Dysgraphia

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Dysgraphia
Other names Disorder of written expression
Dysgraphia1.jpg
Three handwritten repetitions of the phrase "The quick brown fox jumps over the lazy dog" on lined paper. The writing, by an adult with dysgraphia, exhibits variations in letter formation, inconsistent spacing, and irregular alignment, all key characteristics of the condition.
Specialty Neurology, Pediatrics
Symptoms Poor and inconsistent handwriting, Poor spelling and spacing, Other transcription difficulties in absence of oral language difficulties
Usual onsetEarly school age
DurationLifelong
TypesLinguistic Dysgraphia, Motor Dysgraphia, Spatial Dysgraphia
CausesGenetic and Neurological factors
Risk factors Family History, Co-occurring Developmental Disabilities
Differential diagnosis dyslexia, written language learning disability [1]

Dysgraphia is a neurological disorder [2] and learning disability that concerns impairments in written expression, which affects the ability to write, primarily handwriting, but also coherence. It is a specific learning disability (SLD) as well as a transcription disability, meaning that it is a writing disorder associated with impaired handwriting, orthographic coding and finger sequencing (the movement of muscles required to write). [3] It often overlaps with other learning disabilities and neurodevelopmental disorders such as speech impairment, attention deficit hyperactivity disorder (ADHD) or developmental coordination disorder (DCD). [4]

Contents

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), dysgraphia is characterized as a neurodevelopmental disorder [5] under the umbrella category of specific learning disorder. [6] Dysgraphia is when one's writing skills are below those expected given a person's age measured through intelligence and age-appropriate education. The DSM is unclear in whether writing refers only to the motor skills involved in writing, or if it also includes orthographic skills and spelling. [4]

Dysgraphia should be distinguished from agraphia (sometimes called acquired dysgraphia), which is an acquired loss of the ability to write resulting from brain injury, progressive illness, or a stroke. [7]

The prevalence of dysgraphia throughout the world is not known, due to difficulties in diagnosis and lack of research.

Etymology

The word dysgraphia comes from the Greek words dys meaning "impaired" and γραφία graphía meaning "writing by hand". [3]

Development

There are at least two stages in the act of writing: the linguistic stage and the motor-expressive-praxic stage. The linguistic stage involves the encoding of auditory and visual information into symbols for letters and written words. This is mediated through the angular gyrus, which provides the linguistic rules which guide writing. The motor stage is where the expression of written words or graphemes is articulated. This stage is mediated by Exner's writing area of the frontal lobe. [8]

The condition can cause individuals to struggle with feedback and anticipating and exercising control over rhythm and timing throughout the writing process. [9]

People with dysgraphia can often write on some level and may experience difficulty with other activities requiring reciprocal movement of their fingers [9] and other fine motor skills, such as; tying shoes, fastening buttons or playing certain musical instruments. However, dysgraphia does not affect all fine motor skills. People with dysgraphia often have unusual difficulty with handwriting and spelling [3] which in turn can cause writing fatigue. [4] Unlike people without transcription disabilities, they tend to fail to preserve the size and shape of the letters they produce if they cannot look at what they are writing. They may lack basic grammar and spelling skills (for example, having difficulties with the letters p, q, b, and d), and often will write the wrong word when trying to formulate their thoughts on paper. The disorder generally emerges when the child is first introduced to writing. [3] There is accumulating evidence that in many cases individuals with SLDs and DCD do not outgrow their disorders. [10] Accordingly, it has been found that adults, teenagers, and children alike are all subject to dysgraphia. [11] Studies have shown that higher education students with developmental dysgraphia still experience significant difficulty with hand writing, fine motor skills and motor-related daily functions when compared to their peers without neurodevelopmental disorders. [12]

