HHS faculty take a broad approach to dyslexia through research, education and clinical practice

Written By: Rebecca Hoffa, rhoffa@purdue.edu

Chenell Loudermill (left) works with a young child on literacy skills.(Purdue University photo/John Underwood)

Dyslexia affects 15-20% of people, according to the International Dyslexia Association, but from slow or inaccurate reading to poor spelling to trouble with comprehension, the severity of dyslexia symptoms varies from person to person. However, through both research and clinical practice, faculty in Purdue University’s College of Health and Human Sciences (HHS) are working to improve outcomes for individuals with dyslexia.

“Everybody is on a continuum with reading, from very low to very high, and dyslexia is at the bottom end,” said Cammie McBride, professor in the Department of Human Development and Family Science and HHS associate dean for research. “Where you cut that off is a bit arbitrary, whether it’s the bottom 1% of readers or the bottom 5%. The main reason I see it that way is because children who are diagnosed as dyslexic learn the same way as those who are developing typically and have no reading problems. It’s just that those kids with dyslexia need a lot more practice — they don’t need qualitatively different skills.”

With overlapping interests in dyslexia and literacy disorders, McBride collaborates closely with Chenell Loudermill, clinical professor in the Department of Speech, Language, and Hearing Sciences (SLHS), and others in the colleges of Health and Human Sciences and Education as part of a $1.5 million grant from Lilly Endowment Inc. The grant has allowed faculty across Purdue campuses to work together on enhancing curriculum around teaching science-based literacy methods to prepare the next generation of teachers and practitioners. While not centered specifically around dyslexia, the effort is working to ensure all students, including those with dyslexia, succeed with reading.

“Purdue is well positioned to support efforts to improve reading in the state of Indiana, given all of the resources and expertise that we have,” Loudermill said. “I think it will be important for Purdue faculty to collaborate with those who are making decisions about literacy, reading, reading education and reading intervention. We are committed to supporting teachers and other education professionals who are working with kids to improve reading skills so much so that it is reflected in reading scores of the children in Indiana.”

Diving into the research

McBride’s research has extensively focused on dyslexia across languages, particularly Chinese and English, to understand how dyslexia manifests for multilingual individuals. In 2019, she published her book “Coping with Dyslexia, Dysgraphia and ADHD: A Global Perspective,” which summarized some of her findings.

“That research came out of my own personal experiences,” McBride said. “I would give talks in Hong Kong in both international schools and local schools. In international schools, the medium of instruction was English, and in local schools, it’s Chinese. I would get parents who would say to me, ‘I’m switching my child from the Chinese school to the international school because Chinese is too difficult.’ This was not in accord with what I had experienced before, so I became really curious about what the cognitive-linguistic skills were that would be associated with difficulties in reading of Chinese and difficulties in reading of English, and they were somewhat different.”

Ultimately, McBride found in her results children who were dyslexic in Chinese and had no reading or writing difficulties in English. This has been echoed by other studies related to Swedish and English as well as German and English. McBride noted this can have important policy implications, particularly in higher education, for determining foreign language requirements for students with dyslexia.

McBride also has an interest in helping families detect reading and writing problems, such as dyslexia, helping young readers get the support they need sooner rather than later.

“I have a test of word reading in English, and it is suitable for anyone who knows English, whether as a foreign or first language, and I want to develop that further because I think it could be a nice, quick tool for detecting problems early,” said McBride, explaining that this affordable option could be a first step for families with children who may be struggling with reading.

Alongside the cognitive-linguistic difficulties, McBride sees self-esteem issues as one of the greatest challenges individuals with dyslexia face, primarily due to dyslexia being seen as a way the child is lacking by parents or educators who may not understand the disorder well. She said she thinks this is an area where dyslexia research should dive deeper.

“Beyond just making reading exhausting and maybe de-motivating, these kids may not have as much of a childhood as they probably deserve,” McBride said. “It tends to be a focus on their deficit rather than a consideration of all their special gifts and talents and developing those.”

Translating the clinical applications

Beyond innovative research discoveries like McBride’s, Loudermill, in collaboration with former clinical associate professor Tamar Greenwell, established the Purdue Literacy Education and Practice Project (Purdue LEaPP), which includes in scope five pillars: community engagement, equal access, continuing education, interprofessional education, and practice and implementation science. Current literacy-focused initiatives within SLHS include providing intervention services through the Literacy Lab, a free literacy challenge program during the summer, comprehensive diagnostic evaluations for reading and written language, partnership with local school to provide specialized services, professional development for practicing professionals and more.

“With dyslexia being a language-based literacy disorder, we’re perfectly positioned to address that in SLHS,” Loudermill said. “Speech-language pathologists understand what needs to happen developmentally before reading and writing can occur. There is no literacy with language. We aren’t wired to read and write — we’re wired for language. Therefore, we have to learn or be taught to read and write.”

While Loudermill recognizes speech-language pathologists are well-equipped to address dyslexia, she emphasized the importance of all disciplines weighing in to provide children and families with the best resources and outcomes. Dyslexia can often coexist with other disorders and diagnoses, including ADHD and developmental language disorder, which require additional considerations for the child, so she noted the more tools an interventionist can have in their belt, the better.

“The research is so extensive regarding reading from multiple disciplines, and no one discipline owns reading research,” Loudermill said. “Reading profiles vary depending on who children are, their experiences and their language development, so really it takes everyone looking at the whole child to see the best course of action for them to develop their reading skills — an interdisciplinary approach works better and increases outcomes in general.”

Loudermill has observed many misconceptions when it comes to dyslexia, from the root cause to misdiagnoses. However, she explained sometimes these misconceptions can lead to children not getting the support they need early enough, if at all. Because of this, Loudermill advises families and those performing the screenings to pay close attention to all areas that support reading and writing development and not take a proficiency in one common screening area to mean that dyslexia is not present.

“For example, many early screening protocols examine phonological and phonemic awareness; however, performance on phonological and phonemic awareness measures is not the end all, be all when it comes to dyslexia,” Loudermill said. “It is a very powerful information source, but it isn’t the only factor that should be considered when someone is being diagnosed with dyslexia or not. That’s why a good understanding of dyslexia and its characteristics and knowing that reading profiles can differ for a child with dyslexia is necessary.”