A History of Dyslexia and other Specific learning Difficulties

A History of Dyslexia and other Specific Learning Difficulties by
Dr DAVID COWELL BSc MPhil PhD DipPsych PGCE

Dr Cowell is an expert in dyslexia and associated conditions including dysgraphia and dyscalculia. During his 50 year career as a chartered educational psychologist he has worked to help children and adults understand how their own abilities and perceptions differ from others and how they can reach their full potential. It is unfortunate that even today, many parents and teachers are still made anxious by a diagnosis of these conditions and unsure of how to bring out the best in their children.

Dr Cowell is a Chartered Scientist, a Chartered Psychologist (6434) an Associate Fellow of the British Psychological Society and a Member of the Association of Educational Psychologists.

Dyslexia is just made up!

I was prompted to write this short history of dyslexia and other specific learning difficulties since I continue to speak to parents and adults who are told by people, who should know better, that these are new conditions, recently made up by psychologists and don’t really exist. This assertion is completely untrue. The first scientific papers which describe specific learning conditions were written nearly 150 years ago. We knew about dyslexia when our homes were lit by gas or candles and women did not have the vote.

This report looks back as far as the first report in 1877 and shows how it has been well known in all that time.

What are Specific Learning Difficulties?

Dyslexia is the most widely known of a group of conditions known as Specific Learning Difficulties, (SpLD). An SpLD is a learning difficulty which is not due to low general low intelligence, but exists only in specific areas. For example, parents may be baffled that their child is generally quick and bright, excelling in some areas but has difficulty in reading or arithmetic.

There are many SpLD, but the most common are as follows.

• Dyslexia is a condition where the individual has specific difficulty with reading, writing, and spelling.
• Dysgraphia is a specific difficulty with regard to writing. Some authors use the term agraphia, but the condition referred to is the same.
• Dyscalculia refers to a specific difficulty with arithmetic, or mathematics in general. The term acalculia is also sometimes used.
• Scotopic Sensitivity Syndrome, sometimes called Visual Dyslexia is when the individual has visual difficulties when reading, which are not due to poorly focused vision, and would not be helped by wearing glasses, however, tinted lenses are often helpful when reading.
• Dyspraxia is rarely a significant consideration in the diagnosis of SpLD, and is more properly regarded as being part of Developmental Coordination Disorder (DCD).

It is also important to bear in mind that an individual can have a variety of SpLD and diagnosis can be made more difficult because of the anxiety the child and parents have which can lead to problematic behaviour such as refusing to go to school.

Particular learning difficulties are sometimes found in individuals who in addition have certain clinical conditions, including Autistic Spectrum Disorder (ASD), Obsessive-Compulsive Disorder (OCD), Right Hemisphere Syndrome (RHS), and Attention-Deficit Disorder (ADD), however, this is not usually the case

Early Work on Specific Learning Difficulties

The history of SpLD is extraordinary. The first reference to them in the scientific literature was in
1877 by Dr A Kussmaul. From that time, many attempts were made to investigate the nature of SpLD and to draw them to the attention of other professionals and the public – with limited success.

The Textbook of Child Psychiatry, published in 1935, and edited by Dr Leo Kanner was a pioneering book in this field. In this splendid work, there are many references to SpLD. It is also possible to discern the shadow of Sigmund Freud. Reference is made to the discredited theory that SpLD are caused by family factors, as shown in the following paragraph, written by Dr Kanner.

‘Missildine (1946) investigated the emotional background of thirty normally intelligent non-readers. Ten of these children were burdened with overtly hostile mothers. Another ten had mothers who were markedly tense, criticising, and coercive in their attitude to towards their children. Four children suffered from acute sibling rivalry reactions at the time they were learning to read. Two others were indulged, then neglected or rejected as they reached school age, and two were struggling (sic) against parental overprotection. With perhaps one exception, all were insecure, restless, emotionally upset children so that their reading disabilities were but a part of the total picture of their maladjustment.

