Podcast Transcript
ADHD and Dyslexia
Summary:
In this episode of the Pocket MD podcast, psychiatrist Eugene Arnold and psychologist Roberto Olivardia discuss ADHD and dyslexia. Dyslexia is a language-based learning disorder that often co-occurs with ADHD. It affects word processing, spelling, and reading comprehension. Many people with ADHD also have dyslexia, and about half of those with ADHD experience some form of learning difficulty. Dyslexia can be diagnosed through neuropsychological testing beginning at age six, but it often goes undiagnosed. It's important to distinguish ADHD symptoms from symptoms of dyslexia and to treat both disorders. Dyslexia can affect a child’s self-esteem because they may struggle to read or keep up with their classmates. Parents should talk with their child’s teachers if they think their child has dyslexia. There are special programs and educational accommodations in school that can help children manage dyslexia.
Eugene Arnold, MD, Med
L. Eugene Arnold, MD, MEd, is professor emeritus of psychiatry at The Ohio State University, where he formerly was the director of the division of child and adolescent psychiatry and vice-chair of psychiatry. He is a co-investigator in the OSU Research Unit on Pediatric Psychopharmacology. He has forty-five years of experience in child psychiatric research, including the multi-site NIMH Multimodal Treatment Study of Children with ADHD (“the MTA”), for which he was executive secretary and chair of the steering committee. For his work on the MTA, he received the NIH Director’s Award. A particular interest is alternative and complementary treatments for ADHD. His publications include ten books, more than seventy chapters, and more than four hundred articles.
Roberto Olivardia, PhD
Dr. Roberto Olivardia is a Clinical Psychologist, Clinical Associate at McLean Hospital and Lecturer in the Department of Psychiatry at Harvard Medical School. He maintains a private psychotherapy practice in Lexington, Massachusetts, where he specializes in the treatment of attention deficit hyperactivity disorder (ADHD), body dysmorphic disorder (BDD), and obsessive-compulsive disorder (OCD). He also specializes in the treatment of eating disorders in boys and men. He is co-author of The Adonis Complex, a book which details the various manifestations of body image problems in males. He sits on CHADD’s Professional Advisory Board, as well as the Attention Deficit Disorder Association (ADDA) and ADDitude. He presents at many conferences, podcasts and webinars around the country.
Learning Objectives
- Define dyslexia and describe common symptoms.
- Explain how ADHD symptoms and symptoms of dyslexia can overlap.
- Describe a multimodal approach to treating ADHD and dyslexia.
- Learn how parents can support their children with dyslexia and ADHD.
- Learn the importance of interprofessional collaboration in treatment of co-occurring ADHD & dyslexia.
The following transcript has been edited for clarity.
Announcer (00:00): You are listening to Pocket MD training on ADHD in children and adults.
Dr. Eugene Arnold (00:07): Welcome to Pocket MD, sponsored by CHADD—Children and Adults with ADHD— and supported by CDC. I am Dr. Gene Arnold, a child and adolescent psychiatrist, CHADD's Resident Expert, and professor emeritus of psychiatry and behavioral health at Ohio State University. We're fortunate to have as our guest today, Dr. Roberto Olivardia, who will introduce himself. Roberto, would you tell us a little bit about yourself?
Dr. Roberto Olivardia (00:44): Sure. It's great to be here with you, Gene. So, my name is Dr. Roberto Olivardia. I'm a clinical psychologist and lecturer in the department of psychiatry at Harvard Medical School in Boston, Massachusetts. I have a private practice where I specialize in the treatment of a number of things, one of which is ADHD and executive functioning issues. I work with a lot of students with learning disabilities, people of all ages, and also with this particular topic of ADHD and dyslexia. I come from this as a clinician but also as someone with lived experience having ADHD and undiagnosed learning differences when I was young. And I'm the parent of two children, a 19-year-old and a 17-year-old, both with ADHD and dyslexia. I come at this topic from multiple dimensions.
