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Reading difficulties: Research and treatment Associate Professor Genevieve McArthur ARC Australian Research Fellow (Macquarie Centre for Cognitive Science)

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Presentation on theme: "Reading difficulties: Research and treatment Associate Professor Genevieve McArthur ARC Australian Research Fellow (Macquarie Centre for Cognitive Science)"— Presentation transcript:

1 Reading difficulties: Research and treatment Associate Professor Genevieve McArthur ARC Australian Research Fellow (Macquarie Centre for Cognitive Science) ARC Centre for Cognition and its Disorders

2 Making evidence-based decisions about the diagnosis and treatment of dyslexia

3 Outline The importance of reviewing the scientific evidence: Data collection The diagnosis of dyslexia different ways to diagnosis of dyslexia myths about dyslexia how to make an evidence-based diagnosis of dyslexia Treatments for dyslexia how to make an evidence-based decision about treatment causal treatments reading treatments The importance of reviewing the scientific evidence: The Results

4 The importance of scientific evidence Which of these statements – commonly made in the media – are supported by the weight of scientific evidence? True = 1 False = 2 1.You should floss your teeth to reduce tooth decay and gum disease 2.You should take a regular dose of vitamin C to prevent colds 3.You should get a flu shot 4.You should reduce your salt intake to improve your blood pressure 5.You should eat a high-fibre diet to prevent colon cancer 6.You should take gingko to prevent dementia 7.You should drink at least eight glasses of water per day (tea and coffee does not count) 8.You should drink red wine - but not white wine or beer 9.You should stretch before or after exercise to prevent muscle soreness

5 Outline The importance of scientific evidence: Data collection The diagnosis of dyslexia different ways to diagnosis of dyslexia myths about dyslexia how to make an evidence-based diagnosis of dyslexia Treatments for dyslexia how to make an evidence-based decision about treatment causal treatments reading treatments The importance of scientific evidence: The Results

6 ResearchDSM4Response to Intervention Descriptiv e What is impaired? Reading Sensation ~ Academia Everyday reading Reading Response to intervention Reading What is unimpaired? NVIQ Sensation Education Neurology Language ~ IQ Education Diagnostic tests Reading NVIQ Hearing Vision Education history Language ~ Reading IQ Hearing Vision Academia Everyday reading Education history Reading Response to intervention Reading Different ways to diagnose dyslexia

7 Myths about dyslexia More boys than girls have dyslexia If you reverse letters (d for b or p) then you have dyslexia People with dyslexia are more likely to be left-handed People with dyslexia are unusually intelligent People with dyslexia are unusually artistic

8 So … how are you supposed to diagnose dyslexia?

9 Use an evidence-based model of reading

10 regular words: BOOT See word boot Spoken word production Letter identification BOOT P D D L B O O T Letter identification 2 B-O-O-T B-OO-TParsing p u b b oo t Letter-sounds b oot Blending fruit boot Spoken word planning

11 irregular words: BOOK See word book Spoken word production Letter identification 1 BOOK Letter identification 2 B-OO-KParsing b oo k Letter-sounds book Blending book Spoken word planning book BOOK Written word rep book Spoken word rep Meaning

12 See word Spoken word production Letter identification 1 Letter identification 2 Parsing Letter-sounds Blending Spoken word planning Written word rep Spoken word rep Word meaning Lexical Sight-word Nonlexical Phonics to read regular and irregular words you need: two reading routes that work at the same time that work equally well

13 See word Spoken word production Letter identification 1 Letter identification 2 Parsing Letter-sounds Blending Spoken word planning Written word rep Spoken word rep Word meaning Lexical Sight-word Nonlexical Phonics but sometimes they dont: but bad at phonics reading (nonlexical) = phonological dyslexia some good at sight-word reading (lexical) but bad at sight-word reading (lexical)= surface dyslexia some good at phonics reading (nonlexical) many bad at sight-word reading (lexical) and bad at phonics reading (nonlexical)= mixed dyslexia

14 See word Spoken word production Letter identification 1 Letter identification 2 Parsing Letter-sounds Blending Spoken word planning Written word rep Spoken word rep Word meaning Lexical Sight-word Nonlexical Phonics Irregular-word Reading CC2 Non-word Reading CC2 need to assess: two reading routes CC2 each component

