Dyslexie font, coloured overlays and Irlen Syndrome

34 Replies

One of the excellent Dyslexia Victoria Support folk was telling me the other day that she’s planning to write to public libraries asking them to stock decodable books.

This seems to work. All my local Yarra, Darebin and Moreland libraries now have some books with simplified spellings for beginning and/or struggling readers.

The DVS person was thinking about how libraries can help people with dyslexia because she found the following information on the Moreland website:

Of course this information is well-intended, but it’s not well-informed.

Dyslexie font

There is barely any empirical evidence for Dyslexie font,  though recent Macquarie University research suggests that extra space between its letters is what makes it easier to read.

You can add space between letters in a word processor to achieve this without having to buy a special font. Here’s where to click in MS Word to do it:

If you’re writing something for a struggling reader, or setting them up to type on a computer, it’s probably a good idea to do this.

Coloured overlays

The Royal Australian and New Zealand College of Opthamologists has made some very strong and clear statements about vision therapy, coloured overlays and other eye-related treatments for learning difficulties.

I’ve written about this before in a blog post about controversial dyslexia therapies, so will now just quote their media release:

“Reviews of the literature have consistently shown a lack of good evidence to support vision therapies, such as those offered by behavioural optometrists, for the treatment of learning disabilities such as dyslexia.

“Using these expensive, ineffective and controversial treatments may delay a child from receiving the appropriate evidence-based educational remedies. Evidence shows that the earlier the intervention with the appropriate remedial programs, the more effective they are in improving reading outcomes. The use of ineffective interventions may also waste the limited financial resources of the family as well as giving them a false sense of security that the child’s reading difficulties are being addressed.

It is important, therefore, that parents understand that dyslexia and other learning disabilities are not disorders of vision and so, visual therapy is misdirected. Scientific evidence shows that behavioural optometry treatments such as eye tracking exercises, vision therapy, weak glasses to relax the focus, and coloured lenses/overlays do not help children read any better.

Eye care professionals such as ophthalmologists and optometrists are not qualified to diagnose or treat learning disabilities. However, children with learning difficulties will usually have both their hearing and vision assessed because listening and seeing are the first steps in information processing for the purpose of learning. The role of optometrists and ophthalmologists is therefore to diagnose and treat any treatable vision problems that may be contributing to any difficulties at school.”

Irlen Syndrome

You can read the RANZCO position statement on Irlen Syndrome here.

In summary, it says Irlen Syndrome is not a Thing:

Politely correcting the public record

In a sec I’m going to email Moreland library, ccing to the Moreland Councillors I know, congratulating them on having some decodable books, asking them to buy more, and asking them to please correct/update the dyslexia information on their website.

Librarians are great, and want to provide correct information, so I’m pretty sure they’ll do it.

I’d hereby like to propose a game of spotto to the readers of this blog. When you spot incorrect or unhelpful information about dyslexia/learning to read/spell in the public domain, please ask politely that it be corrected, then write about it in the comments below. Encourage others to speak up for the sake of truth and beauty, despite the risk of being told to MYOB.

If we all give information based on scientific evidence to well-meaning people inadvertently promoting ineffective and cost-ineffective interventions, I’m pretty sure they’ll mostly stop.

Following up with a suggestion of how they can assist/promote effective, cost-effective intervention could also make quite a difference for struggling readers/spellers.

Focus on people inadvertently promoting things that don’t work, and think carefully before putting anything in writing about those making money promoting things that don’t work. I know some extremely nice, helpful and skilled defamation lawyers, but you probably don’t want to get to know them too.

I look forward to hearing that lots of people all over the place are doing their bit to help correct and improve information in the public domain.


34 responses to “Dyslexie font, coloured overlays and Irlen Syndrome”

  1. Wendy says:

    regarding decodable readers –
    My local library (Coffs Harbour in NSW) has recently added all the Fitzroy Readers which are prominently displayed

  2. Heidi Greory says:

    Wonderful suggestion Alison. Thanks.

