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

3  Dyslexia

Q 2  The policy

60. In May 2008, the Secretary of State for Children, Schools and Families, the Rt Hon Ed Balls MP, asked Sir Jim Rose:

    to make recommendations on the identification and teaching of children with dyslexia, and on how best to take forward the commitment in the Children's Plan to establish a pilot scheme in which children with dyslexia will receive Reading Recovery support or one-to-one tuition from specialist dyslexia teachers.[75]

61. Sir Jim Rose's report ("the Rose Report") was published in June 2009. Sir Jim commented:

    The Children's Plan made it clear that the Government wants every child to succeed, and it hardly needs to be said that the ability to read well is key to success in education and an essential 'life skill'. Moreover, reading and writing are closely related, and both are dependent on the development of children's speaking and listening capabilities. As the review explains, responses to overcoming dyslexia and other developmental difficulties of language learning and cognition must be robust and set within high quality provision for securing literacy for all children, especially in primary schools.[76]

62. Sir Jim went on to make 19 recommendations that required action by DCSF and a number of non-government bodies. Those aimed at DCSF included suggestions that the Department should:

  • fund a number of teachers to undertake specialist training in teaching children with dyslexia so that access to specialist expertise can be improved across local authorities and schools will form partnerships to share expertise;[77]
  • cancel the pilot scheme in which children with dyslexia will receive Reading Recovery support (see paras 78-79);[78] and
  • work with partners to develop additions to the delivery of Every Child a Reader and other interventions, particularly to make them more focussed on phonic work.[79]

63. The Government accepted and endorsed all of Sir Jim's recommendations[80] and made available £10 million to support their implementation, including funding for the training of 4,000 specialist dyslexia teachers.[81]

Our expectations of the evidence base

64. Literacy difficulties are common and complex. There are a range of reasons why a person may find it difficult to read and write and many of these are claimed to be dyslexia. Given that this is a matter of dispute, the first part of the evidence base must be to define what is meant by dyslexia. What should we expect of a definition of dyslexia? First and foremost, the definition should make it possible to differentiate between people who have dyslexia and people who do not; that is, make diagnosis possible. A secondary consideration is contextual: dyslexia has to be considered in an academic sense (the physiological causes and cognitive manifestation of dyslexia as well as the tools that can be used to manage it) and in a practical educational sense (what difficulties the teacher will have to overcome in order to teach a dyslexic child to teach, and following on from that, what techniques a classroom teacher will employ to teach a child to read). A good definition of dyslexia will take context into account.

65. Following a definition, we are looking for an evidence-base for how best to teach dyslexic children to read. In terms of the kinds of evidence that we are looking for, it is much the same as for general literacy interventions. The best kind of trial design is the randomised controlled trial (RCT). The best kind of data is standardised scores that have statistical power and comparative value (see para 19). It is obvious but worth saying that we are looking for trials specifically on teaching dyslexic children to read, not just poor readers.

The Evidence Check

Defining dyslexia

66. Given the prevalence of people who have been diagnosed as dyslexic, we expected that it had been well defined. In fact, defining dyslexia has proved very difficult. A European Union European Social Fund review of developmental dyslexia concluded that "Dyslexia can be defined in more ways than one, but each definition outlines a different concept".[82] The authors went on to define seven different ways in which a person might be described as dyslexic:

  • Either people are 'dyslexic' if they have alphabetic skills deficits (Seymour, 1986; Stanovich, 1996).
  • Or people are 'dyslexic' if they have severe and persistent difficulty in acquiring alphabetic skills, even though their difficulties might be attributable to moderate learning difficulties or sensory impairments (British Psychological Society, 1999).
  • Or people are 'dyslexic' if they experience difficulty in attaining fluency by automatising word-recognition skills, so long as that difficulty can be attributed, at least in part, to a constitutional factor (Gersons-Wolfensberger & Ruijssenaars, 1997).
  • Or people are 'dyslexic' if their difficulty in acquiring alphabetic skills cannot be attributed to any more probable explanation (such as moderate learning disability or sensory impairment), especially if that explanation relates to experience or opportunity; and this definition is 'exclusionary' (World Federation of Neurology, 1968).
  • Or, with a difference of emphasis, people are 'dyslexic' if their difficulty in acquiring alphabetic skills is accompanied by specific neurological impairments, no one of which may be necessary or sufficient for diagnosis; and this definition is 'inclusionary' (Miles, 1982).
  • Or people are 'dyslexic' if they show a characteristically uneven pattern of facility and difficulty; this definition, too, is inclusionary (Miles, 1983).
  • Or people are 'dyslexic' if they share a secondary characteristic with others who have difficulty in acquiring alphabetic skills, even if they do not experience this difficulty themselves (Miles, Wheeler, & Haslum, 2003).

