The Dyslexia Debate

In the 5th grade class work in, we are currently reading the 2015 Global Read Aloud Fish in a Tree.  In this text, the main character Ally has been diagnosed with dyslexia as described in the movie The Big Picture.  The question is…what exactly is dyslexia?

An interesting chat among LRA (Literacy Research Association) members is going on right now about dyslexia.

Jo Worthy stated:

I was still shocked to read that the interventions used with students labeled as dyslexic in schools and intervention programs are highly scripted and that they are virtually all based on a program that originated in the 1930s, in the heyday of behavioral approaches to learning, and has changed very little since that time. If you’d like a taste, search for Orton Gillingham on youtube and critically examine some of the videos. Again, I was shocked and saddened by what students are doing when they get pulled out of classrooms as they are here in Texas, and by what parents are paying 100/hour or more for. Spoiler: There was not a book or any other meaningful reading material in sight or in use.

I think it’s safe to say that literacy research and practice has come a long way in understanding the importance of helping students see literacy as purposeful and relevant through meaningful instruction and access to a wide range of texts and literacy practices. Students with reading challenges, whether they are labeled dyslexic or not, need and deserve high-quality, meaningful, engaging instruction from knowledgeable teachers. I have had many parents come to me to for advice about dyslexia, and my advice is always the same. I refer them to an outstanding literacy teacher who will use a variety of informal, reading and writing-based assessments to plan instruction geared toward their child’s unique understandings, strengths, interests, experiences, and challenges. All for far less than the cost of tutoring by someone “trained” to deliver a scripted program.

Valdine countered Jo’s claim with:

Those with a reading disorder, as it has been proven in research, require a multisensory approach far different than being offered in mainstream schools unfortunately. This population does not work well to engagement-first instruction. Just as a psychologist would be distracted by a new formal assessment that they are administering, possibly missing the nuance of interpreting student behaviour. A student who does not have the entry level tools  to decode and encode cannot move very efficiently toward our ultimate goal which is comprehension and engagement.

I suggest that academics in the literacy world be cognizant of current brain research.

This lead David Reinking to comment:

As for dyslexia, as a doctoral student back in the early 1980s, Jay Samuels used to tell us that a belief in dyslexia had more to do with religion than with research and science.  Seems like little has changed.  Since the term was introduced in the late 19th century, there is still no clear consensus about what exactly it is, exactly what causes it, who does or does not have it, how prevalent it is, or what specifically to do about it beyond what might be tried with any child having difficulty reading and taught by a well-informed and experienced reading teacher.  

And then George Hruby informed:

Well, in my religion, one of the holiest books for engaging in the necromancy of diagnosis is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, now in a recent 5th edition, meaning it will be around for about another ten or so years. APA warns against the use of the term “dyslexia” because it has been so widely misused. Instead, the correct term, according to the DSM-V, is Specific Learning Disorder with Impairment in Reading. The definition of this, its diagnosis based on symptoms, and its cross-checking with symptoms that allow you to rule out dyslexia are fairly precise, but it amounts to essentially the same definition of “dyslexia” that the NIH put together in 2001, adopted by the International Dyslexia Association in 2002, and more recently by ILA. This simple, one paragraph definition is fine as far as it goes, but it seems that reading disorders are contagious, because few who specialize in their treatment are able to read it with full comprehension (as it would be defined by the Common Core State Standards).

I call attention to one sentence in the middle of the definition in particular. “These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction.” The first two words — “these difficulties” — relate to the preceding  sentence in the definition which lists the primary symptoms: “difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities.”

What that means is that a struggling reader does not suffer from dyslexia if the problem is a linguistic comprehension issue (poor language skills, limited vocabulary, weak comprehension monitoring, inadequate prior knowledge, poor syntactic or semantic processing, etc.). Basing a diagnosis of dyslexia on below average reading comprehension test results (as I have seen done) is not an adequate approach. The MAP test is not a useful screening instrument! This is particularly an issue with the misdiagnosis of post-primary readers.

True, if a reader cannot adequately decode a text, s/he cannot comprehend it. But to jump to the claim that if someone cannot comprehend a text, they suffer decoding difficulties is to fall afoul of the affirmation of the consequent fallacy. If you car is out of gas it will not run. But it does not follow that a car that will not run it is out of gas.

