Saturday, 19 December 2009

The great dyslexia swindle

How refreshing to see that the commons science and technology select committee has been blunt in condemning attempts to classify difficulty in learning to read as though it were some sort of illness. This particular bandwagon has been rolling for far too long and it is about time that somebody spoke out against it.

Dyslexia is a word used to describe difficulty in reading or learning to read. Until a few decades ago, it was only used in connection with patients who had suffered brain damage as a result of trauma or a stroke. Such individuals might develop problems in reading or recognising words. Some of them also suffered from dysgraphia. This can result in people being unable to write coherently, their attempts being largely indecipherable gibberish.
Somewhere down the line, the terms started being used to describe those who had trouble reading and writing for other reasons besides brain damage. Chief of these reasons were poor education or inferior teaching.

Most children learn to read and write fairly easily if they are taught properly. Some have difficulties doing so. These can mean that a child has problems spelling or remembering the correct sequence of letters which make up a word. At one time, we would have described such children as poor readers or even as being illiterate. The remedy was always the same; more and better teaching. Gradually, it became quite the fashion to dignify this sort of illiteracy or semi-literacy as a medical condition. Interestingly though, the remedy for this supposed disability remained exactly the same; more and better teaching.

This is the most fascinating aspect of the whole dyslexia racket. Whatever you call it and whether you think it is an illness or a result of poor teaching, it is treated in the very same way. Systematic instruction in phonics, combined with masses of practice at reading and spelling until the child begins to get the hang of the thing. Since this is so, it is worth asking why on earth it was thought necessary to create something of an industry around reading problems. We know how to help children with such problems, we have known for years, why not just get on teaching them and helping them to become fluent readers? There are two main reasons.

Firstly, by pretending that there is something wrong with the child's brain, it lets teachers off the hook. If all the children in the class have normal faculties and sound brains and yet some of them are not learning to read properly, then the teaching is at fault. We need to ask ourselves if there can be a better way to teach reading. If on the other hand some of the kids in the class have brain damage, then it's not the teacher's fault if those children don't learn to read at the same time as everybody else.

The second reason is that being the parent of a slow or illiterate child is not a particularly appealing prospect. Far better if one's child is struggling bravely against a specific learning disability. So it is in the interest of both teachers and parents to go along with this whole thing, it makes both feel better about it all.

As I say, it does not really signify, because even if there really was a disorder of the brain called dyslexia, the treatment will be pretty much the same as it is for the more common problem known as illiteracy. I am on principle opposed to the multiplication of syndromes in this needless way. It violates both Occam's Razor and my own sense of economy!


  1. "the remedy for this supposed disability remained exactly the same; more and better teaching."

    And/or different teaching, not all methods suit all of the people all of the time, it is stunning how limited some educator's repertoire is. You can get plenty of kids (and adults) over a "hump" by changing approach.

    I wish the remedy here was different/better/more teaching. I have been close to tears on more than a few occasions where the support teacher (sometimes supporting during the lesson in the class, sometimes teaching one on one in a separate room) who thought the best approach was to huff, puff, shout, belittle, do it for them, be antagonistic. There was one in particular that I wanted to slap, I wouldn't normally wish terrible morning sickness on anybody, but hers was so bad that she had most of the pregnancy off sick before taking 18 months maternity leave, and it was an absolute blessing for the kids she was "supporting".

    As things go I actually prefer a non judgmental label like dyslexia when compared to the "thick", "stupid" and "lazy" I got stuck on me when I ably demonstrated myself to be rubbish at spelling and writing. I'm not diagnosed dyslexic, but it was only after it was suggested as a possibility, when I was 11 or so, that my parents stopped haranguing me and I got some help to get me over the hump and give me strategies to overcome the worse of it in production. Nobody used it as an excuse to give up on me or allow me to give up on accuracy, but it took away a lot of the negative overtones that were making things worse due to my state of stress and tension.

