PRO and ANTI the Dyslexia Concept A Dialogue

In the 1960s and early 1970s dyslexia was a relatively unfamiliar concept. That it should have met with opposition is not surprising; many new ideas require time before they register in the public consciousness. What was remarkable, however, was the heat which discussions of dyslexia sometimes engendered. To quote some words which I wrote at the time (Miles, 1967, p. 242): 'Whatever else we know or do not know about dyslexia, it appears to be the case that discussion of the subject makes some people extremely heated and argumentative.'

One of my reactions at the time was to try to clarify my own thinking on the controversies. As a result I decided to write a dialogue. To bring out the contrast between what I took to be opposing views I named the participants in this dialogue PRO, who was for the dyslexia concept, and ANTI, who was opposed to it.

In what follows I have reproduced some extracts, edited and occasionally modified, from what I wrote at the time (Miles, 1971).

PRO starts the dialogue by describing the typical manifestations of dyslexia and ANTI then replies:

ANTI: Yes, of course I have met such children. But this does not mean you are entitled to say that they suffer from 'dyslexia'. If I understand correctly what may be called the 'natural' meaning of the word 'dyslexia', to say that a person is suffering from dyslexia is to say something about what is going on in the person's brain.

PRO admits in reply that he has not directly examined anyone's brain and is content to make a diagnosis of dyslexia on the basis of the person's behaviour.

PRO: If the behaviours already described are present to any appreciable extent, I would immediately say that the child is dyslexic. By this I mean both that these behaviours are present and that the origin of the person's difficulties is constitutional.

ANTI: I myself would never call a child 'dyslexic' precisely because, although I meet the behaviours in question from time to time, I do not know what causes them. Let me try to press my objection further. For the last eight years or so you people have been shouting the word 'dyslexia' from the housetops. Clearly you are out to promote a 'cause'; you want to get people to take dyslexia seriously, and you are saying by implication that traditional educational psychology has somehow failed in this respect. In brief, you want the term to contain 'bite'. Now it seems to me you have two choices: either you must say that dyslexia is a nosological entity, or you must limit yourself to saying that it is a nosographic one. (A footnote then explains: 'The term "nosographic" disease entity refers to a description of a particular disease in terms, for example, of its symptoms and course. The nosological entity is based on knowledge of the cause ... Pulmonary tuberculosis is a nosological entity, since the specific factor ... the tubercle bacillus, is known.' From Hermann, 1959, pp. 94 and 101).

ANTI: In other words, either you want to make a claim about aetiology or you don't. Your dilemma, as I see it, is this. If you use 'dyslexia' as a nosological term, you are saying, in effect, that 'This person is dyslexic' entails both that he or she exhibits some of the behaviours mentioned and that these are due to some constitutional cause. If you say this, however, you are going beyond the evidence. If, on the other hand, you simply say that 'dyslexia' is a nosographic term, then you are no longer saying anything with 'bite'; your apparent victory in 'establishing the existence' of dyslexia has been obtained by definitional sleight of hand. 'All right,' I reply, 'we call these people "dyslexic" - so what?' Any claim to have discovered something which traditional educational psychologists have ignored or overlooked is sheer presumption. No wonder some educational psychologists are cross with you; they have every right to be: you are using a highfalutin term to describe what we all know about and you are implying that they have overlooked something and do not know their job. In addition, since to many people you will seem to be making a claim about causation as well, you are introducing gratuitous confusion.

PRO: I am glad you have mentioned the emotional reactions which the term 'dyslexia' has aroused in some quarters, and I think I see where the difficulty lies for some educational psychologists. In practice there have been parents who, rightly or wrongly, have been so sure that their child is dyslexic that they have had no patience with those educational psychologists who have hesitated to apply the label; they have gone for help outside the state system. With regard to telling parents that their child is dyslexic, certainly in my experience the relief to both parents and child is often quite stupendous. But let us be clear what is involved. The effect of telling parents that their child is dyslexic is logically secondary to the issue of whether the child is dyslexic. What you and I are discussing is the classificatory justification for the term 'dyslexia'; if it is not justified for classification purposes, then the fact that use of it comforts some people is of no more theoretical interest than the fact that it might conceivably be a money-winner. In the present climate of opinion, many educational psychologists attribute such failure to poor teaching or excessive parental pressure, and it is on this issue that believers in dyslexia take a different line . If the difficulties encountered by dyslexic children were the result of poor teaching, one would expect to find groups of dyslexic children from the same class, which clearly one doesn't. As for parental pressure, if you send the parents away thinking you believe them to be neurotic worriers, this seems to me to constitute downright mishandling.

