student and teacher working with letter tiles

dyslexia

What Is a Language-Based Learning Disability?

Blog Type:  Learning Disabilities Date Posted:  Wednesday, November 15, 2017

teacher and girl student working at table

What Is a Language-Based Learning Disability? Five Part Series

Landmark360.org launched the five-part series What Is a Language-Based Learning Disability? to define and explain Language-Based Learning Disabilities (LBLD), offer tips on remediation, highlight the importance of early intervention, and give readers a glimpse into the life a family with a child with LBLD.

Read these posts and give us feedback. We're eager to know what you think.

Part One: What We Know About LBLD and Learning, by Bob Broudoflame
Part Two: Language-Based Learning Disabilities: A Primer, by Melody O'Neil
Part Three: Help Your Struggling Learner: Remediation Is a Key to Success, by Christine Ozahowski
Part Four: It's a Myth That Young Children Cannot Be Screened for Dyslexia, by Nadine Gaab, PhD
Part Five: Language-Based Learning Disabilities on the Homefront, by Angela Timpone Gowans

 

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Landmark360.org's post by Bob Broudo about LBLD and Learning won a 2017 Gold InspirED School Marketers Brilliance Award in the national competition that recognizes excellence in private and independent school marketing and communications.

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Tags:  dyslexia early intervention early remediation programs education language-based learning disability learning research

Language-Based Learning Disabilities on the Homefront

Blog Type:  Learning Disabilities Date Posted:  Wednesday, November 15, 2017 Byline:  By Angela Timpone Gowans

father and son at table with list

This is part five of the five-part series, What Is a Language-Based Learning Disability? 

After I returned from the grocery store for the third time that day because I forgot another essential ingredient for dinner, Dylan laughed and exclaimed, “Mom, I think your executive functioning is not working.” I chuckled and responded, “Yes, I think you are right. I need a better strategy. I need a list!”

My husband, Bob, and I have a saying, “Know your brain and use your strategies for success.” The motto is especially applicable for our children who have Language-Based Learning Disabilities (LBLD).

Information Is Power

After two of our sons, Tristan and Dylan had cognitive evaluations, we shared some of their test scores with them so they could learn about their cognitive strengths and weaknesses. We believe information is power, and the more one knows about themselves, the more power they have to guide their life path. dyslexia strategies checklist graphic

At our house, we use phrases like Language-Based Learning Disability, executive functioning, processing speed, social norms, dyslexia, learning differences, and expected and awkward behavior. These terms describe the different ways our brains are mapped, and they help our children understand their particular brains and the minds of others. We talk about learning differences, LBLD, and neurodiversity to promote understanding and empathy toward others and themselves.

Our mission as parents is to help our children develop into independent, confident, loving, and joyful adults. To guide them through the journey, we use practical strategies and systems to help them acquire the skills they need for a successful life. Practical strategies and systems can help not only children with LBLD but all kids.

Use Your Strategies

To help our children master tasks and skills at home, we use tactics similar to those applied in their classroom. For instance, at the beginning of the summer, I said to Dylan, “You need to go to tutoring at 1:00, but before you go you need to unload the dishwasher, fold the laundry, pick up your room, go for a bike ride, and read for 30 minutes.” My approach didn’t work for Dylan. Instead, Dylan remembered a strategy he learned at school and came to me with a written task list.dyslexia success graphic

Every day, Dylan wrote his daily tasks list, and when he completed them, he did a preferred activity like watching TV or playing a video game. Dylan’s list worked for both of us. Did Dylan need practicing? Yes, of course, every day, but by the end of the summer he independently added new items to his list and required minimal prompting to complete the tasks.

We help and encourage each of our children to use strategies to master new skills and overcome executive function weaknesses. We emphasize that practice and repetition are the keys to success. We openly talk about how some people need to work harder than others or how it might take longer to develop skills.

What success looks like varies from child to child and task to task. We shy away from making excuses for our children or allowing them to give up. We just keep using our strategies to work toward our goals.

 

About the Author

Angela Gowans is Landmark Parents' Association co-president with her husband, Robert. Robert and Angela live in Montpelier, VT, and Beverly Farms, MA, with their children Tristan, Landmark student Dylan, and Liam. Angela is an educational advocate, family mediator, and writer.

 

What Is a Language-Based Learning Disability? Five Part Series

This is part five of the five-part series, What Is a Language-Based Learning Disability?

Part One: What We Know About LBLD and Learning, by Bob Broudoflame
Part Two: Language-Based Learning Disabilities: A Primer, by Melody O'Neil
Part Three: Help Your Struggling Learner: Remediation Is a Key to Success, by Christine Ozahowski
Part Four: It's a Myth That Young Children Cannot Be Screened for Dyslexia, by Nadine Gaab, PhD
Part Five: Language-Based Learning Disabilities on the Homefront, by Angela Timpone Gowans

brilliance award winner icon Landmark360.org's post by Bob Broudo about LBLD and Learning won a 2017 Gold InspirED School Marketers Brilliance Award in the national competition that recognizes excellence in private and independent school marketing and communications.

more learning disabilities posts

Tags:  dyslexia Executive Functioning language-based learning disability parents

It’s a Myth That Young Children Cannot Be Screened for Dyslexia

Blog Type:  Learning Disabilities Date Posted:  Thursday, November 9, 2017

Nadine Gaab

This is part four of the five-part series, What Is a Language-Based Learning Disability? 
Originally published on the International Dyslexia Association website, Feb. 2017

A diagnosis of developmental dyslexia in elementary school is primarily based upon a “wait-to-fail-approach.” This approach requires a child to demonstrate a significant struggle to learn to read over a prolonged period of time before more intensive (quality and quantity) interventional strategies are discussed and eventually put into place. Paradoxically, although a diagnosis of dyslexia usually is not given before the end of second grade or the beginning of third grade (after the requisite period of failing), intensive interventions are most effective in kindergarten or first grade (Wanzek & Vaughn, 2007).   dyslexia graphic delayed

Not only has this added to the difficulty of remediation, this practice of delayed identification of dyslexia can have tremendous psychological and clinical implications. Children with dyslexia show an increased incidence of internalizing anxious and depressive symptomatology (Mugnaini, Lassi, La Malfa, & Albertini, 2007) and are less likely to complete high school (Jimerson, Egeland, Sroufe, & Carlson, 2000) or to enroll in programs of higher education (Dougherty, 2003).

