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Literature Review of Current Approaches to the Provision of Education for Children with Dyslexia

2: Range of Approaches Used to Teach Children with Dyslexia

2.1 Background

Historically, dyslexia has had a reputation for being a ‘hidden disability’, which was the ‘culprit’ for the feelings of shame, guilt and embarrassment in those who were silently suffering from this condition. This view has shifted significantly in recent decades, and nowadays dyslexia is regarded by teachers, psychologists and the general public as a common learning disorder.

A wide range of approaches is used to improve the educational experience and achievement of learners with dyslexia: a testimony to over one hundred years of research undertaken in the fields of medicine, psychology and education (Simpson, 2000). This diversity of approaches also reflects the fact that, since dyslexia is suggested to be on a continuum and the condition ranges from mild to severe (see Riddick, 2006), various interventions and approaches in different degrees are deemed obligatory in responding to the needs of dyslexic learners. Furthermore, the quest for a universally accepted definition and the continuous debate about the exact nature of dyslexia is still ongoing (Gregor et al, 2003; Sawyer, 2006; Simpson, 2000; Vellutino et al, 2004). Consequently, the observation that ‘there may be as many differences between dyslexics as there are similarities’ (Simpson, 2000, p. 356) has led to various approaches, strategies and interventions based on the respective underpinning theories. There are also assertions that inappropriate teaching methods might cause this learning disorder (Joshi et al, 2002; Vellutino et al, 2004).

In contrast, there is overwhelming agreement amongst researchers and academics that the earlier that the dyslexic condition is identified, and given an intervention, the better the diagnosis will be (Amos, 2004; Humphrey, 2002; McNulty, 2003; Polychroni et al, 2006; Simpson, 2000; Tsovili, 2004). For instance, it has been asserted that adopting an intensive structured reading program at the early grade levels can lead to a significant improvement in children’s reading ability (Joshi et al, 2002). However, Snowling (1998) observed that the most common referrals to clinicians were from children who had already failed to learn to read.

The literature also reveals that children’s development of reading and the spelling skills of dyslexic learners may remain delayed despite years of intervention and instruction (see Cooke, 2001; Oakland et al, 1998). Even when reading difficulties have been overcome, it may possibly still cause some residual problems later in life (Snowling, 1998).

2.2 Approaches Used to Teach Dyslexic Learners

In this section, the traditional as well as the most recent approaches used for improving the educational experience and achievement of dyslexic learners will be presented and discussed to provide an up-to-date review of these approaches inside and outside the classroom. Emphasis will be given to the most widely used approaches, especially the ones that generated a greater number of studies in the field.

In the past, the majority of published research on dyslexia concentrated on causation and treatment (Humphrey, 2002) with emphasis on the neuroscientific aspects of this learning disorder. In this review, we took into account the behavioural, emotional and social aspects of conditions affecting dyslexic learners. Furthermore, the advances in computers and technology have also been looked at to see what role they might play in assisting learners with dyslexia.

2.2.1 Additional Support Strategies

Dyslexic learners … are supported to minimise their weaknesses, capitalise on their strengths and to begin to operate at an ability appropriate level.
(MacKay, 2001, p. 4)

Following the then Scottish Education Minister Brian Wilson’s announcement in 1998 that 5,000 new classroom assistants were to be employed over three years, the possibility of assistants supporting the learning process, especially of those learners who need it most, was explored by Wilson, Schlapp and Davidson (2002) in a national evaluation. According to Calder (2004) classroom assistants can contribute to a meaningful and positive learning experience for dyslexic learners. Her small-scale study2 undertaken in Scotland, explored the kinds of support strategies appropriate for a typical dyslexic pupil included provision of learning support, practical support and socio-cultural support as well as emotional support.

Calder (2004) emphasised that ‘learning support’ is highly desirable because dyslexic learners are likely to benefit from additional help in picking up new concepts. The presence of the learning assistants also makes it easier for the teacher to try using new teaching approaches that can be of benefit to dyslexic children. Similarly, classroom assistants can extend some ‘practical support’ to learners, especially when they get frustrated with their writing difficulties. Working closely with learners can also provide some useful information (through observation) of the child’s progress, which they can eventually pass on to the teacher. ‘Socio-cultural support’ also comes in, as they help with the class management and through modelling good social skills. Finally, the literature suggests that dyslexic children may lack self-esteem (Humphrey, 2003; Polychroni et al, 2006) because of their continuous experience of failure (Alexander-Passe, 2004; MacKay, 2004). Skilled classroom assistants, by developing very close personal relationships with the learners and understanding their emotional needs, enable them to respond appropriately in times of learner frustration and exhaustion with school activities.

2.2.2 Development of Phonological Skills

Reading is either viewed as a complex activity (likened to ‘the performance of a symphony orchestra’) or a relatively simple one consisting of two independent processes: decoding, which requires the use of lower order language skills to convert letters into sound sequences, and linguistic comprehension skills (Simpson, 2000; Snowling, 1998). Such an approach, focusing on the development of phonological skills, is based on the premise that decoding and language comprehension are equally essential for reading simply because the written language is a set of codes3.

It is also worthy of mention that the most current and widely held understanding of dyslexia can be traced to the deficit in phonological processing abilities (Sawyer, 2006). According to Simpson (2000), the ‘current consensus is that developmental dyslexia is best regarded as the manifestation of a deficit in the language system’ (p. 357). Stanovich (1988, 1991 cited in Simpson (2000) explains further the rationale for this: it can be observed that a common phenomenon amongst dyslexic learners is that they all display phonological processing problems which lead to their word recognition failures (Lovett et al, 1994; Sawyer, 2006). Snowling (1998) also explains that dyslexia manifests itself in different cultures, languages and school systems, and this supports the argument that the reading difficulties of dyslexic learners stem from their phonological processing problems. This also suggests that children who are delayed in their phonological development are at risk of dyslexia (Snowling, 1998).

