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DYSLEXIA
by Sean Wynne
It implies that the problem is not simply with
reading, but includes spelling, writing and other aspects of language' (Ott,
1997). This broad, all-encompassing
use of the word 'language' is fundamental to an understanding of the issues
involved and implies that 'dyslexia' is more than just 'reading failure', which
was at one time a frequent perception. The
medical fraternity has learned much about dyslexia, particularly with the
developments in neuro-imaging and genetic studies and much is now known about
the function of different parts of the brain. Dyslexia is a complex neurological
condition which is constitutional in origin.
The symptoms may affect many areas of learning and functions, and may be
described as a specific difficulty in reading, spelling and written language.
One or more of these areas may be affected. Numeracy, notational skills (music), motor-function and
organizational skills may also be involved.
However it is particularly related to mastering written language,
although oral language may be affected to some degree. What is the
problem- wide range of symptoms Dyslexia is a learning disability that alters the way
the brain processes written material. The effects of the disorder vary from
person to person. In fact, the only common trait among people with dyslexia is
that they read at levels significantly lower than typical for people of their
age and intelligence. Dyslexia is a language disability, not a reading
disability, so not only does it affect the ability to learn to read, write, and
spell by conventional methods, it affects the ability to communicate in more
subtle ways. Dyslexics have processing, perception, and attention/concentration
problems. Dyslexia has
conventionally been attributed to a left hemisphere deficit affecting language
skills. Learning to read requires an awareness that
spoken words can be decomposed into the phonologic constituents that the
alphabetic characters represent. Such phonologic awareness is characteristically
lacking in dyslexic readers who therefore, have difficulty mapping the
alphabetic characters onto the spoken word.
To find the location and extent of the functional disruption in neural systems
that underlies this impairment, researchers used functional magnetic resonance
imaging to compare brain activation patterns in dyslexic and non-impaired
subjects as they performed tasks that made progressively greater demands on
phonologic analysis. It is no coincidence that both the acquired and the
developmental disorders affecting reading have in common a disruption within the
neural systems serving to link the visual representations of the letters to the
phonologic structures they represent. Although reading difficulty is the primary
symptom in both acquired alexia and developmental dyslexia, associated symptoms
and findings in the two disorders would be expected to differ somewhat,
reflecting the differences between an acquired and a developmental disorder.
In acquired alexia, a structural lesion resulting from an insult (e.g.,
stroke or tumor) disrupts a component of an already functioning neural system,
and the lesion may extend to involve other brain regions and systems. The pattern of relative under activation in posterior
brain regions contrasted with relative over activation in anterior regions may
provide a neural signature for the phonologic difficulties characterising
dyslexia. There may be many reasons for the child's difficulty
with reading, one of which is dyslexia. If
a child is dyslexic, it is important that this is identified and addressed as
soon as possible. In the past,
parents' concerns may have been brushed aside with out any consideration. People who are dyslexic require recognition and
teaching to help them overcome their learning difficulties and it is
inappropriate for critics to comment that the dyslexia lobby's 'new found vigour
diverts funds and attention from children who have genuine disabilities'. The reality of the situation is that dyslexia occurs
throughout the world, in all environments, and does not respect class
boundaries. It can cause a great
deal of anxiety and friction when an otherwise bright child' is still unable to
read despite many attempts. The frustration this causes may then develop into
antagonism between the parties involved. This is the question asked most frequently both by
the lay person and the professional, and is usually followed by, 'Can
you give me a simple definition?'. Many
books and articles have been written and much academic and professional debate
has been devoted to this topic. Scores
of different definitions have ensued. Hammill
(1990) was able to find forty three. The
accent and emphasis of the definition has often been influenced by the
practitioner's professional background and what he/she saw as the underlying
