The Dyslexia Dilemma - Redefined

The term dyslexia was coined in 1887 by a German ophthalmologist, Rudolph Berlin. But there exists no standard for diagnosis. The DSM IV defined “Reading Disorder” broadly as “Reading achievement,… substantially below that expected given the person’s chronological age, measured intelligence, and age-appropriate education.” (DSM IV – 315.00)

An early draft of the forthcoming DSM V filled this gap with a simple definition. The term “Dyslexia” was added to be “consistent with international use”. (A 13 Proposed Revision Rationale).

The condition was described broadly as “Difficulties in accuracy or fluency of reading that are not consistent with the person’s chronological age, educational opportunities, or intellectual abilities.”

However, the APA has now retreated from this position, eliminating the term dyslexia from their recommendation entirely: “Learning Disorder has been changed to Specific Learning Disorder, and the previous types of Learning Disorders (Dyslexia, Dyscalculia, and Disorder of Written Expression) are no longer being recommended.”  (See Neurodevelopmental Disorders.)

The text of the newly defined  Specific Learning Disorder will exclude thousands from consideration or diagnosis, by interposing a diagnostic requirement: that “current skill level” be “well-below the average range.”

This means that higher functioning dyslexics will never have the benefit of a diagnosis. As happened with my own son, they will be deemed to be “lazy” despite the hours they put in to attain barely-average functional skill levels.

Those whose skill level is sufficiently depressed to qualify will lose their diagnosis at the moment any form of intervention is successful. It won’t matter how hard they struggle to get there; the moment their reading scores begin to approach “average” their diagnosis will evaporate. It is likely that whatever support or accommodations have enabled their improved skills will also be withdrawn as well.

This is a political determination, not a scientific one — very much at odds with a growing body of brain research showing that dyslexia is neurologically-based.

The APA will allow comments on the new proposal until June 15, 2012.  Anybody can register at the APA web site at www.dsm5.org and post.   

If you are not happy with the proposal, I urge you to take the time in the next few days to do so.