Secondly, according to this tightly worded sentence, the struggling reader does not have dyslexia if s/he has not had access to effective reading instruction. We can argue about what effective reading instruction entails, but I would suggest that at a minimum it requires (1) a probable approach to teaching reading (nothing works for everyone, and nothing works for anyone all the time, so a good approach is to heft a heavy toolkit), (2) a demonstrably effective reading teacher (we can argue about how to determine that, too, but let us at the very least acknowledge the sizable number of teachers who are either only provisionally certified, or simply untrained and not certified at all — and then there are the teachers across the grades who know little of the fundamentals of teaching reading or supporting reading development), and (3) the student was developmentally ready for reading instruction when it was offered (not all kids are ready at the same time, regardless of what your legislature decrees, and with kindergarten now the new first grade, we can expect increasing numbers of “dyslexic” kids; the curricular maps and pacing guides drive instruction forward whether the kids are ready or not, and by the time the late bloomers are ready, the standardized outcomes have moved on; in this way we construct failure. I have seen too many kids “get it” in 2nd or even 3rd grade and blossom thereafter. My own daughter started 2nd grade at 1st percentile in reading on the MAP, but 12 months later was 86th percentile and has never looked back. Developing off the legislated schedule may be a political crisis for some, but it is not a crime against nature, and does not warrant a diagnosis of dyslexia.

Finally, it is not dyslexia if there are other cognitive abilities (including inabilities) that can account for the difficulty. Severely poor vision, for instance, precludes easy learning of letter identification, and no amount of phonological skill drilling will fix a kid’s vision. Ditto for ADHD, behavioral self-control issues, or severely depressed IQ. I know special ed folks like to confuse this truth by bringing up the discrepancy definition issue, but the discrepancy definition (and the lack of correlation between decoding skills and IQ) only applied(s) to IQ in the normal range. Severely deficient intelligence constitutes a general learning disorder — general because it will impact everything including the ability to learn to read. Claiming a specific learning disorder of someone with a general learning disorder makes no sense; it might be true, but how can you tell? In any case, even most of these kids can still learn to decode, it just takes more time and effort than the pacing guide will allow.

As for Orton-Gillingham, the IES’s What Works Clearinghouse reviewed variations on the O-G multi-sensory approach 9 times including a total of 106 studies! Only 2 met IES criteria for a scientific research, and of those 2 neither demonstrated evidence of effectiveness. But let’s be serious. If dyslexia is indeed “a specific learning disability that is neurological in origin,” and with a presumed genetic basis, than it is unlikely a garden variety reading instruction method from the 1930s like O-G could work. If phonological training can’t fix visual problems, it certainly isn’t going to change your genome or mend severe neurological impediments. The compensatory approaches that are hawked are what ought to be a part of basic reading instruction anyway for all readers. Once the over-learning of orthographic patterns in English has done its work to allow sight word reading, greater reliance on syntactic and semantic patterns is required anyway.

Wanda Hendrick then posted:

What is Dyslexia?
Dyslexia is a brain-based type of learning disability that specifically impairs a person’s ability to read. These individuals typically read at levels significantly lower than expected despite having normal intelligence. Although the disorder varies from person to person, common characteristics among people with dyslexia are difficulty with phonological processing (the manipulation of sounds), spelling, and/or rapid visual-verbal responding. In individuals with adult onset of dyslexia, it usually occurs as a result of brain injury or in the context of dementia; this contrasts with individuals with dyslexia who simply were never identified as children or adolescents.  Dyslexia can be inherited in some families, and recent studies have identified a number of genes that may predispose an individual to developing dyslexia.

Is there any treatment?
The main focus of treatment should be on the specific learning problems of affected individuals. The usual course is to modify teaching methods and the educational environment to meet the specific needs of the individual with dyslexia.

Which prompted Peter Fisher to write:

I am not a fan of the term dyslexia, but we should acknowledge that it may sometimes be helpful to the students themselves. In some cases it is the only way in which they can receive extra services. For other students it enables them not to feel “stupid” as they struggle to do as well as they can with their schoolwork.
 
I have no answers in terms of instruction,  but I don’t want to say that something never works. The issue, as with all labels, is where does one draw the boundaries between someone who is “dyslexic” and someone who is just a below-average reader.

And Nancy Knapp added:

My concern with the term “Dyslexia” is sort of the opposite of Peter’s point ( which I also understand), in that the term implies an irremediable, neurological disability, which in turn implies that, even with great struggle, “dyslexic” people will never become easy, fluent, excellent readers.   This is not only incorrect, but incredibly discouraging.  Actually, I have the same concern with the term “specific learning disability in reading.”

I find it fascinating that in 2015 literacy researchers still do not agree on dyslexia and as a result, I am sure this debate will continue.  Interested in joining the LRA and being part of the debate?  Click here.

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