The wealth of evidence suggesting a causal link between phonological awareness and effective reading justifies the numerous interventions concerned with how phonological skills can be improved (see Gang and Siegel, 2002; Hatcher, 2000; Lovett et al, 1994; Tijms et al, 2003; Schneider et al, 1999; Simpson, 2000; Snowling, 1998; Snowling & Hayiou-Thomas, 2006; Vellutino et al, 1996; Uhry & Shepherd, 1997). According to Joshi et al (2002), a number of studies prove that ‘systematic, explicit, decoding instruction that emphasized synthetic phonics yielded better results than other instructional methods’ (p. 231). Many studies tend to echo the effectiveness of such an approach (see also Hatcher, 2000; Schneider et al, 1999; Simpson, 2000) including their observed long-term impact (Tijms et al, 2003). A large body of research over the years supports the idea that specific instruction in aspects of phonological awareness can effectively assist students in the acquisition of reading skills (Sawyer, 2006; Simpson, 2000). Furthermore, it has also been strongly advocated by its proponents that the ‘central problem of dyslexia’, ie learning to read, can both be solved and prevented by using the right teaching methods and tools4.

It is also acknowledged that the impact of this approach may vary due to three interlinked factors: the severity of the child’s phonological difficulty; other language skills (eg semantic skills); and the type of teaching the child receives (Snowling, 1998). Despite the effectiveness of using phonological approaches, ‘remediation programmes aimed at training phonological skills are often but not entirely successful’ (Torgesen, 2000 cited in O’Brien et al, 2005, p. 333). In fact, there are criticisms that phonics or letter recognition alone is not sufficient for word identification and reading (O’Brien et al, 2005; Smith, 2001). Knowing the position of a letter relative to the other letters in a word is necessary for correct word identification: for example, distinguishing the orthographic input of ‘trap’ versus ‘tarp’ or ‘part’ requires correctly locating the spatial arrangement of the letters in the word (p. 344). As Simpson (2000) puts it, further research may probably help address some remaining issues related to the promotion of phonological skills amongst readers.

There is good theoretical and empirical rationale for intervention aimed at promoting phonological processing skills, but more research is needed to determine how, for how long, and by whom, such intervention is best offered.
(Simpson, 2000, p. 370)

2.2.3 Facilitating a Positive Sense of Self

… we, as educationalists, are presented with our greatest challenge: to teach our children not only to succeed, but also to value themselves.
(Humphrey, 2003, p. 135)

In a paper presented by Hales (2004), he explained that everybody has a personal ‘image’ of his/her position in the world and this belief in oneself defines his/her likelihood of success. Consequently, the lack of belief in oneself may increase the likelihood of failure. In a world where reading, writing, spelling and talking are part of day-to-day communication, it is no surprise that social and emotional difficulties, let alone a low sense of self, are constant companions of most dyslexics. They can easily find themselves in situations where they are regarded as different, strange or unintelligent (easily resulting in feelings of anxiety, stress or depression) especially when people they deal with are not aware of their condition. This perhaps accounts for what Humphrey (2002) explains: research studies of children with special learning needs are likely to develop ‘maladaptive self-referential styles’, ie a tendency to refer to themselves in a negative manner, leading to low self-perceptions as a result of unrealistic comparisons of themselves with their non-dyslexic peers.

A vivid example can be gleaned from a study conducted by Riddick in the UK (1996, cited in Humphrey, 2002) with 22 dyslexic learners, their parents and teachers, in which feelings of disappointment, frustration, shame, discontentment, sadness, depression, anger and embarrassment were found to be caused by their difficulties. Tsovili (2004) further argues that experiences of reading difficulties may not only cause anxiety amongst learners but may even influence their perception of the world.

The idea that ‘the self does not operate in isolation’ (Humphrey & Mullins, 2002, p. 197) is crucially important when aiming to improve dyslexic learners’ views of themselves. Humphrey (2003) elaborates that self-perception, which constitutes all the thoughts, feelings, attitudes and beliefs about a person, is mainly acquired in a social context: ‘the child experiences him/herself indirectly from the particular standpoints of other individuals. Teachers and peers reflect an image of the child, which … is incorporated into the child’s developing sense of self’ (p. 131). This is because ‘self-development is a social learning activity’ (Humphrey, 2002, p. 30). Therefore, knowledge of how views of self are created suggests that the significant individuals (ie parents, teachers, peers) around those with dyslexia play a vital role in the development of these views and perceptions.

With direct reference to the child’s development, ‘the self system is a significant factor in reading success, motivational orientations, self-esteem and learning approaches. Low self-esteem, specifically in scholastic competence and social acceptance, has been linked with social, emotional and behavioural difficulties.’ (Polychroni et al, 2006, p. 415). By contrast, MacKay (2004) contends that the expectation of success has its empowering effect. Some of the classroom-based strategies suggested to support dyslexic learners include:

According to MacKay (2004), such tasks are designed to help in building and developing both the intellectual confidence and self-esteem of the learners in order to prepare them to undertake activities that are more challenging.

Humphrey (2003), in a UK study, also points out that ‘the presence of dyslexia produced marked effects on the self-concept and self-esteem of the children’ (p. 130). This is due to the pertinence of such a condition to literacy, which is considered a pivotal aspect of school learning (Riddick, 2006). This is confirmed by a study undertaken with nineteen teenage dyslexic learners in the UK where Alexander-Passe (2004) found that, amongst adults, rebuilding self-esteem is imperative. He further suggested that rebuilding self-esteem alongside remedial help given to children is the key to remediation. It is also emphasised that ‘until [dyslexic learners’] reading is corrected to an appropriate level … they are always likely to perceive themselves as unintelligent, and their notion of self will suffer’ as a result (Humphrey & Mullins, 2002, p. 200).