    67. The Rose Report acknowledged these problems with definitions and the Expert Advisory Group[83] constructed a "working definition for the review that includes key characteristics".[84]

    • Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling.
  • Characteristic features of dyslexia are difficulties in phonological awareness, verbal memory and verbal processing speed.
  • Dyslexia occurs across the range of intellectual abilities.
  • It is best thought of as a continuum, not a distinct category, and there are no clear cut-off points.
  • 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.[85]

    68. According to Dyslexia Action, a charity and provider of educational services for people with dyslexia and learning difficulties, this definition has received "universal acclaim and agreement" and it has "been adopted by all the dyslexia organisations".[86]

    69. There is, however, a small group of people who argue that the term 'dyslexia' is not useful. Professor Elliott and Dr Gibbs have argued that "attempts to distinguish between categories of 'dyslexia' and 'poor reader' or 'reading disabled' are scientifically unsupportable [and] arbitrary".[87] It is worth recounting the main thrust of their argument at length:

      It is also perhaps something of a paradox that determined advocates for the value of the label will readily agree that the nature of the underlying difficulties experienced by dyslexics can be highly diverse. The list of possible underlying difficulties typically found in the dyslexia literature is lengthy […]: speech and language difficulties, poor short-term (or working) memory, difficulties in ordering and sequencing, clumsiness, a poor sense of rhythm, limited speed of information processing, poor concentration, inconsistent hand preference, poor verbal fluency, poor phonic skills, frequent use of letter reversals (d for b, for example), a difficulty in undertaking mental calculations, low self-image, and anxiety when being asked to read aloud.

      The weakness of such lengthy lists is that they routinely fail to offer meaningful differentiations. Similar items to those listed above are often found in lists of signs of other developmental conditions such as attention deficit hyperactivity disorder or dyspraxia. […] Furthermore, many features seen as indicative of dyslexia can be found in people who have no significant literacy difficulties, and may be evident in poor readers who are not considered to be dyslexic. Many difficulties that are seen as typical of dyslexics are also found in younger normal readers who read at the same age level […]. This suggests that such problems are more characteristic of a certain stage of reading development, than representing pathological features.[88]

    70. In oral evidence, Professor Elliott argued that Sir Jim's definition of dyslexia borders on tautology:

      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.[89]

    71. The Rose Report's definition of dyslexia is exceedingly broad and says that dyslexia is a continuum with no clear cut-off points. The definition is so broad and blurred at the edges that it is difficult to see how it could be useful in any diagnostic sense.


    72. Educationalists have long known that some people struggle to read, even though all other aspects of their cognitive abilities are normal. This phenomenon is what led researchers to study this area and seek to identify and define dyslexia in the first place. From an academic point of view it is interesting as problems with phonological decoding, verbal memory and verbal processing speed can occur across the full range of intellectual abilities. It is worthy of research that the dyslexic continuum exists with co-occurring difficulties—to use Sir Jim's definition—such as motor coordination, mental calculation and concentration. Studies on twins have shown that reading difficulties are heritable, and molecular data point to a site on the short arm of chromosome 6, among other genetic loci.[90]

    73. But we are specifically interested in the Government's policy for diagnosing and managing dyslexia in the real world, in schools. We therefore asked whether diagnosing a child with dyslexia will have any impact on the educational support that he or she receives. As we have noted, the Government has promised "funding for around 4,000 teachers to train in appropriately accredited specialist dyslexia teaching".[91] We wanted to establish that the Government was planning to provide a separate approach to teach dyslexic children, as opposed to children with other kinds of reading difficulties, so we checked with the Minister:

      Dr Iddon: So the Government has a separate policy for dyslexics once dyslexia is diagnosed?

