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School of Public Health
College of Health Sciences, Makerere University

Dyslexia in Children, its Causes, and Measures to Prevent it

Posted on : Tuesday, July 19, 2022

Dyslexia is a neurologically-based, often familial disorder that interferes with the acquisition and processing of language.  Varying in degree of severity, it is manifested by difficulties in receptive and expressive language, in reading, writing, spelling, handwriting, and sometimes arithmetic. It is said to run in families, and several genes are responsible for this difficulty.

This week, we bring to you experts to share on dyslexia among children and how to prevent it.

Host:  It's a pleasure to have you tuned in to Health Pot at this particular time of the hour. We are delighted that you have followed Health Pot for a full year from where we started last year in January up now. We are glad that you are still with us and I welcome you to today’s show. My name is Edrine Osteen Mulazi. Yes, this show is brought to you by Makerere University School of Public Health and we basically major in early childhood development, maternal and child health, and other public health areas.

 Therefore, each time you see us just know we have a package in any of those three areas which you shouldn't miss. It is very important for you as a caretaker, as a teacher, as a parent and as a child as well because soon you will be a mother or father.

 We are delighted to have Dr. Paul Njuki back, last year we hosted him and we talked about normal speech development and language disabilities. Today, we have him talk about something different but still in the same area of early childhood development. Dr. Njuki, we are delighted to have you today on health pot kindly greet viewers and we continue.

Dr. Paul Njuki :  Thank you Mr. modulator. In the interest of audibility, let me take off the mask since you are protected.  Dear viewers, I’m glad to be here to share  what has taken me a bit of time in supporting children with special needs to share about very common condition called dyslexia.

Host: It is very common like you said although we in Africa here or specifically in Uganda we tend to think it is maybe witchcraft or it you know we have a lot of things which uh we attach it to. We are glad that we have you today to erase all the lies in our minds and then we see how we can help our children.  Dr. Njuki, maybe to start with, what is dyslexia?

 Dr. Paul Njuki: Dyslexia. I’ll simply define the term this as a Greek word that means difficulty with and Lexia means words so dyslexia as a condition is a situation where someone has got difficulty with expressing meaning through words.  It could be verbal or non-verbal.

Host: How does it now connect with non-verbal?

Dr. Paul Njuki:  I think there are issues for example symbols that may be a little bit complex, especially in mathematics where somebody may have problems identifying them, we have got the pr squared all that. As I will explain in detail later, I think it concerns both verbal and nonverbal.

Host: When does this condition start? Does it start when a child is born?  Does it start when they're still in the mother’s womb or when they start to speak?

Dr. Paul Njuki: Very early on. I think basically it is a neurological condition whereby someone’s brain is organized differently. We don't want to call it a disability that’s why I use the word condition. It is a situation where God in his own wisdom did not make the two hemispheres of the brain equal.  As you may know, we have got the right hemisphere and the left hemisphere whereby in so-called the typical children we don't want to use the word normal because there is nobody who is normal. If there is any normal person all of us are normal because we are created in God’s image but usually the left hemisphere is equal to the left-right the right hemisphere but for people with dyslexia, the right hemisphere is 10 percent larger than the left hemisphere and as we know the left hemisphere controls language and thinking.

For people with dyslexia, their language facility is a little bit less than a normal so-called normal child that's why basically but this is not a problem it's only that the brain has compensated the energies. People with dyslexia usually have got a bigger brain compared to ordinary people, typical people and that's why for them as I said dyslexia is difficult with the words someone with dyslexia will struggle with the words and anything related to the words. As I said the symbols in the first place. so, when they are communicating, they don't have issues with the words that are why spelling is a challenge for these children.

And you can see dyslexia fairly early, you can hear people or you can hear dyslexia when people speak. Most people with dyslexia will struggle to find words to say even when they are still young when they are going through language development. One of the warning signs of dyslexia is delayed language development and when you see speech delay because speech connects to words. That's why children who have had a speech delay, majority of them end up having a problem with literacy development.

