Adult Dyslexia
A Unique Understanding
by Harold Levinson, M.D.
All dyslexics and all their symptoms and variations can be readily encompassed and easily understood when using a clinically based concept and definition such as the one proposed by Levinson. As a result, it became crystal clear that all dyslexic children become dyslexic adults. Thus the incidence of dyslexia was found to be the same in both children and adults despite significant symptom variations occurring over time. By contrast, all theoretically derived definitions based entirely on reading severity or on only one of many reading (and non-reading) dysfunctional mechanisms have often created more illusions and riddles than solutions.
Thousands of dyslexic adults were neurophysiolgically examined by Levinson prior to and after successful medical treatment. Despite improvements, all demonstrated some neurological evidence of only an inner-ear or cerebellar-vestibular dysfunction similar to that found in dyslexic children. Importantly, adult dyslexics regardless of age respond almost as favorably to inner-ear enhancing medications as do children. And the medications are capable of alleviating all symptoms and their inner-ear determining mechanisms while rendering all non-medical therapies significantly more efficacious . This is crucial since dyslexic adults are reticent to voluntarily seek remediation given their childhood failures. Even were they willing, there is insufficient time and resources to remediate and non-medically treat all the many symptoms characterizing each of millions of suffering dyslexics.
Fortunately, many adult dyslexics selectively compensate and even overcompensate for their prior diverse reading and non-reading symptoms. Since experts still mistakenly believe the traditionally accepted conviction that dyslexia is a severe reading-score impairment, it was also erroneously thought that improved dyslexics with (or attaining) non-severe, normal or superior reading scores are no longer dyslexic. This often creates or supports the mistaken illusion that the incidence of dyslexia decreases in adults and that developmental dyslexia may be "cured" over time or with tutoring. As a result, the remaining frustrations and failures of these dyslexics are incorrectly blamed on psychological factors, including laziness and indifference. Thus guilt is intensified while self-esteem crashes.
In contrast, Levinson was first to recognize and clarify this century-old fallacy of defining the complex dyslexic disorder, involving both reading and non-reading symptoms coexisting in variable intensities, by only severe degrees of only one of its many symptoms. Additionally, the vast majority of dyslexics with compensated reading scores were found to still manifest dysfunctional reading and non-reading mechanisms. By analogy, diabetics with normal or low blood sugars are still diabetic. Just as no one would now consider defining diabetes by the presence of only very high or "comotose" serum glucose levels, the same reasoning should apply to a dyslexia definition dependent entirely on reading-score severity.
Based on extensive clinical research data, the reading and non-reading (writing, spelling, math, memory, speech, concentration, coordination…) symptoms found characterizing and thus defining dyslexics were reasoned to occur when normal brain processors secondarily failed to recognize and compensate for the scrambled signals received and sent. And that this signal defect was due to a primary fine-tuning impairment of inner-ear or cerebellar-vestibular(CV) origin.
Because normal cerebral and related brain processors and even the CV system learn to descramble or compensate and even overcompensate for this hidden signal impairment, symptomatic improvements frequently occur with age unless further destabilized by other acquired or overlapping factors. Thus the primary CV dysfunction in dyslexics persists into adulthood despite marked surface improvements in reading and related non-reading symptoms. To highlight both this compensatory phenomena as well as the unwitting fallacy of calling both the disorder and its severe reading symptom by the very same name — "dyslexia," Levinson presented many patients he termed "Dyslexics without 'Dyslexia.' " These were typical dyslexics manifesting normal or above reading scores. Most important, a majority still demonstrated abnormal reading mechanisms such as tracking errors, reversals, word blurring and movement, light sensitivity, etc.
As most realize, all adult endeavors are significantly impacted by their many and diverse underlying cognitive and non-cognitive dyslexic symptoms. And as most all adult challenges are infinitely more complex than that encountered by children, failing adults are immeasurably more stressed. Thus their prior levels of functioning often regress, sometimes drastically. Anxiety and depression are frequently triggered. New and multiple diagnostic disorders often arise, ie.,PTSD, substance abuse, occupational and social/interpersonal impairments, criminal and other psychopathic activities, etc.
Too often, these secondary disorders mask the underlying dyslexic or inner-ear determinants. And so these undiagnosed dyslexic adults fail to be properly understood and treated. Sadly, a majority of these failing, misdiagnosed and incompletely treated adults, via a vicious downward spiral, give up and are incorrectly considered hopeless and "therapeutically refractory." And since they are not recognized as dyslexic, this rather large failing group of diversely diagnosed disorders also contributes to the mistaken illusion that the incidence of adult dyslexia is less than their childhood counterparts. Many years ago, Levinson recognized other factors initially contributing to the above illusion. Because Pediatricians and teachers no longer saw their compensating developmental dyslexics in adulthood, they must have unwittingly concluded that their dyslexia "disappeared" with them. Moreover, adult dyslexics had learned the benefits of denying and hiding their humiliating deficits from themselves and critical others. Thus these "closet dyslexics" contributed to their own "disappearance."
Not infrequently, adult dyslexics succeed because and/or despite of their frustrating childhood disorder. Some are psychologically driven to prove that they're not as dumb and brainless as they tragically believe or appear. Too often they also feel as impostors, regardless of their outer success and even adulation. Also, because of the brain's neuroplasticity, a dysfunction in one structure or mechanism may trigger compensatory and even over-compensatory functioning elsewhere. These amazing psychological and physiological attempts at compensation for impairments are man's gift from nature. However, some have been misled by this phenomena as well as the presence of geniuses with dyslexia to misconstrue dyslexia as a gift, ignoring the vast majority failing to adequately succeed. Without proper understanding and treatment, countless adult dyslexics are doomed to forever live in frustration and even despair. What a gift?
Adult dyslexic symptoms occasionally remain refractory or significantly so to all the usual beneficial therapies, including neuroplastic compensation. And the assumption often made is that they have a severe and thus resistant form. However, upon analysis one sometimes finds that the severity is mostly determined by overlapping psychological vs. physiological factors. In other words, the dyslexic symptom(s) is initially determined by an inner-ear mechanism. And it is then solidified in place by subconscious emotional determinants, even when the neurophysiological factors improve. Thus psychotherapy is needed to discover and resolve the problem.
Because adults develop greater perspective and descriptive abilities, older dyslexics responding favorably to inner-ear enhancing medications are especially capable of describing their improvements vs. children. Since there exists a dysfunction underlying each and every improvement, rapid and dramatic favorable therapeutic responses served as an invaluable tool for highlighting, dissecting and understanding the hundreds of previously unrecognized symptoms and determining mechanisms characterizing the dyslexic syndrome.
Moreover, adult dyslexics are readily able to describe the many ups and downs of their disorder over time as well as a wide range of previously unknown mechanisms and triggers resulting in compensation and regression (ie.,rotation, zero gravity, altitude, barometric pressure, etc.). Indeed, adults (and children) developing inner-ear disorders (ie., infections, trauma, tumors, etc.) were often shown to acquire both transient and permanent forms of dyslexia for the very first time. In many ways, the detailed historical examinations of both treated and untreated adult dyslexics provided Levinson with the vital insights needed to solve most all the century-old riddles characterizing this previously misunderstood impairment. Hopefully readers will be similarly enlightened, especially after "listening" to adult dyslexics.
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