Wednesday, September 28, 2011

Dyslexia Research Trust - Vision & Coloured Filters

Recent research by the DRT and others has suggested that magnocellular (M) neurones in the brain play a crucial role in reading and that M- deficits contribute powerfully to reading problems because the M system is so crucial for directing visual and auditory attention and eye movements to letter and word features and sounds during reading.

These nerve cells are called magnocells because of their noticeably large size; this equips them for rapid signalling, timing events and tracking changes. Anatomical, electrophysiological, psychophysical and brain imaging studies all concur that these nerve cells develop slightly abnormally in dyslexic brains.

The main aim of DRT research into visual and auditory weaknesses in poor readers is to develop treatments that will help them and prove by randomised controlled trials that they work.

Simple treatments such as blue or yellow coloured filters or musical training3 really can help dyslexics to learn to read.

Then we aim to persuade Policy makers to make them available to all those with reading problems. If we can do these things we should be able to save thousands of children from the loss of self confidence, shame and misery that reading failure so often brings in its train.

Reading is actually very difficult, the most difficult skill that most people are expected to acquire. You need to be able to identify each of a line of small visual symbols where tiny details make all the difference (eg b,d,q,p), then put them in the right order, then translate them into their sounds, and only then can you decide what the word means.

At the same time you have to build up a background knowledge of how words can be split down into their individual letter sounds (phonology). To make matters worse English is littered with exceptions to the letter-sound rules.

Compare bough, dough, lough, cough, enough! After all that effort on reading each word many children can't remember the words they read at the beginning of the sentence to understand the whole thing.

So it is really amazing that 2/3rds of children of all levels of intelligence actually do learn to read so fluently, and perhaps it is not so surprising that 1/3rd of children leave school unable to read properly. But this is not only an appalling waste which costs the country £2 billion per year in terms of additional teaching, truancy, school exclusion, unemployment, drug addiction and crime, but it is a most potent cause of misery.

The children lose all self-confidence and hope. Because literacy is so important in the modern world, they can only look forward to a life of depression and failure. Or their anger and frustration may lead them into aggression and crime. Yet if they survive their schooling, many dyslexics can become remarkably successful.

Prof John Stein, a medical tutor at Magdalen College Oxford, was introduced to children's reading problems by a very wise orthoptist, Sue Fowler.

He found that, like patients with cerebellar damage whom he'd been researching for many years, many could not hold their eyes steady, so that letters seemed to wobble, move around and cross over each other.

These wobbles represent a mild form of oscillopsia that is often seen in cerebellar patients. You can't visually identify letters and their order if they're moving around all the time (try reading when very drunk!).

In cerebellar patients he had shown that their unstable vision was due to damage to large nerve cells in the brain, known as visual magnocells, that are specialised for detecting movement.

When these magnocells are not working properly the servo system that keeps your eyes fixed on a letter fails, and so the letters appear to move around.

So with Sue he set up a clinic to investigate whether children's visual reading problems were due to the same cause. Sue & John were able to show that many dyslexics do indeed have impaired development of these magnocells (though not as seriously as in cerebellar disease), because the cells move into the wrong positions and make the wrong connections during the early development of the brain7; this explains why many dyslexics' vision is so unstable.

They found that in everybody the quality of their visual magnocellular function plays a very important role in how well they can acquire the visual skills required for reading.

Even though letters don't move, the eyes do; so a person's sensitivity to moving visual stimuli predicts his skill at identifying the visual order of letters and the visual form of words, their 'orthography'.

Coloured Filters
Olive Meares in Australia was the first to suggest that children with visual reading difficulties can see print more easily through certain coloured filters.

This was taken up commercially in the USA and UK but these systems require that each child is individually prescribed a special colour; so the glasses tend to cost a lot!

However since the visual magnocellular system is mainly influenced by just yellow and blue light, we argued that only these two colours should really make much difference.

Skiers in a 'whiteout' know that yellow goggles can make things look brighter and more contrasty. This is because yellow enhances their visual magnocellular input.

Thus we've recently confirmed in a small double blind, randomised control, trial that in suitable children simple and cheap deep yellow filters can help them to improve their reading very significantly.

We need to carry out a much larger trial however, to convince the sceptics. Blue filters can be even more effective.

They probably work in a different way; by helping to synchronise the body's internal clock according to changing day length in order to increase magnocellular activity during the day and decrease it at night.

In addition by improving body diurnal rhythms, blue filters can often not only help greatly with reading, but they can also help children's sleep patterns, mood and even their migraine headaches.

About half of all the children with reading problems that we see can be helped simply by wearing either yellow or blue filters. 

To read the full article on Vision & Coloured Filters visit Dyslexia Research Trust

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