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Dyslexia Interventions As The Way For Its Treatment

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The conception of learning disabilities has been around since the twentieth century, individual learners with these difficulties are often unable to read, write or comprehend mathematical problems smoothly (The British Dyslexia Association 2007). There are several specific learning difficulties which include dyspraxia, dysgraphia, dyscalculia, dyslexia and other learning difficulties. For the purpose of this essay, the specific learning disability focused on will be dyslexia. Dyslexia was first coined by Rudolf Berlin, using it as a term to help describe reading difficulties. Today the Dyslexia Association of Ireland (2019) defines dyslexia as a specific learning difficulty affecting the acquisition of fluent and accurate reading and spelling skills. It is broadly known that Dyslexia is the most common learning disability, that being said there is no consensus among experts on the definition of dyslexia nor is there agreement on its causes, hence there are many schools of thought, leading to different theories about dyslexia (Reid 2009). On the contrary dyslexia’s associated difficulties are unanimous and it is often characterised by poor spelling, word reversals, poor recall, poor organisation skills, avoiding reading aloud and written tasks, just to name a few. Thus, the aim of this paper is to critically evaluate evidenced based research regarding reading interventions for individuals with dyslexia. In particular ARROW, Repeated Reading and Units of Sound will be analysed, however before that this essay will briefly delve into the history of Dyslexia and the main theories of Dyslexia namely the Phonological theory, the Magnocellular theory, the Double Deficit theory and the Cerebellar theory.

The term dyslexia has been circulating for over one hundred years. Critchley (1970) as cited in J M Fletcher (2009, p26) states that ‘earlier definitions identified dyslexia as a disorder of reading in the presence of average intelligence, conventional instruction and socio-economic status’. Said definitions have been denounced as they are deemed none inclusive, most of these earlier definitions focused on a visual impairment. Past research on dyslexia also focused on brain dysfunction studies a prime example of this is Benton’s 1975 research where he assessed brain dysfunction to understand the causes of dyslexia and suitable treatment. Thankfully, due to research there is better knowledge of both the neurobiological, physical, cognitive and environmental elements leading to dyslexia. Recent research has now advanced and broadened to include phonological, environmental and cognitive aspects advocating “reading as primarily a linguistic skill, contrary to the once popular notion that it is primarily a visual skill” Vellutino et al (2004, p12). Additionally, it is currently believed that ‘the origins of dyslexia are neurobiological with strong evidence for heritability but environmental factors also shape and ameliorate risk for dyslexia’ Fletcher (2009, p 254). It is also noted that this shift in defining dyslexia is due to advances in scientific knowledge of reading difficulties, credited to the recent Fletcher (2009).

Theories of dyslexia are continuously evolving however, the four dominant theories include the Phonological theory, the Magnocellular theory, the Double Deficit theory and the Cerebellar theory. The Phonological theory purposes dyslexia as a difficulty in storing and recovery of speech sounds, affecting phonemes which are the smallest units of speech. It claims a person with dyslexia will find it difficult to break down words into their smallest units of sound and build them up again, ultimately affecting a person’s ability to remember, understand and reproduce speech sounds. Ramus (2003) explains how alphabetic systems involves learning the grapheme/phoneme correspondence and advises that if speech sounds are poorly represented, stored or retrieved the basics of learning to read will be affected. This theory does not however account for any sensory and motor aspects of dyslexia. Ramus (2003, p101) describes ‘the major weakness of the phonological theory is its in ability to explain the occurrence of sensory and motor disorder in dyslexic individuals.’ Nonetheless, though theorists have differing views on the nature of phonological issues, they agree on the central and causal role of phonology in dyslexia.

The Cerebellar theory delves into the functionality of the cerebellum and cognitive issues associated with this. The Cerebellum is a region in the back of the brain responsible for coordination of voluntary muscle movements, posture and balance. This theory relies on the fact that motor control, speech and phonological processing are learned. Support for this has come from evidence of poor performance in motor tasks, time estimation and non-motor cerebellar tasks in dyslexics. Brain imaging studies have also illustrated discrepancies in anatomical, metabolic and activation areas of the cerebellum of a person with dyslexia Leonard et al (2001). This intervention has been heavily critised as it is extremely difficult to determine the actual proportion of dyslexic individuals with motor control problems, it also does not take into account any sensory aspect.

