The term dyslexia was introduced in 1884 by the German ophthalmologist, Rudolf Berlin, in “Over dyslexie.” He coined it from the Greek words dys meaning ill or difficult and lexis meaning word, and detailed his observations of six patients with brain lesions who had full command over verbal communications but had lost the ability to read.
Berlin himself had been influenced by the writings of another German, Adolph Kussmaul, a Professor of Medicine at Strassburg. Kussmaul noticed that several of his stroke patients could not read properly and regularly used words in the wrong order. He introduced the term word blindness to describe their difficulties. This condition became known as acquired dyslexia.
From Kerr and Morgan to Orton
Developmental dyslexia, on the other hand, refers to the failure to learn to read competently. Recognition of developmental dyslexia is credited to James Kerr and Pringle Morgan. In an article to The Lancet titled “A case of congenital word blindness,” Morgan (1896) identiﬁed a 14-year-old boy called Percy, who despite adequate intelligence was unable to even write his name correctly. Morgan described the boy as “bright and of average intelligence in conversation. His eyes are normal, there is no hemianopsia, and his eyesight is good. The schoolmaster who has taught him for some years says that he would be the smartest lad in the school if the instruction were entirely oral” (p. 1378).
Research into acquired and congenital word-blindness developed both in Britain by James Hinshelwood, an optic surgeon from Glasgow, and in the USA by Samuel Torrey Orton, a neurologist and neuropathologist. Hinshelwood (1917), expanding on the work of Berlin and Morgan, attempted to identify both conditions and concluded that while acquired word-blindness is a neurological condition owing to brain injury, congenital word-blindness is hereditary, but remediable and more common in boys. Hinshelwood attributed congenital word-blindness to a lesion in the left angular gyrus, which impaired the ability to store and remember visual memories for letters and words.
Orton, on the other hand, advocated the term strephosymbolia (twisted symbols) to indicate that the problem was not one of word-blindness per se, but that visual impressions were ‘distorted’ in the perceptual processing of letters and words.
In 1919, Orton was hired as the founding director of the State Psychopathic Hospital in Iowa City, Iowa, and chairman of the Department of Psychiatry at the University of Iowa College of Medicine. In 1925, he set up a 2-week mobile clinic in Greene County, Iowa to evaluate students referred by teachers because they “were retarded or failing in their school work.” Orton found that 14 of the students who were referred primarily because they had great difficulty in learning to read, in fact had near-average, average, or above-average IQ scores. Hinshelwood had also noted that many of his cases of congenital word-blindness were intelligent, but with the advent of IQ tests Orton was able to lend a certain degree of objectivity to this notion, and whereas Hinshelwood had bristled at the notion that one per thousand students in elementary schools might have “word-blindness,” Orton offered that “somewhat over 10 percent of the total school population” had reading disabilities (Orton 1925 & 1939, as cited by Hallahan & Mercer, 2002).
Working from 1925 onwards, Orton studied over 1,000 children. His observations persuaded him that children with dyslexia were especially prone to left-right confusions and reversals, such as mistaking b for d or was for saw. Orton concluded that dyslexia was due to a failure to establish a left-right sense, which was in turn caused by incomplete cerebral dominance. Together with his assistant, Anna Gillingham, he developed a number of teaching strategies, some of which are still in use. Orton’s work inspired many, including the neurologist Norman Geschwind, and led to the foundation of the Orton Dyslexia Society, now the International Dyslexia Association. As a result of Orton’s research, dyslexia passed from the medical to educational ownership. This led to it being ‘treated’ by educational development rather than medical intervention (Macdonald, 2010).
Strauss and Werner
At the beginning of the 20th century the number of children who were diagnosed with congenital word-blindness or developmental dyslexia was small. Because their cognitive and educational features did not correspond to any of the recognized categories of handicap, they were disenfranchised from any formal special education services. This situation was to change dramatically during and after the 1960s, following research in the 1930s and 40s on brain-injured adolescents by two eminent Jewish scholars.
In the midst of the developing holocaust, Alfred A. Strauss and Heinz Werner began making their way to the United States via separate routes. They came together in 1937 at the Wayne County Training in Northville, and began a collaboration which laid the cornerstone for what today is known as the field of learning disabilities.
Strauss and Werner observed that the intellectually disabled adolescents in their care manifested the same perceptual, mood and learning disorders that Kurt Goldstein had found in head-injured soldiers. Following World War 1, Goldstein studied a large number of brain-injured soldiers intensively and for long periods of time. These studies led to entirely novel conceptions of problems such as aphasia, agnosia, and tonus disturbances, and to systematic descriptions of behavioral changes wrought by brain injury. Goldstein also devised rehabilitation programs aimed at returning brain-injured soldiers to some level of productivity.
