Episode 51: Dyslexia, Dysgraphia, and ADHD – Jill Stowell

LD Expert Podcast - Episode #51
Dyslexia, Dysgraphia, and ADHD - Jill Stowell

Did you know that dyslexia, dysgraphia, and ADHD share some common symptoms? Homework may take hours instead of minutes. Teachers see challenges with attention and concentration. These students are often working well below their potential and are at risk for self-esteem issues.

Welcome to the LD Expert Podcast, your place for answers and solutions for dyslexia and learning differences.

Today, we’re discussing some key characteristics and differences between dyslexia - difficulty with reading, dysgraphia - difficulty with writing, and ADHD - Attention Deficit Hyperactivity Disorder, and some strategies that you can use to support students with these challenges.

I’m your host, Jill Stowell, founder and executive director of Stowell Learning Centers and author of Take the Stone Out of the Shoe, A Must-Have Guide to Understanding, Supporting, and Correcting Dyslexia, Learning, and Attention Challenges.

So, homework takes hours - but what is the root of the problem? Is it reading? Is it writing? Attention? Dyslexia and dysgraphia, or really any learning difference, will stress the attention system. When problems with attention - in class or during homework - seem to surface mainly when the student has to read or write, chances are you are not looking at ADHD.

ADHD symptoms typically show up as soon as a child starts school, if not before, and they’re pervasive - not isolated to schoolwork or homework.

Dyslexia may not be fully recognized until 4th or 5th grade when the reading demands increase dramatically and the focus moves from learning to read to content reading or reading to learn.

Our dyslexic learners tend to be bright, observant, and creative problem-solvers. In the primary grades, they may be able to memorize the stories so it sounds like they’re reading when they’re not. They know what a reader should look like and can mimic the behavior even though they struggle to read and write.

If they can’t read enough of the words, I’ve seen many dyslexic students simply make up their own story with such good inflection that they sound like they really are reading.

At the learning center, we see students as young as 5, and sometimes, it’s very obvious that the child is dyslexic, even though they haven’t really had much reading instruction, but we never want to mistake maturity for dyslexia or a learning difference so we always include developmental testing for our young students so we can determine what’s maturity and what’s predictive of a learning problem.

Here are some early signs that your child might be dyslexic:

• Difficulty learning the alphabet
• Speech and articulation problems
• They like to be read to but don’t have an interest in letters or trying to read with you
• Difficulty writing their own name
• Reversing some letters or numbers isn’t necessarily a sign of dyslexia in young children because the peak age for letter and number reversals is 5 ½. Young children are still developing that spatial orientation. However, if there is tremendous difficulty with reversals or if they linger beyond about age 7, there is probably a bigger issue.

Here are some strategies that you can use to support your dyslexic student at school or home.

The first is actually a very old but reliable technique called Neurological Impress Reading. You’ll have to visualize a bit here, but here’s how it works. You, as the guide, sit next to or across from the student. You will point above the word and the student will point below the word. Read slowly but fluently together, pointing to each word as you read it. If the student doesn’t know a word, that’s ok, they just have to say it after you. When you get to punctuation, you both tap twice. Punctuation is an important part of language expression and comprehension, but it is often completely missed by our dyslexic readers. Tapping twice at punctuation helps with phrasing, fluency, and noticing punctuation in print, and it gives the student a chance to mentally regroup and think about what they’re reading. So lots of benefits to that tiny little thing of tapping at punctuation.

Dyslexic students often practice reading incorrectly because their reading accuracy is so inconsistent. Neurological Impress Reading or, we call it NIR, allows the student to see, hear, point to, and say the word accurately, and, because you are reading with them – you’re the guide – it takes the pressure off the student. Our dyslexic students often have good comprehension and inquisitive minds, so reading with this technique allows them to read a little bit higher level and more interesting material than they might be able to read on their own.

Studies on Neurological Impress Reading indicate significant increases in reading fluency and reading comprehension. We encourage parents to spend 10 minutes a day doing NIR with their struggling readers. This can be in any material, including homework. Consistency with this simple technique can really pay good benefits.

Before starting to read or write, you want to help your dyslexic learner get focused and oriented. Doing cross crawls for 30 seconds to a minute can help them get focused and ready.

Cross Crawls is a Brain Gym activity. We like students to do cross crawls standing up, but they can be done sitting as well. Have the student cross one hand across their body to touch the opposite knee. And then do the same with the other hand. Continue crossing hand to knee at a moderate pace. Once students can do hand to knee, I like to have them do elbow to the opposite knee just to get a little more core involvement.

Cross crawls are an integrating, organizing movement that get both hemispheres of the brain activated and working together. If your child starts getting frustrated, or stuck, or they start making a lot of mistakes, take a minute to do some cross crawls. This is a great reset for reading, writing, or attention.

I remember when our staff first learned Cross Crawls. We had taken a Brain Gym training and I told our clinicians to try out the technique right away. So, one of our clinicians, Sandra was a little skeptical, but willing to try it. About 10 minutes into her session with her student, Sandra opened her door and called out, “It works!” Her student had been reading and then started to get flustered and stumble over words, making all kinds of mistakes. She had him stand up and do cross crawls. He then resumed his reading calmly and fluently!