The Magnocellular theory maintains that dyslexia is caused by an aural, visual and tactile breakdown. It suggests that the causation of dyslexia is rooted in problems with processing moving visual information, which is fundamentally intricacies in the magnocellular pathway of the brain. Such difficulties attempt to explain a dyslexic person’s letter reversal and text tracking struggles. This theory was shaped by Stein and Walsh (1997) and it too has been critised, this is due to conflicting data on visual and auditory disorders and it is not certain that auditory deficits do not yield dyslexia. ‘Criticism of the visual side of the Magnocellular theory also focuses on failures to replicate findings of a visual deficit’ Ramus (2003 p854).

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Lastly the double deficit theory suggests that people with dyslexia may have difficulties with phonology, which is our awareness of the sounds in words and processing speed which can lead to reading problems ranging from mild to severe. In particular word recall can be very challenging according to this theory. Ultimately a person that has both a processing speed and phonological concern will inevitably have greater reading complications to that say of a person with one of the above impairments. However, ‘despite extensive behavioural research, the brain basis of poor reading with a double- deficit has never been investigated’ (Norton 2014, p278), in fact some studies argue that rapid automatized naming and phonological awareness are too similar to separate into two entities, nonetheless this theory maintains that both are separate deficits. In conclusion, it is possible that the causation of dyslexia is a combination of all of the above theories or ‘of course it is possible that these theories are true of different individuals’ Ramus (2003, p844) but ultimately the cause of dyslexia is open to debate.

Reading interventions for people with dyslexia ‘should entail training in phoneme awareness, letter knowledge, explicit and systematic instruction in phonics, and the application of these skills to the tasks of reading and writing’ (Duff and Clarke 2011 p5). Not all reading interventions will be successful and may result in the person not making progress. However, it has become evident that the earlier the intervention is implemented corresponds with the likelihood of the intervention being a success. Griffith and Stuart (2013) stress that 15-60% of people with dyslexia will struggle to achieve significant progress if the intervention is implemented at a later stage. This may be in part due to lack of motivation. Units of Sound is a ‘structured cumulative and multi-sensory computer-based programme that has been developed to teach reading and spelling’ Brooks et al (2006 p227). Units of sound are presented individually then built into words and then into sentences. It has been developed to enhance sentence writing, reading accuracy, automaticity and decoding. It was created in 2006 by Dyslexia Action and is designed for students to work and learn independently on the computer in a secure context. It is aimed at both primary and secondary schools. This intervention states that a 1:1 tutor-student ratio is rarely necessary and is not recommended for mainstream students. This is due to the fact that most of the work in this intervention is individual work on the computer. Units of Sound is designed so the student works and learns independently but may be in a group setting where there is a computer for each student. However, Griffiths and Stuart (2013) and Hawkins et al (2011), contradict this outlook and maintain that some students may need 1:1 intensive teaching to make progress particularly in cases where the Dyslexia is very severe. This intervention has reached over two thousand students; however, it is not limited to children and can in fact be implement from the age of eight into adulthood. It has obtained positive results including progression in both spelling and reading ‘the surveys indicated that the teachers, students and teaching assistants who experienced the programme had mostly positive perceptions of the programme and believed that it had improved learning’ (Sheard et al 2015 p25). Hatcher, Hulme, and Snowling (2004) describe how the results of studies on especially Units of Sound and Sound Linkage demonstrate that it is possible in primary school settings to improve basic reading skills by training phoneme awareness and letter knowledge. On the contrary, this theory has also received some critique, Sheard et al (2015) claims the intervention was not implemented for the recommended time, teachers did not complete training as well as organisational and technical complications. Sheard evaluated this intervention using almost eight hundred year seven pupils across forty-five school. Schools that partook in this intervention were from socio economically deprived areas. All students that participated in this study scored below level four in English by year seven. Those that administrated the intervention obtained ten hours of initial online training, in addition to this schools received face to face training but only thirty-one out of the forty-five schools partook in this specific training. The study lasted eighteen weeks and students had sixty minutes participation time and a further thirty minutes independent work per week of the intervention. Although initially this intervention appeared favourably with positive feedback recorded, taking into consideration Sheard et al (2015) randomised control test it would appear difficult to depict a definitive conclusion. Many participants noted that improved ICT support in schools to implement such programmes would be of huge benefit to participants. The study was also compromised due to the high number of schools leaving the intervention also not all students completed necessary testing to determine if improvement was achieved, ultimately resulting in the findings being deemed weak. Furthermore, Golightly (2000) suggests that there is a large number of studies that use this balanced approach in interventions with young readers who still struggle to attain expected progress after their interventions.