On this note, a thought-provoking question is posed in connection with the cause-and-effect nature of developing dyslexic children’s self-esteem (Hales, 2004; Riddick, 2006): does literacy skill boost children’s self-esteem or is it their improved self-esteem that motivates them to learn and develop further? It is also equally possible that a third view is at work ie self-esteem and literacy are interdependent and therefore any progress made in one aspect simultaneously affects the other. What is interesting to note is that when an activity designed to enhance dyslexic pupils’ self-esteem is administered, the impact was also extended to under-achieving pupils and those with poor attendance (Burton, 2004). In Scotland, the Curriculum for Excellence (Scottish Executive, 2004) seeks to provide a broader definition of what constitutes progress and success for all pupils. This includes enabling underachieving pupils to ‘achiev[e] all that they are capable of’ (p. 10). Hence, the concept of facilitating a positive sense of self validates the purposes of the curriculum.

2.2.4 Intensive Remedial Instruction

When Torgesen and his colleagues decided to investigate the conditions needed to promote adequate reading skills in US schools, they employed intensive remedial instruction based on the understanding that ‘the most common form of reading disability suggests that for children with reading disabilities to achieve adequate reading skills, they must receive more intensive, explicit and systematic instruction in word-level skills than is typically provided in schools’ (see Torgesen et al, 2001, p. 35). It was also acknowledged even from the outset of the study that such interventions will be very challenging for broad-scale implementation, but it was felt that it is more important to understand further interventions that can actually accomplish the task of remediation rather than merely stabilisation.

In their study, two theoretically viable instructional strategies for pupils with learning disorders were tested, and the impact of each on the children’s progress compared. Both instructional approaches were designed to be phonemically explicit and systematic, but the methods of instruction as well as the depth and extent of the phonemic decoding practice varied. Both the Auditory Discrimination in Depth (ADD) and the Embedded Phonics (EP) program were used. What is worth highlighting is that both programmes also incorporated teaching principles appropriate for those with learning disabilities. They are characterised by:

(Torgesen et al, 2001, pp. 35-36)

In a study undertaken in England, Humphrey and Mullins (2002, p. 198), describe the characteristics of an intensive remedial instruction:

When it comes to impact, Simpson (2000) argues that personal factors including severity of the problem, cognitive and linguistic skills as well as the person’s age and personality should influence the ‘quantity and quality of general and remedial teaching received and the complexity of the written language system to be learned’ (p. 356).

2.2.5 Multisensory Teaching System/Approach

Now I know that reading is something you can learn how to do, it’s not something that just happens.
(Trevor, 2nd Grade student, Manchester, England after 8 weeks of MTS instruction cited in Smith, 2001)

The use of the multisensory teaching system/approach5 has ‘deep historical roots’ (Joshi et al, 2002, p. 231) which can be traced as far back as the late 1800’s when reading instruction was based on teaching the relationship between the letter and its sound. Such a trend was changed in the early 1900’s after the introduction of the whole-word approach. After this shift of emphasis on reading, Dr Samuel Orton noticed patients who were unable to read, spell and write, yet this was not determined by any obvious physical cause. Working closely with Anna Gillingham (an educator) he developed the use of the multisensory teaching technique.

Later on, Anna Gillingham and Bessie Stillman published a teacher manual, prescribing both teachers and students to be trained using their proposed technique. Between 1965 and 1975, what was then known as the Orton-Gillingham methodology and used by the staff of the dyslexia child study unit, was further refined into a program called Alphabetic Phonics.

More recently, Margaret Smith developed curriculum materials for teaching Alphabetic Phonics. These materials are now known as the Multisensory Teaching Approach (MTA). The areas of study comprise development of alphabet and dictionary skills, reading, handwriting, spelling, comprehension and composition, and are widely used in remedial classes for both children and adults. With this approach, learners are presented with information through two or more learning pathways simultaneously, whenever possible (Smith, 2001).

According to Barbara Foorman, the following conditions are indispensable when children learn to read (see Smith, 2001):

1. Phonological awareness – sensitivity to the sound structure (rather than the meaning) of speech, eg rhyming words.

2. Phonemic awareness – ability to manipulate sound units (ie phonemes) that are smaller than the syllable.

3. Alphabetic principle – understanding that written words consist of alphabet letters that are linked with the phonemes of every word spoken.

4. Orthographic awareness – knowledge of spelling patterns and orthographic rules, morphology and etymology.

5. Comprehension monitoring strategies – strategies for understanding and remembering the text.

6. The Multisensory Teaching principle addresses four of these conditions and is combined with the fifth element to obtain a balanced reading program. This is due to the notion that although it is primarily based on the use of phonics, it is also acknowledged that the use of phonics alone is not adequate.

According to Smith (2001), Multisensory Teaching which may only require 15 to 30 minutes of instruction a day is intended by its promulgators to be a failure prevention programme (see also Joshi et al, 2002). However, it can also be observed that other programmes which evolved from the Orton-Gillingham methodology6 such as the Dyslexia Training Program are also used as remedial reading programmes (see Oakland et al, 1998).

The Dyslexia Training Program (DTP) is a remedial reading program in the US which uses a variety of teaching techniques that appeal to the visual, auditory and kinaesthetic senses. It involves ‘a highly structured phonetic-instruction training with heavy emphasis on the alphabetic system, drill and repetition to compensate for short-term verbal memory deficits, and multisensory methods to promote nonlanguage mental representations’ (Oakland et al, 1998 p. 140). This remedial instruction is not only widely used, but has also been proven to be effective in improving the reading and spelling skills of those children with dyslexia (Joshi et al, 2002).

The curriculum for DTP begins by developing the most basic abilities including letter recognition and gradually extending to a more sophisticated levels of linguistic comprehension (eg syllabication) and then to the more extensive use of vocabulary and to its ultimate goal, ie reading comprehension. The program is structured to ‘establish a link between the printed language and the phonetic elements it represents’ based on the notion that reading comprehension is a by-product of well-developed decoding skills and vocabulary knowledge (Joshi et al, 2002).

