Dyslexics (Diagnosis and Treatment)

– in the House of Commons at 9:45 pm on 20th February 1992.

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Motion made, and Question proposed, That this House do now adjourn.—[Mr. Boswell.]

Photo of Mr Bowen Wells Mr Bowen Wells , Hertford and Stortford 10:02 pm, 20th February 1992

I am pleased to have the Adjournment debate and the assistance of my hon. Friend the Member for Basildon (Mr. Amess). The debate is on the subject of the diagnosis and treatment of dyslexia. I shall start by repeating the words of an eight-year-old child to his mother. The child said, "Do you know what I think? I think God has put my brain in upside down." That shows the problem facing many children suffering from dyslexia.

The signs and the symptoms of dyslexia are that those suffering from it have difficulty with literacy skills and sometimes some aspects of numeracy. They have a short-term memory weakness, auditory or visual. That means that they cannot take down dictation from the blackboard or orally because, by the time five words have been put on the blackboard, they have forgotten the first words. They have language and sequencing difficulties and left-right confusion and mixed dominance. They have motor problems, are clumsy and suffer from the reversal of letters and words. There is a short attention span and dyslexics lack concentration. They also suffer from disorganisation, erratic performance and hyperactivity.

In infant school, such children may be articulate and appear bright, but they may appear shy and have problems with speech and language. They find it hard to settle down to work; they may be clumsy and untidy because of the difficulty that they have in dressing. They may not have decided whether they are right or left-handed. Attempts to write, draw and cut may be very immature. They will experience difficulty in forming letters correctly: they may mirror-write, and not be aware that what they are producing is wrong. They may reverse stem letters, and invert "u" and "n", "m" and "w", more than other children in the class.

Such children have difficulty in associating sounds and symbols. If they are mastered, the children may have difficulty in using sound and symbol knowledge. They may have auditory discrimination problems: for example, "f", "v" and "th" sound the same to them. They may have visual memory and discrimination problems. They do not know how to learn, and cannot learn, by the "look and say" method of teaching children to read. They have trouble following instructions; if they understand them, they often forget them very quickly.

The children have a poor sense of time. They will be late; they will be disorganised. They have difficulty with sequencing—with days of the week and the alphabet, or with counting. If a child cannot read, his teacher may say, "Do not worry. He is a slow developer; he will read when he is ready." And so it goes on in that teacher's class, as the seven-year-old becomes an 11-year-old. Such children may well be frustrated; they may well switch off and daydream.

Typically, the signs are the same in the junior school child, but they become more pronounced. Children will have language problems. They may have difficulty in thinking of the name for something. Conversations will be peppered with "watchermacallit", "thingummyjig" and similar expressions, which give the children time to think what they really want to say. They will have trouble with multiplication tables, days of the week, months of the year and the alphabet. Again, they will be clumsy and disorganised. They will probably develop behavioural problems. Such a child will either be the class clown, or very withdrawn, shy and dispirited. Eventually, he will probably play truant and absent himself from school

Such behaviour is not put right even when the children attend secondary school. Reading and spelling ages will be well below the ability range; reading ability will be adequate, while spelling problems persist. Typically, such children will not read for pleasure. They may have very slow reading speeds. They may get the gist, but get it very inaccurately. Essay writing and written exam performance are well below the standard of oral contributions. Pupils have difficulty in taking notes, and in memorising materials for exams. They will be disorganised, and have difficulty in planning their time and keeping track of materials as a child of 12, 13 or 14 might be expected to do.

The children may have limited vocabularies, and little interest in words. They may interpret language very literally. They will have poor concentration. They will have daydreams, or become fidgety. They will find French, or any foreign language, extremely difficult. Handwriting and presentation may still be poor, and inaccurate copying may present problems.

The children may continue to experience left-right confusion and sequencing difficulty. They will tend to fall apart under pressure, particularly as regards spelling. The quality of their work will be very variable, depending on the conditions in which the work is produced and on how the child is feeling: he has good and bad days.

