Evidence Check 1: Early Literacy Interventions - Science and Technology Committee Contents

Examination of Witnesses (Questions 74-109)



  Chairman: We welcome our second panel this morning: Dr Chris Singleton, the Director of Lucid Research Ltd and Senior Research Fellow at the University of Hull—welcome to you, Dr Singleton—Professor Julian Elliot, the Director of Research at the School of Education at Durham University, and Shirley Cramer, the CEO of Dyslexia Action. Welcome to you all. I will hand over to Graham Stringer to begin the second session.

  Q74  Graham Stringer: Can I trouble you to define what you mean by dyslexia and say whether you think it is a useful term?

  Shirley Cramer: I would like to use a definition that has now been accepted by all the voluntary sector organisations within the UK and by, I think, the majority of scientists and people involved in the field, and that is the one that is in the new report by Sir Jim Rose that came out in June 2009 Identifying and Teaching Children and Young People with Dyslexia and Literacy Difficulties. I would say that I think it is a really good thing that there has been so much agreement across the field about the definition of dyslexia, especially one that incorporates, I think, more flexibility than we have seen before. Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling. I think that is something that we see often with children with these difficulties. Characteristic features of dyslexia are difficulties in phonological awareness, which was mentioned in the previous session, verbal memory and verbal processing speed. Dyslexia occurs across the range of intellectual abilities—there is a huge amount of evidence around that—and, I think, a very important new part of the definition, it is best thought of as a continuum, not a distinct category, and there are no clear cut off points. The definition then goes on to talk about co-occurring difficulties may be seen in aspects of language, motor co-ordination, mental calculation, concentration and personal organisation, but these are not, by themselves, markers of dyslexia. A good indication of the severity and persistence of dyslexic difficulties can be gained by examining how the individual responds or has responded to well-founded intervention. I think that is a very wide-ranging and what I call action oriented definition.

  Dr Singleton: I was a member of the expert advisory group that compiled that definition, as was Professor Greg Brooks, and we spent a great deal of time considering all the definitions, or at least a very large number of definitions, which are available in the literature, bringing together a definition which was well evidenced, as far as we can tell at the present time, and I am greatly pleased that it has been endorsed by all the major dyslexia organisations, and I have not seen significant detraction from that, so I think that we have moved forward. Perhaps to emphasise one thing that perhaps it does not stress but I think is worth mentioning to the Committee, people often raise the question: does dyslexia exist? Of course it depends what you mean by "exist", in the same way as, "Does global warming exist?", but in regard to dyslexia there is a considerable amount of genetic evidence, a considerable amount of neurological evidence that the difficulties which dyslexic children experience have a highly genetic component and that there are many indicators in brain differences, in brain functioning, between dyslexics and non-dyslexics and that those differences centre on the regions of the brain which are responsible for phonological processing, which, as Shirley has said, is one of the core features of the definition. So there is genetic and neurobiological evidence, if you like, which supports that approach.

  Professor Elliott: I take a different stand on this. My view is that the definition that is provided does not really help us differentiate very much between youngsters with varying kinds of reading problems. So it does not really identify a sub-group. I do not think it has much utility whatsoever and we can go into some reasons for that. As far as the evidence is concerned, there is some really excellent evidence at a number of different levels to do with reading difficulties. The trouble is that when you try to put all the bits of evidence together in some kind of sequence the logic falls down entirely. For example, there is clear evidence of a genetic predisposition towards reading difficulty for youngsters but the studies are of youngsters with reading difficulties, not a subgroup called dyslexics. The other problem is that you cannot test an individual child that you see before you with some kind of genetic test to see this. In other words, there is no link between studies that look at groups of poor readers that suggest that there are genetic predispositions for some of those youngsters and then see an individual child and make a judgment as to whether this child is dyslexic or is not dyslexic. As far as neuroscience is concerned, there is evidence to show that in poor readers—not dyslexics but poor readers—certain parts of the brain have low activation or high activation. This is correlational data anyway. We cannot get any kind of causal analysis. There is no test in neuroscience to identify an individual child who you might want to describe as dyslexic or whatever. These are pipedreams. Both neuroscience and genetics are nowhere near helping clinicians to know what to do with youngsters with reading problems. Then we come on to theories of dyslexia. There are multiple theories of which the phonological awareness theory is the dominant one and the one to which I would most subscribe. But there are kids who have reading difficulties who do not show those problems in phonological awareness. Neither do they show problems in terms of working memory. One of the markers is working memory; short-term memory, holding things in their head. So you will see youngsters who will be diagnosed as dyslexic who do not have phonological problems or working memory problems. Then we come to the symptoms of dyslexia. There is a whole range of symptoms and like a horoscope, if you look at a horoscope whichever one you look at you will find you fit. When you look down the list of symptoms, every child with a reading difficulty I have seen in 35 years of work as a teacher of kids with reading problems, as an educational psychologist testing and assessing kids and as an academic has some of these features. The last line is this: if you separate out, within your population of youngsters who have reading difficulties, those whom you identify as dyslexic from those you do not—and this is a really complex issue because someone like Shaywitz, who is a leading authority in the US, talks about 20 per cent of children who have reading difficulties and then she uses the term "dyslexics" in the next sentence in one of her books. Other people say there are four, six or eight per cent dyslexics so we are talking about another 12 per cent of kids with reading problems who are not "dyslexic". The question is the differential diagnosis that we use in medical models should lead to differential interventions, so the next question is having identified a dyslexic youngster as opposed to any other youngster with a reading difficulty who happens to come along to a clinic or is being assessed by a psychologist, having made that differentiation, do you then have clear routes into knowing what to do about it which are different for the dyslexic than for the non-dyslexic? I have read through the Rose Report in great detail and I have read some of Chris's excellent reports—and I have found his report very, very helpful—but in there there is a total blurring between the notion of dyslexic and non-dyslexic. Sorry, it is a long answer.

