What is Dyslexia?

by Jessica Hill, COTA/L June 16, 2022

What is Dyslexia?

You’ve likely heard of dyslexia before. Most people have. Most people associate dyslexia with reading and writing challenges, specifically letter reversals. While those can be associated with dyslexia, it is much more complex than simple letter reversals!

Defined by the International Dyslexia Association, dyslexia is a "specific learning disability that is neurobiological 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.”

What exactly is a learning disability? What does “neurobiological in origin” mean? What does “decoding abilities” really mean? What is the “phonological component of language”?

Let’s break it down a little bit.

Learning Disabilities

What is a learning disability?

According to the Learning Disabilities Association of America, learning disabilities are “a number of disorders which may affect the acquisition, organization, retention, understanding or use of verbal or nonverbal information. These disorders affect learning in individuals who otherwise demonstrate at least average abilities essential for thinking and/or reasoning.”

A learning disability is not something that can be “cured.” Instead, individuals with learning disabilities learn strategies to get through their day successfully. They are typically genetic or neurobiological - meaning they originate in the brain. Anyone can have a learning disability - including individuals with average or above-average intelligence. Therefore, an individual with a learning disability can achieve great achievements in life!

child reading

Dyslexia is a learning disability due to the neurobiological origin - meaning that it originates in the brain and is not due to trauma, illness, or any other diagnosis. Specifically, dyslexia is a learning disability related to written material.

Decoding Abilities

According to Reading Rockets, decoding is “the ability to apply your knowledge of letter-sound relationships, including knowledge of letter patterns, to correctly pronounce written words.”

As you’re reading this, you are automatically decoding each word in order to process and understand what it means. As an adult, you likely do this quickly and efficiently. In fact, most of the words are so familiar from years and years of decoding, that you are able to decode these words automatically. You don’t even have to think about the letters or their sounds - your brain knows what the word is from memory!

For an individual, specifically a child who has dyslexia, they struggle to decode words - even familiar words! As they learn to read in preschool, kindergarten, and elementary school (or earlier in some cases), the letters do not blend together to create words. The child may know each letter and the letter’s sound, but when put together to form words, it doesn’t make sense to their brain.

Phonological Component of Language

Phonology is the relationship between speech sounds that make up our language and what those sounds mean. Think about learning to read - you likely needed to sound out the letters separately before you could blend them together. Now, you are able to do this easily and fluidly from years and years of practice.

For a child (again, we’re going to talk specifically about children here) with dyslexia, they may struggle with the phonological component of language as it relates to specific letter sounds, parts of words, or even entire words. This goes right along with their decoding abilities.

Signs of Dyslexia

As mentioned above, dyslexia is often associated with challenges with reading and writing, specifically letter reversals. But there are several other signs of dyslexia that can be seen in children of reading and writing age.

  • Delayed language development
  • Challenges with learning to read - the child may avoid books
  • Challenges with copying
  • Difficulty with writing words and sentences
  • Delayed or no hand dominance in elementary school
  • Challenges identifying left vs right with consistent practice
  • Difficulty recalling what they read
  • May be slower than peers during reading and writing tasks
  • Poor spelling, even with consistent practice
  • Poor visual memory
  • Challenges with auditory processing (may have a diagnosis of Auditory Processing Disorder)
  • Noted challenges with ocular motor skills - poor visual tracking skills
  • Noted challenges with visual perceptual skills

Additionally, a child with dyslexia may show signs of poor self-confidence or depression, due to the challenges they face. They often compare their skills to their peers - many children with dyslexia understand that they are “different” and may feel like they are not “as good” as their peers.

Diagnosing Dyslexia

Because dyslexia is a neurological learning disability, blood tests or scans cannot diagnose it. Instead, an evaluation (or test) can identify the signs and symptoms for a diagnosis. Information is typically gathered from the caregivers and teachers, if the child is in school. Then, specific tests are given to the child to identify the challenges.

There are several screening tests that can be utilized for children who are in kindergarten in order to identify “at risk” children. These screening test names can be found here. By first or second grade, an evaluation can be performed to identify the signs of dyslexia. Often a school psychologist or a speech-language pathologist is responsible for this evaluation.

Chat with your pediatrician if you suspect that your child is showing signs of dyslexia.

Activities for Dyslexia

If you suspect that your child may be showing signs of dyslexia, or if your child has a diagnosis of dyslexia, there are some activities that you can complete with them to help. If your child does have a diagnosis of dyslexia, they will likely have a specific program and interventions.

The activities provided here are not meant to treat, diagnose, or “fix” anyone. They are simply sensory-based activities that target the skills areas related to dyslexia.

Primitive Reflex Integration

Primitive reflexes have an impact on learning. We are all born with primitive reflexes and these reflexes should naturally integrate as we grow - this means they develop into higher level movement patterns, or “go away.” If a child does not naturally integrate their primitive reflexes (this can happen for a variety of reasons and the reason is oftentimes unknown), challenges in gross motor development, fine motor development, and cognitive development can occur.

