Examination of Witnesses (Questions 74-109)|
4 NOVEMBER 2009
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 Hullwelcome
to you, Dr SingletonProfessor 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 abilitiesthere
is a huge amount of evidence around thatand, 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
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 readersnot dyslexics but poor readerscertain
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 notand 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 reportsand
I have found his report very, very helpfulbut 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 areaand
I know because I have lived in the United States and worked therewas
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
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
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
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
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 countriesmost
of Eastern Europe and Cuba and Barbados I have here in the evidencehave
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
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
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 labelsabsolutelyand
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
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
Chairman: Of course there is. Graham
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 differentiateunless you
want to use the term dyslexia to describe all youngsters with
decoding problemsand 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
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 specialistbrilliant!
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
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
Dr Singleton: Could I add to that,
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
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 dispensationsand
I do clinical work and write reports that a child requires an
exam dispensationyou 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 assistantsof
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
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
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.