Dyslexia

and Carola Felchner, science journalist

Dr. med. Julia Schwarz is a freelance writer in the medical department.

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Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

In people with dyslexia (also: reading and spelling disorder, LRS), the ability to read and write is reduced. But that doesn't mean that dyslexics are less intelligent: they simply find it difficult to convert spoken language into written language and vice versa. Boys are more likely to be affected than girls. Dyslexia is usually diagnosed in elementary school age. It can be positively influenced by special funding. Read everything you need to know about dyslexia here!

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F81

Brief overview

Symptoms: differently pronounced, including Twisting, confusing or omitting letters, reading slowly, difficulty with upper and lower case. Psychological problems as a result of the reading and spelling disorder are also possible.
Causes: presumably genetic
Frequency: An estimated three to five percent of primary school children are dyslexic - boys around three times more likely than girls. Dyslexia can be found in all social classes.
Diagnostics: with the (pediatric) doctor via specific questions, hearing / sight and reading / writing tests
Treatment: targeted support measures, school relief (pressure of grades) and understanding
Prognosis: with early therapy, deficits can be reduced

Dyslexia: symptoms

Albert Einstein, Leonardo da Vinci and Galileo Galilei had something in common: They are not talking about their ingenuity - all three also had dyslexia, also called reading-spelling disorder (LRS) or special reading-spelling disorder. Dyslexia does not rule out a (high) talent in other areas. In the case of dyslexics, the other school performance is usually within the normal range. Studies suggest that those affected only have limited work in the areas of the brain that are responsible for reading and / or writing.

The symptoms of dyslexia can vary widely. Most people affected have both a reading disorder and a spelling disorder. But there are also dyslexics who only have one of the two disorders.

Symptoms of a reading disorder: Those affected often need a lot of time to start reading, usually read very slowly and misrepresent words. Often they leave out parts of the word, twist or replace them. They may swap letters or words so that they cannot properly understand what they have just read.

Symptoms of a spelling disorder: People often write words as they've heard them. Therefore, they often confuse letters (e.g. b with p, c with k or p with q). Sometimes they leave out letters completely (e.g. truth without "h") or insert them in the wrong order. They also often set word hyphenations incorrectly and have problems with upper and lower case letters.

Other signs: Dyslexia is a burden for affected school children. Since they have to laboriously work out unfamiliar words, they are often pressed for time in class work. The fact that they usually make a lot of mistakes is also psychologically stressful. Accordingly, (young) dyslexics often have little self-confidence and are afraid of school. Before exams, this can turn into panic attacks and / or physical symptoms such as abdominal pain. Even depression is possible.

Together with a reading and / or spelling disorder, impaired numeracy (dyscalculia) sometimes occurs.

Do not confuse this with reading and writing difficulties!

Dyslexia is different from "normal" reading and writing difficulties. The latter can occur intermittently, for example when a child is exposed to unfavorable psychosocial factors such as moving house or divorce of the parents. Genetic factors do not play a role here. The child can - with the help of child psychological support - solve his reading and writing problems again in most cases.

A reading and spelling weakness is only called dyslexia if it is genetically determined. Sometimes the term "special reading and spelling weaknesses" is used for this.

Special case: dyslexia

Dyslexia is a reading disorder that often occurs as part of dyslexia. It can vary in severity and be favored by genetic factors. Acquired dyslexia is more common than such a congenital dyslexia: Here the brain or the brain region responsible for reading has been damaged by an accident or a stroke.

Typically, the reading speed slows down dramatically in dyslexia. Often those affected do not understand what they have read, slip in line or twist letters.

A doctor can diagnose dyslexia through various examinations and a special test. With a lot of understanding, special support and an adapted performance evaluation in school, you can help affected children effectively.

You can read more about this in the article dyslexia.

Dyslexia: treatment

Dyslexia should be treated as early as possible. There are two reasons for this: On the one hand, funding measures are more promising if they are applied early on. On the other hand, if therapy is started early, depending on the severity of the disorder, there is less likelihood that those affected will drop out of school or find it difficult to get qualified vocational training.

The most important thing is: the affected child should experience a lot of understanding and patience from parents and teachers. Pressure to perform at home and at school can make dyslexia worse. The same goes for offenses by classmates. Such unfavorable reactions of the environment to the learning disorder can also increase the risk that the dyslexic will become mentally ill. The child must be withdrawn from this vicious circle as quickly as possible.

In addition, dyslexia can be positively influenced by targeted therapy measures. In most cases, extracurricular support is required for this. The children train with special reading and writing exercises. Rhythmic reading aids or computer programs are used.

Often the children need psychotherapeutic support in addition to support. This is especially true if an accompanying mental illness (such as depression) occurs. Depression can prevent the child from improving their literacy skills.

