Comments In Retrospect

(A) Macmeeken (1939, p. 27) describes the syndrome as one of 'directional confusion', and this clearly influenced the writing of the above passage. I would not now place the same emphasis on spatial orientation, since from the early 1970s it became clear that dyslexia is primarily a difficulty with certain aspects of language and symbolisation, rather than a difficulty over orientation.

(B) From the wording of this passage it seems that I was willing to use language which endorses somewhat uncritically the concept of IQ. It is clear, however, from what follows later in the paper that I was already aware of some of the difficulties when this concept is applied to dyslexic children (see also Chapter 9).

(C) I have retained the word 'reversal' as it was in my original paper. I now believe, however, that this word implies a mistaken theory of what is going on. Orton (1989) distinguishes what he calls 'static reversals', for instance 'b' in place of 'd' or 'p' in place of 'q', from what he calls 'kinetic reversals', which involve reversing the order of the letters, for instance by writing 'dna' in place of and or 'tworrom' in place of tomorrow. Some of his examples of 'kinetic reversals' could, I think, be explained not by a directional problem over left and right but by a failure to remember the order in which the letters should be written.

Also some of the so-called 'static reversals' involve reading or writing the mirror image of the correct word, for instance 'on' for no as well as 'b' for 'd'

and 'p' for 'q'. As a result the expression 'mirror writing' found its way into the dyslexia literature and Orton even speculates that some dyslexics were extra gifted at it. However, the only hard evidence which has come my way suggests that this is not so. In Miles et al. (2001), in which my colleagues and I examine the mathematical abilities of 10-year-old children, there is an item which involves the decoding of mirror writing. Eighty-three per cent of 6 333 normal achievers answered the question correctly, but only 48% of 269 dyslexics of the same intelligence level did. This result does not surprise me in view of the cognitive complexity of tasks involving the decoding of mirror writing, and, given our present knowledge of dyslexia, I can think of no reason why anyone should now suppose that a dyslexic would find this task easy (note 3.3).

Orton's ideas in this area, though ingenious, seemed to me to have steered dyslexia research in the wrong direction. This is in no way to dispute the importance of the phenomena to which he called attention but only the theoretical superstructure which he brought in to explain them. In particular I cannot help wondering if the importance of the analogy of the mirror for our understanding of dyslexia has been exaggerated. I have heard lecturers speak in the same sentence of reversing 'b' and 'd' and reversing 'was' and 'saw'. However, although 'b' is the mirror image of 'd', 'was' is not the mirror image of 'saw'. I do not doubt that Orton was aware of this, but some of his successors appear to have been less cautious.

In Miles (1961) I follow Orton's theory by describing Michael's 'b'-'d' and 'p'-'q' confusions as 'reversals'. However, the word 'reversal' now seems to me to have misleading theoretical overtones. It is not clear to me that a child who has written 'b' for 'd' has reversed anything. I now prefer to say simply that the child has written the wrong letter. This avoids commitment to any theory as to why the mistake occurred. Similarly, although in fact 'b' is the mirror image of 'd', I am not sure that it helps to say that a child who writes 'b' for 'd' is doing 'mirror writing'.

(D) In publications later than Miles (1961) I have not had occasion to use the expression 'constructional apraxia'. Later experience has suggested to me that Brenda's attempts to draw a bicycle and a ground plan of her house are atypical of dyslexics in general. In the early 1960s I asked some of my subjects to draw a bicycle, but there were no particularly striking results. My problem at this stage of the research was to discover which of the things that I noticed in individual children were genuinely part of the dyslexic syndrome and which were only a characteristic of one particular individual. In contrast, becoming 'tied up' when attempting to say long words turned out to be an important feature in dyslexia, one which was tested for in the Bangor Dyslexia Test (Miles, 1997).

(E) The ability to recognise what is written on the hand is termed 'graphaesthesia' and has now been the subject of systematic study. A graphaesthesia test was used in the British Births Cohort Study (which I refer to in Chapters 19 and 20), and Mary Haslum and I have recently been examining some of the results (Haslum and Miles, in press). It has been suggested that failure to recognise writing on the skin is a sign of brain immaturity; this, however, is not firmly established.

(F) This is no longer true. The phenomenon is now known as 'semantic satiation'; it has been extensively studied in recent years (see, for instance, Kounios et al., 2000; Black, 2001).

(G) I now recognise that I was far too incautious over my use of the word 'normal'. In view of the ambiguous overtones of the word 'abnormal', to use language which could be taken to mean that a dyslexic person is abnormal in some disparaging sense is wholly unacceptable.

(H) These 'extraneous' movements are now being studied systematically by Turner Ellis et al. (in preparation).

(I) The idea that there could be a failure of integration when stimuli are presented visually as well as when they are presented auditorily seems to me in retrospect to be an ingenious one. There is a limit to the speed at which auditory information can be presented. However, what I now think I should have said is that in dyslexics the speed of information processing is impaired.

(J) The important point, it now seems to me, is that if we use the dyslexia concept this gives us a different view as to the direction of causality. There may be anxious parents and a child lacking in confidence as the consequence of the literacy problems, the original cause being a constitutional one. I was anxious at the time to give the psychoanalytic approach fair consideration, but even in those days I regarded the ideas of Blanchard as rather far-fetched. Now that the constitutional basis of dyslexia has been established by brain-scan techniques there is even more reason to be sceptical. In the early stages of my research, of course, I had to make judgements, sometimes on quite inadequate evidence, as to what approach and what concepts would turn out to be most useful. (K) In the 1961 paper I give a quite erroneous list of what the developmental aphasic child might find easy and difficult; in particular I suggest that they would perform well on memory items!

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Adult Dyslexia

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