Dr. Mary Mollway, Ed.D.
Reading is NOT the problem
The number one reason why parents bring their children to see me is that they are struggling with reading. The school has tried all of its interventions and yet the child is still not reading. I am a reading and dyslexia specialist and so doctors and occupational therapists will often refer people to me for that reason.
However, reading is not the problem. It is a symptom of the problem. I’ll say that again. Reading is not the actual problem. Think of it this way. You go to the doctor and he tells you that your cholesterol is too low. The problem isn’t actually that your cholesterol is too low; something has gone wrong in your endocrine system and that is CAUSING the low cholesterol. As a practitioner, I am always more interested in what is behind the problem. Once we address that, the symptom (in this case, reading), will improve.
So, if an 8-year-old still isn’t reading, what IS the problem? Simply, it is a lack of connection, myelination, and timing in multiple pathways in the brain. Reading is an incredibly complex task and requires all areas of the brain to communicate efficiently, effectively, and accurately for that to occur.
First of all, we have to take in letters and words from the page. This requires our vision system to accurately see the letters from left to right, determine the shapes of each one, take those images, send them back to the visual cortex (this is called Visual Acquisition Time), and then send those up to the language centers of the brain.
Once we’ve identified the letters, our auditory system hops on board, and associates a sound with those letters, known as phonological processing. This is called a “paired association.” The letter “b” always makes a certain sound, so the symbol and the sound have an association.
Then, the sounds like /b/ /a/ /t/ are put together to make /bat/ and that information and sent back to the visual word form area to determine if we already know that word.
The information goes back up to the language centers to determine if we know the meaning of that word. In the case of the word “bat,” it has multiple meanings, including 1) a small mammal; 2) the thing you swing at a ball; 3) the act of swinging at a ball; or to be “at bat” or to be “batty.” We then use context to determine what is the correct definition, put it together with the rest of the words, and then process the meaning of the entire sentence.
All in nanoseconds.
Regulating all of this work is the prefrontal cortex, which exerts executive control over everything else in the brain. This keeps us focused, able to block out distractions, and hold things in short-term, or working memory.
You see how many neurological processes are involved in the “simple” act of reading? If any of those pathways did not connect correctly during early childhood or did not myelinate correctly OR if our prefrontal cortex is underactive and not regulating everything, you will see difficulties with reading. Dyslexia is nothing more than underdeveloped auditory and visual pathways with additional deficits in working memory, processing speed, and attention.
How can this be addressed? Reading tutoring is often not enough. Although systematic and explicit instruction as outlined in the Science of Reading research can bring about changes in the brain, oftentimes students need more intensive work around developing those sensory pathways, improving timing of neural messaging, and improving executive functioning. I’ve developed a protocol for this in my private practice which includes improving sensory system development, evaluating and maturing our primitive and postural reflex patterns, and training the brain using programs like Interactive Metronome and neurofeedback like Play Attention.
As I mentioned, reading is an incredibly complex task, and remediating challenges is not a quick fix. The earlier it is caught the better, so if your three-year-old is already showing signs of not being able to clap in time or identify shapes and colors, intervene early with a neurodevelopmental specialist. It could change your child’s trajectory and prevent reading failure.