Basic information
Scientific name of western medicine
reading disorder
subordinate unit
Gynecology and pediatrics-pediatrics
cardinal symptom
There are obstacles in reciting letters, and words are omitted when reading aloud
Multiple groups
school-age children
transmissibility
noninfectious
catalogue
1 encyclopedia business card
2 disease overview
3 Research progress
4 Clinical manifestations
5 Diagnostic information
6 disease treatment
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Reading disability is a common learning disability of school-age children, accounting for about 4/5 of learning disabilities. Clinically, dyslexia is divided into acquired dyslexia and developmental dyslexia (DD). Acquired dyslexia refers to dyslexia caused by congenital or acquired brain injury and corresponding audio-visual impairment. DD refers to the phenomenon that children with normal intelligence have no obvious neurological or organic damage during their development, but their reading level obviously lags behind their corresponding intellectual level or physiological age. The dyslexia mentioned in this article refers to DD.
Fold and edit this disease overview.
Dyslexia may be one of the most common neurobehavioral diseases in children, with an incidence of 5% ~ 18%. The manifestations of dyslexia may be different in different languages and writing systems, and the incidence of dyslexia in primary school children is about 3%~ 10%. For a long time, it has been thought that dyslexia mainly involves boys. Slavica et al. conducted a retrospective cohort study on 5765,438+08 children born in 65,438+0976 ~ 65,438+0982, in which the incidence of dyslexia in boys was about 2-3 times that of girls. In recent years, more data show that the number of cases between men and women is almost equal. In the previous statistics, the incidence of boys was higher, which was due to the deviation of the school's selection of samples. Some longitudinal studies, whether prospective or retrospective, show that dyslexia is a long-term persistent state, not a short delay in development. With the passage of time, the difference of reading ability between dyslexic readers and normal readers remains relatively stable.
Research progress of folding editing this paragraph
Study on folding behavior
On the basis of studying dyslexia for many years, three most influential theories have been formed in the west, namely, phonological defect theory, general sensory defect theory and cerebellum theory. According to the theory of phonetic defects, DD learners have defects in phonetic representation, storage and/or extraction, which further affects the shape-sound conversion, resulting in poor phonetic skills and impaired reading ability. According to the general theory of sensory deficit, dyslexia is caused by basic sensory deficit, including visual processing deficit and auditory processing deficit. Visual processing defects directly affect reading. Hearing processing defects lead to speech defects, which in turn affect reading. Cerebellum theory holds that the dysfunction of cerebellum in dyslexics leads to the defect of automation, which in turn affects the correspondence between form and sound, leading to the decline of children's reading ability. The cerebellum has many functions, such as individual movement balance, automatic formation, blink reflex, implicit learning and time estimation.
Among the three theories of pinyin dyslexia, phonetic defect theory is dominant, that is, phonetic defect is the core defect of pinyin dyslexia. However, in China, Chinese is a non-phonetic system, and there is no corresponding phonetic rules. Therefore, pronunciation cannot be directly accessed from the metaphysical part, and pronunciation does not necessarily play a necessary intermediary role in semantic access. Therefore, the theory of pinyin dyslexia may not be applicable to Chinese dyslexia. Because the research on Chinese dyslexia started late, there is no mature theory at present.
Study on folded cranial nerves
In recent ten years, with the development of functional magnetic resonance imaging (fMRI) and event-related potentials (ERP), great progress has been made in exploring the brain nerve mechanism of dyslexia. Supporters of all three theories have found evidence of corresponding cranial nerves. According to the theory of speech defect, the dysfunction of cortex around the left lateral fissure of the brain, especially the left temporal parietal junction and the left inferior frontal gyrus, causes speech defect and leads to the decline of reading ability. According to the general theory of sensory deficit, dyslexics have defects in visual and auditory processing, which is due to the abnormality of large cell system. Cerebellar theory holds that the decline of reading ability of dyslexics is due to the disorder of cerebellar function, and the study of cranial nerves has indeed found the abnormality of cerebellar activity of dyslexics.
Folding genetic research
Genetic research shows that genetic factors have a great influence on dyslexia, but only by finding the genes that affect dyslexia can we draw a positive conclusion. Recently, the Human Genome Nomenclature Committee identified nine susceptibility sites for dyslexia: dyx 1-dyx9 (dyx 1,15q21; DYX2，6p 2 1； DYX3，2p 16-p 15； DYX4，6q 13-q 16； DYX5，3p 12-q 12； DYX6， 18p 1 1； DYX7， 1 1p 15； DYX8， 1p 34-p36； DYX9，Xp27)。 Galaburda et al. [14] summarized the genetic research for 20 years and found four susceptibility genes for dyslexia-dyx1c1,KIAA03 19, DCDC2 and ROBO 1. The abnormal expression of these susceptibility genes leads to abnormal nerve cell migration and axonal development, which affects the functions of cerebral cortex and thalamus, further causes defects in perception, movement and pronunciation, and further affects reading.
Fold and edit the clinical manifestations of this paragraph.
