That's the Way I Think

Dyslexia, dyspraxia, ADHD and dyscalculia explained

David Grant

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317296706
• Edition: 3
• Topic: Education
• Subtopic: Education General

About 1 in 20 individuals are dyslexic. This figure also applies for dyspraxia and ADHD. This fully revised edition of David Grant's thought-provoking, insightful book develops our understanding of these specific learning differences and considers the further challenges presented by these overlapping conditions.

This new edition includes a brand-new chapter on dyscalculia. New sections also explore updates in the study of dyslexia, dyspraxia and ADHD as well as visualisation and synaesthesia, in the light of new data and research. These updates enable the reader to gain a fuller understanding of the sensory experiences and thoughts of individuals with specific learning differences.

The author takes a life-style approach to explain many of the everyday experiences and choices of individuals with specific learning differences, including sleep, sports, visualisation and creativity, and uses real life examples explained in the words of those with specific learning differences.

The accessible style of this book will immediately strike a chord with anyone with first or second-hand experience of specific learning differences. It is invaluable and insightful reading for those with specific learning differences as well as their parents and/or partner, teachers, teaching assistants and SENCos.

Chapter 1

---

Dyslexia, dyspraxia and ADHD – the common ground

---

If someone has a history of difficulties with reading words with accuracy and with reading fluently, it may be because they are dyslexic. If there is a history of clumsiness or poor motor coordination, the diagnosis is likely to be one of dyspraxia (also known as Developmental Coordination Disorder). When there is a history of poor concentration, restlessness and impulsivity, the diagnosis may well be ADHD (Attention Deficit Hyperactivity Disorder). On the face of it, these three specific learning differences appear to be very different from each other, and this is true in terms of their core defining features. In the case of dyscalculia, the core defining feature is a lack of numerosity, i.e. an inability to understand the concept of ‘more than/less than’. However, while dyslexia, dyspraxia and ADHD all have some key characteristics in common, dyscalculia is very different. In order to understand the everyday experiences and preferences of individuals who have dyslexia, dyspraxia or ADHD, it is necessary to understand this shared commonality, for it is fundamental in influencing and shaping the lives of these individuals.

Whenever I carry out a diagnostic assessment I begin by taking a detailed life history and then administer a range of tests. These tests fall into two general categories – providing measures of educational achievement and measures of neurocognitive function. (NB: The word ‘neurocognitive’ refers to mental processes which take place in the brain, such as the ability to remember and retrieve information.) By taking an individual through psychometric tests designed to measure the four areas of verbal reasoning, visual reasoning, working memory, and processing speed, a profile of neurocognitive function can be created. In general, when a neurotypical individual (i.e. someone with no known specific learning difference) takes these tests the profile of scores is quite flat. That is, there is relatively little variation in performance across these four ability sets.

However, when dyslexia, dyspraxia or ADHD is present, an individual will, in most cases, perform noticeably better on tests of verbal and visual ability than on ones of working memory and processing speed. This commonality of neurocognitive strengths and weaknesses has wide-ranging consequences for how people with dyslexia, dyspraxia and ADHD experience the world, and it influences many choices they make, including career paths and sporting preferences.

The battery of tests used internationally by psychologists such as myself to measure these four sets of abilities is known as the WAIS-IV (Wechsler Adult Intelligence Scale, 4th edition). For assessing children below the age of sixteen an equivalent battery of tests known as the WISC (Wechsler Intelligence Scale for Children), now into its fifth edition, is used. Both consist of ten core tests, five of which measure language-based abilities (Verbal Comprehension and Working Memory) and five measure visual-based abilities (Perceptual Reasoning and Processing Speed). The ten test scores are used to calculate Index figures for the four ability sets. When the four Index figures are displayed in bar chart form, it is very easy to see whether a profile is an uneven, spiky one, as well as the degree of spikiness. The degree of an individual’s cognitive strengths and weaknesses is then clearly evident.

