Causes and Development of Attention Deficit Disorder - Essay Example

Running Head: LABEL DYSLEXIA Label Dyslexia [Author’s Name] [Institution Name] Label Dyslexia “It is hardly surprising … that the widespread, yet wholly erroneous, belief that dyslexics are intellectually bright but poor readers would create a strong, sometimes impassioned demand to be accorded a dyslexic label.” Elliott, J. (2005) Thesis There are found certain misconceptions about scientific and logical status of dyslexia. Many traditional views regarding dyslexia are not empirically tested and objectively concluded. Rather most of these are misguiding and erroneous. As Elliott points out “Dyslexia persists as a construct largely because it serves an emotional, not a scientific, function. Let’s be absolutely clear about the concept of dyslexia from the outset. First, there is no consensus about how it should be defined or what diagnostic criteria should be used. Forget about letter reversals, clumsiness, inconsistent hand preference and poor memory - these are commonly found in people without reading difficulties, and in poor readers not considered to be dyslexic.” (Elliott, J. 2005) In examining definitions of dyslexia it becomes apparent that different definitions highlight different aspects or levels of the problem. Frith (1992) has proposed that in looking at learning disabilities like autism and dyslexia it is important to look at the links between the different levels of explanation so that we can begin to see the links between biological causation, cognitive impairments, and behaviours such as poor reading and spelling. Although at present there isn’t one agreed definition of dyslexia, the following, put forward by Critchley (1970, 125-30) is one that is still widely used. Dyslexia is a disorder manifested by difficulty in learning to read despite conventional instruction, adequate intelligence and sociocultural opportunity. It is dependant upon fundamental cognitive disabilities which are frequently of constitutional origin. It can be seen that a definition like this includes behaviour, cognition and cause. Definitions like this are often referred to as exclusion definitions because it suggests that a child can only be defined as dyslexic if a number of factors are excluded. Critics would argue that this type of approach tends to favour the identification of middle class children and may have led to the fallacious assumption that dyslexia is a ‘middle class disorder’. To look at the problem another way it suggests that socially disadvantaged children or mildly learning disabled children cannot be defined as dyslexic. But the evidence we have so far suggests that the cognitive impairments underlying dyslexia are evenly spread across the population and are as likely to occur in these groups as any other groups. What has not been researched to any extent yet is how the specific cognitive impairments underlying dyslexia interact with other impairments such as a hearing disability or with environmental factors such as lack of exposure to the printed word. It may for example be the case that whereas under optimal conditions children can compensate for a certain degree of specific cognitive impairment that these same impairments coupled with an unfavourable environment may lead to considerable difficulties in learning to read and write. Jordan and Powell (1995, 219-22) point out that recent research suggests that there may be a link between Aspergers syndrome (high functioning autism) and dyslexia and suggest that dyslexia-type difficulties should not be overlooked simply because a child has already been identified as having autism. Similar problems exist with what are known as discrepancy definitions of dyslexia. In this case it is the child’s poor performance in learning to read and write in relation to their age and level of intelligence that is stressed. Critics would again argue that this tends to favour more intelligent and more middle class children where it is supposed that the gap between their expected performance and their actual performance is more apparent. Another difficulty is that obvious discrepancies between reading and spelling scores tend to diminish as children get older so that by adolescence this approach will exclude many children who do have the specific cognitive impairments underlying dyslexia such as poor short-term memory. Korhonen (1995, p.4) found for example in a longitudinal study that children who had reading difficulties at 9 years of age had a significantly worse digit span at 18 years of age, were significantly worse on a word fluency task and were slower and more error prone on a spelling task in comparison with a control group. Research like this underlines that older dyslexic children and adults still have difficulties which put them at a disadvantage especially in situations such as written examinations. So whilst discrepancy definitions may be good at identifying some children with dyslexia they may well lead to bias in who is identified and the under identification of some groups of children. Part of the reason for the reluctance of some educationalists to recognise dyslexia in the past may have been connected to their underlying disquiet about the way it was defined and the implications that this had for the identification of children and allocation of resources. Antithesis Some of the research studies rebut the arguments presented in the thesis section. They oppose certain traditional views and refute those on the basis of extensive observations. At a very general