Classification

Dysgraphia is nearly always accompanied by other learning disabilities and/or neurodevelopmental disorders such as dyslexia, attention deficit hyperactivity disorder, or oral and written language learning disability (OWL LD) [3] [13] and this can impact the type of dysgraphia a person has. Tourette syndrome, ASD and dyspraxia are also common diagnoses among dysgraphic individuals. [14] [15] [16] Developmental dysgraphia was originally described as being a disorder that occurs solely in dyslexic individuals. Dysgraphia was not studied as a separate entity until mid-20th century when researchers discovered there were different types that occur without dyslexia. [17] Dyslexics and dysgraphics experience similar synchronization difficulties and issues with spelling. However, dyslexia does not seem to impair physical writing ability or dramatically impact fine motor skills and dysgraphia does not impact reading comprehension. [4] Methods for evaluating, managing and remedying dysgraphia are still evolving, [17] but there are three principal subtypes of dysgraphia that are recognized. There is little information available about different types of dysgraphia and there are likely more subtypes than the ones listed below. Some people may have a combination of two or more of these, and individual symptoms may vary in presentation from what is described here. Most common presentation is a motor agraphia resulting from damage to some part of the motor cortex in the parietal lobes.[ citation needed ]

Dyslexic

There are several features that distinguish dyslexic-dysgraphia (sometimes called linguistic dysgraphia) from the other types. People with dyslexic-dysgraphia typically have poor oral and written spelling that is typically phonemic in nature. Their spontaneously written work is often illegible, has extra or deleted syllables or letters, and contains unnecessary capitalization or large spaces in the middle of words which can make each individual word unrecognizable. They may also insert symbols that do not resemble any letter of the alphabet. Writing production generally requires long periods of contemplation and correction. [18]

Dyslexic-dysgraphic individuals have fairly good copied work, and their ability to draw is also preserved. Their finger tapping speed (a method for identifying fine motor problems) is normal, indicating that the deficit does not likely stem from cerebellar damage. [17] Impaired verbal executive functioning has also been related to this form of the disorder. [16]

One study found that boys with ADHD and dysgraphia struggle primarily with motor planning rather than have a linguistic impairment but the prevalence of linguistic/dyslexic-dysgraphia compared to other subtypes is uncertain. [4]

Motor

Dysgraphia can be difficult to diagnose because the handwriting starts out clear and slowly degrades, making the writer appear lazy. Dysgraphia.jpg
Dysgraphia can be difficult to diagnose because the handwriting starts out clear and slowly degrades, making the writer appear lazy.

Motor dysgraphia (sometimes called peripheral dysgraphia) [16] is due to deficient fine motor skills, poor dexterity, poor muscle tone or unspecified motor clumsiness. Motor dysgraphia impairs both motor patterns and motor memory. [9] Letter formation may be acceptable in very short samples of writing, but this requires extreme effort and an unreasonable amount of time to accomplish, and it cannot be sustained for a significant length of time, as it can cause arthritis-like tensing of the hand. Overall, their written work is poor to illegible even if copied by sight from another document, and drawing is impaired. Oral spelling for these individuals is normal, and their finger tapping speed is below normal. This shows that there are problems within the fine motor skills of these individuals. People with developmental coordination disorder may be dysgraphic and motor-dysgraphia may serve as a marker of dyspraxia. [19] Motor-dysgraphics struggle with proper finger grip and writing is often slanted due to holding a pen or pencil incorrectly. [3] [9] Average writing speed is slower than that of non-dysgrapic individuals, but this seems to improve with age. Motor skill deficits appears to be a common cause of dysgraphia; 78% of children with the disorder present kinematic difficulties, while 58% of them display issues with pressure skills. [20]

Spatial

A person with spatial dysgraphia has an impairment in the understanding of space. This impaired spatial perception causes illegible spontaneously written work, illegible copied work, abnormal spacing between letters and majorly impaired drawing abilities. They have normal oral spelling and normal finger tapping speed, suggesting that this subtype is not fine motor based. [16] Symptoms in actuality may vary in presentation from what is listed here.[ citation needed ] Spatial dysgraphia may develop in individuals with lesions on the right hemisphere of the brain. [15]

Miscellaneous

Other subtypes and informal classification systems have been proposed by researchers; this includes but is not limited to phonological dysgraphia, [21] deep dysgraphia and surface dysgraphia. [17] [15]

Signs and symptoms

The symptoms to dysgraphia are often overlooked or attributed to the student being lazy, unmotivated, careless or anxious. The condition may also be dismissed as simply being an expression of attention deficiency or having delayed visual-motor processing. In order to be diagnosed with dysgraphia, one must have a cluster, but not necessarily all, of the following symptoms: [3] [9] [4]

