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D is for dyslexia and diagnostic tests

Raymond Ross visits a centre in Edinburgh where exercise programmes and regular neurological tests are helping young children to cope with their dyslexia, and a secondary school which offers strong support to older children

Claims of a new cure for dyslexia made by millionaire businessman Wynford Dore, who funds the Dyslexia, Dyspraxia and Attention Disorder Treatment (DDAT) Centre in Warwickshire, caused a furore in January when they were broadcast on television. And plans for a DDAT centre to open in Glasgow next month were met with fears that parents might fork out pound;1,585 for a course of treatment to help their children, only to be disappointed.

Treatment at the centre is based on research into the cerebellum, the part of the brain associated with movement and motor skills. Its website claims that "for many years, most researchers have believed that the thinking brain is the area that causes dyslexia and other learning difficulties. The cerebellum was ignored. Exciting new research has now revealed that the disorder lies in this processing (cerebellum) brain."

Critics of the DDAT approach argue that the research has yet to be properly validated and that the cerebellar theory on which the centre's practice is based is neither new nor caters for all forms of dyslexia.

Sheila Dobie, director of the Institute for Neuro-Physiological Psychology (INPP) Scotland and an expert on movement control, is sceptical about DDAT claims, saying the treatment deals with only one aspect of dyslexia and that the INPP's methods are more sophisticated.

The INPP was established in Chester in 1975 to research the effects of central nervous system dysfunctions on the learning process and to develop diagnostic and remedial programmes. Its main focus is clinical practice (working with children) and research.

The centre in Edinburgh has 250 clients undergoing remediation. Though some children are referred and paid for by local authorities and health trusts, most are funded by their families. Children come from as far as Shetland and Exeter to undergo on average 18 months of six-weekly diagnostic tests and reviews to establish their neuro-developmental delay (the omission or arrest of a stage in early development) and monitor their progress.

Mrs Dobie welcomes the enthusiasm with which dyslexia is now being addressed and its greater recognition among teachers and local authorities but points out that in a country such as Sweden all children are screened for dyslexic symptoms prior to going to school. "Ideally, I'd like to see every four or five-year-old in this country being screened, with a further screening at seven."

INPP research indicates that the continued presence of primitive reflexes beyond the first year of life directly affects subsequent developmental skills, particularly balance, co-ordination, eye movements, perceptual skills and language, skills which form the basis for all academic learning.

Children who retain a cluster of primitive and underdeveloped postural reflexes can typically experience difficulties with gross muscle co-ordination, balance and the conceptualisation of movement (dyspraxia), fine motor skills (writing), reading, spelling, problem solving, organisational skills, short-term memory, rote learning, dyslexia and behavioural problems.

"Movement underpins all learning, including speech articulation and all perception areas," explains Mrs Dobie. "A child must learn to control its movement before learning can be undertaken."

The institute's treatment involves an individualised programme of reflex inhibition movements to be practised for five to 10 minutes daily at home under parental supervision. The exercises are modeled on normal infant movement patterns which the developing child should have made in their first year.

"We determine whether or not the child has a specific form of dyslexia caused by poor motor organisation," says Mrs Dobie. "We have to ask is it the auditory system that is deficient? The visual system? The motor component? We need to specify where the problem lies and intervene in the appropriate areas.

"In the past two or three years there's been increasing recognition of the importance of neurological states underlying dyslexia. Addressing one component is not the answer," says Mrs Dobie.

Kirstie Brown, a neuro-developmental therapist and researcher at the INPP Scotland, agrees. "The term dyslexia can indicate the range of symptoms that the child may experience but what we review is the underlying neurological state of the child.

"Many dyslexic children might have difficulties in recall and short-term memory, for instance. Disorder is symptomatic of the condition. They find it difficult to retain and manipulate information.

"But motor organisation is a precursor of sequential organisation. So we start always with neurological intervention and then incorporate whatever system or strategy we think is appropriate."

"Dyslexics can't multi-task and find it difficult to automise their writing. They will adopt postures like stretching, resting their head, curling their feet or occluding one eye by turning their heads when trying to write. We can work at remediation in an instance like this and relieve the dyslexic symptoms."

Some forms of dyslexia can be cured, says Mrs Dobie, but most have residual symptoms.

"All our children have made progress and some will go away and never ever be thought to be dyslexic again.

"It's very difficult in a school to do the level of assessment we do here. It's almost like painstaking detective work. In copying or writing, for example, a child's squiggle could be a motor rather than visual problem. So you need a battery of tests. Schools can't put in this quality of assessment because of the resources involved and the time it takes and they may not have the awareness of where the child's difficulties might lie."

Sheila Dobie and Kirstie Brown run in-service training courses for primary and secondary teachers, classroom assistants, auxiliaries and other related professionals. Contact the Institute for Neuro-Physiological Psychology Scotland, 20 High Street, South Queensferry, Edinburgh EH30 9PP, tel 0131 331 4744.Dyslexia, Dyspraxia and Attention Disorder Treatment Centre, www.ddat.co.ukFor more advice on dyslexia, contact the Dyslexia Institute Scotland, 74 Victoria Crescent Road, Dowanhill, Glasgow G12 9JN, tel 0141 334 4549e-mail glasgow@dyslexia-inst.org.uk

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