An Interview...

Dr. Sally Shaywitz – The Brain and Dyslexia – What Brain Imaging Can and Can’t Tell Us About Reading Difficulties

Dr. Sally E. Shaywitz is a professor of Pediatric Neurology at Yale University. She is the author of "Overcoming Dyslexia" and has published articles in many scientific and popular journals, including Nature, Journal of the American Medical Association, Scientific American and Child. She is a member of the Institute of Medicine at the National Academy of Sciences and the National Reading Panel.  Additional bio info

Dr. Sally Shaywitz is a neuroscientist who is passionately dedicated to helping children and families overcome the pain and strain of reading difficulties.

Note: Remember to click on any word on this page to experience the next evolutionary step in technology supported reading.

(see 'Interview Notes' for more details). Bold is used to emphasize our [Children of the Code] sense of the importance of what is being said and does not necessarily reflect gestures or tones of emphasis that occurred during the interview.

Point of View:

David Boulton: To begin with, help us understand your passion and point of view.

Dr. Sally Shaywitz: All right. I’m a neuroscientist, but a pediatrician by training. My interest in trying to better understand learning disabilities, and particularly reading difficulties, came from my own experience as a resident, seeing many, many children and their families. I became aware of how worried mothers and fathers were about how their children were doing in school, and, also, how little we, particularly pediatricians, knew about it, and had to offer these families. Since that time I chose to not only be a pediatrician, but to specialize in developmental and behavioral pediatrics, and then further in learning disabilities, and then further in reading.

Over the years I’ve really gotten to know so many children and their families, and also I’ve seen the children grow up and got to know them as adolescents and young adults and even adults. I have seen the tremendous cost to these children and their families of having reading problems that often were unidentified and misunderstood and inadequately treated.

David Boulton: So, you connected up with and empathized with the challenges they’re living through in some way that drew you in.

Dr. Sally Shaywitz: Oh, absolutely. As a neuroscientist I feel privileged to be studying the brain, but I think the passion that drives my husband and me, we work together, is really the knowledge and experience of what the cost is to individuals. It’s an enormous, enormous cost and because it seems to be hidden, as I say in my book “Hidden only from those who don’t have to live with it.”It’s frequently terribly misunderstood. Children who are struggling to read, are often told, “Well, you’re not motivated,” or, “You’re not trying hard enough.” Or if a parent is concerned, that parent might be told, “Oh, you’re just worrying, don’t worry, they’ll outgrow the problem.” The idea that this is somehow a phase rather than something that will be with the child for life.

David Boulton: Yes. One of our interests is to explore what happens when children become so ashamed of how they feel about themselves in this process that it creates an almost preconscious aversion to it.

Dr. Sally Shaywitz: Well, I think that’s true. I’ve had the good fortune to speak to many people who are dyslexic, and who’ve been highly successful by anyone’s standards. But if you speak to them, as I have, and you ask them: “Well, what was it like for you when you were a child, particularly, what was school like?” And you see this terrible look on their face. Particularly they recall the really horrible experience of being called upon to read aloud in class, in front of everyone when they couldn’t do it.

David Boulton: Yes.

Dr. Sally Shaywitz: That’s the kind of mental image and emotional experience that stays with a child. It’s really remarkable how many adults will remember that and can picture that classroom and how they felt and how they wanted to get out of there and avoid that at all costs.

David Boulton: Right. Almost everyone we talk to speaks about this feeling level connection with people who are suffering with this challenge.

Dr. Sally Shaywitz: Yes, this isn’t an academic abstraction, it’s about real people who have to live with something that people don’t see, and that’s why I guess it’s been a really wonderful thing that the science has progressed so far, and that we actually now have the ability to see the brain at work, so we can actually see what is happening at the most basic levels.

What Brain Scans Reveal:

David Boulton: Good. Thank you. That’s a great place to start from. Relative to what you were just saying about being able to see the brain working on these fundamental levels, tell me a little bit about your research model, what you’ve been looking for and how you’ve gone about it.

Dr. Sally Shaywitz: Well, clearly, for anyone who’s interested in reading and dyslexia, which was initially described over a hundred years ago, the goal has been to try to understand where, at a fundamental level, reading takes place; and obviously it takes place in the brain. However, the challenge has been how do you study a process within the brain of children who are otherwise healthy? Fortunately, we have a very nice hard skull protecting the brain. So, how do you look within the brains of healthy children? We’ve all been extraordinarily fortunate that two lines of research have converged. One is the understanding of the basic nature of reading and reading difficulties; and the other has been the extraordinary progress in technology that allows us in really quite a benign way to be able to image the brain at work. We use Functional Magnetic Resonance Imaging (fMRI), which allows us to image children and adults as they try to read without using radiation or injections or anything like that.