Dr. Eugene Arnold (01:32): Okay, good. Oh, and I should also mention that I have a master's degree in education, which may be relevant to this particular topic. Can we start out, Roberto, by describing a little bit about what dyslexia actually is?
Dr. Roberto Olivardia (01:48): Yes, there's a lot of misunderstanding. I grew up in the 1980s, and I remember the first time I heard that term was an ABC afterschool special, which actually starred River Phoenix. I still remember it. The conception was that dyslexia was people who read or write words backwards or write words upside down—and that is not dyslexia. Dyslexia is a lot more than that. Dyslexia is a language-based learning disability that affects basically phonological processing with a word. We might have a word like truck that's made up of phonemes or sounds in each of those letters; each letter makes a sound. When we think about reading, it is this very automatic process; we just learned that the letter B is a “B” sound, and it automatically gets encoded in the brain. With people with dyslexia, that automaticity doesn't happen as quickly. So, there's a lot of deficits in phonological awareness of that sound symbol match.
It can also affect spelling tremendously where a lot of people with dyslexia tend to be more phonetic spellers—they spell as something actually sounds. It can affect reading comprehension. And again, when we think about language and with reading, we start to learn certain sounds. For example, if you can recognize that the letter A is an /a/ and that T is /t/, and that together it's /at/. Once the brain has that cohesively, then go through the alphabet—B, add it to the /at/ it's /bat/ /cat/ /fat/ /hat/ /mat/. That is not an automatic process for people with dyslexia. So, if you are seeing the word cat, someone with dyslexia might have a sounded-out /k/ /at/, and then they can see the word /fat/ right afterwards and sound it out as if it's a whole new word. And if you imagine now all of the words that really depend upon these principles of automaticity, that can be very difficult; even in reading language, a lot of it can be very phonetic. So, dyslexia really can affect all of the reading, spelling, how one understands and reads language, in all of those dimensions.
Dr. Eugene Arnold (04:07): Okay. So, does this have anything to do with hearing problems?
Dr. Roberto Olivardia (04:11): No, not at all. So, dyslexia is not a hearing issue, and when we say language-based, it's not a speaking issue either. In fact, a lot of dyslexic individuals could be—their vocabulary in how they speak—can be very articulate. And so we have this kind of myth that people who might have dyslexia might not have high vocabularies, for example, or might not be good orators or speakers. And that's not true at all. And that's why one of the many reasons basically that dyslexia could be undiagnosed and is often under-identified.
Dr. Eugene Arnold (04:46): Yes, in fact, I think I heard somewhere that one of our presidents had dyslexia, I believe the second President Bush. He was reputed to have dyslexia. Okay, so what is the prevalence of dyslexia? How many people would have it?
Dr. Roberto Olivardia (05:04): Good question. So, part of it—before we look at prevalence—is to know that this is massively under-identified and underdiagnosed. There's a lot more work that needs to be done in identifying it. And a lot of it comes down to often just resources of testing and having kids be tested adequately for dyslexia. And a lot of times, because there are kids that might not be strong readers who are not dyslexic, there might be kids that don't have access to strong educational resources. That doesn't mean they have dyslexia. There's literacy, which is different than dyslexia. In terms of prevalence rates—where it's the shadow of what is probably in actuality—studies show anywhere from about eight percent to seventeen percent, which is a big range of people who are probably dyslexic or within that range of language-based learning disabilities. So, it's much more common than people would think it would be.
Dr. Eugene Arnold (06:05): And much more common than ADHD. But do people with ADHD have a greater tendency to have dyslexia—in other words, is the ADHD a risk factor for having dyslexia?
