The Dyslexic Adult

Interventions and Outcomes - An Evidence-based Approach

David McLoughlin, Carol Leather

• Publisher: Wiley-Blackwell
• Year: 2013
• ISBN:
  9781118323335
• Edition: 2
• Topic: Education
• Subtopic: Learning Disabilities

A definitive and evidence-based guide for psychologists, teachers, coaches, HR personnel and all professionals who must understand and work with dyslexic adults.

• The only book to look at dyslexia within the context of life span developmental psychology, including the factors that contribute to success - now fully revised and updated
• Combines an accessible style with a strong focus on evidence-based practice and a sound theoretical model on which to base assessment, counselling, teaching and training
• Provides a clear guide to the kinds of assessment that can be conducted and the ways in which dyslexic adults can be supported in selection, training, education and employment
• Includes coverage of overlapping syndromes such as dyspraxia and dyscalculia, and up-to-date check lists for syndromes that can be used as part of the assessment process

1

Dyslexia in the Adult Years

Synopsis. This chapter describes the characteristics of dyslexia in the adult years, and the current scientific and theoretical explanations for these. A pragmatic model based on interactions within the working memory system is proposed as a way of understanding dyslexia as it affects people during the adult years.

Introduction

Dyslexic people seeking the advice, guidance and support of professionals usually want the answers to the fundamental questions, ‘Why do I find certain tasks difficult?’ and ‘What can I do about it?’ Alternatively, those referring people for evaluation and advice are asking, ‘Why is this person not learning or performing in the way we expect?’ and ‘What can be done about it?’ The subject of this book is the interventions that address these questions and enable dyslexic people to work towards becoming successful in education, employment and life generally.

In the first edition of this book we wrote that ‘the past decade has seen a greater interest in dyslexic adults’ (McLoughlin et al., 2002: 1). There has been an even greater interest in the subsequent decade. This has been prompted, at least in part, by disability discrimination legislation. Nevertheless, this still does not mean that adults have been recognised as a distinct population, with needs that are quite different from their younger counterparts. There has been more research, but the majority of studies focus on students in third tier education and the population ranging in age from 18 to 25 years of age, a period that has become known as ‘emerging adulthood’ (Arnett, 2004). In terms of practice there are many more individual professionals as well as organisations providing services for dyslexic adults, but a greater number of ‘experts’ does not necessarily mean that there is more expertise. Often the practices adopted when working with children are inappropriately generalised to work with adults, who as Patton and Polloway pointed out twenty years ago ‘are not and should not be regarded as children with a learning disability grown up’ (Patton & Polloway, 1992: 411). Nevertheless, most interventions from assessment through to tutoring and accommodation are directed to the adult population who are still in education, and methodologies based on models developed for work with children. Even dyslexic people themselves perceive it as an educational issue, this being advanced as one of the reasons for the failure to disclose it to employers (Martin & McLoughlin, 2012). There is still a need for a fundamental shift in thinking on behalf of professionals, researchers, and all the organisations concerned with providing for dyslexic people. That this is the case is reflected by two reports published in the United Kingdom within the last decade: Rice and Brooks (2004) and Rose (2009).

On its release the former, Developmental dyslexia in adults: a research review, proved sufficiently controversial for Advocacy and Self-Advocacy groups representing dyslexic adults to call for its withdrawal. Although undoubtedly pleased that this population was being regarded seriously enough to warrant the commissioning of a report of this kind, they were disappointed both by the conclusions and the foundations on which they were based. The authors failed to acknowledge that dyslexia is still an evolving concept, as is the case for all the specific learning difficulties, and that there has been a fundamental paradigm shift, dyslexia having come to mean much more than a reading problem to such groups, as well as practitioners. There is now a better understanding of dyslexia at a cognitive level, and this has broad implications for everyday performance. Reading and spelling difficulties are skill deficits that can occur for many reasons, including lack of education.

