Cincinnati Family Magazine

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May 25, 2024

When Reading Is Work: Identifying Difficulties

Your child is struggling to read. Could she have ADD or ADHD? The solution could be as close as an eye exam or a change in diet. Or, it could portend a lifelong struggle for both of you.

What should you do when you suspect your child has reading difficulties?

“The first thing parents should do when they see their child struggling is to talk to a teacher,” says Janet Camp, early intervention specialist at the Tennessee Center for the Study and Treatment of Dyslexia. “If this is their first child, parents may not know what is usual development and what is a problem.”

After that, says Camp, “parents should very aggressively check out skill areas – there are tests that a speech language specialist can give to evaluate how well children are processing sounds. And parents might want to check with an opthamalogist or opt for a more in-depth eye evaluation.”

Although early intervention is the key to helping children with reading difficulties, Camp says testing for very young children is not conclusive. A learning disability is defined as “a discrepancy between achievement and intelligence score, and you’re not going to see that discrepancy until children get into second or third grade,” she says. Until that time, parents “can look into the weak skills and do intervention at home and school – find the skills that need extra support, such as visual and auditory skills,” Camp says.

Auditory Problems

Reading is not just about seeing well, it is about hearing well; words are a collection of sounds. If we can’t distinguish the sounds accurately, we may have trouble reading the words.

“There are two huge areas of language development that affect reading,” Camp says. “One is vocabulary and oral language skills – using whole sentences when you speak, for example. That relates to reading comprehension. Then there’s speech – how well you hear and articulate the sounds. This affects whether or not you learn phonics well. Because each letter or group of letters represents a speech sound, being able to learn phonics accurately and easily is crucial to the beginning steps of reading.”

Trouble reading words can arise in students who cannot match a sound with a letter or cannot blend letter sounds, like “sh” or “ou.” Memory plays a role, too; they may remember that “s” makes the “sss” sound when they read it once, then not recall what sound it makes when they read it later.


Attention Deficit Disorder (ADD) is a controversial diagnosis of children who have difficulty concentrating. The diagnosis indicates an inability to control behavior due to neurological processing disorders, which can cause reading difficulties.

Many facilities, such as the Learning Lab in Brentwood, offer testing to determine the cause of the reading difficulties. Director Pat Elkins recommends a full psycho-evaluation to identify the specific cause. “It needs to be done by a licensed professional – a psychologist,” she says. “The test allows parents to learn a lot about how this child processes information and their learning style.” Elkins adds that many schools also offer testing, and can be a good place to start.

Reading problems often increase with Attention Deficit Hyperactivity Disorder (ADHD), when children have a poor attention span and increased needs for motor activity. Not being able to sit still or listen and focus often leads to behavioral problems in school and at home, in addition to learning challenges. Testing will determine whether the child has ADD with or without hyperactivity.

Tests generally look at attention, inattention, impulsivity and family history, combined with an IQ test, a thorough evaluation in reading and math, visual-motor integration and cognitive processing. The psychologist will take all the information and piece it together, like a puzzle, says Elkins, and make recommendations on treatment.

Treatment methods abound for this increasingly common diagnosis. Generally treatment involves many components, Elkins says. Medication, combined with specific one-on-one assistance in areas such as attention, time management, study strategy and social skills can help

Stress, Trauma and Emotional Issues

“A lot of problems can look like ADD but may be something else, such as an emotional issue,” says Elkins. “Many times there is a combination of factors.” When reading problems arise from stress or other emotional issues, relaxation techniques, exercise or therapy may be appropriate.

A natural brain reaction to stress can actually cause the eyes to defocus. This can make it hard to track words on a page or even to focus on words. Reading problems can stem from worrying or thinking too much. Other emotional issues that can cause difficulty reading include fear of failure, low self-esteem and depression.

Visual Problems

A pair of glasses may be all a child needs to end his struggle, but it is not always so simple. If students experience reading problems by age 6-and-a-half, schedule an eye exam. “It’s important to get a more in-depth eye evaluation than the school provides,” Camp says.

“Screening looks through one eye at a time, but doesn’t evaluate how the two eyes work together and whether they track together from left to right, which is important since we read from left to right.”

Eye exercises can relieve eye fatigue, another problem that can cause difficulty with reading. Overuse of TV, computers and hand-held electronic games has led to more eye fatigue in all age groups. This problem is more serious for children, since their eyes have not fully matured.

Slow visual processing speed, difficulties with visual memory and poor communication between the visual and linguistic systems (the eyes and ears) can also impair reading abilities.

Dyslexia and Other Learning Disabilities

Ten to 15 percent of the U.S. population has dyslexia, a common learning disability, yet only five out of every 100 dyslexics are recognized and receive assistance. Actors Tom Cruise and Henry Winkler struggle with dyslexia, sometimes needing to have their scripts read to them.

According to John Matlock, director of Dyslexia Centers of Tennessee, “It (dyslexia) shouldn’t be labeled. People with dyslexia learn a different way than others.” Dyslexic individuals usually have difficulty interpreting written language but have no problems with sounds or images. Matlock says, “It’s not a disability or a disease. It’s just something they have to deal with.”

The best way to “deal” wth dyslexia, he continues, is to let children know they are like everyone else. “They can be helped and they can be very proud of their educational performance.”

If your child is diagnosed with dyslexia, rest assured that there are programs out there that work and can help. It’s not the end of the world. “Confront the situation head-on,” Matlock says. “The earlier the better.”

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