Update on Dyslexia

Dyslexia literally means abnormal reading and refers to problems learning to read and write.

Research using sophisticated new technology such as "Functional MRI" (a new way to view the way specific parts of the brain perform tasks; only a research tool for the foreseeable future), along with several years of other research, clearly show that dyslexia is a linguistic or language processing problem inside the brain and not a hearing or vision disorder! This means that therapies based on the notion that a vision (eye) or hearing (ear) disorder causes dyslexia can have no more benefit than a kind of placebo.

Dyslexia affects 20 to 30% of people. It is present from early childhood and never fully goes away. However, children with dyslexia can be taught the basic phonological principles of written language that come naturally for non-dyslexics. That is, that letters represent sounds (there are roughly 44 phonemes in English) which combine in certain ways to form words which make up sentences which have meaning!

As children and adults develop, they can also learn to get around dyslexia using the difficult word's context in a sentence, the semantics, the syntax, his or her memory, a word processor, his or her creativity, and raw intelligence etc. to more than compensate. This takes a little more time than the automatic processing of the non-

This fuller understanding of reading and writing disorders has important implications for teachers, schools, tutors and remedial education. Pure "whole language" techniques which emphasize broader early exposure to the more abstract higher concepts of written language while de-emphasizing, at least at first, spelling, grammar, and phonics is appropriate for 70 to 80% of the population but misses the basic concrete "phonics" introductory language skills young children with dyslexia require. Teaching to each student's needs is best.

Do not forget that those with learning disorders including dyslexia are not less intelligent than non-dyslexics. Their IQ's are not lower in general and they may have superior intellects. Many prominent scientists, doctors, lawyers, business people, artisans, artists, musicians, and writers have had dyslexia.

By the way, dyslexia is about equally common in girls and boys although it is more often missed in girls and minorities. Learning disorders often run in families and can be caused by various brain injuries, brain illnesses and certain toxins. About half the time dyslexia is associated with Attention Deficit Hyperactivity Disorder although each often occur separately.

A psychiatrist is a physician (M.D. or D.O.) with special training in treating people who have emotional or behavioral difficulties. These problems may arise from biological (medical and neurological), psychological, social (interpersonal), developmental, or a combination of causes and influences.

Medical school is a four year curriculum done after completing college. Each new doctor then does an internship which is the first part of his or her specialty training. In the "old days" many doctors left training after this internship to become general practitioners. That is rare these days. To become any type of "specialist" takes at least 3 years of residency training after medical school. Most "primary care physicians" such as internists, pediatricians, and family practitioners have done 3 year "residencies". "Sub specialists" have done one or more extra years of training in a "fellowship" to become, for example, a cardiologist, neonatologist, or plastic surgeon.

Psychiatry is a 4 year residency training program, counting the internship year. Child and Adolescent psychiatry is a sub specialty "fellowship" of 2 years done after general psychiatry training. This can be combined into 5 years after medical school.

Board Certified means the physician has successfully completed the required training and then passed special testing in that specialty.

The American Board of Psychiatry and Neurology (ABPN) serves this function for psychiatrist, neurologists, and their key sub specialists.

A recent study adds to the already significant data showing that Prozac appears safe in pregnancy for the fetus and the mother. This is indeed very good news for patients with substantial depression or anxiety disorders who become pregnant. This further implies, but does not guarantee, that this group of medications (Prozac, Zoloft, Paxil and Luvox) likely bring very low, if any, long term risk to developing brains and bodies when used in pregnancy, while breast feeding, in childhood, as well as in adulthood.

Nonetheless, the conservative advice remains to avoid medication in pregnancy, especially in the first trimester, if possible.

The FDA (Food and Drug Administration) recently issued a warning to the public to be wary of the presence of ephedrine or ephedra products in over the counter herbal remedies and food supplements.

Often, ephedrine is added to or is the main active ingredient in health products claiming to increase energy and decrease appetite. Ironically, doctors are no longer allowed to prescribe ephedrine which was used in the past as a decongestant. Ephedrine was removed from all prescription and over the counter medications because it was being abused as "speed". Ephedrine and certain similar compounds are often used by illegal drug labs to make "crystal meth", the most popular "speed" on the streets. Ephedrine has been available in herbal remedies, "vitamin" and "food supplements" (often without the knowledge of consumers) because these sources and companies are not inspected or regulated by the FDA. The FDA has proposed regulating ephedrine from these sources which will likely be opposed by some producers and distributors of ephedra products.

The Associated Press article that appeared in the Arizona Daily Star quoted Dr. Michael Friedman, FDA acting commissioner, as saying, "Consumers should be aware that just because a product is labeled "natural" or from an herbal source, it is not guaranteed to be safe".