General clinical manifestations of folds
In the alphabet writing system, dyslexia may be manifested in the early stages of reciting letters, naming letters correctly, word segmentation, pronunciation analysis or classification. After that, there are some shortcomings in oral reading: missing words, adding words, wrong words, wrong words, replacing words, slow reading speed, long pause time or incorrect segmentation. Reading comprehension is also flawed. Can't recall what you read, can't draw conclusions or reasoning from the materials you read, can't answer questions in special stories with common sense, and can't use the information in stories. In the Chinese system, dyslexia is also manifested as: mispronouncing tones, pronouncing sounds with similar structures (such as "fox" pronouncing "solitary"), mispronouncing polyphonic words and mispronouncing one of the two words. Some children with dyslexia can also show certain language defects and cognitive dysfunction before entering school. For example, when copying pictures, they often can't tell the relationship between theme and background, can't analyze the combination of graphics, and can't integrate all parts of graphics into a whole. School age can be accompanied by language skills barriers, spelling barriers, calculation barriers and so on. Often accompanied by ADHD and behavioral problems. There are more people with immune and autoimmune diseases than normal people There are many left-handers, and the positive rate of nervous system weakness is high.
Folding route
It usually begins in infancy or childhood, and it is obvious at the age of 6-7. Sometimes, dyslexia can be compensated in the lower grades. It is obviously aggravated at the age of 9 or later. Those with mild illness will gradually catch up with reading after treatment, and there will be no signs of dyslexia in adulthood. In severe cases, despite treatment, many symptoms of the disease will last for life.
Fold and edit the diagnostic information of this paragraph.
Refer to DSM-Ⅳ-TR's diagnostic description and standards for dyslexia.
Folding diagnostic description
Diagnostic characteristics
The basic feature of dyslexia is that its reading performance (such as reading accuracy, speed or comprehension ability in individualized standard tests) is obviously lower than the expected level of its actual age, intelligence level and education level (standard A). Activities that will significantly affect an individual's academic performance or require reading ability in daily life (Standard B). If an individual has other sensory defects, his reading difficulty will exceed the degree caused by his sensory defects (standard C). If there is a meridian or other medical and sensory conditions, it should belong to the diagnosis of Axis III. Individuals with dyslexia (also known as dyslexia) will have the characteristics of distortion, substitution or omission when reading aloud; At the same time, both reading aloud and reading silently have the characteristics of slow speed and easy misunderstanding.
Accompanying features and defects
Dyslexia and dysgraphia often occur at the same time as dyslexia, and few people will experience only one of them without dyslexia.
sex character
60% to 80% of dyslexics are men. The current referral procedure may be biased towards identifying male individuals, because they are more often accompanied by obvious interference behaviors with learning disabilities. When we use more careful and rigorous criteria to diagnose dyslexia, rather than the traditional school referral and diagnosis process, the incidence of men and women will be more consistent.
incidence rate
Because many studies focus on the prevalence of learning disabilities, rather than individual reading, mathematics and word expression disorders, it is difficult to determine the prevalence of reading disabilities. It is estimated that four out of every five people with learning disabilities suffer from dyslexia, including those who appear alone or with mathematical expression disorders. In the United States, its prevalence rate is about 4% of school-age children. In other countries that adopt stricter standards to diagnose dyslexia, the prevalence rate may decrease.
course of a disease
Although the characteristics of dyslexia (such as the inability to distinguish common letters or recognize common letters and their pronunciations) may appear in kindergarten, dyslexia is rarely diagnosed at the end of kindergarten or just before primary school, because ordinary schools rarely teach reading before this period. Especially when dyslexia is accompanied by high IQ, the performance of such children in the lower grades is usually within or very close to the standards of this grade, and dyslexia may not be obvious until the fourth grade or later. With early diagnosis and early treatment intervention, a considerable proportion of individuals have a good prognosis. Dyslexia will continue into adulthood.
Folding diagnostic criteria
A. The reading scores in individual standardized tests, such as reading accuracy or comprehension ability, are obviously lower than the expected performance of their actual age, intelligence or education level.
B. the situation in standard a significantly affects an individual's academic achievements or activities that require reading skills in daily life.
C. if an individual has other sensory defects, his reading difficulty will far exceed the degree caused by his sensory defects.
Note: if there are neurological or other medical and sensory problems, it should belong to the diagnosis of axis three.
Fold and edit this disease treatment
Developmental dyslexia is a form of learning disability, and the ultimate goal of studying it is to correct it. With the deepening of research, people have a deep understanding of developmental dyslexia, and some effective correction and treatment methods have also been formed. At present, the correction of developmental dyslexia mainly adopts the following modes:
Folding behavior intervention
Behavior intervention is basically based on the principle of operant conditioning, which can increase or decrease the frequency of a child's target behavior by properly controlling the events related to a child's target behavior. The significance of controlling the environment is to provide opportunities for the emergence of specific behaviors. In behavioral intervention, it is necessary to analyze the premise and consequences of behavior in detail, which is often based on direct observation; Secondly, inspectors should create a stable and structured intervention environment when determining the problems that may lead to or strengthen what we must overcome; Third, the rules of intervention should be clear and consistent, as far as possible in the form of affirmation, not in the form of a single prohibition. In addition, the requirements for children with dyslexia should be less and clear for a period of time, and feedback should be guaranteed at any time.