  3. Maryanne says:

    I approached my local library last week and asked them to purchase the Phonics Books series Talisman, Alba and Rescue series. They had ordered them all within 48 hours!! My son has really enjoyed and benefitted from the Totem series that we bought for him. I am thrilled my library has stepped up to support the children in our community with reading difficulties.

  4. […] Source: Dyslexie font, coloured overlays and Irlen Syndrome […]

  5. Awesome idea Alison! I’ve been working on the ‘politely’ part – hopefully I’m getting better at it! . On a serious note, I’ve had parents inform teachers that their child has Irlen Syndrome and requires colored overlays/ special lenses. We can only hope that this message spreads so that fewer parents go on this rollercoaster of misinformation.

    • Here! Here! More dissemination of good information about evidence-based practice is needed. It is particularly unhelpful when teachers fall into the trap and recommend any of the pathways you mentioned as unsupported by good evidence to parents.

    • Sharne says:

      Whilst I appreciate the need to educate on evidence based studies, I think it is important. Not to mix up Irlen with Dyslexia which are two totally different issues. My daughter has both and whilst the lenses and coloured overlays do not help with dyslexia, without a doubt they help with Irlen. My daughter says the Irlen coloured overlays, lenses and coloured paper reduces the visual stress and letters moving all
      over the place. Her fluency is greatly improved when she has the lenses etc. She is able to write without the surrounding words ‘waving’ and ‘bouncing’. I agree with clarity, however be mindful that you aren’t doing a disservice to those people that genuinely have had amazing success with those options, despite what evidence suggests. I went on this ‘rollercoaster’ and it has been the best thing for my child and has made such a difference for her writing and reading.

  6. Natalie says:

    I know people are always looking for evidence-based practices, but I think it’s also good to take into account what the patient says helps them and what they want. As a person with Irlens Syndrome, I can say that those colored overlays have been my only hope in my Education. It has helped me, my friends, and my entire family that all have it. It’s literally the only thing that has helped me get through college. Reading on white paper in flourecent lights has been the bane of my educational experience (especially with tests and reading papers and books). And if I don’t have it, it can cause me to have fatigue and eye migraines for the rest of the day. I can tell a difference when I use it and when I don’t because my eyes really can’t focus on the page without an overlay for more that 5-20 minutes before my eyes give up.

    In other words, we can give medical advice all day of what we think is best. However, I think that sometimes the best way to get to the root of the problem is to ask what they want and what is helpful to them individually.

    • alison says:

      Hi Natalie, I’m glad you’ve found things that work for you, and of course individuals are free to use whatever interventions they like. What concerns me is health professionals sometimes promote interventions that lack proper evidence, without making this clear to their clients/patients.

    • Sharne says:

      I totally agree. My young daughter has had the same experience. Overlays, coloured paper and lenses have made a HUGE difference for her. It is great to hear from people who experience Irlen, despite what the ‘empirical evidence’ suggests. I am so glad those aids have been helpful to you, as I have seen the difference they have made for my child also.

      • alison says:

        Hi Sharne, your experience is your experience, but the plural of anecdote is not data, and professionals must base their recommendations on data not anecdotes. Alison

        • Sharne says:

          I totally agree, however please don’t wreck it for those who have success with those aids despite what research says. I would encourage aids to be available for those who have had success, even if it doesn’t work for everyone.

        • John Bald says:

          So, the ophthalmologists are at odds with the British Institute of Optometry. They can’t explain the phenomenon, so they assume it can’t exist. The weakness is jntheir methods – they won’t even accept evidence of fewer working days lost to severe migraine, and it is obviously impossible to do a blind trial on a tint.. Insults won’t wash any more, There’s a ppt on my site from Prof John Stein, of Oxford, who is medically qualified. I do not, incidentally, use Irlen terminology.,

          • alison says:

            John, as you know vision is not my field but I’m sure that the people working in it are good people who are interested in finding solutions for migraine etc, and it’s not possible to do blind trials on most interventions that don’t come in pill form, but that doesn’t stop good scientific research being done, and if it ever shows that there is good evidence for approaches that currently don’t have good evidence, I’ll be interested.

