Friday, 17 May 2013

How far has dyslexia come since the 1970s?

Steve McCue refers to the blog by Paul Ross.
Paul Ross asked the question in his blog. How far has dyslexia come since the 1970s? This was my response. What would yours be?
This is my response to Steve McCue’s response J

We still do not have an agreed single definition for dyslexia. There is too much focus on the medical model, our dyslexic brain is broken, we need to be cured and remediated deficit model of dyslexia.’
I agree with this statement. I do not think that this is a ‘fault’. We have created a society in which political and economic success is dependent for most people on the ease with which they can access text. Or rather the way that the text is presented to them in the text books, examinations, official forms etc.
Only two centuries ago in the UK, most people had few demands for literacy on them it hardly affected them. Then as printing got cheaper and we moved through industrialisation the control of literacy over people’s life chances really expanded and with it the need for literacy based education.
Before the general use of computers started to really develop about 20 years ago, this was always printed materials and the printers/publishers tailored the fonts and font size to match their markets.
The markets for reading material were those who could read effectively, small fonts and white backgrounds.
Different printed products were targeted at different markets.  For example, the ‘upmarket heavy newspapers, targeted at the ‘higher socioeconomic groups, who had been successful in school systems where the information was presented in small fonts on pages of crowded text.  For these people larger fonts would have been more difficult with fewer words ending upon each printed page. The newspapers and books would have been heavier and more paper needed.  In addition there had developed an association in the minds of the population that larger fonts were somehow ‘childlike’, suitable for people with low ability or visually impaired.
Newspapers targeted at an audience with a lower level of educational success....’The Tabloids’ used larger fonts, smaller sentences and less text/more pictures. The stories were and remain less intellectually demanding.
These ‘negative’ associations actually seem to inhibit adults from using a larger font even when they already know that they need it and despite experiencing difficulties with the usual small fonts,
The way that the small fonts also usually need high light intensity to process, also seems to have influenced the tendency to use whiter and whiter paper over the years.
The best readers usually seem to read best on the whiter papers, with the most contrast together of course with small fonts.
Most dyslexic adults who I know find the older books and papers with the darker paper easier to read from. The popularity of the Kindle, with its grey background may be partly accounted for by this.

The use of printed materials also makes the grey/white background ‘normal’. There was no choice. So really until around 1998 with Microsoft Word no one really studied in detail the effect of background.  Any consideration being through the use of coloured glasses or overlays from a limited palette. A very hit and miss approach with often confusing outcomes.
The computer screen allows very precise and objective measurement of any changes in reading performance.

Still too many dyslexic kids are being let down by an education system that fails to teach them in ways they can access the learning that takes place in schools.’
I find this an interesting perspective. Let’s avoid the term ‘dyslexic ‘for a moment and consider the way people who find reading difficult are let down.
When all text was presented printed on paper there was very little choice.  Ina previous post I have compared this as a similar situation to being a sportsperson in a world where only elastic size 8 shoes were available.
Different people would be the champions.  It would be a stupid world.  If your feet were smaller than 8, then you would get sore feet when you ran, would never run far, be very unwilling to train and never get really fit.
If your feet were larger than 8, you would squeeze in because of the elasticity but your speed and training would again be limited.
The great thing about a computer screen is that it is easy to fit the text to your eyes and your visual system, just like a shoe can be fitted to your feet.
This is a simplistic view of the situation but is valid way of thinking about the history of reading and reading difficulty.

It is not just about the eyes, it is the way the visual data is processed, limitations on that processing and then the way the associations between visual data and phonological data are processed. There are issues of working memory, auditory problems, phonological problems, possibly cerebellum problems, these will affect the efficiency with which the eyes collect the visual data on which the system is based, in that it is where the muscle tone controlling that collection is centred.  The work on the likely role of the Magnocellular system and its biochemistry and histology is central to both the visual data collection and its temporal and spatial processing, the way the information is coordinated and collated. The extent of demand on the central executive and its relationship with working memory, short term memory and long term memory; but we are only really in this 21st century just starting to make sense of all the components and the ways they interact.

Virtually all of the brilliant neurobiology research pertaining to reading that is going on now has only become possible because of the development of IT, computing and electronics.  We can now collect huge amounts of data and process it in seconds.  Before this era it was a slow laborious task. One world leading researcher I was talking with 10 years ago commented that he could probably conducted his lifetime of research in a few weeks if he had had a computer and modern electronics!
As our culture has become more and more dependent on text we make more and more literacy demands on each other. Virtually all employment requires functional literacy and better. In the last century, certainly before the 1980’s it was relatively easy to survive economically and educationally by avoiding text. Not true now.