Folding cognitive behavior intervention
Cognitive behavioral intervention emphasizes that children with dyslexia form positive and self-regulated learning styles. Cognitive behaviorism holds that individuals can control their own behaviors, and the appearance of behaviors does not simply depend on environmental stimuli or behavioral consequences. In the process of reading, the passive performance of children with dyslexia hinders their potential. Cognitive behavior intervention model advocates cognitive strategy training or self-directed training for children with dyslexia.
(1) cognitive strategy training
It is found that an important problem for children with learning disabilities is the lack of some effective cognitive strategies or the inability to choose appropriate strategies. The basic procedures of cognitive strategy training are as follows: ① Evaluate the existing strategy level of children with dyslexia, make clear their disadvantages, and establish the target strategy to be trained; ② Explain the target strategy to children; ③ Demonstrate the use of target strategy; 4 speech rehearsal; ⑤ Provide low-difficulty materials, conduct control exercises and give feedback; ⑥ Provide reading materials with difficulty equivalent to the age level of children with dyslexia, practice and give feedback; ⑦ Evaluate the strategies of children with dyslexia, and guide children to learn to choose appropriate strategies according to tasks; ⑧ Transfer in practical learning.
(2) Self-directed training
The central idea of self-directed training is to train children to actively use self-directed words to monitor their behavior until a certain task is completed. This kind of training should guide children with dyslexia to set reading goals. Goals should be specific and challenging. This clear and realistic goal can stimulate the reading motivation of children with dyslexia and focus on the tasks that must be completed. Making progress in the pursuit of ideal goals can also enhance a person's sense of accomplishment. In training, the determination of self-directed language is also very important. This kind of self-directed speech, which can be spoken or silent, is used to guide one's own speech or regulate one's behavior. The content and order of speeches depend on the task to be completed, but sentences are best created by children with dyslexia. In the process of reading, children with dyslexia should examine the use of reading strategies and some specific behaviors by themselves, and put the previously formulated self-speech through this process. Self-speech-guided reading activities are carried out in accordance with the steps and established strategies, and play a role in reminding and urging correction when errors or deviations occur. Before letting children monitor themselves, the trainer should explain the specific methods first. In the first few times, the trainer needs to observe the self-monitoring of the child, praise the correct behavior of the child in time, and then gradually withdraw the external monitoring.
The main characteristics of cognitive-behavioral training are: trying to guide children to become active participants in their own learning process; Attach importance to the application of demonstration target strategies and methods; Take the child's foreign language as the intermediary. These characteristics can ensure that children with dyslexia can control their own reading and learning process and change their original passive response.
Functional training of folding nervous system
This kind of training is also psychological process training. This is an intervention method for learning disabilities based on the hypothesis of pathological mechanism of psychological process disorders. The founder of the model believes that learning depends on the advanced functions of the nervous system, and the realization of these advanced functions is based on psychological processes such as basic perception. Therefore, training basic psychological processes can improve brain function and improve academic performance. In recent years, in Japan, China, Taiwan Province Province and other countries and regions, a nerve system function training method called "sensory integration training" has been widely used. This method was developed by Iris. She regards the integration of sensory information, namely sensory integration, as the key function of the nervous system. She believes that sensory integration disorder with dysfunction of vestibular system as the core leads to patients' poor control of muscle movement, lack of spatial cognition, impaired input and processing of somatic sensory information, leading to obstacles in listening, reading, writing, calculation and communication, and it is difficult to benefit from general intervention training. Only by improving the organization of sensory information through sensory integration training can we overcome the problem of dyslexia.
Folding peer guidance
Peer guidance refers to the method that students teach students. This is a new training mode that appeared in the mid-1980s. In terms of cognition, peer guidance stimulates learners' learning motivation. Their attitude towards learning has changed, they are interested in the subjects they teach, and even changed their attitude towards learning and school. They like studying and skip classes less, so their grades are improved faster than those under the traditional teaching mode. In the aspect of socialization, the instructed person has learned a lot of interpersonal skills from peer tutors, improved peer relations and promoted the development of self-awareness. The specific process of this model is: firstly, select some children as instructors and introduce them to their dyslexic peers; Then give special training to the instructors and teach them the contents and methods they need to teach their peers with dyslexia; Then arrange peer guidance activities, usually at least once a week. This model can be one-on-one, but more often it is in the form of several mentors and several companions. Teachers should not only be responsible for setting up peer groups and training teachers, but also further train teachers or provide additional guidance for the educated.
Peer guidance is not suitable for all learning contents and children, nor can it be used for difficult course contents and children with obvious externalized behavior problems.
Folding biochemistry and drug therapy
Biochemical and drug therapy is drug therapy, which first controls and improves the physical condition of children with dyslexia, and then improves their learning state. People have done a lot of research on the after-effects of drug therapy, and found that these drugs have certain curative effect on dyslexia, but the therapeutic effect is limited, so they should be used with caution.
Each of the above correction modes has its advantages and disadvantages. Teaching intervention for children with dyslexia should not be limited to a certain correction model, but should be inclusive and prescribe the right medicine.