Dr. Lisa Rappaport on Parenting & Supporting Dyslexic Learners in School and Beyond

Debbie:

Hey Lisa, welcome to the podcast.

Dr. Lisa Rappaport:

Thank you. Thank you for having me.

Debbie:

Thank you for joining me to talk all about dyslexia. And we have done a couple of episodes on dyslexia and there are a lot of folks in my community whose kids have dyslexia often alongside, a multiple of other things going on. But I’m really always excited when we get to kind of dive into a topic like this, we’ll do today. But before we get into dyslexia and your new book, would you Just introduce yourself in your own words and the work you do. And as part of that, your personal why for the work that you do.

Dr. Lisa Rappaport:

I am a neuropsychologist. work at Albert Einstein College of Medicine and Montefiore Medical Center. I’m going on 25 years there and I am in a pediatric unit where we diagnose all sorts of learning differences and we work with all sorts of children with all kinds of differences and genetic disorders. And I’ve wanted to do this work since I was in high school. I knew I wanted to advocate for children who were dyslexic and for children in general because I was diagnosed with dyslexia when I was six. And although I got the diagnosis at a very young age, there was a then what. Nobody knew what to do. And my mom is actually the one that taught me to read and worked with me straight through high school because my school just didn’t know how to support me. So that’s where my desire came from to do what I do.

Debbie:

So that’s kind of where I would like to start is thinking about how things have changed. I mean, I know, know, I’ve also, it’s been a very long time since I was in school and it just wasn’t something people were talking about at all, you know? And I remember one of my bosses in one of my earlier jobs out of university was dyslexic and it was like, wow. I just remember being like, how did you defy the odds to make it to this big role as a dyslexic person? Because it was just something I didn’t know much about. And so I’m curious to know how things have changed over the past 25 years that you’ve been doing this work in terms of just understanding and awareness of dyslexia in general, maybe, and even of the stigma that can surround it. What kind of changes have you seen when talking about dyslexia?

Dr. Lisa Rappaport:

I have seen tremendous changes because as you said, no one even talked about it. And I think there was an assumption that if you were dyslexic, you really couldn’t learn when I was growing up. And now, there were no accommodations for anybody. And so I tended to hide my dyslexia to the point where I had this book in mind for two decades and didn’t write, didn’t put it out there because I didn’t want anyone at work to know I was dyslexic, even though that’s what we do, because I thought they would see me differently. And so now while kids have rights, they are more understood. I wouldn’t say they’re totally understood, but they are better understood. I think it still needs a lot of work in that area. And, at least there are accommodations in place. Children are going to get extended time. There’s more diagnosis, although not enough. There’s not early enough diagnosis, but I think the stigma has changed along with there’s an awareness that at least it exists. I just heard from someone from my high school who said that he was also dyslexic and we didn’t know about each other. Nobody talked about it back then. Everybody heard it.

Debbie:

Yeah. Yeah. So, okay. So that’s good movement that we’ve seen. You know, literally yesterday I was going back through the archives of my podcast, which I’ve been doing for nine years now. And one of the very first episodes I had was about dyslexia. I was with a dyslexia coach, someone who was dyslexic and who was a former teacher, a former reading specialist. And I re-listened to that interview and she told me that she received as a reading specialist credentialed and a master’s degree in reading, she received no training on dyslexia, which blew my mind at the time. That was in 1994 that she graduated from that program. So it’s still a while ago, but could you talk with us about the state of education today? How aware of our… Okay, so I’m getting a laugh. Okay, so talk to us about what schools know about, especially what educators know and understand about dyslexia.

Dr. Lisa Rappaport:

You know, unfortunately, I still don’t think it’s taught. And if it was taught, I think, you know, there was a big move in the United States to do balanced literacy, which was not phonics based. And if, if people knew more about dyslexia, they would just teach every child how to read using phonics because it covers everybody. One in five children are dyslexic. And why not just put that into the classroom? And so you’re addressing everybody’s needs. I don’t think anyone, teachers are taught early intervention. I don’t think they’re taught to learn the signs of dyslexia or recognize early signs of dyslexia to this day. And I don’t know what they’re taught in school, but I know the schools have a problem. It’s just not taught. And I know in England they’re having a problem because the book is doing very well in England because there’s a problem there with the educational system and dyslexia and a lack of knowledge.

Debbie:

So I’d love to know how dyslexia is assessed. And you talk about it in your book, but if you could share what does that diagnostic process look like? Because my understanding from people I’ve talked with is that there are some kind of straightforward ways, like screeners almost, to know if a student is dyslexic or may be dyslexic. I don’t know if that’s true. Is that accurate?

