by the author based on information needed to answer the research ques-
tion. The following inclusion criteria were used to select the sources, any article not
conforming to this were excluded: (1) Studies in English, (2) Articles that focus on the
characteristics and description of dyslexia as a learning disability are included, (3) Ar-
ticles that define and describe different technological assistance initiatives are included,
(4) Studies from 2009 to 2019, (6) Peer reviewed academic journals.
Articles were obtained from ScienceDirect and Emerald Insight databases. Initially
1286 articles were identified, which were reduced to 168 after screening the title and
key words. 164 articles were read and based on their eligibility to the research question,
80 articles were included in final review.

3 Analysis of Findings
The use of EEG signals and MRI (Magnetic Resonance Imaging) have been mentioned
and briefly looked at in relation to identifying dyslexia or dyslexic traits within indi-
viduals [6], but there are many technologies being used to actually assist learners that
are suffering from dyslexia with studying and performing their academic duties. Some
of these technologies include speech recognition software, text-to-speech software,
mind mapping software, scanning software, hand reading pens, spell checkers, smart
pens, software on multimedia devices like cell phones and tablets, and computer-based
learning programs. These technological options are very popular options when it comes
to assistive technology according to the Dyslexia Association and will be investigated
further. In this review it was discovered that dyslexia is a learning disability that is
largely misunderstood to the world and every aspects from identifying individuals with
dyslexia to the point of obtaining technological aid to assist them is a very difficult task
and all these steps are investigated in more detail to follow. To be able to assist and
obtain proper technological help for individuals who suffer from dyslexia, it is very
important to correctly diagnose and identify the conditions beforehand. Although many
 3

researches would argue on the different types of dyslexia and how it can be identified,
a common identifying method that is used consistently is the double deficit hypothesis,
which proposes that individuals who have problems with phonological processing as
well as naming speed represent independent dyslexic traits [9]. Many other reports at-
tribute the identification of dyslexia in individuals because of the identification of a
dissociation between phonological and visual attention span [10]. There are many traits
that can be associated with the dyslexia learning disability and can be used to hypothe-
size that an individual may suffer from the disability, but there are also quite a few
technologies available to help identify and diagnose individuals who have dyslexia.
Some of these technologies to help identify the condition include DTI (Diffusion Ten-
sor Imaging), EEG (Electroencephalography), ERP (Evoked Response Potential), and
MRI (Magnetic Resonance Imaging). DTI (Diffusion Tensor Imaging) is technology
branching from MRI (Magnetic Resonance Imaging) and is used generally to detect
and investigate the white matter and fibre in the brain, and can be used for multiple
learning disorders beyond just dyslexia as well as other brain-oriented diseases like
Alzheimer’s disease and Parkinson’s Disease [11]. The DTI technology provides the
ability to do extremely detailed investigation into white matter damage in the brain and
is used in practice to investigate both the macro structural and microstructural integrity
of white matter. MRI (Magnetic Resonance Imaging) is used for bigger and more over-
all investigations of the human body and is done by forming images of the human body
through magnetic fields in combination with chemical contrast agents [12]. MRI tech-
nology is frequently used in practice to aid the identification and investigation of dif-
ferent cancers as well as neurological illnesses and conditions like dyslexia, Alz-
heimer’s disease, and schizophrenia. As with all technologies, MRI technology does
not come without any form of drawbacks and many researchers have investigated the
effect of the chemical composition, that is needed for the MRI technology to produce
imaging, on the human body and many are actively trying to determine if those chem-
icals are actually damaging the organs of people who go for these scans [13]. EEG
(Electroencephalography) is technology that makes use of elctrophysiological monitor-
ing to investigate and record the electric activities in the human brain and is generally
used mostly for the identification and possible treatment of more physical problems
like brain trauma and other injuries to the head, but can also be used to investigate some
diseases that are of a neurological origin like dementia [14]. Despite the fact that EEG
technology is more commonly used with more physical problems with the human brain
does not mean it has no place to be leveraged when it comes to dyslexia and other
diseases that are neurological in nature. Many studies have been conducted using EEG
technology to help identify dyslexia and dyslexic traits or tendencies in individuals as
well as the EEG technology being leveraged to help create a treatment and rehabilita-
tion program with great success in helping children who participated to better their
reading skills and speeds by quite a big margin [15]. Evoked potential is a method that
also employs the use of visual, auditory, and sensory stimulation and subsequently us-
ing electric signal monitoring. There are different types of evoked potential studies to
investigate neurological deficiencies, which include VER (Visual Evoked Responses),
BAER (Brain stem Auditory Evoked Responses), and SSEP (Somatosensory Evoked
Potentials), and these different studies all focus on different cognitive brain functions
[16].
4