The teacher will say that the work that the child produces on a good day just shows how well he can do, and that, if only he would make more effort, he would get there. School reports, typically, will contain remarks such as "Must try harder", "He is lazy", "He is careless", "Oral work good, written work poor", "Must work harder at spelling", "Must read more" and "Exam results disappointing".

All those tendencies are typical of dyslexic children throughout their years of schooling, and they can all be corrected. Such children can develop into very worthwhile people, whether they are very intelligent or very unintelligent. They can be helped in their schools.

What are the remedies? Fundamentally, a dyslexic needs very intensive teaching. Dyslexics are infuriating people to teach. The teacher will have to give them extra attention and will have to recognise their difficulties. They will have to be given support, confidence and motivation. Things that they can remember today they will have forgotten entirely within a week. This means intensive teaching.

They cannot learn to spell or read without the use of phonetics or the phonic word method of teaching. Of course, that is not to exclude other methods of teaching to which they will respond, but, fundamentally, it is not possible to achieve reading and spelling recovery unless phonetics and phonics are used. Their short-term memory and their resulting difficulties with dictation or writing down from the blackboard must be understood by the teacher. Unless a child has taken down his prep from the blackboard or, alternatively, has written down what has been dictated, the rest of the lesson will be lost. The teacher must make certain that the dyslexic child has got the material down and is therefore able to do the work. It is therefore necessary that the teacher spends extra time—not much, but some—with the dyslexic child.

Of course, dyslexic children must not be humiliated. Many of them are very conscious of the fact that their friends, who seem to be just about as bright, just the same, as they, can read aloud but that they cannot. They get confused, and then they are criticised and humiliated, with the ridicule that that attracts. That leads to a lack of self-confidence and self-esteem. They then turn off completely, and their confidence evaporates. And this happens at the ages of six and seven. They need help and encouragement and patience—indeed, intensive teaching.

Why should we be concerned about this? These are problems with which any schoolteacher is familiar and has seen day in and day out. It is true that 10 per cent. of the school population have dyslexia, whether mildly or very seriously, and that 4 per cent. probably need statementing. However, the rest can be taught in the classroom. They can be encouraged and helped to realise their capabilities within the classroom.

What happens when provision is not made? For example, it has been proven that, of those below the age of 18 convicted of criminal offences, 80 per cent. are dyslexic. This is typical of the results of not teaching and helping dyslexics at an earlier age. These people use their abilities in an alternative way—many of them criminally—to attract attention, fulfil their ambitions and boost their self-esteem. So it is important socially, as well as from a humanitarian point of view, that we try to enable children to realise their capabilities.

We can correct the situation. By doing so we would save massively in the re-education of these children and in subsequent social and even political costs. The problem could be addressed quite simply and quite economically in a five-point programme, about which I hope my hon. Friend the Minister will be able to respond positively.

First, phonics, or the teaching of reading through the use of phonetics, should be compulsorily included in initial teacher training courses and, indeed, in the one-year postgraduate course. We need to make certain that teachers are capable of diagnosing and teaching dyslexics. Provision must be made in the initial teacher training syllabus and in the syllabus for the post-graduate diploma.

Those teachers who are already in post must be enabled to take a recognised qualification in the teaching of dyslexics, such as that promoted by the Royal Society of Arts, which will attract additional salary as recognition of the additional skill. Thus our existing teaching force will be enabled to diagnose and treat dyslexia.

In addition, the extra provision in the budget of each school, to which I referred earlier, is needed so that the teachers may spend that necessary little bit of extra time coping with the infuriating dyslexic—the pupil who needs a little extra time. That must be provided for in the school budget. Dyslexia requires a ring-fenced part of the education budget of approximately 2·1 million, which must be separate from the special learning difficulties provision in the education budget. It must be separate from and additional to that budget. Dyslexia must not be confused with the generality of special learning difficulties, although 4 per cent. of dyslexics will need special treatment over and above what I am talking about, under separate statementing procedures.

My hon. Friend the Under-Secretary of State has been extremely kind and generous in receiving delegations led by me on two occasions in the last six months from the British Dyslexia Association, with which my hon. Friend the Member for Basildon is associated. At our initial meeting with my hon. Friend, he said that he had a number of investigations to undertake and that he intended to invite those undertaking investigations into teacher training to look into the matter and to make proposals to him along the lines set out at the meeting. He kindly asked the delegation to return six months later.