Based on the intellectually disabled adolescents’ symptoms, Strauss and Werner divided their students in two groups: the endogenous type consisted of students who had a family history of mental deficiency, and the exogenous type had no family history of mental deficiency. According to Strauss and Werner, their intellectual disability was caused by brain injury — before, during or after birth. In comparing endogenous and exogenous adolescents on perceptual and cognitive tasks, they found the endogenous group to be more successful than the brain-injured adolescents regarding these abilities. The endogenous group had no behavioral problems, while the brain-injured group engaged in — what they described as — disturbed, unrestrained and volatile behavior (Franklin, 1987). Kavale and Forness (1985) reanalyzed Strauss and Werner’s original studies on brain-injured children. They concluded that the performance differences reported between the two groups of children — the endogenous and exogenous — were in fact too small to justify the distinction which Strauss and Werner had made.
Strauss and coworkers Kephart and Lehtinen extended Goldstein’s study of head-injured adults and Strauss and Werner’s study of brain-injured adolescents to children. These studies included “children with known brain-damage, such as cerebral palsy,” but also “samples of children who evidenced learning and behavior problems but did not show clinical signs of brain damage” (Kaufman, 2008, p. 3). Strauss and his new coworkers argued that the kind of perceptual-motor and cognitive problems and behavior problems, that Strauss and Werner had found among the exogenous group, were not only to be found in mentally defective children. These problems were also found in children of normal intelligence. They concluded that children of normal intelligence, who exhibited these learning and behavior problems, were also brain damaged, giving rise to the terms “minor brain damage” and “minimal brain injury” (Franklin, 1987). While this line of reasoning comprises an invalid argument — if A then B; B; therefore A — this moved the field forward in a dramatic way. The term “brain damage” was, however, mitigated to a less deleterious one, namely minimal brain dysfunction, and dyslexia together with at least one hundred childhood problems such as strabismus and “sleeping abnormally light or deep,” were included in this all-compassing term (Clements, 1966) — a term no longer in use.
Lehtinen’s early work suggested that remediation of the perceptual disorders was feasible, and was followed by a plethora of visual-perceptual-motor training programs to rectify children’s minimal brain dysfunctions. Names like Frostig, Ayres, Getman, Kephart, and Barsch, associated with different methodologies on the same theme, dominated the 1960s. However, subsequent systematic reviews of 81 research studies, encompassing more than 500 different statistical comparisons, concluded that “none of the treatments was particularly effective in stimulating cognitive, linguistic, academic, or school readiness abilities and that there was a serious question as to whether the training activities even have value for enhancing visual perception and/or motor skills in children indicated” (Hammill & Bartel, 1978, as cited by Kaufman, 2008, p. 3).
In 1963 Samuel Kirk coined the term learning disabilities (LD) to describe children who have disorders in development of language, speech, reading, and associated communication skills, and introduced it to a large group of parents in Chicago, Illinois. They enthusiastically accepted the term and shortly thereafter established the Association for Children with Learning Disabilities.
Advocacy groups, in the rush to generate public awareness of the condition of dyslexia, with the cooperation of a compliant media, have perpetuated the belief that a host of famous individuals such as Albert Einstein, Leonardo da Vinci, Thomas Edison, Walt Disney, and Hans Christian Anderson were dyslexic. The folk myth — the “affliction of the geniuses” — continues to be spread despite the fact that knowledge of the definition of dyslexia and the reading of any standard biographies would immediately reveal the inaccuracy of many such claims (Stanovich, 1989). For example, as Coles (1987) points out, Einstein’s reading of Kant and Darwin at age thirteen is hardly representative of individuals who are currently labeled dyslexic. A systematic study of Hans Christian Andersen’s diaries, letters and poems from age 20 to age 70 concluded that “in all probability, the notion that Andersen had dyslexia is a myth” (Kihl et al. , 2000). But so, with the backing of parent movements and advocacy groups, the LD enterprise became “an enormous machine — indeed a factory — with attending cottage industries, fueled by legal, socio-political, educational, and entrepreneurial energy” (Moats & Lyon, 1993, p. 283).
Education for All Handicapped Children Act
With the passage of the Education for All Handicapped Children Act (EACHA) in 1975, learning disabilities was officially recognized by the United States Department of Education. Public schools were required to identify students with learning disabilities and provide them with special education services. The federal government mandated the need for a substantial discrepancy between a child’s achievement level and his or her potential for achievement, leaving it for each state to decide how to determine whether a student had a severe discrepancy. However, because students are not yet old enough to obtain meaningful and reliable reading and math scores until third and fourth grade, it is difficult to find a discrepancy. This situation has resulted in the IQ-achievement approach being labeled a “wait-to-fail” model (Hallahan, Kauffman, & Pullen, 2015). In its place, policy makers have proposed what is referred to as a response to intervention (RTI) approach.
Variations exist, but RTI usually consists of three tiers of instruction. Tier 1 is typical instruction (with the important provision that it be evidence-based) delivered in the general education classroom. Students not doing well in Tier 1 are provided more intensive instruction in small groups several times a week (Tier 2). Those who are still struggling following Tier 2 interventions are referred for special education evaluation, with special education being Tier 3.
