Wednesday, July 29, 2009

The Eye M.D. association's inaccurate statement about Dyslexia and Vision

I guess it is too much to expect M.D. Ophthalmologists to actually be able to think their way out of a scientific bag. I expect to be slapped around for my comments here but I actually think that just because people have a biased opinion about a subject they shouldn't expose themselves by acting as if they can make a scientific sounding policy about dyslexia and vision unless they actually understand dyslexia as well as vision and the fact that a minority of dyslexics can describe individually specific visual problems that make reading difficult.

Here is the link to the new policy saying that vision has nothing to do with dyslexia

I see Sally Shaywitz and her husband's fingerprints all over the policy statement. I have always said that phonological problems are indeed the most common dyslexia problem ( regardless of the fact that there are a non trivial amount on non responders to phonological interventions)and that if you want to blindly choose an individual selected in a random manner from a group of dyslexics that phonological intervention has the greatest statistical chance of being helped. That method fails for a non trivial amount of dyslexics sometimes because of visual problems seeing text.

That Shaywitz uses fMRI information to prove the phonological problem relationship to dyslexia in her certain manner while not being able to identify if an individual is dyslexic or not by that method suggests to me that she is reading a little more certainty into the data than is there. I am not trying to criticize her, her star is at its height right now and the AAO believes her as if it is written in stone.

This is going to be a long post so I am going to go out on a limb and say that in all of history that there has never been any single way that Doctors have treated a large group of kids (or people in general) so that the results have been positive for every kid. I am not saying that groups haven't been helped just that a certain amount of collateral damage is acceptable. I guess that is why it is OK to promote drugs that may cause death in a few people as a side effect and OK to promote a single phonological intervention for dyslexics that will have some non responders to the intervention.

Sometimes it is informative to actually read the references that are used to evaluate them for quality and make sure they are inclusive of the information to date. GF Eden did one of the first fMRI studies on dyslexia and vision and found about the same differences that are seen in other areas of the brain : you can see differences between groups of dyslexics and non dyslexics. That study was big news at the time I would think the everyone belonging to the Eye MD association would be familiar with the study. G. Eden went on and studied other areas of the brain related to reading and found the same differences as with vision. The eye MD's included one of Eden's studies just not the one on vision. I always liked the comment from a young girl in her study who said she could read if the words would just stop walking. I have a vested interest in this discussion because I sell glasses that would stop those letters from walking so that girl could read normally.

I can understand the eye MDs being upset with the low quality studies done on vision therapy and colored lenses but just as poor studies don't prove anything positive they also don't prove anything negative. It is not proper to conclude that because a study is very flawed that it proves that something doesn't work, it just still needs to be properly studied.

I have no idea about how effective vision therapy is. Personally, I believe there is no way that claims of 80% of learning problems are vision related can possibly be true so there has to be huge failure rates and since it can take months and thousands of dollars and is never guaranteed I would advise against it until a target group can be identified so that the success rate can be raised to the point that a guarantee could be offered. I just don't see that vision therapy is a viable product at this time.

I don't like the lack of a guarantee and the overselling of colored lenses either. Again the studies done with colored lenses have been poorly designed but are suggestive that a better selected at risk population could increase the success rate. The eye MDs just can't claim that poorly designed studies prove a negative when they don't prove anything.

Just because the eye MDs are embarrassed that anyone would invade their turf with big claims little proof and no guarantees doesn't give them the right to speak from the mount and spew poorly researched and selected articles to get rid of the invaders.

Since I sell and financially guarantee that See Right Dyslexia Glasses remove described visual problems that make reading difficult for a minority of dyslexics I have a dog in this (fight) discussion.

Statistically, dyslexics in general and visual dyslexics in particular have a higher rate of poor depth perception. My glasses restore normal depth perception for that group. It seems that eye MDs can't restore normal depth perception yet but they can measure depth perception. Feel free to challenge my glasses ability to do that if you find a dyslexic with poor depth perception. I run across them occasionally myself.