Dr. Lisa Rappaport:

There, there are, there’s a screener I use, but the person who developed it, developed it, I mean, many, many years ago, and she would have been in her hundreds now, so she has passed away. And I don’t think the norms have been updated, but the screening is the screening. mean, and it’s not well understood or known, but yes, you can, because you can look at really little children and see if they can play with language. How is their articulation? Can they rhyme? Can they blend? Can they isolate beginning sounds and ending sounds? Do they know left and right? Can they sequence a story? So there’s all sorts of things that would be considered in a screening, but that’s not how dyslexia is really diagnosed now. People wait until a child is of reading age, around the age of seven, and then they do an educational evaluation, a psychological evaluation, some neuropsych stuff, which gets easier to do as the children get older because a lot of neuropsych stuff isn’t normed until children are a little bit older. And then you’re looking for discrepancies between intelligence and their abilities and what they can and can’t do. And, you know, whether they can do all of the things I just said, and if they’re having trouble decoding words, et cetera.

Debbie:

So are you, I’ve heard people advocate for some kind of mandatory screening for all kids . Why are we waiting? And so I’m just wondering to know your thoughts on that.

Dr. Lisa Rappaport:

I would love that. I would love for people to start screening children by the age of five or even four and to start working with them really early. I mean, why not just teach parents how to play with children with language, whether they think they can be dyslexic or not. They’re fun games and it’s just playing and children love the games. I did them with my own children who are not, my daughter has some learning differences, she’s not dyslexic and my son is not dyslexic but we would play the language games all the time in the bathtub, in the car, in the high chair, it didn’t matter. So why not educate everybody, preschools, parents and just start building and developing language skills when they’re really little because it will support their reading ability when they get older and their ability to learn to read whether they’re dyslexic or not.

Debbie:

Okay, so before we continue, I’m honing in on these very specific questions, but let’s take a step back and just talk about what dyslexia is and isn’t, because there’s probably a lot of misunderstandings or myths about what it is. It’s probably more than most people realize. And yeah, so how do you describe it and how might it show up in our kids?

Dr. Lisa Rappaport:

So it’s really a language processing disorder. It can affect spoken language, written language, or reading comprehension. It has nothing to do with intelligence. It can affect perceptual and spatial areas, it can affect skills, and it can also affect speech, reading, spelling, and math. And so a child might be able to read, but their comprehension might be affected, or they might read extremely slowly, that they might have learned to read. And some children have trouble just learning how to sound out words and identifying words. What it’s not is an intellectual disability. The dyslexic children can learn, they’re intelligent, and they’re capable.

Debbie:

I didn’t realize that it could be, I’m thinking of processing speed, but is that part of dyslexia? You know, if you’re able to read, but you do it more slowly, is that because it’s taking your brain longer to decode or maybe you figured out workarounds to decoding the symbols you’re seeing?

Dr. Lisa Rappaport:

So now there have been studies, there are fMRIs that actually look at the brain while it’s learning, while it’s reading. And they’ve looked at dyslexic readers and more typical readers. And what they found is the dyslexic reader, the neuro pathways that they use are more complicated. It’s not as direct. And that’s why it takes them longer to read. and because it takes them so long to actually process and, and sound out the word, the comprehension is affected. That’s why if you read to a dyslexic person or they can listen to it on tape, their comprehension is phenomenal. My mother actually read to me straight through high school. I didn’t start reading my… I could read to myself, but for my schoolwork, she read to me until the 12th grade.

Debbie:

Wow. OK, that’s super interesting. So let’s talk about ages, right? You said, ideally, this is something that kids as young as four five would be tested for. Are there kinds of windows that are more ideal for identifying these? And maybe talk about that ideal window, and then I’d love to spend a little time talking about what the stakes are for this to kind of be delayed to be identified.

Dr. Lisa Rappaport:

So four or five is very young to have an actual diagnosis, but you can start to see signs. I call them soft signs. So as I said, it could be articulation. It could be sound, symbol association. It could be a real disinterest in learning to read. Most children are very excited to learn to read and dyslexic children tend to avoid it because it’s already difficult. Just learning the sound, symbol association is difficult. Or, you know, some children have very acute articulation, but dyslexic children might have difficulty with that. They may have difficulty identifying left and right. Or as I said, even sequencing a story. If you ask a little child what they did today and you say to them, start with when you woke up and you brushed your teeth and then what did you do? And a child might say, then I had breakfast and then we went to the park. And then I came home and I had a nap and I went to lunch. I had lunch. Whereas a dyslexic child might have a really hard time sequencing the order of their day. And again, little children tend to want to learn the days of the week and a dyslexic child might find that very difficult. So they’re not dyslexic yet and it’s hard to diagnose it when they’re four or five, but those little signs are soft signs that something may be coming.

