It has taken more than 120 years since dyslexia was first described. But we finally have a definition that is universal and incorporates all of our up-to-date knowledge; the science, the paradox, the educational implications, and the importance of a diagnosis for school and for personal life satisfaction. Given the importance of the definition of dyslexia to its diagnosis, a critical step has been its codification into federal law, Public Law 115-391. The law reads, "The term 'dyslexia' means an unexpected difficulty in reading for an individual who has the intelligence to be a much better reader, most commonly caused by a difficulty on the phonological processing, the appreciation of the individual sounds of spoken language, which affects the ability of an individual to speak, read, and spell." This definition applies to all those boys and girls, men and women affected throughout the world. More and more countries are recognizing their citizens who are dyslexic. I have been both surprised and gratified that the first edition of Overcoming Dyslexia has now been translated not only into the usual alphabetic languages such as Portuguese, Dutch, Croatian, and Polish, but also as I noted earlier into Japanese, Chinese, Mandarin, and Korean. The relevance of the unexpected nature of dyslexia on bright children, especially for bright children and adults who struggle to read and for whom reading is a slow, laborious process. The concept of dyslexia as an unexpected difficulty has great relevance. These bright, open, gifted individuals, through extremely hard work, much practice, and resilience often learn how to read relatively accurately, but almost never automatically. Although they were able to read or make good guesses out what a word is, reading remains a slow and tiring process. That said, I have come across quite a number of dyslexic men and women who are relatively fluent readers of material in their area of expertise, such as those in finance who are daily readers of The Wall Street Journal, or those in a particular area of medicine who regularly read articles in their specialty, including cardiology, psychiatry, and anesthesiology. The individual's focused interest in a topic draws her to reading and frequently rereading materials, which leads to a relative degree of fluency in that specific area. The published empirical demonstration of a disparity between intelligence and reading, and the federal definition of dyslexia as unexpected has significant implications for the diagnosis of dyslexia. First, it means that an IQ test is integral to the definition of and the assessment for dyslexia, especially for very bright students. Many schools try to take shortcuts and omit this important test as part of the evaluation of a student with dyslexia. I believe they usually reflect financial constraints. However, such an omission is a disservice to the child. Reading in the average range should not be used to deny a diagnosis of dyslexia or to withhold needed services. Reading scores of bright dyslexic boys and girls may be in the average range, but the manner in which they read, the effort required, and the lack of automaticity observed a slow reading is not average. What matters most in diagnosing dyslexia is what the person must do to read, the energy he expends into ciphering the printed work. Legally and scientifically, no ceiling is placed on what level of reading is consistent with a diagnosis of dyslexia. Bright students can have a reading score in the average range and still be considered, and indeed, are dyslexic. Caution, there are myths about dyslexia that need to be shattered. Among them, dyslexia is a medical and not an educational diagnosis. This is wrong and harmful to dyslexics who need to receive a diagnosis in order to receive school support. While dyslexia is neurobiologically-based, it brings with it significant educational implications. Dyslexia originates from the brain, as does every other learning ability or disability. Who can make a diagnosis of dyslexia? You may have heard only a neuropsychologist can make a diagnosis of dyslexia. Wrong. The diagnosis of dyslexia can be made by a professional with a deep understanding of dyslexia, including an educator, a school psychologist, a physician, and a speech and language therapist. Dyslexia is a clinical diagnosis based on the individual's history, observation of him speaking and reading aloud, and test scores as I said earlier. It is important to know that you do not need to be the person who administers each test in order to be the one to make a diagnosis of dyslexia. In a similar way, if I or anyone else knowledgeable about dyslexia sees a child who may be dyslexic, I will take a history, listen to him speaking, and reading aloud, and order a test of intelligence, along with other relevant measures of reading. The same approach can be and is taken by the professionals. I'm Toby Cosgrove, a recovering heart surgeon and former CEO of Cleveland Clinic. What was your most recent position at the Cleveland Clinic and for how many years? I was CEO of the Cleveland Clinic for 13 years, and that's when I retired from. Did your dyslexia affect you in your everyday practice as a surgeon? Yeah. Dyslexia has been a constant part of my life ever since I heard the word for the first time at age 34. But I didn't read anything other than medical texts for a long time. I wound up finding out that if frequently to do the heart operation, but then if I had somebody who had a name other than Smith or Jones that I would have to call after the operation, I'd be in a slight panic about how do you pronounce the name. But it's been part of my existence and has affected, essentially, everything I do. I frankly think it's been a blessing for me after I got through medical school. How has that been? Well, it turns out that I look at problems differently. The first time I realized this was when I was a consultant for a company and they had very distinguished people around the table and they were presented with problems, everybody around the table and finally came to me and I was thinking about it completely differently than everybody else was. That made me realize that I looked at problems differently. The other thing that dyslexia, that it made me a terrible student, and because I was a terrible student, I just had to work twice as much as anybody else did. I think that persistence was a beneficial offshoot of being dyslexic and struggling so hard with my educational background.