Did you know that around 5-10% of the population have dyslexia or dyspraxia. That basically means around 1 in every 10-20 people you pass when you are out in town shopping! That’s a lot of people. It is not an uncommon disorder. If you keep failing your AKT, or other exams, it is worth checking whether or not you have dyslexia, dyspraxia, or both. If dyslexia is confirmed through a professional assessment, the RCGP may award you extra time (like 40-45 minutes) in the AKT. Don’t think for a second that doctors cannot possibly have dyslexia – people with dyslexia can be high achievers – the research shows that dyslexics often have greater intelligence scores than non-dyslexics. You have to remember that dyslexia and dyspraxia only means that you have a different way of organising things in your head – which is about learning and not actual intelligence. As we see with the research, intelligence is higher.
FAQs – FREQUENTLY ASKED QUESTIONS
Many people with specific learning difficulties have in common a history of frustration and failure, especially in school.
Dyslexia means a problem with language. 10% of the population are dyslexic – it is not uncommon. 6% are mildly affected and 4% more severely so.
It is important to understand that when a dyslexic person *sees* letters or words reversed or mixed up, there is usually nothing wrong with her eyes. The problem is in the way the mind interprets what the eyes see — like an optical illusion, except this mismatch between what illusion and reality happens with ordinary print on a page.
There is no single pattern of difficulty that affects all dyslexic people. A dyslexic person might have any of the following problems:
- They might see some letters as backwards or upside down;
- They might see text appearing to jump around on a page;
- They might not be able to tell the difference between letters that look similar in shape such as o and e and c ;
- They might not be able to tell the difference between letters that have similar shape but different orientation, such as b and p and d and q ;
- The letters might look all jumbled up and out of order;
- The letters and words might look all bunched together;
- The letters of some words might appear completely backwards, such as the word bird looking like drib ;
- The letters and words might look o.k., but the dyslexic person might get a severe headache or feel sick to her stomach every time he/she tries to read;
- They might see the letters o.k., but not be able to sound out words — that is, not be able to connect the letters to the sounds they make and understand them;
- They might be able to connect the letters and sound out words, but not recognize words she has seen before, no matter how many times she has seen them — each time she would have to start fresh;
- They might be able to read the words o.k. but not be able to make sense of or remember what she reads, so that she finds herself coming back to read the same passage over and over again.
- Has extended hearing; hears things not said or apparent to others; easily distracted by sounds.
- Difficulty putting thoughts into words; speaks in halting phrases; leaves sentences incomplete; stutters under stress; mispronounces long words, or transposes phrases, words, and syllables when speaking
- Excellent long-term memory for experiences, locations, and faces.
- Poor memory for sequences, facts and information that has not been experienced.
- Thinks primarily with images and feeling, not sounds or words (little internal dialogue).
- Mixes up between left and right.
- Disorderly or compulsively orderly.
- Can be class clown, trouble-maker, or too quiet.
- Strong sense of justice; emotionally sensitive; strives for perfection.
- Mistakes and symptoms increase dramatically with confusion, time pressure, emotional stress, or poor health.
Dyslexia is sometimes referred to as ‘word blindness’. I’ve spotted it in a couple of my trainees because of a combination of
- a lack of structure to the consultation – and their consultation write up was often unstructured too.
- numerous spelling errors in their consultation write up – especially where letters are incorrectly transposed. There is something called spooning which can be a marker of dyslexia – this is where the first letter of two words is transposed – so, car park is written par cark. Asking a dyslexic person to vocalise a word back words can also be a good marker. Most of us, for instance, can easily work out that LONDON backwards is NODNOL, and we can vocalise it – but dyslexic persons will find this difficult.
- problems with pronunciation (which I initially thought was someone who just had mummbly speech and needed to slow down and put momentary pauses between words so that they came across more clearly – which surprisingly worked!).
- problems with executing verbal instruction. I actually asked both trainees what went on in their minds after the instruction was given as an attempt to ‘look in’ and explore. What they interpreted was different than what was said or read.
- misinterpreting or missing vital information in written instruction
The most important things for me as an educator is to slow down, stop, reflect and explore when you sense something else might be going on for the trainee. Try and get inside their brain – explore what goes on for them. Stay with the experiential difficulty that you have noticed. Explore that difficulty from start to end. Try and work out how the trainee’s processing and organisational strategies.