So, why are we not identifying children at risk earlier and providing them with the resources and tools they need to learn to read as early as possible? Here, I will review three common myths associated with early screening for children at risk for dyslexia.

MYTH 1
Signs of dyslexia can be seen only after two to three years of reading instruction.

While a diagnosis of dyslexia currently requires repeated failure in learning to read, this does not mean that early signs of dyslexia cannot be observed in preschool (or possibly earlier). Deficits in phonological awareness, rapid automatized naming, verbal working memory, and letter knowledge have been shown to be robust precursors of dyslexia in children as young as age 3 (Puolakanaho et al., 2007).

A recent study of more than 1,200 kindergartners in New England not only identified six independent reading profiles, including three dyslexia risk profiles, but also showed that these reading profiles are remarkably stable over a two-year window (Ozernov-Palchik, in press).

Furthermore, studies involving brain measures, such as electroencephalography or magnetic resonance imaging, have shown that the brain characteristics of individuals with dyslexia can be observed as early as infancy and preschool, especially in children with a genetic risk for dyslexia.

A longitudinal dyslexia study in Finland, which followed children from birth until age 8, showed that early differential brain measures could distinguish at-risk children who later developed reading problems from those who did not (Leppanen et al., 2010). Additionally, several studies have shown alterations in white matter (the highways that connect two brain areas and enable fast information flow) in young pre-reading children who subsequently developed a reading disability (Wang et al., in press; Kraft et al., 2016). These studies suggest that these children are stepping into their first day of kindergarten with a brain less optimized to learn to read. Why wait three or more years before we give them access to additional resources essential for improving their reading performance?

MYTH 2
Even with early screening, early intervention is not effective.

It is certainly true that most reading interventions are designed for older children who have been struggling for some time. However, converging evidence points to the importance of high-quality classroom reading instruction in early grades and early interventions for at-risk students (e.g., in a small-group setting) to improve the effectiveness of remediation (Blachman et al., 2004).

A meta-analysis comparing intervention studies of at least 100 sessions reported larger effect sizes in kindergarten and first grade than in the later grades. Furthermore, a meta-analysis across six studies revealed that when at-risk beginning readers received explicit and intensive instruction, 50% to 90% of these children reached average reading performance levels (Torgesen, 2004). Without high-quality instruction and intervention, early reading problems can manifest as serious reading disabilities later on (Stanovich, 1986). Moreover, several studies have shown that the brain’s ability to change and adapt in response to experience (brain plasticity) decreases throughout the childhood years (Johnson, 2001; Johnston, 2009) and that certain skills are harder to acquire after a ‘sensitive period’ (Johnson, 2005). For instance, for most people, learning to speak a second language, especially without an accent, comes with relative ease in early childhood but becomes more difficult later in life (Birdsong, 2001).

MYTH 3
Early screening costs too much for school districts, and there is no time for additional testing.  

There is some truth to this statement. Each school and district must determine the costs of early universal screening. However, many districts already have valid tools for screening the key indicators of dyslexia on hand—the same tools used in second or third grade to assess children who repeatedly fail to learn to read. Reading specialists or special education teachers already may be trained to administer these assessments.

Early assessment could be conducted prior to the start of kindergarten (e.g., in combination with some pre-kindergarten events that already occur), at daycare centers, preschools, or even in collaboration with pediatricians’ offices at the 4- or 5-year-old well-visits. This may add some personal costs, but would reduce screening hours and associated costs later in the school year and beyond.

Additional resources are needed for the interpretation and dissemination of the screenings and their results. Various companies now offer the scoring of standardized tests with turnarounds as fast as two weeks, and several online screening tools currently under development aim to reduce both labor and early screening costs.

Yes, early screenings entail significant costs, but given the costs associated with remediation and the treatment of accompanying psychological and medical problems (e.g., depression, anxiety, and psychosomatic conditions related to academic stress), the benefits of early screening outweigh the costs.

It is important to note that the re-allocation of resources for early identification/intervention should not negatively impact intervention efforts in older grades. More specifically, there will be students in older grades who need intervention, and funds used for early intervention should not be taken from the funds currently allocated for older students. If early screening and early intervention achieve expected goals, eventually there should be fewer older students who need that intense intervention. In the interim, those who missed the early screening and intervention still exist. Also, once early screening and early intervention become routine and effective (even with a 50% to 90% success rate), there will be some older students who continue to need support.

What Should Early Screening Look Like?

dyslexia graphic screenedI recommend incorporating eight key characteristics when determining an optimal screening battery for an individual classroom, school, or district. The first letters of these characteristics spell the acronym SCREENED.   

SHORT A screening battery should be no longer than 30 minutes. The goal is to identify children at risk in key domains and not to diagnose or comprehensively evaluate specific strengths and weaknesses.

COMPREHENSIVE Although short, a screening battery should include all the key domains, including phonological awareness, letter knowledge (letter-sound knowledge for kindergarten and older), rapid automatized naming, vocabulary, listening comprehension, and family history (see below).

RESOURCEFUL Most schools/districts already own assessments that can be used to assess the key domains in young children since these are used in second or third grade to assess children who are repeatedly struggling to learn to read.  

EARLY Screening should be implemented as early as preschool but no later than kindergarten.  

ESL/DIALECT INCLUSION Children who are English learners or speakers of dialect need to be included. Minority children and children from low socioeconomic backgrounds have been shown to have an increased risk for developing reading problems, which can be explained by differences in the quality and quantity of preschool literacy experiences and overall language exposure (Washington, 2001). Prior to third grade, culturally and linguistically diverse children with reading difficulties are under-diagnosed. After third grade, these children are often over-diagnosed (Mancilla-Martinez & Lesaux, 2011) because they are not identified early and do not gain access to the additional resources desperately needed to improve their reading performance.

It is important to note that teacher training is an essential piece in the screening equation. Teachers need to know how to address specific deficits once a child has been identified in order to implement early evidence-based instruction for all at-risk students.

NEUROBIOLOGY/GENETICS The cheapest and fastest screening is to ask parents dyslexia graphic heritablewhether there is a family history of reading disabilities. Dyslexia is strongly heritable, occurring in up to 50% of individuals who have a first-degree relative with dyslexia (Pennington, 1991). The risk and severity of dyslexia is higher when both parents are affected (Wolff & Melngalailis, 1994).

EVIDENCE-BASED RESPONSE TO SCREENING The best early screening battery will not make a difference if classroom instruction/intervention does not target the specific deficits with evidence-based instruction/intervention. The goal is not to refer the at-risk children to special education but to address their specific deficits within the classroom environment.

