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Adult Dyslexia

Adult Dyslexia

This is a comprehensive guide covering the basics of dyslexia to a wide range of diagnostic procedures and tips to help you manage with your symptoms. These tips and tricks have been used on people with dyslexia of every varying degree and with great success. People just like yourself that suffer with adult dyslexia now feel more comfortable and relaxed in social and work situations.

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Dyslexia Facts You Should Know

Dyslexia, Facts You Should Know Is A Unique Fact Filled E-book That Gathers Easy To Read Information About Dyslexia In One Place For The Interested Reader. Learn How to Cope With A Diagnosis of Dyslexia and What To Do Next. Every bit of this eBook is packed with the latest cutting edge information on Dyslexia. It took months to research, edit, and compile it into this intriguing new eBook. Here's what you'll discover in Dyslexia: Facts You Should Know: What is Dyslexia? History of Dyslexia. Is it Dyslexia or Something Else? How You Can Diagnose Yourself. Benefits of Catching Dyslexia Early. What is the Dyslexia Test? How to Get Everything You Will Need for Help in Coping with Dyslexia. Exploring Your Options for Schools and Programs. What is the Individualized Education Program? Alternatives to the Iep. The Roll Your Childs Teacher Plays. Your Part in Your Childs Education. Why Practice, Patience and Practicality are Most Important. Teens with Dyslexia. Success in Life: Adults Overcoming Dyslexia.

Dyslexia Facts You Should Know Overview

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Author: Dee Henry
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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. PRO starts the dialogue by describing the typical manifestations of dyslexia and ANTI then replies ANTI Yes, of course I have met such...

The Bangor Dyslexia Test II

I suggested in the last chapter that clinical judgements were based on the use of a combination of cues, sometimes small ones, which required to be pieced together. This, of course, is what happens in any medical diagnosis. If I could operationalise these cues, I would be in a position to make a judgement as to whether a particular indicator of dyslexia was present or absent and quantify the numbers of each. In the event I found that I would sometimes be presented with a response which I regarded as marginal - not clearly indicative of the presence of dyslexia but also not clearly indicative of its absence. I therefore devised the following notation a clearly dyslexia-positive response would be scored as 'plus', a marginal response as 'zero', and a dyslexia-negative response as 'minus'. If the subject answered the question with no difficulty, hesitation or special strategy, this qualified as 'minus'. If there were hesitations and other signs of uncertainty or if the subject needed a...

Reading Mechanisms And The Classification Of Dyslexias

Reading is a complicated process that involves many different procedures, including low-level visual processing, accessing meaning and phonology, and motor aspects of speech production. Figure 1 provides a graphic depiction of the relationship between these procedures. This ''information processing'' model will serve as the basis for the discussion of the mechanisms involved in reading and the specific forms of acquired dyslexia. It must be noted, however, that the dualroute model of reading that will be employed for purposes of exposition is not uncontested. Alternatives to the information processing accounts, such as the triangle model of Plaut, Seidenberg, McClelland, and colleagues, will also be discussed. The mechanism by which the position of letters within the stimulus is determined and maintained is not clear. Possibilities include associating the letter in position 1 to the letter in position 2, and so on binding each letter to a frame that specifies letter position or...

Other Peripheral Dyslexias

Peripheral dyslexias may be observed in a variety of conditions involving visuoperceptual or attentional deficits. Patients with simultanagnosia, a disorder characterized by an inability to ''see'' more than one object in an array, are often able to read single words Patients with degenerative conditions involving the posterior cortical regions may also exhibit profound deficits in reading as part of their more general impairment in visuospatial processing. Several patterns of impairment may be observed in these patients. Some patients exhibit attentional dyslexia with letter migration and blend errors, whereas other patients exhibiting deficits that are in certain respects similar do not produce migration or blend errors in reading or illusory conjuctions in visual search tasks. It has been suggested that at least some patients with these disorders suffer from a progressive restriction in the domain to which they can allocate visual attention. As a consequence of this impairment,...

Phonological Dyslexia Reading without Printto Sound Correspondences

First described in 1979, phonologic dyslexia is perhaps the purest of the central dyslexias in that, at least by some accounts, the syndrome is attributable to a selective deficit in the procedure mediating the translation from print to sound. Thus, although in many respects less arresting than deep dyslexia, phonological dyslexia is of considerable theoretical interest. Phonologic dyslexia is a disorder in which reading of real words may be nearly intact or only mildly impaired. Patients with this disorder, for example, correctly read 85-95 of real words. Some patients read all different types of words with equal facility, whereas other patients are relatively impaired in the reading of functors (or little words). Unlike patients with surface dyslexia described later, the regularity of print-to-sound correspondences is not relevant to their performance thus, phonologic dyslexics are as likely to correctly pronounce orthographically irregular words such as colonel as words with...

The Effects Of Dyslexiacentred Teaching

Dr Beve Hornsby spent a year in Bangor in the late 1970s, during which time she collected data for inclusion in a thesis for the degree of M.Ed. She had kept careful records of the reading and spelling performance of children referred to the Dyslexia Clinic at St Bartholomew's Hospital. Records were also available from the Dyslexia Institute in Staines and from our own unit in Bangor. The signs of dyslexia have recently become so clear that we do not now have to wait for a child to fail to read and spell before dyslexia can be diagnosed (see Hornsby, 1989). Games such as 'I spy' can be introduced at a much younger age.

Attentional Dyslexia

Attentional dyslexia is a disorder characterized by at least relatively preserved reading of single words but impaired reading of words in the context of other words or letters. This infrequently reported disorder was first described by Shallice and Warrington, who reported two patients with brain tumors involving (at least) the left parietal lobe. Both patients exhibited relatively good performance with single letters or words but were significantly impaired in the recognition of the same stimuli when presented as part of an array. For example, both patients read single letters accurately but made significantly more errors naming letters when presented as part of 3 x 3or5 x 5 arrays. Similarly, both patients correctly read more than 90 of single words but read only approximately 80 of words when presented in the context of three additional words. Although not fully investigated, it is worth noting that the patients were also impaired in recognizing line drawings and silhouettes when...

Performance Of Dyslexics And Nondyslexics On The Rorschach Ink Blot Test

Frequency distribution of differences in dyslexia index between first and second assessments Table 15.1. Frequency distribution of differences in dyslexia index between first and second assessments came over to Bangor to study for her Ph.D. This was in the 1970s. At this stage we felt we knew a certain amount about the cognitive deficiencies of dyslexics, but we certainly knew very little about them on the personality side. It seemed, therefore, that it would be worth while to ask, 'What effect does being dyslexic have on someone's personality ' Dyslexics Controls The subjects were 15 dyslexic children between the ages of eight and 16, and 12 suitably matched controls. We were fairly confident that we could recognise dyslexics clinically, but at the time the Bangor Dyslexia Test was not yet in its final form. It had been checked that all the subjects were of no lower than average in intelligence. As a safeguard each subject was given the test on two separate occasions,...

Dyslexics Oral Language

When I was giving the Picture Completion subtest of the Wechsler (1974) Intelligence Scale for Children - Revised, Eileen Stirling, who was sitting in with me as part of her M.Ed. course, noticed that when the children were asked to name the part which was missing from the picture many of them avoided the necessity for naming by pointing - correctly - to the missing part and saying, 'That bit.' It occurred to Eileen that this was something which might be worth studying in its own right how good were dyslexics at word-finding She checked on this, using 21 dyslexics and 19 controls (note 15.7). All the subjects were boys and were aged between 12 and 16 years. What Eileen found surprised her. In untimed conditions the dyslexics were no worse than the controls at producing something like the right word, but the reproduction of the word was sometimes inaccurate for instance when the correct answer was 'buckle' (of a shoe), two dyslexic boys said 'buttle', while when the answer should have...

Dyslexia In The Kannada Language

I was lucky to have the opportunity to collaborate with two colleagues, S. Ramaa (whose Ph.D. I had examined) and M. S. Lalithamma. Kannada is a Dravidian language spoken in some parts of India. We were particularly interested to discover if the manifestations of dyslexia were basically the same in a part of the world where there was a different writing system and where English was not the child's first language (note 15.9). On tests of visual and auditory discrimination there were no differences between the three groups. This is not surprising, given that the tasks did not involve naming or any kind of phonological skill. There were differences, however, between dyslexics and normal readers in their ability to recall auditorily presented digits and at breaking words into their components, and in the latter task the dyslexics also differed from the non-dyslexic poor readers. (For confidence levels see note 15.10.) Table 15.6. Comparison of dyslexics, non-dyslexic poor readers and...

Dyslexia And The Middle Classes

Next in point of time was the challenge, posed by the notion that, as mentioned in Chapter 12, dyslexia was a middle-class invention middle-class parents were using this fashionable label as a cover for the fact that their children were not very bright. This was, of course, a sneer and was not intended as a piece of serious research. However, there were already data in the British Births Cohort Study on social class. The children had been classified according to their father's occupation in 1980 into the following groups In addition we ourselves had isolated a group which we believed contained a large number of dyslexics and a group of normal achievers for comparison. Data were available on 227 dyslexics and 5959 normal achievers. Table 20.3 shows the number and percentage of dyslexics and controls falling into the six different groups. Table 20.3. Numbers and percentages of dyslexics and controls in each of the social groups Dyslexics Controls Table 20.3. Numbers and percentages of...

