Motivation and emotion/Book/2015/Dyslexia and anxiety in children

Overview
The foundations of education are grounded in early childhood when one begins reading and writing. For people suffering from Dyslexia these simple early steps that map the way for learning are impeded in many different ways. The severity of Dyslexia can range from mild to severe and is considered to be neurological in its origin with cognitive components. Research suggests that it has some hereditary roots (Habib, & Giraud, 2013). Dyslexia or Specific reading disability, as it is now known in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has no impact on intelligence. Most people, especially children who have the disorder, have a normal desire to learn and participate. Early diagnosis is imperative for the implementation of successful intervention plans. Initial testing may include intelligence testing where results do not indicate below average intellect. There is no hearing or vision problems despite some people feeling like their sight is impeded - eye examinations do not indicate that there any sight impairment (Snowling & Hulme, 2012). When all of these factor appear normal the process of learning can come at the price of anxiety and frustration. Anxiety that is felt as a result of poor academic performance due to dyslexia can inhibit the child's behaviour through either withdrawing or acting out. Implementation plans by teachers and parents can help relieve stress and anxiety in children suffering dyslexia through a number of strategies.

This chapter aims to address the following questions:
 * What is dyslexia?
 * How is anxiety related to dyslexic children?
 * What implementation stratergies to help ease anxiety in dyslexic children?



What is dyslexia
Dyslexia is a neurological based disorder that is categorised by continued difficulty with reading and persistent confusion or inability to spell words correctly.

Life Example:
Consider Eric; Eric started primary school at the average age of five like his older siblings. It was noted by both his parents and the school teaching staff that Eric had difficulty learning his alphabet and sounds. Even with extra classroom help Eric struggled.

NB: Eric, the subject of the life example is a child known well to the author of this wikiversity page.

Symptoms:
Quote from the International Dyslexic Association.

"Dyslexia is a specific learning disability that is neuro-biological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge." (http://dyslexiaassociation.org.au)

Symptoms are dependent on the type of dyslexia and severity. Individual’s experiences are unique and varied. The most common symptoms of dyslexia is the addition, subtraction, transposition, substitution and or reversal of letters, numbers and or words, reading and rereading words or sentences with little or no comprehension, trouble learning new words, consistently spelling words phonically, confusion of the letter order in words, trouble with recognising and remembering sight words.

Some suffers note that sentences or words written on a page will move, change, and blend into one another or swirl together when trying to focus, as shown in Figure 2.

Life Example:
Eric's handwriting was also poor and he often transposed his letters and numbers. By the age of seven and in Year two his writing quality was poor and resembled that of a younger child. Eric would avoid reading at all costs and explained that he had trouble seeing the words. He expressed that the words often overlapped on the page and sentences would merge on top of each other. Eric struggles with sight words and fails to recognise words that he has just read or seen.

Diagnosing dyslexia and reading disorders:
Parent and teacher observations of learning behaviour in a child will generally be the first gauge on a child’s learning disability. As Dyslexia has been found to have genetic origins, family history can be a good predictor and indicator of learning disorders (Habib, & Giraud, 2013; Snowling, & Hume, 2012).

Two tests that have been used successfully in the diagnosis of dyslexia in children are listed in the graph below. The aim of both the tests is to recognise phonological defects, accuracy and fluency in the formation, sound, and shapes of words and letters. The most successful course of implementation comes after early diagnosis (O'Shaughnessy,2003).

Tests can be administered to both large groups of children or to individual children. Tests should be administered at the beginning and the end of each school term to monitor progress; early intervention strategies can be implemented for students who fall behind in progress or score considerably lower to aid in their learning (O'Shaughnessy, 2003).

Often a child with learning difficulties will have normal hearing and eye sight, and scores on the Weschler Intelligence scale for children, Fourth Edition (WISC-IV) are not reflective of a child’s learning disability (Habib, & Giraud, 2013; Snowling, & Hume, 2012).

Life Example:
Although Eric's father has never been officially diagnosed with dyslexia, he sees a lot of his own learning behaviours in his son: often spelling words phonetically; poor handwriting; and both read very little for pleasure. Eric and his father both show similar intelligence when it comes to mental arithmetic and spacial awareness tasks. Both father and son have good memories and are also proficient in arithmetic. Due to the similarities in their behaviours, it was Eric's father who first expressed concern over his son’s educational progress compared to that of his other two children.

Different types of dyslexia:
There is much debate about how many forms of the condition exists and the research is varied on how many types of dyslexia there actually are (Castles & Friedmann, 2014). The DSM-5 lists dyslexia as a learning disorder that has replaced ‘reading disorder’, where the DSM-5 now refers to the condition as a 'decoding error in reading skills' where, generally speaking, a child has difficulty with fluency of reading, spelling, hand writing and comprehension.

