Drs. Fernette and Brock Eide

Stealth Dyslexia & Writing

We first posted the following article in the 2E Newsletter (http://2enewsletter.com) a wonderful educational resource.

Stealth Dyslexia

When you read the word dyslexia, what's the first thing that pops into your head? If you're like most people, you'll probably think of a reading disorder. That response is understandable, considering the way dyslexia is spoken or written of by many experts. For example, in 2003 the International Dyslexia Association defined dyslexia as: "a specific learning disability...characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities...problems in reading comprehension, and reduced reading experience..." Yet reading difficulties are just one of the many neurologically-based manifestations of dyslexia. Dyslexia is also frequently associated with difficulties with handwriting, oral language, math, motor planning and coordination, organization, sequencing, orientation to time, focus and attention, right-left orientation, spatial perception, auditory and visual processing, eye movement control, and memory. In fact, in our practice, we often see children who are struggling academically due to difficulties that are clearly dyslexia-related, yet who show age appropriate--and in many cases even superior--reading skills. Because of their apparently strong reading skills, most of these children have never been identified as dyslexic, or given the help they needed to overcome either their academic difficulties.

We have found this to be an especially common problem among intellectually gifted children, because such children are able to use strong higher-order language skills to compensate for the low-level deficits in auditory and visual processing that cause the reading problems in dyslexia. As a result, they are able to read with relatively good comprehension. In fact, this is such a common presentation in our clinic, that we have given it it's own name: stealth dyslexia.

Children with stealth dyslexia share three things in common: 1) characteristic dyslexic difficulties with word processing and written output; 2) findings on neurological and neuropsychological testing consistent with the auditory, visual, language, and motor processing deficits characteristic of dyslexia; and, 3) reading skills that appear to fall within the normal or even superior range for children their age, at least on silent reading comprehension. In addition, many will show a family history of dyslexia, and/or a history of early reading difficulties greater than would be expected for a child with their obvious strengths in oral language. Let's look at the problems experienced by children with stealth dyslexia in a bit more detail.

The most academically disabling difficulty affecting children with stealth dyslexia is almost always dysgraphia, or difficulty writing by hand. Several factors often contribute to their difficulties with written output. First, they typically have the characteristic dyslexic difficulty turning words in their heads into signals capable of causing the motor system to form the appropriate letters needed to make words. They may lack the kinds of visual templates that can be used to form words, or be unable to translate auditory word images into the kinds of signals the motor system needs to form letters. Second, they may havespatial or sequential processing difficulties that make it difficult for them to remember how to form individual letters (resulting in oddly formed letters, reversals, inversions, and irregular spacing), or to remember what order letters or even sounds come in a word. These children are often especially hard for parents and teachers to understand, because they may have verbal IQs in the highly or profoundly gifted range and show every sign of verbal precocity, yet be unable even to write the alphabet--even as teenagers. Third, dyslexic children may have difficulties with sensory-motor dyspraxia. Motor coordination problems are common in dyslexia, and may cause difficulties with the manual aspects of handwriting even for children who are trying to copy directly from examples of printed words. Often these children experience the extreme frustration of knowing what words they want to write, while being unable to get their fingers to make the proper motions. Finally, dyslexic children often have difficulties of visual processing that can contribute topoor hand-eye coordination, or difficulty using visual feedback to guide their writing.

The severe handwriting impairment associated with these deficits produces one of stealth dyslexia's most noticeable manifestations: the characteristically enormous gap between oral and written expression. Even extremely precocious adolescents with outstanding oral language skills, remarkable knowledge bases, and extremely lively minds can produce written documents of such brevity and simplicity that they look as if they had been written by a struggling third grader. The psychic trauma that can result from this gap between aptitude and output is impossible to exaggerate.

Another tip-off to the presence of stealth dyslexia is the presence of spelling difficulties in a child's written output that are far out of character with either their general language, working memory, or attention skills. While these children are sometimes able to score within age norms on multiple-choice tests of spelling recognition, or even on weekly tests of spelling words that study carefully for, they essentially always show significant and surprising deficits when they try to spell words from memory.

