B - 05 Intervention Resistant Dyslexia: a Neuropsychological Profile.

Abstract

Dyslexia is a brain based neurodevelopmental disorder marked by deficits in phonemic awareness and fluency. Brain structures implicated include the left superior temporal gyrus, planum temporal, and frontal regions. Convergent research supports the efficacy of multisensory, systematic, hierarchically organized, phonics-based instruction This study examines a bright, severely dyslexic youngster who, despite seven years of intensive intervention, has made little appreciable progress. Co-morbid neuropsychological weaknesses are implicated in his failure to respond to intervention. The subject is a 13-year-old, 8th grade boy who presented for neuropsychological evaluation subsequent to a history of dyslexia. He attends a specialized school employing evidence-based reading interventions in a small classroom. Despite intellectual functions in the high average range and seven years of consistent intervention, he continues to read at a first to second grade level. Findings from a comprehensive neuropsychological assessment revealed a complex profile characteristic of dyslexia with multiple unexpected deficits in several neurocognitive processes. Data revealed weaknesses in processing speed, verbal working memory, retention, and executive functions. There is little empirical research examining response to intervention in severely dyslexic children. In this case study, the cumulative impact of underlying cognitive weaknesses in speed, working memory, verbal retention, and executive functions are thought to have negatively impacted progress. This youngster is among a small population of individuals with severe dyslexia who do not respond well to intervention. There is a need for awareness of such youngsters and both neuropsychological assessment and research to determine the impact of co-occurring neurocognitive deficits contributing to poor progress.