Reintroducing Dyslexia: Early Identification and Implications for Pediatric Practice

Abstract

Dyslexia is a common learning disorder that renders children susceptible to poor health outcomes and many elements of socioeconomic difficulty. It is commonly undiagnosed until a child has repeatedly failed to learn to read in elementary school; this late diagnosis not only places the child at an academic disadvantage but also can be a precursor to psychiatric comorbidities such as anxiety and depression. Genetic and neuroimaging research have revealed that dyslexia is heritable and that it is undergirded by brain differences that are present even before reading instruction begins. Cognitive-behavioral research has revealed that there are early literacy skill deficits that represent red flags for dyslexia risk and can be measured at a preschool age. Altogether, this evidence points to dyslexia as a disorder that can be flagged by a pediatrician before school entry, during a period of heightened brain plasticity when interventions are more likely to be effective. In this review, we discuss the clinical implications of the most recent advances in dyslexia research, which converge to indicate that early identification and screening are crucial to the prevention or mitigation of adverse secondary consequences of dyslexia. We further highlight evidence-based and practical strategies for the implementation of early risk identification in pediatric practice so that physicians can be empowered in their ability to treat, educate, and advocate for their patients and families with dyslexia.The development of reading proficiency in childhood is a public health issue: literacy is a widely recognized determinant of health outcomes and is associated with many indices of academic, social, vocational, and economic success. 1 In a recent National Academy of Medicine summary, the author highlights that duration of education, which is highly dependent on reading proficiency, is a better predictor of health and long life than cigarette smoking or obesity. 2 Children skilled in reading perform better in school, attain higher levels of education, experience lower rates of disease, are less likely to be incarcerated or experience poverty, are more likely to find employment, and achieve higher average incomes as adults compared with children who fail to achieve reading proficiency. 3 For many children with reading impairments, however, the process of learning to read is rife with struggle and frustration, and these children are left susceptible to adverse secondary outcomes, including anxiety and depression. A neurobiologically based specific learning disorder, dyslexia, affects 5% to 10% of children 4,5 and is a persistent barrier to reading acquisition.

It’s Time to Be Scientific About Dyslexia

“…Audiologists, physical therapists, optometrists, and pharmacists may also seek a role despite the fact that these professions have no measures that can be employed to diagnose or treat dyslexia (or, indeed, other specific learning disabilities; Grigorenko et al, 2020). Sanfilippo et al (2019) advocated that pediatricians should seek to identify an early risk of dyslexia, and recommended that the medical community should become involved in national conversations about this condition. Perhaps medical interest will thrive in contexts where health insurance is increasingly used to fund clinical practice, although this does not sit easily with growing recognition that, as far as practice is concerned, reading disability is essentially an educational problem requiring an educational solution.…”

Investigating Issues and Needs of Dyslexic Students at University: Proof of Concept of an Artificial Intelligence and Virtual Reality-Based Supporting Platform and Preliminary Results

“…It is not surprising that a much has been done to improve the diagnosis of dyslexia, since it is universally acknowledged that recognizing it early, especially before the beginning of the school, is crucial to help affected people fill their learning gap [46][47][48]. However, we are still far from having a rigorous, systematic and widespread methodology to spot it at pre-school age [49]; therefore, the development of supporting strategies and tools for dyslexic people whose condition is found late is of paramount importance.…”

An Approach to Accessible Serious Games for People with Dyslexia

“…Although there is no cure for dyslexia, early evaluation and intervention produce the best results. Sometimes dyslexia goes undiagnosed for years and remains unidentified until adulthood, but it is never too late to seek help [26].…”