So, our first goal was to see if the technology could work, and to be able to identify and localize what are the brain systems used in reading. First we studied adults, good and poor readers. We found that good readers use three major systems on the left side of the brain. Then we found that poor readers had a disruption, a significant underactivation of two of the regions in the back of the brain. But when you see that, the question always is: Is this something that if you see it in an adult, is it the result of years and years of not reading?

David Boulton: Right, or mis-learning to read, as distinct from being something that’s more neurobiological/structural in origin?

Dr. Sally Shaywitz: Well, yes — not quite, maybe having not read… I’ll get to something in a moment, and you’ll see why I’m sort of hedging here.

David Boulton: Okay.

Dr. Sally Shaywitz: Anyway, so our next step was to study a very, very large group of children who were good readers and struggling readers, and we found exactly what we had found in the adults, a significant underactivation in the areas in the back of the brain. This study was really a very, very informative one because there was an unusually large number of children participating, 144. That is a very large number of children for an imaging study and that allowed us to do a number of things. It allowed us to begin to map out: Well, what do these areas do? What was particularly of interest to us was one of the areas — have you seen my book?

David Boulton: I have it in front of me.

Dr. Sally Shaywitz: The area in the back of the brain, the left occipital temporal region, or the word forming area – activation in that area was significantly related to a child’s skill as a reader. So, the individual differences in reading skills were related to individual differences in brain activation. That was very important, because this is a very important area in fluency, which is critical to being able to read not only accurately, but also rapidly and with good intonation. So, we went from simply geographically identifying the systems to being able to see the locations of potential differences between good and poor readers, and what the role of each of these systems is.

Connecticut Longitudinal Study:

Dr. Sally Shaywitz: Then we were able to go even one step further. I directed a study called the Connecticut Longitudinal Study. This study has been ongoing since 1983, where we’ve followed an epidemiologic sample of Connecticut school children. The target population was to reflect and be representative of all children attending public kindergarten in the state of Connecticut.

We’ve now followed and continue to follow ninety percent of that group, so they’re now in their mid- twenties. We gave them reading tests every year and every other year ability tests; asked their teachers about them, asked the families about themselves, asked the children how they felt about themselves. It’s a very broad range of information about the children.

What we were able to do as a result of that is when this group was in their early twenties a few years ago, identify three groups: one group who had never had a reading problem; one group who seemed to early on, in third and fourth grade, have a reading problem, but by the time they were in ninth grade, have really good accuracy, but still not fluent; and the third group, who we call persistently poor readers, they were poor readers in third grade and in ninth grade.

When we imaged them — I’ll make what could be a long story very short — we found that the worst readers, the persistently poor readers, had the systems for reading in place, but they’d never been properly activated. They weren’t connected up the same way as good readers. More importantly, because we had data on these young people from the time they entered school, we knew about their families and schools. What we found was that the persistently poor readers seemed to have lower verbal ability from the beginning and to attend more disadvantaged schools than the group that had compensated.

That has led us to hypothesize that we may be dealing with two different types of poor readers: one type, which would represent about a third of the total group of poor readers, who had their reading problems on an inherent basis. The other, which would represent two-thirds of the poor readers, seemed to have the systems for reading intact, but they’d never been properly activated. So these were shown primarily as environmental influences, perhaps from growing up in more disadvantaged circumstances and from not having received the kinds of reading instruction that would properly activate these systems.

Again, this is not to just to be simplistic and think that it’s either all genetic or all environmental.

David Boulton: Right.

Dr. Sally Shaywitz: With every child it’s always a combination. But in each child, also, there’s a predominance of one or the other. What’s very hopeful is that this large group representing two-thirds of all poor readers are children who really could be helped, who have the systems intact, who don’t have that kind of disruption, but really haven’t that that kind of stimulation either at home or at school that would allow these systems to be properly activated.

Inherent or Acquired?:

David Boulton: Good. How do you differentiate the inherent from the acquired? You said that you were first testing them in the third grade?

Dr. Sally Shaywitz: Well, again, the inherent group is a group that seemed to have difficulty from third grade. By the time they were in ninth grade, they were able to read accurate, but not fluently.

David Boulton: Right.

Dr. Sally Shaywitz: They had improved their accuracy. They seemed to have higher verbal abilities to begin with, and to go to less disadvantaged schools. Now we’re embarking on our genetic studies to actually see if we can find a genetic underlying basis for these reading disabilities.

David Boulton: Okay. But so far, are we close with any tests that actually differentiate the children before they’re exposed to reading instruction?

