Current Status of Treatments for Dyslexia: Critical Review

Abstract

The acquisition of reading is a complex neurobiologic process. Identifying the most effective instruction and remedial intervention methods for children at risk of developing reading problems and for those who are already struggling is equally complex. This article aims to provide the clinician with a review of more current findings on the prevention and remediation of reading problems in children, along with an approach to considering the diagnosis and treatment of a child with dyslexia. The first part of the review describes interventions targeted at preventing reading difficulties in the at-risk younger child. The second part of the review discusses the efficacy of approaches to treat the older, reading-disabled child ("intervention studies"). Factors that impact the response to treatment are also discussed, as are neuroimaging studies that offer insight into how the brain responds to treatment interventions. With appropriate instruction, at-risk readers can become both accurate and fluent readers. In contrast, although intensive, evidence-based remedial interventions can markedly improve reading accuracy in older, reading-disabled children, they have been significantly less effective in closing the fluency gap. Owing to the dynamic course of language development and the changes in language demands over time, even after a child has demonstrated a substantial response to treatment interventions, his or her subsequent progress should be carefully tracked to ensure optimal progress toward the development of functional reading and written language skills.

The Effects of Two Training Programs Regarding Reading Development among Children with Reading Disabilities

“…Longitudinal intervention studies in different countries have demonstrated that phonological awareness training improves phonological and reading skills in novice readers, at-risk and reading disabled children (Alexander & Slinger-Constant, 2004;Ball & Blachman, 1988;Elbro & Petersen, 2004;Lundberg, Frost & Petersen, 1988;Poskiparta, Niemi & Vauras, 1999;Schneider, Kuspert, Roth, Vise & Marx, 1997;Torgesen, Morgan & Davis, 1992). The transfer effects from improved phonological skills to improved reading skills seem to be enhanced when the instruction provides explicit links between phonemes and graphemes (Bradley & Bryant, 1983;Bus & van IJzendoorn, 1999;Ehri et al, 2001;Hatcher, Hulme & Ellis, 1994;Torgesen et al, 2001;Wise, Ring & Olson, 1999).…”

The impact of multisensory instruction on learning letter names and sounds, word reading, and spelling

“…It appears these three participants were treatment resisters, which meant they did not respond or were slower to respond to interventions (Alexander & Slinger-Constant, 2004;Berninger et al, 2000;, based on their lower levels and trends for letter name and sound, words read and spelled. Empirical evidence suggests treatment resisters require differentiated instruction that meet their individual needs (Berninger et al, 2000;Alexander & SlingerConstant, 2004).…”

“…Therefore, the body of research supporting multisensory structured language as efficacious for reading intervention is limited (Alexander & Slinger-Constant, 2004; and often inconclusive ). Yet parents often request it as a preferred form of reading intervention and this has led to an increase in litigation requesting multisensory instruction under the Individuals with Disabilities Education Act .…”

“…Alexander and Slinger-Constant (2004) suggests reading requires attention to sensory input to map representations, such as phonological and orthographic representations, to neural substrates (Alexander & Slinger-Constant, 2004). It appears the lack of attention to incoming stimuli for 9DYS, 10DYS, and 11DYS made it difficult for them to map phonological and orthographic representations.…”

State-of-Science Review: SR-D7: Genetics and the Future Diagnosis of Learning Disabilities

“…Genetics can also help to target children most likely to profi t from interventions. Targeting is likely to be important because successful prevention programmes usually require extensive and intensive, and thus expensive, interventions (Alexander and Slinger-Constant, 2004;Hindson et al, 2005;Horowitz, 2004).…”