DEVELOPMENTALLY APPROPRIATE The assessment components of the screening need to be developmentally appropriate for the targeted age range.   

It is important to note that teacher training is an essential piece in the screening equation. Teachers need to know how to address specific deficits once a child has been identified in order to implement early evidence-based instruction for all at-risk students. Furthermore, additional teacher training, professional development, classroom resources, and increased districtwide dyslexia awareness benefit all students.

Educators and researchers must work together to ensure that all young students are SCREENED, to ensure their access to evidence-based instruction/intervention, and most importantly, to maximize their joy in learning to read.

Through Landmark School’s blog, Landmark360.org, we launched the five-part series What Is a Language-Based Learning Disability? This is the fourth article in the series. Other articles defined LBLD, addressed assessment of LBLD, discussed the importance of remediation of LBLD, and presented a case study of a family with two children with LBLDs. 

References

Wanzek, J. & Vaughn, S. Research-based implications from extensive early reading interventions. School Psychology Review, 36, 541 (2007).

Mugnaini, D., Lassi, S., La Malfa, G. & Albertini, G. Internalizing correlates of dyslexia. World Journal of Pediatrics, 5, 255–264 (2009).

Jimerson, S., Egeland, B., Sroufe, L. A. & Carlson, B. A prospective longitudinal study of high school dropouts examining multiple predictors across development. Journal of school psychology, 38, 525–549 (2000).

Dougherty, C. Numeracy, literacy and earnings: evidence from the National Longitudinal Survey of Youth. Economics of education review, 22, 511–521 (2003).

Puolakanaho, A. et al. Very early phonological and language skills: estimating individual risk of reading disability. J Child Psychol Psychiatry, 48, 923–931 (2007).

Ozernov-Palchik, O. et al. Longitudinal stability of pre-reading skill profiles of kindergarten children. Developmental Science (In press).

Leppanen, P. H., Hamalainen, J. A., Salminen, H. K., Eklund, K. M., Guttorm, T. K., Lohvansuu, K., Puolakanaho, A., & Lyytinen, H. Newborn brain event-related potentials revealing atypical processing of sound frequency and the subsequent association with later literacy skills in children with familial dyslexia. Cortex, 46, 1362–1376 (2010).

Wang, Y. et al. Development of tract-specific white matter pathways during early reading development in at-risk children and typical controls. Cerebral Cortex, doi:10.1093/cercor/bhw095 (In press).

Kraft, I. et al. Predicting early signs of dyslexia at a preliterate age by combining behavioral assessment with structural MRI. Neuroimage, 143, 378–386 (2016).

Blachman, B. A. et al. Effects of intensive reading remediation for second and third graders and a 1-year follow-up. Journal of Educational Psychology, 96, 444–461 (2004).

Torgesen, J. K. Avoiding the devastating downward spiral: The evidence that early intervention prevents reading failure. American Educator, 28, 6–19 (2004).

Stanovich, K. E. Matthew effects in reading: Some consequences of individual differences in the acquisition of literacy. Reading Research Quarterly, 21, 360–407 (1986).

Johnson, M. H. Functional brain development in humans. Nature Reviews Neuroscience, 2, 475–483 (2001).

Johnston, M. V. Plasticity in the developing brain: implications for rehabilitation. Developmental Disabilities Research Reviews, 15, 94–101 (2009).

Johnson, M. H. Sensitive periods in functional brain development: problems and prospects. Developmental Psychobiology, 46, 287–292 (2005).

Birdsong, D. & Mollis, M. On the evidence for maturational constraints in second language acquisition. Journal of Memory and Language, 44, 235–249 (2001).

Washington, J. A. Early literacy skills in African-American children: Research considerations. Learning Disabilities Research & Practice, 16, 213–221 (2001).

Mancilla-Martinez, J. & Lesaux, N. K. The gap between Spanish speakers’ word reading and word knowledge: a longitudinal study. Child Development, 82, 1544–1560 (2011).

Pennington, B. F. Reading Disabilities: Genetic and Neurological Influences.  (Kluwer, 1991).

Wolff, P. H. & Melngailis, I. Family patterns of developmental dyslexia: clinical findings. Am J Med Genet, 54, 122–131, doi:10.1002/ajmg.1320540207 (1994).

About the Author

Dr. Gaab is an Associate Professor of Pediatrics at Boston Children’s Hospital and the Harvard Medical School and a member of the faculty at the Harvard Graduate School of Education. She received a PhD in Psychology from the University of Zurich in Switzerland. She did postdoctoral training with John Gabrieli, Gary Glover, and Paula Tallal at Stanford University and MIT. Her current research within the Laboratories of Cognitive Neuroscience at Boston Children’s Hospital focuses on auditory and language processing in the human brain and its applications for the development of typical and atypical language and literacy skills.

 

What Is a Language-Based Learning Disability? Five Part Series

This is part four of the five-part series, What Is a Language-Based Learning Disability?

Part One: What We Know About LBLD and Learning, by Bob Broudoflame
Part Two: Language-Based Learning Disabilities: A Primer, by Melody O'Neil
Part Three: Help Your Struggling Learner: Remediation Is a Key to Success, by Christine Ozahowski
Part Four: It's a Myth That Young Children Cannot Be Screened for Dyslexia, by Nadine Gaab, PhD
Part Five: Language-Based Learning Disabilities on the Homefront, by Angela Timpone Gowans

brilliance award winner icon Landmark360.org's post by Bob Broudo about LBLD and Learning won a 2017 Gold InspirED School Marketers Brilliance Award in the national competition that recognizes excellence in private and independent school marketing and communications.

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Tags:  dyslexia early intervention early predictors Nadine Gaab Teacher Training

Language-Based Learning Disabilities (LBLD): A Primer

Blog Type:  Learning Disabilities Date Posted:  Thursday, October 26, 2017 Byline:  By Melody O’Neil

boy learning at table

This is part two of the five-part series, What Is a Language-Based Learning Disability? 

Language-Based Learning Disabilities (LBLDs) refer to an array of difficulties related to the understanding or processing of both spoken and written language. The number and severity of language difficulties can vary widely from person to person. LBLDs can affect the following areas:glossary

  • reading
  • listening (auditory processing)
  • oral expression/word retrieval (expressive language)
  • oral comprehension (receptive language)
  • written expression (spelling, grammar, and mechanics)
  • mathematics

When we talk about reading, we’re referring to three main areas: decoding (word attack/phonological awareness), reading fluency, and reading comprehension.