  Chairman: That is very helpful.

  Q75  Graham Stringer: It is interesting. What I find difficult about this is it is a very English-based science, is it not, and this definition would not be recognised if you went to Korea or Finland, say. If dyslexia is genetically based, as we have just heard is the view, why are there not the same problems in those countries that have more transparent languages where there is a direct correlation between the alphabet and the sounds in the language?

  Dr Singleton: There are. Interestingly enough, you say why are there not the same problems in Finland. There is a huge amount of research on dyslexia in Finland and Lyytinen is one of the leading experts on dyslexia in Finland and for example he has published data which shows that about 40 per cent of children of parents who have dyslexia turn out to have dyslexia themselves. Finnish is a completely regular language but there are still problems. The problems are not necessarily as severe as they are in English which is not a completely regular language, but dyslexia is something that is found across the world, so I would disagree that it is a peculiarly English or UK problem.

  Q76  Graham Stringer: I was not saying UK, I was saying English.

  Dr Singleton: You mean in the English language? No, there is research on dyslexia in many other languages, in German, in Czech, in Polish and so on.

  Q77  Mr Boswell: Do they define it in roughly the same way?

  Dr Singleton: They do indeed. If you have a language where you need to relate the sounds of the language to the code of the language then you tend to get the same sorts of problem. If the language is entirely regular then that is easier for the dyslexic individual. The more irregular the language is the harder it is for the dyslexic individual. If you have a language like one of the two forms of Japanese or Chinese where you have got to relate a character to a whole word or a meaning, then the dyslexic difficulties are somewhat different and the distribution of dyslexia may be different. However, I do not know of any reason to believe that dyslexia is not found across the world. It may be differentially distributed because genetic patterns are differentially distributed across the world but the evidence suggests that you find it in other languages as well as in English.

  Q78  Graham Stringer: Professor Elliott?

  Professor Elliott: It is interesting you talk about the definition. "Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling." Basically that is almost tautology because you could put those words to "reading difficulties" in there if you wanted to. The definition in this report is so amorphous and so difficult to operationalise and to utilise that in a sense when you are looking at it across countries it is not really much of an issue for me. The question is: How useful is this differentiation of the dyslexic as opposed to other youngsters who present with reading problems?

  Shirley Cramer: I think this definition of dyslexia is very operational and it is why my organisation and the other organisations who care about children getting the support they need, which is really what it is all about, have accepted it and welcomed it so much. For example the issue of a continuum; we know that there are children who are very mildly affected, very moderately affected or very severely affected. If we look at response to interventions, so what is in the Rose Report and the kind of work we do in our organisation, it talks about providing help at different levels so if a child is falling behind in reading after having good synthetic phonics teaching and they are still struggling they might go to the next level and the Wave 2 provision that Professor Brooks mentioned, looking at what else they might need to support their reading or using different strategies, and then in Wave 3, so if that child is still struggling then they will need more. Severe and persistent difficulty with reading indicates dyslexia. In a sense it is what we do about it that is important and why I think this is important.

