Developmental Dyslexia DD

1
Developmental Dyslexia (DD)

• Applied issues

2
Structure

• Special Educational Needs
• Origins
• Diagnosis
• Prevalence
• Existence?

3
Human Rights

• The United Nations Convention on the Rights of
  the Child (UNCRC, 1990), as well as the European
  Convention on Human Rights (ECHR, 1998) are two
  of the main international instruments that secure
  both the right and accessibility to education,
  and equal opportunities for children with special
  educational needs.

4
Special Educational Needs (SEN)

• The current SEN Code of Practice for England and
  Wales came into effect on January 1st 2002 and
  takes account of the provisions of the Special
  Educational Needs and Disability Act 2001. The
  Code of Practice sets out the way schools and
  Local Authorities (LAs) should provide extra
  support the meet childrens special educational
  needs.
• http//www.teachernet.gov.uk/docbank/index.cfm?id
  3724

5
SEN

• The SEN bill proposed by Sharon Hodgson, Labour
  MP for Gateshead East and Washington West, whose
  son has severe dyslexia would require the
  government to collect information with the aim of
  improving the "well being" of children with SEN,
  who are often misdiagnosed by teachers.
• She said the lack of information on children with
  SEN, ranging from autism to dyslexia, hindered
  provision for them.
• http//services.parliament.uk/bills/2007-08/specia
  leducationalneedsinformation.html

6
Basics

• Developmental Dyslexia affects 80 percent of all
  those identified as SEN (Lerner, 1989 Saviour
  Ramachandra, 2006)
• Genetic origins 65 of kids from dyslexic
  parents were dyslexic (Scarborough, 1990)
• More frequent in boys (Pennington, 1989)

7
HERONDAS (c. 300 BC) trans. M.S. Buck The Mimes
The schoolmaster (1921).

• The poor tablet, which I kill myself, spreading
  with new wax each month, lies abandoned, between
  his bed and the wall, unless, perhaps he gives
  them a look as if they were Hades. Never will he
  write a thing on them if anything he rubs them
  even barer. He does not even know the letter
  Alpha, unless someone shouts it at him five
  times. The day before yesterday, his father was
  trying to teach him to spell Maron and the
  rascal turned Maron into Simon. when he tries
  to recite even some little childs piece when we
  have guests it comes out like drops out of a
  cracked pot but for the seventh and the
  twentieth of the month he knows those days
  better than the star-gazers and sleep never
  overtakes him when he thinks he may be off
  guard.

8
Origins

• Herondas, offers the first reported case of what
  is nowadays termed developmental dyslexia
  (Giannikopoulos, 1992).
• Pringle-Morgan (1896)
• Orton (1925)
• Invention of the printing press Gutenberg (1493)
• Mass reading in the UK - the Forster Education
  Act in 1870 (Gayán, 2001).

9
Language

• Evolution of speech
• Skills required for written language have not
  been selected for
• The alphabetic principle is a recent cultural
  intervention, akin to chess or snooker, which
  puts considerable amounts of pressure on our
  cognitive system and must be explicitly taught
  and extensively practised (McCadliss Noble,
  2003).

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Dificulties with reading

• The presence of reading difficulties, serves to
  remind us that reading can be very effortful
  (McDougal et al., 2005)
• Those who fail to master (or lose) this ability
  pose major issues of social integration (Ramus,
  2004).
• "It is a lonely existence to be a child with a
  disability which no-one can see or understand,
  you exasperate your teachers, you disappoint your
  parents, and worst of all you know that you are
  not just stupid."
• Susan Hampshire, The Dyslexia Institute

11
Developmental dyslexia

• From the Greek dys- lexis, speech or word
  (from legein, to speak cognate with the Latin
  legere, to read)
• Distinct from Acquired Dyslexia
• developmental dyslexia is a disorder
  characterized by an inherent inability to acquire
  reading skills and it is not to be confused with
  acquired dyslexia, which is the term applied to
  an acquired reading disturbance, caused by brain
  damage (i.e. strokes, tumours or traumatic
  injuries), and characterized by the loss or
  impairment of the ability to comprehend written
  or printed language

12
World Federation of Neurology WFN,

• A disorder manifested by difficulty in learning
  to read despite conventional instruction,
  adequate intelligence, and socio-cultural
  opportunity. It is dependant upon fundamental
  cognitive disabilities which are frequently of
  constitutional origin (Critchley, 1970, p. 268).