Interestingly, Smith (2001) also argued that some studies overestimate the effects of the social and cultural background (eg parental literacy, lap time reading to the child) to the learners’ development. Contrary to such prevailing views that socioeconomic status, the quality of linguistic environment provided in the home, parents’ attitude and level of education, available books and other literacy materials have a major impact on the development of the children’s literacy skills (see Snowling & Hayiou-Thomas, 2006), the interventions using the Multisensory Teaching Approach have been proven to be remarkably effective with learners from socially disadvantaged group (Smith, 2001).

2.2.6 Partnership Between Parents and Teachers

… I don’t like to admit it [but] mom and dad really did help me get this far.
(An 18-year-old female dyslexic cited in Amatangelo et al, 2001)

Life for many dyslexics can be difficult and unhappy, as they are often expected to perform like their non-dyslexic peers (Alexander-Passe, 2004). In this respect, any additional support they can receive outside the school is considered invaluable. In a small-scale study with dyslexic learners, Alexander-Passe (2004) found that about two-thirds of the dyslexic participants thought that their parents understood their condition. Another third probably had a more troubled life as a result of not getting appropriate social, emotional and practical support from those closest to them (Fawcett & Nicolson, 1991). In such cases, parents may often not even be willing to acknowledge that there is a problem.

According to Sunderland and Klein (2001), successful dyslexic people tend to attribute their success to the support received from their parents. Based on this philosophy, an 18-hour course called ‘Help Your Dyslexic Child’ was run for six weeks by the London Language and Literacy Unit (LLLU) at South Bank University in summer 2000. The course included information which helped parents to determine whether or not their child was dyslexic; developed their understanding of individual learning styles; and helped them to have practical strategies when helping a child in reading, spelling and writing. As a result, this developed the parents’ confidence in how to offer the best help they could to their child. Similarly, as part of promoting a dyslexia friendliness campaign, parents of dyslexic children in East Sussex took part in sessions that were aimed at understanding dyslexia better, and at helping parents to be aware of their role in developing their child’s literacy (Amos, 2004).

A study undertaken by Hales (2001) highlighted the experience of dyslexic learners and their parents as they discovered various strategies that parents can use to help their dyslexic child. This may include talking to other parents of children with the same condition, believing that their effort can make a genuine difference to their child, and remembering that they know their child best. As part of a two-year evaluation project, which highlighted the parental–professional communications relating to dyslexic learners’ learning difficulties, parents’ roles were said to have evolved from a type of compensation (ie parents’ supportiveness) to communication, then, to accountability leading to participation or partnership in which parents and teachers worked together.

2.2.7 Promotion of Dyslexia Friendly Schools

… being an effective school and becoming dyslexia friendly seem to be two sides of the same coin.
(MacKay, 2001, p. 2)

In a recent journal article based on a study with participating schools in Durham, Riddick (2006) called for the adoption of dyslexia friendly practices to ensure that the needs of children with specific learning needs would be legitimately met. When dyslexic learners’ self-esteem was compared to that of their peers who develop typically, it showed that they had significantly lower self-esteem. Riddick (2006) indicated that environments which implicitly encourage dyslexic pupils to compare themselves with their immediate peers are not helpful. A study by Humphrey (2002, cited in Riddick, 2006), reveals that when the self-esteem of dyslexic learners from the mainstream classroom and those who were in a specialist dyslexia unit were compared, it was found that the latter scored notably higher. According to Riddick (2006), ‘for many children with specific literacy difficulties, the mainstream class is not a "dyslexia friendly" setting’ (p. 146).

So, what is a dyslexia friendly school like? How can an ordinary school be transformed into one that is dyslexia friendly? According to MacKay (2001), in a study undertaken in Wales, a dyslexia friendly environment is characterised by the presence of the following:

MacKay (2001) also argues that effective schools value strong leadership, staff development, and the quality of instruction and learning. In such schools, all children – irrespective of their abilities – are deemed important and so they are provided with the resources and environment that they need to develop optimally. It has been argued that ‘many of the practices advocated for a dyslexia friendly school will benefit a wide range of children and not just those children identified as having dyslexia’ (Riddick, 2006, p. 148).

Riddick (2006) explains, in a UK-based study, that in a school where a dyslexia friendly policy has been adopted, all teachers adopt various techniques ranging from the most simple (eg displaying key words, giving photocopied notes) to a specific teaching technique (eg multisensory teaching), which have proven useful in supporting children with dyslexia. Likewise, the use of computers and laptops will be encouraged for those with literacy difficulties, although this is not an easy option for some dyslexic learners (see Cooke, 2001). Riddick (2006) also suggests using a constructive system for marking or grading, where separate marks are given for content and presentation and students are given a choice whether or not they want to read out loud in class. Teachers may also consider using the school’s website for posting homework assignments as a form of support to dyslexic pupils. Such a provision is incorporated in the school setting in order to remove potential learning barriers amongst dyslexic learners.

In Scotland, Dyslexia Scotwest, which aims ‘to raise awareness and understanding of dyslexia’ and ‘to offer help and support to anyone with an interest in dyslexia’ introduced a scheme called the Dyslexia Friendly Schools Award (DFSA) in 2001. DFSA involved a partnership with The Scottish Executive and East Renfrewshire Council. An HMIE report for East Renfrewshire Council (2005) stated that fourteen schools have already gained the DFSA whilst others were working towards it. Due to the success of the pilot study, the project was extended to schools in West Dunbartonshire and Argyll and Bute

(see http://www.dyslexia-scotwest.org.uk/services/dyslexia-friendly-schools-award ). The criteria7 set before the school receives the award involve:

There is some evidence that schools in Scotland continue to investigate and pilot the concept of dyslexia friendliness (see Reid et al, 2005; HMIE, 2005).