OK, I promised we’d talk about dyslexia, dysgraphia and ADHD, so let’s move on to dysgraphia. Dysgraphia means difficulty with writing. Students with dysgraphia may have dyslexia, as well, but not always.

I remember my very first dysgraphic student. He was one of those kids, on the surface, who seemed like he had it all. He was bright, and popular, he was good at sports, good at conversation...but he was failing many of his classes because he refused to do his homework. At first, his parents thought it was a teenage rebellion thing. His teachers thought the problem was motivation.

This was very early on for me in my practice and I thought the problem with getting homework done was time management and organization.

After working with him for a very brief period of time though, I realized that there was some kind of a roadblock between his brain and his hand. Jordan could not get his thoughts on paper. It wasn’t that he couldn’t physically write, but the process of getting words from pencil to paper was slow and laborious. His mind went so much faster than he could write and spell, that his thoughts were jumbled and incoherent on the page.

Dysgraphia involves difficulty with graphomotor skills, or the physical writing process, spelling, grammar, and getting their ideas from head to paper. So it’s comprehensive. It’s a lot about writing. Just as with dyslexia, each student with dysgraphia looks a little bit different and experiences the challenges in different degrees.

Here are some common characteristics of dysgraphia:

• Too tight or too light pencil grip and pressure
• Awkward or unusual wrist, body, or paper position when writing
• Poor spacing of margins, words, and letters on the page
• Frequent erasing
• Poor spelling, including unfinished words or missing words or letters
• Slower writing than typical same-age students
• Mixed upper and lowercase letters when writing words and sentences
• Irregular and inconsistent letter formation, size, spacing, and placement
• Reversal of letters and numbers
• Avoidance of writing tasks
• Difficulty with written organization and expression even though they may have good ideas when speaking

Students with dysgraphia can be confusing to parents and teachers because sometimes, you look at your child and think, “he can write neatly when he wants to.” The truth is that if they very slowly and carefully draw the letters, these students may be able to produce a fairly neat and legible product. This is effortful, not sustainable, and not the same as writing with fluency.
Handwriting requires kinesthetic feedback, or feedback from the body, in order to guide the hand and body to make the adjustments needed to apply the appropriate pencil pressure and to write with accuracy and ease. Students with dysgraphia often are not getting enough kinesthetic feedback.
Numerous visual skills, including visual–spatial awareness, eye-hand coordination, and visual memory, are involved in spelling and writing. Difficulties with any of these skills draw mental attention away from the content and can get in the way of legibility.
Some students have difficulty crossing the vertical midline of their body, that imaginary line that divides the body in half from head to toe. In order to avoid having to cross the midline, students may adopt a very unusual and uncomfortable posture or position and change the angle of the paper as they write. Their thoughts may be disrupted every time their hand goes across the midline as their pencil moves from left to right across the page.
In spite of the fact that they have good ideas and may be able to express themselves well verbally, some students with dysgraphia experience global interruption in the ability to get their thoughts from their head to the paper. This includes language organization, sequencing, spelling, grammar, sentence structure, and mechanics (like capitalization and punctuation).
At the learning center, programming for our dysgraphic students often starts at the Core Learning Skills Level of the Learning Skills Continuum.

So if you think of learning like a continuum or a ladder that kind of builds, at school, kids are working up at the top of the continuum learning reading, writing, spelling, math and all those other subject areas. But there are whole sets of underlying skills that have to be in place in order to learn efficiently at the top. Those skills involve kinesthetic feedback from the body for body awareness and control, attention, memory, and all kinds of auditory and visual processing skills. If any of these underlying skills are weak or inefficient, it doesn’t matter how young or old you are, it will make things more difficult.

Students doing Core Learning Skills training are guided through increasingly complex visual, motor, and balance activities to increase the brain - body connections and build their awareness and control of speed, force, and movement. Students doing the dysgraphia protocol, wear light wrist and ankle weights to build their kinesthetic awareness - or improve their awareness of information that they’re getting from their body.

Here are some strategies that you can use for your dysgraphic learner.

The first is what we call Lazy Eights for Writing. The student uses their index finger or pencil to draw a small laying down 8 or infinity sign with a flowing continuous movement 8 to 10 times. Start at the middle and draw counterclockwise first, up to the left and around; then clockwise, up and around to the right. This gets both hemispheres of the brain activated for thinking and writing.

Students who have trouble getting started on writing tasks can put a tiny lazy 8 centered at the top of their paper and trace it several times to activate and integrate for writing.

At the learning center, we have our students with handwriting challenges use Handwriting Without Tears paper to help them make their letters accurately and consistently. You can purchase this paper from lwtears.com. This is an interesting paper because instead of having the traditional top and bottom line with dotted lines dividing them, you have only the top and bottom line. The lowercase letters fill up the whole space between the top and bottom lines with tall parts, like on the b or tails like on a g, going above or below the line. The key is using the paper properly. When they do, they become more automatic and accurate with letter formation, size, and spacing and can transition back to regular lined notebook paper, and their writing is going to be more legible and automatic.