3.1 Identification of Dyslexia

There are quite a few technologies that can be leveraged to identify dyslexia and dys-
lexic traits in individuals but one important aspect that has been reiterated by so many
researchers is the fact that early identification of the disorder is very important to be
able to help the individual to overcome their difficulties and problems caused by dys-
lexia. Once dyslexia or dyslexic traits has been identified and diagnosed in an individ-
ual, the individual can start looking at sources that can aid in overcoming the disorder,
like assistive technologies to aid studying and therapy to learn how to deal with the
disorder in everyday life. A study looking at the use of assistive technologies and how
it is impacted by the social structure of everyday life found that individuals who use
assistive technologies are more likely to abandon the use thereof if these technologies
excludes them or makes them feel different in any way to their peers [17]. It is also
recommended that individuals who are diagnosed with dyslexia should undergo therapy
since a lot of people never come to acceptance with the fact that they have the disorder,
which in turn makes it much more difficult to rehabilitate and overcome the disorder.
It is important to distinguish between assistive technology and learning technology be-
fore any further findings and statements can be made. In a broad overview, learning
technology can be explained as technology that is used to help an individual to learn
[18]. Assistive technology, on the other hand, can be described as technology that is
assistive, adaptive, and rehabilitative in nature and is designed to aid individuals with
learning disabilities, who struggle to learn with the normal medium and resources pro-
vided [17]. Although these technologies are very similar in the sense of helping and
aiding individuals to learn, they are used by different demographics and under different
circumstances. Even though there are amazing assistive technologies available to aid
students, there is still a socio economic factor that causes most individuals that are suf-
fering from dyslexia to not be able to obtain access to these technologies because of
financial or other similar reasons. The implementation of assistive technologies is no
simple task either, and comes with both positive and negative aspects [19]. Some ad-
vantages coming with assistive technology implementation include access to new in-
novative technology and that the school will have expertise knowledge on the assistive
technology. Some of the drawbacks of implementing assistive technologies include ex-
pensive training, long implementation time and a lot of funding required to make the
implementation successful [20]. It is very important, despite the cost implication of
implementing assistive technologies that schools attempt to create a safe and inclusive
learning environment for students who are affected by dyslexia and other neurological
disorders, through the means of different assistive technologies as well as an interactive
classroom environment [21]. The way a teacher runs or presents his/her class can make
a big difference when they have knowledge and understanding on different cognitive
disabilities and can help a student with a learning disability to fit in much easier [22].

3.2 Assistive Technologies for Dyslexia

One of the most popular assistive technologies to aid students with dyslexia is the use
of speech recognition software which helps students that struggle with cognitive prob-
lems like reading and writing by allowing these students to speak the sentence they
 5