      Ms Johnson: One of the recommendations out of the Sir Jim Rose report on dyslexia was around having specialist dyslexia teachers to work with children who have been diagnosed with dyslexia, so yes.[92]

    74. We found a definition of 'specialist dyslexia teaching' in the Rose Review, quoting Thomson (1990)[93] who had identified the following features common to most specialist teaching programmes:

    • Phonetic.
  • Multisensory—by which is meant the active and interactive integration of visual, auditory, kinaesthetic and tactile elements of teaching and learning.
  • Cumulative.
  • Sequential.
  • Progressive.
  • Small steps.
  • Logical.
  • Over-learning (by which is meant the systematic use of repetition, both within and between lessons, in the attempt to ensure that newly acquired skills and material are automatised, consolidated in memory, so that they can be readily applied or recalled when needed, and will not be disrupted or confounded by subsequent lesson material).[94]

    75. We asked the experts from whom we took evidence if there was anything in this definition that was not found in teaching practices for all students who struggle with reading. Shirley Cramer, CEO of Dyslexia Action, told us:

      If you are talking about a six-year-old who is struggling with literacy you will be doing the same. In fact, we [Dyslexia Action] 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.[95]

    76. This brings us back to the problem of the definition. As Professor Elliott put it:

      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?[96]

    77. The answer we reached was that it is not useful from an educational point of view. There is no convincing evidence that if a child with dyslexia is not labelled as dyslexic, but receives full support for his or her reading difficulty, that the child will do any worse than a child who is labelled as dyslexic and then receives specialist help. That is because the techniques to teach a child diagnosed with dyslexia to read are exactly the same as the techniques used to teach any other struggling reader. There is a further danger that an overemphasis on dyslexia may disadvantage other children with profound reading difficulties. We conclude that 'specialist dyslexia teachers' could be renamed 'specialist literacy difficulty teachers'. There are a range of reasons why people may struggle to learn to read and the Government's focus on dyslexia risks obscuring the broader problem. The Government's support for training teachers to become better at helping poor readers is welcome and to be supported, but its specific focus on 'specialist dyslexia teachers' is not evidence-based.


    78. DCSF's 2007 Children's Plan set aside funding for "a pilot scheme in which children with dyslexia will receive Reading Recovery support or one-to-one tuition from specialist dyslexia teachers".[97] However, Dr Singleton has argued in his extensive 2009 review that Reading Recovery was unlikely to be effective for the teaching of dyslexics:

      Literature searches failed to uncover any published evaluations of Reading Recovery being used with dyslexic pupils. To decide the question whether Reading Recovery actually works for children with dyslexia therefore requires further research. However, dyslexic children, by definition, have specific problems in acquiring effective knowledge of letter-sound relationships and of the rules that govern these, and in order to become independent readers who can tackle unfamiliar words, they are likely to need more rather than less intensive instruction in phonics. In consequence, it is unlikely that Reading Recovery—in which the teaching of phonics is less than systematic and which enables only a rather small proportion of children taught by this method to tackle unfamiliar words—would be an effective intervention for dyslexia.[98]

    79. Following this advice, the Rose Report recommended that the "dyslexia pilots proposed in the Children's Plan should not go ahead",[99] which the Government accepted.[100]

    80. So what method should be used? Sir Jim Rose, citing Dr Singleton's review of dyslexia interventions,[101] concluded:

      There is a well established evidence-base showing that intervention programmes which systematically prioritise phonological skills for reading and writing are effective for teaching reading to children with dyslexia. […] Intervention sessions for dyslexia therefore need to have a strong, systematic phonic structure.[102]