Debbie:

And then, okay, so then, you mentioned most kids at around seven, then is when they would be expected to be early readers. And that would be more of a sweet spot, I imagine, to really identify if there’s a learning disability happening.

Dr. Lisa Rappaport:

If you’re good, you can. I mean, most schools don’t pick it up till the child is around nine. But certainly by the time a child is six or seven, the discrepancies between other classmates are starting to show up. So if signs are not ignored, you can identify a dyslexic child. Not all dyslexic children, because some of them are good at masking it. Or as I said, they might learn how to decode, but then the comprehension is affected later on. So it is a spectrum and you may not pick it up, not every child will be picked up at a very young age, but certainly if it’s severe enough, they will be picked up if you’re acute at looking at the signs.

Debbie:

Mm-hmm. Yeah, and then I think about the students, as you said, who are masking or maybe they are able to overcompensate. We talk a lot about twice exceptional children until parenting, so some of those kids are really able to figure out workarounds. And so their disability might be hidden for a very long time. And I would love to know what’s at stake with kids who don’t get that diagnosis until middle school or high school. What have you seen?

Dr. Lisa Rappaport:

Shame, self-esteem, it becomes pervasive. You know, if you’re not picked up, your child knows they’re hiding something or compensating and they might become very angry. They might just develop shame. They will, their self-esteem might plummet and, and it goes on from there. They might get depressed. They might get anxious. It’s not easy. the discrepancy between what they’re able to do and what they’re trying to compensate for becomes bigger and bigger. And, you know, I really think shame is the most pervasive thing I’ve heard adult dyslexics talk about.

Debbie:

Well, yeah, I mean, even in your introduction to yourself, you said that you in the workplace didn’t share it for a very long time. How have you navigated that as an adult? Is that something you’re now? Well, obviously you’ve written a book about it, so you’re open about it now, but how did that happen for you that you decided, you know what, I’m done kind of hiding this?

Dr. Lisa Rappaport:

You know what, I’m approaching 25 years at the same job. And it was in year 23 that the book was coming out. You know, it just came out. but at year 23, I decided I don’t have to hide it anymore. I think I’ve proven myself, but it took a very long time. And to be honest, even at my children’s school, I didn’t want the other parents to know because it was nice to have the last couple of decades without people knowing something that I struggled so much with, but my self-esteem has never fully recovered. So it’s something that I’ll probably always work on, but I don’t want other children to have to deal with what I’ve dealt with and probably most people in my generation have dealt with.

Debbie:

Yeah. Yeah, why do you think it is, you know, as I was preparing for this conversation, I was thinking that dyslexia does tend to be very stigmatized for some reason in a different way than autism or ADHD. I mean, they both have their own issues too, but there’s something about dyslexia and the fact that it’s a learning disability that seems to be really loaded. And I’m just curious to know why you think that is.

Dr. Lisa Rappaport:

I think, and it’s not that children with ADHD, I think children with ADHD are, maybe it’s just more out there. It’s not as stigmatized. I don’t know. i mean, you know, if you are, you’re able to do a lot when you’re, when you have ADD, you’re able to kind of put your hands on a lot of baskets and yes, you’re disorganized, but it’s sort of like the nutty professor kind of thing. And people kind of accept it more. Whereas if you’re in a and can’t read, I think that people make an assumption about you. And especially when you’re little, the first thing you are taught to do in school is read. And so when you start falling behind, it’s such a young age and kids are mean at that age and they start making fun of you at that age. It just follows you. So all little children might have trouble sitting, whether they’re ADD or ADHD or not when they’re six or seven, but they’re still learning to read. But if you are sitting there and you can’t learn to read and you’re falling behind, it’s just that you don’t look like other kids in that particular setting. And it’s really difficult. And you’re called out right away.

Debbie:

Yeah. And it does seem to be a thing for a point of pride for a lot of parents to share. My kid started reading at this age, so there’s a lot of attachment to when that happens.

Dr. Lisa Rappaport:

Absolutely, it’s a milestone that parents are looking for and waiting for. And again, the first thing they do in school is teach you to read when you are in primary school. So it’s the thing that everyone is expecting a child to do at a very young age.

Debbie:

So we’ve done, as I said, a couple episodes on dyslexia before. One of those was specifically about advocacy. It was with Mickey Boas, who wrote the book One in Five about her journey of really pushing for her dyslexic son to be served in a public school setting. But what do parents need to know about advocating for an assessment at school, especially if the school is kind of dragging their feet a little bit, but we as parents feel intuitively know that we need to get this checked out.