Mathematical Abilities Of lOyearold Dyslexics

We divided the severe underachievers into the three categories described in the last Chapter - severe underachievers A being those with most indicators of dyslexia, severe underachievers B those with the next most and severe underachievers C those with the fewest. We also wished to compare the scores of the normal achievers. Table 20.5 shows for all four groups the combined score on the Similarities and Matrices tests and the mean scores, with standard deviations, on the Friendly Maths Test. All four groups were at approximately the same level in respect of their combined scores on the Similarities and Matrices tests this rules out intelligence level as a possible factor influencing the results. However, severe underachievers A (the dyslexics) obtained significantly lower scores than underachievers C, and even lower scores than either the moderate underachievers or the normal achievers (note 20.3). One must therefore conclude that there are some aspects of mathematics which present...

Dyslexia Without Severe Literacy Problems

We had already divided the severe underachievers into groups A, B and C according to the extent to which they showed indicators of dyslexia on the supplementary items. We now decided to extend this A, B and C classification to the cohort as a whole, again excluding the low-ability children. We had already become interested in variants of dyslexia (see Chapter 21), since there seemed to be individuals who showed indicators of dyslexia despite the absence any major literacy problems. As far as the present study was concerned we needed to look among those normal achievers who nevertheless showed significant indicators of dyslexia on the supplementary items. Table 20.6. Numbers in each group classified in terms of achievement and indicators of dyslexia Table 20.6. Numbers in each group classified in terms of achievement and indicators of dyslexia It will be seen from this table that there were 422 children in Group VII, that is apparently normal achievers at word recognition and spelling...

Dyslexia and Dyscalculia Are They Two Separate Syndromes

The issue of whether there is a separate syndrome, dyscalculia, in addition to the syndrome of dyslexia, is an issue of where to lump and where to split. At present it seems to me that there is insufficient evidence to justify a firm decision in either direction. I shall assume in what follows that, for reasons set out in Chapter 18, dyslexia is an identifiable syndrome. The question to be discussed is whether the phenomena which constitute what people call 'dyscalculia' can all be explained in terms of a single concept, dyslexia, or whether two separate concepts are needed. According to the principle of Occam's razor, entities (that is concepts) should not be multiplied more than is necessary (note 22.1). There is no doubt that a large number of the calculation difficulties experienced by dyslexics are part and parcel of their dyslexia. I mentioned in Chapter 20 dyslex-ics' difficulty in holding in mind a series of mathematical procedures and carrying them out in the right order....

Dyslexia as a Disjunctive Concept

I suggested, particularly in Chapters 7 and 8 and in Chapters 19 and 20, that dyslexia is a disjunctive concept. This means that there are different ways of being dyslexic in one person it may be manifestations A, B, F and G in another person it may be manifestations B, C, D and H, and so on. No one manifestation is crucial what is crucial is the way in which the manifestations combine. According to the arguments in this book it is possible to be dyslexic without necessarily being a poor reader, that is to say poor reading is not a necessary condition for being dyslexic. It is also possible to be a poor reader without being dyslexic, which is the same as saying that neither is poor reading a sufficient condition for being dyslexic. I want to argue in this chapter that the word 'dyslexia' is also what Ryle (1949) would have called a 'disposition' word. What he had in mind can best be shown by means of examples. It was characteristic of Ryle to draw on the familiar events of ordinary...

The Bangor Dyslexia Test I

How, then, did the Bangor Dyslexia Test originate and what did I wish it to achieve In the first place I believed that dyslexia was a syndrome - a family of manifestations, having a constitutional basis. There was in the 1970s only circumstantial evidence for the constitutional basis the condition ran in families, which suggested a genetic basis, and, more speculatively, it was possible that there were analogies between the behaviour of the children whom I was assessing and the behaviour of adults who were known to have suffered brain damage. I was no neurologist, however, and believed that there was plenty to be found out by a systematic study of my subjects' behaviour.

Gender Ratio In Dyslexia

I was surprised to find, however, that the definition of dyslexia in the Shaywitz et al. paper was simply poor reading in relation to intelligence there was no reference to poor spelling. They also found, not surprisingly, that children who came out as dyslexic on one occasion and had then improved their reading had thereby ceased to be dyslexic on a later testing. Clearly the authors of the paper were not talking about 'specific developmental dyslexia' in the sense that Dr Macdonald Critchley had promoted, and which was the familiar sense of the word 'dyslexia' in Britain at that time. When Mary Haslum, Tim Wheeler and I considered how best to present our own data, we thought it tactful to suggest that there could be two different definitions of dyslexia 'specific reading retardation' (SRR), which our American colleagues had used, and 'specific developmental dyslexia' (SDD), which we ourselves had been using. In the British Births Cohort Study we found a total of 269 children who...

Proposal for a Taxonomy of Dyslexia

There is a further reason why some taxonomies can be better than others. If a taxonomy is proposed from a position of strength - from a position of knowledge - a particular decision to lump or split merits nothing but respect. If two researchers are both aware of all the reasons for lumping and of all the reasons for splitting, even if one person decides to be a lumper and the other a splitter, there is nothing significant left for them to disagree about - at most there might be a disagreement about what similarities and differences are the important ones to emphasise. In contrast, if proposals for classification show a lack of such awareness, they can justifiably be faulted. I suspect that those who opposed the concept of dyslexia in the 1970s (see Chapters 11 and 12) were unaware of some of the reasons for lumping. My thesis is that dyslexia is a syndrome - one which can supply a taxonomy of considerable strength if research findings in a number of areas are seen as interrelated and...

Dyslexia Anomaly Or Normal Variation

It seemed to us that the first question we should try to answer from the data available from the British Births Cohort Study was whether something called dyslexia really existed. In the 1970s there were many people who asserted that it did not. Before any answer could be attempted, however, it was necessary to specify what exactly the question meant. An important clue to answering the question had been supplied to us by Dr Norman Geschwind (see the recollection at the end of this Chapter). It was obvious that some children had reading and spelling problems, but this did not entail 'the existence of dyslexia' in any worthwhile sense in the language of Chapter 10, it would not contain any 'bite'. What we needed to consider was Norman Geschwind's idea of anomaly, as opposed to normal variation. If there was nothing more than normal variation in any of the measures which we judged to be relevant to dyslexia, the scores would conform to the normal (or Gaussian) distribution, which involves...

Surface Dyslexia Reading without Lexical Access

Surface dyslexia, first described by Marshall and Newcombe, is a disorder characterized by the relatively preserved ability to read words with regular or predictable grapheme-to-phoneme correspondences but substantially impaired reading of words with ''irregular'' or exceptional print-to-sound correspon dences. Thus, patients with surface dyslexia typically are able to read words such as ''state,'' ''hand,'' ''mosquito,'' and ''abdominal'' quite well, whereas they exhibit substantial problems reading words such as ''colonel,'' ''yacht,'' ''island,'' and ''borough,'' the pronunciation of which cannot be derived by sounding out strategies. Errors to irregular words usually consist of ''regularizations'' for example, surface dyslexics may read ''colonel'' as ''kollonel.'' These patients read nonwords (e.g., ''blape'') quite well. Finally, it should be noted that all surface dyslexics reported to date read at least some irregular words correctly patients will often read high-frequency...

Central Dyslexias A Deep Dyslexia

Deep dyslexia, initially described by Marshall and Newcombe in 1973, is the most extensively investigated of the central dyslexias and, in many respects, the most compelling. Interest in deep dyslexia is due in large part to the intrinsically interesting hallmark of the syndrome the production of semantic errors. Shown the word ''castle,'' a deep dyslexic may respond ''knight'' shown the word ''bird,'' the patient may respond ''canary.'' At least for some deep dyslexics, it is clear that these errors are not circumlocutions. Semantic errors may represent the most frequent error type in some deep dyslexics, whereas in other patients they comprise a small proportion of reading errors. Deep dyslexics also typically produce frequent ''visual'' errors (e.g., ''skate'' read as ''scale'') and morphological errors in which a prefix or suffix is added, deleted, or substituted (e.g., ''scolded'' read as ''scolds'' and ''governor'' read as ''government''). Another characteristic feature of deep...

Peripheral Dyslexias

A useful starting point in the discussion of acquired dyslexia is the distinction made by Shallice and Warrington between peripheral and central dys-lexias. The former are conditions characterized by a deficit in the processing of visual aspects of the stimulus that prevents the patient from reliably matching a familiar word to its stored visual form or visual word form. In contrast, central dyslexias reflect impairment to the deeper or higher reading functions by which visual word forms mediate access to meaning to speech production mechanisms. In the following sections, I discuss the major types of peripheral dyslexia. Other investigators have attributed pure dyslexia to a visual impairment that precludes activation of orthographic representations. Chialant and Caramaz-za, for example, reported a patient, MJ, who processed single, visually presented letters normally and performed well on a variety of tasks assessing the orthographic lexicon with auditorily presented stimuli. In...