We went back to see my hon. Friend six months later, in January of this year. Again he gave us enormous encouragement by lending his support to the programmes that we put to him and by his understanding of the problems involved. I very much hope that tonight the Minister will be able to give further encouragement to those members of the teaching profession who have to deal with this difficult problem by saying that he will try to implement the five-point programme that I have put before the House.

Photo of Sir David Amess Sir David Amess , Basildon 10:16 pm, 20th February 1992

I congratulate my hon. Friend the Member for Hertford and Stortford (Mr. Wells) on his excellent speech and on raising this important subject.

Dyslexia is of great interest and concern to my constituents in Basildon and is of particular interest to me. At the age of five, in a class of 50, my mother was summoned to see the class mistress in the excellent school that I attended, St. Anthony's infants school, Forest Gate. She was told that I had very severe learning difficulties. I had a pronounced stutter. I could not make the sounds "st" and "th".

For three years after that, I had elocution lessons—special tuition—and was then denied my rightful heritage of a cockney accent. I am very grateful, however, that my learning difficulties were identified. I pay tribute to my hon. Friend and to the Basildon dyslexia association, led by one of my constituents, Mrs. Christine Haggerty, and her excellent committee.

For some little while, Essex county council was reluctant, as the Minister knows, to recognise that there was such as thing as dyslexia. That is understandable. In this day and age, when parents might have anxieties about their children's educational progress, it is easy to seize on the subject of dyslexia and say, "But so many children have dyslexia." We all know that children can be somewhat cruel to each other. I know that my hon. Friend is wary of identifying children in so highlighted a way that they might suffer teasing from other children. However, this is a very important subject.

Excellent workshops are held at the weekend in Basildon. I have been to see the wonderful work that is being done there. All sorts of techniques are used. The children are making great progress with reading, spelling and their general development. I hope that we shall have an excellent centre in Basildon. I endorse my hon. Friend's remarks. We both look forward to listening to the Minister's response to our concerns.

Photo of Michael Fallon Michael Fallon Parliamentary Under-Secretary (Department of Education and Science) 10:18 pm, 20th February 1992

I congratulate my hon. Friend the Member for Hertford and Stortford (Mr. Wells) on raising dyslexia as an issue for debate this evening. This is not the first time that we have debated the subject. My hon. Friend attended the debate that was initiated by my right hon. Friend the Member for Worcester (Mr. Walker) some time ago. My hon. Friend has pursued his interest in this subject with great vigour. I recall meeting him and his associates at the Department, when we had more than one positive and helpful discussion of the subject.

Dyslexia is a very wide and important topic. It is capable of supporting continued debate without retreading old ground. This evening, the subject of debate is more particularly the diagnosis and treatment of dyslexia, upon which I intend to concentrate.

Everything that my hon. Friend said spoke volumes about the need to catch the problems much earlier than we have. Study after study has shown how important it is to identify dyslexia as soon as possible in a child's development. If we do that, those in the medical, caring and teaching professions can then start to take the appropriate steps leading to early remediation of the difficulty, where that is possible.

It is often not appreciated that there are early signs, even in very young children, which suggest that a child might subsequently develop specific learning difficulties. The signs and the children may be difficult to identify with certainty, even by the trained eye. That is because the signals being given are often mixed or very close in nature to the signs which might, equally, indicate different sorts of difficulties or developmental delays.

The main point is that, if a child is giving some cause for concern, the behaviour and performance should be examined more closely and the child should be monitored very carefully over the succeeding period to try to discover the exact causes. As my hon. Friend knows, dyslexia is not just about getting words jumbled up. It is much more complicated.

Even before a child starts school, a doctor or health visitor might see a child with a very bumpy developmental profile. That should sound an initial warning. The doctor may know if other family members have any history of serious problems with literacy. The child may show signs of clumsiness, or poor co-ordination in gross or fine motor movements, distractibility or poor concentration. There may be a delay in the development of speech and language, or by and large normal development coupled with a difficulty in, say, drawing shapes. Anything requiring sequential ability—for example giving the days of the week in order or repeating patterns or instructions—may give the vital first indication of specific learning difficulties.