Phonological/Primary
This is the most common form of dyslexia and is an extreme difficulty in reading. Research suggest it is a dysfunction in the left side of the brain, namely the cerebral cortex. Severity can differ from person to person and does not change over the course of their lifespan. People who suffer from Phonological Dyslexia learn to cope through various intervention strategies. It has been found that the earlier these interventions are implemented, the more successful they are (Snowling, & Hulme, 2014).

People suffering from Phonological Dyslexia often struggle their entire lives with reading, spelling and writing. The condition has been observed in all ethnic cultures and much research suggests it is a phonological deficit which remains across the lifespan. Improvements in adulthood are attributed to a persons coping mechanisms, rather than a reduction in the symptoms or a cure of the disorder. It has been found to have genetic roots and often runs in families. It is more prevalent in boys than girls (Snowling, & Hulme, 2014).

Developmental/Surface dyslexia
Children with this form of dyslexia do not experience difficulties with grapheme-phoneme sounds and have no issues sounding out non-words such as "gop" or "fow". However, children with this form of dyslexia can rely too heavily on grapheme-phoneme conversations and struggle with words in the English language that have silent letters or which are spoken differently to their phonetic sound. For example the "w" in the word "answer" and the "bl" in the word "blood". Children who struggle with this recognise less sight words that their classmates or peers (Castles, Friendmann, 2014).

Trauma dyslexia
This form of dyslexia becomes noticeable after brain injury or illness that affects the area of the brain that is responsible for reading and writing such as Broca's area (Paulesu et al, 1996; Snowling & Hulme 2012).

Theories
Much research has been done into what causes Dyslexia but there have been few empirical findings. Dyslexia is considered a neurological disorder that is genetic in its origins. However the cognitive and biological causes still remain unconfirmed. There are many theories, the strongest are discussed below (Ramus 2003):

The phonological theory
The phonological theory focuses on the dyslexic’s impairment in the rehearsal and/or storage of speech sounds. Grapheme-phoneme correspondences are the smallest units of sound in language. When there are disruptions in the way a person perceives, relays, stores or receives these small units, a phonological misrepresentation occurs. This misrepresentation correlates a direct link between the cognitive and the behavioural problems of dyslexia.

There is more support for this theory than any other with proponents believing that most dyslexics suffer from a phonological defect (Snowling, & Hulme, 2012; Ramus et al 2003).

The visual theory
This theory suggests that the cause of dyslexia is a disruption of the magnocellular pathway when processing letters, numbers and words. The magnocellular pathways help with visual processing and are linked to the posterior parietal cortex. This theory does not rule out the phonological theory and there are weak links between the two theories as mentioned in research by Ramus and colleagues (2003).

The cerebellar theory
The cerebellar plays a role in the motor control and hence is used with speech articulation. Damage or dysfunction in the cerebellar could therefore inhibit the learning of the grapheme-phoneme sounds that are essential for communication. Brain scans have shown differences in the functioning of the dyslexic brain compared to that of individuals who were considered to have normal literacy functioning (Leonard et al 2001). This theory has a more complex link to the phonological theory (Ramus et al, 2003).

The magnocellular theory
Essentially this theory draws all the other underlying theories loosely together and focuses more on a general point of view than a specific one. The magnocellular theory relates to the visual theory and both agree that the cause is not just a dysfunction in the visual pathway but also in auditory function. This theory also suggests that large quantities of stimuli received by the brain can cause the cerebellar dysfunction, linking this theory to the cerebellar theory (Ramus et al, 2003).

The theory also states that there are functional abnormalities in the medial and lateral geniculate nucleus of the dyslexic brain which result in poor performance of tactile function (Livingstone, Rosen, Drislane, Galaburda, 1999). This theory draws together the main dyslexic dysfunctions in visual, auditory, tactile, motor and phonological manifestations (Remus et al, 2003).

Anxiety in Dyslexic children
Anxiety disorders are common in children but similarly to dyslexia, can go undiagnosed especially as anxiety can often be confused with normal childhood fears, concerns, and worries, and can be misdiagnosed as Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD). Children who suffer from dyslexia are more prone to suffering anxiety disorders and mental health problems than their peers (Jordon, 2014).

Starting school can be an exciting, nervous and anxious time for most children. It is generally at the beginning of their school career that children suffering from dyslexia notice differences in their learning skills, class performance and capabilities compared to their peers and become even more anxious (Alexander-Passe, 2014).

Studies by Thomson (1996) with children who suffer from anxiety induced by dyslexia, distinguished two different types of coping in school: Under-reaction; and over-reaction.

Under reaction is where a child will become withdrawn. Based on their previous disappointing performance these children often believe that they will fail and therefore don't try. This occurs, not just academically but contributes to an overall low self-esteem and loss of self-worth (Thomson, 1996; Alexander-Passe, 2014).

