Towards An Early Diagnosis of Dyslexia

If you are a parent with a dyslexic child, it is very likely that the following sentence will hit home for you: “I wish I knew earlier”. Currently, the earliest that dyslexia is diagnosed is in 2nd or 3rd grade, when children have already demonstrated difficulty with reading. By then parents and children will have years of struggle and frustration under their belt. Children with dyslexia are often perceived by others as ‘lazy’ despite their learning potential, and their struggles to read are often misinterpreted as poor behavior or attitude by teachers, parents, and peers. Negative classroom experiences can intensify anxiety, frustration, and confusion, and can lead to decreased self-esteem.

Furthermore, there is an unfortunate paradox in dyslexia diagnosis and treatment that dooms many children to life-long reading difficulty. Although the dyslexia diagnosis doesn’t happen until later, intervention studies are widely documented to have their most potent effects in kindergarten and first grade.

The question then, is whether the diagnosis can precede the symptoms. According to groundbreaking research conducted at the Laboratories of Cognitive Neuroscience at Children’s Hospital Boston, the answer is yes! In the past several years, a team of researchers in the lab, headed by Dr. Nadine Gaab, worked with dozens of pre-readers (infants and children) to investigate early pre-markers in the brains of children with and without family history of dyslexia using cognitive, educational, and brain-imaging methods. The results show differences between the two groups, in structure and function, in different regions of the brain.

Recently, Dr. Gaab received funding from the National Institute of Health to scale-up her research. A new study called Boston Longitudinal Study of Dyslexia (BOLD) is starting this summer and the planned participation numbers are in the hundreds. In the study, children will be first assessed using the most empirically validated cognitive and educational assessments. In a follow-up session, the children will undergo an MRI scan. The MRI machine takes images of the child's brain while they respond to various questions. It is a non-invasive and safe method of using magnetic fields to photographically capture areas in the brain that work the hardest on specific tasks. The main challenge of using MRIs is getting the children to lie still for 40 minutes.

How does the team accomplish this goal? They transform the study into a game. The MRI scanner is designed to look like a spaceship and the child plays a game where they are asked to help two aliens find their planet. The kids love it and at the end they get to choose a prize. The children will be followed for four years - two sessions each year until an official diagnosis of dyslexia can be made. The information obtained from these sessions is invaluable not only for development of instruments of early diagnosis of dyslexia, but also for the insight it will provide into the development of reading. So, not only do the families get to learn all about the cognitive and language development of their children, buts they get to make a significant contribution to science. And did we mention that the kids get to keep the pictures of their brain? As Dr. Gaab likes to say, these make wonderful holiday cards!

Ola Ozranov-Palchik
Research Coordinator, Gaab Lab, Laboratories of Cognitive Neuroscience. Children's Hospital, Boston
May 2011

.• Frequently Asked Questions About Dyslexia