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The Principles of the Orton-Gillingham Approach

Structured

Every lesson in Orton-Gillingham is organized around a consistent set of strategies, activities, and patterns. The student always knows what to expect throughout each lesson. Students easily transition from activity to activity since they are familiar with the routine, creating an anxiety-free environment for both the student and the teacher.

Sequential

Each skill is taught in a logical order or sequence. The student starts by learning simple word patterns (CVC) and then progresses gradually, step by step, to more difficult and complex ideas, including vowel patterns, multisyllabic words, spelling rules, affixes, and morphemes. Because all the teaching skills are taught from the ground up, the student will not have any reading or spelling gaps in Orton-Gillingham. 
See a sample of Scope and Sequence.

Cumulative

Each Orton-Gillingham lesson builds upon itself. The student is taught a skill and doesn't progress to the next until the current lesson is mastered. As students learn new material, they continue to review old material until it is stored in the student's long-term memory.

Explicit

The teacher is at the center of instruction in an Orton-Gillingham lesson. The instructor teaches the student exactly what they need and never assumes or guesses what the student already knows. This method uses a lot of continuous student-teacher interaction in each lesson.

Multisensory

In an Orton-Gillingham lesson, the teacher uses the student's sensory pathways: auditory, visual, and tactile. For example, the student might first look at a picture of an apple when learning the vowel "a." They then close their eyes, listen to the sound, and trace the letter in the air while speaking aloud. This combination of listening, looking, and moving around creates a lasting impression on the student.

Systematic Phonics

Orton-Gillingham includes systematic phonics, beginning with the alphabetic principles in the initial stages of reading development and advancing to more complex principles as the students progress. Students learn that words are made up of individual speech sounds, and the letters of written words graphically represent each of these speech sounds.

The Science of Dyslexia

Physicians began researching dyslexia in the late 19th century. However, the cause of this condition, which makes learning to read and write unexpectedly difficult for some people, remained a mystery for over a century.
In recent decades, genetic research and brain scans using functional magnetic resonance imaging (fMRI) on individuals with dyslexia have shed light on this complex and often hereditary reading disorder. As understanding continues to expand, so do opportunities for individuals affected by dyslexia to become independent, fluent readers.

Research has found that individuals with dyslexia show neurological differences in their structure (gray and white matter) and function. Treatment studies have shown changes in the reading circuitry with effective instruction. fMRI studies before and after intervention show that gray and white matter changes (Keller et al., 2009; Krafnik, Flowers, Napoliello, and Eden, 2011) and brain function changes (Shaywitz et al., 2004; Simos et al., 2002; Temple et al., 2003; Eden et al., 2004; Meyler et al., 2009).

Dyslexia and the Brain

Guinevere Eden, Ph.D., professor and director of the Center for the Study of Learning at Georgetown University, and her colleagues were the first to apply fMRI to the study of dyslexia. In the video, Dyslexia and the Brain, created by Understood, she explains:

Which parts of the brain are used for reading
The differences in brain function between individuals with and without dyslexia
How the brain function of a child with dyslexia changes when proper reading instruction is implemented 

As noted in the International Dyslexia Association (IDA) fact sheet, Dyslexia and the Brain, magnetic resonance imaging (MRI) is a commonly used tool to capture images that illustrate:

Brain Anatomy (e.g., the amount of gray and white matter, the integrity of white matter)
Brain Metabolites (chemicals used in the brain for communication between brain cells)
Brain Function (where large pools of neurons are active)

The Neurological Basis to Dyslexia

There is a neurological basis for dyslexia. Meanwhile, an fMRI is based on the physiological principle that activity in the brain (where neurons are "firing") is associated with increased blood flow to that specific part of the brain. For example, while reading uses the entire brain, language tasks are more specific to the left hemisphere. 
The figure shows the left hemisphere of the brain and highlights areas used by typically developing readers with left hemisphere specialization for reading and language. An fMRI image will show areas of the brain that have increased activity while a reading and/or language task is being performed.
For example, imagine an individual performing tasks with real words and non-sense words while in an fMRI machine. Blood goes to areas of the brain that are activated during these tasks. With fMRIs, researchers can look at where the blood goes, demonstrating the activation in proficient vs. struggling readers. 
Although typically developing readers grow left hemisphere specialization for reading and language, one of the frequent findings in neuroimaging children with dyslexia is that they fail to establish this pattern. Instead, they develop an altered circuit involving greater reliance on the right hemisphere and frontal lobes.

Key Research Findings

Since 2000, key research findings have shown:

Biophysical and structural differences exist in the brains of individuals with dyslexia.
Developmental dyslexia is genetic.
Every individual has brain-based strengths and weaknesses.
Dyslexia is not related to intelligence.
Inherited genes, particularly those that may interfere with the development of specific fibers in the left hemisphere of the brain that are involved with mapping sounds and word/letter recognition, may predispose an individual to dyslexia.
Early intervention is best because the powerful plasticity of the brain in developmental years enables young children to more easily adapt to the Multisensory Structured Learning (MSL) learning method.
Research-based educational interventions create changes in brain circuitry.

Ongoing Research 

In its 2017 report, The State of Learning Disabilities: Understanding the 1 in 5, the National Center for Learning Disabilities (NCLD) notes that "new research is deepening our understanding of the differences in brain structure and function in children with learning and attention issues. Brain scans and other tools are also helping researchers measure the biological impact of instructional interventions on children who learn differently, including those with dyslexia, ADHD, and other issues." 
At the Gabrieli Laboratory at the Massachusetts Institute of Technology (MIT), ongoing research is being conducted in partnership with local organizations, schools, and clinics to provide solutions for parents, educators, and clinicians that work with children. 
Neuroscientist John Gabrieli, Ph.D., director of the Martinos Imaging Center at the McGovern Institute for Brain Research at MIT, is using brain imaging to study differences in children with dyslexia and how reading instruction affects the brain. Findings suggest that a combination of evidence-based teaching practices and cognitive neuroscience measures could prevent reading failure in most children that show signs of dyslexia at an early age. 

Research at Boston Children's Hospital's Laboratories of Cognitive Neuroscience focuses on children with or at risk for various developmental disorders, particularly language-based learning disabilities, such as dyslexia. Experts there in neuroscience, psychology, and education collaborate with clinical experts in fields such as developmental pediatrics and child neurology. 
In this space, Nadine Gaab, Ph.D., leads the Gaab Laboratory, where a team of researchers focuses on language, reading, and brain development in children with a family history of dyslexia and the connections between dyslexia and ADHD. Data derived from these studies will ultimately translate into earlier identification, improved therapies, and better outcomes for children with dyslexia, ADHD, and autism.
In their article, "The Emerging Field of Educational Neuroscience Is Changing the Landscape of Dyslexia Research and Practice," researchers Fumiko Hoeft and Chelsea Myers note that scientific research will continue to influence—and ultimately improve—teaching methods and curricula to enable students with dyslexia to thrive academically and personally.