In the Executive Summary the authors write: ‘dyslexia has been interpreted widely, to embrace most if not all of the ways in which the term has been used by scientists and educationalists’ (Rice & Brooks, 2004: 11). It wasn’t as Part One begins with the question ‘Why do some people find it so difficult to learn how to read, write and spell?’ They should have also asked: Why do some learn to read but continue to find spelling difficult? Why do some people achieve good accuracy, but find it hard to retain what they read? Why do people who master skills they found difficult to acquire, such as reading and spelling, report problems in domains such as organisation and time management? It is only by asking the right questions in the first place that we can evaluate definitions and explanations. Suggesting that if the word `dyslexic’ were to disappear ‘science and the world of literacy teaching and learning might be no poorer’ (Rice & Brooks, 2004: 87), is unhelpful and suggests a bias that undermines the credibility of the report.

Further, whilst the authors make much of the notion that poor readers and/or dyslexics do not constitute a homogeneous group they assume that adults do. Adulthood is the longest stage of human development. There is an enormous difference between the challenges faced by an 18-year-old and those facing a 45-year-old. Learning difficulties need to be understood in contexts, one of them being the stages of development. Dyslexic adults are more than ‘grown up children’ (Price & Patton, 2002: 38). In a review of the Rice Report, Siegel and Smythe (2006) comment that it ‘fails to fulfil its intent by providing an incomplete literature review which ignores critical definitional issues and important studies of the basic cognitive processes, as well as failing to include much of the research on appropriate interventions and accommodations for adult dyslexics, pivotal in understanding the literacy needs of the adult dyslexic’ (p. 69). One might add an understanding of all their needs.

In the Rose Report, Identifying and Teaching Children and Young People with Dyslexia and Literacy Difficulties, dyslexia is defined as follows:

• Dyslexia is a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling.
• Characteristic features of dyslexia are difficulties in phonological awareness, verbal memory and verbal processing speed.
• Co-occurring difficulties may be seen in aspects of language, motor co-ordination and mental calculation.

On the positive side, authors of the report accept that dyslexia exists and the definition goes beyond reading and spelling, acknowledging that there can be co-occurring difficulties in language, organisation and aspects of maths. The focus of the report was ‘children and young people’; but despite this the above is being promoted as a new definition of dyslexia that applies across the board.

It is always difficult to make international comparisons as there are differences in terminology. Nevertheless, in the Learning to Achieve report considering learning disabilities, including dyslexia, prepared by the American National Institute for Literacy (Taymans, 2009) it was concluded that:

1. The concept of specific learning disabilities is valid and is supported by strong converging evidence.

2. Learning disabilities are neurologically based and intrinsic to the individual.

3. Individuals with learning disabilities show intra-individual differences in skills and abilities.

4. Learning disabilities present across the life span, though manifestations and intensity may vary as a function of developmental stage and environmental demands.

5. Learning disabilities may occur in combination with other disabling conditions, but they are not due to other conditions such as mental retardation, behavioural disturbance, lack of opportunities to learn, primary sensory deficits or multilin-gualism.

6. Learning disabilities are evidenced across ethnic, cultural, language and economic groups.

In summary, this report is to be commended as it clearly acknowledges that ‘specific’ in specific learning disabilities such as dyslexia refers to neurological and, therefore, cognitively based causes that are independent of general intelligence and other potential causal factors, and have an impact on performance throughout the life span. It addresses homogeneity, heterogeneity and co-occurrence, but acknowledges the influence of environmental factors, including transitions, on outcomes for people who have a specific learning difficulty.

Although there have been more studies considering the problems facing and the needs of adults, there is no real research agenda, small projects being undertaken by particular individuals or groups. Conducting empirical studies with adults where they are not a captive audience is difficult, finding samples that represent specific populations being a particular problem, as is establishing control groups. Volunteers are likely to be the ‘most needy’, others being reluctant to participate, sometimes because they want to be left alone to get on with their lives. From a research perspective and for whatever reason, in the main dyslexia has remained an educational issue, rather than one which affects daily living, including employment. Outcome research on the effects of interventions during the adult years, including the impact of disability legislation, is much needed but is in short supply (Gerber et al., 2011).

