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Reading and writing: In the ear or all in the mind?
For years, sufferers from dyslexia have been branded as lazy and underachieving. But an American doctor has brought remarkable improvements in children's reading and writing – with the help of travel-sickness pills
By Jerome Burne, The Independent
Disorders, such as dyslexia, that have no standard treatment are infamous for attracting wacky and usually useless cures. So you might be forgiven for regarding with considerable scepticism the idea of treating reading and writing problems with travel-sickness pills. In fact, the idea behind this controversial approach, pioneered by an American doctor who is setting up a clinic in England, fitsthe latest thinking on dyslexia.
For years, treatment of this puzzling disorder has been stuck. Even when it wasn't being dismissed as a middle-class word for "lazy", there was little agreement about how or why it developed or what was the best treatment for it. Some sufferers were helped with intensive multi-sensory teaching; others swore that tinted glasses made a difference; most teachers took the view that if a treatment worked for you – fine. Theories about what was wrong tended to focus on the thinking part of the brain and problems with processing information.
But recently a new consensus is emerging. An idea about dyslexia that has long been around on the fringe has suddenly been propelled centre stage by scientific research at Sheffield University and Queen's University, Belfast. It now looks as if dyslexia is actually a disorder of the movement centres located in a part of the brain known as the cerebellum, which has many links with the inner ear. Difficulties with reading and writing are just one of the symptoms. All at once, the notion of motion sickness pills doesn't seem quite so daft after all.
"Dr Levinson's medication has opened a window for David," says his mother, Jane. Thirteen-year-old David, who was investigated by Dr Harold Levinson last July, has been taking a range of pills and nutrients, to boost his inner ear functioning. "It is not a cure," Jane cautions, "but it has helped him enormously. He's caught up a year and seven months in his reading and he's suddenly able to ride a bike... his self-esteem has gone through the roof."
David was one of around 50 dyslexics who saw Dr Levinson when he visited the country last year. For nearly 30 years, in the face of considerable establishment hostility, Dr Levinson has been treating patients at his centre in New York by checking their inner ear function and prescribing multi-vitamins, herbs such as ginkgo biloba and fatty acids, to correct any weaknesses.
"Under the conventional view, dyslexics have problems with all sorts of higher brain functions like hearing, vision, timing and memory," says Levinson. "But if that was the case, dyslexics would all be severely mentally impaired, whereas in fact they are often very bright." Instead, he believes the problem starts lower down. "Normally the inner ear and the cerebellum fine-tune all the messages that are coming in and out of the brain. In dyslexia this process has broken down in various ways. "If the link with the eyes is affected, for instance, you are going to have problems of coordination when you try to read. Other links may be with hearing or perceiving time or numbers."
One of the most intriguing bits of evidence for Dr Levinson's theory is the discovery of a link between weightlessness and dyslexia. Astronauts discovered that being in zero gravity, which disrupts the working of your inner ear, produces a range of dyslexia-like symptoms. Reading becomes much harder and letters like "p" and "b" are regularly reversed. "Even if you just scramble your inner ear by spinning round and getting dizzy," says Dr Levinson, "you will find it hard to read."
The dyslexia establishment in the UK, however, is still not convinced. Much of its focus has been on practical support for children in school who have problems linking sounds with words on the pages. This poor "phonological awareness", as it's called, means that they find it hard to hear that "cat", "mat" and "bat" all rhyme or to split a word into its component sound chunks – such as "h...el...p".
The British Dyslexia Association claims that there is no successful treatment for the condition and has urged families to think twice before paying out for the drugs and supplements prescribed by Dr Levinson. "There is no such thing as a miracle cure," says a spokesperson, "and it really is irresponsible to peddle anything as such." David's special needs teacher is also underwhelmed. "People do say that it helps," said Susan West, carefully side-stepping any personal opinion. "David has been making good, steady progress and that could be for any number of reasons. Anything that offers reassurance and support is a good thing."
