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Developmental Dyslexia: Neurobiological Understanding and Policy Implications
김성구 대한소아신경학회 2026 Annals of Child Neurology Vol.34 No.1
Developmental dyslexia is one of the most common neurodevelopmental disorders, defined by persistent difficulties in accurate and fluent word reading despite adequate intelligence and educational opportunities. Advances in neuroimaging, genetics, and cognitive neuroscience indicate that dyslexia primarily arises from deficits in phonological processing and inefficient activation of the left-hemisphere reading network, particularly the occipito-temporal and temporo-parietal regions. White-matter studies further implicate reduced integrity of the arcuate fasciculus and related tracts, while genetic research has identified genes with susceptibility loci such as doublecortin domain containing 2 (DCDC2), KIAA0319, and roundabout guidance receptor 1 (ROBO1). Beyond phonological deficits, impairments in rapid automatized naming, working memory, and visual attention are common, and comorbidities with attention deficit/hyperactivity disorder and developmental language disorder complicate assessment. Nevertheless, higher-order language and semantic systems remain relatively preserved, allowing affected individuals to leverage intact comprehension abilities once decoding is supported. Recent studies have also emphasized potential cognitive strengths associated with dyslexia, including creativity, visuospatial reasoning, and narrative thinking, reframing the condition as a neurocognitive profile encompassing both vulnerabilities and assets. Clinically, early identification and intensive, systematic interventions, such as structured, phonologically based literacy programs, are critical for improving outcomes and preventing secondary emotional consequences such as low self-esteem, anxiety, and depression. Intervention studies demonstrate not only behavioral gains but also neuroplastic changes, including normalization of activity in the visual word form area and enhanced white-matter integrity. These findings underscore the importance of timely, individualized, and multidisciplinary approaches to diagnosis, treatment, and educational policy.
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