Dr. Sally Shaywitz: That’s a really good question. That’s the hope. I think that apparently there are behavioral tests that reflect what we’ve known about reading and I think those can tell us which children are at high risk. I think those tests can pretty much pick up a very high percentage of those children who are at high risk. They also pick up children who turn out not to have reading problems. So, they end up, currently, over-identifying children. But that seems to be less harmful than…

David Boulton: Than under-identifying, yes.

Dr. Sally Shaywitz: So, as long as you don’t label children, but say, “These children might benefit from getting extra help and getting highly explicit help,” that seems to be a positive thing to be able to do.

Limitations of Current Brain Scans:

David Boulton: Do we have any brain imaging tests that you’re aware of that allow us to see a signature distinction in the structure or processing of the brain before the process of learning to read that predicts difficulty in learning to read?

Dr. Sally Shaywitz: We don’t. I know exactly what you’re saying, and that would be just a really commendable goal. Currently, when we do functional brain imaging, children have to lie very still, and the youngest that I think we or others have done is about six-and-a-half. So then at that time that would be when children are about near the end of kindergarten. So, you’d expect them to have the rudiments of early reading in place.

It may be possible, with other technologies that are evolving, to be able to identify children earlier.

David Boulton: So, currently there’s a rather significantly sized uncertainty about that threshold.

Dr. Sally Shaywitz: That’s right.

David Boulton: Okay. Relative to your tests, how fast a frequency variation can you see? I mean, for example, with Keith Rayner’s work we’re seeing that the difference between graphemic and phonological follow-up is happening in a five to twenty-five millisecond time window when somebody is reading well.

Dr. Sally Shaywitz: Well, Functional Magnetic Resonance Imagining doesn’t give temporal information.

David Boulton: So, then difficulties associated with the time precarious interactive interplay between these various modules you’re identifying can’t be seen with the equipment and setups we’ve got yet.

Dr. Sally Shaywitz: Certainly not with the Functional MRI. But what we can see, for example, that when we present words to children very quickly if they are using the word formation area that’s critical for fluent reading. That’s possible.

Now there are new techniques that show how the parts of the brain are connected, so we can have a sense — and that’s what I was just telling you about in the last research I mentioned, where we looked at the persistently poor readers who seemed to have all the systems in place, but they weren’t connected appropriately, they weren’t connected properly. I think this is an area where the technology is evolving very, very rapidly, so I think things are really changing as we speak.

David Boulton: So, we’re heading towards being able to peer into this space. It seems when children are reading, if we really track their facial expressions and articulations, there’s a hesitancy, or starting and stopping that happens for struggling readers, and that that starting and stopping has a correspondence to a number of things. One thing for sure is the kind of ambiguity they’re processing at that moment, yes?

Dr. Sally Shaywitz: Well, yes, I think each of us would represent that a little bit differently.

David Boulton: Okay.

The Challenge of Learning to Read:

Dr. Sally Shaywitz: To us, when we think of how children learn to read, children first, you know, obviously learn the letters and the sounds. Then they learn strategies to sound out words. When they’re doing that, that’s still laborious. It demands attention.

David Boulton: Right.

Dr. Sally Shaywitz: After they’ve read a word correctly a number of times — no one knows exactly how many times, some people think four or six, and it probably varies for each child — but have read a word over and over again correctly — and that’s the key, correctly — then that the word becomes automatic, and they just need to look at it and they automatically recognize it. That’s where that occipital temporal region becomes involved. So it’s really that occipital temporal region that is critical because it’s that same ventral stream on the left side of the brain. So this particular area on the left side of the brain, the word forming area, is the area that we and others believe serves the expertise in reading. That’s very, very important because when you can read a word fluently it’s read automatically. That means you don’t have to devote conscious attention to it. And unless you can read words fluently, you’re not going to enjoy reading.

David Boulton: Right.

Dr. Sally Shaywitz: It’s hard work. That why I think so many people misunderstand what a struggling reader is all about. It’s not that they can’t read. That may happen, but it’s very rare. But it’s how much effort they have to put into it.

David Boulton: The bandwidth they’re consuming to do the processing to get to that level of fluency that can allow them to run.

Dr. Sally Shaywitz: That’s right.

David Boulton: Which comes back to the point that there’s certain processing involved. In order to get to a point where there’s the automatic recognition that you’re describing, they need to develop the skills that will allow them to work out a word they haven’t previously encountered.

Dr. Sally Shaywitz: Exactly.

David Boulton: It’s in that process, how well they learn to work out a word that’s confusing them, and how fast they’re able to do that that’s at the core of whether or not this whole thing smoothes out and becomes transparent enough.