Sometimes, specific difficulties unrelated to sensory impairment may become apparent at nursery school. In such cases, the teacher who spots them may be able to seek advice from the educational psychologist or the pre-school specialist teachers. If those difficulties are marked or show signs of developing, careful monitoring of the child will be needed. That means that we must involve the parents at an early stage. They know more about the child than anyone.

By the time the child has got to school, and in the first few years there, the signs of dyslexia or other specific learning difficulties become more easily distinguishable from those exhibited by children with other difficulties or developmental delays. The child with dyslexia is often set apart by the skills shown and by demonstrable intelligence in other areas. The child in his early school days might present as an imaginative and bright child who, for example, rather surprisingly cannot write his or her name, repeat digits or even copy letters or shapes.

The key indicator might again be that the developmental profile is uneven, and those warning bells sound again if there is a family history of literacy difficulties. Again, if there are worries, early referral to the educational psychologist is one way forward. It is only when an accurate profile has been constructed that an appropriate teaching programme can be arranged.

My hon. Friend suggested that the skills required to enable teachers to make a preliminary diagnosis of dyslexia and then to use the appropriate teaching techniques should be included in all initial teaching training courses. Those who provide such courses are already required to equip prospective teachers to teach the full range of pupils whom they are likely to encounter in an ordinary school, and to introduce them to ways of identifying children with special educational needs that includes cases of dyslexia.

Further training is also available for teachers of pupils with dyslexia. Training of teachers to deal with special educational needs in ordinary schools is one of the priorities supported by the Department through the grants for education support and training scheme. The Department has also sponsored the production of an audio-visual pack aimed to assist teachers in ordinary schools to identify children with special needs, one module of which is specifically concerned with dyslexia.

I am delighted to be able to say that the Department has also recently provided £34,000 for research into how dyslexia can be identified as early as possible, so that those needing the sort of specialised teaching methods that I have outlined can take advantage of them without delay. That work is being undertaken by the Hereford and Worcester branch of the British Dyslexia Association in conjunction with Birmingham university, and I look forward to seeing the results.

I deal now with treatment. There is a range of professionals within the child health service who may be able to offer help within an integrated programme of support for the child with special educational needs. Sometimes, emotional and behavioural difficulties are associated with dyslexia. If so, the educational or clinical psychologist has a role. If the child has marked speech or language difficulties, the speech therapist will usually come into it. The paediatric physiotherapist can help if there are gross motor co-ordination difficulties, and the occupational therapist can help if there are fine motor co-ordination difficulties. If the child is easily distractable or over-active on some days and not on others, there may be some other sensitivity or food allergy—in such cases the dietician comes into his or her own. Sometimes, all those professionals need to get together to produce an integrated programme for the individual child, and I urge that they do so when that is going to be of substantial benefit to the child.

Where pupils are identified as having dyslexia, it is up to the professionals concerned to adopt, where necessary, a particular teaching programme to assist the pupil with the areas of difficulty—usually concentrating on r eading and spelling. Examples of such specialised programmes are the Hickey programme, Alpha to Omega, or the Arrow programme. Most such programmes include teaching with a multi-sensory approach in order to give the pupil maximum support through a variety of auditory, visual, and tactile stimuli—each reinforcing the others and lessening the pupil's dependence on any one.

Children are unique, and it is therefore not surprising that their needs are nearly all different in some ways. The key is for the professionals and teachers to discover which of the different approaches will be suitable for the pupil in question.

My hon. Friend suggested that the national curriculum should permit the use of phonics in teaching children to read. I agree. The national curriculum does that. Those parts of the orders for English concerned with reading combine a range of the most widely used and successful techniques for helping pupils to acquire and develop their reading skills. Those include the use of picture and context cues, words recognised on sight and phonic cues.

