Using our current understanding of dyslexia to support early identification and intervention

One of the major risk factors for reading disability is difficulty learning to read words in text in an accurate and fluent manner. This is apparent when a child at risk of dyslexia first starts to attempt to read. Dyslexic children struggle to grasp and automate the alphabetic principle (ie, they cannot "sound out" words or use phonemic decoding strategies) and therefore have difficulty deciphering unfamiliar words that they have not encountered before. Even though many of these words are part of the child's oral vocabulary, the child cannot recognize them in printed form. As a result, reading can be extremely laborious and time-consuming, fraught with errors, and altogether an unrewarding, aversive experience. To be an efficient reader, one must be able to rapidly and effortlessly recognize many words by sight, and for a child to acquire this facility requires multiple exposures to these words. The difficulty that dyslexic children have in developing reliable and efficient phonemic decoding ability makes the acquisition of a lexicon of sight words a much slower process than it is for the average reader. Several other factors can affect a child's ability to read, which are reviewed herein. However, early recognition and treatment of deficient phonologic awareness are an extremely important step in the prevention of a reading problem in the child who is at risk of dyslexia. (J Child Neurol 2004; 19:759-765).