Pam Krueger writes a letter in the air like a land-bound sky writer.

She accentuates each arc and line as she writes in the air a foot in front of her face. The air stirs, but leaves no trace of the letters and words she writes.

For the students Krueger tutors, this exercise is a chance to focus on the movement of forming the letters. Some of her students have dyslexia, a language disability. It is caused by an inability to put meaning with letters and words.

With Krueger's help, they find ways to overcome the disconnect that keeps them from being able to understand language in ways most people can grasp. She is the owner of Every1Reading, a tutoring service in Bismarck that focuses on language disabilities. Her particular interest is in children with dyslexia.

Krueger moved to Bismarck in 2006 from Toronto, where she worked with her church's education department. She and her husband moved here so they could work the family farm near Bowdon.

The approach Krueger uses is called the Orton-Gillingham method. She uses it for early elementary to high school students. It is one of several methods available to help dyslexic people. It uses multi-sensory skills to teach reading.

"We write words in the sky," she said, as she demonstrated. "We say it (the letter) as they write it. It uses all the senses at one time."

When letters are drawn using the whole arm, the brain registers the movement differently than when trying to move a pen or pencil in the same shape, Krueger said.

Repetition and sound factor into lessons to help the students tie meaning to the letters and apply it to words.

The methods Krueger uses are similar to some of the tactics speech language pathologists would use with someone who has a language problem. Speech language pathologists are members of the medical community who work with people with language problems.

Krueger's lessons that apply sound to letters are important because that is central to helping people with dyslexia.

Dyslexia, however, isn't only a childhood disability. The symptoms of dyslexia can occur in some stroke patients, as well. St. Alexius Medical Center speech language pathologist Bobbie Houn uses similar treatment methods to help some stroke patients regain some of the language ability they lost. One woman Houn worked with could not distinguish the shampoo bottle from the conditioner bottle because she could not read it and she couldn't read things, like letters, that she would write.

"She sent me her favorite recipes and Iput them in pictures," Houn said, which was one of the ways she helped her patient adjust to her changed language ability. For example, in a recipe that called for two cups of an ingredient, she used a picture of a one-cup measuring cup and put it down on a piece of paper twice to represent two cups. With the treatment, the woman eventually reached a point she could read children's books.

"Dyslexia literally means poor language," Medcenter One speech language pathologist Tracey Lockrem said. "In the '20s, doctors thought it was a visual problem. Children of normal intellect and social skills couldn't read. That definition is still out there, but it is so far from that."

When a person has dyslexia, they cannot adequately process what they read - what their eyes see and what their brains think they see doesn't match up.

"Kids have a hard time understanding that the squiggly lines on the paper mean something," Medcenter speech language pathologist Cindy Neff said.

When Lockrem and Neff get a child with language difficulties, they check that the reading difficulty isn't caused by another medical condition, such as a hearing or vision problem. If it is dyslexia, they use exercises to build language skills in a new way. They start by helping the child link sound with the letters of the alphabet.

People can talk to their doctor to get an evaluation, if they think their child has a language disability. The school districts and the medical community offers resources to help children with these disabilities.

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@;bismarcktribune.com.)