I have used this method to illustrate the neurocognitive profiles discussed throughout this book. The greater the spikiness, the greater the severity of the specific learning difference. However, it is important to note that dyslexia, dyspraxia and ADHD are not clear-cut categories. Each has a spectrum, and the decision as to whether a specific learning difference is present is a clinical judgement rather than a statistical one. While the degree of spikiness in an individual’s profile is helpful in deciding whether a specific learning difference is present, and, if so, the extent of severity (mild, moderate, severe), it also needs to be considered in the context of that person’s personal history and what is required of them in their academic, work or family life. It is quite possible to be successful in one form of employment or education but then struggle in a different context. This neurocognitive profile also serves as a point of comparison with performance on tests of educational abilities, such as reading, spelling, handwriting speed and maths.

Rosanna was first diagnosed as being dyslexic in primary school. As her university needed confirmation of her early diagnosis I saw her just before she became an undergraduate. Her profile (see Figure 1.1) is a characteristic dyslexic one. As expected, her word reading accuracy, spelling ability and her speed of writing are weak. In contrast, when given a creative writing exercise, the quality of her story was very good. Rosanna performed much better on tests of verbal and visual reasoning ability than on ones of working memory and processing speed. Her spiky neurocognitive profile is typical of many dyslexic individuals.

Figure 1.1 Rosanna’s profile – a typical dyslexic profile

Andre was first diagnosed as being dyspraxic when he was a business studies undergraduate. His test profile (See Figure 1.2) is a typical dyspraxic one. Unlike Rosanna, his word reading and spelling abilities are good. However, as with Rosanna, his handwriting speed is quite slow. Andre’s neurocognitive profile is similar in that it also reveals a weak working memory and a slow processing speed. However, as is typical of many dyspraxics, he performed better on tests of verbal than visual reasoning. For example, an individual who is dyspraxic may have an excellent understanding of vocabulary but have difficulty mentally rotating shapes.

Figure 1.2 Andre’s profile – a typical dyspraxic profile

Leon was an MBA student I diagnosed as having ADHD. As would be anticipated for an MBA student, his test scores for verbal and visual reasoning are very high. However, like Rosanna and Andre, he also performed noticeably less well on tests of working memory and processing speed. Once again, his speed of writing is below expectation.

The double deficit that is such a distinctive feature of the neurocognitive profiles of Rosanna, Andre and Leon is frequently found in cases of dyslexia, dyspraxia and ADHD, irrespective of the intellectual ability, gender, ethnicity or age of the individual. However, it is not inevitably present, and there are variations on it. As a generalisation, an uneven, spiky profile is highly indicative of the presence of a specific learning difference whereas a fairly flat profile would suggest there is no specific learning difference. This is because the tests have been designed so that neurotypical individuals with no specific learning difference who score x on one test are likely to score x, or very close to x, on all the other tests.

Figure 1.3 Leon’s profile – a typical ADHD profile

One way of understanding these four sets of neurocognitive functions is to think of your brain as being like a computer. It is as if verbal reasoning is your word processing package (this includes the dictionary and thesaurus), working memory is RAM (Random Access Memory), perceptual reasoning is the graphics card, and processing speed is the processing chip – how fast you can transmit information from eye to hand and how quickly you can visually scan and process information. In the cases of Rosanna, Andre and Leon, they are all capable of arriving at good answers, but it will take them longer and there is always a danger of their memory overloading and then needing to reboot. These twin deficits of working memory and processing speed are responsible for many of the everyday experiences of individuals who are dyslexic, dyspraxic or have ADHD in that they influence and shape their lives in many significant ways.

Provided a neurocognitive profile is reasonably flat, it is legitimate to use the test scores to calculate what is known as a Full Scale IQ. However, when the profile is spiky it is irresponsible to do so, for the figure that is calculated masks the strengths of that individual as well as their weaknesses. For example, Rosanna’s performance on the tests of verbal and visual reasoning places her within the ‘high average’ banding, while her working memory score puts her in the ‘low average’ band. If this advice is disregarded and a Full Scale IQ calculated when spikiness is present, the resulting overall figure would put Rosanna within the average band. This is misleading and very unhelpful. Her scores on verbal and visual reasoning are the best indicators of her intellectual abilities, and her scores for working memory and processing speed are better seen as being mental scaffolding for these intellectual abilities. When this mental scaffolding is not as strong as it should be, it results in frustration and under-performance unless appropriate supportive adjustments are put in place.