Proponents Of Dyslexia Do Not Agree Among Themselves

Another point sometimes urged by critics of the dyslexia concept was that even among its supporters there was no agreement as to what dyslexia was. This never troubled me, since it was clearly untrue. For the record, however, it is worth pointing out that in the early 1970s Elaine and I held a meeting with Beve Hornsby (co-author of Hornsby and Shear, 1975) and Harry Chasty, of the Dyslexia Institute, to see if we could agree on some basic principles of teaching. We had no difficulty in reaching agreement there needed to be systematic teaching of letter-sound correspondences and the teaching needed to be systematic, structured and multisensory. Dyslexia was not the controversial concept which some of its critics had assumed. As a result of this meeting and from my visits to other dyslexia organisations I was confident that there was broad agreement between ourselves at Bangor and the various other bodies in Britain concerned with dyslexia - the British Dyslexia Association, the...

Dyslexia

A particularly active area of clinically relevant research using fMRI is the study of developmental dyslexia. What makes this effort especially promising is that reading is of such fundamental importance to society and education, but there is limited understanding of the development and actions of the relevant cognitive systems underlying reading, even in normal readers. Psychophysical studies of temporal processing, not only in the auditory domain but also in the context of motor activity and coordination and in the visual perception of motion, have all been implicated, by at least some researchers, in the etiology of dyslexia. Coupling fMRI with behavioral studies in this context has especially rich appeal. Again, as with some of the preceding potential clinical applications, the likelihood is not for a treatment based on fMRI, but, rather, an improved ability to differentially diagnose different types dyslexia and to monitor the effectiveness and modes of action of any behavioral...

Dyslexia Variants

According to Critchley and Critchley (1978, p 124) there can be dyslexia variants. They write as follows 'Children are often referred to a doctor on account of a learning disorder or because of inadequacies in written work, where developmental dyslexia seems at first sight not to be the obvious diagnosis if only because the individual's ability to read conforms with both chronological age and intelligence. Might it be that such cases, or at least some of them, can still be looked upon as falling within a rather broader conception of the syndrome of developmental dyslexia In other words can they be considered as dyslexia variants ' The Critchleys refer to such cases as 'formes frustes' of dyslexia. According to the dictionary the word 'frustes' has sometimes been used of coins when they are debased in the sense of not being genuine currency. One could perhaps look on the dyslexia variants described in this chapter as 'debased' types of dyslexia - not the classic cases but with the...

Thoughts on Brenda and Michael

Minimum possible commitment on the theoretical side. In taking over the phrase 'developmental aphasia' I have deliberately chosen to go further than this. I wish to imply that our understanding of these disabilities in children can be helped by an examination of the whole group of aphasic disabilities in adults. Although there may be no history of actual brain damage, in the sense of injury, in the case of these children, their performance is sufficiently similar to that of brain-damaged adults to make us suspect an analogous failure of cortical function. By convention all terms such as 'aphasia', 'apraxia', 'dyslexia' etc. are assumed to carry the theoretical implication that they are caused by some neurological failure of function, and I have deliberately chosen a term with this implication. Thus to say that a child suffers from developmental aphasia is not, as some have supposed, simply a highfalutin way of saying that he is weak at reading it is to postulate an identifiable...

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. 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...

First Steps Towards Quantification

I remember my mentor, Professor Oliver Zangwill, once saying to me that, before one started to research any area in psychology which had practical applications, one should talk to the practitioners, sit in on their discussions and, in general, get the feel of what the subject matter of the topic to be researched was about. This was good advice as far as dyslexia research was concerned. My first priorities were to meet parents, to talk to teachers and, above all, to gain the confidence of the children themselves so that they were willing to tell me what their difficulties were. To this day I particularly value what people tell me about dyslexia in a clinical setting, even in the absence of tables of figures (norms) which tell me how frequently this or that type of behaviour occurs. Chapter 1 and Chapter 2 of this book each contain one statistical table both tables compare the proportion of errors over consonants to the proportion of errors over vowels in the spellings of Brenda and...

Uncertainty Over Left And Right

From time to time I noticed that, in order to answer the question 'Which is my right hand ' some subjects turned in their seats. I had a gut feeling that this was part of the syndrome, but it was only later that I felt I understood why this was happening. Dyslexia is a labelling difficulty and in this item of the Bangor Dyslexia Test it is the labels 'left' and 'right' which cause the problem. One can save oneself one of the two labelling tasks by turning in one's seat so as to face the same way as the tester. Turning in one's seat is an action - something which one does - and the subjects who turn in their seats are in effect using an ingenious compensatory strategy by which doing something (turning in their seats) is a substitute for naming.

Months Forwards And Months Reversed

Able to say the days of the week correctly, except in the case of the very young ones. This meant that a request to say the days of the week would not have differentiated the dyslexics from the non-dyslexics. The reason for this was also clear in the case of the days of the week there are seven items to remember, compared with 12 in the case of the months of the year, and, since the days of the week come round more frequently than the months of the year, there is more opportunity for learning them. I decided to retain the request to say the days of the week as an option in the case of the seven- and eight-year-olds, since although a successful response would be uninformative a failure would be a highly significant positive indicator.

Digits Forwards And Digits Reversed

I routinely made use of intelligence tests (see Chapter 9 for an account of the problems which I encountered in this area). I found, however, that some of the tests, including the Terman-Merrill and the Wechsler, included items where the subject was required to recall strings of auditorily presented digits. These included both Digits Forwards and Digits Reversed. I had become aware quite early on that many dyslexic children were weak at the recall of digits and, since one of the things which I was looking for was incongruity - poor reading or spelling in relation to intelligence - it seemed absurd to use a recall-of-digits test as a measure of intelligence this would have the effect of making this incongruity appear less than it actually was. It would be far more useful to include a recall-of-digits item as one of my tests for dyslexia. This was therefore what I decided to do.

Assessing Intelligence

The question of how to assess a dyslexic's intelligence is discussed in Miles (1996) in a paper entitled 'Do dyslexic children have IQs ' In it I express scepticism about the value of the concept of IQ in general and suggest that there are particular problems in the case of dyslexics. The idea that an IQ figure represents a fixed quantity and therefore implies a limit as to what a person might achieve seems to me a pernicious doctrine when applied to any individual, and particularly pernicious when applied to dyslexics. I have been influenced on this matter by my reading of Skinner (see Harzem and Miles, 1978, especially Chapter 7). Skinner and his followers have shown the many things which can be achieved by creating appropriate conditions in the environment. The possibility of providing a global IQ has been taken for granted even by those whose main aim has been to break down cognitive skills into their components. Such researchers report in meticulous detail on their subjects'...

Concerns and Disputes I

One of the most cogent of the academic arguments against the dyslexia concept was that of Davis and Cashdan (1963). The authors of this paper argue that if a concept such as dyslexia is to be justified it is necessary to show that the members of this group are distinctive in respect of causation, methods of treatment and prognosis. The authors did not claim that these conditions would never be satisfied but only that at the time of writing this had not happened. At the time Davis and Cashdan had a strong case. Certainly there was the fact that dyslexia ran in families, which suggested that a genetic factor might be at work. However, the evidence for a different brain organisation in dyslexia was only circumstantial, being based partly on the existence of possible analogies between its manifestations and those of acquired aphasia there had been no direct examination of individual brain structures. As things are now, of course, while there is much which remains to be discovered within...

The Need For Good Literature

The concern that children should not miss out on good literature was a well-intentioned one, and arguably the use of reading books whose aim was to train up phonic awareness may at the time (though this is no longer true, see note 12.1) have led to a rather restricted vocabulary and, as a consequence, to dull reading. However, we may justifiably criticise those policymakers who laid it down that letter-sound correspondences should not be taught at all while it may be true that fluent readers can pick up the sense of a passage without looking at every detail, this policy proved disastrous for those who were not fluent readers - and for dyslexics in particular. My own experience with dyslexics suggested to me that, as far as reading is concerned, some may have achieved limited success without the systematic teaching of letter-sound correspondences. The idea, however, that after reading 'good books' dyslexics will come to learn letter-sound correspondences and hence learn to spell seems...

The Need For Evenhandedness

When resources are scarce, it goes without saying that these resources should go to those who need them most. The worry for some educationalists was that, if the dyslexia concept were accepted, resources might be channelled into helping those articulate middle-class parents who made a fuss at the expense of children whose needs might be greater. This was a perfectly valid concern. Sadly, however, things turned sour. The valid concern for a fair distribution of resources degenerated into a slanging match politically motivated people began to sneer that this new and fashionable label, 'dyslexia', was being used by the middle classes to disguise the fact of their children's low intellectual ability. In the words of one critic 'If you live in Acacia Avenue, you are dyslexic if you live in Gasworks Terrace, you are thick.' Such comments were hardly likely to help the situation, and, not surprisingly, some of us found them very exasperating. This was particularly the case for those of us at...

