Ayurveda for the management of dyslexia in children: Some caution required.

Sir,

We read the timely review article by Sharma et al.[1] on the potential role of Ayurvedic drugs in the management of dyslexia in children with great interest. Awareness about dyslexia has grown in our country in the last decade, especially in the megacities, leading to increasing number of afflicted children being detected.[2] Authors have reviewed experimental studies performed in animals and clinical studies performed in elderly demented people to report that Ayurvedic drugs such as Brahmi, Mandookaparni, Shankhapushpi, Jyotishmati, Ashwagandha, Jatamansi, Madhuyashti and Guduchi can help to improve the cognitive functioning of the brain, especially attention and memory.

However, with all due respect, we would like to mention that, until today, the only proven treatment of dyslexia is “remedial education”.[23] Using specific teaching strategies and teaching materials, the remedial teacher formulates an individual educational program to reduce or eliminate the child's deficiencies identified during the child's educational assessment. The child has to undergo remedial education sessions twice or thrice weekly for a few years to achieve academic competence. During these sessions, the child undergoes systematic and highly structured training exercises to learn that words can be segmented into smaller units of sound (“phoneme awareness”) and that these sounds are linked with specific letters and letter patterns (“phonics”).[23] The child also requires practice in reading stories; both to apply newly acquired decoding skills to reading words in context and to experience reading for meaning.[23] Because of the central nervous system's higher plasticity in early years, remedial education should begin early when the child is in primary school.[23]

Even in allopathic medicine, until date, there is no medicine to treat dyslexia.[23] A recent review of double-blind studies to investigate the role of piracetam, a derivative of the neurotransmitter gamma-aminobutyric acid, in the treatment of dyslexia has stated that findings have not been entirely consistent.[4] At best, piracetam can be used as an adjunct with remedial education, but it cannot replace remedial education as the standard of care for dyslexia.[4]

We acknowledge that Ayurvedic drugs may have an important role in improving attention and memory in dyslexic children, thereby enabling their learning potential. However, current scientific literature does not mention that Ayurvedic drugs can be a substitute for remedial education in the treatment of dyslexia.[3] We reiterate the concluding remark by Sharma et al.[1] and strongly urge researchers to carry out double-blind studies to investigate the role of Ayurvedic drugs in the treatment of dyslexia.