High Achieving Dyslexic Adults: Implications for Theory and Practice

David McLoughlin

david.mcloughlin@buckingham.ac.uk

mcloughlin.david@btconnect.com

Overview

• A little history - influences
• Archive research
• A working memory model
• Skills and strategies – cognitive load theory
• Final thoughts

www.dyslexia-idc.org

Influences - early career experience

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Influences – philosophy of science

• Science is not a body of knowledge but a methodology.
• Diagnosticians should adopt a scientist/practitioner approach.
• The criteria for whether something is scientific are testability and refutability, otherwise it is pseudoscience. (Popper, 1963).
• ‘Lived experiences’ cannot be refuted.

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www.dyslexia-idc.org

Influences – philosophy of science

• We should be looking for ‘the loveliest explanation’; the one which provides the most understanding. (Peter Lipton, 2004).
• The loveliest explanation of dyslexia will not come from a search for a core deficit but a model that:

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1. Explains most if not all difficulties
2. Predicts what might be challenging in the future
3. Provides a rationale for strategy development.

www.dyslexia-idc.org

Influences - Tim Miles

• There is no contradiction in saying that a person is dyslexic whilst nevertheless being a competent reader.

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• Dyslexia is a syndrome - ‘a family of lifelong manifestations that show themselves in many other ways than poor reading’. (Miles, 1990, 1998)

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Influences – dyslexia and success

The empirical US studies of successful individuals who have learning disabilities. (Schneiders, Gerber and Golding, 2015).

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• Self-understanding is paramount.
• It leads to constructive strategy development.
• Facilitates self-advocacy.
• Helps people find their niche.

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www.dyslexia-idc.org

Terminology

• Neuro-developmental disorders.
• Learning difficulty – specific.
• Learning disability – specific/general.
• Atypical.
• Exceptional.
• Neuro-diverse.

Euphemisms do not promote understanding.

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www.dyslexia-idc.org

Superpowers/Gifts

The compensatory mechanisms hypothesis:

• A meta-analysis of twenty studies revealed no evidence of enhanced creativity associated with dyslexia. (Erbeli, et. al. 2021.)
• Unconventional coping strategies and modes of thinking in adolescence and adulthood.
• Seeking out opportunities that do not place a heavy emphasis on academic skills.

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www.dyslexia-idc.org

Data from testing

‘The study of individual differences is one of the pillars of psychology and essential to predicting outcomes in domains such as cognition, personality, and emotion. It has influenced the development of psychometric measurement. Understanding individual differences ought to be considered central to theory construction’. (Revelle et.al., 2010)

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Dyslexic doctors: a sample

• 394 graduates in medicine undertaking specialist training.

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• Referred to central London Professional Support Unit by supervisors or self-referred.

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• Screening interview/checklist -> formal assessment.

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Characteristics of Trainees

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Seventy percent in GP training

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Male/Female = 57%/37%

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First language English = 66%

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Asian/African names = 39%/11%

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Presenting difficulties

Most common:

• Examinations = 70%
• Time management = 40%
• Note taking/making = 40%
• Organisation = 25%

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Other:

• Drug names
• Prescriptions

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The average graduate knows 15,000 words. The average medical school graduate knows 30, 000 words.

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Screening

Smythe & Everatt (2001) Checklist for dyslexic adults. The Dyslexia Handbook. Reading, Berks: BDA.

Mean = 47 (SD = 13)

[min = 17, max = 78]

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45-60 = mild

60+ = moderate to severe

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Differential diagnosis

Diagnostic assessment is not just a labelling exercise, but one of explanation.

‘Self-awareness and self-knowledge, gained by and accurate diagnosis of dyslexia, brings in the light and allows a person to understand himself, to know how he functions and learns, the nature of his difficulties and, how to help himself.’ (Shaywitz et.al., 2016)

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Assessment protocol - cognition

Cognitive and processing abilities

• The Wechsler Adult Intelligence Scale (Fourth Edition).
• Measures of naming ability from the Comprehensive Test of Phonological processing.

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Assessment protocol - literacy

• We need the skills we need, so essentially the results are criterion referenced.
• Reading skills are rated as being at one of four levels, professional being the highest.
• Writing speed is expressed as words per minute.
• Poof-reading as a percentage of errors identified.
• Spelling skills are evaluated qualitatively.

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www.dyslexia-idc.org

Assessment protocol - literacy

• Prose reading and silent reading comprehension passages from the Spadafore Diagnostic Reading Test.
• The spelling scale from the Wechsler Individual Achievement Test (3rd edition).
• The writing and proofreading scales from the York Adult Assessment Battery.
• The sight word reading scale from the Test of Word Reading Efficiency.