The symptoms of dysgraphia can change as one ages. [23] Dysgraphia may cause students emotional trauma often due to the fact that no one can read their writing, and they are aware that they are not performing to the same level as their peers. Emotional problems that may occur alongside dysgraphia include impaired self-esteem, lowered self-efficacy, reduced motivation, poorer social functioning, heightened anxiety, and depression. [3] [13] [9] [16] They may put in extra efforts in order to have the same achievements as their peers, but often get frustrated because they feel that their hard work does not pay off. [13] Dysgraphia is a hard disorder to detect as it does not affect specific ages, gender, or intelligence. [13] The main concern in trying to detect dysgraphia is that people hide their disability behind their verbal fluency/comprehension and strong syntax coding because they are ashamed that they cannot achieve the same goals as their peers. [13] Having dysgraphia is not related to a lack of cognitive ability, [3] and it is not uncommon in intellectually gifted individuals, but due to dysgraphia their intellectual abilities are often not identified. [13]

Associated conditions

There are some common problems not related to dysgraphia but often associated with dysgraphia, the most common of which is stress. Developing an aversion to writing is another common issue. Often children (and adults) with dysgraphia will become extremely frustrated with the task of writing specially on plain paper (and spelling); younger children may cry, pout, or refuse to complete written assignments. This frustration can cause the student a great deal of stress and can lead to stress-related illnesses. This can be a result of any symptom of dysgraphia. [9] [11] [13]

Causes

The underlying causes of the disorder are not fully understood, [15] but dysgraphia is known to be a biologically-based disorder with genetic and brain bases. [3] More specifically, it is a working memory problem [13] caused by specific neurodevelopmental dysfunction. [9] In dysgraphia, individuals fail to develop normal connections among different brain regions needed for writing. [13] People with dysgraphia have difficulty in automatically remembering and mastering the sequence of motor movements required to write letters or numbers. [3] Dysgraphia is also in part due to underlying problems in orthographic coding, the orthographic loop, and graphomotor output (the movements that result in writing) by one's hands, fingers and executive functions involved in letter writing. [3] The orthographic loop is when written words are stored in the mind's eye, connected through sequential finger movement for motor output through the hand with feedback from the eye. [13]

Family history of specific learning disabilities may play a role. Children with developmental dysphasia, developmental dysgraphia and developmental dyslexia may be more likely to have family members with one of these conditions. [15] Genetic studies suggest that verbal executive function tasks, orthographic skills, and spelling ability may have a genetic basis. Genes on chromosomes 6 and 15 may play some role with SLDs as they have linked to poorer reading, poorer spelling and lower phonemic awareness. [16]

Diagnosis

Unlike specific learning disabilities and neurodevelopmental disorders that have been more extensively studied, there is no gold standard for diagnosing dysgraphia. This is likely due to writing systems often differing substantially between countries and languages and there being considerable heterogeneity among the therapists who are charged with diagnosing dysgraphia. Consequently, there are several tests that are used to diagnose dysgraphia like Ajuriaguerra scale, BHK for children or teenagers, the Minnesota Handwriting Assessment, ETCH, SCRIPT, DASH and HHE scale. [24] [25]

With devices like drawing tablets, it is now possible to measure the position, tilt, and pressure in real time. From these features, it is possible to compute automatic features like speed and shaking and train a classifier to diagnose automatically children with atypical writing. [24] The features extracted have different importances in the classification through development and allow to characterize different subtypes of dysgraphia that could have different origins, outcomes and could require different remediation strategies. [26]

It is not uncommon for dysgraphic individuals to be intellectually gifted, possess a rich vocabulary and have strong comprehension of language when speaking or reading, though their disorder is often not detected or treated; which may also be in part to developmental dyslexia receiving far more academic and medical attention than developmental dysgraphia. [27] In addition, gifted children with transcription disabilities seldom receive programming for their intellectual talents due to their difficulties in completing written assignments. [3]