ANTI: Surely we should not be quoting cases of mishandling against one another? If a worker in the child guidance field has loaded a parent with more guilt feelings than that parent can stand, this is clearly bad child guidance. But you wouldn't like it if I blamed you for all the mistakes which believers in dyslexia have made.

PRO: Yes, of course, we all make mistakes. What I am talking about, however, is not mistakes as such but the logical implications of a technical term. We need the technical term 'dyslexia' in order to emphasise that the cause of the dyslexic person's difficulties is constitutional in origin. This explanation is radically different from explanations in terms of parental neuroticism, emotional disturbance etc., which have been put forward by many workers in child guidance clinics in the past. The reason why the label 'dyslexia' contains 'bite' is that it constitutes a challenge to some of the more conventional child guidance attitudes. In the case of these particular children, the traditional approach by which one argues from 'This child is a poor reader ' to 'This child must be emotionally disturbed' is mistaken ... I am dismayed by the arrogance and lack of charity which I sometimes find when I read reports on children whom I regard as clearly dyslexic, e.g. 'His mother is a very anxious woman' or 'There appear to be a number of family tensions'. It seems to me arrogant to assume the right to pry uninvited into family affairs and uncharitable to come up - sometimes, I suspect, on very slender evidence - with such hostile comments ... My use of the term 'dyslexia' contains 'bite' in that those whose initial reaction is to try to explain the behaviours in terms of poor teaching or emotional disturbance are being asked to think again.

(Adapted from Miles, 1971)

Inevitably PRO is given the last word, and I think, in retrospect, that he could have made his points somewhat less aggressively.

However, the anger on the part of those in the PRO-dyslexia camp was not without justification. Failure to understand the dyslexia concept led sometimes to downright mishandling. I have never liked being involved in confrontation, whether on academic or any other matters. However, there were some issues over which I had to come off the fence and not just remain academically neutral.

What particularly saddened me was that ignorance about dyslexia resulted not only in failure to meet dyslexic children's needs but in hurtful accusations that they were 'not trying' and hurtful criticism of their parents. Examples of unsympathetic handling have been documented in Miles (1993a, Chapter 22), and I am reluctant to dwell on them in this book, since I hope they are now a thing of the past. For the record, however, I will cite two examples of what seem to me appallingly bad practice. The first was supplied to me by Elaine, my wife.

A psychologist wrote in one of his reports, 'This mother is neurotic.' His reason: the boy at age 11 had a reading age of nine years. The psychologist took the view that this did not constitute a very serious degree of retardation in a boy of average ability, though how the mother could be expected to know this is not clear. His conclusion was that the mother was inventing the problems and was therefore neurotic. In fact, the boy's spelling was virtually non-existent, so that he could not do the required written work, but the psychologist had made no attempt to test the boy's spelling. Recent reflection has made me increasingly conscious of the contrast between this psychologist and the wise Dr Simmons, who was the psychiatrist at the Child Guidance Clinic in 1949 (see Chapter 1), who said that he found no signs of emotional disturbance in Brenda but believed she suffered from a form of aphasia.

Secondly, I myself assessed a boy (I will call him Terence) at the age of seven years 10 months. He turned out to be typically dyslexic (case no. 7 in the Summary Chart in Miles, 1993a, and mentioned on p. 175. There is also a description of him in Miles, 1993b, pp. 96-97). One of his older sisters was clearly dyslexic (case no. 110) and another marginally so (case no. 259, who is Fiona in Chapter 21 of this book). His mother showed me a letter addressed to Terence from his senior remedial teacher. It ran: 'You have fallen behind in your reading and spelling. Let us be quite clear about this, Terence: there is no reason at all (his underlining) why you should not catch up if you make the effort ... You should learn five words each day and you should make special note of those words which you find difficult.'

To say that Terence had 'fallen behind' and that there was 'no reason at all' why he should not catch up with his classmates shows a complete failure to appreciate what Terence's difficulties were.

The accusation of lack of effort is hard to square with his own account of himself, which I discovered in one of his school exercise books. He had apparently been asked to write down what he would ask for if he had three wishes. This is what he wrote:

My thee wisces

1. I wisce that I god haF a stamp awden to geeq (changed to 'keeq') my stamps in I wish that I could have a stamp album to keep my stamps in

2. I wisce That I gode hepe the reFyoujes to Find homes For Them I wish that I could help the refugees to find homes for them

3. I wisce That I was a powem riter and bese OF all I wiisce that I gode rede I wish that I was a poem writer and, best of all, I wish that I could read.

Confronted by these two cases and many similar ones, I had no option but to become a campaigner and not simply an academic who did research. I was a member of the British Dyslexia Association since its inception in 1972, and I have subsequently served on the Advisory Board of the International Dyslexia Association based in the USA. Membership of these two bodies has greatly increased my understanding of dyslexia.

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