15 Outline The importance of scientific evidence: Data collection The diagnosis of dyslexia different ways to diagnosis of dyslexia myths about dyslexia how to make an evidence-based diagnosis of dyslexia Treatments for dyslexia causal and reading treatments how to make an evidence-based decision about treatment an evaluation of causal and reading treatments The importance of scientific evidence: The Results

16 Commercial treatments for dyslexia Causal treatmentsReading treatments

17 Dorothy Bishop dystalk.com/talks/60-evaluating-alternative-solutions-for- dyslexia Introductions to evidence-based decisions about treatment Ben Goldacre

18 Step 1: Find a systematic review Review of all properly controlled studies of a treatment Done by an independent expert not a journalist not a private company not connected with the company (e.g., Rod Nicolson and Dore) Some sources Cochrane Reviews Google Scholar Google What Works Clearinghouse ~ MUSEC Briefings

19 Step 2: DIY systematic review Coltheart, M., & McArthur, G. M. (In Press). Neuroscience, education and educational efficacy research. In M. Anderson and S. D.Sala (Eds.), Education in Neuroscience Oxford, UK: Oxford University Press. no control group control group Significantly bigger reading gains in treated group than control group No difference in reading gains in treated and control groups Large gains in reading scores in the treated group Small gains in reading scores in the treated group

20 Step 3: Use indirect evidence e.g. Eye Q > reading Evidence that the same type of treatment (other brand) improves reading Evidence that the treatment itself (Eye Q) improves a factor (fatty acids) that has been scientifically proven to improve reading Evidence that the same type of treatment (other brand) improves a factor (fatty acids) that has been scientifically proven to improve reading Coltheart, M., & McArthur, G. M. (In Press). Neuroscience, education and educational efficacy research. In M. Anderson and S. D.Sala (Eds.), Education in Neuroscience Oxford, UK: Oxford University Press.

21 Step 4: Ignore brain data Brain data cannot tell us if an educational treatment works or not Focus on the behavioural evidence (i.e., reading behaviour) If a program did not improve reading but did change the brain, would you pay good money to buy it? If a program did improve reading but did not change the brain, would you not buy it? Coltheart, M., & McArthur, G. M. (In Press). Neuroscience, education and educational efficacy research. In M. Anderson and S. D.Sala (Eds.), Education in Neuroscience Oxford, UK: Oxford University Press.

22 Step 5: Ignore anecdotes Biased sample Subjective data Cognitive dissonance Coltheart, M., & McArthur, G. M. (In Press). Neuroscience, education and educational efficacy research. In M. Anderson and S. D.Sala (Eds.), Education in Neuroscience Oxford, UK: Oxford University Press.

23 Commercial treatments for dyslexia Causal treatmentsReading treatments

24 Program1. Systematic review 2. DIY review3. Indirect evidence NA2 studies Reading not tested The effect of PA on reading contentious Strong et al ~ 10 studies No effect Hyatt et al A few studies No effect Bishop 2007 A few studies No effect NA Working memory can be trained but its effect on reading unknown Hyatt 2007 A few studies No effect

25 Program1. Systematic review 2. DIY review3. Indirect evidence NA Phonics has small to moderate effect on dyslexia NA Phonics has small to moderate effect on dyslexia WWC A few studies Small effect NA Phonics has small to moderate effect on dyslexia NA Phonics has small to moderate effect on dyslexia

26 Outline The importance of scientific evidence: Data collection The diagnosis of dyslexia different ways to diagnosis of dyslexia myths about dyslexia how to make an evidence-based diagnosis of dyslexia Treatments for dyslexia how to make an evidence-based decision about treatment causal treatments reading treatments The importance of scientific evidence: The Results

27 Which of these statements – commonly made by the media – are supported by the weight of scientific evidence? True = 1 False = 2 1. You should floss your teeth to reduce tooth decay and gum disease 2. You should take a regular dose of vitamin C to prevent colds 3. You should get a flu shot 4. You should reduce your salt intake to improve your blood pressure 5. You should eat a high-fibre diet to prevent colon cancer 6. You should take gingko to prevent dementia 7. You should drink at least eight glasses of water per day (tea and coffee does not count) 8. You should drink red wine - but not white wine or beer 9. You should stretch before or after exercise to prevent muscle soreness The importance of evidence: The evidence

28 This above all: to the scientific evidence be true, and it must follow, as the night the day, thou are less likely to be false to any man (or woman or child) (Shakespeare … kind of)

29 Thank you


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