So, children when they have turned at least we know I remember I talked about speech development.  By one year all children should be speaking one to ten words that are correct. By one year when they celebrate their first birthday but a child who is not talking at all by one year you should know there is a problem and dyslexia accounts for a wider percentage of this group

Host: Doctor, is dyslexia categorized into two types are their types or it is just a general condition?

Dr. Paul Njuki: I think many scholars would categorize it. They say surface or deeper but I would like to say dyslexia is dyslexia.  Nothing mimics dyslexia so whichever type it is; it remains dyslexia.

Host: What are some of the signs because uh you had started telling us about some of the things and that was speech delay? speaking what is one of the signs of dyslexia?

Dr.Paul: The other problem is about because dyslexia impacts directionality. Children with dyslexia often have issues with the left versus right and the majority of them are called the ambidextrous. They use both but what do you mean by left versus right. I mean they don't tell you quickly which one is left and which one is right. The first two things are the first thing or even if you put food on the table when they put food on the table, either way, they may use either left or right or sometimes they use both.

When you see people using both that means they belong to the dyslexia family. And usually, left-handedness is not a problem but the teachers and parents tend to discourage the children. They should know it is God-made. It's not children being lazy or being funny but that is how God planned it.

Host: Does it mean that someone who uses a left hand belongs to this family? Parents even go ahead and beat their children up not to use the left hand but you realize the child still uses it.

Dr. Paul Njuki: I would really say it is a sign of ignorance!  Teachers have to come to terms with that orientation because it is God who decides.  Nobody tells you which hand to use but you just do it automatically so teachers and parents should appreciate God’s creation because once you fight against it, you are going to lose the child’s purpose for life, it is going to be disorganized so that is why we need to understand that kindergarten teachers need to come to this term.

Parents need to come to terms with this difference because dyslexia come with gifts, there is no dyslexia without a gift.  If there is no gift, that is not dyslexia. Any families where we have got people who are dyslexic you find music; they are great musicians and I know them in this country. They have not been officially diagnosed but when I see a talent you will see their written expression and there's a discrepancy between the two. Someone does so well but when you say that can you put that on paper, you see a discrepancy and that is dyslexia.

Host: So, besides someone having speech difficulties and maybe having hardship in determining which hand to use, which other things can a parent or care taker look at and then they know my child might must be having dyslexia.

Dr. Paul Njuki: As I said, the directionality is a big issue. Children will put on buttons the other way they do not know which slippers to you know   they put the left in the right and the right in the left so that one is a warning sign. Other things could be issues like severe reactions to childhood diseases; children who have dyslexia tend to have to be allergic to some conditions because of the weaknesses. I told you about the brain programming so they have a tendency to have issues  like chronic ear infections,  they've got allergies when they're  growing up.

There are issues like maybe spellings  is a nightmare because when they are  like they're learning their letters for  example a b is written that way but they  don't know whether to go that way or to  go this way.  Instead of b they write d or d instead  of b and w for m  u for n  and so on so. And the teachers really  harass them.  They think they're careless  and the majority of their parents and the  caretakers they think their children  have sight problems . dyslexia is not a  sight problem we see glasses in  schools, many children are already wearing glasses. 

Handwriting is another issue, we call it  dysgraphia; difficulty with writing  because of the orientation of the body (directionality) the letters will go  another way.  A j which is supposed to go  in  maybe the left, it will go right. So I think they have got big issues with  the writing  and  talking . These children or  persons with dyslexia they have hard  time retrieving their words. They may look for  this thing this thing the other one . 

Short-term memory is  an issue.  It's so disappointing to go and  explain that you meet a friend and  maybe you were at school together but  you cannot remember the name. So those are some of the warning signs  and the other issue is that they will be highly  disorganized.  These guys forget keys at home, they lock them inside their  cars and  they spend a lot of  money. So dyslexia is quite expensive  and at school, every day you  have to replace a pen  because once they put something under, its as if it doesn't exist.

