Untangling dyslexia myths and misconceptions

When Tim Odegard was a third grader struggling to learn to read, his parents were told that his IQ score made him “too stupid” to have dyslexia, a learning disability that interferes with the ability to decipher written language. At the time, in the early 1980s, IQ scores for children who were struggling to read needed to be above a certain level for experts to diagnose dyslexia. Other struggling readers often heard instead that they weren’t reading because they were lazy or stupid. Although plenty of scientific evidence has since debunked the idea that intelligence has anything to do with dyslexia, it remains one of many misconceptions about the disorder that have impeded progress in teaching children to read.

Today, studies suggest that as many as 20% of people in the United States have dyslexia, which accounts for up to 90% of learning disabilities (Shaywitz, S. E., et al.,Current Opinion in Psychiatry, Vol. 34, No. 2, 2021opens in new window). Through studies of brains, genetics, and educational strategies, scientists are better understanding causes of reading troubles. But disagreement, debate, and misunderstandings rage on about many details, including how to define dyslexia, how to diagnose it, and how best to teach reading to struggling readers. These disagreements often incorporate politics as well as science.

Nevertheless, consensus is building that dyslexia impacts mental health, interventions can boost self-esteem, and there are clear ways of improving reading abilities for most people (Georgiou, G. K., et al., Annals of Dyslexia, Vol. 74, No. 1, 2024opens in new window).

“We’ve come a long way in trying to raise awareness and dispel the negative stereotype of dyslexia,” said Odegard, who is now a developmental cognitive psychologist and professor of psychology at Middle Tennessee State University and editor-in-chief of the journal Annals of Dyslexia. He learned the results of his third-grade IQ test after earning his PhD. “Although, that negative stereotype is still out there.”

In the context of tens of thousands of years of human history, reading and writing are extremely new technologies—emerging just a few thousand years ago and becoming available to much of society far more recently than that. Our brains did not evolve to handle the task of hearing individual speech sounds, and only a small percentage of children, maybe 5%, learn to read with very little support, said Daniel Willingham, PhD, a psychologist at the University of Virginia. Those students tend to have strong oral language skills and a good ability to distinguish between sounds, such as the difference between “big” and “pig.”

How best to teach children to read has fueled decades of debate, often called the “reading wars.” That debate is particularly salient for children with dyslexia, which is in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) and generally considered to be a deficit in the ability to accurately and fluently decode, or turn printed words into speech. This disconnect essentially represents a bottleneck in the process of bridging the visual system and the language system, according to Kenneth Pugh, PhD, a cognitive neuroscientist at the Yale Child Study Center. “I always say if each word takes your entire soul to pull off the page,” he said, “then by the time you get to the end of the sentence, you kind of forgot the beginning.”

Studies indicate that dyslexia can have significant mental health consequences. Social anxiety, for one, was more prevalent in fifth-grade students who had literacy struggles in the second and third grades, compared with peers who didn’t have the same challenges early on, found a 2023 study of Greek children published in a special issue of the Annals of Dyslexia on dyslexia and mental health (Kargiotidis, A., & Manolitsis, G., Annals of Dyslexia, Vol. 74, No. 1, 2024opens in new window). Children with dyslexia who also had inattention or hyperactivity, which commonly co-occur, were particularly vulnerable to social anxiety, found another study in the same issue (McArthur, G., et al., Annals of Dyslexia, Vol. 74, No. 1, 2024opens in new window). Dyslexia has also been linked to depression and low self-esteemopens in new window.

The disorder and its reverberations can affect the trajectory of a person’s life dramatically. Children with learning disabilities tend to lag behind in academic achievement, and social-emotional struggles can persist into adulthood (Schwartz, A. E., et al., Journal of Policy Analysis and Management, Vol. 40, No. 2, 2021opens in new window). Dyslexia is overrepresented in prisons, according to a report (PDF, 804KB)opens in new window by the criminal justice research firm JFA Associates, and some 70% of inmates read at or below a fourth-grade level.

Stereotypes and stigma contribute to such negative outcomes, found a 2023 review of 16 studies that considered the psychological and academic outcomes for students with learning disabilities, including dyslexia. Stigma arises from the label that characterizes a person as “different,” the researchers wrote, which can play out in a variety of ways. Students might be physically separated from their peers during the school day. Teachers and parents might develop lower expectations of them, the researchers posited. And children might experience bullying from classmates while internalizing the belief that something is wrong with them. Overall, the review found that stigma contributes to low self-esteem in children with learning disabilities (Haft, S. L., et al., Journal of Learning Disabilities, Vol. 56, No. 3, 2023opens in new window).