cause of dyslexia. There is still
no universally accepted definition but dyslexia is officially recognized and
accepted by governments and legislators in many countries worldwide. Characteristics of dyslexia ·
congenital - people are born with it ·
genetic - inherited and runs in families, more males than females ·
constitutional - there is a neurological basis ·
problems with phonological awareness - difficulties wish letter sounds
when reading and spelling and writing ·
problems with language - such as verbal naming or word retrieval or
pronunciation ·
problems with short term memory - which particularly affect auditory
sequential memory (such as for the repetition of digits) or visual sequential
memory (such as used in coding skills). It would be unusual for an individual to have all these difficulties. Usually he will have a cluster of symptoms. The prognosis depends on individual strengths and weaknesses, on the individual learning strategies, on the degree of the dyslexia, on when the diagnosis was made and on appropriate tuition. Yet according to Ott there is still no universally accepted definition but dyslexia is officially recognised and accepted by governments throughout the world. Lack of precise agreement on definition makes it impossible to know the extent of the prevalence of dyslexia in the population. Miles and Miles (1990) stated that 'the absence of consistent selection criteria makes the matter very much one of guesswork' and 'moreover, it is for these reasons that no satisfactory figures are available for the incidence of dyslexia'. If you can't measure it, you can't manage it. 'Based on government-sponsored studies, the British Dyslexia Association estimated that 10 per cent of children have some degree of dyslexia. Appropriate teaching and the use of coping strategies may moderate its effects significantly.' There is still debate over whether dyslexia should be
considered a medical or an education concern. During the debate on the Education Bill in 1981 the
Under-Secretary of State drew attention to the fact that 'the baffling condition
popularly known as dyslexia is difficult to pin down' and 'certain
educationalists presume that it does not exist'. At the time this came as no surprise to dyslexic people,
their parents or their teachers who had long battled with the education system
and were fully aware that 'the situation is one in which friction between
believers and sceptics exists' (Pumfrey and Reason, 1991). The European Dyslexia Association
(1994) stated that 'dyslexia is a medical term: specific learning disability (or
difficulty) is an educational one'. Miles
and Miles (1990) agreed with this when they said 'there is, in our view, a good
case for saying that it is a medical matter in origin and an educational matter
in its treatment' The
differences are personal and include the following :- Talented in art, mechanics, & building. Seems to "zone out," or daydream a lot;
gets easily lost or loses track of time. Has difficulty sustaining attention; seems
"hyper." Tests well orally, not so well on written tests. Learns best through hands-on experience,
demonstrations, experimentation, visual aids, & observation. Gets dizzy, suffers from headaches &
stomach-aches when reading. Does not read for pleasure. Confused by letters, numbers, words, verbal
explanations, and sequences. Reading and writing shows repetitions,
transpositions, additions, omissions, substitutions & reversals in letters,
words, and/or numbers. Spells phonetically and inconsistently. Difficulty putting thoughts into words; stutters
under stress, mispronounces long words, or transposes phrases & words when
speaking. Complains of feeling or seeing non-existent movement
while reading, writing, or copying. Difficulty with vision, yet standard eye exams don't
reveal a problem. Handwriting varies or is illegible. Trouble with writing or copying; pencil grip may be
unusual. Uncoordinated, poor at ball or team sports,
difficulty with motor skills & tasks. Can be ambidextrous. Confuses left/right and over/under. Difficulty managing, & being on time, learning
sequenced information or tasks. Shows dependence on finger counting, tricks, and
gimmicks. Can do
arithmetic, but not word problems; cannot grasp algebra or advanced math. Excellent long-term memory for movies, experiences,
locations, & faces. Poor
memory for sequences. Thinks with images or feelings, not the sounds of
words (little internal dialogue). Extremely disorderly. Isn't "behind enough"
or "bad enough" to be helped in school setting. Can be comedian, trouble-maker, or quiet. Easily frustrated or emotional about school, reading,
writing, or math. Strong sense of justice. Strives for perfection. Mistakes & symptoms increase dramatically with
confusion, time pressure, & emotional stress. Confusion precedes learning; which leads to more