    81. We have reservations about this conclusion, given Dr Singleton's summary of the evidence in his report: "few of the phonics-based interventions […] have been evaluated specifically with children who have dyslexia".[103] He also noted that "Few of the studies in this field conform to methods that may be described as 'gold standard' (i.e. randomised control trials)".[104] We have already noted (para 78) that none of the Reading Recovery studies looked at its impact specifically on children with dyslexia.[105]

    82. We are left concerned that, as with the wider issue of reading interventions, the trial qualities in this area are not of a sufficiently high standard. Sir Jim's assessment of the existing evidence base—namely that a systematic phonic structure to teaching dyslexic children to read is the best approach—is probably correct, but there is a clear need for properly constructed trials, in which children who have been identified as dyslexic are matched against proper control groups and subjected to a range of different interventions. We recommend that future research on the impact of literacy interventions on children with dyslexia should be well designed randomised controlled trials, using appropriate control groups (including children with other reading difficulties and 'normal' children), and test a range of literacy interventions.

    Policy drivers

    83. When we asked the Minister why dyslexic children receive a label that identifies their particular (in theory) problem, but other children do not, she replied:

      Clearly the dyslexia lobby has been very clear that they wanted to have identified the particular concerns and conditions of dyslexia and that is why the Government decided to ask Sir Jim Rose to look particularly at dyslexia and to look at the evidence.[106]

    84. This is an interesting admission: that the Government decided to spend time and money looking specifically at dyslexia because of the strength of the dyslexia lobby, rather than because of any pre-existing, well researched, well defined problem. We have demonstrated the range of difficulties in this area: that dyslexia is so broadly defined that it encompasses a continuum of reading difficulties that have little if any relation to specific literacy interventions; and that the research in this area is not of the highest quality. The Minister's admission explains why teachers who are being trained to help all children with reading difficulties are labelled 'specialist dyslexia teachers'. We recommend that the Government be more independently minded: it should prioritise its efforts on the basis of research, rather than commissioning research on the basis of the priorities of lobby groups.

    75   The Rose Report, 2009, p 8 Back

    76   The Rose Report, 2009, p 1 Back

    77   The Rose Report, 2009, p 23 Back

    78   The Rose Report, 2009, p 26 Back

    79   The Rose Report, 2009, pp 25-26 Back

    80   HC Deb, 22 June 2009, col 41WS Back

    81   Ev 101 Back

    82   M. Rice & G. Brooks, Developmental dyslexia in adults: a research review, European Union European Social Fund, 2004, p 17 Back

    83   The Expert Advisory Group to the Rose Review included Dr Singleton and Professor Brooks, who gave oral evidence to the Committee, as well as Professor Stuart who submitted a written memorandum. Back

    84   The Rose Report, p 29 Back

    85   The Rose Report, 2009, p 30 Back

    86   Ev 22 [Dyslexia Action] para 1.7 Back

    87   J.C. Elliott & S. Gibbs, "Does Dyslexia Exist?" Journal of Philosophy of Education, Vol. 42 (2008), p 475 Back

    88   J.C. Elliott & S. Gibbs, "Does Dyslexia Exist?" Journal of Philosophy of Education, Vol. 42 (2008), p 483 Back

    89   Q 78 Back

    90   The Rose Report, p 37 Back

    91   Ev 101 Back

    92   Q 189 Back

    93   M. Thomson, Developmental Dyslexia (3rd edition), 1990 Back

    94   The Rose Report, pp 89-90 Back

    95   Q 90 Back

    96   Q 78 Back

    97   DCSF, The Children's Plan: Building brighter futures, December 2007, p 9 Back

    98   Chris Singleton, Intervention for Dyslexia, 2009, p 11 Back

    99   The Rose Report, p 15 Back

    100   Ev 101 Back

    101   Chris Singleton, Intervention for Dyslexia, 2009 Back

    102   The Rose Report, p 14 Back

    103   Chris Singleton, Intervention for Dyslexia, 2009, p 120 Back

    104   Chris Singleton, Intervention for Dyslexia, 2009, p 7 Back

    105   Chris Singleton, Intervention for Dyslexia, 2009, p 118 Back

    106   Q 195 Back

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