The right diagnosis and treatment for dyslexia

https://www.theguardian.com/society/2020/sep/20/the-right-diagnosis-and-treatment-for-dyslexia

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Letters: Behavioural optometrist Irfaan Adamally on oculomotor dysfunction, Dr Neville Brown on the success of Maple Hayes Hall school, and Prof Brian Butterworth on the even more severe consequences of dyscalculia

My heart leapt when I saw your long read (The battle over dyslexia, 17 September), but returned rapidly to its normal position as I read it. No mention of the new rules for dyslexia assessors in schools. No mention of oculomotor dysfunction. No mention of behavioural optometry. How disappointing.

Dyslexia, an information processing error in the brain, certainly exists, but many of the children diagnosed as dyslexic are suffering instead from oculomotor dysfunctions of the eyes. To read fluently, the eyes have to perform five processes simultaneously, and a surprising number of people can’t do them all satisfactorily. But when these people go to an optometrist and read the chart, they do so perfectly well. That’s because reading one letter at a time is a static process, unlike reading paragraphs of text, which is dynamic, so they go undiagnosed. Some children shuttle back and forth from optometrist to hospital for years, sometimes even resorting to surgery, when the solution is often simple: a course of “physiotherapy” for the eye known as vision training.

The efficacy of vision training was recognised in 2018 by the SASC accreditation body, which sets examination criteria for dyslexia assessors. They created a new protocol: any child with reading difficulties has to be seen by an optometrist, and if there is nothing organically wrong and spectacles don’t work, then they should be referred to a behavioural optometrist, specialists trained to treat oculomotor dysfunctions. Unfortunately, most children slip through the net because schools don’t have provision for dyslexia assessment, or because assessors are reluctant to practice the protocol, or because they – and the parents – don’t know about it.Irfaan AdamallyChairman, British Association of Behavioural Optometrists

• Prof Simon Gibbs should do his homework before making statements like: “If parents want to send their children to a school like Maple Hayes, that is their right, but [it is] not one a local authority should support financially.” Maple Hayes is a government-approved special school, inspected by Ofsted as outstanding for the progress of children with education, health and care (EHC) plans for specific learning difficulties. It was the top school in England and Wales for added value. The cost of our provision is competitive with costs in local authority schools.

Ofsted has put the special educational needs (SEN) departments of both Staffordshire and Walsall councils in special measures. Why? Because their children with SEN are not making progress. A third of our pupils at MH are from families on low incomes or benefits.

To the parents of the 20% who enter secondary school illiterate or semiliterate – and of the 20% who leave school without qualifications – “dyslexia” means underachievement, which is why it is linked with mental health. All the youngsters at MH have anxiety and depression recorded in their EHC plans. Gibbs and co should descend from their ivory towers and impart their wisdom to local authorities whose practice is to abandon teaching for those with specific learning difficulties and provide generic teaching assistants to do the work for them. That is why tribunals direct placement at MH, where children get specialist teaching.Dr Neville BrownPrincipal, Maple Hayes Hall school, Lichfield, Staffordshire

• There may be a public dyslexia war, but there is a hidden dyscalculia war. Few parents, teachers or indeed educational psychologists have even heard of it. Yet it has a similar prevalence to dyslexia, around 5%-7%, its characteristics are relatively uncontroversial, and its effects are, if anything, more of a handicap.

A 2008 report in the journal Nature noted that “Dyscalculia is currently the poor relation of dyslexia, with a much lower public profile. But the consequences of dyscalculia are at least as severe as those for dyslexia.” It found that dyscalculia can reduce lifetime earnings by £114,000 and reduce the probability of achieving five or more GCSEs (A*-C) by seven to 20 percentage points (the equivalent figures for dyslexia were £81,000 and three to 12 percentage points).

Despite the science and despite its serious long-term effects, there is no educational guidance about dyscalculia on the Department for Education website, despite a written parliamentary question in March 2019 about it by Tulip Siddiq MP. The dyscalculia war is still a battle for recognition.Prof Brian ButterworthInstitute of Cognitive Neuroscience, University College London