confusion, which tends to block the learning process. ·
Word-naming problems. ·
Word mispronunciation. ·
Jumbling words. ·
Poor use of syntax. * Difficulties
with rhyme and alliteration. ·
Hesitant speech. ·
Needs frequent presentation of a word before being able to use it
accurately and consistently. Sequencing Many children have initial difficulties with some of
the tasks described below, but the dyslexic child's problems will be greater and
more persistent. A dyslexic child
will make mistakes frequently that other children make only occasionally. Visual difficulties ·
The child may be poor at drawing - some are excellent and have a good use
of colour. ·
The child may find it difficult to track through a maze. ·
The child may find it difficult to sort beads by shapes. The
child may have difficulty learning to dress himself. Buttons can cause problems because of being unable to
remember where to start. Some lack
the manual dexterity to cope with finding the buttonhole and then putting the
button through it. ·
The child may have difficulty turning door handles, particularly door
knobs. ·
The child may rind doing jigsaw puzzles or making models difficult. Auditory sequential memory difficulties ·
The child may not be able to learn or repeat nursery rhymes or childish
ditties. ·
The child may not be able to repeat messages - when he takes a telephone
call he may forget the name of the speaker, or when given the message 'Dad will
be home late, he has missed the train and will be on the next one' he will
perhaps only remember that 'Dad will be late'. ·
The child may have difficulty in following a series of instructions - he
goes up stairs to look for something and forgets what he has been sent to rind.
He may have difficulty remembering a series of instructions, for example,
from the teacher on the playing field. This
will often be exacerbated by directionality confusions.
Catts (1989) confirmed that 'dyslexies have been shown to perform less
well than normal individuals in the short term recall of lists of letters,
words, digits and sentences'. ·
The child may often find it hard to string a few sentences together to
describe a recent event - 'What did you have for lunch today?' He may begin at
the end of the story and seem to lose his way.
He may also struggle to find the words to convey his meaning. ·
The child may find clapping or beating time to music difficult.
Wolff, Michel and Ovrut (1990) showed that dyslexic children have
persistent problems in tapping rhythm, specifically when asked to tap the hands
asynchronously. ·
The child may have difficulty with remembering common sequences - the
alphabet, days of the week, months of the year.
He finds it difficult to tell whether it is morning or evening.
Phrases like 'next week' 'in a month's time' may confuse him. Varying degrees of dyslexia Knowledge about the extent and severity of the
problem is important for educationalists and government officials who are
charged with budgetary decisions, including provision for people with special
educational needs. Many experienced teachers and researchers comment on
the wide variations in the skills and weaknesses found in the dyslexic person.
Dyslexia can manifest itself in severe, moderate or mild forms.
It is these categories that are at the core of the arguments about the
prevalence of dyslexia. Ott (1997) divided dyslexics into two groups: the
middle group and the low group. The
'middle group' might not even be diagnosed dyslexic as their intelligence covers
the dyslexia and their dyslexia conceals the intelligence, but undiagnosed
dyslexia can be a constant source of internal worry and strain.
The 'low group' experiences severe difficulties with even the mechanics
of reading, writing, spelling, and pencil arithmetic.
Critchley (1981) drew attention to yet another category, the borderline
dyslexic, when he said 'there exist incomplete cases of dyslexia - dyslexia
variants. In other words, the triad
of late reading, poor spelling, and inability to communicate easily on paper,
does not of necessity always occur in combination.
"Formes frustes" (variants) of dyslexia are quite often
encountered among the relations of a person who is known to be a fully fledged
dyslexic'. It is essential to be aware of this wide spectrum and
herein lies the crux of the vexing question - the prevalence.
The figures quoted on the prevalence of dyslexia are no more than
'guesstimates' because there is not a consensus on how to count heads and who to
include, resulting in statistics that are unreliable and fundamentally flawed.
The way forward is for a properly funded national enquirv to be taken of
a large sample of the population to establish the prevalence of dyslexia in the
population. These results could
then help the planners allocate funding for special educational needs and
teacher training.
