Life-long Social and Emotional Effects for Adults with Dyslexia
Over time, many clients will pass through our counselling and psychotherapy services. The law of averages determines that a percentage of those who visit us will be experiencing various degrees of difficulty from the effects of Dyslexia. Some data suggests that up to 16% of the population have some form of Dyslexia. If this data is correct, we can then assume that more than one in ten clients has dyslexia of one form or another. As psychotherapists and counsellors, are we aware of this statistic? Are we mindful of this possibility when we meet a client for the first time? Sometimes it may not be easy to identify who it might be as most people with dyslexia are very good at concealing this difficulty. The following item will inform us of the various aspects of dyslexia and how it affects people of all ages and backgrounds.
I come to school.
I see all the other friends.
Who can rite and read.
But me, I’m all on my own.
Not good at riteing.
Not good at reading.
I site on my bed,
I cry I cry and I cry.
But I bon’t see why.
It’s so hared for me.
Can’t you see?
Jodie Cosgrave, age 11. (Sheikh, 2007)
What is Dyslexia?
“Dyslexia is an alternative term used to refer to a pattern of learning difficulties characterized by problems with accurate or fluent word recognition, poor decoding, and poor spelling abilities. If dyslexia is used to specify this particular pattern of difficulties, it is important also to specify any additional difficulties that are present, such as difficulties with reading comprehension or math reasoning” (DSM-5, 2013, p. 67).
The word dyslexia is derived from the Greek words “dys” meaning difficult and “lexia” meaning reading. More specifically, dyslexia means difficulty in speech. The term “dyslexia” involves difficulties in learning to read and write. But this is not the only form of difficulty that dyslexic people experience. For example, dyslexic people have difficulty in learning phonological information (Frith, 1998). This involves learning the sounds of the letters of the alphabet. Mental arithmetic is also included as one of the difficulties of dyslexia because of the required aptitude needed in learning the symbols and functions of mathematics. Other associated difficulties include poor short-term memory, problems with articulation and co-ordination as well as great difficulty in naming things (Snowling, 1987). The evidence of dyslexia research, the diverse traits among dyslexic children, and the difficulty of the reading process implies that there is no rigid or strict diagnosis. “It is useful to think of dyslexia as a family of characteristics” (Du Pre, Gilroy, Miles, 2008, p. 6). Other shortfalls associated with dyslexia occur in the effecting of writing skills. For example, difficulty in forming letters correctly, inconsistent size of letters, slow or non-production of written data and the illegibility of handwriting. Furthermore, there may be difficulties with oral language such as syntax, vocabulary, ideation, and cohesion (Mather, 2000).
In the 1960s and early 1970s dyslexia was a relatively unfamiliar concept. Today, dyslexia is often referred to as developmental dyslexia and it denotes difficulty in acquiring reading skills, often recognized during early school years (Doyle, Snowling, 2002; Miles, 2006; Khan et al). Currently, it is widely accepted that there is no single influence (be it nature or nurture) on cognitive development (Snowling, 1987). Cognitive abilities emerge as a result of interactions between gene expression, cortical and subcortical (relating to, involving or being a part of the brain below the cerebral cortex) brain networks, and environmental influences (Farran, Karmiloff-Smith, 2012). Despite the popular acceptance of dyslexia as a type of learning disability, there appears to be a wide range of definitions throughout the literature. Miles (1995) wonders if there can ever be one true definition of dyslexia. For example, there are studies that indicate that the symptoms can vary from person to person, and also from situation to situation for the same person. Moreover, if one feels that dyslexia is a syndrome consisting of a series of more or less vague symptoms, then it will be very difficult to arrive at a precise definition of the disorder (Moats, 1994).
