Age of dys-order

21:38, Feb 17 2009
One of these brains is not like the other: a cookie-cutter approach to educational assessment has failed to recognise the role of brain differences in how we learn.

Kiwi youngsters are battling a plague of learning disorders. JOHN McCRONE investigates what might be done to counter dyslexia, dyscalculia and their ilk.

The five labelled pieces of text are an approximation of what some people with dyslexia see when trying to read. Dyslexia, dyspraxia, dysgraphia, dyscalculia: our kids appear to be suffering an epidemic of learning dys-orders.

Add in attention deficit disorder (ADD), hyperactivity, Asperger's and autism, and nearly every family harbours some tale of academic struggle -- and dare they admit it, thwarted hopes and dreams -- when it comes to their kids.

Wonders of reading: a sculpture in front of the Dyslexia Foundation on Worcester Boulevard, Christchurch.

The parental anguish shows on internet forums such as the New Zealand Association for Gifted Children discussion board.

Rebecca, a mum, writes about her "gifted but learning disabled" six-year-old daughter. "It breaks my heart to see how hard she tries, how much she struggles, how much of an effort it is for her to learn these so-called `basic' skills that other gifted children pick up effortlessly; to see the proud parents of the `top of the class' kids at parent-teacher interviews and believing deep down in my soul that my daughter ought to be one of them.

"Because of her cognitive level, she is so very aware of her difficulties and at times can be very down," Rebecca adds.


For years, the education system has resisted the temptation to label children, to recognise that learning disorders such as dyslexia -- a specific difficulty with reading and spelling -- even exist. However, official policy has just done a U-turn.

The Ministry of Education has bowed to gathering scientific evidence that some kids' brains -- perhaps one in 10 -- work differently and therefore need to be taught differently.

Whole new syndromes such as dyscalculia, "number blindness", are about to be recognised. Dyscalculia says some kids are not just dumb or lazy when it comes to maths. They have a brain lacking in an area which gives the rest of us a feeling for numbers, that allows us to sense nine is a bit bigger than seven, and a lot bigger than three.

Guy Pope-Mayell, of the Christchurch-based Dyslexia Foundation of New Zealand, says he is dazed at how fast things seem to be changing.

New Zealand, so long a laggard at dealing with learning disorders, now looks like it could leap-frog to the front of the pack.

"The biggest barrier was the Government's non-recognition of labels like dyslexia. The foundation is only a year old, but the change that has been created has just been absolutely phenomenal," Pope-Mayell says.

To expect a complete policy change might be still a bit optimistic as many teachers remain emotionally wedded to an earlier Kiwi initiative that captured world attention -- the costly Reading Recovery programme.

That is still a hot potato, Pope-Mayell says.

But before considering the politics, what is the explanation of the apparent specific learning difficulties (SLDs) epidemic?

Why are so many otherwise bright and capable children suffering basic learning problems which blight their young lives?

Pope-Mayell believes there are two sides to the answer. On the one hand, science is confirming that people with dyslexia and other "dys-orders" have genuine brain differences. The way they hear and see the world makes it hard to learn basic skills like reading and spelling.

But the other half of the story is that we have adopted a cookie-cutter definition of educational success. The world has become the realm of the white-collar worker. Life revolves around literacy and numeracy.

So it could just be that our kids come with varied brains. In the same way we all have a different body shape, the shape or neural architecture of our brains could be equally various. Indeed, neuro-imaging scanners show the bumps and tucks of the brain are as individual as our fingerprints.

Yet while our brains have this physical variety, it is as if society has decided there is only one game in life. Some of us might be better suited as bulky prop forwards or lanky high jumpers, but society wants us all to be twinkle-toed gymnasts. Any child who is not shaped for double back-flips must still undergo intensive bending and twisting to fulfil whatever gymnastic potential they have.

Guy Pope-Mayell says that 100 years ago, the "learning disabled" would have gone unnoticed. They would have found work as tailors, blacksmiths, typesetters, milliners and countless other forgotten trades. But today, every job seems to need a university degree.

Parents and teachers are all too aware that the good careers will go to those quick with words and numbers. This harsh narrowing of the definition of success has also drastically broadened the definition of failure, Pope-Mayell says.

Psychologists and neuroscientists are still arguing over the causes of dyslexia and other learning disabilities. One big question is whether they are all different faces of the same neuro-developmental problem or a range of quite separate disorders.

Researchers such as Karen Waldie and Anna Wilson, of Auckland University's psychology department, and Gail Gillon of Canterbury's College of Education, say there is some evidence of a common mechanism.

It seems that not all of us experience the world in exactly the same way. Subtle differences in the way our brains are wired means there can be some equally fine-grain differences in the way we deal with raw sensory information.

Given that skills such as reading and counting are not exactly natural to humans -- we may have evolved to be speakers, but writing and arithmetic are recent cultural inventions -- then these small differences can make learning a real struggle.

Waldie says, for example, at least 10 per cent of dyslexics have trouble focusing on words on a page. The type will swim about, swirl, fade, break apart.

This seems strange to the "neuro-typical" among us. Yet the eye evolved to cope with a dynamic world, a place where things of interest are usually moving and changing. Staring at static print is a demand which may stress the visual pathways of some.

Waldie says that for about 70% of dyslexics, surprisingly, it is phonological processing -- a difficulty with hearing -- which is the sensory problem. Dyslexics find it hard to hear words as a collection of individual sounds.