  Chairman: Can I stop you there because I think the point we are trying to make here is is that just reading difficulties or is there this specific term "dyslexia" and how is the specific term dyslexia helpful?

  Q79  Graham Stringer: Can I add to that. It is really answering Professor Elliott's point where he says it is tautological. Why is it not tautological? You say that children cannot read, therefore they have got dyslexia; therefore dyslexia is children who cannot read.

  Shirley Cramer: One of the reasons the United States decided to do a lot of research in this area—and I know because I have lived in the United States and worked there—was that there were a number of people who were concerned in public health (not in education) who said why is it that children who can appear to do everything else are struggling to learn to read? They seem absolutely normal in every other category; why is it that this is so difficult, and the national institutes of health took that on as a public health issue because they were rather curious and intrigued and because there were so many parents and teachers asking the same question. I do not want to say grass-roots but the issues have come up because people/parents have been concerned on the ground wondering why. I think that is why it was looked at in terms of looking at the evidence base around why these children cannot read and often have a basket of difficulties including issues around dyspraxia, difficulty with motor co-ordination, difficulty with numeracy, difficulty with attention. A whole child will have elements of these difficulties and often with dyslexic children you find it is not just about reading.

  Q80  Graham Stringer: Can I go back to Dr Singleton because apart from your oral evidence today we have had a lot of written academic submissions some of which directly contradict what Dr Singleton just said. Can you point us to academic papers that give us the definition of dyslexia in Korea and Finland and Austria and also give levels of literacy in those countries because that seems to me an absolutely crucial issue. We have evidence here that says in countries the like the ones I have just mentioned the term dyslexia does not exist or means something completely different. In Austria dyslexia means reading slowly not being unable to read. If that is wrong I would like to have the academic references that support your case, Dr Singleton.

  Dr Singleton: As I said earlier, the impact of dyslexia on reading in different languages depends upon the structure of the language and if you have a regular language, as in German for example, then it is easier to learn to read and therefore the difficulties that dyslexics encounter are seen more in slow processing speed than they are in difficulties in relating letters to sounds because the relationship between letters and sounds is entirely regular and predictable and it is one-to-one and the same is true in Finnish and in Spanish and in Italian and so on.

  Q81  Graham Stringer: Does not that blow a hole through the definition?

  Dr Singleton: No it does not because if you look at the definition that Shirley has referred to and that appears in the Rose Report and also in my review of the research literature, it says dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling. In these other languages you have difficulties with fluency particularly and furthermore it is not saying that these children have difficulties in reading as a whole; it is a very particular sort of difficulty. I think it is useful in this context to contrast it with, say, reading comprehension difficulties. About ten per cent of children have specific reading comprehension difficulties and they have a completely different pattern of difficulties. They do not have phonological difficulties. They tend to have difficulties with oral language comprehension and their pattern of brain activation is different from that you find in dyslexics. There is also a genetically inherited pattern there but it is a different one and the treatment or the intervention for those children is quite different. If you have a child who has a reading comprehension difficulty but who has accurate word reading, then there is no point in spending time teaching them phonics because they already have the phonics skills. What they need is work on inferencing and text processing and so on.

  Q82  Graham Stringer: Can I just interrupt. That was very useful and interesting but can you refer us to the references on literacy levels in other countries and definitions of dyslexia?

  Dr Singleton: Not off the top of my head and I would not claim to be an expert in literacy internationally. Most of my research was on studies of dyslexia in the English language.

  Q83  Graham Stringer: In answer to the first question you directly contradicted some of the evidence that we have got here that effectively dyslexia does not exist in Finland and Korea, just to name two countries, and now you are saying you cannot give us the academic references for that.

  Dr Singleton: Do you want me to get the books out of my bag?

  Q84  Graham Stringer: No, I would just be grateful if you could send us the references.

  Dr Singleton: I can certainly send you the references. I thought you were asking me for the references off the top of my head.

  Q85  Graham Stringer: No, I am not asking for that.

  Dr Singleton: Without question I can certainly send you the references and provide supplementary evidence on that if you wish.

  Q86  Graham Stringer: Yes please.

  Dr Singleton: I was merely making the point that not all poor readers are the same and it is important to distinguish between different types.

