Is it time to rethink dyslexia?

Declared cases are multiplying, but the diagnosis still lacks scientific rigour, argues Julian Elliott

March 6, 2014

Source: Elly Walton

Some years ago, a student informed me that she was encountering a problem with my classes. When asked to explain a little further, she told me that she had been diagnosed as dyslexic. I asked if she could be a little more specific about the particular difficulties she was encountering. Responding, “I can’t understand what you are talking about”, she explained that the ideas I was expressing were complex and she found them difficult to grasp. I enquired how I might help her with this problem. She replied that she would welcome a single sheet of A4 for each lecture containing a set of bullet points that summarised the key points.

This anecdote exemplifies some of the confusion that surrounds “dyslexia”, a term used to describe a variety of problems. Researchers tend to describe as dyslexic all those who struggle to decode text. Others, often clinicians, argue that only some poor decoders are dyslexic. Still others contend that decoding difficulty is but one part of a much broader dyslexic condition. It is hardly surprising, therefore, that diagnosis is highly subjective and lacks scientific rigour. While special tests and symptom profiles are commonly used, there is no means of making a consistent and meaningful judgement. As the list of so-called signs and symptoms is lengthy, most people reporting reading difficulties will demonstrate some of them. Many such symptoms are found in good readers, and those diagnosed as dyslexic often differ substantially from one another. Many clinicians still employ IQ tests as a basis for diagnosis, even though this practice no longer has any scientific support. Meanwhile, research studies in neuroscience and genetics, often used by proponents to justify the dyslexia construct, are typically conducted with poor decoders (not a so-called dyslexic subgroup), and currently offer no additional diagnostic information.

Dyslexia is an issue of growing importance for higher education with increasing numbers of students disclosing a specific learning difficulty. Typically, diagnoses of dyslexia can be obtained for students who pay self-employed educational psychologists, or specialist teachers, to undertake an assessment. For those who cannot afford this fee, financial assistance can sometimes be available from universities’ Access to Learning funds. Having been paid something in the region of £300 to £600, the assessor may feel strong pressure to come up with a diagnosis of at least “mild” dyslexia.

Once diagnosed, the student can present the assessment report to their university, speak to an assessment centre about their needs and receive a Disabled Students’ Allowance provided by Student Finance England (a service provided by the Student Loans Company). Students in higher education in the UK who are diagnosed with specific learning disabilities/dyslexia are eligible for DSA grants to cover the costs of specialist equipment (including a laptop) up to the value of £5,161, and support and assistance in study skills, typically to the value of about £1,800. A general allowance of up to £1,724 a year is available for assistance with printing and other costs. Interestingly, funding can even be obtained for coloured lenses despite the absence of evidence from high-quality research studies as to the effectiveness of this form of treatment for those with severe reading disability. In addition, the private assessor will often recommend various accommodations (“reasonable adjustments” as defined by the Equality Act 2010), such as additional time in examinations, that the university is legally obliged to make.

Given the questionable, highly subjective basis for a diagnosis of dyslexia, the current position is something of a national scandal. However, I am not arguing that we should not support students with reading and spelling difficulties: on the contrary. It is quite right to assess and address any literacy difficulties that interfere with students’ ability to access the printed word, and speech chips that read texts aloud via a computer, voice recognition software and audio/video recording devices should be made available where these clearly meet a particular student’s needs.

The key problem is that dyslexia diagnoses have moved far away from their original focus (severe reading difficulty) to incorporate an ever-increasing range of cognitive and self-regulatory deficits including poor working memory, processing speed limitations, attention/concentration problems, difficulties in analysing and synthesising complex information, and in organising and expressing ideas. For any students who struggle to cope with academic demands for such reasons, there are obvious equity issues within our highly competitive higher education sector between those who are diagnosed dyslexic and those who are not and, instead, are considered to be academically weaker performers.

Dyslexia is a term that confuses, rather than clarifies, and should be discontinued. Universities, of all institutions, should not perpetuate the use of a term that lacks scientific credibility.

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Reader's comments (2)

There are two inter-related and conflated issues here. The description and the explanation of a particular mind-body capability, ostensibly confined to reading/writing (orthography/cartography). I am assuming few contest that such a condition exists. However labeling the incapability dyslexia and describing it as a neuro-developmental disorder does not constitute an explanation in any scientific or meaningful sense. It will be interesting to see whether the authors of The Dyslexia Debate incur the same wrath, invective, abuse and dismissal as MP Graham Stringer invoked on the publication of his Dyslexia is a myth (see http://www.manchesterconfidential.co.uk/News/Dyslexia-is-a-myth) His confidential column on literacy, crime, dyslexia and wasted money was published as long ago as 12th Jan 2009, and nothing has changed since. Indeed it is difficult to see how any book can change anything when there are so many vested interests involved in the 'Business of Dyslexia'. One only has to consider the number of professional and civil list honours awarded to those for services to dyslexia to realize the enormity of the Kuhnian structural paradigm shift that has to occur before the primary cause of such difficulties are acknowledged: a mis-match between the adept and the writing hand! See Dr Sattler's work at http://www.linkshaender-beratung.de/english/index.htm
As an associate member of the British Dyslexia Association, and with a history of supporting students affected by dyslexia at school, in FE and in HE, can I suggest that Julian Elliott appears to be more interested in raising controversy about dyslexia, than in actually having a serious debate (unless he hopes his article will be a catalyst). He will probably accuse me of having a vested interest but I now work with students in HE across the ability range so I do not have ‘an axe to grind’. Elliott mentions the “questionable, highly subjective basis for a diagnosis of dyslexia”; I would agree that the condition is complex and trying to limit it to a fixed list of symptoms misses the whole issue surrounding dyslexia: that it actually is highly individual and appears to affect the processing skills that lead to the development of language skills. And to suggest that “dyslexia diagnoses have moved far away from their original focus (severe reading difficulty)” is again, to miss the point. For some people affected by dyslexia, they do have severe reading problems, whilst for others, it’s spelling or organisational skills amongst other issues that can limit their achievement. However, just because a condition is hard to diagnose, doesn’t mean that it should be dismissed and that students diagnosed as dyslexia are just out to ‘rip the system off’. Furthermore, if anyone has any experience of working with dyslexic students, they will understand that actually, as Professor Tim Miles argued, it’s often that a teacher gets a ‘gut feeling’ that a student could be dyslexic. Whilst some would argue that this is not rigorous enough to count as a diagnosis, we should not ignore the value of experience. And as for introducing scotopic sensitivity syndrome (a condition that causes perceptual reading difficulties) into the argument, well all I can say is that Julian Elliott doesn’t understand this condition either. Yes, some individuals affected by dyslexia are also affected by SSS, but it can affect anyone, not just those diagnosed as dyslexic; it’s just that, as reading difficulties are often associated with dyslexia, when an assessment is carried out, it’s usual practice to check for SSS. Perhaps Julian Elliott might like to read Michael Thomson’s excellent book “The Psychology of Dyslexia” and he may learn more about the condition than just appearing to have a knee jerk reaction. As for needs assessments, the day when students were allocated a whole package has long gone. Perhaps a greater disgrace is that of charging all HE students upwards of £8,000 a year for tuition fees; now that is a national scandal that should concern all of us.

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