Dyslexia: support already necessary in kindergarten

With the help of brain scans, neuroscientist John Gabrieli is investigating what distinguishes children with a reading and spelling disorder from others. This could pave the way for new interventions.

Image: Pexels

Interview: Meeri Kim

Mr Gabrieli, what does neuroscience know about dyslexia and how has this knowledge changed over the years?

The causes of dyslexia, or reading and spelling disorder, which affects ten to twelve per cent of all children in various forms, are not yet fully understood. It used to be believed that the main problem was the introduction of a visual component to language: after all, an affected child learns to speak at home without any problems, but then has difficulties with written language at school.

And today?

Today, it is widely recognised that the onset of dyslexia usually has something to do with the processing of spoken language. For example, some children lack phonological awareness, an ability that enables us to explicitly understand that a word consists of several sounds. Children who do not develop this skill have difficulty associating sounds with written letters and words they recognise.

Professor John Gabrieli heads the Athinoula A. Martinos Imaging Centre at the McGovern Institute of the Massachusetts Institute of Technology (MIT) in the USA. In addition to his research activities, he teaches in the Department of Brain and Cognitive Sciences and is Grover Hermann Professor in the Harvard-MIT Division of Health Sciences and Technology. He also works in the Department of Psychiatry at Massachusetts General Hospital and at the Harvard Graduate School of Education and heads the MIT Integrated Learning Initiative. In his work, John Gabrieli uses neuroimaging - the visualisation of the structure and functioning of the brain in living humans - to explore fundamental questions about emotions, ageing and memory.
Professor John Gabrieli heads the Athinoula A. Martinos Imaging Centre at the McGovern Institute of the Massachusetts Institute of Technology (MIT) in the USA. In addition to his research activities, he teaches in the Department of Brain and Cognitive Sciences and is Grover Hermann Professor in the Harvard-MIT Division of Health Sciences and Technology. He also works in the Department of Psychiatry at Massachusetts General Hospital and at the Harvard Graduate School of Education and heads the MIT Integrated Learning Initiative. In his work, John Gabrieli uses neuroimaging - the visualisation of the structure and functioning of the brain in living humans - to explore fundamental questions about emotions, ageing and memory.

Is this lack of phonological awareness associated with perceptible differences in the structure or functioning of the brain?

There is some evidence that at least two areas of the brain that are important for reading function differently in children with poor reading skills, which has a detrimental effect. Both areas are located in the left hemisphere of the brain, which is responsible for language skills, among other things, and becomes increasingly important for reading with increasing experience. Part of the left temporal lobe is responsible for recognising written language, while an area in the parietal lobe is responsible for connecting sounds and writing.

Numerous studies have shown that these areas of the brain function differently in children and adults with dyslexia. It has also been proven that the anatomy of the brain in dyslexic children differs in some aspects from others. These differences occur even before they start school, in some cases as early as the first month of life.

Your research lab recently published a study on brain plasticity in people with dyslexia. What did you find out?

In people with normal reading ability, the brain processes what is seen or heard repeatedly more and more efficiently. After the second, third or fourth repetition, this efficiency can be recognised by a lower level of brain activation in response to the corresponding stimuli.

And for people with reading difficulties?

Using magnetic resonance imaging (MRI), we were able to see that the brains of dyslexic adults and children react much less adaptively to repeated auditory or visual stimuli. This suggests more rigidity and less plasticity. These stimuli also included spoken and written words. It can be assumed that less efficient processing of such information is disadvantageous for learning to read.

We were surprised that the lower plasticity also affected aspects that have nothing to do with reading, such as recognising faces and objects. As people with dyslexia have not previously been associated with difficulties in recognising faces or objects, this result is a mystery to us.

A year earlier, studies showed that dyslexics find it more difficult to recognise voices. Does this also have to do with lower brain plasticity?

Yes, and this research result provided the impetus for the new MRI study. We found that dyslexics were worse at recognising voices compared to the control group and wanted to know what happens to the brain plasticity that supports the learning process.

What early interventions are available for children with dyslexia?

There are reading programmes in small groups with a specially trained teacher. These programmes focus on the perception of individual speech sounds and the connection between sounds and writing. This is therefore a very direct approach. Almost all children learn this at school anyway as part of the curriculum, but some need a little more help.

Unfortunately, it is common in our school system to only react when it is too late.

Do they help at all?

There is convincing evidence that interventions of this kind are most effective when they are used in kindergarten or Year 1. With each subsequent school year, they help pupils less. The sooner we identify and support dyslexics, the better it is for them. Unfortunately, it is common in our school system not to react until it is too late.

Well-meaning teachers can't decide whether a pupil actually has a reading problem until they are so far behind that the problem becomes a crisis. This is tragic because not only do these children miss out on the chance of early support, they also get the feeling that they are failing at school. Pupils who lag far behind their classmates and struggle with the subject matter lose their optimism and self-confidence in terms of academic performance.

Do you think that your research findings could contribute to improving current interventions?

If in future we can detect differences in the brain shortly after birth, we will be able to develop completely new interventions that could be used at home. Although this would initially only be a trial, children might then receive support even before they start school.

The exciting possibility of developing drugs to promote plasticity is currently being researched in animals - but this is not yet suitable for use in humans. It is difficult to imagine that there could ever be drugs that have a direct effect on language skills, but drugs to promote plasticity are certainly conceivable. Before such a treatment can be considered in humans, however, a number of ethical questions would first have to be clarified.

This text first appeared in English on BOLD - Blog on Learning and Development.