A disadvantage compensation (colloquially dyslexia-decree, LRS-decree) evaluates the school performance of a child with dyslexia differently in the sense of a "grade protection". In this way, disadvantages for the child resulting from the learning disorder are to be compensated and the child to be relieved of school pressure somewhat. This can also lead to stigmatization. Often, however, the affected child (and the family) is happy to have a diagnosis and, thanks to the “grade protection”, builds up self-confidence and self-esteem.

The compensation for disadvantages is determined in each federal state by the respective ministry of education. If a doctor has diagnosed the learning disorder using dyslexia tests, an application for such compensation can be submitted.

Dyslexia: causes and risk factors

The causes of dyslexia have not yet been clearly clarified. However, it is now assumed that genetic factors play a major role in the development of the learning disorder. Dyslexia often affects several members of a family.

In fact, several genes have been identified that have an impact on literacy. They are responsible for the development of those areas of the brain that perceive spoken language and convert it into written language.

Apparently, even in newborns with dyslexia, acoustic signals are perceived and processed differently. Furthermore, researchers observed that the brain areas that are responsible for language processing work less synchronously in dyslexia and are less networked. Those affected often find it harder to concentrate while reading.

In addition, the following factors can promote or accompany dyslexia:

Language Development Delays: Most children start two-word sentences by 18 to 24 months of age and can speak up to 50 different words. However, around 20 percent of children show delayed language development. Research has shown that around half of these children have dyslexia.

Psychosocial factors: Dyslexics can be found in all social classes. An unfavorable social milieu is, however, a risk factor for the development of the special reading and spelling weaknesses. If the parents' level of education is high, they support the child both emotionally and practically with learning and homework. This apparently counteracts reading and spelling problems.

Impaired visual perception: Apparently, the control of eye movements in dyslexics is impaired, which is why they can read slowly, for example. At the end of the sentence, children who read too slowly can sometimes no longer remember the content of the beginning of the sentence. Sometimes the so-called gaze jumps of the eyes are imprecise. Those affected then slip more easily in the line or skip words.

Weakened phonological awareness: Phonological awareness ensures that words are deciphered and understood while reading. It is weakened in people with dyslexia.

Dyslexia: examinations and diagnosis

If you suspect your child has dyslexia, see the pediatrician as early as possible. The sooner the learning disorder is diagnosed and treated, the better the prognosis. The doctor will first talk to you in detail in order to obtain important information for the diagnosis. Possible questions are:

How has your child developed so far?
When did your child start talking?
How is your child coping with homework?
Does your child like to go to school?
Does a family member already have dyslexia?

Various tests then follow. Their main purpose is to rule out other possible causes of reading and / or spelling problems. Various parameters are examined for this purpose, such as:

Hearing and vision impairment: Hearing or visual impairment can lead to symptoms similar to those of dyslexia. But it has to be treated completely differently. Therefore, it is very important to rule out such diseases.

State of the brain structure: The measurement of the brain waves (electroencephalography, EEG) can provide indications of damage to the brain structure, for example.

Reading and spelling skills: Both are tested by letting the child read aloud or write a small text.

Psychological well-being and the ability to concentrate: The doctor can use special tests to determine whether and to what extent the problems with reading and / or writing have an effect on the psyche of the little patient. These include, for example, the "Depression Test for Children" (DTK, a questionnaire) and the "Test Battery for Attention Deficits" (TAP).

Intelligence test: This can be used to determine whether the child's poorer performance compared to their peers can be attributed to lower intelligence (and not to a learning disorder). It is also determined how big the difference is between the intelligence and the efficiency in the spelling.

Dyslexia: course and prognosis

You cannot prevent dyslexia. However, it can be treated well with various therapeutic measures. Above all, if it is recognized and treated at an early stage, the deficits compared to non-dyslexics can often be significantly reduced. The reading disorder often improves faster than the spelling disorder.

Since dyslexia can put a lot of emotional strain on the affected children, there is always the risk of psychological problems. For example, the children develop fear of failure, fear of school, become listless and withdraw. Depressive moods and psychosomatic complaints such as abdominal pain or sleep disorders are further possible consequences. If dyslexia is recognized and treated early, such complications can often be prevented.

Additional information:

Books:

Dyslexia - LRS: Models, Diagnosis, Therapy and Support (Christian Klicpera, Alfred Schabmann, Barbara Gasteiger-Klicpera, Barabara Schmidt, UTB HmbH, 2017)
Dyslexia guide: recognize early. React correctly. Treat in a targeted manner. (Dr. med Gerd Schulte-Körne, Nikol, 2014)

Guideline:

Guideline "Diagnosis and Treatment of Children and Adolescents with Reading and / or Spelling Disorders" of the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy