Who is dyslexic? What are their symptoms? Does their intelligence level give you a clue? Are slow readers also slow thinkers. Dyslexia affects people of all ages; children, young adults, adults, and older people as well. Here I want to introduce you to one of my patients, Alex, who was 10 years old. First, I want each of you who is listening to imagine what his symptoms might be. Close your eyes and take a minute or two to do that. Here are what his and typical dyslexic symptoms are. Trouble reading, an absolute terror of reading aloud in front of others, problems with spelling, difficulties finding the right word when speaking, the person knows what they want to say, but it's not what comes out of their mouth, mispronouncing words, rote-memory nightmares, all represent the expression of a single isolated weakness within the spoken language system that I will tell you about shortly. At the same time, you will learn that other abilities, intellectual abilities, thinking, reasoning, understanding, are untouched by dyslexia. This contrasting pattern produces the paradox of dyslexia. Profound and persistent difficulties experienced by some very bright people and learning to read. I am emphasizing the strengths of the dyslexic because there is often a tendency to underestimate his or her abilities. The reading problem is often glaringly apparent, while the strengths may be more subtle and often overlooked. As I will discuss in a subsequent lecture, new insights into brain function in dyslexia tells us that it represents a very isolated weakness. The neural systems involved in thinking and reasoning are intact and perhaps even enhanced. Alex's parents brought him to the Yale Center for Dyslexia and Creativity for evaluation. We learned that Alex was extremely smart, scoring in the gifted range in abstract reasoning and in logic. His vocabulary was also highly developed. Alex could learn, he could reason, and he could understand concepts at a very high level. Despite these strengths, his performance in reading words was dismal. For example, he was able to read only 10 out of 24 words on a third-grade level. Reading aloud was particularly painful for Alex. He was reluctant to read in front of the class, and it was easy to understand why. His reading was labored, words were mispronounced, substituted, or often omitted entirely. Words that he correctly read in one sentence, would be misread in a subsequent sentence. He read excruciatingly slowly and haltingly Increasingly, Alex would ask to go to the bathroom when it was nearing his turn to read. If called upon, he often acted silly, making the words into a joke or tumbling himself onto the floor and laughing so that he would have to be sent out of the room. His reading problems were compounded by his poor spelling. In contrast, Alex's Math skills, particularly problem-solving, and reasoning abilities, were in the superior range. At the close of the testing, Alex's diagnosis on reading problems; I don't know the sounds letters make. He was right. Why does Alex have trouble reading? Is it a problem with his visual system, with his thinking, with his language system, all of these, none of these, or one of these? In contrast to a popular myth that children with dyslexia are prone to seeing letters or words backwards, the deficit responsible for dyslexia impact resides in phonology, a specific component of the language system. These poor readers, like Alex, do have significant typical teal to, however, in the letters, often calling or reading saw as was, the problem, is a linguistic one, not a visual one. As noted previously, dyslexia represents a specific difficulty with reading, not at all with thinking. Comprehending spoken language is often at a very high level, as it was for Alex, as our other higher-level reasoning skills. Let's get to know a critical component of the language system. The phoneme; what it is and what it does. The phoneme is defined as the smallest unit of speech that distinguishes one word from another. The phoneme is the fundamental element of the language system. The essential building block of all spoken and written words. It is that different combinations of 44 phonemes produce the tens of thousands of words in the English language. The word cat, for example, consists of three phonemes; k, aaa, and t. Before words can be identified, understood, stored in memory, or retrieved from it, they must first be broken down into phonemes by the neural machinery of the brain. Language is a code. The only code that can be recognized by the language system and activate its machinery is the phonological code. This is critical for both speaking and reading, as shown in this figure. This figure shows a biologic mechanisms to speaking and reading. On top, you'll see speaking and below reading. In speaking, if I want to say the word cat, I have to access and retrieve each of the sounds, the phonemes, the k, the t, and the aaaa, serially order them, and then that will activate the muscles of articulation and I will be able to utter the word "cat". Now let's look at reading. In reading, you start with the intact printed work, c, a, t. In order to read the word, you have to transform each of the letters into its sound. The c into k, the a into aaaa, the t into t. You want to put them together and you can identify the word. In order to read the word, we have to transform each of the letters into its sounds. The c into the k, the a into the aaaa, the t into the t, blend the sounds together and then you can read the word. That's word identification. One of the things that I have been able to learn during this time of learning how to pronounce the eight words, it's sounding them out using my fingers. Like bat; baaat. It's breaking it down in a way that I don't have to memorize words. That's one of the things that's been one of the biggest ground banking experiences that I've learned so far. Doing my tutor time, I don't have to try to memorize a word. I can actually break it down and sound out each letter. It's been so emotional. I literally cried in every session. Literally cry in every session. Being able to sound out words, it's been amazing.