When we talk about dyslexia, there are a couple of primitive reflexes that have been shown to have an impact:

  • Tonic Labyrinthine Reflex (TLR)
  • Spinal Galant
  • Asymmetrical Tonic Neck Reflex (ATNR)
  • Symmetrical Tonic Neck Reflex (STNR)

A series of research studies and the outcomes can be found here.

If you’ve never heard of primitive reflexes and their impact on learning, that’s ok! Many people haven’t. But now that you know, let’s talk about what you can do!

First, let’s talk about some of the other signs that these 4 primitive reflexes may still be present, or retained, along with the signs of dyslexia.

A retained TLR might look like:

  • Poor posture, low muscle tone, poor balance
  • Challenges with sequencing and organization
  • Signs and symptoms of dyslexia

A retained Spinal Galant might look like:

  • Excessive fidgeting, difficulty with focus and attention
  • Hypersensitivity to tactile input
  • Signs and symptoms of dyslexia

A retained ATNR might look like:

  • Gravitational insecurity or fear with movement
  • Poor locomotion skills (includes crawling and walking)
  • Signs and symptoms of dyslexia

A retained STNR might look like:

  • Poor posture, W-sitting, delayed gross motor development
  • Seems to have poor coordination
  • Signs and symptoms of dyslexia
retained primitive reflexes

If you suspect that your child might have a retained primitive reflex, the first step is getting an evaluation for occupational therapy or another professional who is trained in primitive reflex integration - physical therapy, cranio-sacral therapy, or chiropractic care are some other options to look into. The goal: to integrate any retained primitive reflexes through a series of specific exercises that create new neural pathways in the brain. Additionally, you can learn more about primitive reflex integration with our digital course.

Auditory Activities

Oftentimes, dyslexia co-occurs with auditory processing disorder. If you suspect that your child is showing signs of auditory processing disorder, chat with your pediatrician to get an evaluation.

The Listening Program is a great program to look into if you’re seeing signs of dyslexia. This program uses evidence-based music therapy to improve attention, boost memory, strengthen learning skills, and more. Learn more about The Listening Program here.

Check out the Phonics Phone! This is a simple tube that is shaped like a phone - an “old school” phone with one end for your ear and the other for your mouth. This phone is used so that the child can hear what they are saying - specifically it is used while reading so that the child can speak quietly into the phone and better “hear” themselves. Check out more about the Phonics Phone here.

A great activity to target the auditory system and help with some of the challenges associated with dyslexia is using a metronome. You can download a free app on your phone or find a metronome on YouTube. Coordinate activities with the metronome, set to 60 beats per minute (BPM):

  • Read letters on a visual chart. The chart should be placed at eye level and the letters should be large and evenly spaced. Have your child read the letters, then have them try saying the sounds. Practice for 3-4 rounds before taking a break.
  • Using the same visual chart, incorporate throwing or bouncing a ball and catching it while also reading the letters. You can coordinate on every beat or every other beat, depending on the level of difficulty for your child.
  • Instead of letters on the chart, use arrows that point up, down, left and right.
  • Practice spelling words by spelling them on every beat of the metronome. Incorporate a ball skill activity simultaneously, or even practice writing the letters on the beat. Again, practice 3-4 rounds and if it proves to be very difficult, take breaks!

Visual Activities

Oftentimes, a child with dyslexia also struggles with visual perception and/or visual motor skills. Visual perception differs from visual acuity in that it’s not how well you can see, but how your brain interprets what you see and how you react. Visual motor is the ability to coordinate your vision with your movement. Additionally, ocular motor skills are the ability to coordinate both eyes for smooth movements.

If you suspect that your child has severe visual perceptual deficits, you can talk with your pediatrician about getting screened for vision therapy. Additionally, learn more about Irlen Syndrome, a perceptual processing disorder, here.

Simple visual tracking exercises are a great place to start. Holding an item 6-12 inches away, slowly move it in different directions and have your child follow it with both eyes. This can be very tiring, so only do it a couple of times! The more you practice it, the longer your child should be able to do it and the smoother the tracking should become.

The same activities with a metronome, as mentioned above in Auditory Activities, can also be used to help improve visual motor and ocular motor skills.

    Check out our YouTube video on the Top 6 Visual System Activities!

    Additional Strategies

    Some strategies can be utilized to help your child improve their success and self-esteem with school-based activities, specifically reading and writing.

    • Break down reading and writing tasks into small chunks
    • Use frequent brain/sensory breaks - these should include movement!
    • Provide positive reinforcement versus negative reinforcement
    • Incorporate motivating components - what is motivating to your child?
    • Help your child complete activities they are good at - this can help improve their overall self-confidence.

    Check out our YouTube video on 5 Easy Ways and Activities to Improve Reading and Writing Skills


    Jessica Hill, COTA/L
    Jessica Hill, COTA/L

    Jessica Hill, COTA/L, CPRCS is Harkla's in-house Certified Occupational Therapy Assistant (COTA) and Certified Primitive Reflex Clinical Specialist. She has been working with children for over 6 years in outpatient settings. Jessica specializes in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Jessica is the in-house expert, content creator, and one of the podcast hosts at Harkla! To learn more about Jessica, visit the Harkla About Us Page. Make sure to listen to her weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.


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