Reading Difficulties 253attempts to guess the word from its shape rather than on faulty attempts
to decipher the word phonologically. In both reading and writing, letters
and words may be reversed, for example, ‘p’ for ‘q’, ‘b’ for ‘d’, ‘saw’ for
‘was’, a phenomenon sometimes labelled strephosymbolia.
3 Children with SRD are more likely than other children to have
neurodevelopmental and neuropsychological impairments, including
left–right confusion, poor coordination, poor constructional abilities,
motor impersistence and language abnormalities. Whether these asso-
ciated symptoms delineate a specific dyslexia syndrome is considered
later. Children who have early delays in language, but who then catch
up completely are not at greater subsequent risk of SRD.
4 Children with SRD span the IQ range from very bright to very dull.
The mean IQ of children with SRD is average or slightly below average.
Verbal IQ tends to be lower than performance IQ. This may reflect not
only the centrality of language rather than visuospatial deficits in SRD,
but also the fact that children who read little have less opportunity to
build up the skills tapped by the verbal subtests.
5 Epidemiological studies have not supported clinical accounts that left-
handedness or mixed dominance is over represented in SRD. One recent
epidemiological study found an excess of both strong left-handers and
strong right-handers among children with SRD.
6 SRD is more common among children from large families.
7 SRD is associated with a variety of psychiatric problems, as detailed at
the end of this section.
SRD and reading backwardness: is this a distinction
worth making?
Is there any point distinguishing SRD from poor reading that is in line with
the individual’s IQ, for example, distinguishing between subjects A and B
in Box 31.1? The answer is controversial:
Some experts, particularly those more closely linked to education, argue
that there is little practical justification for the distinction. When an
individual is struggling with reading, this is generally due to underlying
phonological deficits – and what is required is extra help developing
phonological awareness. Since this applies to those with reading back-
wardness as well as SRD, educators put less effort into assessing IQ
in detail, investing the time instead in tests of language (including
phonological awareness) along with briefer measures of non-verbal
reasoning.
Other experts, particularly those more closely linked to psychiatry, con-
tinue to favour ‘disrepancy definitions’ – obtaining detailed measures of
IQ and reading attainments in order to identify significant discrepancies
between actual and predicted reading ability, using the sort of regression
analysis shown in Box 31.1. Their rationale for distinguishing between
SRD and reading backwardness is that these two categories differ in
prognosis and associated features (Box 31.2).