Dyslexia is a common learning disability amongst people in the United States as well as throughout the world. Initially called word-blindness, “those with dyslexia struggle to break words down into their smallest constituent parts, making language learning an arduous process.”[1]Dyslexia is has been discovered to be immensely common among children in America; dyslexia is estimated to affect 7-12% of children in the U.S.[2]The relatively high frequency of this learning disability, as well as the somewhat paradoxical nature of its symptoms, has made the understanding of dyslexia an important and challenging area of research. The long history of dyslexia shows us that it was first recognized 150 years ago, and the medical community has continued to debate this condition over time. To better understand this process, this essay asks:When did experts first define dyslexia, and how have their definitions and diagnostic tests for dyslexia evolved over time?
I argue that, since its discovery less than 150 years ago, the definition of dyslexia has taken a deeper and more nuanced understanding. Early experts found themselves struggling to distinguish the problem at hand as they could not find anything wrong with many of their patient’s vision abilities. Additionally, early researchers grappled with separating their patient’s difficulties from other medical conditions such as brain trauma or brain lesions. Dyslexia was first discovered in 1877 by German neurologist Adolf Kussmaul who observed the phenomenon of word-blindness amongst people who struggled with deciphering text and reading words in the correct order effectively[3]. Nearly a decade later an ophthalmologist named Rudolf Berlin coined the term “dyslexia”. The word dyslexia is derived from the Greek word that stands for “difficulty with words.”[4]Berlin used the term as an explanation for the case of a young boy who had severe impairments in reading and writing despite exhibiting normal intellectual abilities. Concurrently, James Hinshelwood, James Kerr, and William Pringle Morgan examined word blindness beyond the isolated symptom but specifically studied cases involving children. This work involving children was an essential step in the study of dyslexia because it removed other potential explanatory variables, such as brain trauma or neglect.[5]
Rudolf Berlin’s study of dyslexia involved many different case studies, investigating the reading abilities of several different patients. “Herr B.”, 66 years old, was Berlin’s first patient and complained of struggling to read which caused him to have difficulty with being efficient at is job as a civil servant.[6]In the text “Bulletin of the Orton Society,” author R.F. Wagner summarizes Berlin’s observations, “’Herr B.’ was able to read the first few words, then stopped and complained that he could not go on with reading. Physical examination revealed that vision was quite normal…he simply could not go on reading.”[7]This first study was puzzling to Berlin as he could not find any issues with the vision of “Herr B.” but it was evident that there was something that was hindering his ability to complete his reading of the text. Following Berlin’s initial study, he continued to collect data from several other case studies of the course of 23 years. Throughout his studies, Berlin observed a similar trend amongst his patients “their reading halted abruptly after three to five words, read aloud or silently.”[8]Berlin is described to believe that his patients were suffering from brain lesions which resulted in their inability to read. Although Berlin’s claim has been disproved, his initial studies caused interest for other scientists to look deeper into this disability.
Since Berlin’s initial findings, defining dyslexia has become far more specific and not all dyslexic individuals necessarily have the same diagnosis. Experts have broken dyslexia into several different branches, each one focused upon a specific issue associated with ability to read and analyze text. The most common type of dyslexia is phonological. People with this learning disability exhibit a disconnect between sounds of language and their written equivalent. This leads to difficulty in sounding out words. Surface dyslexia is another form of dyslexia that involves an individual’s ability to recognize and remember words. Decoding abilities becomes the main factor in this specific diagnosis. This disability causes individuals to struggle with remembering how words sound when spoken or are spelled because their spelling does not necessarily match the way they sound. Some examples of words that people who have surface dyslexia may struggle with are “know,” or “gnat” because they are not spelled the way they sound due to the combination of consonants. Words such as, “red,” or “cat” are easier to read because when spoken, they sound exactly as they are spelled.
Other types of dyslexia include, visual dyslexia, rapid naming deficit, and double deficit dyslexia. Visual dyslexia is often related to similar aspects of surface dyslexia when students struggle to identify words just by looking at them. The reasoning behind visual dyslexia is the assumption that children simply cannot recall what the word should look like and therefore cannot recognize it by sight. Rapid naming deficit also affects one’s ability to identify words and can be defined as one’s inability or difficulty in identifying a word immediately. Those who exhibit signs of rapid naming deficit typically cannot remember the meaning of the word right away, it typically will take the individual longer to come to an answer. Although it is more common for children to be diagnosed with only one form of dyslexia, double deficit dyslexia occurs when a patient exhibits the characteristics of someone who has phonological but also rapid naming deficit dyslexia.[9]
In comparison to Berlin’s initial evaluations, today’s methods continue to be more advanced and a longer, more efficient process. It is necessary to consider the patient’s current age and how their abilities have evolved over the course of their life thus far. According to the International Dyslexia Association, “the profile of strengths and weaknesses of an individual with dyslexia varies with age, educational opportunity and the influence of co-occurring factors such as emotional adjustment, ability to pay attention in learning situations, difficulties with health or motivation.”[10]Taking all of these factors into consideration, it becomes evident that including this information alone demonstrates how far the evaluation and diagnosing of dyslexia has come.
