Lori Massicotte sat beside Teddy Lyman and drilled him on forming nonsense words, sounding like the oft-imitated made-up rap repartee between Snoop Dogg and Adam Sandler during last year's MTV music video awards.
"Perkibble. Now show me `skibble,' " she said before speeding on to "skitive," "sicktive," "consictive," and "consicture."
At Landmark School in Manchester-by-the-Sea, such drills are not so much exercise for the tongue as for the eye, ear, and mind of students like Lyman, 8, who have language-based learning disabilities, including dyslexia. The drills teach language concepts -- including how the mouth physically forms a sound -- most of us apply automatically.
Described centuries ago as "word blindness," we know today that dyslexia is not primarily a problem of seeing -- not stereotypical letter reversal -- but a disorder in linking spoken and written language sounds to print. While it is not a new problem, an explosion of scientific research in the past five years, including brain studies, is offering fresh insight into dyslexia and helping those who have it.
"The new science of reading has given us a way of identifying children early and accurately and telling us what to do, what is effective, what works," said Sally Shaywitz, a neuroscientist who is codirector of the Yale Center for the Study of Learning and Attention and author of "Overcoming Dyslexia," a book for parents and teachers.
According to research by Shaywitz, one in five children is dyslexic, although only a small percentage is diagnosed. By the time dyslexic children are identified, typically in third grade, they have fallen far behind peers who learn to read an average of 1,000 new words accurately and fluently each year, Shaywitz said.
"Imagine what it does to a child's sense of him or herself," she said. "Children who aren't given effective instruction until third grade carry this burden of being behind by 3,000 words."
Unlike speaking, reading is not natural and must be taught. Children must be able to hear the 44 phenomes, or sounds, in the English language and connect those sounds to written letter combinations. Dyslexic children often confuse similar sounds, using the word "lotion" when they mean "ocean." Shaywitz, for example, described a dyslexic child who saw people jaywalking and said, "Those Presbyterians should be more careful" when she meant to say "pedestrians."
Shaywitz said brain research using MRI technology shows three major systems on the left side of the brain involved in reading, with one in front and two in back. "We've learned poor or struggling readers don't activate systems in the back of the brain," she said. And while Shaywitz said this isn't "outgrown," as once believed, she said scientifically based reading programs "can influence the neurocircuitry of the brain."
The fact that people who are dyslexic think differently, noted Shaywitz, is a boon in some areas, with many having strong higher-order reasoning, problem-solving, and critical-thinking skills. Shaywitz said dyslexics are often highly intelligent, and include top scientists, doctors, lawyers, business leaders, such as Charles Schwab, and even writers, including John Irving, John Grisham, and playwright Wendy Wasserstein.
For many, that doesn't make up for the fact that the early school years are painful. The challenge, said Pamela Hook, coordinator of the written language clinic of Massachusetts General Hospital's Communication Sciences and Disorders Program, is to translate new scientific findings into classroom practice to help all children, including dyslexics.
Complicating matters is that professionals are hesitant to diagnose children younger than 8. Hook, also vice president of the Massachusetts branch of the International Dyslexia Association, said this is because early "red flags" consistent with dyslexia may merely reflect a slower maturation process.
"It's difficult because it's hard to know: Will the child have a lifelong difficulty with reading or is this immaturity something which they will overcome?" she said.
Yet, the more science tells us about language development, the more we know: Get to problems early to minimize damage and learn to compensate. Such urgency is driving preschool early intervention efforts and putting pressure on kindergarten and first-grade teachers to spot signs of potential dyslexia.
"Everybody is becoming more aware," said Kathleen Lockyer, Watertown Public Schools special education administrator. She said teachers do more one-on-one checks of reading progress and try to take note, for example, of students who rely too much on pictures or memorization in reading simple books.
Still, Hook said while schools are doing better, they are not testing a key reading milestone: The development of speed, accuracy, and fluency in reading. Hook said those skills are critical to reading comprehension because reading words too slowly makes it tough to draw meaning from text.
Hook believes only about 5 percent of students have severe dyslexia, but that up to 30 percent struggle to learn to read and need more explicit instruction than many schools provide.
For all of Watertown's efforts, Lockyer said, it remains possible a child's dyslexia "wouldn't be discovered until second or third grade because they are making adequate progress."
The problem is not just an imperfect means to measure progress, but that many dyslexic children are smart and learn to compensate, running into trouble only when they reach grade levels where reading and writing are critical, said Bob Broudo, headmaster of the Landmark School, a grade 2-12 facility specializing in language-based learning disabilities.
"They get the math concept being taught, but can't follow the written directions," said Broudo, who said the average stay at Landmark is 2 1/2 years. Rob Kahn, who heads Landmark's elementary and middle schools, said the school teaches students strategies for overcoming their learning disabilities, including breaking information into smaller pieces, whether writing an essay, taking notes, or reading.
Several Landmark middle-school students described elementary-school struggles and the pain of not knowing why they struggled.
"It was fourth or fifth grade when I realized I couldn't keep up with the rest of my class. They were working on an essay, and they were almost done, and I was just starting," said Matt Cohen, 13, of Marblehead.
Matt's mother, Caryn Cohen, noticed in first grade that "he wasn't reading the way he should be" but was reassured by teachers that he would catch up.
Instead, his struggles increased. By fifth grade, she said, "I basically wrote his paper for him. I didn't want to see him fail, his self-esteem was so low."
These days, Matt is a confident and accomplished student who talks about being a sportswriter.
Natalie Whelan of Topsfield, whose son Kevin, 14, is an eighth-grader at Landmark, sensed trouble when he wasn't reading fluently in the first grade and struggled with spelling. She was told not to worry, that boys can lag. It took years -- too many, she said -- to get the proper help. Her advice: Trust your instincts.
"I think most parents feel it," she said. "You look at your child and you have this gut feeling they are working a little harder than everyone else."
Send feedback and ideas to email@example.com