    I'd be cool with an alternative non judgmental (i.e. nothing with "poor" "failing" or "bad at" in it) label where dyslexia doesn't fit the problem in hand, but would be distinctly underwhelmed at any suggestion of going back to the bad old days. I remember how small and stupid I felt and that is a terrible way to make a child feel about themselves. Not to mention counter productive.

  2. ‘Somewhere down the line’ would be 1917, James Hinshelwood, who categorised acquired and developmental dyslexia. Then it was all of 30 years since Dejerine had published his description of Monsieur C’s complex and progressive acquired dyslexia. Samuel Orton did further research in the US in the 1920s and 30s. I suppose you could describe it as ‘a few decades ago’.

    To be sure, most children do learn to read and write fairly easily. But around 20% have consistently had trouble acquiring these skills. Why could this be? Well, of course there are psycho-social reasons. The parent doesn’t encourage, or even disparages reading. Or the child might not, as you put it, be taught ‘properly’. Additionally, the ability to read printed material depends on the efficient working of two sensory modes, the visual and the auditory. Children who have no vision cannot read printed text; children with no hearing can read text, but cannot link the written symbols to the spoken word. A child with no vision or hearing, like Helen Keller, for example, would need to use their tactile sense to make a connection between an object, action or idea and its symbolic representation.

    Ears and eyes are complex things, and take a long time to develop. Never mind the even more complex neural pathways transmitting visual and auditory information to various parts of the brain. Because of the number of possible genetic or environmental factors that could affect the development of ears or eyes, one would expect, on a purely statistical basis, to find significant abnormalities of visual or auditory function in at least 3% of the population (<2SDs from the norm) and noticeable abnormalities in about 15% (<1 SD from the norm). Because accurate reading requires a minimum degree of visual or auditory acuity, it isn’t surprising that around 15% of the population have problems with it. And with writing. And spelling. And arithmetic.

    The problem with dyslexia (the umbrella term) research, and the reason so many interventions have been found to be inconclusive, is that different children might have different abnormalities causing their reading difficulty, so one intervention, such as phonics training, might help children with some types of auditory processing difficulty, but might not address the reading difficulties of a child with, say, poor control of saccadic eye movements. An overview of the dyslexia literature, from Hinshelwood to Goswami, suggests that the majority of dyslexic children have auditory processing difficulties, with a significant minority having visual anomalies.

    I agree that inventing a disorder of the brain called dyslexia could let teachers or parents off the hook. But the dismissal of the idea of possible organic causes for reading difficulties, particularly when there is a substantial body of evidence to suggest that these exist, doesn’t explain why some children in a class, or a family, learn to read perfectly satisfactorily and others don’t. And I would be interested in a more precise definition of ‘slow’ and ‘illiterate’.


    Are you talking about the above report?


  4. My sister and I grew up in a house full of books, with parents who were avid readers. I was reading before I started school; she was not. She endured two or three years of systematic instruction in phonics at her prestigious private school, with plenty of extra help both at school and at home, and she still didn't learn to read or write. It was only when she was referred to a specialist dyslexia centre that she started to make progress. The problem, as she described it to me, was that the letters wouldn't stay still on the page for long enough for her to see what order they were in, or even what shape they were, and that she was so busy concentrating on trying to get them to stay still that she couldn't make sense of anything the teachers were saying about the sounds they made. She was also frightened and depressed by the constant pressure, and the constant failure.
    Now, at 46, she can read well enough to read a novel, albeit slowly, and write well enough to communicate, although her spelling is still erratic, especially when she's tired. She can't read aloud to her children, and she needs help to write official letters and fill in forms. She confuses left and right, misdials phone numbers and reverses letters when she writes.
    Interestingly, she is extremely artistic and her spatial awareness is highly developed. She has a very successful career as a theatrical costume maker, and makes her patterns by eye, rather than by geometry. (Anyone who has ever tried this will know how dfficult it is to translate a 3-dimensional shape into a flat pattern piece, let alone to do it with the artistic flair that she has.) She also has a phenomenal memory. Her IQ measures roughly the same as mine, in the high 130's, if the tests are presented appropriately. She scores lower than me in some areas, and off the scale in others.
    Her self-esteem has always been low and she is only just beginning to realise that she isn't stupid.
    Alan Thomas's research finding that approximately 20% of home educated children are late readers correlates very closely to the 20% of children who leave primary school unable to read. This suggests to me that about 20% of children simply do not reach the necessary level of neurological development to acquire this skill until they are considerably older than the average, just as other children (like your daughter) can do it when they are much younger. Trying to force these children to learn a skill that they are simply not capable of learning results only in damage to their self-esteem and loss of their natural love of learning. The great thing about home education is that these children's learning is not held back by their inability to acquire one very specific skill at a particular age.