Starting from solely evaluating one’s efficiency in reading text, testing and investigating one’s abilities has come a long way since Berlin. Diagnosing dyslexia today requires a very thorough investigation of the patient and their current abilities. Research in the following areas are considered very common during today’s testing: family History and early development, early childhood and primary school grades, as well as middle and secondary school.[11]Granted, it is dependent upon where the patient is currently at development wise when it comes to evaluating these different points in his or her life. Each of these points in development search for specific areas of efficiency that tend to result in the development of dyslexia. Family history and early development search for family related impact such as family history in trouble with reading but also take a look at prenatal treatment as well as if there were any notable delays during the patient’s development of speech. The evaluation of the patient’s first experiences with developing speech are tied included in “difficulty with rhyming, blending sounds, learning the alphabet (and) linking letters with sounds.”[12]This point in development is more closely related to early childhood specifically in children that are in pre-kindergarten and kindergarten. Children who are dyslexic may demonstrate a heightened ability in listening comprehension in comparison to reading comprehension. As patients become older, early to late teens, other areas of research are considered during evaluation. Identified problems are more clear and easier to identify as dyslexic children at this age tend to be, “reluctant readers…slow, word-by-word readers…very poor spellers…may have the tendency to mispronounce common words…weak vocabulary knowledge and use;”[13]additionally, children at this age continue to be superior in listening abilities in comparison to their reading comprehension. Breaking down a patient’s development in this way allows experts to pinpoint specific signs that are relative to particular points.
The patient is questioned about his or her background including family history and testing his or her level of intellectual ability (IQ). Additionally, experts must conduct observations, interviews of the patient, parents and educators as well as distribute a series of testing. It is important to understand what kind of behaviors a student is exhibiting and why testing might be necessary. According to the International Dyslexia Association, the current dyslexia test studies the patient’s oral language skills, word recognition, decoding, spelling etc. Investigating a patient’s oral language skills is seen as one of the first steps to determining if a child should be tested for dyslexia. Individuals may exhibit strong efficiency in oral skills but cannot perform at the same high level in their writing or reading skills. Individuals who experience these challenges are typically suggested to go through with further testing. Word recognition, decoding and spelling focus on a patient’s ability to read and work through printed texts. Those who have dyslexia will struggle with remembering the definition of a word when it is listed alone without any context that may act as a clue to the patient. Spelling and word decoding involve breaking down words into groups in order to understand the combinations of letters and what kind of sounds these combinations make when spoken.[14]
Dyslexia is immensely common amongst children throughout the world. Children in the United States experience the setbacks of this learning disability and it is important that the best methods are available to these individuals so they can be given the accommodations necessary to perform well in everyday life. Initially called word-blindness, the evolution of defining dyslexia and what factors play into it have come a long way in its 150-year history. The commonality of this disability is what provoked my research in analyzing the evolution of dyslexia.
Reference List:
Kirby, P. (2018). WHAT’S IN A NAME? “Word blindness” was a recognised condition more than a century ago. But it was not until the 1970s that it began to be accepted by the medical establishment. History Today, 68(2), 50. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=ahl&AN=127141509&site=ehost-live&scope=site
Sawyer, Diane J., Jones, Karen M. (2018) “Testing and Evaluation” International Dyslexia Association. https://dyslexiaida.org/testing-and-evaluation/
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyslexia/different-types-of-dyslexia
4. Wagner, R.F. Bulletin of the Orton Society (1973) 23: 57. https://doi.org/10.1007/BF02653841
5. http://www.dyslexia-aware.com/dawn/history-of-dyslexia
[1]Kirby, P. (2018). WHAT’S IN A NAME? “Word blindness” was a recognised condition more than a century ago. But it was not until the 1970s that it began to be accepted by the medical establishment. History Today, 68(2), 50. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&AuthType=cookie,ip,uid&db=ahl&AN=127141509&site=ehost-live&scope=site
[2]Kirby, P. (2018). WHAT’S IN A NAME? 50.
[3]http://www.dyslexia-aware.com/dawn/history-of-dyslexia
[4]http://www.dyslexia-aware.com/dawn/history-of-dyslexia
[5]http://www.dyslexia-aware.com/dawn/history-of-dyslexia
[6]Wagner, R.F. Bulletin of the Orton Society (1973) 23: 57.
[7]Wagner, R.F. Bulletin of the Orton Society (1973) 23: 60.
[8]Wagner, R.F. Bulletin of the Orton Society (1973) 23: 61.
[9]https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/dyslexia/different-types-of-dyslexia
[10]Sawyer, Diane J., Jones, Karen M. (2018) “Testing and Evaluation” International Dyslexia Association.
[11]Sawyer, Diane J., Jones, Karen M. (2018) “Testing and Evaluation” International Dyslexia Association.
[12]Sawyer, Diane J., Jones, Karen M. (2018) “Testing and Evaluation” International Dyslexia Association.
[13]Sawyer, Diane J., Jones, Karen M. (2018) “Testing and Evaluation” International Dyslexia Association.
[14]Sawyer, Diane J., Jones, Karen M. (2018) “Testing and Evaluation” International Dyslexia Association. https://dyslexiaida.org/testing-and-evaluation/