What are the treatment options for a school-age child with dyslexia?

Treatment Options for School-Age Children with Dyslexia

School-age children with dyslexia require intensive, individualized phonics-based reading instruction combined with psychotherapy when psychological comorbidities are present, delivered through structured educational programs with appropriate school accommodations.

Core Educational Interventions

Phonics-Based Remedial Programs

• Daily intensive individualized instruction explicitly teaching phonemic awareness and phonics application is the foundation of dyslexia treatment 1, 2, 3.
• Remedial programs must include specific instruction in four key areas: decoding skills, fluency training, vocabulary development, and reading comprehension 3.
• Treatment intensity matters: programs should provide daily sessions focused on the phonologic component of language, which is the underlying deficit in dyslexia 3.
• Behavioral remediation is most effective when started at a young age, though not all children respond equally 2.

Evidence-Based Teaching Methods

• Structured teaching approaches with explicit instruction methods should be tailored to each child's specific strengths and vulnerabilities 4.
• Functional training combined with learning behavior management techniques improves both reading/writing performance and the child's ability to handle persistent difficulties 5.
• Early recognition and referral to qualified professionals for evidence-based evaluations and treatments are necessary to achieve optimal outcomes 3.

School-Based Support Systems

Individualized Education Plans (IEPs)

• Children with dyslexia may be eligible for services under a 504 Rehabilitation Plan or special education IEP under the "other health impairment" designation 6.
• An IEP is recommended to facilitate an educational environment appropriate for each child's specific learning needs 6.
• Educational accommodations should include extended time for tests and assignments, reduced homework demands when appropriate, and provision of teacher's notes 6.

Classroom Accommodations

• Preferential seating close to instruction facilitates learning 6.
• Technology options including tablet computers, laptops, and audio reading programs are often more acceptable to older children who may be self-conscious about using traditional assistive devices 6.
• Early keyboarding instruction should be encouraged to optimize computer accessibility options 6.
• Video magnification and electronic readers can assist with accessing printed materials 6.

Management of Psychological Comorbidities

Assessment and Treatment

• 40% to 60% of children with dyslexia have psychological manifestations including anxiety, depression, and attention deficit that require concurrent treatment 1.
• Diagnostic assessment must include evaluation of the child's psychological state using information from parents and teachers in addition to standardized reading and spelling tests 1.
• Psychotherapy should be provided for any coexisting psychological disturbance, as strengthening the child's psychological ability helps them handle the persistent handicap more successfully 1, 5.

Common Pitfalls

• Vision-based treatments lack scientific support: visual training, muscle exercises, behavioral/perceptual vision therapy, prisms, and colored lenses are not effective treatments for dyslexia 3.
• Children with dyslexia have the same visual function and ocular health as children without learning disabilities; vision problems do not cause or increase the severity of dyslexia 3.

Integrated Treatment Approach

Coordination of Services

• Treatment efforts should be combined and integrated, including individual reading/writing treatment, psychotherapy for emotional support, special education at school, and family support 5.
• Strong family-school partnerships enhance the management process 6.
• Parent training to implement interventions at home is crucial for optimal outcomes 7.

Realistic Expectations

• Dyslexia tends to persist: only about 4% of severely disabled readers attain normal reading level during high school 5.
• However, treatment significantly improves prognosis concerning educational and occupational career trajectories 5.
• Functional plasticity associated with effective intervention can be demonstrated through neuroimaging, indicating brain-level changes with proper treatment 2.

Monitoring and Follow-Up

• Regular reassessment at transition periods (primary to secondary school, secondary to post-secondary) is recommended to adjust interventions as environmental demands change 6.
• Monitoring should address both academic progress and psychological well-being, as early treatment prevents failure at school and reduces emotional problems 5.
• Educational specialists should partner with medical providers to maximize school support and ensure appropriate resource allocation 6.