Evidence-Based Treatment for Dyslexia
Structured literacy interventions that explicitly teach phonemic awareness, phonics, decoding, fluency, vocabulary, and comprehension represent the evidence-based treatment for dyslexia, with daily intensive individualized instruction being most effective. 1, 2
Core Treatment Components
The most effective remedial programs must include specific instruction in the following areas 1:
- Phonemic awareness training - Direct, explicit teaching of sound-symbol relationships, as dyslexia fundamentally represents a phonological processing deficit 1, 2
- Decoding instruction - Systematic teaching of the alphabetic code to improve word recognition 1, 3
- Fluency training - Repeated reading practice to improve automaticity and reading rate 2, 4
- Vocabulary development - Explicit instruction in word meanings and morphological awareness 3
- Reading comprehension strategies - Teaching methods to extract meaning from text 1, 2
Structured Literacy Approach
Structured literacy (SL) interventions should be implemented as the primary treatment framework, incorporating all aspects of spoken language into reading, spelling, and writing instruction 3. This approach includes:
- Morphological skills training - Teaching word structure, prefixes, suffixes, and root words to improve both decoding and comprehension 3
- Daily intensive individualized instruction - Most effective programs provide consistent, one-on-one or small group sessions 1
- Explicit systematic teaching - Direct instruction rather than incidental learning approaches 1, 3
Treatment Intensity and Duration
The evidence supports specific parameters for intervention delivery 1, 2:
- Early intervention is critical - Recognition and treatment should begin as soon as dyslexia is identified to achieve optimal outcomes 1
- Sustained intervention - Treatment effects require ongoing instruction, with some studies showing benefits lasting at least two months post-intervention 4
- Progression from word-level to fluency - Initial focus on word reading accuracy, then advancing to fluency and comprehension as skills develop 2
Adjunctive Interventions
While phonological training remains primary, emerging evidence supports complementary approaches 4:
- Dynamic visuo-attentional interventions - Computerized programs targeting visual attention can improve reading fluency and comprehension, with effects equal to or greater than traditional strategies 4
- Visual perceptual training - Benefits reading fluency and comprehension in some studies 4
- Visually-based reading acceleration programs - Improve reading accuracy and rate 4
Accommodations
Accommodations are essential and neurobiologically supported for dyslexic students throughout their education 2:
- Extended time on tests and assignments 2
- Access to audiobooks and text-to-speech technology 2
- Alternative assessment methods that don't rely solely on reading speed 2
What Does NOT Work
Vision-based treatments lack scientific support and should be avoided 1:
- Visual training, muscle exercises, or ocular tracking exercises are ineffective 1
- Behavioral/perceptual vision therapy has no valid evidence 1
- Colored lenses, filters, or "training" glasses do not treat dyslexia 1
- Prisms and vision therapy do not make children more responsive to educational instruction 1
Critical Implementation Points
The treatment must address the underlying phonological deficit, as dyslexia represents a language-based disorder, not a visual problem 1, 5. Children with dyslexia have the same visual function as children without learning disabilities 1. Treatment directed at visual processing rather than phonological processing wastes valuable intervention time 1.
Referral to qualified professionals trained in evidence-based structured literacy approaches is necessary rather than attempting unproven interventions 1. The genetic and neurobiological basis of dyslexia (involving left temporoparietal dysfunction) supports the need for intensive, direct phonological intervention 5.