Is dyslexia a middle-class badge for illiteracy?

3rd April 2009 at 01:00
Hannah Frankel looks at the most common learning difficulty in Britain

Harry is obviously able, but he struggles with reading and spelling and can only get as far as "j" in the alphabet. Like 1.2 million other children across the UK, Harry, aged nine, has been diagnosed with dyslexia. Derived from the Greek "difficulty with words", it is the most common learning difficulty in Britain, affecting one in 10 children to some degree.

For Harry's mother, the diagnosis was a relief. She had struggled for years to persuade teachers to get her son a statement of special needs. When he was given the label, he became eligible for extra classroom support and more time during exams.

As far as parents are concerned, this extra support is like gold dust. So much so, according to Professor Julian Elliott, an educational psychologist at Durham University, that there is a danger some may fight for a diagnosis regardless of their child's needs.

"Many of the messages that I have received from parents have pointed out that the system has forced them to use the dyslexic label in order to access additional resources," he says. "Parents believe that if their child were to be diagnosed as dyslexic, clear ways of remediating their problems would emerge."

Professor Elliott's views are certainly provocative. He found himself at the centre of a media storm following his appearance on the Channel 4 programme Dispatches: The Dyslexia Myth in 2005. In it, he claimed to have little confidence in his ability to define dyslexia, let alone diagnose it, despite 30 years in the field. Now the controversial debate is likely to be resurrected by Sir Jim Rose's government review into how schools should educate dyslexic pupils. His report, separate to his inquiry into the primary curriculum, is due for publication soon.

Anyone who plans to put their head above the parapet by suggesting that dyslexia is a social construct rather than a scientific one should brace themselves for criticism. A great deal has already come from antagonistic parents who are understandably more comfortable labelling their child dyslexic than slow to learn.

In fact, intelligence has nothing to do with it, according to support organisation Dyslexia Action. The condition can occur at any level of intellectual ability, affecting the great and the good in equal measure. Leonardo da Vinci, Albert Einstein and Winston Churchill were all said to have learning difficulties that resembled dyslexia.

When Graham Stringer, Labour MP for Manchester Blackley, lamented the "appalling levels of literacy" earlier this year, he argued that dyslexia was being used as a scapegoat.

Writing in his local newspaper column, he described the condition as a "cruel fiction", and demanded that the industry that has grown up around it is killed off. He received hundreds of letters - about 20 per cent from supportive teachers and academics, but more than 70 per cent from angry or abusive parents and people with dyslexia.

"I was shocked at the level of anger," he told TES Magazine. "They thought I was denying that these people have problems with literacy. In fact, I was recognising that they do, and saying it's disgraceful that they've been so let down. When parents finally get a statement of educational needs for their child, they feel they've won. I feel they've already lost."

Although Mr Stringer recognises some physical causes for poor literacy, he argues the majority can be countered through improved teaching methods, including a strict focus on synthetic phonics.

Professor Elliott agrees that a diagnosis is a hollow victory for many parents, not least because there is no clear evidence that any one teaching approach is more suitable for dyslexics than any other group of poor readers.

Instead of spending time, energy and money on diagnoses, he believes that resources could be better spent on early, high-quality intervention for all poor readers. Assistance, in the form of extra time, readers, scribes and laptops should be "conditional upon a clear description of the individual's needs, rather than the provision of a diagnostic label", he argues.

Almost 70,000 pupils had extra time - typically another 45 minutes in a three-hour exam - to complete GCSE and A-levels in 2007, according to the Qualifications and Curriculum Authority. The figure has more than doubled since 2005, when almost 44,000 were granted extra time. Ofqual, the new exam regulator, predicts a similar rise when the 2008 special consideration statistics are published this spring.

But Dr John Rack, head of evaluation and assessment at Dyslexia Action, insists that the increase in extra time is not necessarily because more pupils are being diagnosed. Instead, he says it is down to the greater identification of general reading and writing difficulties.

"Even when pupils can't read the question, they may still know the answer," he says. "We must ensure that we are assessing knowledge and not just literacy skills in the foundation subjects." Exams need to be more transparent about the skills they are assessing, suggests Dr Rack. That way, additional help can be provided in response to differing needs, without causing resentment.

"Above all, I want to see a fair system. Dyslexia isn't black and white. There are degrees of severity. Those with mild dyslexia can cope without special arrangements, but I think it's only fair we cater for those who struggle to fulfil their potential because of their dyslexia."

P art of the problem is that dyslexia is not easily identifiable. One recent analysis of research into the condition identified 28 slightly different definitions of the term. The symptoms typically associated with it include everything from poor short-term memory to clumsiness, frequent use of letter reversals (b being used instead of d) and poor verbal fluency. Not only do these blend into other diagnoses, such as dyspraxia, but they are also commonly found in people who are not considered dyslexic, says Professor Elliott.

Dyslexia Action strongly disagrees. It is adamant that a full formal assessment with an educational or occupational psychologist can clearly establish whether or not a pupil has dyslexia. Brain imaging has shown differences between dyslexic and non-dyslexic individuals in specific areas of the language processing regions of the brain, it insists, making it a neuro-developmental disorder.

But reports suggest that psychologists are not always consistent. One will say a boy is not dyslexic, the next will be convinced that he is, especially if strong parental pressure becomes a factor.