Here’s one more tool for dysgraphic learners or any student who struggles to get started with writing or get their thoughts on paper. We call it the 5-minute writing strategy. I actually learned this technique when I was writing my first book, At Wit’s End, A Parents Guide to Ending the Struggle, Tears, and Turmoil of Learning Disabilities. I wrote most of my book that way and found that it was a really powerful technique for reluctant writers as well.

Here’s the premise: Writing is easier when you’re answering a question, so if your child is given a topic to write about, have them turn the topic into a question.

Then, have them visualize the answer. From their mental image, come up with 3 “picture” words - usually nouns or verbs that easily create a mental image.

When they start to write, the first word in the paragraph has to be one of their 3 picture words and the other 2 words have to be in the first paragraph.

The student should write for 5 minutes as fast as they can without stopping to think, erase, or correct. Just write. Then they can go back and edit and proof their writing.

It’s amazing what flows out with this technique, and 5 minutes is a palatable amount for students who dread writing.

An interesting factor that is a common symptom of dyslexia, dysgraphia and ADHD is being ambidextrous.

When we see a person who is ambidextrous and can use both hands equally to do things, it seems pretty amazing. In baseball, switch-hitters (players who can bat either right-handed or left handed) are in demand.

But…when it comes to reading and writing, ambidextrous is often a deterrent and a symptom of a learning problem. It is an indication that the student has difficulty crossing the midline of his or her body.

Remember the “midline” is the imaginary line running from top to bottom down the center of the body that separates the body into right and left halves. Crossing the midline means that one body part (like the hand) is able to go across that centerline and work on the other side of the body.

The ability to cross the midline is important for both the body and the brain. The two hemispheres of the brain have different functions and approach tasks from different perspectives. The two hemispheres need to communicate with each other across the corpus callosum – which is kind of in the middle of the brain – in order to contribute their unique perspective and to coordinate movement and learning.

When a child crosses the midline spontaneously with his dominant hand, that hand will get the practice needed to develop good fine motor skills. If the child avoids crossing the midline, he may tend to use both hands interchangeably to do tasks that should be done just with the dominant hand. As a result, both hands get practice but neither one becomes dominant and “expert.”

If hand dominance does not get firmly established, fine motor skills, such as pencil control and handwriting, will be affected. In addition, crossing the midline for these students can become like a little glitch disrupting working memory, attention, and information-processing speed, all of which are characteristic of dyslexia and ADHD.

About 50 - 60 percent of people with ADHD also have a learning disability. About 3 in 10 people with dyslexia also have ADHD. ADHD does not cause dysgraphia, but research indicates that those with ADHD have a higher risk of developing dysgraphia.

Some individuals with ADHD have no learning challenges. They can read, write, spell, and comprehend, but organizing themselves and managing their time, impulsivity, and distractibility to actually get the work done is a huge challenge. In our experience, addressing the ADHD challenges with a combination of training and biochemistry is the most successful kind of treatment.

At the Stowell Learning Centers, we know that struggles with dyslexia, dysgraphia, or other aspects of learning will stress the attention system. So in our functional evaluation we are looking carefully at the underlying neurodevelopmental and processing skills to determine if the attention challenges the parents and teachers are seeing are a symptom of weak underlying skills or the actual root of the problem, because the treatment will look very different. Most of our students are reported to have attention challenges when they first come in, but most do not actually have a neurobiological Attention Deficit Disorder.

I remember a little girl, Raquel, who came to us at the end of third grade with a new diagnosis of ADD. She exhibited serious attention challenges in school and around homework, but when we tested her, we found that she was dyslexic. After a summer intensive program at the learning center, where she did 3 hours a day, 5 days a week, for about 7 weeks, Raquel went from reading at a first grade level to a 5th grade level. She went on to graduate at the top of her class in high school and later from University with a 3.95 GPA and a degree in geologic engineering.

We have talked a lot today about symptoms, coexistence, and strategies for dyslexia, dysgraphia, and ADHD.

Here’s the key thing that I want you to know about dyslexia and other learning disabilities: The weak underlying neurodevelopmental and processing skills that are at the root of the difficulties can be identified and developed. Real and permanent changes are possible. The brain research and clinical evidence solidly show that new more effective connections and neuropathways in the brain can be made through targeted brain training so that learning can be easier.

My goal for this podcast is to equip parents with knowledge and practical tools for understanding and helping your child. If this episode brought up any questions for you, go to stowellcenter.com and give us a call. We’d love to talk to you.

Next week, we’re talking to Dr. John Danial about Stealth Dyslexia and the trauma of undiagnosed and untreated learning disabilities. Dr. Danial has a great perspective on helping kids and parents through the mental health issues that can come up around struggles in school, so you don’t want to miss it.

At Stowell Learning Centers, we help children and adults eliminate struggles associated with dyslexia and learning differences. We want to make this journey easier for you. Connect with us on social media and on our website, stowellcenter.com, for information and free resources.

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