  7. Susan Caves says:

    And perhaps we will politely point out that while your intentions are good and you are doing what you see as right, we reserve the right to make our own call on what helps our kids. It may be that there is a “lack of good evidence” for some controversial programs, but that does not prove there is no value at all in them for individual children. Nor does it mean that the evidence base that apparently ticks the boxes for you will not emerge at some time in the future.
    I’m sure decodable books are an invaluable tool for teaching phonics and therefore literacy to the vast majority of children, but there are some for whom it just doesn’t work. You can’t blame parents for continuing to search for something else if that is the case. If phonics or any other method of teaching literacy worked for 100% of learners, nobody would be out looking for something else.

    • alison says:

      Of course parents are not bound by the same codes of conduct as health professionals. I think we now realise that some phonics programs are too focussed on letters and not focussed enough on phonemic awareness, and that’s why so many kids learnt to sound words out but never learnt enough phonemic proficiency to build their instant word recognition.

  8. John Bald says:

    The British Institute of Optometry, and Professor Arnold Wilkins, have good evidence for the effectiveness of tinting in a wide range of conditions. See Wilkins, Visual Stress, OUP. The problem with some professionals is that they have set an impossible standard – you cannot do blind testing on a tint – and then complained that tinting fails to meet it. This is not science, but intellectual arrogance.

    • alison says:

      Well, if there is good evidence, it should be provided to RANZCO. You can’t do blind testing on a whole lot of educational things in the way one can give sugar pills to one cohort and drugs to another cohort, and nobody knows who is getting what. But that doesn’t mean you can’t do well-controlled research near the top of the evidence pyramid to ascertain effectiveness. Please refrain from including insults in your comments or I simply won’t be able to approve them

  9. Kerri says:

    I note the comments regarding Irlen Syndrome. Irlen lenses have definately helped my son at school. He did not have any vision difficulties, and does not wear glasses normally. We tested many colours and the colour that worked for him was blue. I appreciate “no evidence”, however my son went from being unable to read a paragraph and maintain comprehension to reading many pages in one sitting, unstressed. The only difference was the lenses. He was able to use the glasses at school which enabled him to complete all subjects at a greater degree than without the lenses. On the days he forgot them, there was a marked difference in his attending to lessons. We considered these lenses as another tool in out kit, to help him manage school with dyslexia. I say “give it a go” we cannot know what will work for every child.

    • alison says:

      Dear Kerri, I absolutely agree that if you as a parent know an intervention has no scientific evidence to back it up, but it seems pretty harmless, and you can afford it, and you’re not depriving your child of other interventions that do have proper evidence to back them up, then it’s up to you to decide whether to use it. However, health professionals should only promote interventions that are backed up by proper evidence.

      • John Bald says:

        Is an optometrist a health professional? The British Institute of Optometry has investigated tinting in a range of contexts, including migraine, and found important positive results. Some opthalmologists are dismissive, but usually on the grounds that tinting can’t meet an impossible test – ie a blind trial. Tinting is cheap, particularly with an overlay, and obviously not invasive. Critical examination is one thing – dismissing something because it can’t meet an impossible test is another.

        • alison says:

          Of course an optometrist is a health professional. This blog is not about migraine, or anything else that tinted lenses may have been found useful for. It’s about reading and spelling, and as RANZCO has stated, there is a dearth of evidence that tinted lenses or overlays help people with reading difficulties.

          • John Bald says:

            The evidence takes the form of case studies, which were a perfectly valid form of evidence in the days of Joseph Lister and remain so today. Work at Colchester hospital in the late eighties and early nineties found an overlap of effect between tinting and some eye exercises, and I’ve seen evidence, though not properly prevented, of improved eye co-ordination following a period of tinting. We don’t live within national boundaries, and the Institute of Optometry’s work is available internationally, as is Arnold’s Visual Stress (Oxford University Press). In Arnold’s view, there is a continuity of effect between the discomfort that some people feel, particularly under fluorescent light, migraine and photosensitive epilepsy. RANZCO’s dismissal of tinting is shared by most British opthalmologists. That does not make them right.