LBLD, Dyslexia, and Related Disabilities

An individual diagnosed with an LBLD often has the specific diagnosis of dyslexia. Dyslexia is a phonologically-based reading disability that results in difficulty decoding words accurately, which affects reading fluency and then reading comprehension. struggles of LBLD graphicNot all people diagnosed with an LBLD have dyslexia, although the majority will. It may be that their basic decoding and reading skills are intact; however, they may struggle with other areas of language processing and written or verbal expression. These difficulties may include:

  • dysgraphia, a disorder that affects spelling, punctuation, and handwriting
  • dyscalculia, a disorder that affects someone’s number sense, math reasoning, and ability to process math facts
  • executive functioning, which limits one’s capacity to initiate and complete tasks, stay organized, manage time, and plan
  • a language disorder (formerly called mixed receptive-expressive language disorder) that affects written and oral comprehension and expression

Attention deficit hyperactivity disorder (ADHD), central auditory processing disorder (CAPD), and anxiety disorders are often seen as comorbid, or commonly occurring diagnoses for people with LBLDs.

Understanding the Cognitive Profile

big picture thinkerAn extremely important piece in defining and diagnosing an LBLD includes looking carefully at the individual’s cognitive profile. A person with an LBLD is going to have difficulties in reading, writing, listening, and speaking, despite having average to above-average cognitive ability, specifically in the areas of verbal comprehension, visual-spatial abilities, and fluid reasoning or problem solving. Although the LBLD individual may have somewhat lower working memory and/or processing speed, they have an overall strong ability for reasoning, problem solving, and “big-picture thinking.” They are bright, visual, and hands-on kinesthetic learners who tend to struggle more auditorily (listening).

 

Next Steps

If you feel that your child/student is struggling at school and suspect that they may have an LBLD, the first step to take is to have either psycho-educational testing (done through the public school system) or neuropsychological testing (done privately). Testing will provide information regarding current levels of cognitive, academic, and language functioning. This will also help with making recommendations regarding possible next steps to take and services that may be needed. Most importantly, continue to encourage your child/student, understand they are struggling, and remember that support is available for all types of learners. 

 

About the Author

Melody O'Neil Landmark School AdmissionsMelody O’Neil is Associate Director of Admission at Landmark School

 

 

 

 

What Is a Language-Based Learning Disability? Five Part Series

This is part two of the five-part series, What Is a Language-Based Learning Disability?

Part One: What We Know About LBLD and Learning, by Bob Broudoflame
Part Two: Language-Based Learning Disabilities: A Primer, by Melody O'Neil
Part Three: Help Your Struggling Learner: Remediation Is a Key to Success, by Christine Ozahowski
Part Four: It's a Myth That Young Children Cannot Be Screened for Dyslexia, by Nadine Gaab, PhD
Part Five: Language-Based Learning Disabilities on the Homefront, by Angela Timpone Gowans

brilliance award winner icon Landmark360.org's post by Bob Broudo about LBLD and Learning won a 2017 Gold InspirED School Marketers Brilliance Award in the national competition that recognizes excellence in private and independent school marketing and communications.

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Tags:  dyslexia language-based learning disability dyscalculia dysgraphia Executive Functioning language disorder decoding reading fluency word attack phonological awareness

The Voices of Students Like Me

Blog Type:  Learning Disabilities Date Posted:  Thursday, August 17, 2017 Byline:  By Natalie Tamburello

people marching protesting

When you think about social movements that you learned about growing up, what do you remember? What do you see in your mind’s eye? For a moment, reflect on your experience when you learned about the civil rights movement. Were you sitting at your desk in a darkened history classroom, watching Dr. King deliver his "I Have a Dream" speech? Were you at a museum, perusing photographs and listening to an audio tour about marches and demonstrations?

"Individuals with learning and attention issues need the opportunity to join together, share their experiences, serve as leaders, models, and mentors, and articulate a vision for a different future that we can all embrace."

How about the women’s rights movement? Do images of Susan B. Anthony, Elizabeth Cady Stanton, or Margaret Sanger come to mind? When you think about the disability rights movement, are you reminded of people crawling up the steps of the Capitol Building in Washington D.C., or of parades of able-minded citizens in wheelchairs who were shut out of libraries, museums, and office buildings that lacked curb cuts and ramps? Now… close your eyes and think about the community of individuals with learning disabilities. What do you see?

Organizations have been fighting on behalf of individuals with disabilities, including learning disabilities, for more than 40 years. Yes, the protections of the Individuals with Disabilities Education Act (IDEA) and the Americans with Disabilities Act (ADA) were put in place, and accommodations for those with learning and attentions issues have increased. Public perceptions have started to change, and we’ve seen improvements in high school and college graduation rates. However, I can’t help but ask myself, what is missing?

A Community Lacking a Movement

I was identified with a learning disability in first grade. Neither I, nor my parents, identified with the disability rights movement from the history books and documentaries produced. There was no community with which we could identify, no protest my family could take me to, no leader with similar experiences for me to look up to, no footage to watch about my community, no speeches to inspire me… nothing… just me and my parents sitting with a specialist, my newly minted documentation, and a box of tissues.

Alone and “disabled.”

I was asked to leave my first school. My parents were told: “This is not the right place for Natalie; we are unable to meet her needs here.” Removed from my friends and the school experience I learned to expect, I moved from one school to another, every three years, in search of an educational roadmap that didn’t yet exist for “my kind of learner.”

Throughout my educational journey I found others like me, learned how I learned best, became increasingly resilient and an effective self-advocate, enjoyed academic success, and volunteered for organizations that worked to improve the experience for students like me.

When it was time for me to choose a career path, I struggled. On the one hand, I wanted to enter the workforce as a successful student who happened to be dyslexic, and leave the dream of lending my voice to the disability rights movement behind. It was appealing to think about contributing to society and leading the “normal life” that I so desperately wanted, not letting my label or educational experiences dictate my career path.

On the other hand, there was no denying that the labels “disabled” and “dyslexic” had become a part of who I was, whether I liked it or not. I searched the landscape of organizations that fought for the rights of people with learning and attention issues, and realized that while all were fighting the good fight, not many of my peers with learning disabilities were leading the way.