Many authors consider that the term “dyslexia” encompasses a difficulty in learning to read (Torres & Fernandez, 2001). However, there is a considerable contingent of highly respected people in the fields of university education and psychology who have argued against the existence of the phenomena known as dyslexia (Doyle, 2003, p. 213). The fact that this notion met with opposition is not surprising. Many new ideas require time before they register in the public consciousness. Heated discussions on dyslexia have taken place in the early days of its inception. Miles (2006) maintains that failure to understand the dyslexia concept led sometimes to blatant mishandling. He was particularly dismayed that ignorance about dyslexia resulted not only in failure to meet dyslexic children’s needs but in hurtful accusations that they were ‘not trying’ and hurtful criticism of their parents. For example, the fact that children of a lower socio-economic status background had more difficulties in reading and spelling was seen to be the result of factors such as linguistic or dialectal background, the parental attitudes from home towards school and so on. It was also speculated that, if parents had fewer educational qualifications, the implication was that they discouraged their children from seeing school work as important and the children picked up that view (Thomson, 2009). It would appear that this hypothesis had some merit when one considers that more affluent parents/guardians would be more concerned with the education of their offspring. Essentially, this meant that one’s place on the socio-economic ladder determined a child’s ability to learn to read and write. Little thought was given to the idea that there may be something physiological at play. It was not really until the late 1970s that dyslexia has been recognized as a specific learning difficulty in the UK and Ireland. Similar developments have taken place in other parts of the world, particularly in the United States.
Since the end of the nineteenth century, the term “dyslexia” has been used to describe certain severe reading and spelling problems. However, there are a great number of varied definitions of the precise meaning of this term. Some refer to the population in question, others to various explanatory factors, and still others to observed symptoms (Gersons-Wolfensberger, Ruijssenaars, 1997).The first diagnosis of developmental dyslexia mentioned in any publication appeared in The British Medical Journal in November of 1896. The article was titled "A Case of Congenital Word Blindness" written by William Pringle Morgan who was a general practitioner in Seaford, Sussex (UK). It was an account of a 14 year old boy, Percy. “In spite of this laborious and persistent training, he can only with difficulty spell out words of one syllable. The boy’s teacher says that he would be the smartest boy in the school if the instruction were entirely oral” (The Dyslexia Handbook 1996, p.11-14).
The Etiology of dyslexia appears to have germinated a number of theories. For example, there is some indication to conclude that there could be some genetic etiology for reading disability. Analysis of data estimated that about half of the deficit found in dyslexics was the result of heritable influences (DeFries, Gillis and Wadsworth, 1990). Tonnessen, (1997) argues that in order to avoid unnecessarily constricting the research into the etiology of dyslexia, it is important that our definitions are based solely on symptoms. However, until recently, the evidence supporting a neurological etiology in developmental dyslexia has rested on a rather infirm foundation of correlative and speculative research (Habib, 2000). The results of these studies have not only provided support for the presumption of a neurological etiology in dyslexia, but have challenged the conceptualization as to which neurological regions and structures may be involved in the dyslexia syndrome (Hynd et al.1991 cited in Leong, Joshi, 1995). Seeking an underlying aetiology to explain the breadth of dyslexic difficulties, Nicholson and Fawcett (1990) analysed the learning processes behind reading and identified the automatic response to text required to develop reading fluency. They found that problems in the functioning of the cerebellum account for a number of the wide-ranging difficulties associated with dyslexia, including balance, handwriting, phonological awareness, working memory, spelling and motor skills. Studies have also indicated that children with dyslexia have difficulties with the processes of attention and attention shifting which are usually associated in particular with ADHD. Studies are also presenting evidence that dyslexia can have co-occurring difficulties such as ADHD or autistic spectrum disorders (Moores, et al., 2003). In line with the difficulty of settling on one definition regarding dyslexia, some researchers suggest that specific learning difficulties are caused when early development of the brain is disrupted and the behavioural symptoms that result will depend on severity and location of neurological impairment which suggests a unifying aetiology for all specific learning difficulties (Powell, Bishop, 1992).