  10. Laura Dickinson says:

    I have to say I agree with many of the comments here regarding Irlen Syndrome and the use of tinted glasses. My son was tested for Irlens when he was six and when he put on the blue glasses he stated, “oh now I can see properly”. This was evidence enough for me that the tinted glasses helped him to see clearly when reading. I too realised that reading text on a white page was difficult for me and used a grey overlay to stop the vibration on the page. My daughter does have dyslexia and I understand that she does need an explicit phonetic approach for her literacy and she receives this but you should not simply dismiss something, especially if you have not experienced yourself.

    • alison says:

      Dear Laura, I’m not sure of your logic in saying that personal experience matters when deciding what intervention works. I am a speech pathologist, my training included a History and Philosophy of Science subject in which we were taught that subjective personal experience should NOT be used as the basis for deciding whether a treatment works or not because it is subjective and personal. Only by using objective scientific methods can we clarify whether something is really effective or not. So far, objective assessment of tinted glasses and overlays have not found them to be effective. If you decide that you disagree with this and still want to use them, or let your son use them, that’s your business, as long as there is no indication of harm being done (and harm can mean delaying or failing to provide intervention that does have objective evidence of effectiveness). What isn’t OK is health professionals recommending interventions for which there is no objective evidence of effectiveness.

      • Laura says:

        Dear Alison,

        My logic is based on my child’s needs and what helped him and also what I found helped myself. I am not saying that tinted glasses should be used as a treatment or solution for dyslexia, but rather for people who have Irlens Syndrome, as these are two different things. I agree that there does need to be evidence to support what treatments are offered by professionals. However, you cannot dismiss personal experience as evidence, as an objective scientific approach is only one way to conduct research. As I have a Doctor of Philosophy whereby my research was based on a qualitative methodology, which included data being collected based on people’s experiences. Also current research for students at university with dyslexia is predomiantly based on personal experience, allowing these students to have a voice. As researchers and advocates for people with specific learning differences, we should not ignore what people have to say about what helps them, as different approaches can work for different people.

        • Rural Psych says:

          I’m sure that because of your studies Laura, that you are well versed in research methodology. Therefore you would understand that the generalisability of qualitative methodologies is inferior to well designed quantitative methods. So the argument ‘it worked for me’ is not one that has validity at the population level.

      • Jenny says:

        Dear Alison.
        I am a bit curious -Is it possible that you are both right? Is it possible that you are right about Irlen Syndrome, but its proponents are also right about the tinted lenses helping, but that they share something else (like , maybe specific sensory processing difficulties, which would explain the fluorescent light thing for example). And that this certain something else is helped by tinted lenses ? I am not educated in this field. But can it be?

        • alison says:

          Dear Jenny, that’s a very nice, conciliatory thought, but until there is proper evidence that Irlen Syndrome exists, I think probably not, the opthamologists are the experts here.

          • John Bald says:

            We have a conflict in the UK between ophthalmologists, who reject the evidence in favour of tinting, and the British Institute of Optometry, which publishes a screening kit and uses an alternative to Irlen’s approach, produced by Cerium. My latest pupil to use a tint (purple) had it prescribed by Anglia Ruskin University, and two professors, Bruce Evans (City) and Arnold Wilkins (Essex, formerly Medical Research Council Applied Psychology Unit), have been involved in developing the approach. See also Wilkins Visual Stress (Oxford). The evidence does not fit the normal mould – you can’t do a blind trial on a tint – but is too substantial to be ignored.

  11. Jo Ouseley says:

    Do remember that at one time dyslexia was not recognised and was dismissed and thought not to exist. Just because you haven’t personally experienced something doesn’t mean nobody does. Irlens is real for some of us, we’ve experienced it for ourselves.

    • alison says:

      Yes, your beliefs are your beliefs and as an individual, you’re allowed to have them. Health professionals, however, need to base their recommendations on scientific evidence. If there is ever any proper scientific evidence for Irlen Syndrome or any of the treatments associated with it, I’m sure professionals like me will take it seriously. Right now there is no such evidence.

  12. […] problem, it’s a language-based problem. Like many others, I’ve said this before (here, here, here, here, here, and here) but the zombie idea of ‘visual dyslexia’ still seems to be […]

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