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Subject: [greatschools] WSJ: Disorder Hints At How Brain Learns to Read

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The Wall Street Journal

January 8, 2004

Disorder Hints

At How Brain

Learns to Read

By ROBERT MCGOUGH

Staff Reporter of THE WALL STREET JOURNAL

There is a small corner of the mysterious world of autism where children

silently sit and read dictionaries at age two, but don't say their first

word until, say, three or four. Reading is such an obsession that these

children may read every license plate and sign in a parking lot as they

walk through it. They can decode and pronounce words and sentences far

beyond the ability of their contemporaries, though they often struggle

to comprehend the passages they have read.

This is the world of hyperlexia, a disorder whose definition is still in

dispute among researchers but which encompasses children with autistic

characteristics who also are stunningly precocious readers. Like other

children on the autistic spectrum, they have great trouble with social

interactions, including difficulty looking others in the eye or

understanding others' emotional states. One estimate is that they

comprise only two in 10,000 in the general population.

Researchers are beginning to study these unusual people to learn more

about both autism and reading, hoping to find clues that will help

autistic people and those with dyslexia and other reading disabilities.

A study in the journal Neuron this week is the first to peek inside the

brain of a hyperlexic child using functional magnetic resonance imaging,

a way of looking at the brain at work. The researchers suspected they

might find some unusual places being used in the brain of the child, a

nine-year-old boy who learned to read before he could speak.

Instead, they found that the boy for the most part used the same places

in the brain that normal and above-average readers use. But he used them

in a more intense way. The places were in the left side of the brain, in

an area that in other studies appeared underused by children with

dyslexia. Because hyperlexic kids can read well despite significant

language delays -- and because they largely seem to use the same brain

wiring, if more intensely, as regular readers -- the study suggests that

reading can be learned through visual information rather than oral language.

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This conclusion bolsters the practice of training dyslexic children to

associate " sounds with visual information, " says Guinevere Eden,

director of the Center for the Study of Learning at town

University, in Washington, and senior author of the study. In such

training, dyslexic children are taught to decode writing by tapping out

the sounds of a word, or using blocks of different colors to represent

word sounds.

" I say it with hesitation, " Dr. Eden says, but " it argues that good

[spoken] language is not crucial to developing good reading skills. " The

notion challenges current dogma that considers the ability to read words

on a page to be inseparable from the ability to speak words.

Moreover, " the more we know about how they succeed at reading, " says

Turkeltaub, lead author on the study, " the more we may be able to

learn about teaching other autistic kids to read. "

Little research has been done on hyperlexic children, in large part

because there is little money available for research into a rare

condition that isn't life-threatening. And there is no official

diagnosis of hyperlexia. But some researchers say that studying the

disorder makes sense as a way of finding treatments for reading

disabilities. " To be great at basketball, " says Geschwind, a

neurologist at the University of California, Los Angeles, " you don't

study people who can't shoot. "

Ilene Freed, the Washington-area mother of , the boy in the

brain-imaging study, says she realized her son was reading at a bit more

than two years old, when she inadvertently skipped a line while reading

" a fairy tale of some difficulty. " Her son, who hadn't yet uttered his

first word, picked up her finger and placed it on the line she had

skipped. Amazed, she purposely skipped another line in the story; again

he moved her hand to the sentence she had skipped.

Parents of hyperlexic children say their initial euphoria at discovering

that their toddlers were already reading turned to confusion and concern

as autistic traits such as language delay, social difficulty and, at

times, obsessive interests and behaviors came to the fore. They say

their concerns were often dismissed by doctors and acquaintances who

assured them their children would turn out to be normal. Echoing a

common complaint, Rinker-Schaeffer, president of the American

Hyperlexia Association and parent of a hyperlexic child, says, " We were

blown off by our pediatrician. "

Typically, hyperlexic kids aren't diagnosed as classically autistic, but

rather on a different part of the autistic continuum, often under the

category " pervasive developmental disorder not otherwise specified. "

Most often they are boys, although girls can be hyperlexic, too. Like

classically autistic children, those with hyperlexia often have great

difficulty fitting in. But their precocious reading skills provide an

avenue for interaction with the world. Often, parents and therapists

say, such children respond to written directions -- " stop jumping on the

couch, " " please use a yellow crayon " -- after apparently failing to

comprehend spoken instructions.

Their memory for the written word can be astonishing. Phyllis Kupperman,

a speech pathologist and director of the Center for Speech and Language

Disorders, in Elmhurst, Ill., recalls the three-year-old who came to her

clinic and assembled crayons on the floor to spell " Ponderosa

Steakhouse. " She says parents can direct their children using written

to-do lists: A mother who wants the child to eat dinner before a cookie

might write, " 1. vegetable 2. milk 3. cookie. "

Researchers say hyperlexic kids don't always comprehend the passages

they read, but many parents say the children do understand, often in

surprising and creative ways. The outlook for them usually depends on

how severe their other autistic-like impairments are. They may be rent

with anxiety over minute changes in routine, or overwhelmed by social

situations. Some are highly sensitive to certain sounds or smells. " We

have kids who read and type and spell wonderfully, but remain quite

severely autistic, " says Ms. Kupperman. " We also have kids who read and

type and spell just as wonderfully, and are able to accommodate to the

point of attending college or working. While they still have noticeable

differences, they are functioning and contributing to society. "

Ms. Freed says that , the boy in the imaging study, needs extensive

training about social cues. For instance, if someone is looking away

during a conversation or tapping fingers, it means the person is bored

and he should change the topic. But , now 11 and reading at the

level of a 26-year-old, is doing extremely well, Ms. Freed says. Earlier

this school year, he wrote and delivered a persuasive speech and was

elected president of his elementary school.