However, the statement is made that ‘therapy’ should be guided by two major considerations: educational and psychiatric. Other authors (op. cit.) also state that a child who has SpLD requires, regardless of its cause, specific remedial instruction. Monroe (1932), Gates (1937), and Fernald (1943) reported effective means of coping with specific difficulties. Monroe (1932) emphasised the importance of making a detailed analysis of the specific errors made by each child and the importance of using appropriate techniques to correct these errors. She stated:

‘We tried to teach the children who had trouble in learning to read to utilise the possible secondary or vicarious steps in word-recognition which are not usually presented in ordinary instruction. For example, the child whose visual discriminations were precise for small patterns such as letters, but not for large ones, such as words, was taught by a method which began with the small units and built up the larger ones gradually. The child who had trouble in recognising the special orientation of patterns was taught to use a manual one to give the position of the pattern. The child who failed to discriminate precisely the sounds of words was taught the movements of placing the speech organs to obtain the desired sounds and hence to rely on the kinaesthetic cues of articulation rather than on audition. The child who had difficulty in recalling a visual symbol (the word as seen) was taught to associate each with the same overt response, and hence to build up the desired associations by a secondary link. The child whose motor control of the eyes was inaccurate for keeping the place of reading was taught to utilise a combination of eye-hand movement in developing the desired habit.

The 1944 Education Act and up to 1990

Despite the recognition of specific learning problems, particularly difficulty with reading in bright children, the 1944 Education Act in Great Britain still suggested that the condition could be attributed to a physical medical based description such as visual impairment, hearing difficulties, moderate and severe subnormality, delicacy, and maladjustment. Indeed, many children had to submit to being described as ‘mentally subnormal’, in order to receive help. This classification was completely inappropriate for children who only had a learning difficulty in a specific area and required a different learning pattern form children who struggled in all areas.

An alternative view was to class children with SpLD was to make a psychiatric diagnosis of maladjustment. Many children with SpLD did indeed find themselves sent to unhelpful and inappropriate activities such as play therapy, with often disastrous consequences.

In the following thirty years, the only provision for children with SpLD was located in a number of specialised and private clinics found mainly in London. However, the arguments regarding SpLD continued and particularly focused on dyslexia, with the result that the distinction between SpLD and dyslexia became confused – a confusion which still prevails!

By the late 1960s and 1970s, there had been a plethora of reports which attempted to deal with SpLD but which lacked an information base, focus, and the support of legislation. These reports included that by Professor Jack Tizard in 1972, the Bullock Report of 1975, and the Warnock Report of 1978.

Following the publication of the Warnock Report (1978), which investigated the nature of the ‘statementing’ process for the identification of the Special Educational Needs of Children, the arguments about dyslexia continued, as though this was some strange new phenomenon which had been invented to make teachers lives difficult.

Into the 1990s the view of SpLD as a medical or psychiatric problem persisted in the education sphere and even among psychologists there was a lack of knowledge of the diagnostic and remedial techniques which were becoming available. There was particular confusion about dyspraxia and children thought to be dyspraxic were sometimes sent to be assessed by physiotherapists, rather than psychologists.

1990 to the Present Day

It was not until the 1990s, that research established a broader and more empirical definition of SpLD as a difficulty with regard to information processing. It became clear that they were not developmental difficulties than a child would grow out of, but persisted throughout life, and were sometimes difficult or impossible to eradicate entirely.

In the 1990s, the legal definition of SpLD as a handicap enabled the perception and remediation of such problems to become a legal necessity in organisations such as schools and universities, and in employment generally.

In the year 2000, a multi-disciplinary committee was set up to devise an effective and up-to-date diagnostic strategy for diagnosing university students with these difficulties. In 2005, the SpLD Working Group produced guidelines supported by the Department for Education and Science (DfES). Unfortunately, it was apparent that there were insufficient diagnostic materials available for individuals over the age of 16. The 2005 protocol, as it became known, did not come into use until 1 September 2009. A partial revision was carried out in 2012. Some universities, including Oxford, also require additional information to that required by the protocol.

