Dyslexia: background part one

 

In today’s classrooms, children have to ‘read to learn’. Children who cannot read are ‘effectively disenfranchised’ (Department for Education, 2013:13). In the span of civilisation, however, mass literacy is a relatively recent phenomenon. Written communication began with a picture or sign to represent something and alphabetic writing came last (Clayton, 2013). The English language has a ‘deep’ orthography – it is phonologically opaque with an inconsistent grapheme-phoneme correspondence, which may exacerbate the difficulties faced by struggling readers (Malatesha & Aaron, 2006). Other languages such as Finnish have a transparent orthography with a one-to-one direct grapheme-phoneme correspondence.

Whilst language and literacy are linked, supporters of linguistic nativism (Chomsky, 1975) believe humans are born with the ability to speak. Perhaps not all humans are born with the ability to link speech sounds to their written representation? This seems to be the case with dys (difficulty), lexis (language), (Ott, 1997). Moreover, it would seem that dyslexia is as much a speech and language difficulty as one of reading and writing (Snowling, 2000b). Children may struggle to retrieve new words in speech and to sequence and articulate them. It seems that where dyslexic children are reading, they still struggle to spell and get their thoughts on paper.

Within the field of dyslexia, experts rarely agree (Elliot &Grigorenko , 2014). Whilst this makes for a lively debate, it is inhibiting research and understanding of the difference. It is a dynamic area of study, probably due to the fact that there have been many advances in the area of brain-based research. Within the field, the same issues are thrashed out: the relevance of IQ (Siegel, 1992), the importance of phonology (is this cause or effect?) (Nicholson and Fawcett, 2008) and whether dyslexia should even have a separate category within the field of reading difficulties (Elliot and Grigorenko, 2014).

Controversially, Elliot and Grigorenko (2014) would suggest not. In their book, they argue that because experts disagree on the cause of dyslexia, the term should be dispensed with. Ramus responded in an article (2014:3371) arguing that dyslexia is a ‘specific cognitive disorder’, he concluded that where a child does not respond to early intervention, dyslexia should be considered.

In support of this, dyslexia is largely constitutional in origin, there is a neurological difference, though the exact detail is not known. Within the left hemisphere of the brain, Broca’s area and Wernicke’s area are thought to be involved in language comprehension and processing. In non-dyslexics, these areas are larger than on the right. However, dyslexic post-mortem brains showed a symmetry, (Geschwind and Levistky, 1968). A study by Paulescu et al (1996) suggested a disconnection between the two hemispheres.

In dyslexic brains when reading, there is under-activiation in the left hemisphere and over-activation in the right (Shaywitz and Shaywitz, 1998), known as ‘the neural signature for dyslexia’ (Shaywitz and Shaywitz, 2008:1336). With the rise of the ‘read to learn’ style of classroom, dyslexic children are placed under considerable stress as they struggle to learn to read and to ‘read to learn’. This may not be helped by the fast pace of phonics programmes such as Letters and Sounds. Intervention is often left too late because of the ‘wait and see’ approach.

What Rose (2009:44) suggests is early, tailored intervention to reflect ‘individual language needs’. However, practitioners tend to wait to see if what can be developmental differences (learning alphabetic code, discrimination of phonics sounds), correct themselves over time. Assessment is important both to screen for the difficulty but also to provide a thorough profile of the learner, with strengths, weaknesses, an understanding of environmental factors (at school and home) and behavioural challenges.

What is the medical background of the learner? eg glue ear can affect the processing of speech sounds. Developmental information, such as when a child walked or talked is useful, did they crawl? (Nicholson & Fawcett, 2008). This information helps to build a profile. Each case is unique in the complex tapestry of dyslexia. The environment has an impact on dyslexia (Morton and Frith, 1995), and the brain is highly plastic throughout life. With the correct intervention, dyslexia can be alleviated, without it, symptoms will be exacerbated and this impacts hugely on self-esteem, (Burden, 2008, Humphrey, 2002). Early assessment and specific, evidence-based intervention is crucial before affective issues, including behavior, become a barrier to learning.