  Professor Elliott: It is hard enough to get any consensus in this country as to what the definition actually means beyond saying it is youngsters with reading decoding problems, let alone in another country. What I would say is if you look at the reports of academic papers such as Lyytinen and others around the world who have done studies, they use the term dyslexia in what I call a fairly loose kind of way, often to describe youngsters or adults with reading difficulties or decoding problems. Sometimes they use the notion of IQ discrepancies between reading and IQ which is now discredited. What I would say is these people do not make clinical judgments about whether an individual child is dyslexic or not. They are doing research into reading difficulties, not dyslexia per se.

  Q87  Dr Iddon: I have an interesting rider to what Mr Stringer has been asking you. Do children who are brought up multilingual who have a dyslexic problem in English have the same problem in the other languages that they speak?

  Dr Singleton: As far as I am aware yes they do. There have not been a huge number of studies of this but there certainly are cases in the literature where dyslexic difficulties are experienced in more than one language where an individual has a multi-lingual background.

  Q88  Dr Iddon: I want to turn now to the teaching of children who are diagnosed with dyslexia. What does the evidence provide us with as the best way of teaching dyslexic children?

  Shirley Cramer: There are some educational intervention studies from the UK and many from the USA and I think we have mentioned before the randomised control trials around children particularly with reading difficulties which show that children need help on phonological awareness. I think the evidence you heard in the previous session about phonics. We certainly know that if struggling readers do not have the basics and are not taught synthetic phonics then it is very hard for them to become readers. The research shows that structured multi-sensory teaching, so teaching little and often, making sure that you reinforce the teaching, is a very, very important way of teaching children with dyslexia. Each child is different so there are individual characteristics: are they mildly dyslexic, are they moderately dyslexic, are they severely dyslexic, how does it show? In our organisation we provide an individual education plan. We look at what the specific needs are of the child and put together a teaching programme for that child. That is based on the skill of the teacher and an understanding of the needs of the child as they are presented. There is a number of strategies our teachers can use. We have computer-based based programmes that are structured multi-sensory programmes and very helpful particularly for older children. We have a variety of different strategies for younger children, again depending on the presentation, but they will all contain elements of multi-sensory teaching in the way the children will learn, and also reinforcement, what we might call over-learning, because obviously if people have a short-term memory problem reinforcement of something is very important and it is structured in a certain way so that the child who has phonological processing difficulties can learn.

  Q89  Dr Iddon: The evidence we have in the Committee suggests that phonological interventions do not work for all dyslexic children. If they do not work with a particular child what direction does the teaching take then?

  Shirley Cramer: It will depend on the difficulty that the child is showing, so for example Chris has just mentioned reading comprehension. Often the kind of things that we are dealing with are writing difficulties as well because there are children who have specific issues with forming sentences and with thinking through how to specifically write something for a classroom piece. It is not just about reading and it is not just about writing, but it is the variety of things that a child may need to do to develop strategies to allow them to access their education, so there is reading first but there are many others aspects of that. It is not just about phonology although that is very important. They will look at other ways of allowing the child using multi-sensory techniques, a variety of techniques, to do that. But the training and the skill of the teacher is really paramount in this, I would say.

  Q90  Dr Iddon: Are you telling us that the interventions for dyslexic children when they have been diagnosed should be quite different from the interventions that we give to other poor readers?

  Shirley Cramer: No, I am not saying that because I think it is the wave approach that I mentioned before. If you are talking about a six-year-old who is struggling with literacy you will be doing the same. In fact, we have programmes ourselves where we work with mainstream education and we use our multi-sensory teaching techniques and phonological awareness with all the children. We do not care why they are struggling with reading. Some become more accurate and they make progress. Those that are not making progress we then have to look at them again and say what else do these children need, do they need it more intensively, do they need this more often, do they need something different, and that is how the wave would go up. In fact, that would provide a more cost-effective approach to teaching children who are struggling.

  Professor Elliott: This is exactly my point. My point is that the public believe that if they get this diagnosis this will point them to a differential form of intervention and that they will do something different. "At last I have got the diagnosis; now they know what to do about it," and that is not correct. The approaches that groups such as Dyslexia Action are advocating are good approaches but they are for all kids with problems and even then you have to make individual assessments of different youngsters. The idea that you can sub-divide the population of people struggling to learn to read into dyslexics and non-dyslexics is untenable.

  Dr Iddon: Graham Stringer has already intimated that children's literacy skills in some countries—most of Eastern Europe and Cuba and Barbados I have here in the evidence—have higher literacy rates than children in the UK at similar ages. How do they teach their children to read if they can achieve those higher literacy skills than children in Britain? What is the difference internationally? Is there any evidence on that?