The dyslexic deficits in handwriting and spelling tend to be more persistent and resistant to treatment than the reading deficits. It's important that children with dyslexic dysgraphia be identified as early as possible so that they can be given appropriate handwriting interventions, and so that they can begin as early as possible to develop proficiency in keyboarding. Keyboarding should become their primary means of written expression for as much schoolwork as possible--in many cases, for math as well as language output.

In addition to difficulties with written expression and spelling, children with stealth dyslexia often show persistent, though subtle, difficulties with reading. Despite the appearance of age-appropriate reading comprehension on routine classroom assignments or even standardized tests, careful examination of oral reading skills almost always reveals persistent difficulties with word-for-word reading. Though often subtle, these deficits, which usually result in subtle word substitutions or word skips, can result in significant functional problems, especially on tests. We frequently see children who consistently show good comprehension reading lengthy passages or even long books, yet who significantly underperform or even fail written tests of reading comprehension because they have difficulty reading short test questions or multiple choice answers.

This seemingly paradoxical difficulty reading short passages can be better understood by considering the nature of the reading difficulties children with stealth dyslexia usually have. As we've mentioned, these children typically show difficulties on the word-by-word reading level, including word skips or occasionally substitutions due to misreading. When they read longer passages, these children are often able to use their excellent higher-order language skills to fill in or correct errors in word reading, drawing on the redundancy and contextual cues that are usually available in longer passages. However, as reading passages get shorter, they contain fewer contextual cues, less redundant content, and often, more condensed syntax. As a result, there will be fewer means of correcting individual word errors, so the likelihood of errors actually increases as passages decrease in length. Unfortunately, there are few types of writing that are more brief, non-contextual, low-redundancy, and condensed than test questions or multiple-choice answers. On such passages, a single missed word--especially conditionals like "not" or "except," or comparatives like "before" or "since"--can yield catastrophic results, and there will be few cues available to show that an error has been made. As a result, children with stealth dyslexia often make "silly mistakes," responding in ways quite different from the way they would have answered had they correctly interpreted the question or answer choices. The same kinds of problems are often seen in math work, as well.

Although these mistakes typically result in underperformance, the 2e child with stealth dyslexia may be able to compensate well enough to avoid actual failure, especially during the early elementary years. As a result, they may not be correctly identified as having dyslexia or any other learning challenge, and appropriate interventions may not be provided. This frustrating pattern will be all too familiar to anyone familiar with 2e children: impairments severe enough to significantly impair learning and school performance, but not severe enough to be recognized or to qualify for appropriate services or accommodations. Like many 2e children, gifted stealth dyslexics often "fall between the cracks," so that the nature of their problem goes unrecognized.
Typically, the children we see with stealth dyslexia struggle through elementary school performing well below their potential, often making superhuman efforts just to keep up. When they meet the heavier writing demands (and sometimes also the more complicated reading assignments) in middle and high school, they frequently find that they are no longer able to keep up. A downward spiral of failure and despair is often the result. This outcome is completely unnecessary. With early identification and appropriate interventions, these children can be equipped to gain all the knowledge and success of which their powerful minds make them capable.

Tags: dyslexia, dyslexia college, dyslexia in adults, dyslexia writing, dyslexics, gifted, gifted dyslexia, gifted dyslexics, stealth dyslexia

