Chapter 2

Paradox of Dyslexia

One hundred years ago, in November 1896, a doctor in Sussex, England, published the first description of the learning disorder that would come to be known as developmental dyslexia. “Percy F.,... aged 14,... has always been a bright and intelligent boy,” wrote W. Pringle Morgan in the British Medical Journal, “quick at games, and in no way inferior to others of his age. His great difficulty has been—and is now—his inability to learn to read.”

In that brief introduction, Morgan captured the paradox that has intrigued and frustrated scientists for a century since: the profound and persistent difficulties some very bright people face in learning to read. In 1996 as in 1896, reading ability is taken as a proxy for intelligence; most people assume that if someone is smart, motivated and schooled, he or she will learn to read. But the experience of millions of dyslexics like Percy F. has shown that assumption to be false. In dyslexia, the seemingly invariant relation between intelligence and reading ability breaks down.

Early explanations of dyslexia, put forth in the 1920s, held that defects in the visual system were to blame for the reversals of letters and words thought to typify dyslexic reading. Eye training was often prescribed to overcome these alleged visual defects. Subsequent research has shown, however, that children with dyslexia are not unusually prone to reversing letters or words and that the cognitive deficit responsible for the disorder is related to the language system. In particular, dyslexia reflects a deficiency in the processing of the distinctive linguistic units, called phonemes, that make up all spoken and written words. Current linguistic models of reading and dyslexia now provide an explanation of why some very intelligent people have trouble learning to read and performing other language-related tasks.

In the course of our work, my colleagues and I at the Yale Center for the Study of Learning and Attention have evaluated hundreds of children and scores of men and women for reading disabilities. Many are students and faculty at our university’s undergraduate, graduate and professional schools. One of these, a medical student named Gregory, came to see us after undergoing a series of problems in his first-year courses. He was quite discouraged. Although he had been diagnosed as dyslexic in grade school, Gregory had also been placed in a program for gifted students. His native intelligence, together with extensive support and tutoring, had allowed him to graduate from high school with honors and gain admission to an Ivy League college. In college,Gregory had worked extremely hard and eventually received offers from several top medical schools. Now, however, he was beginning to doubt his own competence. He had no trouble comprehending the intricate relations among physiological systems or the complex mechanisms of disease; indeed, he excelled in those areas requiring reasoning skills. More problematic for him was the simple act of pronouncing long words or novel terms (such as labels used in anatomic descriptions); perhaps his least well-developed skill was rote memorization.

Both Gregory and his professors were perplexed by the inconsistencies in his performance. How could someone who understood difficult concepts so well have trouble with the smaller and simpler details? Could Gregory’s dyslexia— he was still a slow reader—account for his inability to name body parts and tissue types in the face of his excellent reasoning skills?

It could, I explained. Gregory’s history fit the clinical picture of dyslexia as it has been traditionally defined: an unexpected difficulty learning to read despite intelligence, motivation and education. Furthermore, I was able to reassure Gregory that scientists now understand the basic nature of dyslexia.

Over the past two decades, a coherent model of dyslexia has emerged that is based on phonological processing. The phonological model is consistent both with the clinical symptoms of dyslexia and with what neuroscientists know about brain organization and function. Investigators from many laboratories, including my colleagues and I at the Yale Center, have had the opportunity to test and refine this model through 10 years of cognitive and, more recently, neurobiological studies.

Myths of Dyslexia:

Mirror writing is a symptom of dyslexia. In fact, backwards writing and reversals of letters and words are common in the early stages of writing development among dyslexic and nondyslexic children alike. Dyslexic children have problems in naming letters but not in copying letters.

Eye training is a treatment for dyslexia. More than two decades of research have shown that dyslexia reflects a linguistic deficit. There is no evidence that eye training alleviates the disorder. More boys than girls are dyslexic. Boys’ reading disabilities are indeed identified more often than girls’, but studies indicate that such identification is biased. The actual prevalence of the disorder is nearly identical in the two sexes.

Dyslexia can be outgrown Yearly monitoring of phonological skills from first through 12th grade shows that the disability persists into adulthood. Even though many dyslexics learn to read accurately, they continue to read slowly and not automatically.

Smart people cannot be dyslexic. Intelligence is in no way related to phonological processing, as scores of brilliant and accomplished dyslexics— among them William Butler Yeats, Albert Einstein, George Patton, John Irving, Charles Schwab and Nicholas Negroponte— attest.

Putting It in Context

The phonological model crystallizes exactly what we mean by dyslexia: an encapsulated deficit often surrounded by significant strengths in reasoning, problem solving, concept formation, critical thinking and vocabulary. Indeed, compensated dyslexics such as Gregory may use the “big picture” of theories, models and ideas to help them remember specific details. It is true that when details are not unified by associated ideas or theoretical frameworks— when, for example, Gregory must commit to memory long lists of unfamiliar names—dyslexics can be at a real disadvantage.

Even if Gregory succeeds in memorizing such lists, he has trouble producing the names on demand, as he must when he is questioned on rounds by an attending physician. The phonological model predicts, and experimentation has shown, that rote memorization and rapid word retrieval are particularly difficult for dyslexics.

Even when the individual knows the information, needing to retrieve it rapidly and present it orally often results in calling up a related phoneme or incorrectly ordering the retrieved phonemes. Under such circumstances, dyslexics will pepper their speech with many um’s, ah’s and other hesitations. On the other hand, when not pressured to provide instant responses, the dyslexic can deliver an excellent oral presentation. Similarly, in reading, whereas nonimpaired readers can decode words automatically, individuals such as Gregory frequently need to resort to the use of context to help them identify specific words. This strategy slows them further and is another reason that the provision of extra time is necessary if dyslexics are to show what they actually know. Multiple-choice examinations, too, by their lack of sufficient context, as well as by their wording and response format, excessively penalize dyslexics.

But our experience at the Yale Center suggests that many compensated dyslexics have a distinct advantage over nondyslexics in their ability to reason and conceptualize and that the phonological deficit masks what are often excellent comprehension skills. Many schools and universities now appreciate the circumscribed nature of dyslexia and offer to evaluate the achievement of their dyslexic students with essays and prepared oral presentations rather than tests of rote memorization or multiple choices. Just as researchers have begun to understand the neural substrate of dyslexia, educators are beginning to recognize the practical implications of the disorder. A century after W. Pringle Morgan first described dyslexia in Percy F., society may at last understand the paradox of the disorder.

Quoted from: Shaywitz, Sally E. “Dyslexia.” Scientific American, vol. 275, no. 5, 1996, pp. 98–104. JSTOR, www.jstor.org/stable/24993452. Accessed 4 Nov. 2020.