Host: Does  that mean mothers who used to put the  knives  in the armpits and then beat us  because they can't see the knives  thinking  we played with the knives. While they are still beating you the  knife falls down, does it mean they also  have dyslexia?

Dr. Paul Njuki: Dyslexia is very common. The  prevalence is one in every five people  that is 20% of our population .  So, I think we should not take it for  granted that it is a public health disaster . We need to spend money as a country to  make sure that you create awareness  among the population. Particularly, the  expectant mothers. I think antenatal clinics should address this issue .

Host: before the commercial break, you had taken us through some of the signs and symptoms that a caretaker can look at and know their child  must be at risk but then what is the  earliest time a caregiver or a parent  could really suspect  that their child  might be having this condition ?

Dr. Paul Njuki: Thank you moderator. I think I’d like to  inform our viewers that dyslexia is easy  to detect if you know  the warning signs. As I said, dyslexia can be heard a child who is struggling with words. It   should stop by the by the time the kid  is before kindergarten but if by p1 the  child is still saying um  for a man  then that is  that one is a developmental stage but  once it goes beyond the four years  then you should know there is a real  issue  about writing,  children learn to print their letters  when they are in kindergarten  by Primary one  if the child is still  reversing  p1 p2 if the child is still reversing  letters, it's a big one in sign.

 Host: A  parent would say my child didn't go  through kindergarten they joined school  from p1 could that also be an excuse?

Dr. Paul: No, it shouldn't be because at least a full  year of exposure to writing should get  the kid out of trouble if he lands into  good teachers who  are well prepared but if it continues  then that's a big issue.  If  the spellings continue past  three years  of instruction;  reading and writing  then you should know that is a real danger. Even some adults  it's fairly common I was a teacher  educator at university for 25 years,  I could still find students doing masters  but still with spelling challenges.  If that is the case dyslexia should be suspected.

Host: What about children that find hardships and coping what has been written on the blackboard putting it in the book? For example the teacher writes “boy” and this child doesn't write boy but writes “byo” or “yob”

Dr. Paul Njuki: I think  maybe the other issues which I did go  into, children with the dyslexia  the  letters will remove  within the words.  I think why we tell you that the child knows what  to do  is that the same letters are the ones that move.  For example they write a word  “so” for “was”.  So when you see that they are  the true number of letters then that  points to dyslexia, it's not a mental  impairment or retardation as it used to  be called.

So I think we need to watch  out for these things and the other  characteristics include  overwriting .Someone writing  you know  printing a letter so many times on six  and he writes it many times and they  make it so dark so dark that one is  another warning sign. Skipping the pages in a book you find  that a child  skipped a page  that means there is an issue of reading.  Tracking where you have been  or someone who reads and mid-way then he/she goes back to the beginning, that’s another warning sign. Another  issue is children cannot read  backwards  if you tell them they can read one two  three four up to ten but ten nine eight  seven they can't go backwards that's  another warning sign. So one of the big issue in dyslexia  is reversing  and so parents  should know because  i think they are the first  to see these challenges because they are  dealing with smaller numbers they can  see their child  and these children hating homework. kids hate homework and  they don't want  to do it.  It's a nightmare they put it  aside until the last minute until the  parent  emphasizes that you must do it but a  child who doesn't have dyslexia even  before they eat their food they want to  finish their homework. If you see dreading or  the unwillingness to do their homework  that is a major warning sign as well.  So, it starts fairly early and in  adulthood people don't want to write  they want to listen, they want to send  text messages instead of really writing  a text message because text message is  cheaper than calling , they prefer voice notes to calling.

Host :  Wow!! So doctor, what are some of the risk factors  associated with dyslexia?

Dr. Paul Njuki: The  biggest risk factor is  one of the parents  having dyslexia  because dyslexia is  hereditary. There is no other cause of  dyslexia. If one of the  parents has it,  half of the children  will have it . If mom and dad have it, all  the children will have it. Some mildly and   others severely. So children should never be punished for  spelling errors when  they are rooted in the  family. you find the grandma and grandpa punishing them other than this kid you are punishing innocent people punished for crime they never committed.   