Dr. Roberto Olivardia (06:17): So, what we know is about fifty percent of people with ADHD tend to have a learning difference or learning disability, the most common of which is dyslexia. So, there are other learning disabilities like dyscalculia, which affects mathematics, and dysgraphia, but dyslexia is the most common. So, it's not uncommon to see ADHD and dyslexia together, comorbidly. Interestingly, when both are there, it's very common that one will be undiagnosed. And I've often found in my experience that the ADHD often gets diagnosed and the dyslexia often, if it does get diagnosed, it gets diagnosed typically for the majority of people around fifth grade. The reason for that is that in early education we're learning to read, we have reading class, and then at about fourth, fifth grade, we go from learning to read to reading to learn. So you don't have reading class anymore, you just have English, your English class.
A lot of times kids with ADHD who also have dyslexia might be told maybe it's the ADHD, because kids with ADHD can have reading issues, but not because they have problems decoding words, not because they have problems with phonological awareness or processing, but maybe they're bored. I didn't enjoy reading as a kid unless it was super, super stimulating to me. I got very impatient with reading. I would skip sentences and fly by them. Now, I think I probably—also given my kids' experience—probably had somewhere on the dyslexia spectrum myself, but there was ADHD that can also impact reading comprehension. So, I think a lot of times with kids who have dyslexia who also have ADHD, [they] are told, oh, this might be the ADHD, or they'll catch up. Then suddenly it gets to a grade where it's very clear there's a big disparity between where your child or your student is and where other kids are. And it's really now impacting their ability to learn. It's common with ADHD, but lots of people with dyslexia don't have ADHD and lots of people with ADHD don't have dyslexia.
Dr. Eugene Arnold (08:29): Okay. What causes dyslexia?
Dr. Roberto Olivardia (08:31): So, what we know is that similar to ADHD, dyslexia has a lot of neurobiological and genetic underpinnings to it. Basically in the brain we know that there are certain parts of the brain that get activated when we read. There's a part of the brain called Broca’s area, which basically helps us with word analysis and articulation. There's another part of the brain called the occipital temporal lobe, which basically takes a picture and form of the letters and the words and further kind of connects that to certain sounds. There’s the parietal temporal lobe, which gives further kind of analysis. So in a neurotypical reader, those three parts of the brain are the most activated when learning a word so that it's this kind of quicker process. With dyslexia, basically the Broca’s area is being activated, but the other parts are not activated as strongly. So basically, it's almost imagining that as opposed to let's say if you're driving from one destination to another, and there are three routes you can take.
So, if one route is a little bit jammed, you don't have to wait in that traffic jam, you can just take another route. With dyslexia, imagine it's just one route to get there. So if there's traffic jam or it's unfamiliar words, if it's longer words, it's going to take a lot longer to process. You almost don't have the support of those other parts of the brain as a team working at getting that language done quicker and processing quicker. Because I can tell you as a parent, one of the first things that alerted me, and I was always aware of just my genetics and my own neurodiversity, being very aware of both of my kids and knowing the genetic influences. But when my son was six and the word /the/ came up in a sentence and he was like /t/ /he/ and I said, oh, that's /the/ like “the cow jumped over the moon.”
He's like, okay, /the/. And then “the cow jumped over,” and then the word /the/ was there again and it was as if he didn't see it. And this is not a memory issue. It's important to know this is just related to sort of reading. My son had a great memory actually, but that word /the/ was as if he saw it for the first time and he's like /t/ /he/ again. The part of the brain that helps make it more automatic isn't working as strongly. We know there are these neurological influences, and we also know dyslexia runs in families. We find that for kids with dyslexia, there's like a forty to fifty percent chance they have a parent with dyslexia. It's not uncommon that if you have dyslexia, you also have a sibling with dyslexia. So, we know that there are genetic influences there as well, and similar to what we would see with ADHD.
Dr. Eugene Arnold (11:20): Okay. So how would you go about diagnosing dyslexia? Who can do it? What tools does it take?