However, teachers should not dismiss parents' concerns about their child out of hand, warns Maggie Snowling, professor of psychology at the University of York. They are usually more in touch with their child's needs than anyone else, she says, and can see the frustration it causes at home.

"Schools need to have frequent meetings to share with parents what interventions they are providing and, importantly, provide evidence that the child is responding," says Professor Snowling. "Too often a child with dyslexia shows a poor response to intervention but the diet remains `more of the same'."

Dr Rack admits that assessors can reach contradictory conclusions, but says any uncertainty can be countered with a second opinion. "Dyslexia has been damaged by over-use," he admits. "Some pupils with a mild degree of dyslexia are getting benefits, despite not really needing them. It's potentially damaging, but I think we are robust enough to absorb it because we have a far greater understanding of what dyslexia is now.

"There is no doubt that there are people who are dyslexic. With early support and recognition, they can be hugely successful."

Scientific evidence reinforces the argument that dyslexia is real, argues Professor Anthony Monaco, head of neurogenetics at the University of Oxford. His team's work at the Wellcome Trust Centre for Human Genetics has confirmed a genetic link to dyslexia.

The team has identified multiple genes as possible causative factors, which interact with different environmental factors. If one parent is dyslexic there is a 50 per cent chance that their children will inherit it.

Within the next year, Professor Monaco hopes to have further results that could form the basis for tests that can predict sibling risk. This could lead to earlier intervention before the age of seven, which can drastically increase reading ability.

A ll the experts agree that early intervention is critical. Dr Rack, who is on Sir Jim's expert advisory group, is confident that the report on dyslexia will recommend that difficulties are picked up at key stage 1, without the help of a complex diagnoses. Early help should be enough to meet the needs of those with mild literacy problems, while those who continue to struggle will have access to further support as they move through the education system.

Children with the highest risk of dyslexia can be identified as early as five or six years of age, before they have even started reading, according to Uta Frith, emeritus professor of cognitive development at the University of London.

It may not be entirely reliable at present, she says, but it does help to identify abnormal learning styles before they irreversibly dent self- confidence. "One child may just be illustrating temporary delay that will right itself naturally, but another's learning difficulties may be very meaningful," she says.

"It's important to know what the causes are because if you don't find out, parents will make them up."

Early identification is at the core of the Reading Intervention project in Cumbria, which has subsequently been taken up in north Yorkshire. The intensive 12-week programme involves one-to-one phonics teaching within a wider focus on high-quality teaching. It has been independently accredited with raising the reading age of pupils by up to nine months and the spelling age by up to eight months.

"It's a highly individualised programme that raises standards within just 28 hours of intervention," says Heather Swain, the educational psychologist co-ordinating the project in Cumbria. "But it's not a miracle cure. Success is dependent on having a highly-trained workforce."

Partnership for Literacy (P4L), another whole-school intervention programme, screens all Year 2-5 pupils to identify any weak literacy skills. It tests them again at the end of the 20-week programme. Run by Dyslexia Action, the two-year-old project aims to ensure that children with weak literacy skills are identified as soon as possible and provided with help from trained members of staff.

New Haw Community Junior School in Addlestone, Surrey, is one of 33 primary schools involved. Logistically, it cannot provide one-to-one intervention for all its 368 pupils, but it did want to provide extra support for approximately 90 pupils with special educational needs. Training from P4L encouraged the school's teachers to look closely at the language they used. "We hadn't realised just how shaky some of their (pupils') language foundations were," says Jan Keating, the special needs co-ordinator at the school. A Year 4 boy who had spent half an hour trying to write a rap eventually admitted he did not know what a rhyme was; others had been studying condensation without being able to explain what it was.

"Now we are careful not to presume knowledge," says Ms Keating. "If we are looking at a new science topic, we'll explain the vocabulary first, alongside visual backups, so that the children have something to hook their knowledge on to."

Teachers also use headphones and microphones to help pupils hear and spell words as part of the project, and record their voice as they read it out. Ms Keating has already seen marked improvements since the introduction of the programme in December. "It's been a revelation," she says. "It makes sure we catch everyone before any literacy problems become too deeply ingrained."

Professor Elliott welcomes programmes such as this, but emphasises that they should be made available to all poor readers, not just those whose parents push for access to educational psychologists.

"All youngsters with reading difficulties should be provided with such structured intervention programmes, initially in small groups and where necessary, individually," he says. He, and other researchers like him, would rather identify all children with literacy difficulties at an earlier age, than see parents fight for dyslexic diagnoses. "We want more assistance for these children, not less."

D espite their different interpretations about dyslexia, Dr Rack would also like to see less dependence on diagnoses, and is confident the Rose report will reach a similar conclusion. "I'm convinced the Rose report will mark a change in thinking," says Dr Rack. "It will move away from diagnostic categories and towards identifying individual difficulties on different dimensions or levels."

How they respond to different skills will determine where, if at all, they fit within a sliding scale of learning difficulties. Pupils may exhibit signs of dyspraxia, attention deficit disorder, or sit somewhere in between. Few will be "typical dyslexics" - whatever that means.

"There's a move to recognise different dimensions of dyslexia, and for the response to take that into account," says Dr Rack. "The question should not just be, `Are you dyslexic?', but, `To what extent? In what way?'"

Never mind parents; for pupils, a diagnosis is just the starting point

Risk signs of dyslexia


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