Repeated reading requires reading a text numerous times, familiarising oneself with the content. This intervention can be applied in school or at home by reading with another pupil or a parent or guardian. The aim of the intervention is to develop automaticity and reduce the length of time someone with dyslexia would spend focusing on decoding the text. Ehri (1995) states that if attention is consumed by decoding the ‘little or no capacity is available for comprehension’ ultimately affecting academic success. According to Jefferson et al (2017) two thousand students participated in this intervention over a nine-month period. Following the study improvement in reading was evident. This theory is also supported by Griffith and Stuart (2013) beliefs that some students need 1:1 intensive teaching to make progress particularly when a person’s dyslexia is severe. However, there is possibility that results could have been predisposed due to students and teacher’s awareness of the study. In addition to this, Chad and Baker (2009) cited in O’ Keefe (2012) propose that results from Repeated Reading interventions were not supported by binding research and did not meet the research-based criteria, deeming findings unreliable. They claim that the seven methodological categories developed by Gersten et al. (2005), (which range from description of participants and setting to impact of variables) are usually not all tested, as certain areas lack sufficient detail to satisfy criteria. Chad and Baker (2009) did acknowledge that it was very difficult and time consuming to satisfy all criteria to the standard required. They also praised Gersten et al (2005) and stated that they should be applauded for their founding of meticulous standards of assessment in their attempts to improve the assessment and diagnosis process.

ARROW stands for Auditory, Read, Respond, Oral and Write, it was founded by Dr Colin Lane. This intervention is ICT based using a method of recording a student’s voice, known as a self-voice approach. After an initial test to establish the persons level, the intervention targets speech, spelling, reading, listening and is applicable for primary, secondary and adult settings. It is ‘centred upon a very simple but far reaching idea, that most of us think in the sound of our own voices’ Arrowtution (Arrowtution, 2019, p1). It is multi-sensory in that the person listens to speech, reads text of spoken information, responds, repeats verbal content then writes using their self-voice before self-assessing. It can be completed in groups or individually as long as each person has access to their own computer. The Department of children as cited in Arrowtution (Arrowtution, 2019, p1) describes the ARROW intervention as achieving noteworthy results. It is renowned for aiding memory recall, speech and language improvement and reading and spelling skills. Furthermore Brook (2016, p34) states ‘the Bristol study showed remarkable benefit for spelling and spectacular progress in both reading accuracy and comprehension’. This study included eighty-five year six students and spelling ages increased from 8.45 years to 9.03 years. Nugent (2011) as cited in Nugent et al (2019, p3) ‘indicates that ARROW can be an effective intervention with gains of more than a year recorded in both word reading and reading comprehension’. Brooks (2016) states the most effective interventions included highly structured schemes for improved spelling, phonological skills embedded with the broad approach for improved reading, directly targeted practise for comprehension skills and targeted use of technology such as the ARROW intervention. However, on the contrary, there is some criticism of the study such as admin bias, various tutors and timeframe of implementation of the intervention. There is also a limited amount of research on self-voice interventions entirely. Brooks et al. further addresses this issue by stating that there are still a limited number of reading interventions for students with dyslexia or specific learning difficulties.

In summary, dyslexia is lifelong will not be outgrown and plausibly present from birth. The effects of dyslexia can be moderated by individual and specific interventions. Early identification of children with dyslexia is 80% accurate, Grizzle (2007) Solity (200) emphasises the importance of regular assessment and continuous monitoring of progress, stating it is vital in determining the success of an intervention. All of the deliberated reading interventions (Units of Sound, Repeated Reading, and ARROW) recorded an improvement in students’ abilities. For interventions to be deemed successful it is imperative that they are intensive, structured, cumulative, involving phonological training, phonics and followed up with reading and writing practise of skills learned (Hatcher, Hume and Snowling 2004). However, ultimately there is evidence to suggest that even with the best practices, interventions are not always effective for persons with dyslexia Duff and Clark (2011). Crucially further research is required to fully appreciate such non responders. With conflicting research, it is difficult to evaluate these interventions in their entirety however what is undoubtedly extremely evident is that early intervention is key in persons with dyslexia making significant progress. J M Fletcher (2009) even goes so far as to claim it is even possible to prevent dyslexia in many children with early intervention.

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