Treatment

Treatment for dysgraphia varies and may include treatment for motor disorders to help control writing movements. Helping dysgraphic students overcome writing avoidance and accept the purpose and necessity of writing may be needed. [9] The use of occupational therapy can be effective in the school setting, and teachers should be well informed about dysgraphia to aid in carry-over of the occupational therapist's interventions. One common form of therapy is the use of Thera-putty, which helps develop dexterity. Treatments may address impaired memory or other neurological problems. Some physicians recommend that individuals with dysgraphia use computers to avoid the problems of handwriting. Speech-to-text programs have also been suggested as a potential treatments for dysgraphia. Speech-recognition technologies are used in two ways: dictation and computer control. As a dictation tool, spoken words are translated into written text; the student speaks the words into a microphone and the words are typed. The computer-control tool allows students to control the computer and software applications by speaking commands. If students are going to use speech-recognition software, they need to use consistent, clear speech. The use of computers also allows patients to experiment with different ergonomic keyboards. Today, there are many alternative keyboards for consideration. There are keyboards with enlarged and/or alphabetically arranged letters; there are key boards that are ergonomically designed; and there are mini keyboards for students who have a limited range of motion. Dysgraphia can sometimes be partially overcome with appropriate and conscious effort and training. [3] The International Dyslexia Association suggests the use of kinesthetic memory through early training by having the child overlearn how to write letters and to later practice writing with their eyes closed or averted to reinforce the feel of the letters being written. They also suggest teaching the students cursive writing as it has fewer reversible letters and can help lessen spacing problems, at least within words, because cursive letters are generally attached within a word.[ citation needed ] Many students see great success with cursive after extensive therapy.

Prevalence

It has been estimated that up to 10% of children in the world are affected by disabilities like dysgraphia, dyslexia, dyscalculia and dyspraxia. [19] [28] Estimates on the true prevalence of dysgraphia are not available due to lack of research on the disorder.

School

There is no special education category for students with dysgraphia; [3] in the United States, The National Center for Learning Disabilities suggests that children with dysgraphia be handled in a case-by-case manner with an Individualized Education Program, or provided individual accommodation to provide alternative ways of submitting work and modify tasks to avoid the area of weakness. (It can often be difficult for students to have general accommodations for any student that might have dysgraphia as "Careful planning should precede all technology purchases, as many technologies are costly and school budgets are limited. In considering adoption of any of the technology recommended")[ United States-centric ] [11] Students with dysgraphia often cannot complete written assignments that are legible, appropriate in length and content, or within given time. [3] It is suggested that students with dysgraphia receive specialized instructions that are appropriate for them. Children will mostly benefit from explicit and comprehensive instructions, help translating across multiple levels of language, and review and revision of assignments or writing methods. [13] Direct, explicit instruction on letter formation and guided practice will help students achieve automatic handwriting performance before they use letters to write words, phrases, and sentences. [3] Some older children may benefit from the use of a personal computer or a laptop in class so that they do not have to deal with the frustration of falling behind their peers. [13] Predictive text technology has been suggested as something that could greatly help students with dysgraphia. [29]

It is also suggested by Berninger that teachers with dysgraphic students decide if their focus will be on manuscript writing (printing) or keyboarding. In either case, it is beneficial that students are taught how to read cursive writing as it is used daily in classrooms by some teachers. [3] It may also be beneficial for the teacher to come up with other methods of assessing a child's knowledge other than written tests; an example would be oral testing. This causes less frustration for the child as they are able to get their knowledge across to the teacher without worrying about how to write their thoughts. [11] Dysgraphic students may benefit from special accommodation by their teachers when being required to write. Accommodations that may be helpful include but are not limited to; offering larger pencils or pencils with special grips, supplying paper with raised lines to provide tactile feedback, allowing extra time for classwork assignments, scaling down large written assignments and breaking down long written assignments into multiple shorter assignments. [16]

The number of students with dysgraphia may increase from 4 percent of students in primary grades, due to the overall difficulty of handwriting, and up to 20 percent in middle school because written compositions become more complex. With this in mind, there are no exact numbers of how many individuals have dysgraphia due to its difficulty to diagnose [3] and exact prevalence depends on the definition of dysgraphia. There are slight gender differences in association with written disabilities; overall it is found that males are more likely to be impaired with handwriting, composing, spelling, and orthographic abilities than females. [13] [16]

The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) does not use the term dysgraphia but uses the phrase "an impairment in written expression" under the category of "specific learning disorder". This is the term used by most doctors and psychologists. To qualify for special education services, a child must have an issue named or described in the Individuals with Disabilities Education Act (IDEA). [ United States-centric ] While IDEA does not use the term "dysgraphia", it describes it under the category of "specific learning disability". [ United States-centric ] This includes issues with understanding or using language (spoken or written) that make it difficult to listen, think, speak, read, write, spell or to do mathematical calculations.[ citation needed ]