My hon. Friend also argued that instruction in phonics should be made compulsory in ITT courses. Phonics is already a feature of such courses, at least according to the staff involved, but it is usually presented—I think that this is the core of my hon. Friend's concern—as merely one of the various possible strategies of attack. The Council for the Accreditation of Teacher Education inquiry into the teaching of reading produced some useful evidence on that, and I must ask my hon. Friends to be patient and await the publication of its report, which is imminent. I shall say a little more about that in a moment.

As for the support grants and teacher training, the Government recognise that in-service teacher training has a crucial role to play in implementing all aspects of the curriculum. The GEST programme is the principle vehicle. In the current year that programme is supporting LEA expenditure of £170 million in relation to the implementation of the basic curriculum and related assessment arrangements, of which £78 million is for in-service training. In 1992–93, that will rise to £88 million. Of that, about £12·9 million has been set aside by the Government to support local education authorities in the training of teachers and others involved in special educational needs, including those in further education.

My hon. Friend suggested specifically that part of that money should he ring-fenced for courses on specific literacy difficulties and that resources devoted to dyslexia should be kept separate from other SEN resources. We have been conducting a thorough review of the GEST arrangements as they apply to training related to special educational needs. We have considered the number of categories of special educational need training which are eligible for grant under the GEST programme. We have not made the final decisions, but the review is nearing completion and we hope soon to be able to incorporate any changes in the GEST programme for 1993–94. I cannot say much more than that other than that I am pursuing my hon. Friend's specific suggestion.

My hon. Friend also suggested that holders of the Royal Society of Arts diploma in specific learning difficulties should be entitled to receive additional salary allowances, as do at present, for example, holders of qualifications in the deaf, blind and deaf-blind field. I should make it clear that those latter qualifications are mandatory for teachers working in the areas concerned, while the RSA diploma is not, but in any case, the school teachers' review body, in its first report, said that it intended to seek specific evidence on the pay and conditions of teachers in special schools and classes generally as part of its next review. Therefore, we must await its findings on that.

When I addressed the House on the subject of dyslexia last April, I said that my right hon. and learned Friend the Secretary of State had asked the Council for the Accreditation of Teacher Education to undertake an inquiry into the preparation of student primary teachers to teach reading. The council was asked as part of that inquiry to consider dyslexia specifically, and its report will be published shortly. I am taking a keen interest in how it will be received as a contribution to improving reading standards. My hon. Friends will find that report contains much of interest, and much that strengthens their case for further reform.

It will be evident from my remarks that improving reading standards is a priority for this Government. We recently announced also a national trial of the reading recovery programme pioneered in New Zealand by Dame Marie Clay. That involves the provision of daily individual teaching in reading and writing for the lowest achieving six-year-olds in ordinary classrooms. Within an average of 12 to 15 weeks, most of those children will have reached the average level of attainment in reading, and we hope that those gains will be sustained.

By providing that tuition for the lowest-achieving pupils at age six, we believe that the number of children in our schools with reading difficulties can be effectively reduced. Funding is concentrated on teacher training in the early stages.

As you, Mr. Speaker, have graced us with your presence tonight, and have a considerable personal interest in the subject, it is appropriate that I should conclude my remarks with a reference to a major development very close to the constituency that you have served so well and so long, for so many years.

When I spoke on dyslexia last April, I mentioned the important research being conducted at the Harris city technology college in Croydon. It is receiving £250,000 of central support over three academic years, and it is already producing interesting results. The intention is to meet the need for further practical investigation into how dyslexia can be tackled.

Our overall aim, building on that research, is to ensure that all pupils have the fullest access to the national curriculum. That research is in midstream, and it will not be finished until the autumn of 1993. There are, however, encouraging signs that research may have helped already towards identifying new ways of grading and diagnosing dyslexic tendencies in children—but more must be done.

I am grateful to my hon. Friends for raising and pursuing this important matter. I welcomed an opportunity to say a few words about the positive steps that the Government have taken, which I hope have been helpful. My personal view is that the Department, local education authorities, and the wider educational world are moving the issue of dyslexia forward. I want the House left in no doubt as to my personal commitment to seeing progress made.

Question put and agreed to.

Adjourned accordingly at twenty-eight minutes to Eleven o'clock.