I repeat – many people with specific learning difficulties have in common a history of frustration and failure, especially in school.
Dyspraxia mean a problem with doing. It is an inability to EITHER conceptualise, organise or execute a sequence of unfamiliar actions. It is sometimes referred to as Developmental Co-ordination Disorder. 5-10% of the population have dyslpraxia. People who have dyspraxia often find the routine tasks of daily life such as driving, household chores, cooking and grooming difficult. They can also find coping at work is hard. People with dyspraxia usually have a combination of problems, including:
GROSS MOTOR (large movements)
- Balance prblems. Difficulty in riding a bicycle, going up and down hills
- Hand-eye co-ordination problems. Difficulty with team sports especially those which involve catching a ball and batting. Difficulties with driving a car
- Lack of rhythm when dancing, doing aerobics
- Exaggerated ‘accessory movements’ such as flapping arms when running
- Tendency to fall, trip, bump into things and people
FINE MOTOR (small movements)
Lack of manual dexterity – using cutlery, cleaning, cooking, ironing, craft work, playing musical instruments
Problem with manipulative skills: typing, handwriting and drawing. May have a poor pen grip, press too hard when writing and have difficulty when writing along a line, putting on makeup, shaving, doing hair, fastening clothes and tying shoelaces
- May talk continuously and repeat themselves. Some people with dyspraxia have difficulty with organising the content and sequence of their language
- May have unclear speech and be unable to pronounce some words
- Speech may have uncontrolled pitch, volume and rate
PERCEPTION (interpretation of the different senses):
- Lack of awareness of body position in space and spatial relationships. Can result in bumping into and tripping over things and people, dropping and spilling things
- Little sense of time, speed, distance or weight. Leading to difficulties driving, cooking
- Inadequate sense of direction. Difficulty distinguishing right from left means map reading skills are difficult.
- Difficulty in planning and organising thought
- Short-term memory can be difficult. May forget and lose things.
- Unfocused and erratic. Can be messy and cluttered
- Poor sequencing causes problems with maths, reading and spelling and writing reports at work
- Accuracy problems. Difficulty with copying sounds, writing, movements, proofreading
- Difficulty in following instructions, especially more than one at a time
- Difficulty with concentration. May be easily distracted
- May do only one thing at a time properly, though may try to do many things at once
- Slow to finish a task. May daydream and wander about aimlessly
- Difficulty in listening to people, especially in large groups. Can be tactless, interrupt frequently. Problems with team work.
- Difficulty in picking up non-verbal signals or in judging tone or pitch of voice in themselves and or others. Tendency to take things literally. May listen but not understand
- Slow to adapt to new or unpredictable situations. Sometimes avoids them altogether
- Impulsive. Tendency to be easily frustrated, wanting immediate gratification
- Tendency to be erratic ñ have ‘good and bad days’
- Tendency to opt out of things that are too difficult
- Emotions as a result of difficulties experienced:
- Tend to get stressed, depressed and anxious easily
- May have difficulty sleeping
There are a number of websites offering online Dyslexia assessment tools. What you have to remember is that these are ‘rough and ready’ screening tools. They may help you determine your probability, but they should not be used as a replacement for making contact with a professional who is qualified at doing Dyslexia assessments. To keep things simple – if you feel that you have some of the signs and symptoms as listed by www.bdadyslexia.org.uk, then seek the advice of a professional assessor.
- This ‘rough and ready’ dyslexia screening tool costs around £30: www.spot-your-potential.com
- This one for dyspraxia is free: www.dore.co.uk/learning-difficulties/dyspraxia/free-dyspraxia-test
- There is a quick test available from the University of Leeds. Click here to access it.