  Chairman: Can anybody respond to that? We will have to pass on that, Brian. In reply to a member of the audience, sorry, you cannot speak. I do not mean to be disrespectful.

  Q91  Dr Iddon: Could I ask one final question. If we intervene early with dyslexic children as poor readers and poor writers as well should the interventions with dyslexic people continue through their education, certainly through primary school?

  Shirley Cramer: It really depends how severe the dyslexia is. In fact, if you teach a child with mild dyslexia to read and they understand what they need to do, they understand their own learning, then, no, you do not need to do anything extra as long as they understand that they might read more slowly, for example, or that it might take them longer to do certain things. The point about early intervention is prevention. You want to prevent educational failure and there are far too many children in classrooms who are really struggling because they have not had the right kind of help and that is the point really.

  Q92  Chairman: Our question is does defining them as dyslexics help those children or not?

  Shirley Cramer: It does not if you do not have people who are trained to teach them. That is the bottom line if you like. It does not matter what you call anything; if you do not have people who are skilled in the classrooms and in the education system to support the children then they are not fully included, they are not part of it. Professor Elliott and I would disagree on this but for some children and for some adults the label of dyslexia is very important because what it says to that person is there is a reason why they are having difficulty learning to read and for a child whose self-esteem is very badly damaged at ten or 11 who is really struggling, to understand that because of their uncle or grandfather this is a difficulty that runs in the family, it is not because they are thick or stupid it is because they have a specific difficulty is enormously helpful to their learning because once they understand that they can then say, "I will do something about it."

  Professor Elliott: Having worked in clinical work for 25 years, parents want labels—absolutely—and the label does help a lot of parents, but the question is the scientific rigour behind the label and whether or not the label can be used in a clear way so that everyone knows exactly what we mean by that label and it is consistent. A lot of educational psychologists have said to me they use the label because parents like that even though they know the term itself is conceptually flawed.

  Dr Singleton: I think we should not forget that dyslexia is not just a difficulty with word reading; it is also a difficulty with spelling and with writing, and as dyslexics get older, particularly if they have had the right sort of help from the sort of teaching that Shirley was referring to, their reading tends to improve but they still have subsequent problems. Dyslexics tend to remain lifelong poor spellers, for example. It is very difficult to remediate spelling in English. They continue to have difficulty in structuring their writing. It takes them a long time to produce written work appropriate to their intellectual capabilities and their reading tends to remain slower than other individuals. That is the sort of profile you see for example in dyslexics at university level and that is another reason why it is important for the individual to understand the nature of their difficulty so that they can find appropriate strategies or be helped to find appropriate strategies to overcome those difficulties so they can realise their potential throughout secondary education and on into university and career.

  Dr Iddon: Chairman, I think we should say to the two ladies, one at the back and this lady here, that if they have any evidence there is still time to send it into the Committee.

  Chairman: Of course there is. Graham Stringer?

  Q93  Graham Stringer: It is really on Dr Singleton's point and again I am interested in the academic references, not off the top of your head, because there is a deep conflict in terms of the scientific evidence we are getting on this matter. One of the submissions says when dyslexics are taught to read the question in the written evidence is where does it go? If it is a condition and then people are taught to read, there are some dyslexics who read as well as other people when they have been defined, they are eventually taught to read and they are indistinguishable from other people who learned to read rather more easily. You are saying, if I understand it, that a lot of people defined as dyslexics can be taught to read but they never get up to the level of people who found it easier. I would be interested in the academic references on that.

  Dr Singleton: I certainly did not say they never did. I said that is the profile that you tend to see in older dyslexics particularly at university level. They are put under a great deal of stress in terms of the amount and complexity of reading and writing that they need to do and that is the problem under which they struggle. The pattern of difficulties in dyslexia extends across verbal memory, as Shirley has said, and that impacts on things like the ability to recall facts and figures in examinations so under those sorts of conditions it takes them longer to produce the work. In answer to your question does dyslexia go away, no, dyslexia does not go away but clearly a lot of the difficulties that dyslexia presents to the individual in learning to read and write can be overcome and, furthermore, if you look at the brain-scanning studies there is brain-scanning evidence that you can get changes in patterns of brain activation in response to teaching. That is not surprising. The brain changes in response to learning just as when cabbies are learning The Knowledge in London parts of their brain change. Basically the brain changes, but I do not think that dyslexia goes away; it is simply individuals acquiring strategies and skills as a result of good teaching to get round their difficulties.