  5. A question for those here who are obviously very knowledgeable about dyslexia. I remember reading somewhere that forcing some children to read too early effectively causes some forms of dyslexia (it didn't state that it was the only cause). Is there any research to support this theory? It sounds logically possible but I know very little about dyslexia.

  6. Anonymous: reading is a compiled skill, one which has become automated. It can become automated only if visual and auditory input is consistent. If a child has inconsistent input (because of poor eye movement control or poor language acquisition because of repeated ear infections, say) it will take the child's brain much longer to form consistent pathways of neurones in order to read reliably. In my son's case, he sometimes reversed letters, inverted them, mistook some letters for others (m&h, l&j) and couldn't hear the differences between some sounds (b/d, br/bl), so for him the letter symbols weren't consistent and he kept getting the sounds 'wrong' without knowing why - he didn't hear them like his teacher did.

    If a child with unreliable sensory input is pushed into reading before they are physically ready, they are quite likely become very resistant; reading simply doesn't produce a pattern, and is confusing. If their errors are consistent, they can develop pathways of neurones which will be automated to produce the wrong outcomes (my son read all consonant blends as their initial letter, so formed a pattern where b,bl & br all spelled b - it took a while for this to be unlearned.)

    As for research - the dyslexia research is dominated by the idea that there is a single brain condition called 'dyslexia'. Many researchers subscribe to this idea and get very confusing results from their work. Others think it's a pile of junk and that teachers should teach properly. Anyone who argues that there isn't a 'thing' called dyslexia is automatically assumed to be in the second group, even though they might be saying 'there isn't a 'thing' called dyslexia, dyslexia is an umbrella term encompassing lots of organic abnormalities that lead to problems with reading'.

    I haven't come across any research that demonstrates this specific problem, but in general the dyslexia research is way behind cognitive neurology on this and cognitive neurologists are focussing on how 'normal' mechanisms work.

  7. Suzyg, when I said, with reference to dyslexia, "until a few decades ago, it was only used in connection with patients who had suffered brain damage", I meant this to be understood in terms of general usage. Before the 60s, the only textbooks which contain references to dyslexia are works on neurology for those dealing with damage to specific areas of the brain. There is no use of the word in textbooks on the teaching of reading. The term used there for children who are slow in acquiring literacy is of course "Educationally Sub-normal" or ESN for short. The rot set in with the Plowden Report and the move to open plan classrooms in primary schools. At about this time, the late 60s and early 70s, it became fashionable to attribute reading problems to causes wholly unconnected with teaching. ESN began to be seen as a pejorative term and the fiction was adopted that reading difficulties had nothing to do with teaching but were a result of this mysterious malady known as dyslexia. Look at a few books on reading published in the 50's and then at a few from the 70s and you will see what I mean.

    Strong evidence that this is nonsense can be seen from the epidemic of dyslexia that we saw during the height of the "Real Books" method of teaching reading in the late 80s and early 90's. Some schools, including many independent ones, were immune from this virulent outbreak of dyslexia. The teaching of reading by means of synthetic phonics seems to provide some protection from this disease!