Then I closed my eyes and remembered the social movements of the past, and realized what was missing and how I could fill that void. It was the voice of students like me who have lived the experience of learning differently. We, who were told, “you can’t,” “you won’t,” “you shouldn’t,” who were held back, graduated late, took tests in closets, transferred schools, dropped out of school, sat at the back of the classroom sweating, sat in the front of the classroom determined, stayed up all night trying, cried on our way to and from school, got that first A, read that first book on our own, told that first friend about the struggle. Those personal and emotion-filled experiences matter and make up an essential pillar of any successful social movement.

Disability Rights Movement on the Rise

At the start of any movement, there is a sense of urgency and unrest, and a core of individuals band together to right a wrong, correct an injustice, or implement changes that help to shape a just, equitable, and inclusive society. Powered by parents and shaped by lawmakers, the disability rights movement put policies and protections in place to ensure that every person with any disability was a valued and contributing member of his or her community.

I started on a journey to join a movement and represented a new generation of my community. I went to graduate school and did research so that I could talk the talk; I already knew how to walk the walk. I now work for the National Center for Learning Disabilities (NCLD), one of the organizations that have been at the forefront of the disability rights movement representing people like me. Because of their work and the collaborative efforts of a handful of other remarkable organizations, individuals with learning disabilities now have real opportunities to develop advocacy skills, build self-confidence, and access the tools needed to succeed in a society that often overlooks the potential of individuals who learn differently.

I am now a proud member of the first wave of young adults who have benefited from these protections. And through this foundation, we have been able to find and develop a voice. I know that NCLD and other organizations working on behalf of people like me understand the power of student voices, but understanding how to incorporate our voices and stories and to utilize them to energize, personalize, and realize the movement, is a much more complicated task.

Even now, I think about that moment with my parents, the newly minted documentation, and the box of tissues and ask, “What could we do now as an organization, as a growing and outspoken community within the larger disabilities rights movement, to lift up and empower our voice? How do we replace the tissues with a soapbox and a megaphone, and how can we prevent shame and stigma from entering our storyline? How can we provide every 10-year-old, 13-year-old, 16-year-old, 18-year-old, 26-year-old like me with a platform, a place in this movement, and a sense of belonging, strength, and purpose?”

Yes, we need laws and regulations, but when we recall the social movements of the past, what do we see? We see the real voices, names, and faces of individuals who are living the experience. Individuals with learning and attention issues need the opportunity to join together, share their experiences, serve as leaders, models and mentors, and articulate a vision for a different future that we can all embrace.

As a young professional, every year that goes by distances me from the day-to-day student experience, and I have a deeper appreciation of the importance of integrating the voices of students even more now. I am proud to work for NCLD, an organization that is committed to integrating and lifting up student voices. NCLD is committed to ensuring that all programming is informed and guided by the very population we serve. In addition to our Student Voices Research and internship program, we have engaged young adult advisors, and incorporated their voices and perspectives in our strategic plan. These steps are just the beginning. I encourage all organizations currently working to defend and protect the rights of a population that is not yet fully integrated into the organization, to find a way to include the voices of those served. Consider asking yourself the question: “Who is the face of our mission?” And if that face isn’t sitting at the desk next to you, then we have work to do.

When I have children, my hope is that they will close their eyes, think about the disability rights movement, see my face, and the many faces of individuals with learning disabilities among a crowd of many.

This post was originally published on New Profit's website. Read the original post.

About the Author

Natalie Tamburello

Natalie Tamburello is on the Learning Resources & Research team at the National Center for Learning Disabilities.  

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Tags:  attention deficit hyperactivity disorder disability rights dyslexia dyslexia and professional success dyslexia awareness dyslexia legislation dyslexic community learning disabilities self-advocacy social movements

Prevent Summer Learning Loss Before It Happens

Blog Type:  Learning Date Posted:  Tuesday, May 30, 2017 Byline:  By Joanna A. Christodoulou

boy reading

"Reading must be integrated into summer activities."

Reading activities during the summer can play an important role in helping students maintain their reading skills. Summer slump, or the potential for academic skills to regress during school vacation, is a concern for many students.

Children with language-based learning disabilities, such as dyslexia, may be at a higher risk of summer slump than their peers (Christodoulou et al., 2017). More generally, children who may also be more vulnerable to summer slump are those who take a vacation not just from school, but also from engaging with text during the summer months. These reduced reading experiences may be because students don’t enjoy reading; they may not feel good about their reading skills; or they have limited access to the library or books at home. In addition to options to enroll students in summer reading instruction, camps, or related activities, other programs are available to families at little to no financial burden.

Parents can help by considering three goals

First, parents and children can set a reading intention together about what to achieve during the summer. A reading intention can describe what to do and how it will be done. The focus does not have to be on the total number of books read, but can also be on what each child wants to learn about (e.g., the solar system, gardening, etc.). Creating a certificate or written agreement that both parents and children sign can offer a fun way to support this commitment. This goal can also be achieved through summer reading programs offered locally in libraries or community centers.

Second, identify the correct reading level for your child. To do so, you may seek assistance from your school or library staff. One rule of thumb for texts appropriate for a child to read independently is that they read five or fewer words incorrectly for every 100 words in the text. Independent level texts can be read by the student on his/her own, or students can read these texts aloud to others. Keep in mind that texts that are more challenging should not be excluded from summer reading lists as these may be great candidates for parents and children to read together. Identifying your child’s reading level for books she or he can read independently and those she or he can read with a partner is an important goal to aim for before the end of the school year.

Third, parents can identify their child’s areas of interest. Collecting topics that are intriguing, exciting, informative, and of interest will be key to selecting high interest reading material that children are motivated to read (Kim, 2007). More importantly, the motivation to learn about high-interest topics by reading can help struggling readers overcome some barriers; this is a common trait shared among successful adults with dyslexia (Fink, 1998).

Several organizations offer online texts for students with dyslexia. TextProject offers free books across a wide range of reading levels. Bookshare is a free online library that offers ebooks for students who have challenges accessing print. The Perkins Library offers free reading resources (e.g., audio, large print books, playback equipment) for Massachusetts residents with reading disabilities. Learning Ally offers audiobooks that can be useful for pairing with texts (i.e., listen and read at the same time) that students may otherwise have some difficulty reading independently.

In addition to supporting positive reading experiences during the summer months, families may consider contributing to research efforts aiming to improve outcomes for struggling readers. Supporting area researchers is a way to empower families and children with reading disabilities or difficulties, advance the science of reading, and meet other community members invested in supporting reading development. These opportunities range in their time commitment, gift card and prize offerings, and location. More information can be found on the website of the Massachusetts Branch of the International Dyslexia Association.