Medical Or Educational

I now pass to issues where there were apparent conflicts but where these were due not so much to disagreement as to misunderstanding. In particular there was the issue of whether dyslexia was a medical matter or an educational one. In the 1970s this distinction was sharper than it is now. Medical budgets were separate from educational ones and funding had to come either from one budget or from the other. From this point of view dyslexia was an awkward hybrid no one had ruled whether it properly belonged in education or in medicine. One of the reasons why some people objected to the dyslexia concept was because of its allegedly 'medical' overtones. In medicine it is common to use the words 'patient', 'diagnosis', 'treatment' and 'cure' but, if a child has a reading problem, so some people supposed, such terms are inappropriate. In the words of one critic (I do not remember the source), the term dyslexia 'wraps in medical mystery what should be an educational problem'. It is admittedly...

One Should Not Label Children

For example, if a teacher does not use the label 'dyslexic', other labels such as 'lazy' or 'lacking in concentration' will take their place. I remember an occasion - I had been addressing a local Dyslexia Association - when someone raised the objection about labelling. In reply a mother immediately stood up and said, 'My son prefers the label dyslexic to the label dumbo.' This was greeted with prolonged applause.

One Cannot Repair Damaged Brains

Those who take this view can be reassured that that is not what advocates of the dyslexia concept were implying there is nothing defeatist about labelling a person 'dyslexic'. Indeed, one of the main points of the label is to make sure that they do receive help. In sum, the objections to the dyslexia concept were many and varied. Some were more deserving of respect than others, and in some cases nothing more was needed than the removal of misunderstandings by improved communication.

Legislation and Governmental Recognition

The first attempt in Britain to achieve legal recognition for dyslexic individuals was in 1970, when the Chronically Sick and Disabled Persons Act of that year included a reference to 'acute dyslexia'. The word 'acute' appears to have been poorly chosen, since this word is normally taken to mean 'coming on suddenly'. In this context, however, it should presumably be taken simply to mean 'severe'. Because of this clause the Tizard Committee was appointed to look further into what was needed. Unfortunately the Tizard Report (1972) was a great disappointment as far as the recognition of dyslexia was concerned We are highly sceptical of the view that a syndrome of developmental dyslexia with a specific underlying cause and specific symptoms has been identified We think it would be better to adopt a more usefully descriptive term, 'specific reading difficulties', to describe the problems of the small group of children whose reading (and perhaps writing, spelling and number) are...

Further Quantification I

It had already become plain that dyslexics were weak at recalling auditorily presented digits. During the 1970s it occurred to me to ask if they were also weak at recalling them when the digits were presented visually. The presentation of stimulus material by computer was not an option at the time, and it was necessary to use a device called a tachistoscope, by means of which it was possible in controlled conditions of illumination to expose visual stimuli for time intervals as short as a single millisecond (that is, one thousandth of a second). Elaine and I had long been suspicious of the idea that there were 'visual dyslex-ics' who learned better if material was presented auditorily, and 'auditory dyslexics' who learned better when material was presented visually. Now all the subjects in Miles (1993a) had been tested on their recall of auditorily presented digits, and data were available on 42 of them who had also been tested in the visual condition. If it were true that some...

Do People Remain Dyslexic

Twenty-two of my subjects came back to the Bangor Unit for reassessment (Miles, 1993a, Chapter 19). It was therefore possible to compare the number of positive indicators obtained on the Bangor Dyslexia Test at the first assessment with that obtained at the second. My belief had always been that dyslexia is a lifelong condition, and I should have been seriously worried if I had found any large difference in respect of 'pluses' (positive indicators) between the two assessments. The scoring system of the test allows for development in the case of three out of the 10 items, Repeating Polysyllabic Words, Digits Forwards and Digits Reversed. It is assumed that even those with dyslexia will to some extent improve their performance on these three items without ceasing to be dyslexic. In the case of the other seven items adjustments for age in the scoring system were unnecessary. Clearly familial incidence does not change and if there is a history of left-right or 'b'-'d' confusion, it is...

Starting Teaching At Age Seven

It was possible to study in detail 10 seven-year-olds, eight boys and two girls, all of whom were severely retarded at reading and spelling and all of whom (bar one, for whom there was no record) showed characteristically dyslexic responses on the Bangor Dyslexia Test. Elaine and I also had the opportunity to contribute a section on dyslexia to a book on developmental disorders among Kerala children (see Miles and Miles, 1999b).

Age Of Vocabulary Acquisition

There was a large amount of anecdotal evidence that dyslexics were late in learning to talk, but I owe to my colleague John Done an ingenious way of establishing the matter experimentally and quantifying the amount of lateness. After initially presenting these pictures to children John started on the main experiment. This involved giving the same 65 pictures to dyslexic and control subjects aged about 14.6. (The controls were marginally younger, so that, if there were any effect of age, it would count against the hypothesis which we were testing.) The response latencies of both groups correlated highly with the previously determined age of acquisition. However, the response latencies of the dyslexics were considerably longer than those of the controls. Overall, when he took into account the age of acquisition of the different words, John found that the difference in response latencies between the two groups produced an overall difference score of 67 milliseconds this was found to...

Matching Sentences With Symbols

It will be seen that, whatever the stimuli, the dyslexics needed more time than the controls before they could respond correctly. The difference was more marked in the case of 'b' and 'd' and 'left' and 'right' than it was in the case of 'above' and 'below' or 'star' and 'plus'. Statistical analysis showed that the left-right and 'b'-'d' tasks were differentially more difficult for the dyslexics (note 16.1). As far as the other tasks were concerned, the dyslexics were always slower but there were no other tasks which they found extra difficult. These results confirmed the view, widely accepted among those with experience of dyslexia, that the distinction between 'above' and 'below' causes fewer problems for dyslexics than the distinction between 'left' and 'right'. This is presumably because 'above' and 'below' remain the same whichever way one is facing, whereas 'left' Table 16.1. Response times in seconds for dyslexics and controls to various combinations of stimuli Table 16.1....

Colournaming Experiments

From earlier research, for instance Denckla and Rudel (1976), there was reason to believe that if dyslexics were presented with a card containing familiar colours and asked to name them they would be slower at doing so than suitably matched controls. The reason for this, however, was not clear. One possibility was that in dyslexics the transmission of information through the nervous system is slower, with the result that, colour for colour, dyslexics take longer time. However, I had sometimes had the opportunity to observe dyslexics in a colour-naming task, and it seemed to me possible that, colour for colour, they might be no slower than controls but that they might become 'tied up' at certain stages of the task - perhaps through being overwhelmed by the effort called for in continually having to find the right name. In that case their longer overall time would be the result of extra long delays over a small number of colours, rather than a slight slowness over each individual...

The British Births Cohort Study I

At birth and in subsequent follow-up studies medical, social and, in 1980, educational data were obtained. My own involvement was in the follow-up in 1980 I was invited to explore what could be found out from the cohort study about the existence and nature of dyslexia (note 19.1). I took the view that a necessary condition for a diagnosis of dyslexia was poor reading or spelling in relation to intelligence. In choosing a measure of intelligence it was necessary to bear in mind the existence of the so-called ACID profile (see Chapter 9) and the general danger that on some of the traditional tests of intelligence dyslexic children might obtain scores that did not do justice to their intellectual level. Fortunately I had had the opportunity to see in advance some work by my colleague Dr Michael Thomson on the performance of dyslexics on the BAS (note 19.3). Michael found that on some items the dyslexics in his group scored above the average as determined by the published norms and on...

Should Handedness Be Routinely Recorded

It had been widely supposed over many decades that among dyslexics there was either an excess of left-handers or possibly an excess of those who were neither Table 20.4. Categories of handedness normal achievers (N 6382) and dyslexics (N 235), percentages in brackets Table 20.4. Categories of handedness normal achievers (N 6382) and dyslexics (N 235), percentages in brackets Thus we found no evidence that there was anything unusual about the handedness of dyslexics in comparison with the normal achievers in our study. Three further papers presenting data from the British Births Cohort Study have been published in Annals of Dyslexia (Miles et al., 1998, 2001 and 2003).

Sketch 6 Rick Loeffler

Rick wrote to me from America at the age of 51 on account of his mathematical difficulties. He had read Dyslexia and Mathematics (Miles and Miles, 2004), and 'it was like I was reading about myself'. He was interested in moving to a more demanding job but needed a university qualification in mathematics which he had been unable to obtain. He had been told that his disabilities were not of any recognised kind and that he was therefore not eligible for financial help. He told me that he had no reading or spelling problems, and he enclosed a report indicating that he had been found to have a verbal IQ on the WAIS-R (Wechsler, 1992) of 138 and a performance IQ of 111 (full scale IQ 128). A copy of the Bangor Dyslexia Test was posted to him so that he could be tested by a qualified psychologist. There were five and a half positive indicators. He reported that his father and brother were dyslexic and that he used to confuse 'b' and 'd'. He told me that in the case of the Left-Right item...

Times Tables And Subtraction

I had been asked at one point to teach spelling to a dyslexic boy from St David's College who, I was told, also had difficulty in learning his times tables - would I help I had no idea why the boy found his tables difficult, but I can never resist bait and therefore agreed to explore the matter. When I did so, it became immediately obvious that his difficulty with his tables was part and parcel of his dyslexia. I also noted that, although he was aged about 12, he still used his fingers for calculation. From this point on I became aware that problems with calculation were manifestations of dyslexia. I therefore had no hesitation in including some subtraction items and the task of reciting tables in the Bangor Dyslexia Test. I suppose you could say that I was widening the concept of dyslexia so that it included these two mathematical items, but this seemed preferable to limiting the concept to 'poor reading' and then being confronted with a mass of disparate phenomena, which often...