  Q94  Mr Cawsey: I suppose for me the heart of what we are trying to look at in this report is basically when governments take decisions about what they are going to do and follow as a policy, is it based on evidence or is it following fashions and whims or whatever is going round at the time. The Government has accepted the Rose Report in full and part of that is how do you diagnose children with dyslexia. Are the panel content that that is evidence based?

  Professor Elliott: No I am not, because having spent so many years doing this, a child who comes to a clinic and has to be assessed on this, a child with reading difficulties will present with some of the symptoms that are in the Rose Report. If you look at some of the things in there it is like tautology. Problems with decoding are in there as a symptom so the difficulty is how do you differentiate—unless you want to use the term dyslexia to describe all youngsters with decoding problems—and I would be happy with that, I could live with that. It is the idea that somehow you can make a differentiation within this population. There is no evidence you can do that; I am sure of that.

  Dr Singleton: I am equally sure you can. I have been doing it for many years and there are plenty of papers in the literature to show that you can. If you take a child with decoding difficulties, there are all sorts of reasons why they might have decoding difficulties. They may not have been taught decoding very well in the first place because the techniques the teachers used were not particularly appropriate to that child or maybe the teaching was rushed or whatever but they may have decoding difficulties because they have underlying problems with phonological awareness. That in turn could be due to different reasons. It could be due to a genetic difficulty with processing phonological information or it could be because their language experience before they came to school was such that it did not afford them the good language base to develop phonological awareness. We have described there three different types of individuals who with appropriate testing, coupled with the child's response to intervention (that is how well do they respond to good, well-structured intensive teaching) enable you to distinguish the dyslexics from the non-dyslexics and that really is the approach that is very clearly presented in the Rose Report and it is evidence-based. All of the points in relation to that teaching is evidenced. The references are there in the Rose Report and it also refers to the report which I produced for DCSF which was peer-reviewed by ten of the leading experts on literacy development in the country and which has over 400 references on this. So there is evidence that you can do this and I think that the strategy recommended by Rose and adopted, I am pleased to say, by the Government is an evidence-based strategy.

  Shirley Cramer: Yes, it is a very good question and I would agree with what Chris said. I think that this report has taken the evidence. It has had a very distinguished group of people on the external advisory group. It spoke to stakeholders across the piece and parents were very involved in this, as were a variety of different views. It is very clearly written in terms of what needs to be done and I think for people like me who are concerned about what next, it is very clearly stated what we need to do within schools in order to support children who are struggling with these issues much better. I think that is highlighted on the response to intervention which, it seems to me, also makes this a very pragmatic and the most cost-effective approach to take to ensure that these children get the support they need at the earliest possible time and much of it is down to ensuring that we have much, much improved teacher training around these issues at all different levels, at the levels of core skills, advanced skills and specialist skills. I would just like to say one more thing and that is that Professor Elliott is mostly on his own in his views on this. He is a minority voice in this and I want to make that point.

  Chairman: I think that is for us to decide.

  Q95  Mr Cawsey: Okay, that was on diagnosis so we have got two yeses and a no in terms of the Government using the evidence to reach their position. As far as actually teaching children with dyslexia, or whatever you want to call it to widen it, are we just going to get the same two/one again in terms of have the Government used the evidence to come up with the right strategies?

  Professor Elliott: To qualify my first answer, I do not disagree with the statements in here but it is just whether you can draw upon all of that to make that differentiation.

  Q96  Chairman: I do not want to go over that again.

  Professor Elliott: Secondly coming back to intervention, I cannot find anything in here which suggests different forms of intervention for dyslexic kids than other kids with decoding problems. I have read it and maybe I have missed it but I cannot see it.

  Shirley Cramer: In the report it talks about funding and the Government committed on the day the report was launched to commit funding to specialist teacher training to train teachers for a certificate or diploma in dyslexia and literacy. That is up to two-thirds of the way towards a master degree, so training people who are specialists in the system.

  Q97  Chairman: But what will they do that is different?

  Shirley Cramer: What they will do that is different is have a basis on which they are able to use a variety of different interventions and understand what is happening with individual children. It is quite a long training. It talks about the basics in teaching of reading and all the evidence based around that. It is probably quite surprising that very few people in initial teacher training are taught about how to teach reading. That is a very clear part of the teaching and training with a specialist. It also goes into all the varieties of difficulties around dyslexia and the strategies that we know work around that and there will be how you support people in writing and how you support people who are really struggling with reading. There is a variety of things but getting a skills base—

  Q98  Chairman: Can I stop you there. We just want to know what will be different? My wife is teaching Reading Recovery this morning. What will she be doing differently as a result of going for a dyslexia diploma rather than teaching children who have genuine difficulties learning to read?

