Is Your Child Showing Exceptional Reading Abilities? It Could Be Hyperlexia

by Yashoda Hospitals | Aug 27, 2021 | Pediatrics

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When a child starts reading early and surprisingly beyond their expected ability it is called Hyperlexia. This is often accompanied by an obsessive interest in letters and numbers, which tends to develop as an infant.‌ Often, but not always, Hyperlexia is part of the autism spectrum disorder (ASD). It’s considered a “splinter skill”, a unique skill that doesn’t have much practical application. But therapists can often use a child’s hyperlexic skills as a tool for their therapy and treatment.

Causes of Hyperlexia

Among children with autism, about 6% to 14% have hyperlexia though not all people with hyperlexia have autism.
Approximately 84% of children with hyperlexia have autism and approximately 1 in 54 children have an autism spectrum disorder.
Hyperlexia has subtypes, only some of which overlap with autism.

Symptoms of Hyperlexia

Hyperlexia I: It happens when children developing without disabilities learn to read early and far above their expected level. Because other children eventually learn to read and catch up, and this condition is temporary.
Hyperlexia II: This type of hyperlexia occurs in children with autism. They are often obsessed with numbers and letters, preferring books and magnetic letters over other types of toys. They also frequently remember important numbers such as license plates and birth dates. These children usually have more typical signs of autism such as avoiding eye contact, lacking affection and being sensitive to sensory stimuli.‌
Hyperlexia III: This type is like hyperlexia II, but the symptoms decrease over time and finally disappear. Children with hyperlexia III generally tend to have excellent reading comprehension, but their verbal language development may be behind, and they also have remarkable memories. As compared to children with autism, children with hyperlexia III easily make contact and are outgoing and affectionate.

Treatment for Hyperlexia

Hyperlexia 1 is not a disorder as such and does not require nor warrant a diagnosis. The differences in intervention strategies, educational placements, outcomes and long term implications of an ASD diagnosis warrants caution when applying an ASD diagnosis to a child who reads early, or speaks late. (more about late speaking children later). While early diagnosis and intervention must be applauded for all children with developmental delays, if the child has hyperlexia as a presenting symptom and ASD is a possibility, a differential diagnosis approach should be considered before applying a definitive diagnosis of ASD. A period of watchful expectation will eventually reveal the natural history of the disorder and whether the hyperlexia falls into type 2 or type 3. Children with hyperlexia type 1 don’t require to be treated.

Hyperlexia 2 and 3: Three interventions have been reported to be especially helpful in children with hyperlexia 2 or 3. These include speech and language therapy, occupational therapy and play-based ABA (applied behavioural analysis). A sound treatment program using the child’s strengths and interests to help with areas of weakness is vital to success. Therapists who are open-minded, willing to adopt the child’s goals and curriculum, and creatively and cooperatively solve problems are best suited to deal with the unique challenge these children present. Finding the right people to implement the child’s treatment plan is critical to success.

The most important aspect to remember is to use written language to help teach the child the skills they need. When in doubt, write it out. This empowers the child by building confidence and reducing stress as they stay within their comfort zone during the learning process.

The main and critical difference in intervention between children with hyperlexia 3, as opposed to hyperlexia 2, has to do with education placement. Children with Hyperlexia 3 benefit from being fully integrated into their classroom, with peers of the same age. Alternative placements usually provide few appropriate communication partners and less opportunity to engage in social communication. Hyperlexia 2 children, in contrast, most often benefit from alternative placement in special education classrooms because mainstream classrooms may be too over-stimulating and course material may be better taught and learned in more relaxed one on one arrangements.

Education placements must be individualized in either group taking into account each child’s skill set. Often parents need to become very active advocates on behalf of their children to obtain the most optimal school placement.

Occupational therapy for Hyperlexia

Occupational therapy is specialized for each person, but the occupational therapist always works on any areas of difficulty, which may include; Sleeping, Feeding, practising self-care, participating in school activities, participating in social activities, writing and responding to sensory stimulation appropriately. The first step in the treatment is to make the right diagnosis. When a child presents with hyperlexia, that diagnosis is best made by a multidisciplinary team familiar with Autism spectrum disorder (ASD) and the several forms of hyperlexia described above. If the diagnosis involves an ASD consideration, that diagnosis should best be listed as a differential diagnosis until the passage of time reveals the true nature of the “natural history” of the disorder. i.e. whether the hyperlexia fits the hyperlexia 2 or 3 categories. Such a workup would generally occur at a child developmental or similar clinic and the multi-disciplinary team would ordinarily include a speech and language therapist. The final diagnostic findings would be shared with the school team responsible for the Individual Education Plan (IEP) for appropriate education decisions. And such work up would provide the right foundation for such other interventions.

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