Sketch 10 Elizabeth

Critchley and Critchley (1978, pp. 126-7) describe the following variant of dyslexia 'There is a variant of dyslexia which may present itself in the guise of Since the Friends House library also contains letters written by Elizabeth's father and brothers, it seemed worth investigating whether there were signs of dyslexia among members of her family. The result, however, turned out to be negative there are virtually no spelling errors in any of these letters the writing is legible and there is no absence of punctuation. However, there is further evidence that Elizabeth Fry was dyslexic, not from her misspellings but from some of the entries in her journals. Small signs may be insignificant on their own but, taken together, can be seen to form a coherent pattern.

Overall Comments On The Sketches

If one relied solely on scores on reading and spelling tests, there is a risk that one will fail to detect manifestations which are important and interesting. What is needed, I suggest, is a widening of the concept of dyslexia so that cases such as these can be included.

Service for the County of Gwynedd

If I had had to convince the educational establishment of the time that research into dyslexia was of value, I do not think the dyslexia research at Bangor would ever have got off the ground - much of my time would have had to have been spent in making (probably unsuccessful) applications to grant-giving bodies, whose educational advisers could well have been hostile at the very mention of the word 'dyslexia'. Fortunately, however, in the 1960s and 1970s, as head of the Psychology Department at Bangor, I was left free to investigate any topic of my own choosing without any interference from the government. My academic colleagues on the college's faculties and senate were invariably supportive, and although I continued from time to time to publish books and papers in areas other than dyslexia - particularly on the philosophy of behaviourism (Harzem and Miles, 1978) and on the philosophy of religion (Miles, 1959, 1998) - dyslexia research occupied by far the largest part of the time...

Repeating Polysyllables

Among the more difficult words at the end of the Schonell Word Recognition test (Schonell and Schonell, 1952) is the word preliminary. What I have found with dyslexic children and adults is that responses which I had not believed were relevant to the diagnosis suddenly 'hit me in the eye' as having a significance which I had hitherto not appreciated. In this particular case I do not know how many times I had given the later part of the Schonell Word Recognition test to my subjects before I realised that stumbles over the word preliminary might be of diagnostic relevance. From then on I made a point of trying to notice whether such stumbling occurred. In this connection I consulted with my colleague Gill Cotterell, who had been teaching children at the Word-Blind Centre in Coram's Fields (see Chapter 4), and asked her if she had encountered anything similar. She said she had, and told me of a boy who had said 'par cark' for car park. Soon afterwards Elaine and I were giving lessons to...

Conventions

Throughout this book there are many examples of dyslexics' writings. These have been reproduced in roman type ('dsgib'), while correct spellings for words have been reproduced in italic type (described). When reproducing dyslexics' writings, I have striven to be as faithful to the original work as possible. Therefore, there are a few instances when a word had been crossed out by its writer this crossing-out has been reproduced. Lastly, since there are both male and female dyslexics, I have used the expression 'he or she' except when this would have been inelegant and clumsy. When I have quoted from my earlier publications, for instance Miles (1961), I have left 'he' and 'his' in place since at the time the matter was considered less important than it is now.

Brenda

It was at this Child Guidance Clinic that my interest in dyslexia was first aroused. By a remarkable coincidence it was on my first day at the clinic that I met Brenda. Brenda was being referred at the age of 10 because of her poor progress in some aspects of her school work. She was being educated as a day girl at a private school not far from her home. Tests given by myself and two colleagues showed Brenda to have an IQ of 116 on the Terman-Merrill (1937) test, a reading age of 8.3 years and a spelling age of 8.3 years on the Schonell (1945) reading and spelling tests, and a mental arithmetic age of 7.0 years on the Burt (1947) test. Her vocabulary score on the Terman-Merrill test (17 words correctly explained) gave her a pass at year xiv - far above the norm for her age. The incongruity of these results was clear, though it is interesting that at the time I had failed to appreciate the significance of her low score on the mental arithmetic test - the fact that there was a...

Recollections

By the mid-sixties Marion Welchman had begun her pioneering work in the dyslexia field - prompted initially by the unsympathetic treatment meted out to her son, Howard, in his early days at school. Marion had heard about the work of the committee of the Word-Blind Centre and with characteristic energy had sought us out. I first met her at one of the committee meetings, where she was received with the utmost courtesy by Dr White Franklin and Dr Critchley. However, the person who first introduced her to us described her, in a rather disdainful voice, as 'a mother from Bath who thinks she may be able to do something'. At the time, of course, none of us knew how much this mother from Bath would be able to contribute to the understanding of dyslexia not only in Britain but on a worldwide scale. From our first I was afterwards to make many friends on the other side of the Atlantic. There was the much loved Margaret Rawson. Margaret lived from 1899 to 2001, dying at the age of 102, after...

Michael

The psychologist who originally tested Michael thought that absence from school and some learning inhibition due to emotional causes might be sufficient to account for Michael's weakness at reading and spelling. Even at the time, however, and with my very limited knowledge of dyslexia this seemed to me unlikely. His parents certainly showed some anxiety, but not a disproportionate amount in the circumstances. A psychiatric interview led Dr Simmons to conclude 'I could find no good evidence of maladjustment of a kind that would warrant concern.' It was not until many years later that I realised that becoming 'tied up' when saying certain long words could be an indicator of dyslexia. I then included the request to repeat some suitable words as part of the Bangor Dyslexia Test (Miles, 1997). In many of my talks I have presented this reproduction to local Dyslexia Associations and other organisations as an illustration of how a highly intelligent boy can nevertheless produce weird and...

Recall Of Sentences

In Miles (1993a, pp. 138-9) I note that when I gave my subjects sentences to remember from the Terman-Merrill (1960) test they were often able to report the gist of the sentence correctly but did not get the exact words right. When this happened, I said the sentence over again and asked them to have another try. What I found was that in some cases they needed as many as five or six repetitions before they were word perfect. This seemed a good idea for a student project, and I enlisted the help of two final-year students to check whether for the correct recall of sentences dyslexics needed more repetitions than controls (note 16.6). We found that the dyslexics needed many more repetitions than the controls. The number of repetitions needed for each of the four sentences is set out in Table 16.5. All differences were highly significant (note 16.7). We found that no control participant needed more than four repetitions for any one sentence or more than eight repetitions overall (that is...

Talking Things Over

It was always interesting to go through the results of the Bangor Dyslexia Test. I sometimes asked if they had noticed anything similar to what I had picked up, for instance confusion over 'left' and 'right' or becoming 'tied up' when trying to repeat long words. If they had, it was then possible to tell them that this was part of the overall dyslexic picture. Parents have sometimes said to me in irritation 'Yes, he was assessed by an educational psychologist who told us he was intelligent but a poor reader and speller. This was of no help because we knew that already.' As a result of such comments I began to ask myself, 'What else does a diagnosis of dyslexia provide ' I remember assessing a student who had previously been in the navy. When I gave him the 'left'-'right' items on the Bangor Dyslexia Test, he was immediately able to recall that his commanding officer had sworn at him for confusing 'port' and 'starboard'. What had been an isolated event suddenly made sense to him....

Sketch 1 Fiona

Fiona was assessed by me at the age of nine years three months. On the Schonell R1 test of single-word recognition (Schonell and Schonell, 1952) she had a reading age of 11.0 and on the S1 spelling test a spelling age of 9.2. On selected items of the WISC (Wechsler, 1974) her scaled scores were Comprehension 20, Similarities 20, Vocabulary 17, Picture Completion 16, Block Design 18 and Object Assembly 14. A score of 16 places a child in the top two and a half per cent of their age group on any reckoning, therefore, these scores are extremely high. On my method of scoring (see Chapter 9) her results placed her in the Z category, the highest possible and suggestive, at least in some respects, of an IQ in the 140s. When given the Bangor Dyslexia Test, she reported that she had worked out 'left' and 'right' by means of the strategy 'I write with my right hand'. She responded correctly to Months Forwards and Months Reversed, but her mother told me that Fiona had spent considerable time...

Sketch 2 Philip

Reversed - errors which are well outside normal limits for a non-dyslexic 10-year-old of average intelligence. He wrote 'b' in place of 'd' on several occasions, for example he wrote 'boll' for doll, 'barsing' for dancing and 'binermite' for dynamite. He needed to use his fingers for simple calculation he lost his place in saying his six-times and seven-times tables, and in trying to explain his arithmetical difficulties he said, 'All double numbers - I sometimes put them the wrong way round.' Overall, in what was later to become the Bangor Dyslexia Test, he was found to have five and a half positive indicators. Although he was not seriously retarded in spelling, many of his spelling errors which he made seemed to be of a typically 'dyslexic' kind 'prepterion' for preparation (later 'prparlion'), 'torw brigde' for Tower Bridge, 'wroy' for worry, 'Amecar' for America and 'libtgh' for light.