13
Benton (1978) Rutter (1978)

• Its key terms conventional instruction,
  adequate intelligence, sociocultural
  opportunity, and constitutional origin were
  often characterized as imprecise, unspecified and
  vague.
• Definition by exclusion (Miles Miles, 1999).
• Difficult to operationalise

14

• Developmental dyslexia is currently grouped with
  a heterogeneous class of language difficulties
  that are collectively known as learning disorders
  (Kandel, Schwartz, Jessel, 1995). It is also
  known as specific reading disability, and the
  terms are employed in the literature
  interchangeably.

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Definition (BDA, 2008)

• Dyslexia is a specific learning difficulty which
  mainly affects the development of literacy and
  language related skills. It is likely to be
  present at birth and to be lifelong in its
  effects. It is characterised by difficulties
  with phonological processing, rapid naming,
  working memory, processing speed, and the
  automatic development of skills that may not
  match up to an individuals other cognitive
  abilities. It tends to be resistant to
  conventional teaching methods, but its effects
  can be mitigated by appropriately specific
  intervention, including the application of
  information technology and supportive
  counselling.

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• Phonology/ Phonemes
• /s/
• Graphemes/ Orthography
• Grapheme-phone correspondence (GPC)
• 26 letters and 46 sounds in English
• 1,120 letters or letter combinations (graphemes)
  to represent 46 sounds (phonemes) (Paulesu et
  al., 2001)

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Italian

• Italian orthographic system comprises of 33
  graphemes that are adequate to represent 25
  phonemes, and that grapheme-to-phoneme
  correspondence is unequivocal (Paulesu et al.,
  2001).
• After 1 year of tuition, 40 reading accuracy in
  the UK, 90 in Italy after 6 months.

19

• Same phoneme, different graphemes
• Bought, yawn, caught, taut, bore, boar
• Same grapheme, different phonemes
• Foot, blood boom

20
BDA defn - descriptive

• Important in creating an awareness, a label.
• By creating a label, descriptive definitions can
  even be advantageous in certain situations, where
  labelling may be a prerequisite (e.g. for legal
  purposes) to ensure that the described population
  is recognised and offered support (Reid, 2003).
• The pressure to label becomes especially apparent
  in academic settings where diagnosis becomes the
  means by which a child may access services such
  as an individualised teaching plan for a learning
  problem (Eide Eide, 2006).
• Attaching a formal label such as dyslexia to the
  individual concerned also has the benefit of
  replacing negative informal labelling (i.e. lazy,
  careless, stupid) that quite often takes place in
  the absence of an alternative, thus alleviating
  terms that carry implications of personal failure
  (Riddick, 2000 Dale Taylor, 2001).

21
But

• Descriptive definitions tend to transfer the
  locus of problems within the individual rather
  than addressing the environmental factors that
  may have produced or exacerbated the display of
  symptoms (Riddick, 2000).

22
WFA defn - discrepancy

• Based on the unexpected discrepancy between
  aptitude and achievement (Reid, 2003)
• IQ and reading age
• VIQ and PIQ
• The middle class disease
• Dyslexia is more easily detected in those with
  average or above average intelligence because of
  the obvious difference between their literacy
  skills and intelligence and aptitude in other
  spheres (Osmond, 1993).

23

• Reading ability is known to be significantly
  correlated with IQ (Snowling, 2000)
• IQ concept is a controversial one and it has been
  argued that it is an inappropriate way of
  diagnosing what is essentially a reading
  difficulty (Stanovich, 1996).