Dr. Roberto Olivardia (11:27): So, it really does, unlike with ADHD—where neuropsychological testing can often produce a high false negative rate, and we know we need more thorough clinical evaluation with ADHD—dyslexia, on the other hand, neuropsych testing is very good at identifying dyslexia and there are a lot of empirically validated instruments to look at reading that are normed and referenced. And what I was told when my son, he was six when he got diagnosed by a colleague, is that typically at age six and up, you can diagnose dyslexia. Before age six, instruments are normed on younger individuals, although there are screening instruments that can alert people as to whether there's a chance or a possibility for dyslexia. Typically that would be neuropsychologists in education systems. If your kid is in a public school, you can basically ask for testing and typically a school psychologist can administer those tests that would then alert that there's some potential for dyslexia or reading disability.
It's typically these instruments and these tests, these questionnaires that would need to be done. Also, making sure, because what these tests are picking up on is not just, again, with ADHD, you might see someone who has poor reading comprehension, but they're able to decode the words, but they might just, let's say, get distracted. That's very different than someone with dyslexia that might, again, if it's an unfamiliar word, might skip it and just try to get the context of something. So, typically psychologists, neuropsychologists, school psychologists, some physicians, if they have access to those tools and instruments, can diagnose.
Dr. Eugene Arnold (13:13): Okay. How do you distinguish between ADHD symptoms and dyslexic symptoms?
Dr. Roberto Olivardia (13:19): With reading, what’s so important is first starting out with, is this person able to decode the word? So, with ADHD, kids that have ADHD that don't have dyslexia, they don't have a problem with decoding the word. So, they see the word “teacher” and they read it as “teacher.” With dyslexia, we know that decoding is difficult. And also what's common in dyslexia, and I certainly have this a lot as a kid, is syllable segmentation issues. For example, we have the word “teacher,” we just learned that “teach” and “er”, when you put it together as “teacher” as opposed to someone with dyslexia might read that word and segment the syllables at /teak/ /her/, which is a very different word, and I would do that, or I put emphasis on syllabi. I remember in 10th grade reading the word “lunatic” as /luna/ /tic/ and I had no idea what a /lunatic/ was.
I'm like, what is a luna? And my teacher thought I was a bit of a class clown too, so she thought I was kidding. And she said, “The word is lunatic.” And it was as if somebody just presented a new word in front of me and I was, “Oh, oh, right, okay.” And that still happens honestly, even in my adult life now. Kids with ADHD, now let's say they might misread a word, but more because they're being impulsive or it's more that they're speeding through, they're not taking time to read the word, they might be getting distracted. That's different than with dyslexia. And the same with reading comprehension that with dyslexic individuals, reading comprehension can be really impaired because there's so much energy just getting through, even reading the content of it that if you're having trouble word to word to word to word, by the time you get through a paragraph, you're like, “what did I just read?” because you’re just trying to get through it.
With ADHD, reading comprehension is not about, again, that same struggle as much as maybe a kid who's just bored by the content or they're getting distracted by other stimuli that's in the room. Another big thing is with spelling, and this is one of the things that even with educational remediation and interventions tends not to get better with dyslexics. And my son who's 19, we are very grateful that spellcheck exists because dyslexics are very phonetic spellers. So, they would write the word “knife” as NIFE. Frankly, I think it's actually easier to read that kind of spelling because it's literally as it's spelled. Where kids with ADHD do not have dyslexia, you wouldn't see those spelling deficits in that kind of way. And then also just even engagement with books, it should be noted too that not all dyslexics hate reading, not all of them do poorly in school.
With ADHD, I mean, years ago, and maybe even in some circles, people would still believe now that, “Oh, you can't have ADHD if you are an A student.” That's not true. And the same is true with dyslexia. You have kids that could be really overcompensating. And I can tell you from my experience, I couldn't read through something like Shakespeare, and everything was just so boring to me and so dense. But I was always good at getting the gist of something with very little reading of it. And so there are ways that, especially adults that I work with who are dyslexic, who are not diagnosed as kids that they compensated and navigated through. So, it's important also in sometimes even hearing when somebody is reading and with a kid with ADHD and if they're reading out loud, they can read the word to word. With a dyslexic kid, you'll often find them skipping words, having a much harder time, not being as quick with their reading. And that's something that you'll also see as a much slower rate typically with kids with dyslexia.
