Getting To the Heart of Dyslexia: A Guide to Early Signs, Causes and Treatment

When a child learns to read, their brains must connect letters and sounds to form words. Dyslexia interferes with this decoding process. Children with dyslexia often learn to read differently because their brains form letter-sound connections more slowly. This affects how they understand and remember written words.

At Orthovision, we believe parents deserve clear answers about why reading is difficult for their child. Our role is to uncover the specific factors at play and to guide parents with holistic, science-based solutions.

What is dyslexia?

Dyslexia is a brain-based learning condition (not a sign of low intelligence) that makes reading and language tasks harder. It stems from differences in how the brain processes written language. A child with dyslexia may see words clearly but still struggle to break them down into sounds or match letters to those sounds.

This is one of the learning challenges that typically appears in the early school years, and while it is lifelong, it’s manageable with proper support. Through early intervention, children can develop alternative strategies that help them read and learn effectively.

What are the signs of dyslexia?

Dyslexia often presents as a cluster of reading and language difficulties. Common signs include challenges with basic reading and writing skills. These include:

• Trouble recognising words or sounds. Some children struggle to sound out new words or associate letters with their corresponding sounds.

• Mixing up letters. For example, confusing “b” and “d” or reversing sequences.

• Slow reading that affects understanding. When decoding takes all their effort, comprehension drops.

• Ongoing spelling trouble. Some children spell the same word differently each time they write it.

• Avoid reading aloud. Many become anxious about reading in class.

• Difficulty remembering sequences. They may forget steps in instructions or the order of letters in a word.

These signs of dyslexia in children can appear as early as preschool or kindergarten, when they start learning letters and sounds. Early support makes a huge difference. For instance, identifying dyslexia by second grade allows children more time to learn alternative reading strategies.

Common causes & contributing factors for dyslexia

The exact cause of dyslexia isn’t fully understood, but research suggests a combination of genetic, neurological, and environmental factors. Dyslexia often runs in families and involves differences in brain development, with a child’s brain wiring or functioning in ways that affect reading processing. Key contributing factors include:

• Genetic and hereditary influences. Dyslexia is highly genetic. If a parent or close relative has dyslexia, a child is more likely to have it too. Researchers have identified specific genetic conditions (like Down syndrome) that can increase dyslexia risk.

• Brain structure and processing differences. People with dyslexia have subtle differences in brain areas responsible for language and reading.

• Delays in early language development. Some children with dyslexia may have early speech delays or trouble learning new vocabulary. Such delays aren’t the cause of dyslexia by themselves, but they often coincide with it.

• Coexisting issues (vision or auditory). Major medical organisations emphasise that no eye defect causes dyslexia. Kids with dyslexia do not have higher rates of vision problems than the general population, but if a child has a vision issue, dyslexia can add more difficulty in seeing. Problems like poor eye teaming, tracking, or focus can make reading more tiring. Similarly, auditory processing difficulties or attention issues can co-occur and worsen a child’s learning fatigue.

When should you have your child tested for dyslexia?

If your child consistently struggles with reading or word recognition despite age-appropriate instruction, it’s best to get an evaluation.

Children often exhibit obvious reading difficulties before entering third grade. When your child is evaluated early (often by 2nd or 3rd grade, or even earlier for severe cases), parents can start effective interventions sooner.

It’s important to remember that testing is not about “labelling” a child in a negative way. A dyslexia evaluation helps identify how a child learns best and what support they require. The results can guide tailored teaching strategies and accommodations (like extra reading time or multi-sensory learning methods). Early assessment clears the path for these supports before a child falls behind.

When to seek a specialist assessment, including a visual-cognitive evaluation?

You should consider a specialist evaluation when:

• Your child shows one or more of the dyslexia signs listed above, especially as school demands increase. If a child with reading struggles is entering higher grades without making progress, a more thorough evaluation is necessary.

• Reading or homework consistently leads to fatigue, frustration or avoidance. If your child often complains of headaches, eyestrain, or “brain tired” feelings after short reading sessions, it could indicate underlying vision or processing issues.

• Standard interventions haven’t helped enough. For example, even after tutoring or extra phonics practice, your child still reads slowly or doesn’t comprehend text.

At this point, a comprehensive visual-cognitive evaluation is highly recommended. This assessment is available at Orthovision Singapore, where we offer two tailored services: the Developmental Visual Cognitive Assessment for children and the Comprehensive Functional Vision Assessment for adults. 

Our holistic approach combines tests of visual efficiency (how well the eyes focus, team up, and track) with visual processing and cognitive integration. These evaluations measure eye teaming (binocular vision), focusing ability, eye movement control, and how the brain interprets visual information. This aligns with professional standards for learning-related vision care.    

A visual-cognitive assessment involves two key components. The Developmental Visual Cognitive Assessment evaluates how the brain processes visual information (not eyesight itself), focusing on the interpretation and organisation of what the eyes see. The Comprehensive Functional Visual Assessment, on the other hand, examines how effectively a person uses their vision during everyday tasks like reading and maintaining focus. So this isn’t just whether they can see 20/20 on a chart.

These assessments don’t replace educational or psychological testing; rather, they complement them. By identifying vision-based challenges such as tracking or focusing issues alongside learning assessments, parents gain a complete understanding of their child’s learning profile. This leads to genuinely personalised support that brings together effective educational strategies, such as specialised reading instruction, with targeted visual therapy for dyslexia. 

Why standard reading support or regular eye tests may not be enough?

While phonics-based programs and standard eye exams are essential, they often miss vision-related factors that impact reading. Many children with dyslexia have normal eyesight yet struggle with focusing (skipping lines or fatigue after short reading sessions). Without evaluating how the eyes work during reading, hidden issues can go undetected, hence limiting progress. The table below compares the goals, gaps, and outcomes of each approach.

Aspect	Standard Reading Support	Regular Eye Tests	Vision Function Test
Primary Goal	Improves literacy skills	They examine eye health and clarity of vision.	Evaluates how eyes work during reading.
Core Focus	Phonics, decoding, and comprehension strategies.	Visual acuity (20/20 vision) and eye health.	Eye teaming, tracking, focusing, and visual processing.
Identifies	Language-based learning gaps (such as letter-sound knowledge).	Refractive errors (near/far-sightedness) and eye diseases.	Oculomotor or perceptual issues that affect reading.
Limitation	Does not assess eye movement or visual stress factors.	Doesn’t examine eye coordination or processing during reading.	Requires a specialist. It is not routine in schools.
Outcome for Child	Offers better phonics skills but may plateau if visual issues persist.	Good visual acuity, yet reading difficulties may remain.	It highlights hidden vision problems so targeted therapy can begin.

 A comparison table for standard reading support, eye tests & vision function test

What can parents do to support young children with dyslexia?

Supporting a child with dyslexia starts with trust; that means trusting your instincts when something about reading feels harder than it should. Because dyslexia can be compounded by issues such as visual processing and eye tracking problems, a multidisciplinary approach works best. Early support fosters confidence and lays the groundwork for long-term success.

•  Identify early: Seek a full evaluation when concerns arise.

•  Support at home: Read together and encourage them to keep practising.

• Coordinate care: Combine educational and vision therapy with school accommodations.

• Build a team: Collaborate with specialists who understand dyslexia causes and can offer consistent support.

If you are seeking clarity and assistance in dealing with dyslexia, book the assessment at Orthovision Singapore. This comprehensive exam can uncover hidden visual factors and guide you to the right learning and vision-based solutions that best complement dyslexia therapy in Singapore.