Assessment of dyslexia is problematic because the exact cause is unclear and scientists cannot agree. Working in the field, one gets a ‘feel’ for dyslexia and how it is different to other learning difficulties. It is hard to pin down. An early pioneer, psychologist Tim Miles, (2006) wrote about the specific symptoms shown by children (poor spelling, lack of phonemic awareness, sequencing difficulties, difficulties with consonant clusters) who had been referred to him for emotional issues. This led to his awareness of dyslexia (which he called an aphasia) and to the first dyslexia screening tool in the UK, the Bangor Assessment Test.

The test was designed from the behaviours shown (b/d and left/right confusion), more recent tests strive to be scientific, addressing underlying causation and cognitive processes. Before we can assess for dyslexia, it is important to get some idea of what defines the difficulty. Teachers and other practitioners need guidance to identify it.

For years, the Discrepancy definition ruled (Nicolson, 1996). It is easy to understand and for teachers to identify i.e. a pupil who seems bright in other areas, who is struggling to learn to read. To some extent, this will still be used as an indicator in schools. More accurately, the sort of discrepancies to look for may be a discrepancy between oral ability and written work (Rose, 2009), reading comprehension and decoding (Phillips et al., 2013). Nicolson and Fawcett also argue that their postural stability test does differentiate between poor and dyslexic readers (Fawcett, Nicolson, & Maclagan, 2001).

One of the first official definitions (World Federation of Neurology, 1968), indicated that all other factors should be ruled out before dyslexia could be identified i.e. an Exclusionary definition. In line with the Discrepancy Theory, it too mentions intelligence as a factor and the social background of the individual. The impact of this kind of definition might be lots of children from lower social groups with seemingly low IQ who are dyslexic and escape diagnosis. The theory of ‘adequate intelligence’ was reiterated in a 1994 definition by the International Dyslexia Research Committee some years later, which suggested that difficulties (in single word decoding) were unexpected in relation to a pupil’s other abilities (Lyon, 1994). This theory went unchallenged for some time.

Snowling (2000a) makes some important contributions to the Discrepancy Theory, pointing out that some dyslexic children struggle more with writing and spelling than reading and also that children who do not practice reading (and these may come from higher social groups) might show a discrepancy but not be dyslexic. Badian (1994: 45), found that one could distinguish between dyslexic and poor readers, specifically in the areas of ‘automatic visual recognition and ‘phonological decoding of graphic stimuli’. IQ is very hard to measure and there are now lots of theories about intelligence, Gardner (1983, 2006) being one. Does one have to be intelligent to learn to read? Research would suggest not (Allor et al, 2014).

In the 50s, Miles was presented with children because of their emotional and behavioural issues, he discovered their difficulties were educational. Here we have one of the biggest challenges in dyslexia: a condition that is medical in origin but educational in treatment (Miles and Miles, 1990). Sometimes, children withdraw their intellect (Holt, 1964), known as learned helplessness, they can’t succeed and stop trying (Burden, 2008).Social background and the environment in school (Morton & Frith, 1995), can have a massive impact on learning and one must be mindful of this in assessment. Within the framework of Morton and Frith’s environment framework, come physical, social, cultural and dietary factors. Taking the environment into account and understanding that the brain is highly plastic (able to change) helps to explain the many different presentations of dyslexia.

Dyslexia should also be considered in English as Additional Language children who struggle with literacy, one cannot assume any difficulties are simply to do with the acquisition of an additional language (Deponio et al, 2000). One 1994 definition (Lyon, 1994), mentioned cognition and later definitions focus on differences in cognitive processing and are more descriptive, giving teachers and support staff better guidance on what to look for. A 2001 description (Peer 2001:3) mentions slow processing, short-term memory, visual and auditory difficulties and sequencing as some of the difficulties. It says the difficulties might include ‘alphabetic, numeric and musical notation’. This definition says of these children ‘All have strengths’ – a good assessment should indicate what those strengths are. This is helpful for the child, their parents and teacher.

Dyslexia is a ‘different learning ability’ (Pollock and Waller, 2004), with many students compensating through excellent oral skills, creativity and imagination. Through an assessment these strengths can be brought to the fore and weaknesses can be supported, raising achievement. The current definition of dyslexia adopted by the British Dyslexia Association is one based on the Rose Report (2009), which introduced the idea that dyslexia is a continuum with no cut off point. In line with current theory, it also mentions difficulties in phonological awareness and the need for specific intervention. The BDA made an addition in 2011, which acknowledged visual processing difficulties, although there is some contention around this.