Dr. Lisa Rappaport:

You have to be a tiger mom or dad or parent. You just can’t relent. And I always say the mom or the parent knows. There’s an instinct with parents. They know. And when the school says the child is fine or let’s give it time, don’t do it. If you know, you know. And even in my own, when I see a child, if the parent says, I just know there’s a problem, I always say, you know, it’s an instinct and parents know their child and you’ve got to insist and keep going. And if you need to get in a lawyer, then you get a lawyer. But you have to insist that your child gets the evaluation and then gets the interventions.

Debbie:

And is that something in your experience that public schools in the US, you know, we’re talking about are required to provide for students and is there a standard evaluation that a student who is suspected of having a learning disability would receive?

Dr. Lisa Rappaport:

Yes, so it is the law that public schools must give a child an evaluation. it can be, the child can be referred by the parent, if not the teacher. So anyone can make that referral. And it is the law that the school has to follow through with it. And what was your other question? What was, It’s a standard, yes, a standard evaluation. So the school can do the bare minimum. They have to do an educational, they have to do a psychological, they do not have to do neuropsych testing. And sometimes children can compensate pretty well with the educational and the psychological and you really don’t pick it up without the neuropsych stuff. But schools are not required to do neuropsych testing.

Debbie:

Right. So then that becomes the onus is on the parent to figure out a way to get the additional testing, which can cost a lot of money, right, to get an outside evaluation. Yeah. And you said in addition to pushing for, to being that tiger parent, to pushing for the evaluation, to ask for accommodation. So what would strong intervention in a school system look like? What are we?

Dr. Lisa Rappaport:

Yes, it can. It can.

Debbie:

What would be the ideal?

Dr. Lisa Rappaport:

So there’s no typical because it depends on what the child needs. And each child has their own profile. And based on the testing and the results of the testing, then they create an IEP, which would give the child accommodations based on what they need. Not every child needs extended time. Not every child needs the use of a calculator, but those are options, but it really depends on the results of the testing.

Debbie:

And I know that there’s technology that’s being developed all the time that can be supporting students with dyslexia. Are there any specific tools that you recommend in classroom settings for students who are struggling with dyslexia?

Dr. Lisa Rappaport:

Not necessarily in the classroom. There are, I mentioned, tools in the book that children can use. I mean, it depends on the child because it’s hard for me to wrap my head around the fact that a child can actually learn from a computer because I, as a child, just needed someone to sit next to me and literally show me things and demonstrate. But this generation has grown up with computers, so their brains are more adaptable. And there are definitely websites that you can go to and apps that you can go to that will quiz a child and explain math to a child. I don’t know that I could have learned it that way. So it’s hard for me to understand how children who are dyslexic, but they’re doing it. So I guess children that have grown up in the computer age are finding some of these apps and they are mentioned in my book that are helpful. I always think one-to-one is the best. I always see patients in person, you know.

Debbie:

I’m curious, I don’t know, I’m just thinking about all the tools that are available now too in terms of AI and voice to text. Do you feel like the needs for dyslexic humans have changed or are there some things now that because of all the tools available, there are some skills that dyslexic people don’t need to learn?

Dr. Lisa Rappaport:

So I’m really old fashioned in that way. I really want children to know they can learn and they should learn. And yes, you can have a calculator, but I still think children should have to learn how to do math and how to multiply and learn math facts. And children should still learn to read, even though they can have someone read to them for the rest of their lives. And they should learn to write because they’re capable. And I think there is something with self-esteem that diminishes if you have to rely on an instrument to do that for you. And it is definitely hard, but it is definitely worth it. It is worth it for your independence and it’s worth it for their self-esteem. And so I am a stickler that they should get the interventions and the accommodations, but they should still be expected to learn the skills.

Debbie:

Okay. All right. I just had to ask, it’s where my brain went. I’m so curious, because we are living kind of in the Wild West when it comes to what’s available. Yeah.

Dr. Lisa Rappaport:

Yep, yeah, definitely.

Debbie:

So you have a whole chapter in the book on things parents can do at home in the family to support a child’s learning. And so do you have any best practices? You’ve talked a lot about your moms being such a support for you as you were living at home and navigating all of this. Any best practices for parents who want to help their kids kind of grow their skills in ways that feel really empowering, but not like, my gosh, you know, I got to get my kid on track.

Dr. Lisa Rappaport:

I think, well first of all, organizational skills are really important because again, one of the subtle signs of dyslexia is sequencing skills. And just like I said, when they were little, if they can’t tell you a story from beginning to end or what they did, that’s a sequencing skill and so is organization. so dyslexic children tend to have trouble organizing themselves. It could be their bedroom, it could be their desk at school, and it could be their homework or their backpack. I’ve seen a lot of backpacks that need organization.