Dr. Sally Shaywitz: That’s right. I don’t know if I would use those exact words, but I would agree with the idea.

David Boulton: Okay. So there’s a time that it takes to work it out that’s associated with creating a phonological experience of the word they’re reading, yes?

Dr. Sally Shaywitz: Well, yes, a phonologic model that’s able to transform the letters into the sounds the letters have to represent.

David Boulton: And in the course of doing that, as we know, there’s this very ambiguous — to the child, anyway — relationship between the letters and the sounds, that their brain has to work out.

Dr. Sally Shaywitz: Oh, absolutely. When I lecture, what I always say is: That’s the whole challenge in reading. The spoken language is not a challenge, because it’s natural, it’s been with us forever, it’s been certainly hundreds and thousands of years. We as human beings are genetically programmed and our brains are hardwired for spoken language; whereas written language, from an evolutionary perspective, anyway, is much newer.

Brain Not Wired For Reading:

David Boulton: Evolutionarily yesterday.

Dr. Sally Shaywitz: We’re not hardwired for written language. Many societies on earth indeed rely solely on an oral language. So whereas spoken language is instinctive and natural – you don’t have to teach a baby to speak, you just expose that baby to a spoken language and that baby will learn, eventually, to speak –reading has to be taught. It’s artificial, it’s acquired.

What Must Be Learned?:

Dr. Sally Shaywitz: So then the question is: What is it — that’s the key question — what is it that a child has to learn? Why is it that the lines and squiggles on the page have meaning at all? Why aren’t they just abstract symbols? So we say, well, what do they have to link to? We believe that what they have to link to is something that has inherent meaning, and those are the sounds of spoken language. That really sets the template for what you need to do to teach children to read.

David Boulton: Yes. I don’t know whether you had a chance to look at our interview with Paula Tallal?

Dr. Sally Shaywitz: No.

David Boulton: We’re completely tracking together here. We understand the distinction between that early stage, when we’ve got to be able to generate virtual or actual sound from the letter configurations, and later, the kind of morphological all-at-once pattern recognition that will allow you to move faster than sound.

Dr. Sally Shaywitz: Right.

David Boulton: And there’s a big confusion that happens between those two. So just coming back to kind of close up on the brain scans: At the moment, anyway, we infer the timing aspects of the relationships between these submodules in the brain that are involved in working out the letter sound correspondences, but we cannot see those in action yet, right?

Dr. Sally Shaywitz: No.

Unnatural Challenge:

David Boulton: Okay. One of the things that our project starts off with is the distinction between oral language and written language. With oral language, depending on which expert, 50,000 to a million years old, whether you go genetics or…

Dr. Sally Shaywitz: How can anyone know? There’s no way that we know exactly when we began.

David Boulton: No, but we do know from facial anthropological structural shifts when we became capable of more rapid articulate speech.

Dr. Sally Shaywitz: Right, but that’s still a big window.

David Boulton: Yes, it’s still a big window, but as you pointed out just a few moments ago, there’s a big difference between the time we’ve had to adapt to speaking and listening…

Dr. Sally Shaywitz: That’s right, exactly.

David Boulton: And the time that we’ve had to adapt to writing and reading. I mean, only a few percent of Mesopotamia and Egypt could read, and during the Dark Ages, only a few percent of Europeans. English as a written standard for mass writing and reading is only a few hundred years old.

Dr. Sally Shaywitz: That’s correct.

David Boulton: The English code, in particular, is a fusion of the sound system of Latin and the letter system of Latin with the sound system of English. It has very confusing letter-sound level correspondence ambiguities that takes time for the brain to work through, and that time has some correspondence to the stuttering that we experience or see in the processing that children are going through that are struggling. Yes?

Dr. Sally Shaywitz: Go ahead. I’m listening.

Assessing Interventions with Brain Imaging:

David Boulton: So what do you think are the significant ‘jewels’, – the core points most missing in our general society’s appreciation or understanding of the challenge of learning to read?

Dr. Sally Shaywitz: Okay. But before I forget, I should tell you one other thing that may be of interest to you.

David Boulton: Anything, anytime. I’m wide open.

Dr. Sally Shaywitz: Okay, and that is we actually just recently published a paper that showed that if you give evidence-based reading intervention to children, you can actually reorganize the brain and help the children to develop that left word forming area that’s so critical for fluency.

David Boulton: Right.

Dr. Sally Shaywitz: So it takes it from the theoretic to really the empirical, to having been empirically demonstrated.

David Boulton: Right. We’re following that as well and I appreciate your drawing attention to that. The closer we get to meeting children in the confusions they’re experiencing and helping them resolve and become confident in their ability to resolve them, the better they learn. There’s any number of systems that might be helpful, depending upon how well it meets up with the particular individual child and the particular configuration of their challenge and struggle.