Over-reaction occurs when a child acts out to compensate for their academic abilities, for instance a child may become the 'class clown' and engage in inappropriate behaviours to mask their academic incompetence (Thomson, 1996; Alexander-Passe, 2014). Initially both reactions could be misinterpreted as attention deficit disorder and as such, are often misdiagnosed (Jordon, 2014).



Research into learning disabilities in children from primary school upwards to high school has showed higher levels of stress and anxiety that manifests into worry. Dyslexic children displayed a lower self-worth and overall general unhappiness than their more accomplished academic peers (Carrolls, & Iles, 2006). Even with considerable support from family and school, children suffering from dyslexia have a more negative self opinion and raised levels of general anxiety when it comes to their academic performance.

Riddick, Sterling, Farmer and Morgan’s (1999) undergraduate study of dyslexic students remains the strongest research into the conformation of the relationship between dyslexia, learning disability and anxiety. It has also provided evidence to support that although negative emotions and anxiety levels are high during the school years, these feelings and emotions generally diminish over time despite the dyslexia remaining prevalent (Riddick et al 1999; Carrolls, & Iles, 2006).

Life Example:
Eric has very poor self-esteem often using phrases such as, "I am dumb" and, "I can't do it" often before he has tried the activity. His frustration often see him display behaviours which disrupt the class. Eric appears anxious and will retreat to the corner of the room or hide under the desk if he is asked or required to read or perform tasks he deems will make him appear sub-standard in front of the class. This behaviour has progressed to the extent that he has had to be removed from the classroom to minimise disruption to the class.

Emotional theories of anxiety in dyslexic children
There have been several different theories that have been linked to learning disabilities and anxiety in children. Three of the theoretical explanations of anxiety and learning difficulties are (Nelson, & Hardwood 2011):

(Nelson & Hardwood, 2011)

Implementations to help children with dyslexia:
Research suggests links between anxiety disorders and dyslexia in children which are more psychosocial / environmental in their origins. Strong academic and family support for an individual suffering from dyslexia can help lower risks of any mental health disorders. The use of coping strategies and early intervention processes will also help to reduce or eliminate undue stress, poor mental health and anxiety disorders (Jordon, 2014).

In early interventions, the two key focal areas for teaching children with dyslexia are word decoding and single word identification. These strategies can help the child progress towards fluency and comprehension as their education career progresses (Shaywitz, Morris &, Shaywitz, 2008).

It is important that children who suffer with reading disabilities are given alternative means to acquire information and knowledge. Listening to recorded material is one of the simplest alternative ways, as it can focus the child’s attention on the literature and information without their attention being distracted by having to write the words (Jordon, 2014; Shaywitz et al, 2008).

Computer programs that offer functions such as print-to-screen and speech-to-print software help to reduce the child’s anxiety in regards to spelling, handwriting, and fluency enabling the child to focus on the information.

Other classroom practical suggestions include:


 * Extra time on written examinations and assignments should be given to allow for more thorough reading and understanding of instructions and questions.
 * Allowing participants to use hard copy produced by electronic whiteboards to reduce effort and confusion caused when copying from the board to a book.
 * Giving dyslexic children the opportunity to answer exam questions orally rather than in written form.
 * Not calling on dyslexic children to read in front of the class unless they feel comfortable and confident about doing so.
 * Allowing written work to be completed on a word processor or tablet to aid with spelling and grammar.

Life Example:
Eric is now loving school and looking forward to moving through his schooling years with his friends. With help from teachers who understand Eric’s condition they have implemented a few strategies in helping him cope. If Eric is feeling anxious and overwhelmed in class he can retreat to a quiet reading corner that has been created for the use of all the students. If the teacher notes Eric in the reading corner she will take a moment to listen to his anxieties and give him other activities like ‘Find-a-words’ or ‘Where’s Wally’ books which help him to refocus his attention and calm his anxiety. Eric also listens to audio books while following the written text in a book, he is encouraged to listen to these books several times and then reads the book to himself without the audio. Once he is feeling confident he then reads the book to a teacher or assistant before being paired with a younger student he can read the book too. Although this is a long process, it builds his confidence, self-esteem and literacy skills.

As with the example with Eric the main focus on reducing the anxiety in children with dyslexia is understanding, support and patience.

Conclusion
Dyslexia is a continued and persistent difficulty in the ability to read and write. It is often misdiagnosed as ADD or ADHD as behavioural problems are often a result of the reading disorder. Children often complain of problems with their eye sight despite eye examinations with normal results.

Dyslexia is found to have genetic origins and is more prevalent in boys than girls. Children with dyslexia can often display anxiety by withdrawing and becoming unproductive or acting out and becoming disruptive to the class.

Through early diagnosis and implementing positive strategies children can learn to manage their disorder despite the persistence of the condition through the lifetime.