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How is Hyperlexia in Children Treated?




While dyslexia can impair a child’s ability to read, hyperlexia intensifies their ability to read at an early age. You may ask, “Why would a precocious reading ability need to be treated?” Unfortunately, these children will be lacking in comprehension and other areas which necessitates treatment.


Treatment can help children with hyperlexia become better learners, and overall improve their successes in life.


In this article, we will take a close look at hyperlexia, its symptoms, and causes, and finally, we will discuss hyperlexia treatment that can help improve the child’s symptoms.


What is Hyperlexia?


Hyperlexia is a learning disability that involves a child’s ability to read at levels far beyond those expected for their age. “Hyper” means better than and “Lexia” means reading or language. He or she can decode written language easily, which is the driving factor in their precocious ability to read so early.


It is not unusual to see a hyperlexic child knowing how to spell long words before turning two years old! By the age of three, he or she will most likely be reading whole sentences.


So how exactly is reading at a young age a learning disability? After all, aren’t these the desired outcomes when it comes to teaching a child to read? The trouble comes when these early readers struggle with understanding speech and can have comprehension deficits. Unlike other gifted readers, hyperlexic children will have below-average oral language skills.

Symptoms


To differentiate between a gifted reader and a hyperlexic, there are some stark differences to watch out for. Signs of hyperlexia include the following symptoms:


  • Show strong readings skills by age 5; typically starts to read early, between the ages of 2 and 4, but can be as young as 18 months

  • Reading abilities far surpass his or her peers

  • Is fascinated by things like letters, numbers, fonts, languages, anatomy, and geography

  • Difficulty speaking or communicating

  • May have some behavioral problems like poor eye contact, trouble giving and receiving affection, withdrawal, and repetitive behaviors

  • Lacking social skills

  • Decoding words quickly but struggling to understand what they have read; low reading comprehension skills

  • Will teach themselves to read or with little teaching

  • Will like books more than toys or games

  • Will show signs of a developmental disorder like autistic disorder

  • High reading skills but lacking in learning skills

  • Struggles with putting together puzzles and figuring out games and toys

  • Repeats words he or she sees or hears over and over, known as echolalia

  • Spells words out loud or in the air with fingers

Types of Hyperlexia


There are several types of hyperlexia. They are:


  • Hyperlexia I: This type, though rare, includes neurotypical children with early reading skills. Oftentimes they can read at a 7th-grade level upon starting kindergarten.


  • Hyperlexia II: This includes children who are autistic. Kids with hyperlexia II are obsessed with letters and numbers and things like birthdays, license plate numbers, or the solar system. They will show behavioral problems like avoiding eye contact, withdrawal, and easily feeling sensory overload.


Besides autism, these children may also already be diagnosed with PDD/NOS, Asperger’s, a behavior disorder, a language disorder, a learning disorder, or have been qualified as gifted.


  • Hyperlexia III: This type of hyperlexia can show some of the autistic behaviors mentioned above and be categorized as “autistic-like”. However, these behaviors will typically go away. Those with hyperlexia III can have amazing memory and comprehension skills but will have difficulty speaking. Children with hyperlexia III can also have trouble with auditory processing, sensory integration, and social delays.

Causes of Hyperlexia


Hyperlexia can be a splinter skill or savant skill in a child with an underlying autism spectrum disorder (ASD). Researchers found that almost 84% of hyperlexic children are autistic. However, as you can see from the types listed above, not all hyperlexic kids are on the autism spectrum. And not all autistic children have hyperlexia (it is estimated only between 6 to 14% of autistic children are affected by it).


From a neuroscience perspective, hyperlexia is caused by dysfunction happening in the brain. Similar to developmental dyslexia, hyperlexic reading is associated with the activation of the left superior temporal cortex. But while dyslexic brains will see a hypoactivation (under activation) of this area, brains with hyperlexia will experience hyperactivation.


Hyperlexia typically doesn’t develop on its own as a stand-alone condition. Children with hyperlexia can have other conditions such as sensory integration disorder, attention-deficit/hyperactivity disorder (ADHD), childhood apraxia of speech, motor dyspraxia, obsessive-compulsive disorder (OCD), depression, and/or seizure disorder.


Regardless of accompanying diagnoses, the causes of hyperlexia are still unknown and more research is needed. But, even though we may not fully understand the cause of this learning disorder, there are plenty of treatment options that can make a difference.





How to Treat Hyperlexia in Children?


Next, we will explore how hyperlexia is diagnosed and treated in children. So let’s start at the beginning.

Diagnosis


Before treatment can start, a clear diagnosis of the child must be given. But unfortunately, the diagnosis doesn’t go by the book since hyperlexia is associated with a variety of possible behavioral and learning problems. And hyperlexia is also not clearly defined by the DSM-5, which makes diagnosis a bit tricky (Hyperlexia is listed as a part of autism).


Hyperlexia is diagnosed based on symptoms and changes over time. However, the child may be given special tests including blocks or a puzzle that will test their language comprehension. Or they will simply have a conversation. A doctor can even check the child’s hearing, reflexes, and vision to rule out any impairments causing delayed speech or poor communication skills.


There will be a difference in intervention strategies, educational placements, outcomes, and long-term implications if ASD is suspected. Therefore a differential diagnosis approach should be taken before definitively diagnosing the child with ASD. These children with signs of autism must be watched over time to eventually find whether their hyperlexia falls into type II or III.