level research and writing on dyslexia can be put under three major headings. First, there is the large body of cognitive research Second, there is a broad band of educational research and writing, and finally there is a surprisingly small amount of research on the social and personal consequences of dyslexia. Inevitably there is considerable overlap between these areas and, for example, some of the studies on intervention have been derived directly from cognitive research but have clear educational implications. Despite the overlaps there is a case to be made for suggesting there is still a lack of engagement between these various areas of research. The major concern thus far of cognitive psychologists has been to identify the processing deficits underlying dyslexia. They have been less concerned in looking at how these deficits might interact with broader everyday influences such as a child’s view of herself as a learner. In contrast much mainstream educational research and writing has ignored or denied the existence of dyslexia as a concept and it has therefore not been directly researched or written about. Many educationalists would argue that they have included many so-called dyslexic children within a different conceptual framework which sees them as part of the continuum of children with specific learning disabilities within the broader category of children with special needs. From this perspective there has been a considerable amount of research especially on children who have had difficulties learning to read. The problem is that because some cognitive and educational researchers have started from different perspectives with different approaches to defining and identifying children with a difficulty it is hard to compare and draw meaningful conclusions from their relative research. As stated before there is less research at present on the social and personal consequences of dyslexia. Much of what exists comes from outside the mainstream of academic research and consists of personal accounts in the form of autobiographies or collections of case studies. At this informal level there are also the opinions of clinicians and specialist teachers on the personal consequences of dyslexia. At a more general level there is research on children’s self-concept as learners (Burns 1982, 109-14) and the personal development of a range of children with special needs. Dyslexic children if viewed as part of the continuum of children with special needs were in danger of having their difficulties exacerbated by repeated failure unless appropriate support was available. The point about not having a rigid division between handicapped and non-handicapped does highlight some of the problems inherent in a concept such as dyslexia. this is not a problem peculiar to dyslexia: labels as diverse as ‘autism’, ‘clumsiness’ and even seemingly more quantifiable ones such as ‘visual’ and ‘hearing impairments’ all raise the same issue of where the cut off point is drawn. This is an issue of how a label is applied and it does not necessarily invalidate the label itself. Another criticism of categories particularly pertinent to dyslexia is that they draw resources away from children who don’t fit a particular category. But this criticism is actually about the way in which the allocation of resources is linked to categories and not about categories in themselves. Critics of the use of the label dyslexia would argue that this label is used to distance dyslexics from common or garden backward readers and by doing so imply that a special and different level of support is required. Supporters of the term ‘dyslexia’ would argue that this criticism is based on an outdated discrepancy and exclusion definition of dyslexia and that if a process based definition of dyslexia is used then many children formally classified as backward readers might in fact be classified as dyslexic. They would also argue that identifying the underlying processing problems that an individual child has is very much in line with Warnock’s recommendation that ‘remedial’ children should not all be lumped together and that skilled assessment should discriminate between children and inform the type of specialist support they required. This approach does not suggest that dyslexic children should receive proportionally more support than other children it suggests that all children should receive support specific to their learning needs. A final and strong criticism that the Warnock Report had of categories was that they led to stigma and negative labelling sometimes of a long-term nature. The Warnock Report was expressing a view widely held in the 1970s and 1980s (Szasz 1961, 98-101; Goffman 1968, 66-69) about the problems of labelling. Few would disagree about the negative connotations attached to certain labels and the harmful consequences that can ensue. But the danger is that this can lead to oversimplification and over generalisation of the argument. It can be argued that the nature, purpose and context in which a label is used all influence the degree of positive and negative outcomes associated in using it. A child with a visual impairment for example may not want to be publicly labelled as such within school, but may want teachers to know enough about the impairment so they can adapt teaching appropriately. The child may also want at a personal level to understand the visual difficulties that they have and be given some idea of whether any improvement or deterioration can be expected in their sight. Norwich (1990) in a comprehensive critique of the objections given to categorisation in the Warnock Report states that the relation between any general category and its use for individuals is a complex one.’ (Norwich, 1990, 227-39) As a general point it can be suggested that the concept of dyslexia was being debated during the 1970s and 1980s within a cultural context which was doubtful or sceptical of the value of labels. But it can be argued that in order to have a full and accurate picture of a child’s learning difficulties we need to know how all the environmental factors which are in operation interact with the within-child factors to produce a particular outcome. Some special educationalists, in extending the thinking of the Warnock Report, were highly critical of explanations of learning disability which focused on within-child factors. Whilst they were correct to criticise the exclusive use of within-child factors the danger was that in some cases by denying the role of these factors they were adopting what could be called the ‘without-child’ approach. The Warnock Report specifically mentions the needs of dyslexic children as part of a wider group of children with reading, writing and spelling difficulties. It comments that it hopes that its new recommendations on assessment leading to the formulation of individual need will be of particular help to this group of children. The report goes on to say Although there are no agreed criteria for distinguishing those children with severe and long-term difficulties in reading, writing and spelling from others that may require remedial teaching in these areas, there are nevertheless children whose disabilities are marked but whose general ability is at least average and for whom distinctive arrangements are necessary. Synthesis Let us now synthesise each and every view of both sides i.e. of thesis section and of antithesis section so that an accurate synthesis may solve this problem. If we have a hazy or inaccurate idea of what kind of child our environmental factors are interacting with, we can end up with the wrong picture. This is not a problem exclusive to dyslexia. The integration of children with physical disabilities into mainstream schools is examined at one time. What surprised her was the number of mainstream teachers who knew nothing about the specific nature of the impairments that some children had and the specific learning disabilities that accompanied these impairments. The problem is that because ‘dyslexia’ is physically invisible you have to know what it is before you can clearly see it. This explains why it is possible for teachers to claim that they have been teaching for 30 years without coming across a child with dyslexia. As they know nothing about dyslexia they never see a child with dyslexia! Many of the mothers in this sample had known something was wrong with their child’s learning but it was only when they came upon information describing dyslexia that they identified this as the difficulty. Similarly several specialist teachers also said that before they knew about dyslexia there were children in their class who mystified or puzzled them. It was only in retrospect that they realised that these children were dyslexic and many of them felt guilty that they had been able to do little for these children. To return to the main point of this argument, a move to an interactional approach which stresses the importance of both within-child and environmental factors is needed if we are to do full justice to many aspects of special needs. Research into the learning of children with severe learning disabilities shows that different groups of children have different cognitive profiles and different strengths and weaknesses in the way that they learn (Clements 1987, 89-93). This suggests that no child’s learning should be described by vague terms such as ‘slow’ and far from threatening our overall approach to special needs, dyslexia can help us to improve the way that we think about and approach a whole range of special needs. Pumfrey and Reason (1991, 156-60) point out that it is important that if constitutional factors are highlighted we don’t then overlook environmental factors such as the way children are taught. It can be argued that if we take the ‘whole’ person as our starting point and listen to what a person with a disability has to say we are less likely to do this, as people with disabilities have to grapple with environmental factors every day of their life and can tell us graphically how these affect them. Dyson and Skidmore (1994) in their survey of provision for specific learning disabilities in secondary schools found that schools based provision on children’s perceived needs rather than specific labels as such. This approach was thought to work well from the point of view of the schools but does beg the question of what informed or guided teachers’ perceptions of need. It can be argued that where teachers understand something about the difficulties involved in specific learning difficulties or dyslexia this will inform and direct their perception of need. (Dyson, 1994, 277-83) One mother in the study found that although her son’s secondary school was very sympathetic about his poor literacy they completely dismissed the idea of specific learning difficulties and thought that all his problems were caused by lack of confidence and would thus be solved by improving his confidence. His mother felt this was a partial solution which didn’t take on board the specific nature of the literacy difficulties he was having at school. As more is learnt