2.2.8 Teaching Based on Learners’ Preferred Learning Style

… each student with dyslexia should be taught in the way he or she learns best.
(Ellis, 1993 cited in Exley, 2003, p. 216)

The idea of tailoring the teaching and learning strategies to suit the needs of dyslexic learners is primarily based on the concept of individual learning styles (Exley, 2003). Cogan and Flecker (2004), in their book Dyslexia in secondary school: A practical handbook for teachers, parents and students, agree with the idea that once the learners’ learning styles are identified, appropriate teaching methods can be implemented. According to Amos (2004), a lot of work has recently focused on the importance of identifying and teaching in accordance with the children’s individual learning styles. This is partly influenced by the recognition of the fact that dyslexic learners exhibit sufficient but different strengths, needs and approaches to learning (Exley, 2003). It is argued that this is also a means of providing learners with more opportunity to succeed by emphasising their affirmative experience of learning.

A small-scale study by Exley (2003) with students in rural Northamptonshire looked at how the performance and attainment in both literacy and numeracy of dyslexic learners could be improved if their preferred learning styles were taken into account. In her study of four male and three female participants, she conducted appropriate assessment to ascertain whether the students were predominantly visual, auditory or kinaesthetic learners. The results informed the bases on which literacy and numeracy lessons were planned and carried out.

The findings of this research suggested improvement in the performance of all seven students who took part in the research. Five of them showed much improvement in both the mathematics and spelling tests, whilst the other two who made the least progress were also identified as having emotional and/or behavioural difficulties. The results of this research strongly suggest that ‘[w]hen students are taught using their preferred learning styles, they not only increase academic attainment but also improve their attitudes to learning and behaviour’ (Given, 1996 cited in Exley, 2003, p. 218).

However, a rejoinder to Exley’s paper from Mortimore (2005) argues for caution in the application of learning style theory to teaching dyslexics since the ‘[e]xamination of the existing research into learning style and dyslexia reveals a complex picture’ (Mortimore, 2005, p. 145). It was argued that more than 70 theories on learning styles have been devised and this plethora of models is the focus of a lot of controversy related to validity and reliability. In addition, Mortimore (2005) also stressed that labelling a student with a particular learning style can restrict rather than liberate him/her.

In addition, a related argument was put forward by Kotula (2003) with regard to the instructional materials used for teaching dyslexic children: reading materials need to be carefully selected to ensure that they will ‘best hold children’s interest, teach the desired values, or provide readiness for reading instruction’ (p. 190). Yet Kotula (2003) also acknowledged that doing so is accompanied by a lot of challenges (eg conflict between the age of the reader and the difficulty of the reading materials).

2.2.9 Use of Special Computer Software

Mentl helf esae. frm as far bak as rekuds are kept mentil ilnes has ben defned xplrud ad dokumntd in the letretre its cuzs haf ben atrebud to a mlutetde of resens rangng from posesten demens bad sprtes and krses.

(A severely dyslexic learner’s uncorrected writing cited in Cooke, 2001)

The potential benefits of word processors in helping dyslexic learners ‘suggest there is justification for examining how a computer might be used to assist dyslexic readers with text reading and production’ (Gregor et al, 2003, p. 341). They have a number of features which are particularly helpful to those who have literacy problems. These may include consistent and clear text on the screen, spelling aids, grammar function, and a predictive-typing facility.

However, although a computer is acknowledged to be a useful aid, it also has its limitations. For example, by the nature of the computer and its functions, it is not designed to be used by those who need to wear tinted glasses when reading. Therefore, a team consisting of a software engineer, a teacher with a specialism in dyslexia, a usability engineer/psychologist and a programmer designed SeeWord – a highly configurable word processing environment that allows dyslexic learners to select the settings the learners considered most appropriate for reading the text. Experimental findings suggest that dyslexic learners can benefit significantly when reading from the screen using this special software. Gregor et al, (2003) suggest that a larger-scale evaluation of such software is necessary.

In another study, which took place in a Spanish context, an intervention (ie a computer-based reading practice) was given to two groups of children: 14 dyslexic children, and 31 ‘garden-variety’ poor readers. Another group (ie control) with 28 children with low reading performance was not given the intervention. Pre- and post-tests were administered to all children in the areas of word recognition, reading comprehension, phonological awareness and visual and phonological tasks. The study findings indicated that there was improved word recognition for the two groups who received the intervention, albeit that dyslexic learners demonstrated difficulties during computer-based word reading. The study also demonstrated that ‘low-IQ children with [learning disabilities] were more successful than those with high IQs in improving their phonological awareness skills [suggesting] that intelligence-level information may not be necessary for differentiating children with reading disabilities from garden-variety poor readers’ (Jimenez et al, 2003, p. 46).

Other programmes that have been specially developed for dyslexic learners over the last ten years include ‘Punctuate Plus’, ‘Sounds & Rhymes’, ‘Soapbox’, ‘Chatback’ and ‘Magic E’ (see http://xavier.bangor.ac.uk/xavier/software.html).

At the Fifth BDA International Conference held in York, Ann Cooke (2001) presented a case study of ‘J’, a mature-age student with severe dyslexia. Undertaking a three-year degree course was a real challenge as she had very limited literacy skills combined with great difficulty with handwriting and with numbers. As a result, she was heavily dependent on a word-processor/computer, which literally performed the mechanical tasks of reading and writing for her. With all the support available to her, including access to course content, study support and funding amongst others, she eventually achieved a degree in psychology. J’s case demonstrated that lack of functional literacy can be overcome at a cost not only in personal but also in financial terms. Cooke (2001) also emphasised that although technology is now widely available, she is not suggesting that it is an easy alternative for severely dyslexic learners.

2.2.10 Use of Suitable Print Size and Background Colour

According to Vellutino et al (2004), the most prevalent and influential research on dyslexia before the turn of the century focused on the deficiencies in the dyslexic’s visual system. A study conducted by O’Brien et al (2005) in the US specifically explored dyslexia as a visual-deficit learning disorder and addressed the question ‘Do dyslexic learners have a preferred print size to facilitate faster reading?’