For children with language-based learning disabilities, such as dyslexia, in particular, summer vacation provides an opportunity for positive reading outcomes, but to achieve this, reading must be integrated into summer activities. To access appropriate texts, families can visit the local library, enjoy book swaps with neighbors, or explore online reading opportunities.

Christodoulou, J.A., Cyr, A., Murtagh, J., Chang, P., Lin, J., Guarino, A.J., Hook, P., & Gabrieli, J.D.E. (2015). Impact of intensive summer reading intervention for early elementary school children with dyslexia. Journal of Learning Disabilities.

Fink, R. (1998). Literacy development in successful men and women with dyslexia. Annals of Dyslexia, 48, 311–346.

Kim, J.S. (2007). The Effects of a Voluntary Summer Reading Intervention on Reading Activities and Reading Achievement. Journal of Educational Psychology, 99, 505-515.

About the Author:

Joanna A. Christodoulou Joanna A. Christodoulou, Ed.D. is Assistant Professor in the Department of Communication Sciences and Disorders at the MGH Institute of Health Professions in Boston, MA.

More information: beamstudies@gmail.com

Facebook link: http://bit.ly/BEAMteam_FB

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Identifying Students with Dyslexia

Blog Type:  Learning Disabilities Date Posted:  Friday, July 12, 2019

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By Donell Pons

When my son was in second grade, it became apparent he was not going to read without serious intervention.  His speech was not delayed, but he was completely unaware of rhyme, the sound-to-letter relationship eluded him, and almost every characteristic of letter formation was challenging, from lower to upper case, left to right, and top to bottom.  Although I was aware of my husband’s struggle with reading, despite being very bright, and the subsequent struggle my daughter had learning to read, I was still unaware of the heritable component of dyslexia. Had I been informed, I would have had my son screened for dyslexia and insisted he receive reading instruction following the guidelines of Structured Literacy

Unfortunately, I didn’t know, so we stumbled into intervention after years of struggling and too late to spare my son from the tremendous anxiety that comes with struggling to read despite being plenty bright. In fact, it’s the plenty bright part that makes dyslexia so painful. My son, husband, and daughter were all painfully aware that learning to read was much harder than it should have been and that knowledge made everything in school far more difficult. Thankfully, through the efforts of many researchers, psychologists, educators, and parents, there has been an increasing move to screen for dyslexia and provide appropriate instruction.  

Once I knew what I was looking for, I could see the signs of dyslexia running throughout my family.  When I cautiously questioned my husband about his reading, he revealed that, when he was in school, it took him more than six hours a night to complete his homework. He often misspelled the months of the year and struggled with certain days of the week. He had to practice his home address. He would often blaze past construction signs and public signs, appearing to disregard the information when, in truth, he couldn’t read it quickly enough to process what it meant.

When observant parents know what to look for in regard to dyslexia, then they can begin to see a pattern of behavior that distinguishes dyslexia from other reading challenges.

One in five students has a learning disability, the most common of which is dyslexia. Now that all but four states (legislation is pending in many states) have finally adopted dyslexia as its own category of special needs, more districts are taking action to identify and accommodate students with dyslexia. There are so many ways parents can recognize the telltale signs of dyslexia, and it can make all the difference for those affected. If remediation is conducted early and appropriately, students who show signs of dyslexia are likely to learn to read just like their non-dyslexic peers. When observant parents know what to look for in regard to dyslexia, then they can begin to see a pattern of behavior that distinguishes dyslexia from other reading challenges.

Characteristics of Dyslexia

Many researchers now agree that struggling word-level readers share some characteristics such as poor phonemic awareness (PA) and below-average rapid automatized naming (RAN). Phonemic awareness refers to the ability to manipulate sounds in spoken words, and RAN is the amount of time needed to name known stimuli including digits, letters, and colors.

Sally Shaywitz at the Yale Center for Dyslexia and Creativity, author of the highly regarded book Overcoming Dyslexia, has a comprehensive list of recommendations for parents and educators, including being observant of early language development focusing on rhyming, word finding, and pronunciation. She also counsels parents to be attentive to print-to-language skills like naming individual letters. Shaywitz also recommends examining family history, which can be a strong indicator.

Both of my children with dyslexia were verbal in childhood, with no obvious signs of language challenges, until I started introducing the alphabet with letter-to-sound correspondence. As soon as I would introduce a letter with its sound, my children with dyslexia would forget it. My otherwise very quick children were absolutely struggling with the basic connection between written letters and their corresponding sounds.

Common Experiences in the Classroom

In the classroom, students with dyslexia will continue well past elementary school to misspell common words, such as the days of the week or months of the year. They often have anxiety about being in the classroom because of the numerous tasks involving reading and writing. Writing assignments may go unfinished, even when the student seems engaged in the topic. Penmanship may be sloppy, not because of an underlying handwriting issue, but to disguise poor spelling. Often, the student will randomly capitalize words or letters within words because not only are the rules of spelling and grammar elusive but also because discriminating between the letter formations is still unclear.

My son with dyslexia will often accept a lower grade rather than ask for much-needed help to finish a writing assignment. He is capable of completing any writing assignment with speech-to-text or a scribe. If those aren’t available, he won’t even attempt to finish the assignment. Writing takes so much effort with a language-based learning disability like dyslexia that it’s essential, even after reading remediation, to provide accommodations for students with dyslexia. The truly sad part is my son has so much to say on many topics, but he’d rather remain silent than struggle to spell the more complex words associated with his higher understanding.  

What to Do if You Suspect Your Child Has Dyslexia

If you suspect your child has dyslexia, you can immediately request the student be evaluated under the Child Find mandate found within the Individuals with Disabilities Education Act. The wording of Child Find is clear: “Schools are required to locate, identify, and evaluate all children with disabilities from birth through age 22.” Identifying students who need services is an important first step. Child Find covers home-schooled students as well as those in private schools. This means that a student under 22 years of age who has not been identified still qualifies for identification even if the student is “advancing grade to grade.” For more comprehensive information regarding Child Find, search Wrightslaw.com or Understood.org.  

If a child is struggling enough with reading that a parent is asking the school for help, then that parent and child deserve consideration.  The alternative is to ignore a plea for help that doesn’t simply go away but escalates into larger issues, such as truancy and disengagement, leading to higher dropout rates.