Here are a number of things worth exploring. This is just a list of stuff. Remember, all dyslexic/dyspraxic persons are individuals and therefore different. Not everything in this list will be relevant or will help you. The professional person who assessed you should be able to help you determine which of these will help amongst other things. You should have had a fairly long consultation at which the diagnosis was made… (roughly 2-3h from someone like Dyslexia Action). This consultation is meant to be both diagnostic and therapeutic – helping you, the trainee, to look at ways to work with the dyslexia which has been identified. You should be able to come back with ideas on what needs to change and how your working organisation can help you. The employer has a duty to make reasonable adjustments to the workplace to fit in with the disability which has been identified… details of this will be in the professional report. There may be no need to make adjustments… but to GP educators, I’d advise a record of having discussed if there are any and if so what to do about them. For the GP training scheme – if there are various further rotations to move on to then future employers should be told in advance so that arrangements can be made as easily as possible (the trainee is also advised to inform their next work post).
Help with READING
- Do a Google search on “text to speech software”
- A copy of : ACE Spelling Dictionary by David Moseley – It’s a brilliant book which has helped loads of people with learning difficulties. You can buy it here and is quite a short book.
- A reading pen: www.readingpen.co.uk
- And finally, try and get a small notebook (like the ones Police Officers use) and produce a list of commonly used words that you have difficulty with (either spelling or pronunciation). And keep that little notebook in your pocket all the time
Help with LEARNING
When learning new tasks dyslexics and dyspraxics are more dependent on the cognitive rather than unconscious part of their brains than people without specific learning difficulties. Therefore, Dysplexic and Dyspraxic persons learn best through hands-on experience. Things like
- visual aids.
Help with AKT/CSA/GP CONSULTATIONS
- Inform the RCGP examination team – the trainee will get extra time at the AKT, though they will probably want sight of the report for confirmation. There is no extra time at CSA.
- In terms of the CSA: I’d suggest looking at the written descriptions very carefully – the trainee will hopefully be aware of their pitfalls in reading the information under pressure
- In terms of the GP consultation (and also the CSA): focus on structuring the consultation … which is an issue for some people with dyslexia which can be associated with improved video-spatial skills and reduced sequential planning skills.
- General Intellectual Abilities
- Pattern of Cognitive Strengths & Weaknesses:
- cognitive profile (usually irregular in Dyslexia)
- verbal and non-verbal reasoning skills (usually normal in Dyslexia)
- auditory working memory (derranged in Dyslexia)
- processing visual information at speed (derranged in Dyslexia)
- Attainments in Basic Skills:
- core literacy skills word reading, reading comprehension and spelling
- speed of reading
- free writing and copying skills
- spelling, sentence structure and handwriting
- phonemic decoding and phonological processing at speed
- most of these are derranged in Dyslexia.
RAM’S CLOSING STATEMENTS
- If you have dyslexia or dyspraxia, remember these are not diseases and they are not mental handicaps. You simply have a different way of processing things and that can be an advantage because you may see things differently from those who aren’t dyslexic/dyspraxic. Most of us have something called left-brain ‘analytical’ thinking but dyslexic/dyspraxic people often have right-brain ‘creative’ thinking. Some of the greatest contributions to society in history has been from right brain thinkers.
- A good analogy for this is to think of the journey from Leeds to Birmingham. Most people would take the motorways M1 or M62 – and therefore see the same thing again and again and become too familiar with the journey. Being dyslexic is like taking another route. Perhaps a combination of motorway and ‘A’ type roads. Okay, this route may take a bit longer BUT a) you will end up at the same destination and b) you will see more interesting things on the way. Yes – you may need additional navigation skills because the journey you have taken is not as easy as the direct motorway route, but don’t forget that your journey will also be different, and perhaps richer.
- Your dyslexia/dyspraxia does not need to be an obstacle to your future development. It is up to you if you want to make it a problem or obstacle. A more positive approach would be to try and understand your dyslexia/dyspraxia so that you can use strategies which naturally boost those strengths inferred by being dyslexia/dyspraxic. Every dyslexic/dyspraxic person is different. Therefore you need to understand your own needs which will be different from other dyslexic/dyspraxic persons. While you may share commonalities with others, you are, at the end of the day, an individual. Every dyslexic/dyspraxic person is different and should be treated as an individual.
- Dyslexia/Dyspraxia is part of you. Don’t hate it or be frustrated by it. Show it some internal motherly love because it is part of you and it is here to stay with you as a companion for life. Don’t forget – it is one part of the equation that has got you to where you are today. It has helped shaped your character or persona. Stop fighting it. Learn to start dancing with it.