Dr. Paul Njuki : Like I said after one year of good instruction in reading and  writing,  you should be out of trouble  but people who continue up to senior  four, can't blame a kindergarten teacher.  I think it is a reality after going  through primary seven and you're in the  secondary and you're still making  sparing errors I think you should not  blame the past. We have done studies of  deprived children and  children coming from the  village to Kampala where  they are expected to speak English and yes  but after a year these children begin  gaining and they may overtake  these people if they are gifted.

Host : You had brought in something to do with expecting mothers,  is there anything they can do to cab dyslexia  information ?

Dr. Paul Njuki : In developing  countries, we do genetic counseling. Other than checking for HIV only, there should be room under public health and  primary health care I  don't know whether  it can be treated as a primary  care issue  but parents should be checked. We need machinery in the Ministry of Health to check  genetics of a person so when you are  going to marry you have a choice to marry someone who is dyslexic or not . I have seen people who marry people without hands without legs in the same way if you want because  people with the dyslexia have got a very  creative mind they think outside the box that's why they are most successful in any  money issues because they are high risk  takers.

The challenge we have in schools is that these guys who struggle academically they fight a lot  and when they grow, domestic violence is unavoidable they are always fighting  because they are high risk takers. They don’t compute the costs of hitting someone, of slapping someone they end up in a jail so I think it's a big issue any money they take a loan not computing how they repay  them they are rich today tomorrow they have gone to zero so dyslexia is an issue  yeah  wow it is indeed an issue

Host :  Now that we're in Uganda we really we have not reached  that time  where we can access such technology of  taking genetic genetic counseling and all that what can someone do, how can someone really  match this so that they cannot  pass this to the next generation?

Dr. Paul Njuki : It is really difficult  because we can't keep you know we have  got  any science  we avoid any breeding  otherwise would you say people who are dyslexic marriages who are dyslexic but  it is natural we have seen it happen  people who are who have dyslexia tend to marry  their counterparts with dyslexia why  they have got birds of the same feathers  flock together musicians married musicians, doctors marry doctors that's why dyslexia isn't is it like a bush fire it goes so fast I think what you need to  do first of all I want to thank minister  of education and sports together with  the partners we have been able to  develop a national learning needs  identification tool  and it is here  published by minister of education but I  think a copy is over there  is a tool this is a resource guide  parents we in the future we are trying  to see how this tool can be rolled out  by three years all children you know 

Ugandan children should be screened  to see whether they have dyslexia or not  and once that is in place  teachers will know from day one  who has dyslexia and their plan  programs accordingly so it will be public information. Now that you have got a national  learning needs identification tool we  shall know how many you're going to have  dyslexia  and we shall know how many teachers know how to we equip our teachers we call it retooling to ensure that these children get taught the way they're supposed to do I’m sure in the future we should not have any child failing exams  Uganda national examinations body.

These  guys are usually wonderful  in music,art  great carpenters, great designers. You can  think about a gentleman like Bill  Gates who was diagnosed with dyslexia but  you can see he invented Microsoft  and this is a benefit to the entire  world. We have people who have  made history even here in Uganda. We see  children with dyslexia coming up with  great acts.  I run a school  secondary school but no student has ever  failed fine art  because they are three dimensional  thinkers. They think outside the box and this is great  if government can understand and the  universities also know that this is a  person with dyslexia they offer them  courses where they can excel other.

Host: Of course, we cannot exhaust issues with dyslexia but we shall have doctor even next Friday. It is very important that you don't miss the repeat of this show on Wednesday at exactly 10:30. Tell your friend, neighbor or anyone who has missed this show to watch that repeat or you can even follow us on our social media platforms. You'll find on YouTube, Facebook  chat event or Family TV and  all the  other social media platforms.  Edrine Osteen Mukalazi is my name I'm  Jonathan the producer Tony Santo on  social media.  God bless you we  meet again next time.

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