I think using the FAQ's on a dyslexia site as a reference indicates a sloppy gathering of information to develop a national policy on dyslexia and vision not being related. Also since Eden's study on dyslexia and vision indicating dyslexia and vision are related was of the same excellence as the one you used as a reference
I wonder if the eye MDs did more than read the abstracts. Eden often mentions the non universality of her results as pertains to dyslexics.

Put the policy back on the agenda and do a better job next time. Here is some info on visual dyslexia.


Kathryn said...

Don't get me started on docs! The fact that they "know everything" when their knowledge actually is a very small box creates so many problems.

It wouldn't be so bad if they just wouldn't publish their ill founded beliefs - & convince the public to trust them.

hayesatlbch said...

To be as fair as possible it seemed more a slap dash emotional response, probably to the fairly recent explosion in ads for vision therapy claiming 80 % of learning disabilities are vision related, the therapy taking months and having no guarantees.

They did indeed throw the baby out with the bath water by buying into the single cause of dyslexia is poor phonological processing.

One must assume that the people who can describe visual problems that make reading difficult will not be looking to the AAO for a sympathetic ear.

My advice to those offering vision therapy. If you can't identify who is going to indeed be helped with their learning disability problems by vision therapy ( no one believes your 80%) you will continue to be looked at as a scam.

Dyslexia in children said...

Dyslexia is a neurological development disorder. The symptoms are clear but there is no proper medication found on it. It is also found in children. There are many big personalities also who suffers from dyslexia. Kinesis and Eurythmics has proved effective.

hayesatlbch said...

I like people to comment on my blog but to just have a comment that you copy and past from blog to blog on different subjects as you do ,such as repeating your comment from , doesn't really add much to a different discussion.

I am not sure what you mean. Yes most of the problems of Dyslexia are
due to "neurological development disorder." So if that is your entire picture of the condition of dyslexia then you probably agree with the eye MD statement that vision and dyslexia are not related.

Actually all the science that has determined dyslexia is neurological is from fMRI studies of the brain and different areas related to language processing being different in groups of dyslexics and non dyslexics. The same differences are seen in fMRI studies in the visual centers of the brain but I would argue that it is actually impossible to tell if the differences are not somewhat distorted because the inputs are distorted for some dyslexics ( visual dyslexics) . The statistics seem to indicate that only a small (about 10%) of dyslexics have visual problems as a cause of reading problems. So while the same differences are seen in the brain in the visual centers as language processing centers it seems that those more common visual processing problems might not result in actual reading problems.

I try to keep things simple when I discuss visual dyslexia. If a visual dyslexic can describe visual problems that make reading difficult then that by definition makes reading slow inaccurate and likely to impair reading comprehension. Removing those described visual problems is what my See Right Dyslexia Glasses actually do. There is no reason for me to market my visual dyslexia glasses to those with language processing problems as my glasses have no affect on that type of problem and so would not be effective or of benefit for language processing problems.

My contention is that despite what the eye MD's say is that ,while they are correct in general that dyslexia and vision are not related, there is a well documented group of people that describe visual problems that make reading difficult that I believe it is their obligation to address. Their failure to do so forces me to offer a solution for those problems. That they use the lack of published scientific proof as a basis for their argument seems to imply that every advance in their field has been documented with scientific evidence. I would suggest that while lasic sugery is now fairly well established that the earlier forms of radial cutting with sharp knives to reform the shape of the eye was once accepted as state of the art and came with many difficulties.

I would also suggest to the public that the newest laser eye corrections have as a basis software to shape the eye that is not able to be changed by the eye doctors that use the machines. In fact much of the skill needed to evaluate and correct vision has now become knowing how to use provided equipment. While it is still common to hear advertised the thousands of lasic surgeries completed as a selling point, the fact remains that when new better equipment comes in, a technician explains to the doctor how to use it and then the doctor uses the equipment on clients with the instruction that was received from the equipment technician.

I am getting away from the point of the post somewhat but it seems as if the advances in eye health care are being made by equipment manufactures rather than the eye doctors themselves. If I had unlimited financing I have already designed an instrument that could determine an infants predisposition towards visual dyslexia . It would be simple enough to be used by an average trained nurse on a newborn of a few days old and would measure the absolute amount of natural auto fluorescence in the baby's eyes. I predict that someday it will be a required test.