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Liane AkanaPermalink Reply by Liane Akana on May 27, 2009 at 12:18am
We are very grateful that you have shared what you know about stealth dyslexia. In our son's case, his total avoidance of reading and writing despite scoring in the 94th percentile in verbal tests didn't add up. We went so far as having a full psych/IQ eval with a psychologist to determine whether he was dyslexic and/or ADD (at his teacher's insistance). The eval ruled out dyslexia and recommended medication for ADHD. If it weren't for Drs. Eide book, we'd still be in the dark. Many of the tears over writing, spelling and multiplication tables finally made sense! What the psych eval did do was identify him as a candidate for GT services and once in, the attention problems magically disappeard. It is hard to advocate for your child when you don't know what you're dealing with. I would love to see the information on stealth dyslexia more widely known and understood by professionals and educators.
Drs. Fernette and Brock EidePermalink Reply by Drs. Fernette and Brock Eide on May 29, 2009 at 8:59am
Here's a copy of the handouts of our Powerpoint on Stealth Dyslexics. If we get a chance, we just got some software that allows us to record audio with our powerpoints and we could convert it into a video. That would probably help too... The file is a pdf file, so you may need Adobe Acrobat Reader (free download http://get.adobe.com/reader/) to open it.
Attachments:
Cindy ClendenenPermalink Reply by Cindy Clendenen on May 29, 2009 at 1:25pm
Not asking for a diagnosis, or anything. Just sort lamenting, I guess! L! This fits better than other things that I have seen. Maybe I just need to buy the book. :) Well, I have two that seem to fit into this category. But for one of them, the verbal part doesn't really fit. He has a hard time getting what he wants to say out of his mouth. Where he is precocious is Math. Scored post high school in math on his standardized test in the 6th grade. Oddly, he competes on Math competition teams, and does well enough to compete at the state level, but I am having the hardest time getting him through his Algebra text book! He has been working on it for two years! ?? Not too sure what to do with him right now. We were told that he was ADD/Dyslexic sort of early on. He seems to read fine, albeit slowly, and his handwriting is bad, but not terrible. Spelling is awful! But he is 14 now, and all of a sudden seems to have a visual memory that he never had before? Very confusing. Terrible organization. Terrible social skills. Terrible study skills, and seems to freeze up and forget what he studied when it comes to the test. Honestly I am really worried about high school next year.
Drs. Fernette and Brock EidePermalink Reply by Drs. Fernette and Brock Eide on May 29, 2009 at 2:27pm
The stealth dyslexic profile is a late blooming profile. Check out the videos in the video gallery and you'll see a similar trend. It's possible rather than The Mislabeled Child, you might like the DVD from our webinar. The one entitled "Dyslexia and Writing Challenges in Gifted Children" in particular might be up your alley. We also included a lot about what can help with writing in there too. The DVD was done as part of a benefit for our daughter's cancer fund - and can be purchased here or on Amazon here.

Visual memory continues to increase into young adulthood - that's why if you interview college and grad school age dyslexics, you'll often hear them saying, "I seem to be getting smarter and smarter..."
Cindy ClendenenPermalink Reply by Cindy Clendenen on May 29, 2009 at 3:30pm
Thank you so much! I will pick up the DVD set this afternoon. (...When my husband-who will remember our paypal password- comes home. :0) I'll also check out the videos in the gallery. I so appreciate your response!

Cindy
dhfl143Permalink Reply by dhfl143 on May 30, 2009 at 4:37am
I got the DVD on Stealth Dyslexia and am very pleased.

Cindy Clendenen said:
Thank you so much! I will pick up the DVD set this afternoon. (...When my husband-who will remember our paypal password- comes home. :0) I'll also check out the videos in the gallery. I so appreciate your response!

Cindy
Cindy ClendenenPermalink Reply by Cindy Clendenen on June 24, 2009 at 9:08am
Well, I have watched the Webinar DVDs and I found it extremely helpful! I found it oddly emotional to watch, and I'm going to have to go back and watch it again to really get all of the content. But it was very good, and from what I did get out of it, it explained a lot!

I bought the book, Mislabeled child too. Haven't had a chance to get too far into that yet.

But I wanted to say thanks to the Dr.s' Eide for their amazing work. You are a great encouragement to we dyslexics/parents of dyslexics and you are appreciated.