So I think helping your child stay organized without nagging them, but teaching them is a really important skill that will take them very far. Also, I think sharing your own difficulties and failures. I think a lot of times parents want to seem perfect to their kids, but in the long run, it does them a disservice. And it’s better to just say, you know what, I didn’t do well in biology or I had trouble with this skill when I was growing up or I totally failed at this and this is what I did. So I think having a running dialogue so that you’re not the perfect person, but you teach them how to pivot and also not stressing grades because, and a lot of parents are very stressed when their child gets a bad grade, but the truth is it’s then what moment, then what? So you, you failed Spanish today. You came home with an F on your Spanish test. Now what? Now what’s going to happen? What will happen tomorrow? And the answer is not much. Maybe your grade went down a little bit, but nothing so terrible is going to happen. You’ll learn the material that you missed. Also I think, I mean, I could go on and on about this, plugging your child into something that they’re good at so that they do derive self-esteem in an area where they’re naturally talented is really important.

Debbie:

Yeah. I mean, you have a whole chapter in the book also called practices for bolstering self-esteem, which I really appreciate it again because of the shame we talked about earlier and the stigma and the toll that it can take on kids. wanted to just also mention, you’ve said a couple of times the sequencing and the organizational. So of course that to me, I would put that in the executive function bucket, but obviously students who are dyslexic, people who are dyslexic, hand in hand with that are executive function challenges, is that right? Yeah, okay. Yeah, okay. So before we wrap up, just, there was something you shared in the, was at the end of your book, you tell a story about yourself as a high school student and a question that a teacher posed to you that was a turning point in your life which I wrote down here, the teacher said, you’re either not trying hard enough or you’re stupid, which is it? And I read that I was like, Whoa, and that was a defining moment for you. Would you just tell us a little bit about that moment in your life and how it changed you?

Dr. Lisa Rappaport:

It was junior year of high school. It was a very rigorous school and it was actually the dean who called me into her office to say that I was being put on academic probation because I was failing chemistry. I was getting a D in trigonometry and I was getting a D in Spanish too. And that’s when she said, we’re putting you on academic probation. I had been at that school my entire life and she said, so you’re either stupid or you’re not trying. What’s going on? And I did leave school that day and told my parents, at that point I was 16. I had always hated school and I really hated school in high school. But that was the point where I came home and I said, I’m absolutely quitting. I am 16. I don’t want to do this anymore. And my mom and I had been going at it for so many years and she finally said quit. I can’t do it either. And once I was on academic probation, you know, that was the end of it. And I spent that entire weekend with a friend who was in college, he was home for the weekend and we really talked it through. And he was very good at saying to me, well, what will your life look like if you really don’t go back to school Monday? And what will it look like if you do? What will happen? And we went through my options and we realized I hit rock bottom and I really had nowhere else to go but up. So that Monday for the first time, my mother did not wake me for school. I woke myself, I got myself to school, and I went for myself. And I decided I really had nothing left to lose. I was just gonna do my best and try to get a high school diploma.

Debbie:

He’s a good friend.

Dr. Lisa Rappaport:

He’s very good, still my friend. And I have to say it’s still the hardest degree I ever earned was my high school diploma.

Debbie:

And of course you continued to get a PhD. So you obviously turned things around.

Dr. Lisa Rappaport:

And I eventually went to Penn, University of Pennsylvania, because I was so determined to have somebody else validate me. I did not feel validated. Having my mother tell me that I was smart was not enough for me. I was determined to go to an Ivy League school for myself, because in my mind, that meant I was smart.

Debbie:

Yeah. Wow. Thank you for sharing that. That really struck me. read that story, you know, as a very, very much a C student myself who really dislikes school as well. I read it with much interest when I saw that. So let’s wrap up. I just want to name the book again. It is called Parenting Dyslexia, a comprehensive guide to helping kids develop confidence, combat shame, and achieve their true potential. And is there any last kind of thoughts you want to leave listeners with if they have kids who are dyslexic or they suspect their child has dyslexia, what would you want them to take away from this?

Dr. Lisa Rappaport:

I’d let them know that this is just a point in time. That dyslexic children don’t thrive in high school or lower. They thrive in life but not when they’re younger. And to just remember it won’t always be like this. It will get better, it will get easier, and they will thrive. It just isn’t their time in high school.

Debbie:

That’s great. Thank you. Thank you so much. And congratulations on the book. And yeah, thank you for everything that you shared today.

Dr. Lisa Rappaport:

Thank you, I appreciate it.