Dr. Sally Shaywitz: That’s saying a lot.

David Boulton: Yes, well, I think we’re in alignment, because this is a huge problem.

Dr. Sally Shaywitz: This is a really huge problem. It’s one that I think is really underappreciated because for those who don’t experience it or don’t understand it, it’s very much hidden. But what’s been amazing is how many people it affects.

Lack of Understanding:

Dr. Sally Shaywitz: I mentioned to you that I had written a book. I just received from my publisher the copy of the tenth printing.

David Boulton: Congratulations.

Dr. Sally Shaywitz: I think on one hand I’d like to think this is a well-written wonderful book, and on the other hand I know that one of the reasons it’s been so popular is because this affects so many people.

David Boulton: Right.

Dr. Sally Shaywitz: There’s been such a lack of understanding that so many people who’ve experienced or who have loved ones who have had difficulties, or educators who have tried to teach children, know that there’s something real, and have been frustrated with the lack of knowing what this is.

I was introduced today, my book received an award, and the person introducing me was an extremely well known, extraordinarily successful businesswoman who is also dyslexic. She spoke about how difficult it was, that when she was in second grade, they told her mother that she was stupid and that she had to be kept back. She was put in a class with two children, one child who was retarded and one child who had just come from another country who couldn’t speak English.

I think we’ve come far away from that level, but I think that people really don’t understand how much has been learned, just about what you and I were talking about, about the basic need to go to the sounds of the spoken word, but also how much has been learned in terms of what we know about the neurobiology, and how that translates to help us understand what are the most effective approaches to teaching children to read.

Education and Science:

Dr. Sally Shaywitz: As I said, I’m a physician, and this month I’ve been taking care of sick children in the hospital. When we make our morning rounds and we talk about what treatments to use, we always look to the evidence, you know, what is the evidence that for a treatment – treatment A versus treatment B – we look at the scientific literature. What is to me extraordinary, truly astonishing, is that in education, that’s never been part of the culture. What is chosen – what books are chosen, or programs, really reflect a philosophy, or what publishers tell people – lots of different things, but not true science.

David Boulton: Well, there seems to be a rather assumption-based war that goes on between some different interpretations of how human beings learn in general, and learn to read in particular. There are people, and I’ve talked to some of them, who firmly believe that given enough success, the kids will pick up the code processing skills without needing to be explicitly conducted through learning them.

Dr. Sally Shaywitz: Right. Because there are people who inherently believe that you can treat cancer by an extract from apricot pits.

David Boulton: Yes.

Dr. Sally Shaywitz: We need more than beliefs, we need to show evidence.

David Boulton: Right. And we need to reframe — we need to challenge the assumptions in an environment, situation and setting where they can actually be approached by the people that are holding them.

Dr. Sally Shaywitz: Well, that’s right. You need to do a scientific study, and you’ve got to have a hypothesis, and come up with a hypothesis that can be challenged, that can be falsified.

David Boulton: Right.

Dr. Sally Shaywitz: Because science has a real process. What’s really been extraordinary, is in the last several years we’ve really had a cultural and a paradigm shift where the very basic tenets of science have entered into education. That’s very hard, because it’s not been part of the culture.

I’ve sat in meetings with educators in New York City, where there’s the huge issue of how to teach children how to read. I sit and I listen, and I think, well, what is the problem here? These people are intelligent people. Then it struck me that the whole notion of science and what that implies and the process, and how you validate something is foreign to them. It’s not the fault of these individuals, it’s just not the way they were taught. People who’ve come through schools of education and wherever else they’ve trained, the scientific process has just not been part of the conversation.

Reframing Reading:

David Boulton: Yes. Well, we’re hoping to address some of that by creating an experience for people that contextualizes the challenge of reading by understanding the artificiality of it by virtue of its history; the kind of confusion in letter sound correspondences that developed when these systems collided, because originally it wasn’t that way, and then inside the view that you’ve got of the brain and how it’s processing, so that people understand, ultimately, that this is an artificial, technological interface process.

Dr. Sally Shaywitz: That’s correct.

David Boulton: It’s a virtual reality system. The code works, in the beginning anyway, on our sound system, not unlike the way the player piano script works on a player piano. It’s got to generate these sounds firing…

Hard to Imagine:

Dr. Sally Shaywitz: I think that many people who are very good readers don’t even remember learning to read.

David Boulton: Right.

Dr. Sally Shaywitz: It’s hard for them to imagine that for others it could be so difficult.