Dr. Eugene Arnold (17:22): I have to ask you, have you seen the comic strip Crabgrass, which is currently focusing on dyslexia? One of the protagonists, Kevin, was discovered to have dyslexia because he wasn't finishing a book that he was reading, and his friend Myles was talking about how interesting the book was. When he found out Kevin had dyslexia, Myles said, “So that means you can't read?” and Kevin said, “It doesn't mean I can't read, I can read. It's just that it's a big chore.” Is that a good description of the plight of the person with dyslexia?
Dr. Roberto Olivardia (18:00): It can be, yes. There is a range of how severe it can be. So in my son's case, he was pretty severe. He could not read in first grade; he was in, we'll talk about interventions. My daughter, on the other hand, her dyslexia manifested in a different way where it would be as you just mentioned, where she could read, but it was very laborious. It just took a lot. And that was my experience growing up. It takes a lot. I get fatigued very easily when I read. Now we have technologies of Audible and audio books and things like that. Another distinguishing factor, interestingly, is that, overall, kids with dyslexia can actually be excellent auditory processors. I remember having a book on tape when we would take rides to road trips and stuff and my son would totally be able to, even though he also has ADHD, but I don't know if the dyslexic parts almost overcompensate by auditorily processing it better than kids with ADHD typically do—they tend to get more distracted. But yeah, there are some kids, they can read, but it's a lot of just more energy. And then there's some kids with dyslexia, really, it's just very difficult for them to read unless they get the proper interventions.
Dr. Eugene Arnold (19:18): Yeah. Does this have any social implications like ADHD, for example, if someone's impulsive and impulsivity intrudes on other people, it has social consequences, but is there any analogous problem with dyslexia?
Dr. Roberto Olivardia (19:35): One of the things, and this is something I feel so passionately about, when my son got diagnosed, the first thing I remember saying and thinking was, I really don't care if he can ever get through War and Peace. I don't really need him to be a literary expert. He cannot think that he's stupid because unfortunately, Gene, a lot of people with dyslexia, and this is especially if they're not diagnosed, but even when they are diagnosed, [they] often struggle with this sense—but even more so if they're not diagnosed, that they're stupid, that they're dumb, because we have culturally this notion that strong readers are smart people and if you're not a strong reader, you're not a smart person. And that's not true with dyslexia. Just like with ADHD, you could have a high IQ and be severely dyslexic. And that disparity for a lot of young people, unfortunately, they start to think maybe I'm not that smart. Maybe I'm an imposter because I cannot read. That's something that just comes so naturally to everybody.
I work with a lot of young people for whom it really takes a hit on their self-esteem—unless, and this is the big part because I always say dyslexia in and of itself is not hazardous to your health, you have the name. Studies show that with the label of dyslexia, kids actually often feel relief. They often feel validated like, “Oh, okay, so it's not stupidity.” And I get where parents are coming from because parents will often say, when I give talks, they're like, oh, I don't know. I didn't want my kid to know that they're different. And I say, first they are different, but it's our job to tell them that different is not defective, that we need to define the term for them because they know they are.
I think this is very common also for folks with ADHD. Everyone I know with ADHD, myself included, has a memory when they were young of knowing I'm wired a little bit differently than other people are in this classroom. And the hope is that narrative doesn't spin into this is bad or I'm stupid or whatnot. So for a lot of kids with dyslexia who are not diagnosed, they think they're stupid and then it can really spiral into anxiety, school refusal behaviors. Sometimes what can look like oppositional conduct disorder behavior, but it's really kids that just would rather look like they're difficult than to look dumb in that way. And when I was younger, the remedy, what they would do, was just keep a kid back. I remember, Gene, when I was in eighth grade, there was a student in my class who was kept back three times.
