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Dr Jessica Narowlansky, Psychologist
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BA (Hons), Mont Dip, Dyslexia Guild, PG SpLD, PATOSS Head of Specialist Education and Wellbeing for Cavendish Education Education Consultant for The Child and Adolescent Development Centre
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Child behaviour

Under-detection of dyslexia in girls

As an SEN specialist, anecdotally speaking, girls are brought to see me on average three to four years later than boys. How, with the level of dyslexia awareness being what it is today, can this be the case? I believe the answer lies in our deeply embedded, often unconscious, expectations of how dyslexia presents in our children.
In Short
What studies have shown time and again is not necessarily a higher incidence of dyslexia in boys than girls, but that dyslexia is far more likely to be detected and identified in boys.

Girls can pass undetected with their dyslexia by being very well organised, quiet and neat in their behaviour – so teachers might not notice – although a specialist will pick it up.

Possible symptoms of dyslexia to watch for in girls include:

Hyper-organisation.

Emotional/physical issues.

Girls with autism can similarly pass undetected more often than boys.

Under-detection of dyslexia in girls

In her landmark longitudinal study in schools in Connecticut, USA, Dr Sally Shaywitz (see references below) found while testing revealed no significant difference in the prevalence of reading difficulties between sexes, there was a clear pattern of schools referring far more boys for assessment.

A startling example of this referral bias was illustrated in the difference between the children identified by researchers as having a diagnosable reading difficulty versus those identified by schools. For example in more than 300 second graders, researchers identified 8.7% of boys and 6.9% of girls as having diagnosable reading difficulties, while in the same population the school identified 13.6% of boys and only 3.2% of girls. In analyzing this trend throughout the study, Shaywitz found one clear issue consistently arose. As within schools behavioural difficulties was a primary reason for referral; many girls were slipping by as they were literally not making enough noise to be noticed. Further to this point, a recent Georgetown University study exploring dyslexia in male and female brain anatomy asks if methods of testing may be gender skewed as “models on the brain basis of dyslexia, primarily developed through the study of males, may not be appropriate for females and suggest a need for more sex-specific investigations…”

Similarly, in recent years underdiagnosis of girls has become very important on the Autism agenda. It is now accepted that gender biased expectations allow many AS girls to go undetected due to their drive to mirror socially acceptable behaviours while, in truth, feeling completely isolated.

As a society we hold to the idea that girls mature more quickly than boys; are more likely to adapt themselves to conventional behavioural expectations; are less likely to demonstrate disruptive behaviours when angry or frustrated. In essence, what studies have shown time and again is not necessarily a higher incidence of dyslexia in boys but that dyslexia is far more likely to be detected and identified in boys.

So how can we spot more of our dyslexic girls?

Along with the more commonly accepted warning signs such as issues with reading and writing, apparent laziness, daydreaming, organisational difficulties, many girls may overcompensate for these difficulties in their desire to cope. Therefore, also watch for:

  • Labouring over work to make it look beautiful. A lovely looking piece of homework the teacher thinks took 30-minutes was painstakingly laboured over all evening.
  • Presentation may not reflect content quality. Despite looking perfect, work content seems weak or disjointed; likely due to over focus on tidy handwriting and spelling.
  • Hyper-organisation. Overcompensation for internal chaos by over-organising. This self-inflicted pressure creates high anxiety levels while consuming unseen, exhausting hours of work.
  • Emotional/physical issues. Dyslexic girls are more likely to struggle with depression and/or anxiety which can result in more serious mental health issues over time.

References:

Evans, T. M., Flowers, D. L., Napoliello, E. M. and Eden, G. F. (2014) ‘Sex-specific gray matter volume differences in females with developmental dyslexia’, Brain Struct Funct, 219(3), pp. 1041-54.

Shaywitz, S. E., Shaywitz, B. A., Fletcher, J. M. and Escobar, M. D. (2018) ‘Prevalence of Reading Disability in Boys and Girls: Results of the Connecticut Longitudinal Study’, JAMA, 264(8), pp. 998-1002.

Further reading:

The Dyslexia Handbook 2018 available through British Dyslexia Association (BDA)

The Parents’ Guide to Specific Learning Difficulties (Chapter 3 pp 40 – 67) by Veronica Bidwell – Jessica Kingsley Publishers 2016

Overcoming Dyslexia: A new and complete science based programme for reading problems at any level – Sally Shawitz MD, Vintage Books, New York, 2005

Useful websites:

The Yale Centre for Dyslexia and Creativity

http://dyslexia.yale.edu/advocacy/toolkit-for-parents-educators-and-students/printable-materials/

British Dyslexia Association (BDA)

http://www.bdadyslexia.org.uk/

PATOSS: The Professional Association of Teachers of Students with Specific Learning Difficulties https://www.patoss-dyslexia.org/SupportAdvice/

Jessica L. Narowlansky

BA (Hons), Mont Dip, Dyslexia Guild, PG SpLD, PATOSS, IDA

Head of Specialist Education and Wellbeing for Cavendish Education

Education Consultant for The Child and Adolescent Development Centre

DISCLAIMER
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