David Boulton: Yes, it is. We can talk about dyslexics or people that are struggling on the most severe side of this, but we can also step back and say, on a broader level in terms of not simply whether they can read or they can’t read, but reading improficiency and its psychological and cognitive processing challenges and consequences, reaches to the extent that, according to national statistics, you know, sixty-five percent of all twelfth graders are below proficient.

Dr. Sally Shaywitz: That’s right. It’s believable.

David Boulton: Yes.

Dr. Sally Shaywitz: At first blush it seems, oh, how can that be? But it is. I’ll give you one example. It’s actually somebody that I write about in my book – a man who graduated from high school in New Haven, Connecticut, but couldn’t read. You know, New Haven is the home of the Yale University and this man graduated, even though he couldn’t read. Then he got a job as an appliance repairman. But now apparently if you want to fix appliances, there are computer chips, so you can’t do it by feel and the way you could have manually. You need a verbal mediation, you need to be able to read, and he couldn’t.

David Boulton: Yes.

Dr. Sally Shaywitz: Then you hear what it means to someone like him not to be able to read, and he’s highly intelligent. But then he actually went to an adult program to teach him to read. He went for three and a half years working full time with I think two children at home as well. Then he learned to read, and he can tell you what the differences are, how he can pick out a card for his wife’s birthday, which he never could do before, how he can read a menu.

Then you realize all those little things that we all take for granted, what it means when we can’t do it. It’s hard for most people, they dichotomize, they think if you can’t read, you must be stupid or retarded. They don’t know there’s a huge group of people who just don’t read well enough or fast enough to have a pleasurable or enjoyable experience.

David Boulton: So that it develops positive affect rather than negative affect in association with it.

Dr. Sally Shaywitz: That’s exactly right. I lectured for our own Hospital Ladies Auxiliary about a week or two ago. What was amazing to me was here were these sort of ladies, very well dressed, in good circumstances, and they came up to me afterwards to tell me about their reading problems. You would never have imagined that this group of ladies would have a reading problem, and what it meant to them. How they were worried about what their children or their grandchildren would have to go through what they had gone through, and continue to go through.

David Boulton: Yes.

Dr. Sally Shaywitz: But it’s a very big secret in our society.

Secret Shame:

David Boulton: Well, we’ve been interviewing a number of people on the adult literacy and juvenile justice sides to get a triangulation on two levels: the shame aversion and the hiding that goes on. Robert Wedgeworth at ProLiteracy described a recent adult literacy studies in which what they found to be the most striking correlation in the buying behavior of people that are challenged with respect to reading, is the extraordinary degrees they go to hide it.

Dr. Sally Shaywitz: Oh, absolutely.

David Boulton: It just goes to show us again how powerfully locked up this is with shame.

Dr. Sally Shaywitz: Oh, absolutely. To give another example — I think it would be very important for people, though, in your project to make sure that people can understand how very bright and sometimes very successful people can have this. Some of the most distinguished professors or our best students will come and ask to speak to me. This has happened so often now that my assistant knows, and she’ll lead them into my office, and they’ll look around to make sure no one can hear, close the door, and then will say, “I have to tell you something. You’re not going to believe it. And no one knows this about me.” Then I know exactly what they’re going to say, you know, what a terrible reader they are, or how slow they read, or how long it takes them. They’re filled with shame and they think they’re the only one who has this. I say, “Well, you know, I’ve seen many of your colleagues.” I don’t mention who they are. They say, “Really? I can’t believe that.” They think they’ve somehow fooled people. (More “shame stories”)

David Boulton: Yes. That’s such a powerful piece. The other thing that very few people get that’s connected to this is more at the processing level, that the more that shame accumulates the easier it is to trigger.

Dr. Sally Shaywitz: That’s right.

David Boulton: And the moment that it triggers it sucks up bandwidth, that diminishes their brain’s capacity to process the code.

Dr. Sally Shaywitz: Well, that’s right. That’s right. That’s why it’s so critical to try to reach children really early.

David Boulton: Yes.

Dr. Sally Shaywitz: Because it’s just an extraordinary thing, and how it affects people in every walk of life. I hope you will show some highly successful people talking about it.

David Boulton: We will.

Childhood’s Greatest Risk:

Dr. Sally Shaywitz: I feel that people have to understand this because so many lives that could really be enriched and contribute to society are cut off. People assume that if their child can’t read well, well, then they go that way rather than be able to dream of being a doctor or a lawyer or a writer, whatever.

David Boulton: The shame aversion fundamentally cuts off their learning as well as their self-esteem.

Dr. Sally Shaywitz: Absolutely.

David Boulton: So we’ve got to bring this out. Our first article basically says: more children suffer life harm from the consequences of the challenge of learning to read than just about anything else they face.