    I am, by the way, always a little suspicious of supposedly neurological disorders such as dyslexia and ADHD which cannot be diagnosed except by the behavior and conduct of the victims. The so-called Minimal Brain Dysfunction or MBD was a good example of this although less commonly used these days.

  8. Erica, I don't doubt that some children have trouble learning to read and never really take to it, even in adulthood. Like most people, I have friends and relatives in this condition. I can't see any need though to invoke neurology as an explanation! If you try and get a young child to do anything in the wrong way, it can make her resistant to that particular aspect of learning. Imagine if one were to insist on teaching calculus to a seven year old. Suppose one badgered and hectored at her when she could not quite grasp the idea of integration. I would not be at all surprised in such circumstances if you were to put the child off mathematics for life. This would not be a neurological difficulty; it would be lousy teaching methods. I have certainly known this happen with the teaching of reading.
    I have noticed that those like my daughter who are taught very young in a certain way, do read very young. I have also noticed that those who are not taught systematically tend to be late readers. In tha absence of hard evidence from neurology, my guess is that this is a teaching difficulty and not a brain disorder.

  9. Simon, I quite agree that teaching methods might have led to a wrongly attributed cause for reading difficulties. However, the fact that teachers were not aware of the research literature from the 1920s and 1930s on sensory deficits is a poor excuse for consistently failing to support appropriately around 20% of the population. The flaw in the 'poor teaching' argument is that the distribution of children with reading difficulties appears fairly even. Most teachers report stubborn problems in some children. And many families with children with stubborn reading problems have other children, taught by the same teacher, with no problems. How come the other children learned to read without difficulty?

    In your comments to Erica, you say that there is no need to invoke neurology as an explanation. That's true only if there is no neurological evidence explaining the problem. There is a substantial body of evidence suggesting that visual and auditory processing difficulties lead to difficulties with reading acquisition. You can't just ignore this evidence on the grounds that it is simpler to suggest that poor teaching methods are to blame.

    And one can't determine whether one's teaching methods are 'good' or not, until one has an idea of the nature of the problem in each child. Arbitrary dismissal of neurological explanations for reading difficulties is risky, because people without a background in biology might be tempted to conclude that bio-medical causes *cannot* be to blame, as distinct from not being to blame in all cases.

  10. It's not really a question of my dismissing neurological causes, more a case of their being irrelevant. In the 60s, if a child was not reading by a certain age, certainly by the end of primary school, he would quite possibly be classed as ESN and placed in remedial classes. Leave aside for a moment the stigma of this for a child, and focus on what would typically happen in such a class. All the activities are precisely the same as we would now use with a child who had been diagnosed as suffering from dyslexia. In other words, the introduction of a new diagnosis has not made treatment any simpler or indeed changed it at all. From that point of view, it is an unnecessary hypothesis. There is some neurological evidence, but it is usually from subjects who have already been diagnosed as suffering from the disorder. This is a fatal flaw in the whole idea, by the way. In other words, they are taking people who are already known to have reading problems and then examining brian function. Any abnormality is then announced as the "cause" of the reading problem. This is putting the cart before the horse. Other people have precisely the same abnormalities and do not have reading difficulties.

  11. Actually, thinking it over, it would be very interesting to stage a double blind test of this neurological idea of dyslexia. What would be needed were two groups of children, one with reading difficulties and one group without. Then we could take the children to neurologists and see whther they could say which children had reading problems, based purely upon the examination of their brains. I'll warrant that they would not be able to do so!
    What happens is that a child who is known to have difficulties in this area is taken to a specialist who runs all sorts of tests. The guy then finds deficits in various areas and claims these as the cause of the reading problem. You might as well blame the colour of the child's eyes. Until some method is devised whereby neurology can diagnose dyslexia without anybody knowing beforehand the nature of the problem being investigated, I shall remain sceptical. It is worth remembering also that many children have huge problems with their brains, like a third of the brain being missing and still show normal development.