I would hope that they don't do that today. Generally it's not the practice today, because it doesn't work just to have someone, it's almost like if you've never spoken Chinese, and I'm just speaking to you in Chinese, you're like, “I have no concept of this.” And I'm like, we’ll just keep you back and I'm going to speak to you again in Chinese and keep doing the same thing. That's not going to work. Repeating a grade doesn't help that. You need specific educational remediation. So that's the thing. And also, we want to basically teach these kids strategies of how they can talk about it. And this is where, honestly, the ADHD field has come a long way because there's a lot less stigma than there was years ago around ADHD. We still have a way to go, but we need to do that same thing with dyslexia.
And what I did with my son, with both of my kids, is I explained it. My son was six when he got diagnosed, my daughter was a little bit later. I said, a lot of people don't understand this, frankly, and it's not your very bright individual. He was a fan of the show Shark Tank and three of the sharks on Shark Tank are dyslexic Daymond Johns, Barbara Corcoran, and Mr. Wonderful Kevin O'Leary are all dyslexic. Really, it was so convenient because he's such a fan of the show. I said, so, if somebody is surprised because he had to be pulled out of classes, he was in special ed from first grade every summer, he was in a remediation program. And I think it's important to help these kids know how to talk about it with their peers. And one of my proudest moments that I always think back to is after we had this conversation, and I bought every children's book I could find on Amazon about dyslexia.
Henry Winkler, the Fonz, is dyslexic, and he has this whole series of children's books called Hank Zipzer, who's this awesome, I think he might have ADHD as well, but he's definitely dyslexic, bought all those books. And I remember picking my son up from school and, Oh, how was your day? It was great. And we had music class, and we had to read these words to the song. He goes, I couldn't read any of the words. And I said, oh, what happened? He goes, oh, I just went to this girl next to me. And I said, can I stand next to you and hear you say the words? I can't read any of these words. And again, my son scored in the 99th percentile in vocabulary, and I said, sometimes people will be surprised that your reading is where it is. And she said, “What do you mean you can't read this?”
And he said, no, I have this thing called dyslexia, [like] three of the sharks on Shark Tank. And he just matter-of-factly explained and she went, oh, okay, and that was that. And that to me was like, oh my gosh, because those are the moments where if you don't have that, he could have felt like, oh my gosh, so belittled by that, and even though it wasn't her intention to bully him, she just was shocked by it. So, we want the diagnosis, we want the identification so that these kids understand there's a name for this and that there's lots of smart people that have dyslexia, and it just makes reading and spelling a little bit challenging, so that it doesn't have to be a social-emotional issue.
Dr. Eugene Arnold (25:29): To some extent, you're taming the beast by naming it.
Dr. Roberto Olivardia (25:32): A hundred percent.
Dr. Eugene Arnold (25:33): Yeah. Okay. So, this kind of brings us, then, to other things that can be done for people with ADHD and/or dyslexia. How are they treated? Do the same treatments work for both, or do they need different treatments? Maybe talk a little bit about the ICARD study?
Dr. Roberto Olivardia (25:49): Definitely. With dyslexia, that it really requires different educational accommodations than what we would have a neurotypical reader have. So, there are various programs—the Wilson program is one, Lindamood-Bell, Orton-Gillingham. These are empirically validated educational, basically remediation for dyslexia. It's not enough to just have the same teaching that a non-dyslexic student would have with reading. So that's why getting the diagnosis and having it be identified is really important, because it will require typically an IEP or an individualized education plan in school because it's more than just a modification. You'll typically be meeting with a specialized language-based instructor who has that knowledge. Now with ADHD, what we know is that if you treat ADHD, it's going to help. It doesn't directly treat the dyslexia, but it absolutely helps because if you have a child that's not grounded or is impulsive, is getting distracted, it's going to make it even that much harder for them to do the work that they need to do to remediate the dyslexia. So there's no medication for dyslexia. It's really this more educational instruction, but it can't be emphasized enough how important that instruction is because it really is catering to how that brain has to learn the basics of phonemes and all that processing that comes more automatically to a neurotypical reader.