I often hear school personnel express concern that every parent thinks their child has dyslexia followed by every parent will ask to have their child tested.  These statements puzzle me. If a child is struggling enough with reading that a parent is asking the school for help, then that parent and child deserve consideration.  The alternative is to ignore a plea for help that doesn’t simply go away but escalates into larger issues, such as truancy and disengagement, leading to higher dropout rates.  So what’s wrong with listening to a concerned parent and walking through a quick screening to see if dyslexia could be present? My husband should have been identified as dyslexic numerous times, as he was clearly underperforming given his potential. Basically, it’s never acceptable to see a student unable to read or write at grade level without any known intervention or support and say nothing.

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About the Author

Donell Pons
 

Donell Pons is a reading and dyslexia specialist in Salt Lake City, Utah. Pons started her career in education when her youngest son was diagnosed with dyslexia. She has a master’s degree in education and teaching from Westminster College, along with a certification in special education. Connect with her at dbpons@gmail.com.

 

 

 

 

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Pending Dyslexia Legislation in Massachusetts

Blog Type:  Learning Disabilities Date Posted:  Monday, March 5, 2018 Byline:  By Nancy Duggan, MA. S.C.

women in courtroom

Decoding Dyslexia Massachusetts (DD-MA) began a campaign in 2012 to raise dyslexia awareness across the state through collaboration with parents, educators, and neuroscience researchers. The effort has made steady progress in building dyslexia awareness in the parent, educator, and policy-maker communities.

Since 2013, dyslexia legislation in Massachusetts has come further along than ever before.

Initiating Legislative Action

One of DD-MA’s goals goals has been to initiate legislative changes that would help students get early services by providing the scientific context for dyslexia and the need for early identification. The legislative process in Massachusetts includes a two-year session. We have worked together to navigate the process. Public Dyslexia Hill Days, private meetings, and multiple public hearings have provided legislators with:

  • an understanding of the challenges that families face,
  • the need for educators and students to get support,
  • the relevant neuroscience research that supports our mission.

Dyslexia legislation has come further along the path than ever before. The 2016–2018 legislative session started with four proposed bills, H.330, H.2872, S.294, and S.313, that can be called “dyslexia legislation” pertaining to education. These bills were supported, in combination, by over 50 different members of the Massachusetts 190th General Court, the official title of the State Legislature. Special thanks goes out to the initial sponsors who drafted this legislation, Rep. Alice Peisch of Wellesley and Rep. Chris Walsh of Framingham, chair and vice-chair, respectively, of the Joint Committee on Education; Sen. Bruce Tarr and Sen. Barbara L’Italien; and the legislators who petitioned alongside them. The vibrant team of DD-MA students, parents, educators, and neuroscience researchers are responsible for calling attention to this issue as a passionate, respectful, and informed team of advocates for improved outcomes, and these legislators are working together to take action.

The Legislative Process

The legislative process in Massachusetts requires a hearing, which took place on July 11, 2017.  Families joined a powerful team of experts who explained to the legislators in live testimony and with written testimony the need for dyslexia legislation, particularly the importance of early screening and identification, a clear and accurate understanding in schools of what dyslexia is, and that evidenced-based instruction, teacher training and professional development are needed. DD-MA worked with families across the state and multi-disciplinary experts to ensure that the testimony was scientifically sound, broad-based, including social-emotional outcomes, academic outcomes, and teacher, educator, and administrator support.

Whats Next?

DD-MA is very pleased that the Joint Committee on Education has released legislation favorably that addresses dyslexia and early screening. Both the House and the Senate will consider the same version in each chamber. When the new draft language is public, it will be posted on the Massachusetts State Legislature website. Once the redrafted bills, with new numbers, are made public, the clerk will also post which committee will be next to consider the legislation. For the time being, parents, students, and educators can continue to advocate for dyslexia awareness and the need for the legislation to pass by building a positive and informed relationship with your State Representative, State Senator, and their legislative staff.  Share with them your personal story and express interest in the outcome of dyslexia legislation.

Follow DD-MA on Facebook: https://www.facebook.com/DecodingDyslexiaMA/

Nancy Duggan is the Executive Director of Decoding Dyslexia Massachusetts.

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The Best Way to Explain Learning Disabilities to Your Child

Blog Type:  Learning Disabilities Date Posted:  Tuesday, February 12, 2019

son and father talking

By Rick Lavoie, M.A., M.Ed.

A parent once called my special education school to request an admissions visit for her and her son, who was struggling mightily in school. She asked a strange question in her initial phone call: “Does the school have any signs or posters displayed that identify the program as a school for kids with learning disabilities?”

I asked her why she wished to know this. She replied, “My son doesn’t know that he has a learning disability and we don’t want him to know.” He knows, Mom. Believe me, he knows.

I have long been puzzled by a parent’s reluctance to discuss a child’s learning disability diagnosis with him. The knowledge that he has an identifiable, common, measurable, and treatable condition often comes as great comfort to the youngster. Without this information, the child is likely to believe the taunts of his classmates and feel that he indeed is a dummy. The truth will set him free!

If a child does not have a basic understanding of the nature of his learning challenges, it is unlikely that he will be able to sustain his motivation in the classroom. Because he is puzzled about the difficulty that he is experiencing at school, he is unlikely to be able to commit to his studies.

What Learning Disabilities Are and Are Not

When discussing the child’s learning problems with her, it is critical to explain what the disorder is — and what it is not. You may find that the child holds many misconceptions about her disorder (“It goes away at middle school”; “It means I’m stupid”; “I’ll never be able to read”), and it is important that you clarify and correct this misinformation.

During these discussions, emphasize her strengths and affinities and do not simply focus on her weaknesses and difficulties. Express optimism about her development and her future.

Remind your child that she can indeed learn, but that she learns in a unique way that requires her to work hard and participate in classes and activities that are different from those of her peers and siblings. Emphasize the fact that this situation exists through no fault of the child’s. Explain that learning is a particular challenge for her and that it may take longer for her to master skills than it will take her classmates. Remind her that she will “finish the race,” though she may have to take a different route. Let her know that the adults in her life are solidly on her side.

Draw on learning struggles and challenges that you faced and outline the strategies you used. This information can be comforting for a child. I do not find it useful to cite famous people with learning problems as a means of inspiring and motivating a child.