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WAIS Index score profile

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Processing: rapid naming

N.B. Naming speed deteriorates over the lifespan but at only one second per decade up to the age of 55. (Wiig et al. 2007)

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Literacy

• Reading accuracy – all professional level
• Reading comprehension – 23% technical level
• Silent reading speed – mean 161 (sd 47) [expected rate 250 wpm]
• Writing speed – mean 29 (sd 3)

[expected rate 25 wpm]

• Spelling – mean 106 (sd 6)
• Proofreading – mean 83% (sd 17)

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More archive data

• N=1423
• Education – 601
• Work – 822
• Age range – 18 to 78 (mean 29.4 years)
• Females/males – 701/716

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More archive data N=1423

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Working Memory

• Cognitive psychologists agree that the processes attributed to working memory are essential in human cognition. One must keep information in mind while processing it to function intellectually and socially.
• Life comes at us very quickly. One of the abilities that enables us to make sense of the world is working memory. We process what we learn and if we are not processing, we are not living. You can’t turn working memory off; if you do you are in a coma.

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Working Memory

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Visuospatial Sketchpad

• Storage and manipulation of spatial and visual information

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• Stores form and colour information

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• Stores spatial/movement information

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It has a limited capacity

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Phonological Loop

• Remembering serial information
• Temporary storage for unfamiliar words while they are being remembered
• Preserves the order in which words are presented
• It is very important to language learning
• Underlies grammar and syntax

It has limited capacity

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Central Executive

• Planning
• Sequencing
• Maintaining attention
• Resisting interference
• Changing set
• Time estimation

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Episodic Buffer

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• Integrates/binds information from a range of sources into a single structure or ‘episode’

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• Acts as an intermediary between the Central executive, phonological loop and Visual spatial sketchpad

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• Conscious awareness is the principal mode of retrieval from the buffer

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Hedonic detector

• Hedonic adaptation is the process by which people become accustomed to a positive or negative stimulus.
• The hedonic detector picks up positive or negative associations from the episodic component of working memory.
• People who have dyslexia will be more inclined to access the negative.

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Implications: Difficulties

• Problems with literacy, especially fluent comprehension.
• Procedural aspects of numeracy
• Problems with general memory tasks
• Time management/estimation
• Dealing with change
• Organisational difficulties

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www.dyslexia-idc.org

Non-cognitive abilities

Negative

• Confidence
• Self-esteem
• Anxiety

Positive

• Motivation
• Perseverance

www.dyslexia-idc.org

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‘Sometimes not being able to forget is more difficult than not being able to remember’.

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www.dyslexia-idc.org

www.dyslexia-idc.org

Cognitive load theory – Sweller, 2011

• Cognitive load refers to the effort used in working memory.
• Overload can have negative effects on task completion.
• If dyslexic people have an inefficient working memory system they will be more prone to overload than others.
• Interventions should reduce cognitive load

www.dyslexia-idc.org

Skills, Compensation and Adjustment

• The Skills people need to develop e.g. read, comprehend, write reports and assignments, proofreading, self-advocacy

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• Compensation are what people can use to help them e.g. practical and technological aids

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• Adjustments are the changes that can be made to help: extra time, proofreading, specialist teaching/coaching/mentoring

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Strategy Development: Principles

• Strategies serve different purposes
• Strategies must be individualised
• Strategies do not eliminate processing difficulties
• The best strategies come from experience
• The law of parsimony – they should achieve the goal, consuming as few intellectual processes as necessary

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Making working memory work

• Use imagery – episodic memory.
• Rely on understanding – semantic memory.
• Practice – procedural memory.
• Frequency.
• Study for short periods.

www.dyslexia-idc.org

Interventions: skills

• Reading strategies – to address lack of fluent comprehension

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• Examination techniques - particularly reading and interpreting questions

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• Self-advocacy skills – providing solutions

www.dyslexia-idc.org

The most important skill: �Self-advocacy

• Never just tell people you are dyslexic, dyspraxic, neuro-diverse.
• Always tell people you have …….. which means that……………….
• Tell people how you do things……………………
• Provide solutions not problems.

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www.dyslexia-idc.org

Interventions: adjustments in practice

• Time – extended performance targets.
• Help set realistic and achievable goals.
• Allow to delegate proofreading.
• Minimise distractions.
• Provide admin support.
• Ensure technology is available.

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www.dyslexia-idc.org

Summary

• Inefficient working memory ability is a cognitive marker of dyslexia.
• A cohesive working memory model provides one of the loveliest explanations as it:

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1. Can explain difficulties beyond reading.
2. Predicts future challenges.
3. Provides a rationale for strategy development.

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Further reading

www.dyslexia-idc.org

Forthcoming

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Dyslexia and Working Memory:

A scientific and practical lifespan perspective.

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McLoughlin and Martin

CUP. (2024?)

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Some good advice

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‘My advice to other people with disabilities would be to concentrate on things that your disability doesn’t prevent you from doing well, and don’t regret the things that it interferes with.’

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Stephen Hawking. (2011)

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