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• The cardinal trait of developmental dyslexia,
  according to discrepancy-based definitions, is
  that the individual though advantaged in all the
  above respects, exhibits reading, writing, and
  spelling attainments which are well below the
  level expected based on cultural background, and
  intellectual and emotional functioning (Thomson,
  1990).

25
Assessment of DD

• In Britain nearly 80 of psychologists identify
  dyslexia on the basis of one-off assessments,
  specific to quantifying the discrepancy between
  aptitude and attainment (Pumfrey Reason, 1991).
• Likewise, nearly 80 of all states in the USA
  adhere to the same normative-based discrepancy
  model (Frankenberger Fronzaglio, 1991).

26
How discrepant?

• It is possible to predict a childs reading age
  (RA), given their chronological age and IQ,
  compare it to his or her actual RA and then
  calculate the statistical significance of the
  difference (which should exceed the 95 level).
• Reading scores equal to at least 1.5 to 2
  deviations below the norm for an individuals age
  are considered to denote skills belonging in the
  dyslexic range (McCandliss Noble, 2003).
• A reading lag of 18-24 months below expectation
  for age should be the minimum (Seymour, 1986
  Snowling, 2000 Ingesson, 2006)
• Two years is arbitrary and refers to a level of
  deficit that varies with age (Wilkins, 2003).

27
Discrepancy quantification methods for the
identification of dyslexia.

• Predicted CAIQ ? RA
• Actual RA'
• Criterion (RARA) p lt.05
• CA Chronological Age
• RA Reading Age

28
Discrepancy quantification methods for the
identification of dyslexia.

• Predicted CA ? RA
• Actual RA'
• Criterion (RARA) 1.5 SD

29
Discrepancy quantification methods for the
identification of dyslexia.

• Predicted EGL
• Actual AGL
• Criterion (EGLAGL) 18 months
• EGL/AGL Expected/ Actual Grade Level

30
Discrepancy quantification methods for the
identification of dyslexia.

• Predicted VIQ PIQ
• Actual VIQ - PIQ
• Criterion (VIQ - PIQ) ? (VIQ - PIQ)

31
But

• Siegel and Smyth (2006) refute the discrepancy
  between IQ and reading ability as a valid
  diagnostic marker, on the premise that the former
  is not equivalent to the latter, and therefore
  cannot predict it thus a discrepancy between the
  two cannot be considered unexpected as current
  definitions often imply.
• 60 per cent of dyslexics do not manifest an
  IQreading achievement discrepancy.
• Discrepancy criteria lack predictive value, and
  their application is limited to children above
  the mean of the intelligence distribution
  (Ingesson, 2006).

32
Poor/ delayed readers

• garden variety (Stanovich, 1988 1996)
• Reading delay is associated with individuals
  whose reading and writing levels coincide with
  their intellectual abilities or mental age, but
  fall behind the level expected based on their
  chronological age (Thomson, 1990).
• Non-(IQ/RA)discrepancy-defined

33
IQ

• 16 of the population has an IQ score of less
  than 85 (Pressley, 2002)
• garden variety delayed readers may completely
  overcome their difficulties in learning to read
  following intensive, structured teaching
  (Vellutino et al., 1996)
• Dyslexics may compensate and be able to read

34
IQ Normal Distribution
35
Maras (1996)

• I'd rather have dyslexia
• Perceptions of kids with Emotional Behavioural
  Difficulties (EBDs)

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The Prevalence of Dyslexia

• Rates between 5 to 17.5 (Shaywitz, 1998).
• Figures of up to 30 have been reported in the
  United States (Kandel et al., 1995)

39

• Different inclusion and exclusion criteria
  (Cotton, Crewther Crewther, 2005)
• Variations in the amount of stringency applied
  (Démonet, Taylor, Chaix, 2004)
• Differences in the diagnostic criteria employed
  in English- versus non-English speaking countries
  due to language-specific requirements (Shiota,
  Koeda, Takeshita, 2000)