And that is how debates on unconventional treatments usually end. It may work for some, it may also be a placebo effect. In the absence of proper trials who can tell? However, Dr Levinson's prospects of being taken seriously have been dramatically improved as a result of work being done by Professor Rod Nicolson, a psychologist at Sheffield University, who has found that the cerebellum, an area of the brain long associated with movement, but recently linked with all sorts of related activities, is underperforming in dyslexics. When you imagine playing a tennis stroke, when you are speaking, or even when you are trying to memorise a list of words, the cerebellum is involved.
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"Essentially the cerebellum is vital for learning skills that become automatic, skills like driving a car," says Professor Nicolson. "The reason dyslexics find reading such a trial is that reading never becomes really automatic." In a series of studies, Professor Nicolson has found that around 80 per cent of the dyslexic children that he tested had an under-functioning cerebellum.
The relevance of all this for Dr Levinson's ideas is there are extensive links between the inner ear and the cerebellum. One strictly practical result of Professor Nicolson's research is that he has developed a series of simple physical and mental tests that can be done by five-year-olds to detect who is at risk of dyslexia. "That way we can catch them and support them before they start failing," he says. So far, copies of these tests have been delivered to over 3,000 schools.
Someone else who believes Dr Levinson is worth taking seriously is Dr Peter Blythe of the Institute for Neurophysiological Psychology in Chester. Years ago he became interested in the links between coordination, eye-movements and reading difficulties, and now the Institute trains teachers who use a series of exercises as a treatment for dyslexia.
"We favour a physical approach rather than drugs or supplements," says Dr Blythe. "But we are also targeting the coordination and movement system governed by the cerebellum." So why does the cerebellum develop problems in the first place? Dr Blythe's idea, recently backed up by a successful double blind trial published in The Lancet, is that it is linked to primitive reflexes – such as sucking – that develop in the womb.
"Normally they fade after the first year," he explains, "but in dyslexics they persist and interfere with the proper development of the nervous system, and the cerebellum. From recent brain-scanning studies we know that the cerebellum is involved in rote learning, problem solving, word recall and sequencing tasks like days of the week and multiplication tables. All things that dyslexics have problems with."
Dr Blythe's ideas have been taken up by researchers at Queen's University in Belfast who conducted the recent trial. "By doing exercises you can stimulate the primitive reflexes and give the brain a second chance to control them," Dr Blythe explains. He claims his methods are over 76 per cent effective. What distinguishes Dr Levinson from both Dr Blythe and the Belfast group is that he uses medicines and supplements rather than exercise. "It's true that some people may find even five minutes of exercise a day too much," says Dr Blythe. "On the other hand, taking pharmaceuticals every day for a couple of years may worry others."
The dyslexia jigsaw is far from completed and it will undoubtedly take years of research to unpick all the connections between the cerebellum, the inner ear and primitive reflexes but the outline of this frustrating disorder now seems far less fuzzy.
For details of Dr Levinson's treatment visit the website at www.dyslexia-add.co.uk; The Institute for Neurophysiological Psychology (01244 311 414) or visit the website at www.inpp.org.uk.
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'I couldn't read very well, because the words went all blurred. now I enjoy reading'
Dominic Grimshaw, aged eight, is one of Dr Harold Levinson's patients. His handwriting examples were done before and after his treatment, with an interval of seven months.
"I couldn't read very well," says Dominic, "because the words went all blurred on the page and got spaced out." Unlike some dyslexics, he didn't visit a string of specialists. Besides some remedial reading classes at school, he saw only an optometrist, who prescribed eye exercises. "Neither seemed to do much good," says his mother, Patricia. "He still had poor concentration and used to become furious when he was trying to read because it was so frustrating. He also had difficulty telling his left from his right."
After he saw Dr Levinson for the first time last year all that changed. "I could see the words much better," says Dominic. "My reading is now much better and my handwriting is also better."
He is no longer having any special needs teaching and he enjoys reading now. "He sat down and read all the way through Jaws the other day," says Patricia. "We know the pills make a difference because when he stopped taking one of them for a while he started day-dreaming again. Dyslexics often do that because reading is such hard work they need to rest their eyes."
Although Dominic is delighted with the changes, not everything is perfect. "I'm supposed to take nine or 10 pills every day," he says, "but they don't taste very nice. Sometimes I forget to do it."
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