Final Thoughts

I now think that Brenda's difficulty in drawing the plan of her house and drawing a bicycle is atypical of dyslexics in general. Certainly I found that in later writings I had no occasion to use the expression 'constructional apraxia'. It is clear, however, that I was aware even at the time of some of the problems in determining a dyslexic child's intelligence, and this problem was one which very much came to the fore in subsequent years. Looking back, I am now aware that there were many interesting points about Brenda's and Michael's spelling errors whose significance I did not appreciate at the time. The commonly accepted view nowadays is that dyslexics have a deficit in the area of phonology, that is in the recognising, remembering and ordering of speech sounds. When I wrote the original paper, this idea had not come to the fore. It was Overall I think it fair to say that with increased experience I have changed some of my views on points of detail but not on what I take to be the...

Sketch 3 Mary

Mary came for assessment at the age of 10. Her twin sister, Janet, had been referred because of suspected dyslexia, and their parents asked whether anyone in the team would like to assess Mary as well even though she was not dyslexic. This offer was accepted. Both twins turned out to be well above average in intelligence as judged by their results on the WISC-R (Wechsler, 1974). Janet turned out to be dyslexic, as her parents had supposed. In Mary's case, however, as far as her reading and spelling were concerned, there was no trace whatever of dyslexia on the Schonell tests (Schonell and Schonell, 1952) she had a reading age of exactly 12 years and a spelling age of over 13 years - and this at the age of 10. However, she was found to have four and a half positive indicators on the Bangor Dyslexia Test, with 'pluses' on Left-Right and Digits Forwards and Familial Incidence, as well as 'zeros' on Polysyllables, Tables and Months Reversed - a total of five and a half 'pluses'. The...

Sketch 4 Edward

Edward was discovered in 1981 at the age of 14 when control data were being obtained for the Bangor Dyslexia Test. The usual safeguards were specified as to adequate intelligence and opportunity, and in the case of this particular age group it had been decided to accept as controls all those who had spelled 72 or more words correctly on the Schonell S1 spelling test (Schonell and Schonell, 1952). This corresponds to a spelling age of just over 12. (It had been decided that anyone whose spelling was at this level could not be regarded as having any significant dyslexic problems.) Edward spelled 79 words correctly and was therefore included among the controls. Yet his responses on the tables item in the Bangor Dyslexia Test were quite clearly those of a dyslexic both a medical doctor with considerable experience of dyslexia who was also present and I were agreed on this, and we particularly noticed how other control children at the school could rattle off their tables without the least...

Sketch 5 Helen

When I gave Helen the Bangor Dyslexia Test, she showed positive indicators on Left-Right, Tables, Digits Forwards, Digits Reversed and Familial Incidence (her father was reported to be dyslexic) and a zero on Subtraction - the first four sums being answered correctly (9 - 2, 6 - 3,19 - 7, 24 - 2), but in the case of 52 - 9 there was a long hesitation before she responded '43' and to arrive at the correct answer to 44 - 7 she responded, 'Not sure 44 - 10 is 34 37.' Her tally of 'plus' responses on the Bangor Dyslexia Test was thus five and a half.

Sketch 7 Charlotte

Dyscalculia has largely been ignored in comparison (with dyslexia) but the disability can be very demoralising - not to say inconvenient - in this modern world. There must be thousands like me who have struggled with this common condition all their lives. The results of the Bangor Dyslexia Test were inconclusive. She made one error on the polysyllables item ('an enemy' for anemone), made one error over subtraction and, having mistakenly said that eight sevens were 54, she continued by saying that nine sevens were 61. The results on the Left-Right, Months Forwards, Months Reversed, Digits Forwards, Digits Reversed and 'b'-'d' confusion were all negative. Sketches 8 and 9 are different from the previous seven, since my evidence is second hand. I decided, however, that, despite this and their brevity, they were sufficiently challenging to be worth inclusion. The historical sketch, that of Elizabeth Fry, is different again and exemplifies how dyslexia variants can be of many different...

The Word Blind Centre

Early in 1962 I was surprised to receive a letter from Dr Alfred White Franklin, who was then chairman of the Invalid Children's Aid Association. It invited me to take part in a conference at St Bartholomew's Hospital on the theme of dyslexia or word-blindness the invitation had arisen because he had read my paper on the subject (Miles, 1961). Dr White Franklin held a senior post as physician at St Bartholomew's Hospital. I afterwards learned that he had been coming across a significant number of children who were refusing school and in some cases showing signs of stomach upsets and the like. I rate him as one of the unsung heroes of the dyslexia movement since he had the insight to appreciate that these school-refusers had one thing in common - they had difficulty in learning to read and spell. The conference was a decidedly stormy one. There was a foretaste of the heated and not always very courteous arguments which were to rage about the concept of dyslexia for the next 20 years. I...

Suggested Reading

Phonological dyslexia. Special edition of Cognitive Neuropsychol. 13(6). Coltheart, M., Patterson, K., and Marshall, J. C. (Eds.) (1980). Deep Dyslexia. Routledge and Kegan Paul, London. Friedman, R. B. (2002). Clinical diagnosis and treatment of reading disorders. In Handbook of Adult Language Disorders Integrating Cognitive Neuropsychology, Neurology, and Rehabilitation (A. E. Hillis, Ed.) Psychology Press, Philadelphia. Patterson, K., Marshall, J. C., and Coltheart, M. (Eds.) (1985). Surface Dyslexia Neuropsychological and Cognitive Studies of Phonological Reading. Erlbaum, Hillsdale, NJ. Riddoch, M. J. (Guest Ed.) (1990). Neglect and the peripheral dyslexias. Cognitive Neuropsychol. 7(5 6) (Special issue).

Recommended Readings

Five meta-analytic reviews of anger treatment have appeared that have examined the relative efficacy of CBT with adults, adolescents, and children (Beck & Fernandez, 1998 Bowman-Edmondson & Cohen-Conger, 1996 DiGiuseppe & Tafrate, 2001 Sukhodolsky & Kassinove, 1997). The populations treated included college students selected for high anger, aggressive drivers, angry outpatients, batterers, prison inmates, students with learning disabilities, individuals with developmental delays, and people with medical problems such as hypertension and Type A personalities. The results of the meta-analyses indicate that the anger treatments seem to work equally for all age groups and all types of populations and are equally effective for men and women The average effect sizes across all outcome measures ranged from .67 to .99, with a mean of .70 (DiGiuseppe & Tafrate, 2001, p. 263).

Empirical Bases For Behavioral Case Formulation

Are recommended as the treatment of choice in conjunction with medication therapy for a number of depressive disorders. Behavioral methods have also been proven effective for externalizing behavior disorders, anger management problems, learning difficulties, social skills deficits, coping skills deficits, pain management, compliance issues in medical treatments, and sleep problems.

The Genetic Epidemiology of ADHD

Family studies have provided evidence for the genetic heterogeneity of ADHD. Studies that systematically assess other psychiatric disorders suggest that ADHD and major depression often occur together in families that ADHD children with conduct and or bipolar disorders might be a distinct familial subtype of ADHD and that ADHD is familially independent from anxiety disorders and learning disabilities. It may therefore be appropriate to divide ADH children into those with and those without conduct and bipolar disorders, thus forming more familially homogeneous subgroups. In contrast, major depression may be a nonspecific manifestation of different ADHD subforms.

Impairments And Management

The occurrence of secondary conditions. Associated primary conditions include abnormalities of posture and movement as well as learning disabilities, seizures, and problems with vision, hearing, and speech. Over time, movement abnormalities often place abnormal stresses on joints, resulting in secondary conditions such as joint contractures and bony deformities. Treatment interventions may include but are not limited to pharmacological therapy, surgery, physical therapy, occupational therapy, and speech therapy.

Presentation History

Again, the medical history and physical examination will frequently reveal the source of infection. Viral illnesses, including respiratory infections and gastroenteritis, account for the majority of febrile illnesses and usually have system-specific symptoms, such as vomiting, diarrhea, rhinorrhea, cough, or rashes. In this age group, such symptoms are more often indicative of an organ-specific infection. Bacterial infections of the respiratory tract include most notably otitis media, pharyngitis, and pneumonia. Otitis media is generally caused by Streptococcus pneumoniae or Haemophilus influenzae, and antibiotic therapy, such as amoxicillin, should be directed at these organisms.27 Although pneumonia is commonly of viral etiology, it is appropriate to institute antibiotic therapy with amoxicillin or erythromycin. The physical signs of meningitis, such as nuchal rigidity and Kernig or Brudzinski signs, may be inapparent in children even up to the age of 2 years. A bulging fontanelle,...

Array construction and application of genomic microarrays

Array CGH is being increasingly applied to the identification and analysis of sub-microscopic deletions (microdeletions) or gains (microduplications) in patients with constitutional genomic rearrangements in order to identify genes contributing to the patient's phenotype. Array CGH-based approaches are particularly suited for the analysis of patients with learning disability and dysmorphology (15-17). In a study of 50 patients with cyto-genetically normal karyotypes but with learning disability and dysmorphic features, we identified 12 patients (24 in total) harboring subtle genomic copy number changes. These copy number aberrations ranged in size from those involving only a single clone to regions as large as 14 Mb. Interestingly, none of the rearrangements coincided with previously reported cases from similar patient groups. We detected seven different microdeletions of which six were de novo and one deletion inherited from Array CGH is also proving valuable in the more detailed...

