Amy Li's heart aches whenever she finds her son struggling without success to memorise the Chinese characters he has learned in school during the day.
"Once he asked me why he couldn't learn the words by heart and read properly like others. I didn't know what to tell him. I felt helpless," says Li, who has quit her job to spend more time helping her eight-year-old son, Alex, with his schoolwork.
Like many children with dyslexia, Alex cannot read fluently, nor write to dictation even after putting in enormous effort. He omits or adds extra strokes to the characters when copying, and finds it hard to make words fit in allotted spaces.
It is estimated that about 10 per cent of schoolchildren in Hong Kong suffer from different forms of specific learning disabilities (SpLD). Dyslexia is the most common of these.
Dyslexia is a reading disability that results from the brain not being able to interpret or recognise particular characters. The developmental disorder, which affects people with normal or superior intelligence, takes different forms. These become apparent with dyslexic children who struggle with Chinese, a language based on pictograms.
According to Dr Siok Wai-ting, assistant professor of linguistics at the University of Hong Kong, when reading English the brain maps a sound onto a letter. So words can be read even if they have never been learned.
But in reading Chinese, the brain maps graphic forms of characters onto a meaning. That often means memorising what a character sounds like.
"Phonetics is less important to learning Chinese characters. Few rules dictate when to pronounce what in Chinese. While certain components or radicals may indicate the pronunciation of a character, they are often unreliable. Moreover, there are many characters that sound the same, but look entirely different," Siok explains.
As Chinese characters consist of strokes, helping Chinese dyslexics to improve their visual-spatial function would be a better way to help them improve their reading and writing, she adds.
One way would be to help them become more aware of the structure of a character.
Li first noticed something different about Alex when he was in preschool. She noticed he was a poor reader compared to other children his age. She had him examined at a government health centre, where the results indicated he had developmental issues, without pinpointing the type. Li suspected her son was dyslexic, but it wasn't until last year when he was in the second term of Primary One that he was diagnosed.
Since most children in Hong Kong do not receive structured or formal reading and writing instruction in preschools, they are rarely diagnosed with dyslexia, says a spokesman for the Education Bureau (EDB). Youngsters are usually assessed for SpLD in reading and writing after they enter primary school.
But preschool teachers should refer to a resource kit available at the EDB website edb.gov.hk/ to identify the child's needs and adjust and modify their teaching activities accordingly, the spokesman adds.
The bureau has put in place an early identification and intervention programme for Primary One pupils with learning difficulties. Using a checklist, teachers start observing their students at the start of the school year and provide extra assistance to those who have trouble learning.
If the problems persist despite intervention, the children will then be assessed by the school's educational psychologist.
Professor Kevin Chung, head of special education and counselling at the Hong Kong Institute of Education, says teachers helping children with dyslexic problems are encouraged to break down their teaching routine into detailed steps, give students more time in tests and examinations, and use games and activities to help them improve their reading and writing ability.
"Teachers can adopt the 'multisensory' approach in, for example, teaching new words," says Chung. "They can help their students associate the word with a shape, or remind them of the core component. Then ask them to cover their eyes and imagine something that would remind them of the word, before having them gesture it in the air and write it down on paper."
In Alex's case, while he receives some support at school, such as a group session with its educational psychologist - twice a month, 25 minutes each time - to develop his reading and writing ability, Li feels more is needed. She sent Alex to classes at the Boys' and Girls' Clubs Association to improve his ability to read and write, while she signed up for a course at Polytechnic University to learn about helping dyslexic children.
Last summer, she also enrolled her son in a programme for the remediation of dyslexia at the Uncle James Child Development Centre in Central. Each week, Alex has been meeting an occupational therapist who helps improve his sensory integration function - the ability to organise information from areas such as the skin and muscles necessary to interact with the environment in a meaningful way.
Some dyslexic children have a weak sensory integration, and Alex is one of them. "When writing, they may not be able to fit words in a grid or on a line, and they often have difficulty creating the right amount of spacing between different components of a Chinese character," says Wendy Leung, the development centre's programme manager.
"The symptoms can be evident in everyday life, too. These children may seem clumsy; they knock glasses off the table; bump into others; and may trip themselves while walking. These problems stem from their inability to process spacing in their brain," she adds. Alex receives training to strengthen his visual perception - such as by drawing lines in a confined space - as well as to build up muscles.
Uncle James, an offshoot of the St James' Settlement charity, also offers speech therapy to help dyslexic children who have problems with sequencing, or difficulty in following more than two sets of instructions or putting things in order, which is also associated with dysfunction in sensory integration.
The centre also provides reading and writing classes in schools for children with learning difficulties. Social workers and psychologists use materials such as flash cards to help them better remember radicals or parts of words.
In 2011, the EDB launched a five-year project to support junior primary students with SpLD in reading and writing, using a tiered intervention model developed by the "READ & WRITE: a Jockey Club Learning Support Network".
The initiative brought local academics and non-governmental organisations together to design and implement more effective teaching approaches for youngsters with SpLD.
The first tier of the model entails teaching students - with SpLD or not - basic Chinese-language skills, enabling all to learn more effectively. The second level provides support to students with greater learning difficulties through small-group teaching.
According to Professor Connie Ho of the University of Hong Kong's psychology department, who is the principal investigator of the initiative, while many students in the second tier are dyslexic, some are poor readers or low achievers. The most intensive third tier offers individualised support to those diagnosed with SpLD. Ho says more than 100 primary schools have adopted the model.