We can finally note that SpLD are now included in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, which is normally referred to as DSM-V. This Manual is most usefully found incorporated into the more comprehensive Textbook of Psychiatry. A number of sections can also be found online.

The Present

The true nature of SpLD is now widely understood by psychologists, and there are excellent tools for identifying the specific area of difficulty and how it can best be handled to allow children to achieve their full potential. The techniques which can be used by people with SpLD really do work extremely well.

The focus of this report mainly talks about children however there are many adults with SpLD who have been made to feel that they are not intelligent and there is an enormous sense of relief when they find out that this is untrue. Indeed when a child is diagnosed with a condition such as dyslexia, many parents say ‘Me too’ and recognise that they have the same condition.

So, if you ever hear people say that there is no such thing as dyslexia, or that it is just some new thing to make teachers lives more difficult, you can just let them have a copy of this report.

Historical References

BENDER, J. F., Do You Know a Dyslexiac? (sic). Scient. Monthly. 1946, 63, 299-304.
BETTS, E. A. The Prevention and Correction of Reading Difficulties. Evanston, Row, Peterson & Co., 1936.
BLANCHARD, P. Reading Disabilities in Relation to Maladjustment. Ment. Hyg, 1926, 12, 772-788.
_______ . Attitudes and Education Disabilities. Ment. Hyg., 1929, 13, 550-563.
_______ . Psychogenic Factors in Some Cases of Reading Disability. Am. J. Orthopsychiat., 1935, 5, 361-374.
FABIAN, A. A. Reading Disability: An Index of Pathology. Ibid., 1955, 25, 319-329.
FERNALD, G. M. Remedial Techniques in Basic School Subjects. New York, McGraw-Hill. 1943.
(Extensive bibliography.)
FILDES, L. G. A Psychological Inquiry Into the Nature of the Condition Known as Congenital Word Blindness. Brain, 1921, 44, 286-307
GANN, E. Reading Difficulty and Personality Organization. New York, King’s Crown Press. 1945.
(Extensive bibliography.)
GATES, A. I. The Improvement of Reading. New York, Macmillan, 1937. HALLGREN, B. Specific Dyslexia (‘Congenital Word-Blindness’): A Clinical and Genetic Study. Copenhagen, Munksgaard. 1950.
HINSHELWOOD, J. Congenital Word Blindness. London, Lewis. 1917.
KIRKPATRICK, M. E. Twenty-five Nonreaders. New England J. Med., 1939, 230, 1064-1067.
KUSSMAUL, A. Disturbances of Speech. In Cyclopaedia (sic) of Practical Medicine, 1877, 14, 581875.
MISSILDINE, W. H. The Emotional Background of Thirty Children with Reading Disability. Nerv. Child, 1946, 5, 263-272.
MONROE, M. Children Who Cannot Read. Univ. Chicago Press. 1932.
ORTON, S. T. Word Blindness in Children. Arch. Neurol. & Psychiat., 1925, 14, 581-615.
_______ . Reading, Writing and Speech Problems in Children. New York, Norton. 1937.
RABINOVITCH, R.D., DREW, A. L., DE JONG, R.N., INGRAM, H., & WITHEY, L. A Research Approach to Reading Retardation.
Res. Publ. Asso. Res. Nerv. & Ment. Dis., 1954, 34, 363-0396.
TULCHIN, S. H. Emotional Factors in Reading Disabilities in School Children. J. Educ. Psychol., 1935, 26, 443-454. https://www.msn.com/en-gb/health/mindandbody/lavender-really-does-help-you-relax-and-could-even-treat-anxiety-scientists-reveal/ar-BBOMlhX?ocid=spartandhp