See also

Related Research Articles

<span class="mw-page-title-main">Dyslexia</span> Specific learning disability characterized by troubles with reading

Dyslexia, previously known as word blindness, is a learning disability that affects either reading or writing. Different people are affected to different degrees. Problems may include difficulties in spelling words, reading quickly, writing words, "sounding out" words in the head, pronouncing words when reading aloud and understanding what one reads. Often these difficulties are first noticed at school. The difficulties are involuntary, and people with this disorder have a normal desire to learn. People with dyslexia have higher rates of attention deficit hyperactivity disorder (ADHD), developmental language disorders, and difficulties with numbers.

Agraphia is an acquired neurological disorder causing a loss in the ability to communicate through writing, either due to some form of motor dysfunction or an inability to spell. The loss of writing ability may present with other language or neurological disorders; disorders appearing commonly with agraphia are alexia, aphasia, dysarthria, agnosia, acalculia and apraxia. The study of individuals with agraphia may provide more information about the pathways involved in writing, both language related and motoric. Agraphia cannot be directly treated, but individuals can learn techniques to help regain and rehabilitate some of their previous writing abilities. These techniques differ depending on the type of agraphia.

<span class="mw-page-title-main">Handwriting</span> Writing created by a person with a writing implement

Handwriting is the personal and unique style of writing with a writing instrument, such as a pen or pencil in the hand. Handwriting includes both block and cursive styles and is separate from generic and formal handwriting script/style, calligraphy or typeface. Because each person's handwriting is unique and different, it can be used to verify a document's writer. The deterioration of a person's handwriting is also a symptom or result of several different diseases. The inability to produce clear and coherent handwriting is also known as dysgraphia.

Dyscalculia is a learning disability resulting in difficulty learning or comprehending arithmetic, such as difficulty in understanding numbers, learning how to manipulate numbers, performing mathematical calculations, and learning facts in mathematics. It is sometimes colloquially referred to as "math dyslexia", though this analogy can be misleading as they are distinct syndromes.

Reading for special needs has become an area of interest as the understanding of reading has improved. Teaching children with special needs how to read was not historically pursued due to perspectives of a Reading Readiness model. This model assumes that a reader must learn to read in a hierarchical manner such that one skill must be mastered before learning the next skill. This approach often led to teaching sub-skills of reading in a decontextualized manner. This style of teaching made it difficult for children to master these early skills, and as a result, did not advance to more advanced literacy instruction and often continued to receive age-inappropriate instruction.

Nonverbal learning disorder is a proposed category of neurodevelopmental disorder characterized by core deficits in non-verbal skills, especially visual-spatial processing. People with this condition have normal or advanced verbal intelligence and significantly lower nonverbal intelligence. A review of papers found that proposed diagnostic criteria were inconsistent. Proposed additional diagnostic criteria include intact verbal intelligence, and deficits in the following: visuoconstruction abilities, speech prosody, fine motor coordination, mathematical reasoning, visuospatial memory and social skills. NVLD is not recognised by the DSM-5 and is not clinically distinct from learning disorders.

The following outline is provided as an overview of and topical guide to autism:

A reading disability is a condition in which a person displays difficulty reading. Examples of reading disabilities include developmental dyslexia and alexia.

<span class="mw-page-title-main">Disorder of written expression</span> Medical condition

Disorder of written expression is a type of learning disability in which a person's writing ability falls substantially below normally expected range based on the individual's age, educational background, and measured intelligence. Poor writing skills must interfere significantly with academic progress or daily activities that involves written expression. This disorder is also generally concurrent with disorders of reading and/or mathematics, as well as disorders related to behavior. Since it is so often associated with other learning disorders and mental problems, it is uncertain whether it can appear by itself; and dysgraphia can be considered to be a specific form of the disorder. The prevalence of disorder of written expression is estimated to be of a similar frequency to other learning disorders, between 3 - 5%. A diagnosis can be made based on results of several assessments.