Prevalence and Comorbidity:
Comorbidity is a common occurrence in developmental disorders. For example, “attention deficit” can be shown to co-exist with dyslexia. Both disorders are fairly frequent in their co-occurrence (Dakin, Erenberg, 2005; Tridas, 2007). Attention deficits are problems precisely when new skills have to be learned. Therefore the attention deficit would result in poor learning and poor achievements in a whole range of school subjects, not just reading (Shallice and Burgess, 1991). Given the difficulties in defining and identifying dyslexia, it is hard to come up with a precise estimate of the number of individuals affected. The consensus among many researchers (Miles, 2006) and organisations such as the British Dyslexia Association (BDA, 2008), is that at a conservative estimate 4 per cent of the population are severely dyslexic and another 6 per cent have mild to moderate dyslexia (Ramus, 2003). It is often pointed out that on average this indicates that there will be one severely dyslexic child in each class (Shaywitz, et al, 1990). On a wider scale, international research statistics relevant to this particular study cites figures ranging from 2% to well over 10% of the population having severe dyslexia, while a further 6% may be mildly or moderately dyslexic (O’Hare, 2010; Leong, Joshi, 1995; Young & Browning, 2004; Smythe, Everatt & Salter, 2004). It is suggested by some researchers that Dyslexia is the most prevalent type of learning disability (Spofford & Grosser, 1996). Gender imbalance in dyslexia has been reported from a variety of research studies, and there appears to be some consensus that dyslexia is more common in males than females (a ratio of 4:1). Research also suggests that left-handed males may have an even higher risk factor. Boys tend to have more pronounced defects in reading and spelling than girls and a number of studies have shown that specific reading disabilities may be hereditary, but that it is less likely in girls (Lawerence, Carter, 1999).
When asked how they feel about their struggle as a dyslexic person, many would describe emotions such as anxiety, frustration and anger in many areas (Riddick, Sterling, Farmer & Morgan, 1999; Bartlett, Moody & Kindersley, 2010). Whether in College, a work situation or invested in significant relationship situations, they might feel anxious about whether they will be able to manage their workload (Du Pre, et al, 2008; Beetham, Okhai, 2017). There appears to both negative and positive consequences for the individual’s experiences living with dyslexia in a primarily non-dyslexic society (Morgan, Klein, 2000). Chapman (1988) reviews much of the work in the area of dyslexia and self-esteem and concludes that dyslexic children tend to have lower general and not just academic, self-concepts than their peers. Some research suggests that many dyslexic individuals have a sense of failure, low self-worth and a feeling of being less competent throughout their adult lives. These inept feelings also include behaviour and social acceptance (Smith, Nagle, 1995). Evidence would suggest that it is because these adults have remained reading disabled, they have continued to experience such low self-esteem. The long lasting effects of frustration and disappointment can inhibit the psychological growth of children leading to a sense of inadequacy in adulthood (Maughn, 1995; Gross, 1997). Dyslexia can be a cause of much anxiety for an individual. For example, a study examined levels of mathematics and statistics anxiety as well as general mental health amongst graduate students with dyslexia and those without dyslexia; it was found that students with dyslexia had much higher levels of mathematic anxiety relative to those without Dyslexia (Jordan, McGladdery, Dyer, 2014).
Where it takes a long time to process information, such skills may be blocked from surfacing and pressure to perform quickly may result in the adult dyslexic feeling disorientated and confused. Directional confusion is also common with dyslexia; they find it hard to remember and recall left and right (Miles, 2006). Children with cognitive inefficiencies such as dyslexia are considered to be at risk of educational failure or of not achieving at a level consistent with their measured ability level. Researchers have also shown that, in addition to their educational under-functioning, dyslexic children are at risk of experiencing low self-esteem, and show behavioural, emotional and social maladjustment associated with their learning difficulties (Hales, 1990). Research would also indicate that it is also important to identify and address the social and emotional problems of children with specific learning difficulties in the early life as there is evidence to suggest that these difficulties may persist into adulthood and the earlier the intervention the better (Du Pre, Gilroy, Miles, 2008).