Waldie says that even a word as simple as "cat" is made up of three phonemes or sound units -- kuh-aah-tuh. She says dyslexics can hear and understand the whole word, but falter on the finer sensory task of resolving cat into its three distinct components.

This is why an early sign of dyslexia in children is a difficulty with word games involving rhyming or spoonerisms. Turning "silly cheats" into "chilli seats" is the kind of tongue twister than demands you can hear the "s" and "ch" as distinct sound units. Children with dyslexia will mispronounce words such as vanilla or hallelujah because they cannot get a sharp mental image of the sounds they want to make.

Again, in evolutionary terms, this kind of fine-grain auditory attentional difference is no big deal. Dyslexic kids usually have plenty to say and can say it without trouble. But it is a different matter when they have to learn to read or spell.

Faced with a written code in which three letters -- c-a-t -- are supposed to represent three sounds, it would certainly help to be able to hear each sharply separate.

Waldie says these kinds of basic sensory issues explain why dyslexics can have a high IQ, yet labour at learning the "simple things", the rest of us take for granted.

Many reasons have been suggested for why individuals would differ in their perceptual abilities. Some researchers think normal brain development could get derailed by overheating during a difficult birth, a poor early diet, or go astray due to a genetic weakness.

Studies have claimed the brains of dyslexics show clear structural differences, such as tangled brain cells -- ectopias -- "in the wrong places", or a shortage of a particular class of brain cells important for processing fast-changing time and motion details.

However, other researchers say the differences do not need to be explained away as some kind of damage. More likely they are part of the normal variability in the development of brains. Indeed they argue that just as different body shapes are better suited to different sports, so a dyslexic brain might have its own hidden advantages. There are many reports that dyslexics excel at visual thinking, that they are perhaps more dynamic or holistic because they do not have such a stable, or broken-up, sensory experience of the world.

Regardless, the essential explanation is the same. Everyday white-collar skills such as reading and writing are harder than they seem. So a child with an even slightly differently organised brain may find it hard to get the early sensory footholds needed to master the skill.

The same neural story is being offered for dysgraphia, dyspraxia and now, dyscalculia. Dysgraphia is difficulty with hand-writing, getting words down on paper. Dyspraxia, also known as clumsy-child syndrome, is a problem with fine-grain motor co-ordination and sequencing.

While both seem to be about physical output rather than sensory input, there is still a need to be able to distinguish fine detail, to handle high-speed information sequences.

Dyscalculia is the newest kid on the block, having only just been recognised as a specific learning disorder.

Anna Wilson, who with Waldie is carrying out neuro-imaging studies of the brains of dyslexics and dyscalculiacs, says children with the problem not only fail to memorise their times-tables, they usually have a striking difficulty with learning to read a clock face and tell the time.

Often they seem disorganised or inattentive as they have little sense of passing time or deadlines. Frustrated mothers will complain their child never seems to know whether it is a school day or the weekend.

Wilson says brain scans suggest that dyscalculiacs may be born with a smaller intra-parietal sulcus, a postage-stamp fold in the wrinkled brain surface known to be specialised for creating the kind of spatial sense that allows you to feel Saturday comes a certain distance after Monday, or five times six is immediately going to be a much bigger number than five plus six.

Again, in evolutionary terms, an underweight intra-parietal sulcus might not be such a big deal. Our caveman ancestors did not live such structured lives. But for modern children who need to attach some sort of meaning to abstract sets of digits, suddenly it could become a low-level roadblock to learning.

Wilson says once you know the signs to look for, dyscalculia is easy to pick up. With one in 20 children probably affected, it seems just as commonplace as dyslexia. But perhaps it has been recognised because being "bad at maths" has almost become socially acceptable.

Educators like Gail Gillon, an expert on phonological dyslexia at Canterbury's College of Education, says New Zealand has long taken a different approach to dyslexia and other learning issues.

"There's been this socio-cultural perspective that it doesn't matter what we think this child has, we just want to treat it as a child," she says.

This meant no labelling. It applied as much to singling out children as gifted as those with some specific learning problem. The celebrated Reading Recovery programme came out of this ethos. Its goal was to identify children behind on their literacy and give them extra one-on-one tuition. While widely admired because of the money devoted to it, and the effort to catch kids as young as six, Gillon says experience shows that its unselective model has probably failed dyslexics.

She says once you understand that dyslexics have more fundamental sensory issues, then you will apply quite different techniques to aid them. And indeed, would be able to intervene even earlier.

"We know the predictors of being at risk of dyslexia are the kids who struggle with rhyme, with pronunciation, with breaking words into syllables or individual sounds. So why not work with them at four, five or six to develop those skills, to help them before the problem even presents itself?" Gillon says.

The same argument goes for dyscalculia and dyspraxia, Gillon says. If they are more sensory difficulties than intellectual ones, then the education system needs to take a directed approach.

For many years, the lobbying efforts of groups like the Specific Learning Disabilities Federation (Speld) fell on deaf ears. But last April, the Ministry of Education announced it now acknowledges dyslexia as a specific issue.

And in October, as part of the announcement of a new curriculum, ministry officials began to detail the changes.

Pope-Mayell says the ministry is promising early testing and directed intervention. Even better, he says, it is moving on from the deficit model where dyslexia and other disorders are treated as purely a brain handicap that needs to be remedied.

"Because we had our head in the sand in the 1980s and 1990s, we now have an advantage over other countries. We missed that chapter when they saw dyslexia as just a deficit.

"Now we can jump ahead straight to chapter two where we recognise the strengths dyslexics may also have," says Pope-Mayell.

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