<span class="mw-page-title-main">Developmental coordination disorder</span> Medical condition

Developmental coordination disorder (DCD), also known as developmental motor coordination disorder, developmental dyspraxia or simply dyspraxia, is a neurodevelopmental disorder characterized by impaired coordination of physical movements as a result of brain messages not being accurately transmitted to the body. Deficits in fine or gross motor skills movements interfere with activities of daily living. It is often described as disorder in skill acquisition, where the learning and execution of coordinated motor skills is substantially below that expected given the individual's chronological age. Difficulties may present as clumsiness, slowness and inaccuracy of performance of motor skills. It is often accompanied by difficulty with organisation and/or problems with attention, working memory and time management.

<span class="mw-page-title-main">Learning disability</span> Range of neurodevelopmental conditions

Learning disability, learning disorder, or learning difficulty is a condition in the brain that causes difficulties comprehending or processing information and can be caused by several different factors. Given the "difficulty learning in a typical manner", this does not exclude the ability to learn in a different manner. Therefore, some people can be more accurately described as having a "learning difference", thus avoiding any misconception of being disabled with a possible lack of an ability to learn and possible negative stereotyping. In the United Kingdom, the term "learning disability" generally refers to an intellectual disability, while conditions such as dyslexia and dyspraxia are usually referred to as "learning difficulties".

<span class="mw-page-title-main">Management of dyslexia</span>

Management of dyslexia depends on a multitude of variables; there is no one specific strategy or set of strategies that will work for all who have dyslexia.

Deep dyslexia is a form of dyslexia that disrupts reading processes. Deep dyslexia may occur as a result of a head injury, stroke, disease, or operation. This injury results in the occurrence of semantic errors during reading and the impairment of nonword reading.

Language-based learning disabilities or LBLD are "heterogeneous" neurological differences that can affect skills such as listening, reasoning, speaking, reading, writing, and math calculations. It is also associated with movement, coordination, and direct attention. LBLD is not usually identified until the child reaches school age. Most people with this disability find it hard to communicate, to express ideas efficiently and what they say may be ambiguous and hard to understand It is a neurological difference. It is often hereditary, and is frequently associated to specific language problems.

The history of dyslexia research spans from the late 1800s to the present.

Dyslexia is a reading disorder wherein an individual experiences trouble with reading. Individuals with dyslexia have normal levels of intelligence but can exhibit difficulties with spelling, reading fluency, pronunciation, "sounding out" words, writing out words, and reading comprehension. The neurological nature and underlying causes of dyslexia are an active area of research. However, some experts believe that the distinction of dyslexia as a separate reading disorder and therefore recognized disability is a topic of some controversy.

Dyslexia is a complex, lifelong disorder involving difficulty in learning to read or interpret words, letters and other symbols. Dyslexia does not affect general intelligence, but is often co-diagnosed with ADHD. There are at least three sub-types of dyslexia that have been recognized by researchers: orthographic, or surface dyslexia, phonological dyslexia and mixed dyslexia where individuals exhibit symptoms of both orthographic and phonological dyslexia. Studies have shown that dyslexia is genetic and can be passed down through families, but it is important to note that, although a genetic disorder, there is no specific locus in the brain for reading and writing. The human brain does have language centers, but written language is a cultural artifact, and a very complex one requiring brain regions designed to recognize and interpret written symbols as representations of language in rapid synchronization. The complexity of the system and the lack of genetic predisposition for it is one possible explanation for the difficulty in acquiring and understanding written language.

<span class="mw-page-title-main">Characteristics of dyslexia</span>

Dyslexia is a disorder characterized by problems with the visual notation of speech, which in most languages of European origin are problems with alphabet writing systems which have a phonetic construction. Examples of these issues can be problems speaking in full sentences, problems correctly articulating Rs and Ls as well as Ms and Ns, mixing up sounds in multi-syllabic words, problems of immature speech such as "wed and gween" instead of "red and green".

<span class="mw-page-title-main">Gerstmann syndrome</span> Neuropsychological disorder caused by damage to the inferior parietal lobule

Gerstmann syndrome is a neuropsychological disorder that is characterized by a constellation of symptoms that suggests the presence of a lesion usually near the junction of the temporal and parietal lobes at or near the angular gyrus. Gerstmann syndrome is typically associated with damage to the inferior parietal lobule of the dominant hemisphere. It is classically considered a left-hemisphere disorder, although right-hemisphere damage has also been associated with components of the syndrome.

The following outline is provided as an overview of and topical guide to dyslexia:

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Further reading