  Shirley Cramer: At different levels in the system, if she were to become a specialist—

  Q99  Chairman: She is a specialist—brilliant!

  Shirley Cramer: A brilliant specialist I am sure then she would be deployed hopefully in the school slightly differently than being a classroom teacher because a specialist teacher in the way that this report envisions it would be supporting other teachers in what they do in the classroom so whole school, they would be teaching children with the most severe difficulties.

  Q100  Chairman: I am sorry to be pedantic but what are the actual techniques she will be using which will be different?

  Shirley Cramer: I think understanding what the needs are of the specific child.

  Q101  Chairman: She does understand all that but what will she do differently?

  Shirley Cramer: She will be able to provide an individual programme for different children and if they are in secondary education for example she would be able to go and talk to the maths and geography and history teachers about what that particular child needs in the classroom and how they might change their classroom behaviour in order that that child might get the information, that being one example of something that might be done differently if somebody in a school was a specialist. They might recommend for example that a child use a laptop in the classroom. Again if they are at secondary age that might be something they would need to do. They might recommend that the child had extra time for examinations because a specialist teacher would have the skills to do that. So there are a variety of different things in the school that a specialist teacher might be able to do.

  Dr Singleton: Could I add to that, Chairman.

  Q102  Chairman: I do not understand what is different.

  Dr Singleton: To add to what Shirley said, I think there are lots of other things that the specialist teacher will be doing. For a start she will putting in place procedures by which children within the school with dyslexia are not missed and at the present time there are clear indications a lot of these children are slipping through the net. For example, the No to Failure project, the final report of which is here and I hope the Committee will look at, found that about half of the children who were screened in that project in 20 schools who were found to be at risk of dyslexia were not on the SEN register. These were children in years three and seven. Schools clearly need to have systems so that those children do not slip through the net. By the way, these were children who had poor reading and spelling and who had phonological difficulties and poor phonics and so on. Also what such a teacher will be doing is putting in place cost-effective ways in which well-trained and well-managed teaching assistants can support children with these sorts of difficulties much earlier in the classroom. This is a clear point of difference between the sort of approach we are talking about here and for example Reading Recovery. I would perhaps refer you to evidence from York where Professors Hulme and Snowling have very effectively used well-trained teaching assistants to deliver good interventions in a very cost-effective way.

  Q103  Mr Cawsey: On the Reading Recovery we heard earlier that where there is a Reading Recovery specialist the whole school improves perhaps because of the spread of good practice to other people who are in the schools.

  Dr Singleton: This is structured programmes which are delivered by well-managed and well-trained teaching assistants. As Professor Slavin said in his submission earlier, there is quite a bit of evidence from the United States that projects and interventions of that nature can be just as effective as individually delivered projects and are much more cost-effective.

  Professor Elliott: The panel must be able to see the flaws in this example. What people are describing is good practice for youngsters who are struggling to learn with literacy so therefore if you need to get exam dispensations—and I do clinical work and write reports that a child requires an exam dispensation—you do not need a dyslexic diagnosis to get that. You just have to show what the nature of the problems are and why they need access arrangements. Kids might need laptops or speech chips or all sorts of things. You do not need a dyslexia diagnosis to do that. You just need to know that they need a laptop because they have specific problems that you have identified that would be helped with a laptop. Working with teaching assistants—of course you need to work with teaching assistants and you need to work with other people in the department for all kids who are struggling to learn with their literacy. You do not need a differential diagnosis. I have not heard an answer yet and I have never heard one anywhere where someone can actually say of the 15 or 20 per cent of kids who are struggling to learn to read, we have eight per cent of kids with dyslexia and they require a programme which is substantially different to the programme for these other kids who are struggling to learn to read. I have not heard that yet and no-one has every told me that, and this is why I keep bleating about it.

  Q104  Mr Cawsey: We have had a discussion about whether what the Government is doing is evidence-based. If I could turn that slightly the other way round: what is the Government not doing that the evidence is pointing that they should?