The term word blindness is now obsolete. This is also true of such less known and infrequently used terms as word amblyopia, thypholexia, amnesia visualis verbalis, analfabetia partialis, bradylexia, script-blindness, psychic blindness, symbolia confusion, primary reading retardation and developmental reading backwardness. Even the term coined by Orton, strephosymbolia, never caught on, despite the popularity of his theory (Gjessing & Karlsen, 1989). Most of these terms have now been discarded in favor of the terms dyslexia, reading disability and learning disability, with learning disabilities (LD) as the umbrella term for a variety of learning difficulties, including dyslexia. Dyslexia is categorized as a “specific learning disorder” in the DSM-5, published in 2013 (American Psychiatric Association).
Video: Dyslexia case study
Meet Susan, Vivienne’s mom. Vivienne was adopted from China at age 5. This video is about Susan helping her 11-year-old daughter catch up on development delays, including dyslexia. They started with the Edublox program 13 weeks ago. Click here to follow their journey to learning success.
References and sources:
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
Armstrong, T. (1987). In their own way: Discovering and encouraging your child’s personal learning style. Los Angeles: Jeremy P. Tarcher, Inc.
Clements, S. D. (1966). Minimal brain dysfunction in children; terminology and identification. Phase one of a three-phase project. U.S. Department of Health, Education and Welfare. Retrieved August 10, 2019 from https://files.eric.ed.gov/fulltext/ED022289.pdf
Coles, G. S. (1987). The learning mystique. New York: Pantheon Books.
Corballis, M. C., & Beale, I. L. (1993). Orton revisited: Dyslexia, laterality and left-right confusion. In D. M. Willows, R. S. Kruk & E. Corcos (Eds.), Visual processes in reading and reading disabilities (pp. 57-74). New York: Routledge.
Cruickshank, W. M., & Hallahan, D. P. (1973). Alfred A. Strauss: Pioneer in Learning Disabilities. Exceptional Children, 39(4), 321-327.
Franklin, B. M. (1987). From brain injury to learning disability: Alfred Strauss, Heinz Werner and the historical development of the learning disabilities field. In B. M. Franklin (Ed.), Learning disability: Dissenting essays (pp. 29-46). Philadelphia: The Falmer Press.
Gjessing, H. J., & Karlsen, B. (1989). A longitudinal study of dyslexia: Bergen’s multivariate study of children’s learning disabilities. New York: Springer-Verlag.
Hallahan, D. P., Kauffman, J. M., & Pullen, P. C. (2015). Exceptional learners: Introduction to special education (13th ed.). Upper Saddle River, NJ: Pearson.
Hallahan, D. P., & Mercer, C. D. (2002). Learning disabilities: Historical perspectives. In R. Bradley, L. Danielson, & D. P. Hallahan (Eds.). The LEA series on special education and disability. Identification of learning disabilities: Research to practice (pp. 1-67). Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers.
Hammill, D. D., & Bartel, N. R. (1978). Teaching children with learning and behavior problems (2nd ed.). Boston: Houghton-Mifflin.
Hinshelwood, J. (1917). Congenital word-blindness. London: Lewis.
Kaufman, A. S. (2008). Neuropsychology and specific learning disabilities: Lessons from the past as a guide to present controversies and future clinical practice. In E. Fletcher-Janzen, & C. R. Reynolds (Eds.), Neuropsychological perspectives on learning disabilities in the era of RTI: Recommendations for diagnosis and intervention (pp. 1-13). Hoboken, NJ: John Wiley & Sons.
Kavale, K. A., & Forness, S. R. (1985). The historical foundation of learning disabilities: A quantitative synthesis assessing the validity of Strauss and Werner’s exogenous versus endogenous distinction of mental retardation. Remedial and Special Education, 65, 18-24.
Kihl, P., Gregersen, K., & Sterum, N. (2000). Hans Christian Andersen’s spelling and syntax. Allegations of specific dyslexia are unfounded. Journal of Learning Disabilities, 33(6), 506-519.
Macdonald, S. J. (2009). Towards a sociology of dyslexia. Exploring links between dyslexia, disability and social class. Germany: VDM Verlag Dr. Müller
Mather, N., & Wendling, B. J. (2012). Essentials of dyslexia assessment and intervention. Hoboken, NJ: Wiley.
Moats, L. C., & Lyon, G. R. (1993). Learning disabilities in the United States: Advocacy, science, and the future of the field. Journal of Learning Disabilities, 26(5), 282-294.
Morgan, W. P. (1896). A case of congenital word blindness. The Lancet, 2(1871), 1378.
Nicolson, R. I., & Fawcett, A. J. (2008). Dyslexia, learning, and the brain. London: The MIT Press.
Opp, G. (1994). Historical roots of the field of learning disabilities: Some nineteenth-century German contributions. Journal of Learning Disabilities, 27, 10-19.
Selikowitz, M. (2012). Dyslexia and other learning difficulties. Oxford: Oxford University Press.
Stanovich, K. E. (1989). Learning disabilities in broader context. Journal of Learning Disabilities, 22(5), 287-297.
Tønnessen, F. E. (2015). Can we read letters? Rotterdam: Sense Publishers.