Hard to learn

Although dyslexia is considered a learning disorder, there is no relationship between dyslexia and intelligence.

SOME people have a learning disability that leads to difficulty in learning and using certain skills. The skills that are usually affected are reading, writing, listening, speaking, reasoning, and doing mathematics.

The terms used for these disabilities are dyslexia, which refers to difficulties in reading and spelling; dysgraphia, which refers to difficulties in writing; and dyscalculia, which refer to difficulties in doing mathematics.

This article is about dyslexia, which is derived from the Greek works, dys (difficulty), and lexia (use of words). The symptoms range from the very mild to the very severe. People with dyslexia have difficulties with phonemic awareness, verbal memory and verbal memory speed.


Phonemic (or phonological) awareness is the ability to learn how speech sounds make up words, connecting the sounds to alphabet letters, and learning how to blend the sounds into words. Changes in the sounds lead to different words with different meaning. This ability is believed to be crucial in early reading and spelling development.

Verbal memory is the ability to remember a sequence of verbal information for a short time. Verbal processing speed is the time taken to recognise and process familiar verbal information, e.g. this speed is the time taken to recognise the letters, A, S, E, A and N, process it, and then realise that it refers to the Association of South East Asian Nations. Although dyslexia is considered a learning disorder, there is no relationship between dyslexia and intelligence. Dyslexia has been defined well by Shaywitz, who stated that, “Dyslexia is a reading difficulty in a child or adult who otherwise has good intelligence, strong motivation and adequate schooling … Dyslexia reflects a problem within the language system in the brain.”

Dyslexia is reported to affect about 10% of schoolchildren, with about 4% having severe difficulties that affect their learning ability in school. The incidence in males is estimated to be 1.5 to three times more than that in females. It affects all ethnic groups.

Roots of dyslexia

Dyslexia is a genetic condition. However, there are various theories about the causes.

It occurs in certain families. It is estimated that a child of a dyslexic has a 40% to 60% chance of developing the condition. If an identical twin has the condition, it is very likely that the other twin would also have the condition.

Scientists have detected genes that may lead to dyslexia, but their effects on the brain have yet to be elucidated.

The phonological processing impairment theory is believed by many to explain how dyslexia affects reading and writing. The ability to understand spoken language is an innate capacity of the brain, which recognises a word as a whole and does not register it by the units of sound that constitute a word (phonemes).

However, reading and writing requires the ability to recognise the letters in a word, identify from the letters the phonemes, and then bring them together to form a word. This process, which is termed phonological processing, is believed to be impaired in dyslexics.

There is evidence from magnetic resonance imaging (MRI) that the part of the brain (left hemisphere) involved in producing, analysing and identifying written words demonstrate less activity in dyslexics when they read. This may impact upon phonological processing.

MRI has also shown that the activity in the cerebellum of dyslexics is different from those without the condition. The cerebellum, which is found at the lower back of the brain, is believed to be crucial to the processing of language, coordination and assessment of time. This may explain why dyslexics have difficulties with coordination and time management.

Distinctive features

There is individual variation in the features of dyslexia. Each affected person would have distinctive features.

The features in a pre-school child include delayed speech development when compared to children of the same age; speech problems, like an inability to pronounce long words; problems expressing spoken language, like an inability to remember the right word to use; lack of understanding or appreciation of words that rhyme; or lack of interest in learning the letters of the alphabet.

It is not always possible to detect dyslexia in a pre-school child.

The features in the early school years include problems learning the names and sounds of letters, erratic spelling, problems copying written language, and poor phonological awareness, i.e. the ability to recognise that words are comprised of smaller sound units (phonemes) and new words can be created by altering the phonemes.

The child may also have difficulty in making sense of unfamiliar words by considering smaller words or collection of letters.

The features in the later primary school years include problems with spelling, problems understanding and recognising new words, and slow reading speed.

The features in secondary school include problems with reading fluency, slow writing speed, and problems expressing knowledge in writing.

Some dyslexics reach adulthood without the diagnosis ever being made. Their features include avoidance of reading and writing and hiding these difficulties from others, reliance on memory and verbal skills instead of reading and writing, poor spelling, and poor time management.

Dyslexia is associated with poor numerical skills, poor short term memory, poor concentration, poor time and organisational management as well as problems with physical co-ordination.

The earlier dyslexia is diagnosed, the more likely its management will be effective.

If a child has difficulties with reading and writing, a discussion with the teaching staff and a consultation with the family doctor would be helpful. The latter would exclude health problems which affect the child’s ability to read and write, e.g. vision problems, poor hearing, and other conditions like attention deficit hyperactivity disorder. The former would help in a review of the teaching methodology and provide alternative approaches and support, which is helpful for many children, including those with mild or moderate dyslexia.

If the problem persists despite the above, an assessment by an educational psychologist would be advisable. The latter is a specialist who assists children with problems in their educational progress because of emotional, psychological, cognitive (learning), or behavioural factors. This can be challenging as there are not many educational psychologists available in the country.

Alternatively, assistance can be sought from the Dyslexia Association of Malaysia, which has centres in Peninsular Malaysia. Its contact details are 6, Persiaran Kuantan, Off Jalan Setapak, 53200 Kuala Lumpur (Tel: 03-4025-5109).

The assessment includes an evaluation of the child’s reading and writing abilities as well as other skills like vocabulary, memory, reasoning, language development, processing speed of visual and sound information, organisational skills, and approaches to learning.

A diagnosis of dyslexia is made if the child’s reading and writing skills are poor despite appropriate teaching methodology and the child’s logic and verbal skills are unaffected.

Adults can also have similar assessments done.

Treating dyslexia

There is currently no cure for dyslexia. However, there are many interventions that can assist dyslexics. The degree and type of intervention is determined by the severity of the problems.

Interventions before a child goes to school are effective in achieving long term improvements in the condition. There is evidence that interventions which improve the ability to identify and process sounds (phonological skills) are effective.

These interventions, which are called phonics, concentrate on recognition and identification of sounds in spoken words (phonemic awareness) and instruction on phonics, spelling, writing, vocabulary, comprehension, and fluency.

There is evidence that effective methods of teaching phonics to dyslexics have certain features:

● Teaching is structured, with gradual increase based on what has been learnt previously.

● Use of different senses.

● Reinforcement with regular practice.

● Development of other useful skills.

● Recognition that there are different learning methods and approaches and then selecting the appropriate one for different situations.

● Breaking down the dyslexic’s emotional barriers, like anxiety and frustration, with empathy, encouragement, and promotion of the dyslexic’s self-esteem.

Many older children find the use of educational software applications useful rather than text or exercise books.

Similar approaches are useful in adult dyslexics.

In a nutshell

It is useful to remember that about 95% of dyslexic children respond well to educational interventions, with reasonable to good progress in reading and writing. About 5% continue to experience difficulties and would need more rigorous and long-term support.

It must be emphasised that although dyslexic children encounter daily challenges, even those with severe dyslexia can go on to have full and productive lives.


Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organization the writer is associated with.