Why I don’t use the standard model of Dyslexia used in Austria
There are three main views of dyslexia that I am aware of, and they have a historical progression over time.
I’ll call them the Deficit Model, the Neurobiological Model and the Talent Model.
Surprisingly, the first of these to develop is the Talent Model. In the 1890s the first known publication of dyslexia was printed. It was written by Dr. Pringle Morgen, a British Opthalomist who worked with a boy who “despite being the brightest lad in the school” could not learn to read or write. Dr. Morgen and the boy’s schoolteachers were clearly more interested in the boy’s extraordinary intelligence, than his difficulty with reading.
As the 20th century progressed, a huge change occurred in literacy in the general population. Until relatively recently, skilled reading and writing was the domain of specialists. Even highly educated people were not universally expected to be literate with the written word. Suddenly, this changed, and reading and writing, in the developed world, became a standard skill which everyone, if they are to function in society, is expected to possess.
By the mid-20th century, a new view of dyslexia had emerged — the deficit model.
Increasingly, descriptions of dyslexia (or “word-blindness” as it was known then) focused less on the balance of talents and deficits but on the deficits by themselves. Dyslexia became discussed as a “pathology.”
For all of this time, no consensus definition of dyslexia existed until 1968 when the World Federation of Neurology created one:
“A disorder manifested by difficulty in learning to read despite conventional instruction, adequate intelligence, and socio-cultural opportunity. It is dependent upon fundamental cognitive disabilities which are frequently of constitutional origin.”
Basically — according to this definition, if you are of normal intelligence, are given normal instruction, and are socially advantaged enough to access education but you have difficulties reading and writing then you are considered dyslexic. However, they also note, in this definition that there is usually something constitutional about this, i.e. it is inborn.
Soon after this definition was published, it began to be critiqued and updated.
Twin studies were published which proved that there is a genetic component to dyslexia; the field of neuroscience began making major leaps as technologies improved. To look only at one deficit and to ignore the brain seemed increasingly problematic. In response to this, a new definition emerged — that dyslexia is a difference in the brain, which may symptomatically give rise to problems in reading and writing.
In 2002, the International Dyslexia Association, a leading organisation in regards to research into dyslexia, published this definition (emphasis mine):
“Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.”
To a modern audience this may not seem very groundbreaking, as we are used to assuming that differences in how somebody thinks or perceives has something to do with their brain, but compared to the previous definition, it is a big leap.
Although this definition is still fairly focused on deficits, looking at dyslexia as a neurobiological difference means that research into dyslexia has to search for underlying differences in perception and cognition. We didn’t evolve as greater apes reading and writing. In our brain there is no “reading area” or “writing area”. There are hand manipulation areas, there are object recognition areas, there are sound and language processing areas. Our ancestors needed these things to survive. No early hunter-gather needed to read or write, so the brain didn’t evolve to do it.
Our ability to read and write comes from the interplay of brain areas that all evolved to do something else.
The talent model is now re-emerging. Thanks to a lot of research and advocacy, more and more people are acknowledging that some of the most talented and successful people in the world are dyslexic.
A famous BBC study found that over half of the worlds self-made millionaires are dyslexic. Many of the inventions that define the modern world — the lightbulb, the CD player, the smartphone — are made by people who are known or thought to have been dyslexic.
The way I understand it, personally, is that the strengths and challenges stem from the same basic cognitive patterns. If your brain is tuned to see the big-picture at the expense of detail, then this is a cognitive pattern.
Saying you have a “detail deficit” is a strange thing to say. A trade-off has been made, but this is how the brain works. We have not evolved to be complete all-rounders. There are limited cognitive resources and the brain is constantly performing cost-benefit analysis. If you want to be a high-level footballer, you will invest cognitive resources into developing very refined lower body co-ordination. If you want to become a high-level pianist you will invest cognitive resources into very refined finger-hand control. It is extremely rare for someone to become a premier league footballer AND a virtuoso concert pianist.
This is about practice, but there are also inborn cognitive tendencies, and this is what dyslexia, and other neurodivergences, are based on.
Dyslexia in Austria Today:
In order to get diagnosed as dyslexic in Austria, you need to pay privately for a psychologist to assess you. They will usually do two things:
They will administer a standardised IQ test.
They will administer a reading and writing test.
If your IQ is above 70 but you are in the bottom 12 percentile for reading and writing, then you are considered dyslexic. That’s pretty much it…
Basically, no other cognitive differences are needed to be understood in order for a diagnosis of dyslexia to be made. In other words, psychologists in Austria are still using the 1968 definition of dyslexia which much of the world has already left behind.
In comparison, when I was assessed for dyslexia in England by a specialist, the report found that I was average for reading and writing, very good at completely non-verbal reasoning, but very poor at the cognitive skills that link language and non-verbal reasoning together.
This gap, which included things like phonological memory, procedural learning and symbol recognition (I could never play sheet-music), justified, in the English speaking framework, a diagnosis of dyslexia. In Austria, I probably would have been diagnosed with something else.
When it comes to adult dyslexia this is important — when somebody “catches up” with their reading and writing, the pure deficit view says they are “cured” of their dyslexia, but the neurobiological view doesn’t.
From a neurobiological perspective you may have been successful in compensating a weak spot, but that doesn’t really change your basic “wiring” and cognitive patterning, for better or worse. Whether you’re an adult with dyslexia, or a parent of a dyslexic child, it is usually helpful to know that there is something in how you process information which will stay with you for your whole life.
And this is a good thing! It underlies your talents.
I strongly believe that the deficit view is outdated and not very useful. It neither gives insight into the actual processes of how individuals with dyslexia tick, nor does it suggest strategies for dealing with it better (except to practice reading and writing more until you are no longer in the bottom 12 percentile). But most importantly, it ignores the enormous quantity of evidence of the advantages of dyslexia.
If you are dyslexic, you need to find that thing that makes you come alive, that put you into a state of flow, where you can thrive. This is your life-raft. And, it’s also the thing that probably tunes you into what your brain does best, and develops the talent that lies within you.
Final Note
For the scientifically minded readers who might be curious about my sources, I will point to the two major diagnostic manuals in use today for the field of mental health. One is the DSM-V (Diagnostic Statistical Manual) and the other is the ICD-10. The ICD-10 is the standard reference in Austria, whereas in the US and the UK the DSM is more dominant. The ICD-10 uses the the “IQ-Achievement discrepancy model” for dyslexia which is the fancy name for the “deficit model” I describe above. The DSM-V classifies dyslexia as a “neurodevelopment disorder,” although it groups it together with dyscalculia as one entry called “Specific Learning Difficulty” (SLD).
One major difference between the DSM-V and the ICD-10 in terms of dyslexia is that the DSM-V states that
“Any other disorder, such as Intellectual Disabilities, auditory or visual acuity problems [emphasis mine], other mental or neurological disorders or adverse conditions, such as psychosocial adversity, lack of proficiency in the language of instruction, inadequate instruction that may have plausible explanation for the difficulties being experienced by the individual must be taken into account first before confirming the diagnosis.”
Whereas the ICD-10 is, comparatively indifferent about how the “specific reading disorder” came about, so long as the symptoms are the same. This may not sound like a big deal, but it leads to a very different understanding, and therefore set of assumptions about dyslexia. In my Legasthenie Trainer Ausbildung, we talked a lot about doing the detective work — looking for things like “auditory processing disorder” or eye problems to explain the problems we might encounter with our clients. This makes sense if you take the ICD definition. From the standpoint of the DSM these things can potentially rule out a diagnosis of dyslexia.
This is my, highly unscientific, pop interpretation of these differences.
