The Dyslexia Controversy Never Ends

An article by a freelance news writer from “Optometry Advisor” newsletter made its way around the DOC-L (or VTOD) listserve last week on the topic of vision and dyslexia.

The article was based on a poster presented at the American Academy of Optometry last week by a group affiliated with Boston Children’s Hospital and Harvard Medical School. This was a follow up on a study that the group published in 2019 in the journal Vision Research. Our VisionHelp colleague Dr. Dan Fortenbacher added to the discussion with a timely reference to a VHG blog post he did at the time referencing a Michigan Vision Therapy Study Group meeting on the subject.

It seems like there’s nothing like the topic of dyslexia to stir the passions of the vocal minority in both optometry and education who doubt the existence or relevance of the term. I recall a prominent behavioral optometrist (now deceased) whose name I won’t mention who loved to stir the pot as a dyslexia denier in the late ’60s and early ’70s. And just two years ago a prominent literacy expert (now retired) engendered headlines in Educations circles by denying that dyslexia exists. An insightful article that goes beyond rhetoric on the topic was published in Optometry and Vision Development in 2005 by Christenson and Griffin. It reviews the optometric management of dyslexia, and revisits some of the long-standing controversies.

It’s hard to believe that ten years have passed since the Eides published The Dyslexic Advantage (nine years for the paperback). But it’s worth revisiting what they wrote about vision (pages 180-181):

“Fluent reading also requires a well-functioning visual system, which is something many persistently slow readers lack. There’s considerable controversy in the reading community about the role of vision and visual interventions in dyslexic reading challenges. We reviewed this controversy in detail in our book The Mislabeled Child, and as we wrote there, there really does seem to be a subset of individuals with dyslexia whose inadequate visual skills delay their reading progress, and who can benefit from visual evaluation and treatment … visual treatments can enhance the rate of reading development for people with severe problems with eye movement control and focusing. For some, the differences can be dramatic and can prevent prolonged underperformance or often uncomfortable symptoms like eyestrain or headache while reading; or behaviors like squinting, tilting the head, closing one eye, or putting the head very close to the page. Individuals with dyslexia who often experience visual symptoms while reading or doing other forms of fine-detail close-up work deserve a thorough visual evaluation. The appropriate specialist to perform this exam is a developmental optometrist who has speciality training in the kinds of functional eye skills that allow the eyes to work well for fine-detail work. These specialists usually have the letters F.C.O.V.D. in addition to O.D. after their name, and many can be located at”

The Boston Group cited in the research above is making a nice contribution toward the guidance provided by the Eides. They are suggesting that the CISS (Convergence Insufficiency Symptom Survey) should be used more routinely in children with developmental dyslexia.

2 thoughts on “The Dyslexia Controversy Never Ends

  1. Whenever the ‘debate’ comes up, I often point to this: – an excellent and mostly objective review of the state of affairs.

    There appear to be three poles to those who maintain the debate: Dyslexia does not exist (I can recall reading this in the DOC-L group, led to some conflict); Dyslexia is all visual (also read this on DOC-L, more conflict); Dyslexia exists, it’s all ‘neurobiological’, whatever that even means, and cannot be moved by therapy (these are generally the practitioners who do not generally study or work with human vision).

    Then, there are those who recognize that vision matters, that it’s multifactorial, that it cannot be ignored. They understand that when vision is ignored and where there is dysfunction, it can appear as a variety of disorders including reading and attention problems which, when addressed, seem to calm the waters and obviate the need for such diagnoses. I think, Len, to this group, there is no debate.

    Dr. B

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