1 The diagnosis is clinical. 2 The treatment is educational. 3 The understanding is scientific. A survey of 882 psychologists conducted by
Pumfrey and Reason (1991) found that 87 per cent of them preferred to use
'specific learning difficulties' when writing reports and only 30 per cent found
the use of the word 'dyslexia' appropriate. It
is a war of words. Another reason
sometimes put forth by the combatants is their dislike of labelling children.
The BDA (Crisrield, 1996) said that dyslexic people often think it
[specific learning difficulty] derogatory. There have been many changes in education throughout
the 1980s, including the Education Reform Act 1988, which resulted in The
National Curriculum. The Education
Act 1993 required the Department of Education to issue a Code of Practice on the
'Identification and Assessment of Special Educational Needs' for Local Education
Authorities, schools and all those who help in them and work with children with
special educational needs, including ·
The child may find counting difficult - particularly counting backwards . ·
The child may show signs of poor auditory discrimination. He may hear the sound but be unable to identify what he
hears, just as the colour-blind person can see the colour but is unable to
recognize the colours. Such a child
will often be accused of not listening or being inattentive. Motor skills Motor skills are so called because the muscles that
perform these skills work like a motor controlled by the brain. Fine motor skills Fine motor skills are those associated primarily with
the fingers and hands. Lenneberg (1967) pointed out that 'the appearance of
increasingly complex speech and language behaviour paralleled milestones in
motor development. A sense of
rhythm is important to help improve motor co-ordination'. Some children have no difficulty acquiring these skills while
others do it late – the child may not be able to use a rubber effectively. ·
The child may hold his pencil awkwardly. ·
The child may rind it difficult to tie shoe laces. The child may find learning to do a tie extremely
difficult. Gross, motor skills Gross motor skills are those associated with the arms
and the legs. The child may find hopping difficult. The child may be constantly bumping into people and
objects. In games he often collides
with others. He may bump into other
children on the stairs at school because the child who is going up the stairs
does not realize that another child is coming down the stairs on the left, at
the same time. The child may have a tendency to knock things over or
to drop things. Going up steps may prove difficult - some children
have a tendency to do so one at a time. When
coming down the stairs they tend to continue to jump off the final step. Learning to ride a bicycle can be a tortuous process. Setting the table may be difficult - knives and forks
may be put on the wrong side. Learning to swim can be difficult for some children,
especially the breaststroke because the arms and leg movements must be
synchronized. Others rind bilateral
breathing required for the over arm can be difficult: when the right arm comes
out of the water the head has to be moved to the left and vice versa. Playground games may be difficult, especially if they
involve words such as left/right, up/down, backwards/forwards, in front/behind.
Learning to dance may be difficult for some children, particularly if
there is a sequence of steps to be remembered, as in country dancing. The child may experience difficulties with
co-ordination in the gym when climbing the ropes, crawling through apparatus,
standing on one leg or walking along a bench.
The child who has very pronounced difficulties in this area can be
assessed by an occupational therapist who will use tests and make a clinical
observation. This may result in a
diagnosis of dyspraxia, which implies poor co-ordination and difficulty in the
planning and carrying out of fine and gross motor skills. Someone who is cross-lateral will use different parts
of the body for different tasks, for example, his left foot to kick and his
right eye to look through a camera lens. Inconsistencies are often evident in
the young child. Researchers have
'observed higher rates of weak right handedness among a spectrum of
developmental disorders' (Duane, 1991), thus a child may throw a ball with his
right hand but may use a knife with his left hand when eating.
It is well-established that certain people who are predominantly right
handed can be left handed for specific tasks, for example, when playing cricket.
This is not regarded as dysfunctional as long as the person is consistent
in their handedness. It is
essential to realize that cross-laterality is not in itself a diagnosis of a learning difficulty. Lack of consistent handedness or ambidexterity can
lead to greater difficulties when the child begins to use crayons, felt pens or
a pencil. One of Orton's early observations was that there was
a high frequency of left handedness in dyslexics and in their families.