40
Cross cultural variation

• Approximately two-thirds of what we currently
  know about the nature of developmental dyslexia
  comes from studies that were conducted and
  published in English-speaking countries (i.e.
  USA, UK, Australia, Canada and New Zealand)
  (Ziegler et al., 2003).
• Lower rates in Japan
• 0.98 (Makita, 1968) to 1.7 (Miyazaki, et al.,
  1995)

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42
Wydell and Butterworth (1999)

• Cross-cultural differences in the reported
  incidences of dyslexia due to the transparency
  and granularity of each languages writing
  system.
• Low prevalence of dyslexia in any language
• (i) where print-to-sound mapping is one-to-one
  (or transparent) and, when this relationship does
  not apply (i.e. print-to-sound mapping is
  non-transparent or opaque)
• (ii) any orthography whose smallest orthographic
  unit representing sound is coarse (i.e. a whole
  character/word).

43
Culture and biology

• Because of the rarity of dyslexia in
  non-alphabetic writing systems, there is often a
  small amount of published dyslexia research in
  these countries (Shiota, et al.,2000).
• Dyslexia is likely to appear as more or less
  damaging under certain conditions, such as
  language (Goulandris, 2003).
• Can have a biological basis despite the cultural
  diversity (Paulesu et al., 2001).

44
Age

• Dyslexia is a persistent, chronic condition that
  does not represent a transient developmental
  lag (Shaywitz Shaywitz, 2005).
• Over time, poor and good readers tend to maintain
  their relative positions along the spectrum of
  reading disability (Shaywitz et al., 1995).
• Although reading abilities improve with time and
  practice, in most cases, dyslexics reading
  skills remain poor compared to those of their
  peers, even in adulthood (Snowling, 2000
  Mortimer Crozier, 2006).

45
Life course

• As a life-long developmental disorder, dyslexia
  has similar, yet distinct manifestations
  throughout development from infancy to adulthood
  (Hayes et al., 2004).
• The developmental nature of the disorder suggests
  that some of these manifestations typically fade
  as learning and maturation take place, only to be
  replaced by different cognitive and behavioural
  patterns (Turner, 2004).

46
Other problems

• Sequencing (i.e. remembering the alphabet, months
  of the year, days of the week, etc.)
• Balance and motor coordination (Stein Walsh,
  1997 Ramus, 2004)
• Clumsiness, forgetfulness, poor spatial
  organization, and distractibility (Shovman
  Ahissar, 2006).
• The Dyslexia Early Screening Test (Fawcett
  Nicolson, 1997) includes factors such as postural
  stability, beads-threading and naming speed (i.e.
  digits, letters)
• Orientation (for example, distinguishing between
  left and right, or east and west)
• Time management
• Short-term memory
• 60 per cent of the dyslexic population also
  exhibit numeracy difficulties (Osmond, 1993).

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pre-dyslexic (Turner, 2004)

• Language predictors and non-language predictors

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Pre-school Language

• Has persistent jumbled phrases, e.g. 'cobbler's
  club' for 'toddler's club'
• Use of substitute words e.g. 'lampshade' for
  'lamppost'.
• Inability to remember the label for known
  objects, e.g. 'table, chair'.
• Difficulty learning nursery rhymes and rhyming
  words, e.g. 'cat, mat, sat'.
• Later than expected speech development.

49
Pre-school non-language indicators.

• May have walked early but did not crawl - was a
  'bottom shuffler' or 'tummy wriggler'.
• Persistent difficulties in getting dressed
  efficiently and putting shoes on the correct
  feet.
• Enjoys being read to but shows no interest in
  letters or words.
• Is often accused of not listening or paying
  attention.
• Excessive tripping, bumping into things and
  falling over.
• Difficulty with catching, kicking or throwing a
  ball with hopping and/or skipping.
• Difficulty with clapping a simple rhythm.