wish to convey. The software takes a recording of the spoken sentence and breaks it
down into individual sounds, and by making use of different algorithms, will analyse
the individual sound and will then write down a word that it finds most similar to the
spoken word [23]. More research efforts have gone into using speech recognition soft-
ware as a base and branching into more specific assistive technology like fully auto-
mated closed captioning. Fully automated closed captioning is technology that lever-
ages speech recognition software to produce very accurate captions on video material
for students that may struggle with their hearing cognition [24]. Speech recognition
software has not only helped students to improve their learning ability, but also to boost
their confidence since many students have no problem speaking, but because of the
effects of the disorder, struggle with their reading ability [23]. Another frequently used
assistive technology is text-to-speech software and would basically work in the com-
plete opposite way as speech recognition software, catering for the students who have
trouble puzzling together the words they hear in a way that makes sense or even more
commonly used for students who have visual issues. Text-to-speech technology is a
form of speech synthesis that takes text as input and converts this input into a voice
generated output which enables the student to listen to what is written down instead of
having to see and read the text [25]. One study in particular shows that readers who
were using a text or speech assistive software were able to read at about 165 words per
minute, while the average reader is at about 200 words per minute, showing that even
though these software technologies are able to help people, they are still producing re-
sults that are 17% less effective than the average reader [26]. Another highly techno-
logical innovation which has been uncovered to aid students with dyslexia and other
learning disabilities, is the smart pen. The smart pen is a pen that can be used by stu-
dents in a very similar way to that of writing with a normal pen, but the smart pen has
technology built in that records words that are spoken and synchronizes them with
words that a user has written down on a special paper [27]. The biggest concern about
the smart pen that was raised by users has to do with privacy issues, where the users
are not comfortable with their conversations being recorded, seeing as the smart pen
records spoken word in order to perform synchronization with the written words on the
paper [27]. Another widely used assistive technology for students with dyslexia, is spell
checking software. Spell checking software checks the spelling and sentence structure
of the words the user is typing and has the ability to correct words that are misspelled
and indicate where a phrase or word has not been used correctly [28]. One more me-
dium exists that also plays a very important role in the field of assistive technologies,
and that is the use of multimedia devices like smartphones, tablets, and even desktop
computers. In recent years there has been an immense increase in the amount of appli-
cations being created for assisting students with their learning journey, because almost
everyone in today’s society has a smart phone or tablet and can leverage these devices
to gain access to software applications aimed at assisting them in a way tailored espe-
cially for the learning disorder they might associate with [29]. The ability to leverage
multimedia devices as a host or platform where assistive technologies can be used en-
ables developers to really customize and develop user interfaces and features specifi-
cally tailored to the exact needs and preferences of students with learning disabilities
[30]. Another example of software that can be used to help students with dyslexia is the
use of courseware. Courseware is software that assists students through the means of
6

any multimedia device that can be used in schools or even for self-improvement and
studying at home, and is presented in the structure of an academic course, with different
work pieces, assignments, tests, and self-evaluation exercises [31].

3.3 Accessibility and Inclusiveness of Assistive Technologies

Even though there are amazing technologies available nowadays in the field of assistive
technologies, the reality remains that there is a big financial gap between the people
who are able to obtain access to these technologies and those who cannot. It was found
that through primary, secondary, and tertiary school structures in Nigeria, assistive
technologies for students with visual impairments only have an availability rate of 3%
to 6%, assistive technologies for the hearing impaired only have an availability rate of
2% to 4%, assistive technologies for students who are affected by learning disabilities
only have an availability rate of 2% to 8% [32]. The biggest obstacle in today’s world
is the accessibility to these technologies and how the education system can become
more inclusive towards students with learning disabilities. Because students with dys-
lexia, or any other cognitive illness for that matter, perceive situations in life differently
than other students, it can be a difficult task for teachers to include them into their
studying methodology without any flaws [33]. Different studies have already confirmed
accessibility to assistive technologies as a problem in not only the educational system,
but also in society. As such, even regular activities, like working on the internet be-
comes a problem for these students [34]. An innovative attempt to solve the problem of
navigating and accessing the web for students with dyslexia is the use of a customized
toolbar to improve web accessibility. The aim of this technology is to provide a web
browser extension that allows students with dyslexia to customize the web pages to
their liking and to have it in a way that they understand and feel comfortable working
with [35]. More research into web accessibility, specifically with dyslexic users, shows
that these users experience problems very similar to most users, which shows that de-
velopers do not necessarily have to go to extremes with their development and design
in order to include these users who have different disabilities [36]. Some of these prob-
lems that are experienced when using the web include confusing design layout, no clear
navigation method, making poor use of colors in design, small and unreadable text, and
overcomplicated use of language. Inclusive design can be seen as developers under-
standing diversity in a population of potential users and addressing the diversity to de-
liver a design or product that is suitable for all the different users [37]. Design that is
more focused on specifically dyslexic users usually incorporate the above mentioned
qualities, as well as being minimalistic and incorporating the use of plain, easy to read
and understand language and sentence structure [36]. Taking into account that accessi-
bility is a big issue with assistive technologies, there are quite a few communities that
are trying to fix the issue by establishing an online environment where individuals have
open source access to assistive technology software, with the goal that individuals in
society can benefit from this and that the adoption of assistive technologies in schools
can increase to help learners overcome their learning difficulties and improve their live-
lihood [38]. The idea behind this online “directory” of open source software is to create
an environment where developers can come together and contribute their ideas and
software solutions that can be used freely by anyone who may not necessarily have the
 7