Thank you,
Cindyc.
Lorri CentineoPermalink Reply by Lorri Centineo on August 3, 2009 at 10:37pm
Cindy Clendenen said:
Not asking for a diagnosis, or anything. Just sort lamenting, I guess! L! This fits better than other things that I have seen. Maybe I just need to buy the book. :) Well, I have two that seem to fit into this category. But for one of them, the verbal part doesn't really fit. He has a hard time getting what he wants to say out of his mouth. Where he is precocious is Math. Scored post high school in math on his standardized test in the 6th grade. Oddly, he competes on Math competition teams, and does well enough to compete at the state level, but I am having the hardest time getting him through his Algebra text book! He has been working on it for two years! ?? Not too sure what to do with him right now. We were told that he was ADD/Dyslexic sort of early on. He seems to read fine, albeit slowly, and his handwriting is bad, but not terrible. Spelling is awful! But he is 14 now, and all of a sudden seems to have a visual memory that he never had before? Very confusing. Terrible organization. Terrible social skills. Terrible study skills, and seems to freeze up and forget what he studied when it comes to the test. Honestly I am really worried about high school next year.
LuizaPermalink Reply by Luiza on August 26, 2009 at 4:55pm
Hi Michele,

Your dd sounds like mine. She had described visual issues when she was reading - words dancing and things like that. Yet my eye-doctor told me her vision was "perfect." Most eye-doctors test for visual acuity, using those visual charts. She did just great with those. Only when we took her to a pediatric developmental optometrist at 10 yo did me find out about the extent of her visual problems. She has trouble controlling her eye-movements from left to right and down the page (visual tracking) and problems with moving the focus of her eyes smoothly from far to near (accommodation) and some other things. These 2 problems wreaked havoc with her reading and with copying from the board at school.

She wouldn't have grown out of her visual problems. Yet visual therapy was extremely helpful for her. Her reading fluency went from the 1% to the 50% in 4 months or so of therapy.

So I'd suggest that you checkout the lead for an optometrist you had. Here is the link for the professional association of developmental optometrists:

http://www.aoa.org/x6107.xml

Michele Marshall said:

Currently, she can read just about anything you put in front of her, with really good comprehension. But, she complains about visual "issues" when she reads - words "floating," letters disappearing, lines marching, pages being "too bright," etc. When I discussed this with her eye doctor, we were told that she just needed to "mature" to be able to process what she's "capable" of reading as opposed to what she's physically comfortable reading.


But, she avoids reading (for pleasure) all the same. We did go through some books tonight, discussing ones she had read (at adult levels and other levels) and *why* they were readable, as opposed to others. Line spacing and page brightness seem to be key factors here. Tomorrow we're going to go through the "large print" area of the library and see if anything there looks readable to her. Then, I hope to encourage her to read for a short while daily (without fail) and see if that helps at all - she was agreeable to this.


Some people seem to find it helpful to use color film over a white page when reading, but we never tried that.



And I would rest here, if the issue were entirely visual. But then there is the handwriting.

DD has trouble with handwriting too.



Math was a struggle,

DD had trouble learning Math facts. Now at college, she is a science major, but up until a few years ago she thought that she was "no good with Math."


A lot of the links and suggestions I've run across seem to focus on "teaching reading" to dyslexics, which we don't need at this point.

I hear you. DD learned how to read, more slowly than her peers, but pretty well. It was difficult to get anybody to listen when I said that I suspected dyslexia.


If stealth dyslexia is, indeed, my Dd's problem, I'm not sure where to go or what to do from here. How do I help her improve her writing capabilities - because she *does* want to? (She's currently rejecting keyboarding as an option, saying it's even slower than cursive!)


Your daughter is not alone. One of the suggestions to help dd write better was to give her a keyboard. We were all very excited about the idea, but as it happened for her learning to type was not much easier than learning to write by hand and it caused much anxiety too.

Another thing that help her was Speech Therapy. Did you think of having her expressive language evaluated by a Speech Pathologist? Speech therapy was helpful for dd.