50
Primary school age Language

• Has particular difficulty with reading and
  spelling.
• Puts letters and figures the wrong way round.
• Has difficulty remembering tables, alphabet,
  formulae etc.
• Leaves letters out of words or puts them in the
  wrong order.
• Still occasionally confuses 'b' and 'd' and words
  such as 'no/on'.
• Still needs to use fingers or marks on paper to
  make simple calculations.
• Poor concentration.
• Has problems understanding what he/she has read.
  
• Takes longer than average to do written work.
• Problems processing language at speed.

51
Primary school age non-language indicators

• Has difficulty with tying shoe laces, tie,
  dressing.
• Has difficulty telling left from right, order of
  days of the week, months of the year etc.
• Surprises you because in other ways he/she is
  bright and alert.
• Has a poor sense of direction and still confuses
  left and right.
• Lacks confidence and has a poor self image.

52
Dyslexic students

• Dyslexics can achieve reading and spelling skills
  that are sufficient for academic success (Frith,
  1999).
• They are likely to compensate for their
  difficulties by using different neural systems to
  achieve similar behavioural outcomes (Hayes et
  al. 2004 Nicolson Fawcett, 2007).
• The stability of the diagnosis throughout the
  lifespan has therefore been called to question
  (Hayes et al., 2004 Siegel Smythe, 2006).
• But an underlying deficit in phonology continues

53
Comorbidity

• Specific Language Impairment (SLI)
• Dyspraxia
• Attention deficit (hyperactivity) disorder
  AD(H)D
• ADHD may be a consequence of dyslexia (Pauc,
  2005) or used to increase support (Eide Eide,
  2006)

54
Dyscalculia is like dyslexia for numbers.

• 40-50 of dyslexics show no signs of dyscalculia.
  They perform at least as well in maths as other
  children, with about 10 achieving at a higher
  level. 
• The remaining 50-60 do have difficulties with
  maths. Difficulty in decoding written words can
  transfer across into a difficulty in decoding
  mathematical notation and symbols. 
• For some dyslexic pupils, however, difficulty
  with maths may in fact stem from problems with
  the language surrounding mathematical questions
  rather than with number concepts e.g. their
  dyslexia may cause them to misunderstand the
  wording of a question.

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Possible strengths (BDA, 2008)

• Innovative thinkers.
• Excellent trouble shooters.
• Intuitive problem solving.
• Creative in many different ways.
• Lateral thinkers.

56
Dyslexiacentre.co.uk

• Its not all doom and gloom, many famous people
  are dyslexic.Here are a few examplesAlbert
  Einstein, Richard Branson, Gary Rhodes, Whoopi
  Goldberg, Cher, Joanna Lumley, and Tom Cruise
  just to name a few.  
• Dyslexia is often identified as a difference
  between your verbal ability and the written work
  you produce.  
• Dyslexics are often good conceptual thinkers so
  often they move into careers like architecture,
  design, engineering or computers. 
• Dyslexics can be very creative thinkers moving
  into jobs such as cooking, music, drama or media
  and the arts.  
• Many dyslexics have good spatial awareness and so
  may be at games like chess or connect 4. 
• But dyslexics can also be average thinkers. They
  aren't always brilliant. You don't have to be a
  genius to be a dyslexic. Most dyslexics are
  average - like everyone else!

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Whats it like being dyslexic?

• "My brain is wired differently."
• "It's like my computer crashing with too much
  information!"
• "I know what I want to say, but I can never find
  the right words."
• "I see things from a different perspective."
• "I have all the right ideas, but I can't get them
  down on paper."
• "Speaking out in front of other people makes me
  stumble and forget what I was trying to say."

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In summary

• More than 100 years of scientific research have
  failed to provide a consistent account of
  developmental dyslexia (Miles Miles, 1999).
• http//www.bdadyslexia.org.uk/index.html