Historical Overview

Perhaps the most influential early contributions to the understanding of dyslexia were provided in the 1890s by Dejerine, who described two patients with quite different patterns of reading impairment. Dejerine's first patient manifested impaired reading and writing subsequent to an infarction involving the left parietal lobe. Dejerine termed this disorder ''alexia with agraphia'' and attributed the disturbance to a disruption of the ''optical image of words'' that he thought to be supported by the left angular gyrus. In an account that in some respects presages contemporary psychological accounts, Dejerine concluded that reading and writing required the activation of these optical images After the seminal contributions of Dejerine, the study of acquired dyslexia languished for decades, during which time the relatively few investigations that were reported focused primarily on the anatomic underpinnings of the disorders. The field was revitalized by the elegant and detailed analysis...

Care in the Community

Most people with Down's syndrome live in the community some live with parents or caregivers, but adults often live independently or semi-independently. Many people with Down's syndrome can learn about healthy eating and manage their own diets. A dietitian's role in a community learning disability support team is likely to encompass not only individual assessment but also teaching and educating people with Down's syndrome as well as parents, caregivers, and other professionals.

Management Of Bipolar Disorder In The Youth

In addition, parents should be aware of the possible educational impairment associated with bipolar disorder. Bipolar children and adolescents are at risk for learning disabilities 48 . Therefore, psychoeducational testing is important in the comprehensive treatment plan once the child's mood is stable. A bipolar child can be unfocused, unmotivated and lethargic because of mood symptoms, and impulsive, inattentive, anxious or disabled because of comorbid conditions. Prescribed medication may also result in cognitive dullness, fatigue and poor handwriting. Unfortunately, some of these side effects may not completely go away despite careful medication monitoring, dosage reduction and changes in time of administration. Both clinicians and parents should be aware of the long-term implications of this illness pertaining to schooling and career planning. A bipolar child generally falls under the educational label of serious emotional disturbance (SED). According to the 1999 report by the US...

Defining Disability Conceptual Issues

The idea of disability and these related concepts are tricky to define. The conditions that often are referred to as disabilities are varied, including sensory losses, learning difficulties, chronic systemic illnesses and their effects (such as constant fatigue and pulmonary insufficiency), mental illnesses, lack of limbs, and lack of mobility. Do all these conditions have a common feature Does every biological abnormality qualify as a disability Does the availability of technological aids play a role in determining whether a bodily state is a disability To what extent does being disabled depend on the environment in which a person lives The very definition of disability is controversial there is no single accepted definition.

Clinical Description

NF1 usually presents with pigmentary features. Multiple cafe-au-lait macules begin in early childhood, and skin-fold freckles appear between 3 and 5 years of age. 2 Iris Lisch nodules are melanocytic hamartomas that are useful in diagnosis but are clinically silent. 3 Other common nontumor manifestations include skeletal dys-plasia, macrocephaly, vascular dysplasia, and learning disabilities. Skeletal dysplasia most often affects long bones, particularly the tibia. 4 Tibial dysplasia presents in infancy and creates risk of fracture. Orbital dysplasia occurs in association with trigeminal plexiform neurofi-broma. Children with NF1 tend to be short and have relative or absolute macrocephaly. 5 Vascular dysplasia consists of nodular proliferation within the arterial wall and may cause arterial stenosis or hemorrhage due to dissection. 6 Learning disabilities occur in at least 50 of affected individuals and include both verbal and nonverbal problems. 7 There may also be attention deficit...

Molecular Genetics

The lesion consists of other heterozygous cells, including fibroblasts and mast cells, recruited to the lesion by cytokines yet to be identified. Malignant growths are likely to arise from the acquisition of additional genetic changes, such as loss of function of p53. It is unclear whether some of the nontumor manifestations, such as learning disability, also arise from a tumor suppressor mechanism, or whether haploinsufficiency explains any of these lesions.

Spatial Place Attribute

Task could be due to difficulty in separating spatial patterns, resulting in enhanced spatial interference. Evidence in favor of this idea comes from the observation that when fimbria-fornix lesioned rats are trained on the water maze task from only a single starting position (less spatial interference), there are very few learning deficits, whereas training from many different starting points results in learning difficulties. In a similar study it was shown that total hippocampal lesioned rats learned or consolidated rather readily that only one spatial location was correct on an eight-arm maze.

Attentiondeficit Hyperactivity Disorder

Initial reports of deficiencies of essential fatty acids among children with attention-deficit hyperactivity disorder and dyslexia raised the promise of potential nondrug treatments. Convincing treatment data from interventional trials has not yet been reported. (Stevens et al. (1995) found that 53 subjects with attention-deficit hyperactivity disorder had significantly lower concentrations of AA, EPA, and DHA in plasma polar phospholipids when compared to 43 control subjects. (Stordy 1995) has described decreased rod function comparing 10 young dyslexics to 10 controls. In an open trial, supplementation with a fish oil containing 480 mg of DHA d for 1 mo improved scotopic vision among these dyslexics. Stordy (2000) has also reported that supplementation with a mixture of essential fatty acids improved motor skills in a open trial of 15 children. Two well-controlled, double-blind placebo-controlled trials among children with attention-deficit hyperactivity disorder supplemented with...

Predictors Of Psychopathology

It has been hypothesized that bipolar offspring show deficits consistent with the syndrome of nonverbal learning disabilities (NLD) 8 . A recent test of this hypothesis showed that children at risk for bipolar disorder have a significantly higher verbal IQ than performance IQ, as well as psycho-motor deficits, but academic deficiencies in mechanical arithmetic relative to reading and spelling abilities, typical of NLD, were not demonstrated 27 . Whether these cognitive abnormalities are predictive of the development of bipolar disorder is still unclear, even though they are similar to those found in adults with bipolar disorder 88 .

Challenges Facing Early Diagnosis

Early detection of cognitive change that heralds Alzheimer's disease poses some challenging obstacles. Early symptoms of dementia are commonly overlooked because they are relatively mild, do not call for immediate medical attention and are commonly discarded as signs of old age, fatigue, poor physical health or depression, even by primary care physicians. When a patient is initially evaluated for dementia with neuropsychological tests, it is exceedingly rare to have preexisting baseline tests for comparison. While most elderly people will have had prior measures of other health indicators (e.g., measures of blood pressure, cardiac function, pulmonary function, blood tests) as a matter of routine heath care, very few individuals will have had prior cognitive testing unless there was a specific problem in the past (including early learning disabilities or prior impairment of cognitive functions). Estimates of prior level of functioning can be derived but these can be quite imprecise...

Consequences of Child Abuse and Neglect

Child abuse and neglect has been associated with increased risk of adverse outcomes. Not all abused and neglected children suffer immediate or lasting consequences beyond their immediate injuries. Nevertheless, abused and neglected children are at increased risk for a range of physical, mental emotional, and social behavioral difficulties. The pathways to these outcomes are currently unclear, but involve a combination of compromised brain development and long-term psychological and emotional sequelae associated with their abuse and neglect. Abused and neglected children are at increased risk of school-related difficulties resulting from cognitive and learning difficulties or from emotional adjustment problems. Abused and neglected children are at increased risk of relationship problems stemming from low-self esteem or aggressive tendencies. Abused children are also at increased risk of juvenile delinquency. Girls who have been sexually abused are at increased risk for violence in...

Food Borne Infections during Pregnancy

Toxoplasma gondii is a parasite that can be transmitted to the fetus in utero through transpla-cental transmission, causing stillbirth, miscarriage, or mental retardation. The parasite has been found in raw, inadequately cooked or cured meat, cat feces, and unwashed raw fruit and vegetables. It has also occasionally been reported in unpasteur-ized goat milk. In the United Kingdom, toxoplasmosis occurs in approximately 2.5-5.5 in 1000 pregnant women (1750-2850 cases per year), generally causing flu-like symptoms, swollen lymph glands, or muscle aches and pains that last for a few days to several weeks. If a pregnant woman contracts the infection, there is an approximately 30-40 chance of fetal infection (congenital toxo-plasmosis). Infants who became infected before birth may develop growth problems, vision and hearing loss, hydrocephalus, brain damage, epilepsy, and other problems. In Europe, congenital toxoplasmosis affects between 1 and 10 in 10 000 newborns, of whom 1 or 2 develop...

Cognitive Abilities and Intelligence

Much is known about the genetics of mental retardation and learning disabilities. The most common single causes of severe general learning disabilities are chromosomal anomalies (having too many or too few copies of one of the many genes that occur together on a chromosome). These genes may reside on additional chromosomes, for example trisomy 21 (an extra chromosome 21, or three instead of the normal two) is the cause of Down's syndrome, and the fragile X condition may by itself account for most, if not all, of the excess of males among people with severe learning disabilities (Plomin, DeFries, et al., 2001). A large number of rare single-gene mutations, many of them recessive, induce metabolic abnormalities that severely affect nervous system function and thus lead to mental retardation. Because the specific alleles involved are individually rare and recessive, such metabolic abnormalities can cause learning-disabled individuals to appear sporadically in otherwise unaffected...