There is a good deal of evidence that anxiety disorders among older pupils are more common in dyslexics (Carroll, Lles, 2006; Riddick et al, 1999). Anxiety, however, can be presented in many different ways including irritability, restlessness and poor concentration as well as the physical symptoms including dizziness, faintness, sweating, tremor, nausea, and shortness of breath, diarrhoea, hyperventilation and many more symptoms The Division of Educational and Child Psychology report on dyslexia by the British Psychological Society (1999) even goes so far as to suggest that emotional behaviour problems linked to dyslexia can be an aspect of the diagnosis, particularly in relation to school absence. As a young person moves through adolescence into adulthood, the emotional consequences of not being able to overcome their dyslexic difficulties can become more acute (Torres, Fernandez, 2001). Even those who manage, as a result of good teaching and personal effort, to gain access to higher education will continue to need emotional support (Reid, Fawcett, 2004). Occasionally, a psychotherapist will be part of this support. Therefore, it would be important to be mindful that sooner or later, a client with dyslexia will knock one’s door.
Remarkably, when asked for an opinion on dyslexia, many people associate the term with children only (Fielding, 2012). Dyslexic adults also have difficulties, not just with reading and writing, but also saying long words, remembering instructions, number accuracy and filing things in the correct order. They also have difficulties with short-term memory and visuospatial skills such as the ability to recognise squares, circles triangles and so on (Bartlett, Moody & Kindersley, 2010). The major factor for dyslexics is likely to be the frustration, embarrassment and the worry that they will be seen as “stupid” or “lazy” when they cannot showcase their true abilities (McLoughlin, Leather & Stringer, 2002). “The Westernised school system promotes a particular notion of the skills necessary to achieve social and economic competence” (Barnes, Mercer, 2003, p.144). This attitude may lead to the marginalisation of students and adults with specific learning disabilities, such as dyslexia. “Dyslexia can be perceived as a Cinderella disability, it is entirely invisible” (Bell, 2009, p.74). Those affected can go unnoticed and are often skilled at obscuring or masking their difficulties (Miles, 2006). Arguably, the members of the public are often poorly informed about dyslexia. In a peculiar way, this may also include the group of adults with dyslexia who are not aware that they are dyslexic.
Students of all ages are conditioned with the mentality that if they succeed in learning to read and write they will be successful in their lives. If they fail to gain these educational skills they will be considered failures on many levels. Living with this outlook can have the effect of making people feel inadequate (Miller, 2015). People may also experience shame and embarrassment and therefore feel they cannot be open about their difficulties because such attitudes are supported in popular culture (Herrington et al, .2001, cited in Tanner, 2009). These attitudes reflect not only the failure barriers and social oppression that exists within society, but also the way those attitudes have been internalised by members of society who, as unconscious conduits, perpetuate these attitudes (Bell, 2009; Price, Gerber, 2008).
Third Level students with dyslexia often experience problems with information processing, note-taking, essay writing and organization (British Dyslexia Association [BDA], 2013). The absence of confidence can affect their performance, especially in social situations, such as reading and writing in front of others. Dyslexic students can present a specific challenge to their tutoring staff because their difficulties are well hidden (Riddell & Weedon, 2006). The possibility of meeting the needs of students with dyslexia and enhancing their learning potential is, therefore, contingent upon their choice to self-identify as having a diagnosis of dyslexia (Morris, Turnbull, 2007). Contemporary upgrades of student facilities with dyslexia include note-takers, dictaphones, spellcheckers and extra time or support for assessments and exams. Modern-day computer programs such as “speech to text” and coloured filters for PC screens have also increased the capabilities of students with dyslexia and related difficulties.
