I had the good fortune of speaking with Prof. Galaburda in July 2023. He is known for his research in cognitive disorders…so this guy knows a lot about dyslexia! In 2017 he received The Dyslexia Foundation's Einstein Award. This award honors an individual who has made significant contributions to increasing our understanding of dyslexia and improving the lives of individuals with dyslexia. I had reached out to him with my story and he sent me a short reply while on vacation!! Before we set up our Zoom call, he wrote to say this:

“Dyslexia is not always easy to diagnose; there are other causes for reading and spelling difficulties; and dyslexia itself can be different from person to person. As the most common form of dyslexia, called phonological dyslexia because there is an underlying problem with hearing/manipulating certain sounds of language, is more frequent in boys than in girls (maybe 4 times as frequent), one should remain always vigilant as to the diagnosis in a girl/woman. As with any specific learning disability, it is very helpful to be intelligent (of course not all dyslexics are intelligent, since not all non-dyslexics are intelligent either). Being intelligent helps in developing alternative strategies for getting information from the written page. Being educated and knowing a lot helps too. So, for instance, the words “sympathy” and “symphony” look and sound reasonably alike and may cause a dyslexic person difficulty. Yet, they appear in very different contexts, so that an intelligent, well-educated dyslexic can figure out which of the two the text is referring to. Is it about a funeral? Is it about a concert? The catch 22, however, is that it is more difficult to be well educated when reading is a challenge. However, nowadays particularly young people have better access to other information domains, such as YouTube, podcasts, interactive screens, which can help get the information without having to read it in a big fat book. That said, it is not easy when reading is hard (you know this better than I).

As I wrote above, not all dyslexia is phonological. We have seen cases of visual dyslexia, and so far only in girls (I don’t write “women” because they were all very young, not for a lack of respect). One of them, who called herself Davida, was about your age when we saw her. I will attach a paper we wrote on her. It is very difficult reading, even for someone fully trained in cognitive neuropsychology. The bottom line is that Davida could not stabilize certain types of visual images, which included but was not limited to letters, and text on a book page was impossible for her to read. Moreover, people at her school thought she was faking it, which did not help her emotionally. We not only found out what her problem was, but discovered a wave length of light (color) that stabilized the images for her and gave her glasses with that color that did the trick. Be careful though, because there is a lot of junk out there in the literature about colored lenses and dyslexia. I think that Davida was a very unique case, not a garden variety dyslexic. She is in college now.”

WOW! I did not know that! Very interesting that not all dyslexia is phonological!

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We had a very productive 1-hour call where he answered questions (9 in total) I had relating to his research and learning disabilities (dyslexia in particular).

I have decided to reproduce his answers to 3 of my questions. I hope to reproduce more of his answers to my other questions in future.

1. What are the significant neural differences of learning disabilities such as dyslexia or attention-deficit/hyperactivity disorder (ADHD) and how do these neurological differences impact learning and academic performance? Do you think they are related?

   “If you mean what are their differences from usual development or what are their differences from each other requires a different response, albeit related. The most important difference between the two conditions is that they affect different brain systems. ADHD affects the dopaminergic/noradrenergic system that is located on top of the brain between the two hemispheres in the so-called inter hemispheric fissure. Dyslexia affects systems that process sound into language on the lateral surface of the brain surrounding the so-called Sylvian fissure. The exact mechanism is not known for either. There are some chemical features, such as the handling of dopamine and norepinephrine for ADHD, and NMDA receptor function for the latter, but these are somewhat speculative. The two conditions are not neurally or chemically related, but it is true that with ADHD it is difficult to read because of focus and concentration issues and with dyslexia it is difficult to keep things in mind when the message is corrupted. An example of a similar phenomenon is seen in usual people in a foreign language environment, whereby they lose tract of what is being said because they don’t have facile, clear representations of the words in their minds from lack of good knowledge of the language.”

2. How do genetic and environmental factors interact to influence the development of learning disabilities? What role does neuroscience play in discovering these complex interactions? Is there any sense of which of the genetic or environmental factors is most influential?

   “Everything we do is the result of the interaction between what we have learned and our genes. Even broken bones is genetic. So, for instance, two people of the same weight, age, gender, etc. jump to the ground from the second floor identically, yet they will not break their bones exactly the same because of the genes that built their bones slightly differently. With learning disabilities this is magnified, because genes and culture play important roles. Imagine two identical twins (well even identical twins aren’t completely identical, but close enough), one learning to read in Italy and the other in the US. Even though the share mostly the same genes, one language is more forgiving of dyslexia (Italian) than the other, because of the different structure of their sound systems. Imagine the same twins, one in a wealthy family with tutors galore and the other growing up in the inner city with many fewer resources to help in special education. In the former the dyslexia will be stronger than in the latter. Neuroscience alone cannot get at the interaction among all the factors that contribute to the actual manifestations of a dyslexia risk. It requires social scientists, educators, lawyers, the government, as well as neuroscientists and geneticists, to tackle and beat the problem. In severe cases, the genetic factors are more influential. In milder cases, environmental factors are more influential. Today, it is easier to work on environmental factors, so this is more important an approach. In the future, as we learn more about the genetics and become more capable of changing genetic influences, perhaps things will change. However, I vote for fixing the inequities in our world first.”

3. What are the key neural mechanisms and processes involved in learning disabilities? How do they differ from typical/normal learning processes? Have these been isolated to a certain part of the brain, types of neurons or neurotransmitters?

   Answered above. “Different learning disabilities affect different systems. The brain is organized into systems, or networks, that participate in learning and performing different skills. These systems affect different parts of the brain. Lots of research has shown that there are subtle differences in the brain structure that can be shown using MRI scans, structural and functional. Animal models have also shown effects of altered genes on the structure and function of the brain in dyslexia and ADHD. Other conditions, such as dyscalculia, or lack of musical abilities, are less well understood.”