Perhaps I need new leads at this point? Anyway - thanks for any input or advice!

Good luck, Luiza
LuizaPermalink Reply by Luiza on August 26, 2009 at 9:04pm
When your daughter writes, does she seem "at a loss for words" sometimes?

When she tells stories, does she sometimes get into such detail that *you* lose track of where her story is going?

Did she ever say to you something like, "How can I write that...?" Then she says what she wants to say, and you answer, "You could write it just like you said it," and she looks all surprised and happy.

My daughter did all of the above, and truth be told, me too.

Speech Pathologists evaluate problems with understanding or producing language, and work with kids who have language processing problems. Many dyslexics, I understand, have language processing difficulties.

My daughter had speech therapy for pragmatics, or for using language in everyday situations. She learned and practiced techniques to engage in the give and take of conversation. Most of us just pick up on what we need to do to have a conversation, but she needed to be taught.

I heard good things about the Lindamood-Bell therapies, but we never had a chance to try them.

Luiza

I hear

Did you think of having her expressive language evaluated by a Speech Pathologist? Speech therapy was helpful for dd.

Why did this help your dd, might I ask? Vaguely, I remember there were a few "word issues" she had as a child - mostly things that were idiosyncratic and not consistent.
Drs. Fernette and Brock EidePermalink Reply by Drs. Fernette and Brock Eide on March 9, 2011 at 6:49am

Gifted students with dyslexia are often stealth dyslexics because although they have a severe ability-achievement discrepancy (differences between ability or IQ scores and achievement scores in oral reading - like from the WIAT-III), an average of all their subtest scores may still be in the average or near average range. 

 

The problem with this is that they aren't the sum of their scores - their program needs to be differentiated for their advaced conceptual and problem solving ability as well as specific interventions or supports for reading, writing, spelling, math, or whatever. What gets mislabeled as underachievement is often twice exceptionality. 

 

We find the subtest scores much more helpful in identifying how education should be customized. stealth dyslexics often have very high verbal comprehension index and perceptual reasoning index, an average working memory index, and slow processing speed. Achievement scores often show strong listening comprehension and math problem solving, but lower oral reading accuracy, math facts fluency, and writing mechanics and sometimes essay. 

 

Lots of stealth dyslexics succeed as adults without identification, but it often means they were able to overcome hurdles, were bypassed for programs, and under-recognized for their creativity and intellectual ability.

LianePermalink Reply by Liane on March 10, 2011 at 6:28pm
It was rather surprising to learn that DS has scores in the superior range for verbal, mostly because of his stregnths on the questions that required him to figure out a is to b as c is to . . .  Unfortunately, at the grade school level, this skill does not translate into success in writing! The biggest hurdle he had to get over was organizing his thoughts (often kept him from starting his writing) and providing enough detail to make his writing interesting (assumed reader knew what he was talking about and left out important info).

Drs. Fernette and Brock Eide said:

Gifted students with dyslexia are often stealth dyslexics because although they have a severe ability-achievement discrepancy (differences between ability or IQ scores and achievement scores in oral reading - like from the WIAT-III), an average of all their subtest scores may still be in the average or near average range. 

 

The problem with this is that they aren't the sum of their scores - their program needs to be differentiated for their advaced conceptual and problem solving ability as well as specific interventions or supports for reading, writing, spelling, math, or whatever. What gets mislabeled as underachievement is often twice exceptionality. 

 

We find the subtest scores much more helpful in identifying how education should be customized. stealth dyslexics often have very high verbal comprehension index and perceptual reasoning index, an average working memory index, and slow processing speed. Achievement scores often show strong listening comprehension and math problem solving, but lower oral reading accuracy, math facts fluency, and writing mechanics and sometimes essay. 

 

Lots of stealth dyslexics succeed as adults without identification, but it often means they were able to overcome hurdles, were bypassed for programs, and under-recognized for their creativity and intellectual ability.

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