about dyslexia it is becoming clearer that there are different degrees of the problem and that individuals differ in the precise nature of the problems that they have, although there are enough commonalties to justify the overall label of ‘dyslexia’ or ‘specific learning difficulties’. (Yasutake, 1955, 329-44) It may well be the case that those with mild to moderate difficulties will be helped by moves to more phonics based systematic teaching of reading or the introduction of multi-sensory methods to the classroom. What is less clear is how far these approaches will alleviate the more severe difficulties that some children have. It may be that these more severely affected children will need more individual and specific teaching over a longer period of time. It is important that a developmental perspective is taken and that the long term difficulties that some children have are acknowledged and planned for. It is also important that not only are children given academic help but that they are also given personal support and that everything possible is done to maintain their self-esteem and to help them develop self-awareness and positive coping strategies. In this study it was found that telling children they were dyslexic was an important part of boosting low self-esteem. It also enabled children and their families to access a whole range of support such as role models, literature, support groups and so on which they may not have otherwise had contact with. For this reason it is important that schools, even if they prefer the term ‘specific learning difficulty’, acknowledge the word ‘dyslexia’ and allow children and parents to feel comfortable in using it. If after an assessment a child is told that he is dyslexic and is given a positive explanation of what this means, he knows then that he is not stupid and that he is not lazy, and that something can be done to help him. So often, later in children's lives this moment has been traced back to being a turning point, when lack of confidence and despair have been replaced by a growing determination to succeed. In some schools there is still antipathy towards the concept of dyslexia. The attitude is often that dyslexia is used by middle-class parents as a cover-up for a child who is not very bright or who is lazy. It does, though, seem fundamental to good teaching to recognise that all of us do not learn things in the same way. In areas other than literacy this seems to be accepted without query. Nobody argues that the inability to sing in tune is due to stupidity or laziness. Literacy problems, however, produce entirely different reactions. Throughout the centuries the ability to read and write has been - quite wrongly - linked with intelligence. It was priests who were literate; they read the scriptures and copied and translated theological texts. Children of the aristocracy and at the manor house had governesses who usually ensured that they acquired a proficiency in literacy and numeracy. These people tended to be put on a pedestal and respected for their positions in society and for their evident intelligence and ability. In this way competence in reading and writing became linked with intelligence and social position. Conversely, the inability to read and write was linked with lack of education and apparent stupidity. It is just this attitude that has been handed down to us over the centuries and which, even today, is difficult to eradicate. It is the ability to comprehend and use knowledge which indicates intelligence. In more recent years there has been an emphasis on norms in education. It is often forgotten that these statistical norms include the backward and most advanced pupils. Norms are useful as an indication of the average ability and are used as a guide in the National Curriculum in the UK. Tests are useful provided that the results are interpreted with a view to giving a child the tuition that will enable him to improve his standards. If he does badly, he must not just be considered a failure. Something must be done! An obvious psychological problem may cloud the picture and over-emphasise one aspect of an assessment. Children - like adults - are complex in their make-up. A learning difficulty may be put down to an experience such as adoption, parents' divorce, changing schools several times and, therefore, other causes like dyslexia or dyspraxia may lie undetected. Consequently, the child does not receive the necessary support and understanding. It is for these reasons that there needs to be co-operation among professional people, and it is essential that class teachers are aware of the possibility of a variety of causes for a child's learning difficulties. It is also essential for it to be recognised that, for instance, a child might be assessed as having a speech and language processing problem, but with specific tuition he may overcome many difficulties, but still need treatment for dyslexia. For instance, his ability to express himself and comprehend could be greatly improved, but his reading and spelling will still need attention. Much has been said and written about good reading schemes and less good reading schemes, the various methods of teaching reading and spelling, and the best equipment with which to put across basic numeracy. Little has been said about the different ways in which people function. To give an example, a Look-Say reading scheme will no doubt be excellent for children who mentally take photographs of words as they read; these are the children who have good visual recall for words. It is