There are various reasons why reading impairment can be caused by a stressed visual system. Firstly, when compared with skilled readers, dyslexic learners are probably less efficient at picking up visual information (ie distinguishing letters in words). Secondly, they may be suffering from lateral masking (‘crowding’) effects. Lastly, it may be a product of short visual span, which determines the number of letters that can be recognised at a glance (O’Brien et al, 2005).

The study made some interesting findings, one of which suggests that ‘dyslexic readers behave like younger non-dyslexic readers with regard to having slower maximum reading rates and higher critical print sizes’ but ‘the slowest dyslexic readers did not necessarily require larger print size thresholds to attain their maximum reading speed, whereas slower non-dyslexic readers did’ (O’Brien et al, 2005, p. 345).

2.2.11 Spelling and Vocabulary Training

… there is a strong relationship between vocabulary knowledge and reading comprehension
(Stanovich, 1986 cited in Fawcett & Nicolson, 1991, p. 379)

Spelling Training

It is widely recognised that spelling mistakes are characteristic of many dyslexic learners (Pavlidis & Katana, 2004). In this regard, Sonday (2004) endorses the teaching of spelling for two reasons:

Based on a UK study, Lee (2004) strongly advocates the use of the SpELSS method (Spelling Easily with Logic, Syllables and Suffixes) as one that both works and appeals to dyslexic learners. This logical approach to spelling is designed to help dyslexic learners to have more control of their spelling by learning and analysing the roles of vowels, syllables, syllabled words, and consonant and vowel suffixes amongst others. Lee (2004) also pointed out that spending more time for these lessons will help ensure that dyslexic learners can integrate them into their writing.

Bos and Reitsma (2003) investigated the effectiveness of various spelling exercises in a Dutch context. Taking cognisance of their own experience and with a specific poor speller in mind, a group of experienced support for learning teachers were asked to rank several sets of spelling exercises from the most to the least effective. Such exercises include identification of strategies for teaching spelling:

Their study proposes that ‘a rule-based strategy [is found] to be the most effective, irrespective of children’s IQ, phonological skill, or attention’ (Bos & Reitsma, 2003, pp. 124-125). A slight reservation was expressed whether the findings of the study with a transparent language like Dutch are transferable to an opaque language like English.

Vocabulary Training

Fawcett and Nicolson (1991) contend that ‘[t]he ability to learn new vocabulary is a crucial component in the acquisition of verbal competence [since] almost every verbal ability or aptitude test includes a vocabulary subtest’ (p. 379). This principle prompted them to conduct a longitudinal study involving 13 dyslexic adolescents over five years. Participants from Sheffield were chosen for whom efforts to remedy their reading deficit had proved unsuccessful, resulting in a deficit of at least 18 months.

The participants were initially categorised into two groups (ie the poor vocabulary and the good vocabulary) and were all given a pre-test on different aspects of the experimental tasks followed by six weeks of training on specified vocabulary items. The experiment comprised both enriched and traditional training techniques. The enriched training involved the use of difficult words (eg philanthropist, scapegoat, astound) chosen to encourage generating sentences, semantic linking and identifying affective reactions, as opposed to purely discussion of dictionary definitions. The traditional training employed the use of worksheets, crosswords and word bingo, amongst others, which were presented by using dictionary-type definitions. Parents were asked to provide assistance (eg giving examples that would stimulate the discussion, working directly with their child using the prescribed word cards and work books). At the end of the training period, an immediate post-test (equivalent to the pre-test) was administered and was followed-up by a post-post test six months later. A significant improvement was noticeable from the ‘good vocabulary group’ when their pre-test and post-test performance was compared. Likewise, it is worthy of mention that the improvement in knowledge of words persisted even after six months. This was not the case for the ‘poor vocabulary group’, however, in this simple vocabulary training programme, the experimenters were also able to draw the conclusion that ‘the training program …should prove sufficient to lead to long-term improvements in vocabulary knowledge if the initial vocabulary level is adequate’ (Fawcett & Nicolson, 1991, p. 383).

2.3 Effectiveness of Teaching Approaches and Interventions

In the inclusion of examples of best practice for this review, we adopted two major considerations. Firstly, we included studies which employed rigorous methodology that enhanced the trustworthiness of the results. This included how various criteria were set in the selection of research participants. Secondly, we attached high importance to studies which demonstrated very effective outcomes.

2.3.1 Case Studies: United Kingdom

It is apparent that a lot of the research in the United Kingdom concerns the use of creative interventions, as well as exploration of issues deemed beneficial to dyslexic learners. The case studies selected for inclusion in this report represent examples of practices which proved effective in various settings and environments. Further details of these cases, which offer a lot of innovative ideas for schools/teachers/LEAs to consider, will be provided below.

Creation of Self-Esteem Groups

As a response to what academics and researchers (see Hales, 2004; Humphrey, 2002; Humphrey & Mullins, 2002; Tsovili, 2004) identified as something lacking amongst dyslexic learners (ie a positive view of oneself), a six-week intervention designed to enhance the self-esteem of secondary dyslexic learners from a school in Winchester was studied by Burton (2004).

The intervention is primarily based on the Esteem Builders Complete Program by Borba (1989, cited in Burton, 2004). According to this programme, the five building blocks of self-esteem comprise:

(Burton, 2004, pp. 57–58)

There were four groups of students who participated in the six-session course8 where each session lasted fifty minutes. The first two groups were used for piloting the study, whilst the third and fourth groups took part in the main study. When it became more apparent that the intervention led to immediate benefits for the pupils, it was decided to conduct a more systematic and robust evaluation of the outcomes. Therefore, the focus of discussion for the results (Burton, 2004) is on the fourth group.

Two of the building blocks, namely ‘security’ and ‘affiliation’ were reflected within the individual activities and group work tasks. Participants were also encouraged to practice the Rogerian counselling concept of ‘unconditional positive regard’, to follow some rules (eg taking turns to speak, being kind to each other), and to show mutual respect (Rogers, 1983). The other building blocks were incorporated in the content of the sessions.

