Management of Dyslexia
Dyslexia should be managed through highly structured, intensive educational interventions that explicitly teach phonemic awareness and phonics, combined with early neuropsychological evaluation to identify specific learning deficits and guide individualized remediation strategies.
Core Treatment Approach
Educational Interventions (Primary Treatment)
Implement daily intensive individualized instruction that explicitly teaches phonemic awareness and the application of phonics as the foundation of treatment, as dyslexia is fundamentally a language-based disorder characterized by phonological processing deficits 1, 2.
Remedial programs must include specific instruction in four key areas: decoding skills, fluency training, vocabulary development, and reading comprehension 2.
The condition can be managed by highly structured educational training exercises that target the phonological coding deficits underlying the disorder 1.
Occupational therapy focusing specifically on writing skills may be beneficial for children with visual-spatial or visual-motor integration difficulties that commonly co-occur with dyslexia 3.
Formal Assessment and Educational Planning
Early neuropsychological evaluation is useful and beneficial for identifying specific interventions that optimize school performance, particularly for children showing concerning surveillance results or at high risk for developmental disabilities 3.
Formal neuropsychological testing should assess visual-spatial abilities, executive functioning, attention, and academic skills to create an individualized remediation plan 3, 4.
Secure an Individualized Education Program (IEP) or 504 Plan to formalize educational accommodations, as children with learning disabilities are more likely to require special education services 3, 5.
Potential accommodations include: using a computer for written work, allowing extended time for tests, and providing assistive technology for children with writing difficulties 3, 5.
Timing and Prevention
Early Intervention
Preventive intervention in kindergarten and at home is often effective when behavioral and brain measures identify infants and young children at risk for dyslexia 6, 7.
Evidence-based teaching practices combined with early identification could prevent dyslexia from occurring in the majority of at-risk children 7.
Early recognition and referral to qualified professionals for evidence-based evaluations and treatments are necessary to achieve the best possible outcome 2.
Comorbidity Management
Screen and Treat Co-occurring Conditions
40% to 60% of dyslexic children have psychological manifestations including anxiety, depression, and attention deficit that require concurrent treatment 6.
The diagnostic assessment must include evaluation of the child's psychological state, with additional information from parents and teachers 6.
If ADHD is comorbid with dyslexia, treat the ADHD with FDA-approved medications (particularly stimulants) as first-line treatment, as this addresses attention deficits that interfere with learning 5.
Psychotherapy should be provided for any coexisting psychological disturbance 6.
Collaboration and Monitoring
Medical home providers should collaborate with education specialists and school intervention personnel to present formal medical and developmental evaluations to school personnel and maximize school support 3.
Interventions should specifically target visual-spatial abilities, as children with learning disabilities would benefit from this focused approach 3.
Reassess the diagnostic formulation if response to adequate treatment is poor, considering unrecognized comorbidities or psychosocial stressors 5.
What NOT to Do: Common Pitfalls
Do not recommend vision therapy, muscle exercises, ocular pursuit-and-tracking exercises, behavioral/perceptual vision therapy, "training" glasses, prisms, or colored lenses/filters, as there is no valid scientific evidence that these treatments are effective for learning disabilities 2.
Vision problems do not cause or increase the severity of dyslexia—children with dyslexia have the same visual function as children without the condition 2.
Avoid delaying treatment while pursuing unproven interventions, as early evidence-based intervention is critical for optimal outcomes 7, 2.