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21st March 2008 at 00:00

Exercise, fish oils and computer games have all been promoted to help dyslexic children. Dorothy Bishop examines the evidence

Richard can't read. His mother has tried reading with him at home, but this seems to do no good; the eight-year-old makes excuses to avoid reading and just gets upset if she insists. Meanwhile, his older brother and younger sister are confident readers. All parents in this situation will ask themselves two questions: why is my child having these problems, and what can I do to help?

In recent years there has been a growing tendency to answer these questions with reference to the brain. Whereas in the past the blame would have been placed on the parents (neglectful), teachers (incompetent) or the child (lazy), we now recognise that there are substantial differences in brain organisation from one child to another and that these can affect a child's ability to learn.

If we can find out what is going on in the brain to make reading difficult, then rather than giving poor readers more instruction, shouldn't we be trying to fix the underlying problem? Although this seems like a good idea in theory, in practice there is little evidence of effectiveness of brain-based interventions. Yet they are being promoted.

One example is a computerised intervention programme called FastForword, which grew out of neuroscientific research that suggested that children's language and reading difficulties could be the consequence of sluggish brain responses to sounds.

FastForword aims to sharpen neuronal responsiveness by training the child to hear small differences between sounds using computer games. An initial report in the journal Science suggested impressive improvements for children undergoing the programme.

Subsequent studies in which FastForword was compared with other more traditional interventions showed no greater benefit for those on the programme.

Another example is the exercise-based intervention advocated by Dore Achievement Centres. Over a period of about one to two years, children carry out daily exercises to improve balance and co-ordination, with the aim of boosting development of a region of the brain known as the cerebellum.

There is some evidence that the cerebellum might be implicated in reading difficulties, but there is no reason to suppose that improving non-reading skills will affect brain regions that are involved in reading. The only published study evaluating this method claimed astonishing gains in treated children, but it was heavily criticised for poor methodology and misleading presentation of findings.

A different approach to brain intervention is the use of fish oil to remediate children's learning difficulties.

The neuroscientific basis is speculative but not implausible: studies using animals have confirmed that brain development depends on availability of omega-3 and omega-6 fatty acids, and there is some evidence of an increased rate of fatty acid deficiencies in poor readers.

However, there is little research to indicate whether ingestion of fish oil is an effective treatment for reading disability. One study with children who had dyslexia and attention difficulties reported improved attention for those on fish oil but no results were reported on reading. Promising evidence was obtained in an Oxford-Durham study that reported improved reading ages in a treated group of children who had been identified with developmental co-ordination disorder (poor co- ordination).

However, it is unclear whether similar improvements would be obtained for children with dyslexia, and whether treatment would work for those who don't show clinical signs of fatty acid deficiency.

Caution is merited because there is a common pattern for new treatments to be greeted with great enthusiasm and stories of dramatic improvement, only to find that the results don't stand up when further studies are carried out by independent researchers.

Neuroscientific research is important and holds the key to providing better understanding, and ultimately more effective intervention, for children's reading difficulties. However, translating research into practice is difficult and we should look hard at the evidence for effectiveness before accepting treatments that claim to train the brain.

The best way of helping children who have reading difficulties seems to be individualised instruction in reading and phoneme awareness, rather than pills.

Dorothy Bishop is Professor of Developmental Neuropsychology in the department of experimental psychology at the University of Oxford. She is speaking at next week's conference of the British Dyslexia Association in Harrogate, March 27-29.

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