Using a standardised psychometric test of children’s self-esteem (ie the Five-Scale Test of Self-Esteem For Children) improvements were noticeable in every component (ie global, academic, body, family and social) for the fourth group, with the greatest increase in the social component. Due to the small number of participants, no sophisticated analysis of data was carried out. Nevertheless, the data clearly showed an increase in scores for their self-esteem following six sessions of intervention. This finding was complemented by the positive feedback and comments received from the participants who found it disappointing when the sessions ended. What they considered most helpful was the opportunity to talk and get to know others who were experiencing similar difficulties. The sessions also made them recognise and realise their respective strengths as well as giving them confidence in coping with dyslexia and other aspects of school life (Burton, 2004).

At the end of the course, the Headteacher, the Special Needs Co-ordinator and class teachers said that they could see improvements in the children’s behaviour and in their peer relationships. They also agreed that the intervention had been a positive experience for the children concerned. Burton also felt that the ‘willingness of the teacher-in-charge to invest a significant proportion of allocated EP [educational psychologist] time as well as teacher time to such group work is in itself evidence that it is highly valued in terms of the outcome for pupils’ (Burton, 2004, p. 68).

Flying Start Programme

The Flying Start programme was a summer programme organised by the City of Edinburgh Council for dyslexic learners. The five aims of the programme were:

(Dodds & Houston, 2004)

This special one-week activity for dyslexic learners took place on the last few days of the summer vacation in 2002 and 2003 at Leith Academy in Edinburgh. From the very first morning, the activities were geared to contribute to a positive atmosphere within the programme and to make young people at ease and to get to know other participants. Workshops included film-making, photography, drama, story telling, craft activity, art, t-shirt making (which relies heavily on using ICT) and other leisure activities. There were also visits to some interesting places in Edinburgh (eg Alien Rock – an indoor climbing wall, the Botanic Gardens, the National Portrait Gallery), and games to promote co-operation and teamwork. The final day ended with a barbecue and presentation afternoon.

According to Dodds and Houston, the marked difference between the first session on Monday morning and the last session on Friday afternoon was obvious not only to the programme organisers but also to the participants themselves. It was also apparent that the programme achieved the objectives it set for this group of learners. The creative workshops enabled dyslexics to realise that they had the capacity to do various challenging things successfully. The enjoyable activities instilled a more positive attitude towards learning and helped them to gain more confidence in what they could achieve. The whole programme also provided them with an opportunity to get to know other learners who were in similar circumstances to themselves and who could also be a powerful source of support. The tremendous impact of the programme could be seen from the very positive comments from the 84 pupils who attended the programme (Dodds & Houston, 2004).

Promotion of a Dyslexia Friendly School Environment

Using the principle of a dyslexia friendly school approach, a comprehensive school in North Wales incorporated into their practices the four key areas in transforming an ordinary school into a dyslexia friendly one. These areas included building strong school leadership, assimilation of whole school approaches to special needs in general, rigorous monitoring and evaluation, and creating a culture of high expectation for all in order to meet the needs of dyslexic pupils (MacKay, 2001). In addition, the school offered specialist provision intended to provide supplementary support for students who were severely dyslexic by giving them five hours each week of access to special teaching from a very experienced and highly qualified dyslexia specialist.

Strong leadership was also encouraged through the creation of a Special Educational Needs Co-ordinator (SENCO)9 (often this will be a Senior Teacher and a member of the Senior Management Team) and the promotion of the ‘corporate responsibility’ principle towards children’s progress. Additionally, as part of the whole school approach, staff received training, through a rolling INSET programme, in the following areas:

A rigorous process for monitoring the progress of pupils in various subjects through the school’s IT and intranet system was also implemented. Subject teachers helped the students to monitor their own progress through target setting. Depending on the outcome, targets were to be reviewed and modified, after seeking the SENCO’s advice if necessary. Finally, teachers were encouraged to look ‘through’ spelling and organisational mistakes and assess the underlying quality of dyslexic learners’ work .

All this effort was supported by the headteacher’s high expectation that all pupils (including dyslexic pupils) would take part in national examinations. This implied that dyslexic learners would work much harder than everyone else in their attempt to produce acceptable work. In using the principles of dyslexia friendliness, Mackay (2001) claimed that dyslexic pupils were very successful, pointing to their results: all those in year 11 were leaving with passes at GCSE, and a high percentage achieving 5+ A–Gs with higher grade passes.10 What was found from using the dyslexia friendly approach was that although the study skills techniques were meant to support and enhance the learning of dyslexic pupils, they actually enhanced the learning of all the pupils (MacKay, 2001).

2.3.2 Case Studies: International

In this section we present a few examples of studies (undertaken mainly in the United States and in other European countries) which demonstrate a well-developed and systematic approach in their methodology leading to effective outcomes. These studies implicitly show that when more than one methodological approach is used in research, the research findings are consequently enhanced.

The Dyslexia Training Program: A Multisensory Method for Promoting Reading

‘Dyslexia is a language learning disorder that results in deficits in reading, spelling, and, often, written language’ (Oakland et al, 1998). Having this tenet at its core, the three qualities which are believed to facilitate the reading development of dyslexic learners involve:

(Oakland et al, 1998, p. 140)

In a research study led by Oakland (1998) in collaboration with other academics from different parts of the United States, an attempt was made to validate the effectiveness of the extensively used Orton-Gillingham approach (and its adaptations) for promoting reading.

The experimental study involved 48 dyslexic pupils in total. Twenty-two (22) pupils were in the experimental group, and 26 were in the control group. Various tests (eg Wechsler Intelligence Scale for Children-Revised, vision and hearing tests) were conducted to ensure a suitable match between the two groups. As a result, students found to have brain lesions and major emotional problems together with those who were non-native English speakers were excluded from the study. For a period of two years (10 months of the year, and 5 days per week), a subset of the experimental group attended Dyslexia Training Programme reading classes, involving a multisensory approach. Another subset of the experimental group received their reading lessons through videotapes (also containing the Dyslexia Training Programme) whilst the control group were given school-based reading assistance.