‘There are still too many dyslexics in our prisons because they have been failed by the education system.’
I agree with this statement, although even when pupils are identified as dyslexic, most interventions in the past had any real benefit. Very few teachers had any idea what to do. Actually in Cambridgeshire in the 1970’s it was almost forbidden to use the word.  I was actually told off once for suggesting that a student might be dyslexic.  There seemed to be a fear that it might mean too much ‘money was needed to help’. In retrospect, many of the students who I am confident would have got more appropriate help now, were marginalised and I can imagine the temptations to be outside the law, in the way they were almost pushed outside of ‘society’

The review by Dr Michael Rice with Professor Greg Brooks of the NRDC (The National Research and Development Centre for Adult Literacy and Numeracy in the UK), published in May 2004 is the classic work on this subject.

‘Developmental dyslexia in adults: a research review’

This review was very badly received by ‘the dyslexia Industry’ when it was published... I recommend that everyone interested in this subject reads it with an open mind.
It is an exhaustive study which questions many of the ideas almost ‘faiths’ associated with dyslexia.
Myths are in a sense really concerned with the seeking of answers of understanding in an area which is complex and then feeling comfortable with the level of understanding you have reached. They involve rejection of ideas and people appearing to conflict with your own set of beliefs. These are subliminal rejection, not intentional but they help in reinforcing your own model or explanation of an idea such as ‘dyslexia’. Each person believes/knows that their ideas are the correct one. They know ‘the truth’.

‘There is still too much misinformation and too many incorrect myths surrounding dyslexia.’
Quite true. (I think!!).
The idea that boys are more clumsy and disruptive than girls and boys more likely to be dyslexic.
People who write letter reversals  b p, for example are more likely to be dyslexic.
Left handed people are more likely to be dyslexic
What is probably true is that these people are more likely to be ‘labelled as /diagnosed as dyslexic; in that anecdotally there appears to be an association with poor reading skills. Now that does appear to me to be true.  These people have other issues that result in them being ‘noticed’ as having problems

 ‘In most schools all dyslexic kids learn to be /are failures’.
They get marginalised, often, I think, because they cannot ‘perform’ at the level expected of them.
They get told off, but do not really understand why.
Slow, lazy, easily distracted, clumsy, messy and many other negative attributes.

‘I am dyslexic and a dyslexia specialist.....I believe that dyslexia is not a disability that it is a difference and that it is society that disables us. I believe in the social model of dyslexia. Dyslexia is a result of our evolution and as such reflects human diversity. Thus dyslexia is a difference not a disability. That all kids in school have the right to be learn and achieve according to their potential. This disabling begins in school where we are not taught in ways we can access the learning effectively. Of course there are some great dyslexia friendly schools, colleges and universities out there but they are far and few between.’
I actually agree closely with Steve on most of this but that is also true of many other disabilities.  A friend of mine, the late David Morris, was actively involved in disability rights throughout his adult life. Dave was because of physical disability, severely restricted in his mobility, but he saw his disability in terms of ‘barriers’ each of which needed reducing or removing to enable maximum access. He and colleagues and friends worked tirelessly to these ends. 
In the case of Dave, his disability had a clear medical/genetic origin. Dyslexia is a far more complex concept. In different countries and cultures the manifestation of the symptoms to some extent reflect the written language characteristics, alphabetic versus ideographic and in alphabetic languages, the extent of opacity, the extremes being such as Finnish ( Transparent ) English (Opaque) The research on the genetics associated with persons identified as dyslexic, reported at the Oxford-Kobe Symposium, demonstrated that this approach, was almost too complicated to utilise in barrier reduction, to a very large extent because ‘dyslexia’ itself as a ‘cobweb’ concept .In that  it manifests itself in so many ways, the phenotype is almost indefinable.
Let me give you two examples at the extreme.
1.    When I was teaching, I had the pleasure of working with a pupil, who at the age of 10 in the early 1980’s had been diagnosed as dyslexic by people at the Dyslexia Institute ( Now dyslexia Action). His mother who was financially limited struggled to pay for his attendance at weekly sessions to teach him ‘coping strategies’ and attempts to help him learn to spell, develop his working memory ( Kim’s Game  if I remember correctly)  Nothing seemed to have any effect.
At secondary school he was given extensive special needs support but from my knowledge NOBODY informed his teachers that he had been identified as dyslexic. Nobody went out of their way, as far as I or he remembered to remove or lower any barriers. What did happen was that his lively character, willingness to discuss, and argue got associated with all of the negative labels  experienced by most of the dyslexic students I see at universities He was marginalised, excluded repeatedly, but remarkably remained affable.
At no time did he remember support staff or dyslexia specialists ever suggest he have his vision tested. But then Dyslexia is nothing to do with it???????? He did have a ‘strange eye' though! Partly that caused him even more marginalisation
In 2001 I had just started to use the binocular eye tracker, We had worked out our original algorithm to optimise computer screens for students and I persuaded (not much was needed we had collaborated at the IOO) Anita Lightstone, the Low Vision chief at the Royal National Institute for the Blind (RNIB) to demonstrate what could be done in front of Prof Alistair Fielder a leading researcher associated with the RNIB.
I tracked down my ex-student and persuaded him to accompany me to London and be taken through the procedures in front of Professor Fielder and Anita. It was a matter of trust on his part. He did not know what I was going to do or why. A brave man, he was offered a trip to London and a good curry afterwards in exchange for his cooperation!
Eventually Prof Fielder did turn up and the demonstration began.
Let’s call my ‘guinea pig’...A….  On the eyetracker it was clear that one eye was totally suppressed, for whatever reason. His other eye was at most allowing the processing of two characters per fixation. The apparently wild movements of the suppressed eye appeared to be ‘tugging’ at the ‘good eye’ resulting in lots of head movement as he struggled to read.
At the conclusion of the optimisation both eyes were moving together and he was actually reading rather fluently much to his own surprise, and started to talk excitedly about what he had experienced.