  12. "I am, by the way, always a little suspicious of supposedly neurological disorders such as dyslexia and ADHD which cannot be diagnosed except by the behavior and conduct of the victims."

    Not so long ago MS could not be diagnosed and was considered a mental illness or hysteria. Just because something cannot be diagnosed yet, doesn't mean that it will not be in future. It's surprising how much there is still to learn about the human body when you look at medical conditions. I mean, they don't even know what causes diabetes despite it being recognised as a condition for three and a half thousand years, so why are you surprised they do not understand things like dyslexia or ADHD yet?

    "I have also noticed that those who are not taught systematically tend to be late readers. "

    Plenty of people also know those who have not been taught systematically and have read early. How have you reached the conclusion that there is a tendency for them to be late readers? Can you site research? The numbers in the Alan Thomas' study correspond to late readers in schools yet very different approaches were used.

    "Then we could take the children to neurologists and see whther they could say which children had reading problems, based purely upon the examination of their brains. I'll warrant that they would not be able to do so!"

    This assumes that our technology is advanced enough to recognise what might be relatively minor differences. As with MS it may just be too soon to expect results.

    "Until some method is devised whereby neurology can diagnose dyslexia without anybody knowing beforehand the nature of the problem being investigated, I shall remain sceptical."

    Why sceptical, why not just suspend judgement until we know better? The people with MS who were diagnosed as hysterical would probably have been happier and suffered less if doctors had taken a more neutral approach with their diagnosis.

  13. "Can you site research?"

    Or even cite, LOL!

  14. "Other people have precisely the same abnormalities and do not have reading difficulties". Interesting to see some evidence for that. Do you have figures for literacy levels for school leavers from 1880 to say, 1980?

    "Until some method is devised whereby neurology can diagnose dyslexia without anybody knowing beforehand the nature of the problem being investigated, I shall remain sceptical." You could start by brushing up on what methods have been devised to date; Price & McCrory in Snowling & Hume's book 'The Science of Reading' has a useful literature review. And Franck Ramus has a nice accessible chapter in the 3rd edition of Gazzaniga's 'Cognitive Neurosciences'.

    Again, I agree that the majority of children with reading difficulties will be helped by what you describe as 'good' teaching, but dismissing the need to look any further is a bit tough on children who actually need intensive speech therapy, audiological interventions, vestibular exercises or modulated blue light (affects dopamine levels). As I said before, subtle visual and auditory deficits are not included in screening tests, and few teachers are aware that such things exist, which means that children with multiple sensory processing abnormalities can struggle on through good teaching and bad, until they finally reach specialist ophthalmological or auditory services when they are 9 or 10.

  15. Hmm, I am not sure that I am about to make much sense... in fact I am so bogged down by the perils/delights of Christmas I am not sure that I can make coherent sentences anymore.....but I do know that my dd who does have an auditory processing disorder (which has sort of morphed into a diagnosis of autism) and who did in fact have neurological proof of something odd going on (should please you Simon!) in that an ABR under general anaesthetic gave consistently peculiar results for several years, until the responses became normal (explanation from worthy expert consultant was "neurones had matured!")- yet this dd read without much trouble and without much need of phonics. She does however have the classical autistic lack of comprehension sometimes, but that is another matter! Whereas another dd who is supposed to be entirely normal struggled with reading and needed lots of good phonics teaching to master it, and still isn't great at spelling. Don't know what that proves, except that there is always an explanation for everything.

    I do agree though that not everything diagnosed as dyslexia is in fact that, and schools have a lot to answer for in some cases

  16. "Don't know what that proves, except that there is always an explanation for everything." - should have read " there isn't always an explanation" - sigh...