Germplasmcontinuity Theory

The American behavioral neurologist Norman Geschwind (1926-1984) speculated that excessive intrauterine exposure to androgens inhibits development in the individual's thymus and left cerebral hemisphere Geschwind attempted to explain why learning disabilities and left-handedness are associated with autoimmune disorders and, also, to explain why they are more prevalent in men than in women. Thus, according to Geschwind's theory, the brain's architecture and certain patterns of behavior (such as dyslexia) are related to exposure during fetal life, in particular, to high levels of the male hormone testosterone. See also LANGUAGE ACQUISITION THEORY LAT-ERALITY THEORIES MIND MEN-TAL STATES, THEORIES OF RIGHT-SHIFT THEORY SPEECH THEORIES WER-NICKE-GESCHWIND THEORY. REFERENCES

Miscellaneous Applications

Another area in which NF reportedly has been successful is specific learning disability. Most often the anecdotal reports and papers presented at NF conferences involve the successful treatment of dyslexia (specific reading disability). Unlike the protocols for the disorders mentioned earlier, which primarily involve amplitude training of specific frequencies, protocols often mentioned in the successful treatment of reading disorders have involved phase and or coherence training. Usually the training is designed to help the client learn to modify phase and or coherence relationships between left posterior scalp sites or between those sites and left frontal sites, specifically between sites overlying Broca's and Wernicke's areas. Modification of such relationships involves modification of neural timing relationships between the sites involved rather than changing amplitudes at those sites. Because considerable research suggests that neural timing abnormalities may be the basic causes...

Disorders Involving Educational Behavioral Intervention

Learning Disabilities Learning disabilities are found in some 5 (or more, depending on source) of school-aged children. In most states, a learning disability is documented by a 15-point or greater (i.e., 1 standard deviation or more), difference between ability as measured by individual IQ test and school achievement, as measured by standardized individual achievement testing measuring basic skills such as reading, arithmetic, and spelling. Although arithmetic disorders are not particularly rare, language-related learning disabilities exert by far the greater impediment to learning and are the most frequent learning disorders noted. Language learning disorders can be of two generic types. a. Language Learning Disabilities Language learning disability, reflecting generalized neurodeve-lopmental asymmetry involving the dominant cerebral hemisphere, is the more common type of learning disability seen for neuropsychological evaluation. The learning problem may involve recognition-decoding...

Reading And The Right Hemisphere

Dyslexics is mediated at least in part by the right hemisphere. One seemingly incontrovertible finding demonstrating that at least some right hemispheres possess the capacity to read comes from the performance of a patient who underwent a left hemispherectomy at age 15 for treatment of seizures caused by Rasmussen's encephalitis. After the hemispherectomy the patient was able to read approximately 30 of single words and exhibited an effect of part of speech she was unable to use a grapheme-to-phoneme conversion process. Thus, as noted by the authors, this patient's performance was similar in many respects to that of patients with deep dyslexia, a pattern of reading impairment that has been hypothesized to reflect the performance of the right hemisphere.

Corpus Callosum And Cognition

Despite many attempts to link morphological callosal differences to sex differences in lateralization, learning disabilities, and schizophrenia, definitive work in these areas remains elusive, and they will not be discussed here. The possibilities are intriguing, but the problems at this point contain too many degrees of freedom. The callosum appears to be a lever that could unlock our knowledge of brain function, but choosing the correct place to stand to use that leverage remains a problem.

Communication Problems

In contrast, receptive aphasia can impair the ability to comprehend instructions at mealtimes and thus affects compliance with rehabilitative advice. If paralysis and visual field and perceptual deficits are combined with expressive dysphasia and dysarthria, then nonverbal communication can also be limited, resulting in an inability to denote assent or dissent by nodding the head or to use gestures to convey meaning or point to food items utensils. Early involvement of speech therapists is vital to enable individuals to regain lost functions in speech and language. In selected patients use of visual material, i.e., charts or pictures of food items and symbols, can he helpful. Use of short sentences, normal volume speech, avoidance of jargon, and patience in allowing individuals to respond to questions are also helpful in general communication.

Cross Cultural Review of Responses to Bodily and Behavioral Differences

Joan Ablon (1996), for example, exploring the differential access to intimacy and sexual experiences for men and women with neurofibromatosis found that two thirds of the women she interviewed were married, as opposed to only one third of the men. The single men in her sample were much less likely to have had sexual experiences than the women. Ablon notes the persistence of women in finding a partner. She hypothesizes that they continue strategizing to connect with a man because in U.S. society women are socialized to be interpersonal communicators. However, the lack of achievement by many of the men, due to early learning disabilities and social failures, negatively impacts their gender identity, which significantly contributes to their social withdrawal. Nayinda Sentumbwe working in Uganda (Sentumbwe, 1995), provides another instance he found that cultural beliefs that blindness is incapacitating contributed to the fact that sighted men will have sexual relations with blind women...

Maternal Stress and Motor Development in the Offspring

Schneider's104 findings also raise another possibility. Unlike the control infants who showed rapid and linear motor development postnatally, both early and mid-gestation prenatally stressed infant monkeys showed either a flat or much more variable trajectory of development, suggesting that the discrepancy in motor abilities between the stressed and control infants increased postnatally. Hence one explanation for the abnormal postnatal motor development trajectories is that the stressed infants had significant motor learning difficulties that limited their ability to overcome their deficits with postnatal activity-dependent experience.

Features Of Fraxa And Fraxe

Fmr1 Southern Blot

The fragile X syndrome affects males to a greater extent than females in males, learning and social deficits are moderate to severe, with social impairments usually preventing them from fathering offspring although sperm production is thought to be unaffected. In adult males, visible signs of the condition often include a large head, long face, large ears, and macroorchidism however, in children, the phenotype is likely to be restricted to developmental delay with perhaps some autistic-like features such as gaze avoidance or hand-flapping. 2 Females with fragile X syndrome vary from apparently normal phenotypes to moderate learning disability, often with heightened anxiety, social withdrawal, or depression.1-3-1 The appearance of fragile X phenotypes in women In addition, in 1991, the existence of the distinct condition of FRAXE was established when it became clear that several ''fragile X'' families (i.e., showing expressed site fragility in Xq27-28 and learning disability) did not...

Hyperactivity and Antisocial Behavior

In children, there is an increasing frequency of the diagnosis of ADHD, a condition characterized by inattention, impulsive and disruptive behavior, learning difficulties, and increased levels of gross motor activity and fidgeting. Also, the prevalence of food allergies and intolerances has been increasing. Perhaps it is not surprising that dietary explanations and treatments for ADHD have been sought regularly for several decades, given theories of allergic reactions or intolerance to food additives, ingredients in chocolate, and even refined sugar (often grouped as the 'Feingold theory', after an early instigator of unproven dietary intervention). There has also been a long-standing interest in the possibility that antisocial behavior in children and adults might in part result from poor nutrition, although early studies were poorly designed. Behavioral effects of sugar and of many additives have by and large not been supported by controlled studies however, determining...

Qualitative Features Of Neurocognitive Complications

Attention, learning difficulties, difficulties in retrieval of information but not accelerated forgetting, and some executive dysfunction. To the extent that there are language problems, these are more in the area of fluency rather than naming. In contrast, the so-called cortical dementias (Alzheimer's disease and multi infarct dementia) are characterized by severe memory impairment that includes difficulty in learning new information as well as rapid forgetting, problems in naming and comprehension, and disturbances of praxis. Thus, HIV-infected persons with asymptomatic neuropsychological impairment or MCMD tend to have mild learning difficulties, some problems with attention, difficulties with speed of information processing, some psychomotor slowing, and occasionally, difficulties with fluency. Although this may be the most

The Sealed Record Controversy

Although adopted children comprise less than 5 percent of the population, the percentage of adopted children in mental-health facilities and residential treatment centers has been reported to be as high as 30 percent. Some researchers have found that adopted children score lower in academic achievement and social skills than the nonadopted, have a high incidence of learning disabilities, and display behavior characterized as impulsive, aggressive, and antisocial (Schecter et al. Brodzinsky and Schecter Brinich). Psychotherapists have postulated that an adopted child's perception of rejection and abandonment by the birth mother can cause low self-esteem. Ignorance of origins (genealogical bewilderment) can lead a child to rebellion against the adoptive parents and society, and eventually to delinquency (Wellisch Sants Kirschner and Nagel).

Therapy versus Enhancement

However, this approach has some well-known problems and limitations. First, social and cultural factors play an important role in delineating the normal range of values that define disease. For example, dyslexia is recognized as a disease in developed nations because it interferes with reading, but it does not cause that problem in a nonliterate society. An adult in the United States who is shorter than four feet tall is regarded as having a disease dwarfism but the same adult living in an African pygmy tribe would be regarded as normal. Modern psychiatrists recognize depression as a mental illness, but it was regarded as a lifestyle or bad mood a hundred years ago.