People may not be fully aware of the relationship between their mental and emotional wellbeing and the environment they living and growing in. Psychosocial effects relate to several key areas related to psychological and social functioning and the availability or lack of central supports (Hunter-Carsch, 2001). Looking at those external factors a little bit more, there is some evidence that behaviour disorders and even criminality can be associated with dyslexia (Stattin & Klackenberg-Larsson, 1993; Maughan et al. 1996). The acquisition of literacy can be an effective solution to re-offending among prisoners. There is a very high incidence of illiteracy among prison populations, some of whom, of course, will be dyslexic (Thomson, 2009). Those who don’t make the academic grade are likely to give up and seek ways to conceal their difficulty and perhaps move into a variety of unsuitable jobs, possibly even taking to crime (Reid, Came & Price, 2008). Leaving school with minimal qualifications, they may well drift from job to job until they stumble upon one where a high degree of literacy is not an essential requirement. Those who are fortunate and/or more resilient may, on the other hand, end up in “helping” professions, such as social work, childcare or the prison service, where interpersonal skills have traditionally counted for far more than high level literacy.
Dyslexia in the workplace is an area where highly developed practices have yet to fully emerge, although the recent supports developed in many colleges and universities in a number of countries will eventually pave the way for more enlightened workplace practices. The lack of employer awareness of dyslexia can have a profound effect on the worker (Sauter, McPeek, 1993). There is an abundance of literature and research about childhood dyslexia. Adult dyslexia remains relatively un-documented, particularly from a lived perspective. Text literacy is fundamental to life in the modern world. It is virtually impossible to find a job which does not require some level of reading, writing and remembering, or some use of a computer. Adults with dyslexia sometimes also struggle with time management and organization at work. Planning and organizing, setting out timetables, distinguishing between the important and the urgent, remembering appointments, passing on telephone messages from memory and meeting deadlines can be exceptionally difficult for many people with dyslexia (Hoien, Lundberg, 2000). Some people may get bogged down, overwhelmed by the workload and stressed. However, there are ways round these difficulties and some are outlined below.
Much of the literature on learning disabilities and dyslexia has focused on children, facts and figures to illustrate important concepts about this often confusing, invisible disability. However, there seems to be a lack of current empirical information describing what actually happens to children with learning disabilities when they grow up and strive to become successful adults (Blackorby and Wagner, 1996). For example, in the United States well over 50 per cent of Americans with disabilities are either unemployed or in menial occupations, with the largest group being people with learning disabilities (Bolles, Brown, 2001). According to studies carried out in the US, many adolescents with learning disabilities will drop out of second level education before completing final exams and many will end up in the prison system. For those who make it to third-level College, undoubtedly some will have problems completing their degree program (Valeri-Gold et al., 2001). For all the adverse or unfavourable aspects of the effects of dyslexia there are some positive features. For example, self-disclosure is perceived as a very important element of self-determination and the foundation for normalization of persons with disability (Field and Hoffman, 1994). Furthermore, self-disclosure is perceived as an indication that an individual is attempting to take control of his or her destiny. This appears to be a critical factor reported on the research of highly successful adults with learning disabilities (Reiff, Gerber, & Ginsberg, 1997).
Researchers have been working on dyslexia and reading problems for about a hundred years. However, we still have not reached a strong consensus as to how to define ‘dyslexia’. We need clear and useful definitions rather that a “one size fits all”. The search to fully explain dyslexia has resulted in an ever-widening range of symptoms being integrated into definitions alongside the inclusion of difficulties associated with related syndromes. Prevalence of dyslexia ranges from 2% per cent to well over 10%. An important realization that emerges from the research is that self-disclosure can lead to many positive aspects in the life of a person with dyslexia. Schools and colleges attempt to to meet the requirements of dyslexics’ by providing intensive remedial input, study skills, laptops, extra examination time and so on. Emotional and psychological support for student s of all grades would be helpful. There is always a danger that people with learning difficulties will slip through the “safety nets”. Some will end up getting involved in crime and other antisocial activities. On the other hand, many people with dyslexia become very successful on a worldwide basis.
Author: Christina Flood.
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