Dr. Sally Shaywitz: Well, that’s very interesting. In my book what I say is that parents need to look out for the clues, because I say, “Your child is more likely to have a reading problem than any other problem that you’re going to see your pediatrician for.” 

Dyslexia Numbers:

David Boulton: I’m really enjoying this and could go for a lot longer but I want to hold to the hour that I asked for. You’ve been attributing that up to twenty percent of the population has or could have dyslexia.

Dr. Sally Shaywitz: Right.

David Boulton: When we talked with Reid Lyon and James Wendorf, they’re very clear in the way that they frame it, coming at it from two different but correlated angles, that only about five to six percent of children, according to all of their studies and information, have anything that might be considered neurobiological in origin that’s impeding their learning to read; that for ninety-five percent of the children that are in various stages of struggle, that struggle has to do with how it is we are meeting them, teaching them, unfolding this before themand that as a consequence, if we take your twenty and overlay it on that, there’s a kind of a definitional confusion.

Are you saying that twenty percent have an inherent problem with dyslexia, or that what we call dyslexia, which is such a general and broad term, stretches across twenty percent, part of which is neurobiological and part of which is instructional?

Dr. Sally Shaywitz: That’s an empiric question. We don’t know the answer to that. But if I were to come down on it, I would say that it would be just what we reported when I was telling you about the two-thirds and one-third. So I would, I think…

David Boulton: Basically, that actually brings it right back into alignment, right?

Dr. Sally Shaywitz: Exactly.

David Boulton: Okay. That’s what I thought. I just wanted to make sure we explicitly went through that loop together.

Dr. Sally Shaywitz: Right. And we don’t know. That’s why we’re carrying out genetic studies, to really see the differences.

David Boulton: They’ve backed into their five to six percent numbers; they’re not bottoms-up, right?

Dr. Sally Shaywitz: I don’t know where they — I think they got their number because what’s been shown is if you give children highly effective, evidence-based intervention you can bring down the number of struggling readers to five to seven percent.

David Boulton: Right. But that’s what I mean, they’ve backed into saying how many people might have neurobiological problems.

Dr. Sally Shaywitz: Yes.

David Boulton: Because they can’t see them directly, they’re inferring them from how many people they can help inside the box of what they can offer.

Dr. Sally Shaywitz: I think what you said is correct. [laughter]

David Boulton: Okay.

Dr. Sally Shaywitz: I think so, because what’s nice is it all overlaps; what I’m saying and what they’re saying really comes to the same thing, essentially.

David Boulton: Right. And I think there was enough potential for confusion here that I wanted to get more explicit in that space.

Dr. Sally Shaywitz: Glad we clarified that.

David Boulton: Yes.

Slow Readers Need More Time:

Dr. Sally Shaywitz: I don’t know if you want to get into it or not, because it’s probably a little different than what your primary focus is on, but a very important thing is children grow up to be adolescents and young adults, and whatever they want to aspire to be, a teacher, a doctor, a lawyer, a writer, they often have to take a series of tests. One of the things we know is that because children who struggle to read don’t develop that left word forming area that’s responsible for being able to read more fluently, they read very slowly and require extra time.

That becomes a really important thing because so many children who’ve worked so hard all their lives, they come to the point where they need to take an SAT or an ALSED Law School Admissions Test or a GRE, and they require extra time if they’re going to be able to show what they know. There’s been a very strong – it’s not a movement, I don’t know the right word – but these children are more and more being denied the extra time that they require.

David Boulton: There’s this general failure in the way that we think about assessment to actually meet the kids in some way that reflects what their situation is.

Dr. Sally Shaywitz: That’s right, not to feel that they’re somehow getting away with something or weak. If somebody needs glasses, you wouldn’t question it, or if a diabetic needs insulin, in the same we know that children or young adults and adults who have reading problems require extra time. For me, as a physician and as a scientist, one of the most exciting things has been that we’ve been able to now demonstrate that in children who are dyslexic, they don’t develop that word forming area but they do develop compensatory regions on the right side of the brain and also in the front that allow them to read. But not automatically so that they can become highly accurate readers, but by the investment of an extraordinary amount of time and energy. They can get there, but their route is much slower and more inefficient.

David Boulton: Right. There’s some kind of a circuit detour that’s had to happen for them.

Dr. Sally Shaywitz: Exactly.

David Boulton: Which is slower in processing and results in them needing more time to be as effective in the task.

Dr. Sally Shaywitz: Right. What I say now is that dyslexia simply robs a person of time, accommodations like extra time return part of it, and that a person who is dyslexic has as much a physiologic need for extra time as a diabetic needs for insulin.