Still, dyslexia often goes unidentified. In a sample of close to 10,000 fourth graders in Italy, nearly 2 out of 3 students with the disorder had not been diagnosed (Barbiero, C., et al., PLOS ONE, Vol. 14, No. 1, 2019opens in new window). Despite legislation in most U.S. states that governs screening, intervention, and other dyslexia-related services, non-White students and children who go to schools with predominantly non-White populations are also less likely than others to get diagnosed via dyslexia screening programs, Odegard and colleagues found in an analysis of data from 7,947 second-grade students in 126 schools in Arkansas (Journal of Learning Disabilities, Vol. 53, No. 5, 2020opens in new window). Students attending majority-White schools, on the other hand, had access to more reading supports than other schools, found research in Boston, according to an article in the Hechinger Reportopens in new window, an education publication.opens in new window

Those disparities reflect and likely exacerbate gaps in reading ability, studies suggest. According to 2022 data from the National Assessment of Educational Progressopens in new window, just 33% of fourth-grade students and 31% of eighth-grade students are at or above proficiency levels in reading. Proficiency levels were 38% for White eighth graders compared with 16% for their Black classmates. Some of those children are likely to have dyslexia and other learning disorders and would benefit from extra intervention.

The interaction of reading troubles and self-esteem troubles can have cascading consequences beginning in elementary school, when struggles with reading begin to become highly visible, said Mark Seidenberg, PhD, a cognitive neuroscientist and professor of psychology who recently retired from the University of Wisconsin–Madison. Seidenberg has studied language, reading, and dyslexia for more than 40 years and has published dozens of peer-reviewed papers on the topic. Adults with dyslexia can learn to read, but issues with confidence can begin in childhood. “By the time they are in fourth to sixth grade, if they’re still failing, their motivation to continue drops off and they disengage,” Seidenberg said. “The consequences of not being able to read are huge.”

[Related: Treating patients with dyslexia]

Diagnosing dyslexia early on is important because it can make the difference in whether or not a student qualifies for school-based educational services to improve reading, Pugh said. But diagnosis can be challenging because there is no definitive test that can determine whether someone does or does not have dyslexia. Like other forms of neurodiversity, the disorder occurs on a spectrum, and diagnoses usually involve screening assessments with cut-off points and a subjective evaluation by assessors who vary in their reliance on different models of the disorder.

Meanwhile, false stereotypes still get in the way of accurate diagnoses. The idea that people with dyslexia see letters backward, for example, is a myth that has persisted and proliferated, according to the Yale Center for Dyslexia and Creativityopens in new window. What Odegard experienced as a child—the belief that there must be a significant difference between a child’s cognitive abilities and reading abilities in order to diagnose dyslexia—has also persisted even though the standard, known as the discrepancy model, has been debunked, Odegard said.

In the search for more objective measures, some researchers are looking to the brain, where studies using MRI and EEG are showing patterns that distinguish the brain of a person with dyslexia from the brain of a person without dyslexia. Scientists have long known that multiple brain areas are involved in reading. These regions, which regulate processes like speaking and object recognition, are predominantly in the left side of the brain, in areas such as the parietotemporal and occipitotemporal regions. In people with dyslexia, studies have indicated a smaller amount of gray matteropens in new window and less brain activity in these regionsopens in new window. Dyslexic brains also show different patterns of activation in a variety of regions while reading compared with nondyslexic brains (Richlan, F., Frontiers in Psychology, Vol. 11, No. 155, 2020opens in new window).

These patterns appear to be consistent across languages and writing systems, suggesting some universal signatures in the way the brain struggles to learn to readopens in new window, Pugh said. (Although brain-imaging studies can’t yet be used for diagnosis, his group and others are looking into brain-stimulating techniques that might give specific neurons a kick, especially in children with dyslexia who struggle the most.) “If you’re typically developing, you develop a certain left hemisphere connection, particularly between the left occipitotemporal cortex and Wernicke’s and Broca’s [language areas]. They have to sort of strengthen each other and connect,” he said. “In the absence of treatment, dyslexia presents very often with a failure to see that.”

Genetics also plays a role in determining who develops dyslexia. Twin and family studies indicate that genes explain 40% to 60%opens in new window of the risk for developing dyslexia (Gialluisi, A., et al., Molecular Psychiatry, Vol. 26, No. 7, 2021opens in new window). Multiple genes are involved, and studies are ongoing to understand the mechanisms and the ways that home and school environments influence the effect these genes have on the brain.

Richard Wagner’s group at Florida State University has proposed viewing dyslexia as a spectrum of severity and acknowledging that dyslexia has many causes that can interact with each other (Journal of Learning Disabilities, Vol. 53, No. 5, 2020opens in new window). “As opposed to thinking that there’s a dyslexia test or that there’s a single indicator, it’s a constellation of risk factors,” Odegard said, “some of them being your language skills, others being aspects around you.”

Identifying who has dyslexia is only half the battle. Next comes the task of teaching these individuals to read. In general, studies indicate that for children with dyslexia, it is particularly important to address specific components of reading, Pugh said, including a focus on phonics, which makes the link between letters and sounds explicit.

In addition, the most successful instructional reading interventions include work on spelling, vocabulary, and connected-text reading (or reading multiple sentences that are related to each other), found a 2022 meta-analysis of 53 studies. And dose matters. For students with dyslexia or at risk for dyslexia, the study suggested that every extra hour of intervention helped improve outcomes (Hall, C., et al., Reading Research Quarterly, Vol. 58, No. 2, 2023opens in new window). Extra intensive and sustained instruction matters most for the 3% to 5% of children with dyslexia who struggle the most, Odegard added.

