garten, but parents should vigilantly watch their child's response to early reading instruction even in PreK. Dyslexia shows up very early in classroom instruction. Are they having trouble learning their letter names and sounds? Do they find it hard to blend several sounds together to make a word? Do they have an awkward pencil grip? Is there a family history of reading problems? Did the child experience early language delay? These are some of the early risk factors and signs that should trigger an immediate response from both the parent and the teacher.

Parents need to aggressively advocate for their child at school, at the very first sign of reading difficulty, and insist that there be no delay in testing and putting an IEP in place. They should not be persuaded to "wait and see" because this morphs into "wait to fail." The wait to fail approach is behind most of the depression and anxiety seen in dyslexic students. For parents with older struggling readers, it's never too late to advocate for your child.

It's also important to help dyslexic children and teens identify, focus on, and develop their strengths and talents – especially while they are working on their reading proficiency. They need encouragement to pursue activities that will bring them the recognition and sense of achievement that every child needs. There are also many digital learning tools available that can be harnessed to keep learning stress-free.

"Students who are tutored after school (when they are generally tired and hungry) perform much better with a non-sugary healthy snack right before the tutoring session"

WHAT ABOUT VISION THERAPY?

One of the more controversial topics in dyslexia treatment is the use of vision therapy (VT). VT has been the subject of many studies to evaluate its impact on dyslexia. While it's important to rule out vision problems early in a child's life, VT for dyslexia has not been supported by the research.

Interestingly, a study that appeared in a 2018 issue of JAMA Ophthalmology found that visual deficits like ocular motor tracking and vergence impairment are far more prevalent in school-age dyslexic children compared to children without dyslexia. But at this time, there are no studies that have found that using VT to address these deficits can remediate dyslexia. In fact, several randomized, controlled double-blind studies did not show that treatment consisting of repetitive ocular motor tasks do anything to improve learning disabilities, reading, dyslexia or ADHD.

By contrast, evidence-based reading intervention by itself has produced a long history of success for dyslexic students. Could it be that the intensity and visual focus required in dyslexia-related reading interventions indirectly address visual deficits, as well as, the phonological and fluency deficits in dyslexia? Certainly, more research is needed to answer this and other questions about visual deficits in dyslexia.

The American Academy of Pediatrics and the American Academy of Ophthalmology, along with several other related medical associations, issued a joint statement on vision therapy and dyslexia. According to their statement, scientific evidence does not support

vision therapy as a treatment for dyslexia.

Multiple appropriately controlled studies have found that although convergence training reduces problems with binocular vision and fusion, these improvements do not lead to improved reading skills. The same is true for the use of colored lens or overlays, changes in font, and "brain training." According to the results and implications of one major study released in 2022, "there is little evidence that interventions that do not involve actual instruction in reading generalize to improve reading skills."

DYSLEXIA RESEARCH CONTINUES…

Although we've learned so much about dyslexia, there is still work to be done. Dyslexia is finally getting the attention it deserves in terms of research funding, legislation, and teacher training. In addition to evidence-based reading interventions, new research will continue to shed light on how health and nutrition can contribute to the formula for success. •

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