Geschwind (1982) cited that he and Dr Peter Behan 'completed a study on a
large group of strongly left-handed people and confirmed that this population
has a much higher rate of dyslexia and other learning disabilities than a
control population of strongly right-handed individuals'. Summary,and conclusions 1
The clamour for early recognition is becoming louder and has been
marshalled by the dyslexia organizations. Parents
are better informed, many have had to struggle with dyslexia themselves and are
therefore quickly alerted to similarities between their own and their child's
development. ·
There is a body of opinion, and research evidence, which shows that
children who are 'at risk' can be identified before they go to school or shortly
after they start school. 3
Screening tests, have been developed which can alert those who deal with
children whose progress is uneven or who are slow ' at acquiring certain skills.
These may turn out to be the children who later struggle when learning to
read. 4
Caution needs to be exercised in the use of such screening tests.
Counselling and practical advice will need to accompany any screening
programme to reduce any alarm or anxiety that may be raised. ·
Early identification of a learning difficulty must be accompanied by the
appropriate measures to help remedy the problems.
Chasty (1996) said that 'schools represent the most critical period for
diagnosis. The earlier the
diagnosis, the more immediate the help - and the less serious the damage to the
child'. 5
There is much evidence to support the idea that the earlier the
identification of a problem, and the sooner appropriate intervention is begun,
the better, quicker and more cost effective it will be for child, parent, school
and society. It may prevent years
of humiliation, frustration and despair. 6
There is evidence that there is a genetic link in dyslexia and that it
reappears in succeeding generations of families.
Pennington (1989) argued that 'family history could be used to help
screen for children at high risk for this disorder'. This has important implications for fiscal management and for
those in control of the budgets for the provision of funds for children with
special educational needs. Early
recognition and intervention can be cost effective. ·
There is a wide spectrum of difficulties.
The symptoms.of dyslexia vary. Inconsistency,
unpredictability and unexpectedness are its most consistent features. 7
Miles (1974) stated that 'in my experience cross-laterality is of no
special use, even as a diagnostic sign, since there are plenty of people who are
cross-lateral without being dyslexic and plenty of people who are dyslexic
without being cross-lateral'. Yet
in a survey of learning support teachers Reid (1990) found that 'the issue of
cerebral dominance appears to be the most frequently cited cause [of specific
learning difficulties] raised by the sample'.
'But despite extensive research the relevance of laterality to dyslexia [... 1 remains a matter of
dispute.' (Hiscock and Kinsbourne, 1995). Spoken language *
identifying the problem *
how parents and teachers can help Language is universally acquired by humans.
Most children learn to speak and require very little help to do so, but
'some children have to work harder and for a longer time than others at learning
language' (Bloom, 1980). Masland
(1990) stated that 'dyslexia is a disorder of language'.
The US government's definition of learning disabilities Public Law 94-142
states that 'children with specific learning disabilities exhibit a disorder in
one or more of the basic psychological processes involved in understanding or in
using spoken or written language. These
may be manifest in disorders of listening, thinking, talking, reading, writing,
spelling or arithmetic' (US Office of Education, 1977). According
to Carlisle (1994) the following factors can be significant when making a
diagnosis of acquired dyslexia: a)
A history of placental dysfunction 'small-for-dates- baby'. b)
Difficult birth with anoxia (lack of oxygen). c)
Head injuries as a result of an accident. d)
Brain tumour. While schools identify approximately four times as
many boys as girls as reading disabled, longitudinal and epidemiological studies
show that as many girls are affected as boys. Reading disability reflects a
persistent deficit rather than a developmental lag in linguistic and
reading skills. The
ability to read and comprehend depends upon rapid and automatic recognition and
decoding of single words. Slow and inaccurate decoding are the best predictors
of difficulties in reading comprehension. The ability to decode single words
accurately and fluently is dependent upon the ability to segment words and
syllables into abstract constituent sound units (phonemes). Deficits in
phonological awareness reflect the core deficit in dyslexia. Treatment/Intervention |
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