In Western society the majority of the population is over 16 years of age, and ‘the majority of the dyslexic population are adults’ (Eden et al., 2004: 412). Nevertheless, the needs of this group have been given far less attention than those of children still at school. Whilst this makes sense if one assumes that early intervention will minimise the impact of dyslexia on people’s lives, it is unfortunate. Considering the nature of dyslexia as it is manifested across the life span should lead to a greater understanding of the needs of dyslexic children. It is only by taking a long-term view that we will develop a complete understanding of the nature of dyslexia and how it affects people, and provide appropriately. Furthermore, the persistence of dyslexia in the adult years raises important issues about definition, with consequent implications for practice. It demonstrates more clearly than anything else that the focus should be underlying processing abilities rather than observable behaviours (Vellutino et al., 2004).

To take advantage of the provisions of disability discrimination legislation both in the United Kingdom and in the United States, for example, a dyslexic person must establish that their difficulties constitute a mental impairment that has significant day to day effects (UK) or substantially limits one or more major life functions (USA). A narrow view based on the experiences of children and focused on literacy or education will not protect dyslexic people from discrimination, nor will it allow them to access important resources. This is best illustrated by a United Kingdom Employment Tribunal decision in which it was determined that an individual should not be considered to be disabled within the meaning of the Disability Discrimination Act, 1995. The decision was based in part on the claimant’s educational background. He was educated to degree level, and had received positive appraisals about his report writing at work. This was, however, someone whose processing abilities were within the bottom 1 per cent of the population, and who had significant problems with silent reading speed and comprehension, as well as writing speed. He had allowed himself four hours travelling time to keep an appointment, a journey that would take most people an hour. There was reference to his ability to drive, but not to the fact that he had taken the test more than ten times before passing, and that he no longer drove because, having informed companies of his difficulties, the insurance premiums he was quoted were prohibitive. The ‘day-to-day effects’ or ‘substantial limitations’ were patent, but the Tribunal could not see beyond dyslexia being a reading and spelling issue. In commenting on a young dyslexic woman’s personal account of the difficulties she experienced Wehman (1996) wrote ‘that “dyslexia” does not do justice to the complexity of the experience, the effort required to compensate and cope, or the many other aspects of life that are affected’ (p. 347).

Establishing a large body of quantitative data might be an unachievable goal so we must rely on the small scale studies which exist, as well as the individual experiences of dyslexic people and those working with them to underpin interventions. The latter provides only qualitative data, but it can contribute to understanding, as well as inform theory and practice (Everatt, 2007). There are also several factors that should influence good practice in assessment, coaching, teaching, training and employment, including:

i the nature of dyslexia in adulthood

ii psychological development across the life span

iii the principles underlying education and training in the adult years

iv the factors research has shown to contribute to the success of dyslexic people

v the educational and legal context.

The first of these is described in this chapter. Chapter 2 describes ii to iv and the last is discussed in Chapter 10.

History

The notion that people can have specific difficulties with reading despite being able to perform effectively in other areas has been around for a very long time (see Miles & Miles, 1999). Nevertheless, dyslexia is one of the specific learning difficulties and the real thrust in understanding these came in the 1960s. In particular, Kirk (1992) proposed a causal model that assumed the concept applied to individuals with average or better than average intelligence, but who experience difficulties at one of four levels:

• Input – from the senses.
• Integration – the brain interpreting this information.
• Memory – the information being stored and retrieved.
• Output – behaviour including reading, writing and language.

The last of these is the result of difficulties at one or more of the first three, although the emphasis in understanding specific learning difficulties is now on integration and memory process, rather than perception. Letter reversals, for example, wer...