David Boulton: Yes.

Dr. Sally Shaywitz: Now that we can show that with our brain imaging, that’s made an extraordinary difference. Because I’ve seen too many young people who were applying to graduate school or professional school who struggled their lives to reach the point where they can read accurately, but not automatically, are turned down for extra time. It’s like somebody climbing to the top of a mountain and you suddenly step on their fingers, and don’t let them take that last step, and knock them down. So, it may not sound like an important thing to you, but for all those people who have had difficulty reading it is.

David Boulton: All of these dimensions are critical. We’re looking at the family context, the social context, very particularly at the emotional affective context as well as the cognitive processing challenge.

Dr. Sally Shaywitz: That’s at the very — that’s at the heart.

David Boulton: Yes.

Dr. Sally Shaywitz: That’s the heart and soul of it. Because you can teach a person to read, and you can do all the things, but if they’ve had that hurt and that pain and that blow to their self-esteem, that’s the most difficult. We have no medicine for that.

David Boulton: Yes. And it’s not just a bad feeling they’re having; it’s fundamentally processing-level debilitating, draining of the efficiency that’s necessary to process the thing that could make them feel better. It works in a downward spiral.

Dr. Sally Shaywitz: That’s right.

In Closing:

Dr. Sally Shaywitz: Well, it sounds like — I’m feeling good speaking to you because it sounds like you really care.

David Boulton: I really care. This is my life work. I am totally focused on this all the time.

Dr. Sally Shaywitz: Well, I’m glad, because it’s my life’s work.

David Boulton: Yes. I feel like we’ve met each other well. I look forward to meeting you in person and interviewing you on camera for the documentary. I really applaud and congratulate you for all that you’ve done that’s helping so many children.

Dr. Sally Shaywitz: I think what you are doing and will complete, and I guess continue to do, will really have an enormous impact.

David Boulton: Yes, thank you. I hope so. We’ve done interviews with people ranging from the man who discovered the basic principles of the emergence of the Standard English, and orthography experts like Venezky, and people that studied the emergence of writing with the Hebrews, Phoenicians and Greeks and the fall of letter-sound correspondence. We have also interviewed Pat Lindamood and Nanci BellPaula Tallal, and other people working on the circuitry of sound, and then Keith Rayner on visual perception, and Keith Stanovich and others. We’re trying to bring together a matrix that will allow people to really understand how all these things connect. We’ve got to reframe how we think about all of this.

Dr. Sally Shaywitz: Well, that will be wonderful. But how long a documentary are you going to make?

David BoultonThe broadcast documentary will be three hours long, but there will be a ten-hour extended DVD for teachers and professionals.

Dr. Sally Shaywitz: Isn’t that wonderful.

David Boulton: Yes, so it’ll go from the beginning of oral language and the brain — did you ever read Terrence Deacon’s The Symbolic Species?

Dr. Sally Shaywitz: Yes.

David Boulton: I really enjoyed conversations with him.

So we’ll go from the development of language and its effect on consciousness, to the emergence of writing, the breakdown of phonetic correspondence — remember in Plato’s day, the letters and sounds were the same — and up to the challenge of today. We will visit the history of attempts to fix the code as well as the reading wars. We want to dispel the myths about the code and get down to the fact that learning to use it is a technological process – like learning to program a remote control or use a machine. It’s a virtual reality machine. Our children are feeling ashamed of being confused because of the way we’re contextualizing and helping them through the confusions caused by our technology.

Origins of the COTC Project:

Dr. Sally Shaywitz: What got you so interested in this?

David Boulton: For twenty years I have been interested in learning about learning. I really believe that in the long run, if you take any problem human beings have, and you look at it for more than one generation, it comes down to how well the children learn. Therefore, the greatest responsibility of adults is to steward the health of the children’s learning. How well they learn boils down to how well they participate from the inside out in what they’re learning. All of which leads to the question: what is causing children to have difficulty learning? That leads to reading. Just when I get there, my daughter has a reading problem.

Dr. Sally Shaywitz: Oh, my.

David Boulton: She has an auditory memory processing deficit – which, by the way, I think is a misleading term, it caused her to stutter during reading in a way that allowed me to see the correspondence between code ambiguity and mental processing stutters on the one hand; and on the other hand, to see the powerful influence of shame, and how it works, and how the two interact with each other. That’s led me — that’s what began this for me.

Dr. Sally Shaywitz: Wow. It sounds like a true life’s work, like a calling.

David Boulton: Yes. That’s the way it feels.

Dr. Sally Shaywitz: Well, I wish you well.

David Boulton: Thank you, I wish you well.