The Professor dismissed the eyetracking information and the change in reading performance as being of no interest. ‘A’ stood up and in a very clear statement, which I will not report in full, turned to the Professor.
‘You might think it is of no interest but it is of ***************interest to me, reading has really ************   ** my life’; added a few more choice bits and stormed out to the Pub where I met him later.

Appropriate intervention to reduce /remove barriers had not been available to him before. Inappropriate intervention had been tried and reinforced his sense of failure and alienation.

2.     My second example concerns a mathematics student at a leading UK university, having attended a, very expensive, public school he had achieved 3 Grade A Advanced level grades.
He had had all the support his father could afford. He knew he was clever, he had been told so. The school had used every available way of minimising the barriers, with extra 1:1 tuition, extra time for his examinations, scribes when necessary. He was very articulate, very logical, an excellent mathematician. But if he had to read a block of text it was slow, faltering. He had had virtually no social life because it took him so long to read /study anything.
His father brought him into Westminster Access Centre 6o find out what we were going to do. An hour later, the student was laughing and reading fluently. He had a piece of ‘magic plastic’ and a setting for his computer screen. As a mathematician, he had followed the logic and he now felt in charge, empowered. His father sat there in disbelief and took out his calculator. After a few minutes his comment was.
‘I have spent over £45,000 on this in the last few years and this was it! A bit of plastic and a coloured computer screen!

Ok so these are two examples when what I do worked really well but it was only possible because of computers screens and the ability to calculate with millions of numbers in a few seconds. It would have been impossible to control the parameters controlling the image and calculate and analyse the outcomes without a computer.

But in the real world there is not equal access. With other ‘dyslexic’ people it may not work as effectively, there may be other factors that are limiting their reading performance that need dealing with as Steve says below.

‘Yes we have accessible technology that some dyslexics can use to enable them to overcome literacy barriers. But they are not a panacea and do not work for everyone. More to the point the high cost of this software makes it inaccessible in terms of cost for many dyslexics’.

As I wrote above not everyone gets access to accessible technology in addition some of the ‘accessible technology’ can be in itself be limiting..

An example here is text to speech technology. Learning is far more accessible if this is used in conjunction with maximised access to the text visually Visual processing assistance in conjunction with text to speech software would be synergistic.

If yo look at a lot of ‘accessibility options’ on computers they themselves are often written with very small fonts and are in themselves inaccessible. The instructions you get when you actually find them are often again, very complex and in small fonts excluding from the start many people who could make use of them.  We really need the default screen settings to be more accessible in the first place and easy to navigate. A better ‘User experience’!

In addition I rarely find any actual auditing of the benefits of much accessibility technology. It is a multi-million pound industry with a lot of ‘box-shifting’.

‘Yes dyslexia has a little higher profile now but in the main it’s a quite negative profile that focuses on what we do struggle to do. But we are just like everyone else out there in the non dyslexic world. We do struggle with some things but we can excel in others. Dyslexia is a difference not a disability and it’s a difference that needs to be embraced, nurtured and encouraged from day one in school.’
Now this makes absolute sense except that I actually think of dyslexia as being ‘many differences’ to take a word from my true love…biology …it is truly ‘polymorphic’!

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