  17. >>>>>>>I am, by the way, always a little suspicious of supposedly neurological disorders such as dyslexia and ADHD which cannot be diagnosed except by the behavior and conduct of the victims.<<<<

    Mmm...same can be said about autism, which is why it took so long for a neurologist to diagnose my dd with it. It would be much easier if there were a simple blood test, as with Downs, but there isn't. So, we have to observe, record, analyse, compare and assess over time. There is nothing wrong with that method.

    The problem arises when people who are simply not qualified to make the assessment hand out terms which may mislabel a child for life.

    I agree with much of what you say about Dyslexia, though. It is usually a failure of teaching. However, there are some children with other additional behaviours, such as extreme dyspraxia, who do seem to be having something going on in their brains other than just the result of poor phonics teaching.

    Mrs Anon

  18. The trouble is with neurological causes, Mrs. Anon, that nobody usually carries out tests on children who have completely normal development which is giving no cause for concern. So that an investigation is carried out via MRI scan or EEG because a child is suffering from epilepsy, say, or some other problem. When they discover that there is partial agenesis of the corpus callosum or a ventricle on the right side of the brian, it is then announced that this is the "cause" of whatever was being investigated. However, such abnormalities occur in children with normal development as well.
    So for example in a case known to me of a child who had a brain scan to find out the cause of her epilepsy, it was found that she had a large ventrical on the right side of the cerebrum which meant less brain tissue on that side. This girl was a perfectly normal reader for her age and had no other problems aprt from her epilepsy. However, I have seen precisely the same thing show up on a child with severe "dyslexia" and dyspraxia and this was then announced as the "cause". The same thing happens with EEGs. Some children who are late reading show great immaturity on the EEG and this is suggested as a reason for their delay in reading. Other children have the same immaturity and are reading perfectly well. It can sometimes happen that when we know already the nature of the problem, then we are apt to find a cause when we look at the brain.

  19. Simon, you're quite right to point out that a brain abnormality is not necessarily the cause of a behavioural difficulty. Nor does a brain abnormality necessarily interfere with reading. The brain areas involved in reading are extensive, but they are also specific. Children who have had half their brain removed because of severe epilepsy can still develop more or less normally, because of the duplication of function in the hemispheres and the high degree of plasticity in the young brain. Damage to a specific area required for reading, or damage after reading is already acquired, can produce a different picture.

    It is important not to overlook the issue of brain development. It isn't only brain damage that can cause reading difficulties; as I pointed out earlier, abnormal sensory input can lead to abnormal development of the brain.

    I would be interested in research showing that the pattern of the abnormalities seen in 'dyslexic' children has also been found in normal readers. That is not what has been found in the dyslexia research; see the papers I cited yesterday.

  20. yeah, no, tbh if you'd had the experience of teaching a dyslexic child to read i doubt you'd be questioning whether, at the least, some kids have serious and persisting difficulties with reading which don't correlate to their abilities in other areas. The thing is, I'm assuming you have only really taught one child to read-your daughter. Its easy to extrapolate out from that and assume everyone else is doing it a bit wrong. Honestly, I have three kids, after teaching the first two to read early and feeling very smug about it, I really thought dyslexia was a bit of a scam. Enter my third child. Really, dyslexia is real, and to a bookish intellectual family it really is a curveball. But its not an excuse for anything. Actually, my youngest, dyslexic, child has always been told that she needs to work that much harder, that she needs to make sure she can read, because honestly, in this life, no one will make allowances for dyslexic once you are over 18.

  21. Hey I know this is off topic but I was wondering if you knew of any
    widgets I could add to my blog that automatically tweet my newest twitter updates.
    I've been looking for a plug-in like this for quite some time and was hoping maybe you would have some experience with something like this. Please let me know if you run into anything. I truly enjoy reading your blog and I look forward to your new updates.
    my site - What is addiction?

  22. I really like it when individuals get together and
    share thoughts. Great website, stick with it!
    my site: usa bank account with atm card