Hyperlexia can be diagnosed by a child psychologist, behavioral therapist, or speech therapist. Unfortunately, a pediatric or family doctor may need to refer to these experts and may be unable to make the diagnoses themselves. Occupational therapists, special education teachers, or social workers can help diagnose hyperlexia.

Treatment options


As we mentioned, there are different types of hyperlexia. Each child needs an individualized treatment plan based on their own individual needs and learning style. Treatment plans range from a few years to adulthood.


  • Treatment for hyperlexia I: Hyperlexia I is not a disorder, so it does not need a diagnosis.


  • Treatment for hyperlexia II: Speech and language therapy, occupational therapy, and play-based applied behavioral analysis (ABA) can improve symptoms. These children benefit from alternative placement in special education classrooms. This is because regular classroom settings can overstimulate the child. Therefore, it is more helpful for the child to be taught in relaxed, one-on-one environments that enable them to concentrate on the material.


  • Treatment for hyperlexia III: Speech and language therapy, occupational therapy, and play-based applied behavioral analysis (ABA) can improve symptoms. These children benefit most from full integration into their classroom with other children their age.


The treatment for the child should center on the child’s strengths and interests to help improve the areas of weakness. The therapists involved must be open-minded and willing to work with the child’s unique challenges. Professionals of this caliber can be found at any Rite-Care facility, with the experience and education to improve the child’s chances of success.


Next, we will take a closer look at possible treatment options available for kids with hyperlexia.

Language comprehension exercises


Hyperlexic kids seem to struggle most with comprehension. Integrating exercises like these into the child’s treatment plan will be most beneficial for improving comprehension skills. A parent can do them with the child at home, or they can be used in school or therapy sessions.


  • Visualizing and Verbalizing kit: Many parents and educators use Lindamood-Bell programs to help hyperlexic children work on comprehension. Though the programs can be expensive, they seem to be highly effective. This kit includes things like word cards, Sentence by Sentence lessons, Word Imaging Easel Book, and more.


  • Story grammar and story mapping exercises: This approach is often used in schools and by speech and language therapists. It is beneficial for kids with ADHD, hyperlexia, and other learning disabilities. Story maps provide a visual-spatial display of key information in stories the child reads.


Children in Kindergarten could use a story map to record the beginning, middle, and end of the story, while older children can include more in-depth information. The map prompts the child to identify story elements like the characters, time, problems, goal, action, and outcome of the story and record them.


  • Scaffolding and the Scaffolding Interrogatives Method (SIM): Scaffolding in education refers to breaking up learning into chunks, then providing the tool or structure to use alongside each chunk. Scaffolding used in the context of reading would involve a preview of the text and a discussion of key vocabulary. Teachers could also chunk the text, reading and discussing each chunk at a time.


Research surrounding the Scaffolding Interrogatives Method (SIM), has shown this method to be beneficial for reading comprehension.

Speech and language therapy


To help improve a child’s expressive language, spoken word comprehension, and social interaction, working with a speech therapist can help. Hyperlexic children often have issues with pronoun reversals, articulation errors, and difficulty answering questions. Speech therapy can help with these issues and more.


The speech-language pathologist (SLP) will use things like visual timetables/schedules, pictures, visual prompts, association games, cause-and-effect predictions, and social stories.

Occupational therapy (OT)


Occupational therapy (OT) can also be of great benefit for hyperlexic kids. OT can help the child improve their fine motor skills, impulse control, sensory integration, self-regulation, motor planning, and more.


The OT treatment plan will be specialized for the child and will be centered around the highest areas of difficulty. Some of these areas could include sleeping, feeding, self-care, school participation, social participation, writing, and response to sensory stimulation.

Individualized education programs (IEPs)


In the United States, those with learning disabilities are allowed individualized education programs (IEPs) when entering school. These plans will lay out a designated path for the child’s specialized learning needs. Learners will get extra help in difficult subjects, and with skills, they are lacking in.


IEPs are made for children as young as 3 years old, and for any child who could benefit from special attention in these areas, they are struggling in.

Applied behavior analysis (ABA)


While some children benefit from just speech therapy, others may also benefit from applied behavior analysis (ABA). ABA is a type of therapy that focuses on improving specific behaviors, like social skills, communication, reading, and academics. It also focuses on teaching the child adaptive learning skills like fine motor dexterity, hygiene, grooming, and punctuality. It is primarily used to treat children with autism.


ABA can help hyperlexic children attend to teaching or help them learn fundamentals like potty training, dressing themselves, etc. It also helps them learn to follow a classroom routine. Letter interest, word recognition, and reading can be used to motivate the hyperlexic child and teach them new skills.

Medication


Medication is always the last option. It must be stipulated that medications, diets, or supplements prescribed to the hyperlexic child are not cures. However, they can help with some symptoms of anxiety, OCD, and ADHD that can accompany hyperlexia. Reducing these symptoms could make it easier for the child to focus and learn.

Outlook for Children with Hyperlexia


The sooner the hyperlexia diagnosis is found, the more successful the prognosis for most cases will improve.


These children will likely see an improvement in their language and social skills. Some of them may be able to eventually attend college or live on their own. However, others may need ongoing special education, therapy, and supervised living throughout their lifetime.


Providing the Best Treatment for Hyperlexia


At California Scottish Rite Foundation, we want to give these children the best resources to help them improve their symptoms. Through donations, we fund Rite Care Centers all over California that specialize in hyperlexia and other learning disorders.


With the right diagnosis and hyperlexia treatment, we hope to see these children make it to lead successful, independent lives. Our goal is to secure the funding to do that. We could use your help; please donate to this very worthy cause!


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