254 Chapter 31
Box 31.2Differences between specific reading disorder and
reading backwardnessMore strongly associated with:
Specific reading
disorderReading
backwardness
Poor prognosis for reading √
Marked male excess √
History of relatively specific problems in
speech and language development
√
History of widespread developmental delays √
Overt neurological disorder √
Social disadvantage √SRD and developmental dyslexia
Is there a subgroup of children with SRD who warrant a diagnosis of
developmental dyslexiaon the basis that their reading problems are part
of a wider neurodevelopmental syndrome that is clearly constitutional
rather than environmental? Epidemiological evidence from the Isle of
Wight study does not support the notion of a pure dyslexic subgroup.
Although children with SRD were indeed more likely to have other
neurodevelopmental and neuropsychological problems (poor coordina-
tion, constructional difficulties, left–right confusion, etc.), most of the
children had only one or two of these additional problems and there was
no evidence for two distinct groups of children: a dyslexic group with
many associated problems and a non-dyslexic group with few or none.
Furthermore, it made no difference whether a child with SRD had many
or few associated neurodevelopmental problems as far as many important
outcomes were concerned: prognosis, response to treatment, likelihood of
associated psychiatric problems, or likelihood of having a positive family
history of reading problems.
Thus there is currently little justification for distinguishing developmen-
tal dyslexia from SRD. Some educationalists and researchers avoid using
the term ‘dyslexia’ at all, while others use the term to delineate a group
of children with particularly marked deficit in phonological skills (even if
some of these children have compensated for this deficit and read well).
It is tempting to abandon such a controversial term. In the real world,
however, a label of dyslexia is widely recognised, usually conveys the
message that the child’s reading problems are not the result of stupidity or
laziness, and sometimes results in important practical benefits for the child
(for example, extra time in examinations). Given this, there is no reason
to deny any child or adolescent with SRD a label of dyslexia if this is to the