Dyslexia:
An alphabet soup of remedies
Seann Prophet got a B+ in Grade 11 English.
The respectable mark for the 17-year-old isn’t just a grade for his transcript: It’s a milestone for the boy who barely understood most of what was going on in his first years of school and it’s a marker for his mother and the teacher who figured out his learning disability puzzle.
But it took years of work through a tangled path of educational theories and expensive supports to get there. How schools, parents and provincial governments help these kids involves a varied and fluid menu of theories and resources.
Seann was in Grade 2 when his teacher, Penny Shepherd-Hill ran up to his mother Lisa in the corridor of his Maple Ridge, B.C., school.
“She put both her arms on me and said: ‘Lisa, I know why Seann can’t read and write and I’m going to help him do it.’”
Before that day, “I was waking up in the middle of the night, worrying about him in school, and we were only in Grade 2. I looked at her and I actually burst into tears.”
Seann, like one in five children – about four in every kindergarten class – was struggling with dyslexia. With most of the first term this school year behind them, these students are beginning to realize they can’t do what the other students can.
Like Seann, they will struggle to recognize the alphabet, write their names, pronounce words, or learn rhymes – trivial delays at first that could snowball into major problems that will plague them through life.
Accommodations at school can give students a burst of success, but leave them with a lifetime of crutches. Interventions can be expensive and hard to come by and their efficacy is not well understood.
Tackling dyslexia has varied from province to province, district to district, even between teachers.
Do you make it easier for the child to learn in a traditional classroom through accommodations, such as more time and fewer questions on tests, a scribe or, increasingly, a computer to help them take notes? Or do you treat and actually strengthen those cognitive weaknesses through interventions that teach them a new way to learn to read and write?
“The assumption has always been: Learning disabilities are lifelong. But the current research is that this is untrue,” said James Hale, a professor in the Werklund School of Education and in the faculty of medicine at the University of Calgary.
If kids with dyslexia are identified early and their learning needs are determined, their brains can be rewired so they learn just like other kids.
“We’ve now shown that if you give the right intervention to the right individual, their brain actually does change,” he said.
If we don’t get to these children early, “we really miss the boat,” he said
The change in Sidney Fisher began in preschool.
The bright and curious little girl suddenly lost interest in learning her alphabet, spelling her name and doing tracing activities with shapes, letters and numbers, said her mother Barb Fisher.
One day, a school friend got into their car and picked up a book.
“That little kid picked up and read that book – cover to cover. And I just about fell over dead. I went into school the next day and said: ‘Should we be doing this? Cause we’re not,’” Ms. Fisher recalled from her home in Cochrane, Alta.
Now 12, Sidney did not learn how to read in Grade1 or even Grade 2.
Staff at her elementary school reassured the Fishers that “the light bulb would go on,” so they persevered through the “torture” of two hours of homework every night, and four or five on the weekends.
By the time she was in Grade 3, Sidney was slipping into a depression, her mother said. “It went from ‘I hate school’ to ‘I hate myself.’ ”
When the school finally arranged for Sidney to be tested by a psychologist, they did not receive a diagnosis. They received a code.
“Code 54, the learning disabilities code,” her mother recalled.
This meant that Sidney would be eligible for accommodations to her workload: more time on tests, fewer questions than everyone else, and help in the resource room.
Accommodations using technology, are “a route to go,” especially in cases of severe language disability, said Judith Wiener, a professor of applied psychology at the University of Toronto.
Typical readers average in the tens of thousands of words they know by sight.
But one of Dr. Wiener’s students, a 21-year-old, has only 300 words that she can read, although she’s of perfectly average intelligence and has had four years of tutoring.
“When she comes across a sign or some direction that she can’t read, she puts it into her phone,” Prof. Wiener said.
VoiceOver on the iPhone helps her read text messages or any word she doesn’t know. She also uses Google to search new words. “For her, that’s opened up her world.”
Some students have also had success with word-prediction software that completes the word being typed and suggests next words, enabling students to write without struggling with word choice.
Prof. Wiener said there is evidence the software improves spelling, which can be a terrible challenge for those with dyslexia. Instead of seeing the incorrect spelling over and over again, the technology reinforces the correct one.
But others worry that, while accommodations are necessary, they don’t reach the cause of the problem.
Prof. Hale said accommodations can sometimes be at the expense of trying to remediate the weak area of the brain.
A good example is giving a computer keyboard to someone who has motor problems with handwriting, he said.
“What people don’t realize is the handwriting of words and the letters actually facilitates [the children’s] ability to connect sounds with letters, which is a major concept with reading disability.”
Accommodation strengthens the areas that the brain is using to get around the problem, but does nothing for the weak areas, Prof. Hale said. That’s where intervention comes in. But it can be expensive for parents and unavailable for teachers.
The education ministries in British Columbia and Alberta say accommodation and intervention strategies are left up to individual school boards. In British Columbia, the ministry said districts in Nanaimo and Surrey have noteworthy intervention programs.
Seann Prophet was lucky enough to be in Ms. Shepherd-Hill’s class. The teacher had enrolled in a San Francisco program at her own expense to train in the Orton-Gillingham method for teaching students with dyslexia, an intervention technique Lisa Prophet hadn’t heard of and which is still not widely available in schools.
When Seann was in Grade 3, Ms. Prophet remembers coming home from work and asking her son how his day went.
“He goes ‘Mom. It was great! It was amazing! … Mommy, I understood what the teacher was saying at the front of the class.’
