How does one treat learning disabilities – especially dyslexia – and what about the occurrence of attentional problems that may confound these learning difficulties or provide social adjustment difficulties?

Whether or not there is any treatment will depend upon the severity of the condition. And what the treatment will be will depend upon its type. At the very least, it requires understanding on the part of both the educational and home environment. The first steps are always behavioral – how can we make the classroom setting optimal for this learner to optimize his/her attention or specific skill acquisition in reading, spelling or arithmetic? From a medical standpoint, if these prove ineffective alone and severity is great enough, and also if one has a safe and can prove there is an effective form of treatment, then a variety of medicinal approaches may be of assistance.

For attentional problems, psychostimulants or other classes of medicine that favorably influence the metabolism of the transmitter in the brain called dopamine can be considered. These include Cylert, Ritalin, Dexedrine, Adderall, and Desoxyn among the stimulants; and among the non-stimulant agents, Wellbutrin, Prozac or Zoloft may simulate or facilitate dopamine metabolism while elevating mood in those who are depressed or assisting in obsessiveness in those with obsessive-compulsive symptoms. Their effect can be measured in the case of the psychostimulants (other than Cylert) in one hour and for Cylert in three days. In the case of psychotropic agents, results can be measured in a matter of two to four weeks. When specific problems occur in reading, there may be an advantage if there are attentional problems in the use of Cylert over Ritalin based on studies we have done in the recent past. But Cylert carries the risk of potentially injuring the liver, whereas the other stimulant agents do not. It also has the advantage that a single dose in the morning tends to last the entire day. This lessens the necessity of the student to take a medicine in school, which is something, particularly older children, dislike intensely.

Reading instruction research shows that phonological awareness training is essential, and in some instances helping brain processing speed of speech sounds as is fostered by the Fast Forward program can be attempted. But the agents Piracetam and Hydergine are agents which for some individuals facilitate verbal processing, i.e., speaking, and also in processing reading. These agents, however, take anywhere from two to four weeks to help. Agents which may be helpful to memory and sometime facilitate academic performance, are phosphatidl choline (trade name for one of the agents we have used called Phoschol 900). Its effectiveness in improving memory can be measured in one month's time.

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