After analysing results from the two Dyslexia Training Programmes which differed in the way they were delivered, it is interesting to note that the two subsets made comparable progress in reading comprehension, word recognition and spelling. When the performance of the experimental group was compared with the control group, the gains achieved by the former group in various reading-related tests were very evident. The study’s findings (Oakland et al, 1998) assert that the Dyslexia Training Program is effective in promoting the reading development of children with dyslexia. The reading gains achieved by the experimental group, albeit modest, are clinically significant. What makes this study more credible is that the use of a two-year intervention (which is relatively long) managed to eliminate many of the flaws of other reading intervention studies. The length of time used for the intervention, for example, was sufficient for the pupils to adopt a particular reading strategy. In addition, issues pertaining to consistency and control of experimental variables were resolved by using videotapes and encouraging teachers to adhere strictly to the principles of the Dyslexia Training Programme.

Personalised Multimedia Method (PMM)

A study in Greece, in collaboration with six other European countries, evaluated the effectiveness of the Personalised Multimedia Method (PMM), developed by George Pavlidis to help remedy the spelling problems of dyslexic learners (Pavlidis & Katana, 2004). PMM is a multimedia program (run on a PC running Microsoft Windows) designed to improve the reading, spelling, intonation, handwriting and vocabulary of learners. There are six grades and each grade contains five levels of difficulty. Previous positive feedback on the effectiveness and user-friendliness of PMM prompted Pavlidis and Katana to undertake an experimental study into whether or not the PMM could help improve the spelling of Greek dyslexics.

The selection of the participants depended on satisfying ten criteria proposed by the researchers (eg normal IQ, vision, hearing, having Greek as a first language, and having had adequate educational opportunities). After the initial assessment, twenty children took part in this study which lasted between four and six months, with a total training of 22.5 hours. Two experienced trainers assisted the pupils throughout the intervention. PMM has advantages over other reading remedial methods, firstly, because the learning process is presented as a game. Secondly, the multimedia and graphics used are interesting and captivating. Thirdly, learners were given immediate feedback which is believed to help increased their motivation to learn. A typical teaching session with the use of PMM comprised three stages:

During the session learners were given time to have intonation training, to work on a combined spelling and pronunciation technique, and to have further training on spelling with known and unknown words. When scores before and after the teaching session were compared11, spelling errors were immensely reduced after students undertook the prescribed PMM training. These data were obtained after participants were tested twice – before and after approximately five or six months training. The data showed that all participants who underwent PMM training had a reduced number of writing, dictation and composition errors in all categories (eg visual, intonation and grammatical errors) when pre-training and post-training tests were compared. This led to Pavlidis and Katana (2004) concluding that PMM is an effective tool for improving the spelling skills of Greek learners with dyslexia. Pavlidis and Katana also claimed that one year of training using PMM is equivalent to children achieving more than six years of full time school training. The transferability of such a study to the Scottish context may still require further exploration.

Intensive Remedial Instruction

A US-based research study which sought to compare the effectiveness/impact of two tested instructional programmes for severely dyslexic learners was undertaken by Torgesen et al (2001). In their study, both instructional approaches were designed to be phonemically explicit and systematic but the methods of instruction as well as the depth and extent of the phonemic decoding practice varied. Both the Auditory Discrimination in Depth (ADD) and the Embedded Phonics (EP) programmes were used.

The Auditory Discrimination in Depth program was designed to directly attack the phonemic awareness problems of children with reading disabilities by helping them discover articulatory cues to the number, identity, and order of phonemes in words. It emphasizes instructional activities that teach children to ‘feel’, as well as hear, the individual sounds in words. … [T]he vast majority of time in this program was spent building phonemic/articulatory awareness and applying this awareness to solving decoding problems with individual words.
(Torgesen et al, 2001, p. 35)

On the other hand,

… the Embedded Phonics (EP) program … provided explicit instruction in phonemic decoding strategies (letter-sound knowledge and blending) within a direct instruction framework. Phonemic awareness was stimulated during spelling and writing activities, and word identification strategies were practiced extensively while the participants read text. The EP program provided much more practice than the ADD program in reading and comprehending meaningful text, while the ADD program provided more explicit (down to the articulatory level) and extended practice on phonemic awareness and phonemic decoding skills than the EP program.
(Torgesen et al, 2001, p. 35)

Various criteria were also used to select the participants in this study. These criteria included: being identified by their teachers as having serious reading difficulties at the word-level; having average standard scores on two measures of reading at the word-level; having a verbal intelligence over 75; and having a low score in a phonological awareness assessment. Setting criteria also meant excluding some children from the sample (including those for whom English was a second language, those who were adopted, and those having a neurological condition or having a sensory or visual deficit).

In the administration of the two interventions, no control group was used due to the extremely high intensity of the interventions. Teachers who helped to administer the programme had the required knowledge and experience. Training sessions took place in a room provided by the school. The intense treatment was on a one-to-one basis in two 50-minute sessions for each day of the school week. This training lasted over a period of eight to nine weeks, consisting of 67.5 hours of instruction per child in total. There was a battery of both pre- and post-tests for assessing the effectiveness of the two interventions.

ADD and EP were both adjudged to be equally effective instructional techniques for severely dyslexic learners. According to Torgesen et al (2001), ‘the most striking finding from this study was the size of the gains made by this sample of severely disabled readers, as well as the stability of those gains over the 2-year follow-up period. Both instructional methods produced very large alterations in the children’s growth rates for broad reading ability when compared with the rate they had been growing during the previous 16 months’ instruction in learning disability resource rooms’ (pp. 50-51).

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