“To this day, it gives me goosebumps to think my child sat in class for three years and he did not understand what was happening at the front of the classroom.”
Developed in the 1930s by Samuel Orton and Anna Gillingham, the Orton-Gillingham method teaches those with dyslexia to read in a systematic and sequential way.
Best one-on-one or in small groups, it employs multisensory techniques – words and letters that can be physically touched and pulled apart – to help children remember language rules that typical readers may pick up without thinking. But while the approach has been in use for nearly a century, like many interventions for dyslexia, there is no scientific evidence of its efficacy.
Likewise, scientific study is lacking on the effectiveness of the Arrowsmith Program, despite a 30-year track record and 5,000 case studies, said Howard Eaton, director of the Eaton Arrowsmith School in Vancouver and Victoria.
The program attracts students from all over the world. Base tuition is close to $30,000 a year.
As with Orton-Gillingham, there has yet to be a controlled study that offers evidence that it works. A randomized controlled clinical trial is where one intervention is compared with another, or to no intervention at all, and is proven to be more effective.
This evidence is necessary before the academic community at large will take the program seriously, said Mr. Eaton, who would like to see more children, including those in public schools, access the Arrowsmith Program.
There are a number of studies now in progress on the effectiveness of the Arrowsmith Program, including some at the University of British Columbia’s Brain Behaviour Lab. Data is to be published next year
Mr. Eaton explains the Arrowsmith Program is based on two things: First, the brain is plastic and can change. Second, there are cognitive weaknesses related to learning difficulties.
The technique targets those cognitive weaknesses and improves them, which in turn increase the student’s capacity to be an effective learner, he said. The program does this through cognitive exercises, each designed to strengthen specific areas of the brain.
Among the exercises, students wear a patch over the left eye while tracing unfamiliar symbols and speed-writing nonsense words. Covering the left eye forces the right eye to do all the work, said Barbara Arrowsmith Young, director and founder of the program.
Information from the right eye targets the left hemisphere of the brain, an area that’s involved in motor planning for tracking symbol patterns.
Fluent readers have efficient eye tracking that moves smoothly across the page but “if the eye is kind of jerky, this would be the student apt to skip a word, miss letters within a word, and skip a line,” she said.
The Arrowsmith Program exercises are designed to prevent other areas of the brain from compensating for poor tracking performance, Ms. Young said.
In this way, the Arrowsmith program is very different from traditional special education that try to find areas of strength to support the area of difficulty.
“We’re exactly the opposite. We’re trying to go right in and target the area of difficulty and work it through the graded series of cognitive exercises to stimulate function,” Ms. Young said.
In the public system, Ontario is slowly moving a program developed at the Hospital for Sick Children in Toronto into its schools. About 650 have teachers trained in the Empower technique, which is based on the idea that people with dyslexia have a “phonological deficit,” a difficulty understanding the sounds represented by letters.
For example, it’s hard for children with dyslexia to understand that the word cat is made up of three sounds: “k” “a” and “t.” Yet they can have very good word comprehension.
“Students with reading disability tend to be poor strategy users,” said Karen Steinbach, program co-ordinator for Empower.
Based on 30 years of teaching and evaluating the progress of more than 3,000 struggling readers, the hospital has developed an intervention program to teach dyslexic children strategies to identify words quickly – the key to fluency. Empower works by giving students many strategies to decode words; the process of changing symbols to sounds for reading, and sounds to symbols for spelling.
Empower is recommended for groups of four to eight students. It requires four full days of professional development training for teachers and costs $5,000 per teacher.
The Waterloo District School board reports that before Empower, the mean reading level of participants was well below grade-level targets. Following participation in the 110-lesson program, reading scores of those students improved, with their mean reading level falling within the board’s grade-level targets.
Data from the Hamilton-Wentworth District School Board shows that after the program, primary and junior students made significant gains on reading achievement tests.
Nearly half of Canadian adults between the ages of 16 and 65 have low literacy skills. At the same time, professional and technical occupations that are being created that require increasingly complex literacy skills, according to a report by the B.C. Ministry of Regional Economic Skills and Development. The report found a 1-per-cent improvement in literacy can increase economic output by 1.5 per cent. This improvement would potentially increase national economic output by $32-billion.
But Prof. Hale, at the University of Calgary, said most schools aren’t catching on to kids with issues fast enough. He’d like to see all teachers become “brain literate,” educated in changing brain functioning in all children. Yet, very few teachers know anything about the brain.
Prof. Hale spearheads the university’s Centre for Brain Literacy, a global effort to try and get teachers and psychologists to understand and recognize the various patterns they see in children. It’s more than just the identification of a reading disability “but what the causes of the reading disability are,” he said.
Prof. Hale said it was a big mistake in early understanding of learning disabilities to wait and see if kids caught up.
“We’re not evaluating kids, especially in Canada, often until third, fourth, fifth grade,” he said, adding that’s too long and allows the brain to develop bad habits.
With the help of teacher Penny Shepherd-Hill, Ms. Prophet discovered her younger son had some of the same issues as Seann, allowing her to ensure he got early intervention and a smoother start to school than did Seann.
Ms. Prophet is aware – and frustrated – that not all parents have access to the same benefits she has.
“As a parent, you know, you send your child off to school and you trust that they’re being taught and they’re getting it. And when you find out that they’re not … it’s a really scary place to be as a parent.
“I owe Penny a gratitude that I can’t even explain.”