financial means to obtain help in another way. Another problem that was briefly
touched on in this study is not only the accessibility of the technologies but the aban-
donment thereof even when students have access to it. The biggest contributing factor
to abandonment of assistive technology can be attributed to students and individuals
not accepting that they have a condition or an illness, as well as other conditions that
may be caused because of the knowledge of their illness, like depression and anxiety
[39]. More factors contributing to the abandonment of assistive technologies include
financial reason, where users may not be able to sustain the use of the technologies
financially and the fact that the use of these technologies make the users feel different
than their peers. These statements are further backed up by research findings that the
use and idea of assistive technologies are still very foreign and alienated in the minds
of society and have not yet been accepted into their norms of living, and thus causing
the users of these technologies to feel self-conscious and out of place [40]. Cultural
diversity is also a factor that comes into play when investigating the accessibility that
students have to assistive technologies. Some researchers have made statements that
the first thing to do when trying to remediate the inaccessibility to assistive technologies
is to try and close the gap between the different cultures and their ability to obtain these
technologies [41]. Steps that can be taken to achieve this include aiding schools in more
rural areas to incorporate assistive technologies into their classrooms and to provide
training and courses for teachers to be able to teach and run the classroom in a more
inclusive manner. By incorporating these changes students from all cultures have a bet-
ter chance at obtaining aid as well as different cultural societies may learn more about
dyslexia and other cognitive disabilities which can lead to a more accepting and inclu-
sive society outside of an academic view [42]. Establishing a culture of inclusive design
and development will greatly benefit these individuals in the academic world and in
society as a whole.

4 Conclusion
It is found in this study that a very large number of research articles are based on a
young population who are affected by the dyslexia learning disability, which stems
from researchers having found that it is very important to identify and start treating the
condition at a young age to be able to see more effective results. It was found that there
are numerous assistive technology innovations and products available in the industry
and that these technologies come with both positive as well as negative impacts for the
students that are able to obtain and use them. The acceptance for assistive technologies
and even people who are seen as “different” because of their cognitive disabilities are
still very low in society, making it extremely difficult for these students to be able to
adapt and fit into the educational systems that are in place. This leads to a high rejection
rate of assistive technologies. More problems leading to students not being able to fit
into the educational system are results of teachers not understanding and having enough
knowledge of cognitive disabilities or schools not being able to incorporate a more in-
clusive learning experience because of the expenses involved in obtaining and incorpo-
rating the needed technological solutions. The main problem that arose after investigat-
ing numerous research, was that assistive technologies are extremely inaccessible to
8

individuals since it is generally very expensive or it simply is not available in a lot of

areas where the residents are in a low socio-economic class, such as some third-world
and developing countries. The main problem of the accessibility to assistive technology
should be addressed around the world and how these technologies can be made availa-
ble in a financially sustainable way.

Acknowledgement. Publication funded by NRF UID/127494.

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