as though they have a very good mental camera with an excellent lens which records the letters of a word clearly in their memories. When they see the word again on a different line or page they recognise it immediately from the mental picture called forth in their mind's eye. When they need to write it they know exactly what letters - and their correct order - to put down, and the hand usually glides effortlessly across the page. There is nothing very clever about this; it just happens that a person is constitutionally made with the skills that are needed for literacy. If you have a different make-up, then that same Look-Say reading scheme may for you be a disaster, as each word may need to be decoded instead of being recognised. Similarly, a phonological difficulty (that is, a difficulty building up an awareness of speech sounds and linking them to the written word) makes a purely phonic approach inappropriate. Spelling for those with no - or poor - visual recall for words is very often an enormous problem as, particularly without a knowledge of phonics and language structure, children usually have no notion of what to put on paper. It is like finding yourself in a strange country without a map and being expected to find your way about. There are, however, some people with no visual recall for words who somehow manage to spell correctly, often through chunking the syllables, but often also they are unable to analyse how they do it. These difficulties also affect handwriting. Sometimes the image of the letter can be neither recalled nor linked to the relevant sound, so the writer is at a loss as to what is required. On the other hand, he may visualise the letter but be uncertain how to form it, and also be unsure of the order of the letters of a word. Numeracy is affected too. The formation of numbers and their direction is often a problem, as well as learning multiplication tables and the order of arithmetical operations. This ability to sequence verbal and symbolic material correctly (that is, to get information in the correct order) is definitely enhanced by the ability to visualise in the mind's eye. It is also important to know the order of the days, months and seasons. Orientation, in the sense of getting things the right way round, is important when map-reading, finding one's way, knowing right from left. Many people may have the odd quirk - perhaps confuse right and left or be unsure of letters, for instance at the end of the alphabet - but a dyslexic person tends to have a sufficient number of such difficulties to make life very uncomfortable, resulting also in loss of self-confidence. As with the label 'dyslexia', when there is an explanation for the difficulties being encountered there can be enormous relief for all concerned - child, parents and teachers. It is then understood that there are underlying reasons for the poor concentration, impulsivity and restlessness; the child is not merely 'naughty' and being badly managed at home. Even with a diagnostic label there are no simple answers. It is the pattern of difficulties which must be considered. Once again, the lines between diagnoses become blurred as the child may be experiencing other difficulties as well; for instance, frustrations encountered with speech and language processing, literacy problems or very low self-esteem, and worrying, all of which can lead to severe concentration difficulties. Research has shown that there is a genetic disposition to an attention deficit disorder. It also seems reasonable that such a disorder may be exacerbated by stress or by a traumatic experience in early childhood. Either of these might explain an inability to concentrate, to relate to peer group, to accept authority and generally be considered 'impossible'. It may be that the realistic course of action under these circumstances includes medication. Methylphenidate (Ritalin) is the most widely administered drug in such cases. Ritalin is a stimulant. It stimulates the brain which, in turn, produces more of the normal chemicals which calm a child down and so modifies behaviour. References Burns, R. (1982) Self-Concept Development and Education. London: Holt, Rinehart & Winston. 109-14 Clements, J. (1987) Severe Learning Disability and Psychological Handicap. Chichester: Wiley. 89-93 Critchley, M. (1970) The Dyslexic Child. London: Heinemann. 125-30 Dyson, A. and Skidmore, D. (1994) ‘Provision for pupils with specific learning difficulties in secondary schools’. A report to SOED (Scottish Office Education Department). University of Newcastle upon Tyne. 277-83 Frith, U. (1992) ‘Cognitive development and cognitive deficit’. The Psychologist: Bulletin of the British Psychological Society, 5 (1), 13-19. Goffman E. (1968) Stigma. Harmondsworth: Penguin. 66-69 Jordan, R. and Powell, S (1995) Understanding and Teaching Children with Autism. Chichester: John Wiley & Sons. 219-22 Korhonen, T.K. (1995) ‘The persistence of rapid naming problems in children with reading disabilities: a nine year follows up’. Journal of Learning Disabilities, 28 (4). Norwich, B. (1990) Reappraising Special Needs Education. London: Cassell. 227-39 Pumfrey, P.D. and Reason, R. (1991) Specific Learning Difficulties (Dyslexia): Challenges, Responses and Recommendations. London: Routledge. 156-60 Szasz, T. (1961) The Myth of Mental Illness. New York: Harper & Row. 98-101 Yasutake, D. and Bryan, T. (1995) ‘The influence of affect on the achievement of behaviour of students with learning disabilities’. Journal of Learning Disabilities, 28 (6), 329-44. Read More