  Professor Elliott: We made a programme called The Dyslexia Myth that went out on Channel Four in 2005. A number of the world's leading researchers and people in this room were involved as well and what this programme said was that we should identify kids at an early age who are struggling with literacy, and intervene really quickly. Do not waste a lot of time with quasi medical diagnoses which are not clearly understood, that have all sorts of different symptoms that different people label. It just gets in the way. You could take away the term dyslexia overnight and you could just say let us intervene with kids with problems; let us not have sheep and goats.

  Q105  Mr Cawsey: You are saying that dyslexia is a comfort blanket.

  Professor Elliott: I am saying for some people it has that function. Dyslexia is a useful term where people are working in genetics labs. I was in America last week at Yale University in a genetics lab and they use the term dyslexia as a loose term to talk about reading difficulties, but when we get into the clinical world and we are talking about an individual child, then it becomes much more problematic.

  Q106  Mr Cawsey: So are you saying the quest to find a dyslexia diagnosis hinders the early interventions that the child actually needs?

  Professor Elliott: My real concern would be if one followed this through and said we will identify these dyslexic kids and give these kids extra resources, extra time and extra help, and there are other kids with literacy problems who do not get this diagnosis, what will be the future for them? Will they be seen somehow as less worthy, less intelligent, lazy, unmotivated; all the negatives that people think are lost when the dyslexia label comes in; will they get this? What I am concerned about is there may be youngsters who do not get this. If we talk about the dyslexia friendly schools movement which is an intervention in schools which is very, very good with lots of great ideas about how you do this, every Headteacher I have ever spoken to says they do this with all kids with reading problems. They do not have a small group of dyslexics and do it with them and leave everyone else out; these ideas are great for everyone. It is the whole mythology that there are these clinicians out there who can make this differential diagnosis and this will lead to an intervention which is different—

  Chairman: Professor Elliott, you have made that point.

  Q107  Mr Cawsey: Does anybody else want to comment? What is the evidence saying that the Government should be doing that they are not?

  Dr Singleton: Can I introduce something which I think the Government does need to pick up on, and I hope it will, and that is the issue of what is called visual stress. Visual stress is found in about 20 per cent of the population. It is experience of unpleasant visual symptoms and headaches and eyestrain in response to reading and it interferes with the development of reading fluency and it interferes with comprehension and it is huge problem if you have got to go to university and so on. There is good evidence on this and it is something which can be easily identified and treatable. It is more common in dyslexics and indeed in individuals who have reading difficulties than in the rest of the population and there are good reasons for that which I can go into but probably because of time it is not worth doing. This is something which schools are beginning to address but because there are a lot of, shall I say, snake oil merchants out there who are perhaps keen to make some money on this, I think it is important that the Government issues guidelines to schools based upon the best evidence for how this can be readily identified and dealt with in the classroom.

  Shirley Cramer: I think that the evidence, especially the robust evidence which I know you are interested in, has now been taken into account by this report and others. I think my concerns are around the next steps and the evidence we need to find. We need to know more information about the inter-relationships between dyslexia and people who have what we call dyspraxia, which is difficulty with motor co-ordination, the inter-relationship with that and attention and dyscalculia, so there is something about the specific learning difficulties which in our field we call "hidden" disabilities when we are dealing with the older population and needing to understand more about that. I think it is more about the evidence that we need to gather and get and using the evidence well, so I am concerned that all of the recommendations that are mentioned in this rather comprehensive report are taken forward and have practical application within our schools system.

  Q108  Mr Cawsey: Finally I just want to finish with the same question that I finished with the first panel on, and that is do you as a panel have a concern that the imperatives and speed of the political cycle mean that ministers do not always evaluate and weight the evidence in a way that would be helpful to having good evidence-based policy?

  Shirley Cramer: I think that it is very difficult in the political cycle given how long some of this research, particularly intervention projects, takes. A really robust intervention project will take quite a long time to set up, to actually deliver and then to look at the outcomes of that and make good policy on that. Therefore I would like to echo what Jean Gross said in the first session and that is that there should be some body that is created like the national institutes for health or the National Institute of Clinical Excellence whose job it is to look at this and make recommendations.

  Q109  Mr Cawsey: Is that a general view?

  Dr Singleton: I would certainly agree with that, yes.

  Chairman: On that note of unanimity I would finish this session. Can I genuinely thank you all very much indeed because I think it is great to be able to have quite a clear difference of opinion. Everybody, including our Committee, wants to see effective readers developed in our schools with the best strategies at the end of the day. Thank you very much indeed.

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