Working memory

Working memory refers to the capacity to remember verbal information for a short period of time. It is like a voice in your mind. It used to be called short-term memory but the term ‘working memory’ is now preferred as it better captures how the voice in your head works. It is an active rather than a passive process. But it is of limited capacity. For example, if I were to ask how many letters there are in the word forest, this would require thinking about how the word is spelt and then counting the letters. Provided their spelling is not bad, this is a task many people could undertake without undue difficulty. Now imagine being asked how many letters there are in the word hippopotamus. This is a much more challenging task even if you can spell hippopotamus without difficulty, for the voice in your head has to work within a limited capacity.

One component of working memory is known as the phonological loop. This is rather like a loop of tape that mentally repeats what you have just said or thought. For example, when counting how many letters there are in hippopotamus, you might start by thinking hippo has five letters. This thought is placed onto your phonological loop to keep it on repeat in the background while you go on to focus on the next part of the word, pot. This has three letters, which need to be added to the previous five letters, the number you have been repeating to yourself. You then need to move to the last letters while keeping the number eight fresh in memory. This exercise is a relatively simple multi-tasking one and yet it is quite challenging. It requires much more working memory capacity than when counting how many letters there are in the word forest. Some individuals can bypass this memory limitation by being able to mentally ‘see’ the word. However, most people do not have this option.

For many individuals with a specific learning difference there is a mismatch between verbal reasoning skills and working memory, in that their working memory capacity is proportionally much smaller than it should be. This results in a number of difficulties, including multi-tasking. For example, when making notes in a lecture or taking minutes in a meeting, you have to be able to remember what has just been said, decide whether it is important enough to write down, and write it down at the same time. On top of this, if you are dyslexic and have to think how a particular word is spelt, making notes becomes even more difficult. This is captured in Illustration 1.1 below in which Hannah depicts her feeling of being overwhelmed with information in a lecture. Irrespective of whether it is dyslexia, dyspraxia or ADHD that is present, many people report having considerable difficulties with taking notes in lectures or meetings. Consequently, they either make notes without being able to follow what is being said or stop making notes and listen.

A limited working memory capacity also impacts on the writing of essays and reports. Many of the individuals I see recall being told by teachers that their essays contain excellent ideas, but the organisation is weak. Writing an essay is a form of story-telling, with a distinct beginning, middle and end. It requires many skills. You have to remember what you have read or viewed; decide what to include and what to leave out; remember who said what, and when, and where; you have to organise your ideas. All of these aspects require conscious thought and an ability to hold them in working memory. You also have to think about punctuation, spelling and your choice of words when writing, which also require working memory. While writing, you have to remember what you have already written (so as to avoid repetition) and, at the same time, think about what you still need to include. It is not surprising that when there is a shortage of working memory capacity the flow of written ideas becomes like a stream of consciousness, as the high level of multi-tasking required becomes impossible. Thoughts are written down as they occur and extensive editing is then required. Editing also requires working memory as a judgement has to be made about which ideas are more important than others, and this can only be done by considering those ideas simultaneously. It is therefore not surprising that the handwriting speed of individuals with specific learning differences is slower than that of their peers. The more working memory capacity there is, the greater the ability to multitask.

Illustration 1.1

Reading is another process that requires multi-tasking. You need to be able to read words and understand their meaning; take note of punctuation and grammar; remember what you have just read; you need to decide what is important. If you stop to think about an unfamiliar word, this switch of focus can easily take up so much working memory capacity that the details of what you have just read are lost. Even if reading skills are good, it is very easy for working memory capacity to become overloaded when reading for information. This feeling of being overwhelmed by information when reading is a very typical one (see Illustration 1.2). Reading for academic purposes is very different from reading for pleasure. When engaged in recreational reading you can flow with the story, but when reading an academic text every word is important.

Working memory is a complex phenomenon. Although the capacity appears to be fixed this will vary with stress, when it seems to shrink, and automaticity, which results in an enhancement. Many activities, such as learning to drive, play a musical instrument, learn a...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Preface
• Acknowledgements
• Introduction
• 1 Dyslexia, dyspraxia and ADHD – the common ground
• 2 What is dyslexia?
• 3 What is dyspraxia?
• 4 What is ADHD?
• 5 What is dyscalculia?
• 6 Visualisation and synaesthesia
• 7 Colours and reading
• 8 Being creative – or becoming creative?
• 9 Sports and genes
• 10 Invisible girls, invisible women
• 11 Sleep
• 12 Neurodiversity and concluding remarks