Dr. Eugene Arnold (27:29): Okay. I think the ICARD study took kids who had both ADHD and dyslexia in a two-by-two design and had some of them get both medication for ADHD and instructional remediation, others got instructional remediation with the placebo pill, and others just got medication without the instructional remediation. They found that the treatments were very specific, that the medication for ADHD helped the ADHD but didn't do much for the dyslexia and the instructional remediation helped the dyslexia significantly, but did not actually change the ADHD symptoms. So, it sounds, then, like it needs to be a multimodal approach to kids with the double whammy.
Dr. Roberto Olivardia (28:20): Definitely. And that's where, for parents out there listening, that when you have a child with either or both ADHD and dyslexia, you become your child's advocate. And that's very true with dyslexia, especially where parents, and it's so important for parents to find community and talk to other parents who have kids who have dyslexia to know, because each school system is different. And the truth is that not all school systems are designed similarly with the same resources. And so, a lot of times you might find yourself fighting and really advocating, but sometimes fighting for resources to get your kid what they need, sometimes it's not going to be adequate. Having those IEP meetings and talking to teachers and sharing with the school, especially if you have a child that is overcompensating in school but melting down at home, which happens to both ADHD and dyslexic kids. I was exhausted by school and when I would come home, I'd just be so tired, and again, reading fatigued me so much. [In] high school, I'd fall asleep in classes and stuff, but I don't think teachers really understood how difficult that was for me.
So parents are on the front lines, and they need to share that information to say, just so you know, they're squeaking by in school and maybe because they want to be a good student and they don't want to embarrass themselves around their peers, but they're coming home and they can't even engage with homework when they have ten pages to read, they just look at it and they're paralyzed. That information is really helpful and lets them know that they need these empirically validated remediations for reading and again, finding community. There's a grassroots organization called Decoding Dyslexia that has chapters in most states in the US. We have a very active chapter here in Massachusetts. They were phenomenal. Other parents who basically share resources and then here in Massachusetts before the pandemic, they bring all the kids together so the kids have community and meeting other kids with dyslexia and sharing all the strengths that come along with that brain. Because it's just like, it's not uncommon, for example, to see in the entrepreneurial field and fields of innovation, people who learn and think differently. Makes sense, but you can't get there unless you can get through and navigate through the obstacles of making sure you're getting the right education.
We have a joke in the dyslexia community that sometimes a problem isn't the dyslexia as much as not getting the right resources or “dysteachia” that they're not being taught the way that they need to be taught.
Dr. Eugene Arnold (31:07): It sounds like one of the points you're making is that the home and school have to work together. They have to communicate each way and realize what the student is going through, and I'm wondering if a daily report card has any value there. I know it's very effective with ADHD. Does it also help with dyslexia?
Dr. Roberto Olivardia (31:27): Sure. The more collaboration the better. And I always say that's so important to try. A lot of times it can feel like there's almost this adversarial relationship, and I think it's so important to not, obviously we want to minimize it as much as possible and really bridge a gap because teachers are doing the best they can. And he was in his Montessori kindergarten class and his teacher said, there's something different with his reading, and she was picking up on something, and it was really great that we would work together because there are things like, you wouldn't have a kid with dyslexia read out loud, for example. That could be socially humiliating for a student with dyslexia. So that kind of information to let the teacher know, and that's something you can put in the IEP, not ask to read out loud, but yeah, if there's that kind of communication, even a simple email, and I know teachers are so overwhelmed that there's so much work that they have to do, but certainly on a weekly basis to say, I'm noticing this here in school. What are you seeing at home? And the more communication and collaboration the better.