A more realistic approach might be to cite people whom the child knows as inspirational examples: “Did you know that Uncle John also had trouble in school and he had to repeat third grade? It took him forever to do his homework and he still has difficulty writing. But he has a terrific job at the hospital. He enjoys cooking, just like you, and nobody makes a better chili!”

Demystify your child’s daily struggles. One of the most valuable and important roles that a parent can play in the life of a child with special needs is that of a demystifier. The parents should explain the disability to the child, thereby making sense of the child’s daily struggles. The youngster often feels greatly relieved once he realizes that his difficulties actually have a name and that others have similar problems and challenges.

It is important that these explanations be made in a sensitive and age-appropriate way. This important information should not be communicated in an intense “let’s discuss your learning disability” session. Rather, you should discuss the child’s challenges with him in a gradual, informal, and sequential way.

Look for and take advantage of teachable moments. When a child asks a question related to his disability, remember to answer his question honestly and sensitively, and be wary of providing more information than the child can handle or understand. As an analogy, imagine that the child is an empty cup devoid of any information about the nature of his disabilities. You are represented by the pitcher, filled with data, reports, information, and knowledge about the disability. Slowly “pour” your knowledge into the cup until the vessel is full. Always end the conversation by assuring your child that you are eager to have discussions with him.

The demystification process is a crucial step in the child’s journey toward self-advocacy. As an adolescent and adult, she must know how to explain her difficulties and needs to teachers, coaches, and employers without parental intervention.

How to Connect with Your Child About His Learning Disability

If your child runs into problems — say, setting the dinner table — caused by his disability, you might use that opportunity to explain his sequencing and directionality problems in the following way:

“Carl, I know that this is difficult and frustrating for you and I really appreciate your willingness to stick with it. It’s tough for you to remember the order you should follow when setting the table, but it will be easier if you refer to the checklist that we made last week. Remember? We keep it on the shelf near the dishes. After you have used the checklist for a while, we will begin phasing it out and I’ll bet that you will be able to set the table by yourself within a few weeks. We followed that process when you learned to make your bed, and you do that chore really well now.

“Remember that the knife and spoon go on the side of the hand you write with, and the fork goes on the other side. These problems that you have relate to something called sequencing and directionality. The skills will always be a little difficult for you, but you are doing much, much better. All of your hard work with Mrs. Carter in your OT class is really paying off. The extra lessons that Coach Simons is giving you in soccer should help your directionality, too.”

About the Author

Rick Lavoie

Excerpted from The Motivation Breakthrough: 6 Secrets to Turning On the Tuned-Out Child, by Rick Lavoie. 

Rick Lavoie is a lecturer and consultant who has more than 30 years experience working as a teacher and headmaster at residential schools for students with learning disabilities. He consults on learning disabilities to several agencies and organizations, including PBS, the New York Times, the National Center for Learning Disabilities, Child magazine and WETA.

He holds three degrees in special education and has served as an adjunct professor or visiting lecturer at numerous universities, including Syracuse, Harvard, Gallaudet, Manhattanville College, University of Alabama, and Georgetown.

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Are Dyslexia-Related Expenses Tax deductible?

Blog Type:  Learning Disabilities Date Posted:  Monday, February 4, 2019

parents talking to person with computer

By Adam M. Domow, CPA

As a certified public accountant, I’ve been asked by many parents of children with dyslexia if they can deduct on their tax returns expenses incurred on tuition, tutoring, evaluations—money spent helping their children learn.

In the United States, dyslexia is considered a medical condition that interferes with a student’s ability to learn, and related expenditures are potentially deductible as medical expenses. Sounds easy enough, right? Not quite, although these expenses are eligible to be claimed as a medical deduction, merely paying the expenditure is not sufficient enough to claim the deduction.

Most taxpayers are familiar with certain itemized deductions, such as state taxes, mortgage interest, and charitable donations. The medical expense deduction, however, might be new to some. Eligible medical expenditures can be claimed as a deduction, but to claim these deductions, total medical expenditures must exceed 7.5%-of-adjusted gross income (AGI) for 2018 and 10% starting in 2019.

What are considered medical expenses?

Eligible medical expenses are any costs incurred in the prevention or treatment of injury, disease, or in the case of dyslexia, learning disabilities. Medical expenses include health and dental insurance premiums (unless paid through a pre-tax plan), doctor and hospital visits, co-pays, and prescription drugs to name just a few. Generally, medical expenses do not include school tuition and related costs. That is unless the child has dyslexia, and then expenditures include items such as school tuition, transportation, lodging and meals, professional consultations, evaluations, and other forms of mental health treatment.

To increase the chance of success if challenged by the IRS, your doctor should recommend that special treatments, including schooling, are needed to address the learning disability. Additionally, the primary reason your child is attending the specific school is for medical care and not for behavior issues that might not qualify as learning disabilities.

Making sense of the AGI

Here’s a simple example that illustrates the 7.5%-of-adjusted gross income concept.

Assume that a married couple filing joint (MFJ) tax return reports $200,000 of adjusted gross income, $50,000 for school tuition for a private school for students with dyslexia, and other medical expenses related to the child with dyslexia totaling $20,000.

The first step is to determine the 7.5%-of-AGI threshold that must be reached before eligible medical expenses will result in a medical deduction. Therefore, the threshold amount is $15,000 ($200,000 x 7.5%). This means that expenses in excess of $15,000 can be deducted.

 

deduction graphic

Can I claim medical expenses from prior years?

Good news, prior years are potentially not lost. If you paid for medical expenditures related to your child’s medical condition and did not claim (when you could have) a medical deduction, you might be able to file an amended tax return to correct the oversight. As in the current year, a case-by-case analysis needs to be done when going back to a prior year to determine if amending a return will, in fact, provide you with a greater tax benefit.

Next steps

If you prepare your own taxes and plan to claim the medical expense deduction, you need to fill out the IRS Form 1040 and attach Schedule A. If you work with an accountant or someone who prepares your taxes, be sure to mention that you may be eligible for the medical expense deduction.

About the Author

Adam M. Domow

Adam M. Domow earned his Certified Public Accountant (CPA) license in 2001 and an MBA with specialization in taxation from St. John’s University (NY). 

Adam M. Domow CPA
adomow@domowcpa.com
www.domowcpa.com

Landmark360.org is not intending to provide tax advice. We recommend that each individual who thinks they qualify for a medical expense deduction consult a qualified tax advisor regarding their individual situations.

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Tags:  dyslexia taxes medical expenses adjusted gross income tax returns

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