Managing stress and addressing mental health might be part of the solution, too, experts said, although research is still new and studies are small. Because anxiety is prevalent in children with learning disabilities and can interfere with learning, some experts advocate for strategies such as exercise, meditation, and mindfulness (Tarrasch, R., et al., Frontiers in Psychology, Vol. 7, No. 578, 2016opens in new window). Mentoring programs that connect children with similar struggles can also reduce depression and improve self-esteem, Stephanie Haft, a clinical psychology doctoral intern at the University of California, Berkeley, and colleagues found in an evaluation of a program that paired elementary and middle school students who have learning disabilities and attention-deficit/hyperactivity disorder with mentors in high school or college who have the same conditions (Child and Adolescent Mental Health, Vol. 24, No. 4, 2019opens in new window).

Instituting these approaches will require overcoming ingrained educational ideas, Seidenberg said. Instead of an explicit focus on phonics and other useful strategies, for instance, many schools continue to use curriculum known as “balanced literacy,” which is based on outdated ideas that children will learn to read if you hand them books and teach them to guess at what the words are based on letter and picture clues. It can be hard to persuade teachers to change when it seems that what they have been doing has worked for most students.

Researchers are also working to overcome a long history of skepticism about dyslexia. For decades, Seidenberg said, some influential educators argued that the disorder was simply an excuse made by ineffective teachers and that every child could learn to read if they were just taught correctly. As a result, dyslexia became a “dirty word” in education. Another persistent and harmful myth, he said, is the idea that dyslexia is an advantage or “desirable difficulty” that may produce extraordinary achievement (Odegard, T. N., & Dye, M., Annals of Dyslexia, 2024opens in new window). “We need neuro-realitiesopens in new window,” Odegard said, that don’t sugarcoat reality and instead “acknowledge what we really need as a community to help our children.” Knowing they have dyslexia can help children understand why they are having more trouble than their peers in school, and that can be heartening, Willingham added.

Given the obstacles to change, some advocates are pushing for policies that legislate evidence-based reading interventions. “You have generations of educators who’ve been taught that dyslexia was a thing that was invented by people to excuse the failures of the educational system,” Seidenberg said. “As opposed to, it’s a condition that actually affects people.”

As evidence accumulates about the most effective interventions, researchers are also gathering evidence about what makes some children resilient, even when they are at risk of dyslexia—with the hopes of boosting the same kind of resilience in others. Those factors can include social and emotional strengths and high-quality instruction early in life, wrote University of California, Los Angeles literacy researcher Maryann Wolf and colleagues in a 2023 review of the history and future of dyslexia (Annals of Dyslexia, 2024opens in new window).

On the cognitive side, Haft and a colleague wrote in a 2016 article for the International Dyslexia Associationopens in new window, it is important to nurture oral language skills, vocabulary knowledge, and goal-setting strategies. From a social-emotional perspective, it helps to give children with dyslexia a sense of control and self-worth (see Treating patients with dyslexia).

Debate continues about whether dyslexia is associated with different ways of thinking or certain kinds of strengths. Based on anecdotal observations, people have long suggested that dyslexia is overrepresented among entrepreneurs and in creative fields. And a variety of pop culture books, including The Dyslexic Advantage, argue that understanding these differences can help people find workarounds, compensatory techniques, and useful technologies to succeed at school and in the workplace. “If you know who you are, you know how your mind works, you’ll know the best way to learn,” said coauthor Brock Eide in a lecture to The Lab School in Washington, D.C. “The key to success is building on your strengths.”

However, many of those theories remain speculative and based on correlations, Odegard said, and run the risk of causing harm through stereotyping. “The kids I work with tell me that these myths make them feel like impostors for not having one of these abilities or ways of thinking differently,” he said. For now, there are not enough data to say whether trends are real and biological, or if observations are based on “the fact that so many dyslexic kids have to fight like hell for everything, making some of them extra highly motivated,” Pugh said. “There are good reasons to explore this question further.”

Most studies on hypothetical strengths in dyslexia fail to acknowledge the heterogeneity of people with the learning disorder, Wolf added. “There needs to be far more and far better research on the putative strengths of individuals with dyslexia,” she said. In the meantime, students with dyslexia need to know that they are as talented and intelligent as their peers, wrote Wolf and colleagues in their 2024 paper arguing for a new definition of the disorder (Annals of Dyslexia, 2024opens in new window). As other studies have shown, there is no link between dyslexia and IQ, they pointed out (Tanaka, H., et al., Psychological Science, Vol. 22, No. 11, 2011opens in new window). As a difference, dyslexia becomes a disability only in the context of disabling environments.

Despite the challenges that dyslexia presents for students, structured reading programs that emphasize resilience, persistence, and self-esteem can set children up for success, Wolf and colleagues concluded. “The history of rigorous reading intervention studies in the last 20 years underscores how well we can remediate children at risk for dyslexia, regardless of their race, socioeconomic background, or IQ,” they wrote. With early and effective interventions, they added, children can learn to read.