Dr. Eugene Arnold (32:35): Do you want to summarize the main points that you would like the audience to take away?
Dr. Roberto Olivardia (32:42): Absolutely. So, dyslexia, again, is a language-based learning disability. It's not related to intelligence, it's not related to hearing issues. It's not related to one's ability to articulate words and vocabulary. It is really around the parts of the brain that recognize words and sounds and symbols, and that affects spelling and reading and reading comprehension. It affects a lot more people than people would think it affects. Also gender-wise, boys and girls equally, it tends to run in families, neurobiologically based, but is still identified. If your child is having issues with reading, definitely talk to the school about it and say, I don't know if this is, maybe they're just not as interested in the reading, but I want to keep my eye on this. And if you have reason to believe that the child is getting especially behind and starting to hate reading, get them tested; and especially if it's something that runs in the family, to know that's an important genetic influence that could be there as well.
And to know that once your child gets the proper empirically validated remediation, again, it has to be these programs that are designed to help kids with dyslexia. When they have that, it doesn't have to impact their self-esteem. Again, dyslexia is not hazardous to your health; that if they get the right framework of what it is and the right educational approach, some things, again, like spelling, they're probably not going to be great spellers ever. We don't have to be these days. We have spellcheck and there are wonderful resources and technologies. My son's on the dean's list and he's in college now, but he still uses these resources even though he's at grade level now to read. But part of it also psychologically is lean into other support of the community. I work with a lot of young kids with dyslexia to not only deal with sometimes the self-esteem part, but just the acceptance, because it is frustrating when it's taking you maybe three times longer to do something than it might your peer.
There is this level, just like with ADHD, this level of acceptance of, this is just how my brain is wired. I wouldn't throw out my brain for anything. I attribute a lot of my successes to this brain, but I also attribute a lot of frustrations and not-so-great things sometimes to this brain. That work is also equally important, honestly, because you want the child to have an understanding of I accept that this is how it is, and, with this knowledge to know that there are resources available to me and I just have to partake in those resources and not carry shame around that. And whatever your child's interested in, if they're interested in music, athletics, science, Google those who are dyslexic, individuals who are in those fields so that they can look to those people and think, oh, okay, I'm in pretty good company. Similarly, if your son's an athlete or daughter's an athlete and they have ADHD and they see someone like Michael Phelps or Simone Biles, and to know this doesn't have to hold me back, but I have to work at it at the same time.
Dr. Eugene Arnold (36:00): The analogy I've often used is that some people naturally learn to swim when they're young. You throw them in the water and they take off paddling and just do it naturally. Other people have to take swimming lessons in order to learn how to swim. Some kids have similar conditions that they have to take lessons to learn how to do it, and they have to try a little harder, but that's not all bad because if you learn how to try hard, that could carry you a long way in other ways in life.
Dr. Roberto Olivardia (36:31): A hundred percent when it's hard for a child to understand it when they're young. My son's essay, his college essay actually was about what being dyslexic [is like] and that whole experience and the extra work and every summer program and the tutors, but how it really built this resilience in him that he feels like he's navigated all of these things that didn't come easy, and now he is not as thrown by adversity in that way. And I feel that way about ADHD and some of the issues that I had, that I'm like, okay, I got through it, and I navigated it. It wasn't always easy, but at the same time it built something in me, but provided that, again, you need that right support, the right education, and a sense of community.
Dr. Eugene Arnold (37:21): Okay, we're at the end of our time. I want to thank you, Dr. Olivardia, for some very optimistic and encouraging, maybe even inspiring information about what can be done to help dyslexia, whether comorbid with ADHD or not.
Dr. Roberto Olivardia (37:37): My pleasure. Thank you, Gene.
Announcer (37:41): Pocket MD is brought to you by CHADD with funding from the US Centers for Disease Control and Prevention, and in partnership with the Rainbow Center at Rainbow Babies and Children's Hospital.