The resurrection of the political career of former health secretary Matt Hancock began this year with what he must have thought was a crowdpleasing, uncontroversial foray into special educational needs diagnosis: a call to screen all primary school children for dyslexia. 

Hancock has dyslexia himself. It’s one of the most common learning difficulties that teachers will encounter: the NHS estimates that one in 10 people has some degree of dyslexia. There are countless redemption tales of people with dyslexia fighting adversity and being successful. The narrative, Hancock’s advisers will have told him, is good. The topic is safe.

“Simple early screening and education would go a long way towards helping dyslexics into the workplace and out of the cycle of crime, and be so valuable to businesses who can make the most of all that potential,” Hancock wrote in a Telegraph article announcing the private members’ bill that would require the screening to take place. 

The use of the term “dyslexics” would have jarred with many in education. The association with crime, even more so. But for some, the whole idea of screening for dyslexia would have caused considerable unrest. In both the teaching profession and among academics, dyslexia is far from the “safe” topic Hancock seems to believe it is. 

Dyslexia “is an emotive and often contested issue” is the official verdict from Cambridgeshire County Council’s guidance for teachers and parents on “literacy difficulties/dyslexia”.

Indeed, academics have long argued about whether dyslexia actually exists - and, if it does, whether we should be labelling children as “dyslexic” or not. 

Trapped in the middle of that debate, of course, are teachers. These arguments seep down and influence parents, Sendcos, local authorities and school leaders. In the face of accountability and parent pressure, and their own commitment to doing what is best for every child, what they need is clarity. So, is there any?

Definitions and diagnosis

To start with, it’s important to establish some basics about how the term “dyslexia” is defined by academics who assert the validity of the concept.

Dyslexia is “synonymous with disorder of reading fluency and spelling”, says Maggie Snowling, honorary professor in the department of experimental psychology and president of St John’s College at the University of Oxford, and one of the foremost experts on the condition.

The 2009 Rose review for the Westminster government on identifying and teaching children with dyslexia and literacy difficulties offered a definition of dyslexia that included the features of “difficulties in phonological awareness, verbal memory and verbal processing speed”; of being “a continuum, not a distinct category”, with “no clear cut-off points”.

In terms of the causes of dyslexia, says Snowling, “if it is there without any associated difficulties - and this is the rub, because this is the complexity - it’s a phonological processing problem. That’s a problem in processing speech sounds. There’s a part of the brain that is specialised for the input and output of speech; that part of the brain does seem to be affected [in people with dyslexia].”

Phonological processing is “understanding the sound structure of speech”, explains Julia Carroll, professor at the Centre for Global Learning at Coventry University and author of Developing Language and Literacy: Effective Intervention in the Early Years. People with dyslexia seem to have difficulties in matching up letters to particular sounds in words and understanding how the sounds in words are structured, she adds.

Many of those with dyslexia come from “families in which there is a strong family history of reading difficulties…which suggests that it’s very likely to be genetically based”, says Valerie Muter, a former consultant neuropsychologist at Great Ormond Street Hospital, whose books include Early Reading Development and Dyslexia.

The “classic dyslexic child” has reading and spelling problems but is “pretty much good at everything else”, Snowling says.

However, “since the 1990s, scientists have realised that there are other children who have got just the same phonological differences and reading and spelling problems, but they also have a more significant language impairment”, she continues.

“What I’m trying to say to people now is there are really two routes to being dyslexic,” Snowling adds. “One is to have a language problem - and part of that language problem will be a phonological difficulty that will affect reading and spelling. But the other cause is where you just have the phonological problem.”

The second group “can be very slow readers but they kind of understand what they read”, whereas the first group “will also have great problems with reading and with understanding”, she says.

And “if you’ve got a language difficulty, you often have a problem with attention, executive control and motor skills” - problems associated with, but separate from, dyslexia, adds Snowling.

In this argument, then, dyslexia is complex, but definable. 

Running against the case for dyslexia made by Snowling and others came a book published by academics Julian Elliott and Elena Grigorenko in 2014, The Dyslexia Debate. It caused a stir with its argument that the term “dyslexia” should be abandoned, that it lacks scientific rigour and educational value.

“What I’m saying to schools is when people diagnose dyslexia, don’t assume everybody is talking about the same thing…don’t assume that the diagnosis has any scientific basis,” says Elliott, professor of education at Durham University, principal of Collingwood College and a former school teacher.

Imagine two 10-year-old children, both reading at the level of a six-year-old: one gets a diagnosis of dyslexia; one doesn’t. Elliott’s question is: what would be the difference between these children?

In other words, “is dyslexia referring to a subgroup of kids within a much broader group of poor readers?” And if it is, “what are the criteria by which you make that judgement” about how to distinguish between a child with dyslexia and a poor reader, he asks.

What about phonological processing?

Those are “the most common sort of problems in poor readers”, says Elliott. “But there are some poor readers who don’t have phonological problems and some kids with phonological problems who don’t become poor readers.

“The [academic] literature is quite clear now that you cannot use phonological [problems] to come up with some simple diagnosis of dyslexia.”

A particular pattern

Of course, at the moment, diagnosis is the key to intervention because of how the education system is set up - an additional level of support kicks in once a child receives an education, health and care plan (EHCP) following a formal assessment, for instance - plus a diagnosis of dyslexia does have other benefits, according to Snowling.

“The thing about the label is it can be an important explanation for people who have got difficulties - perhaps they are very frustrated by them, feeling very low self-esteem, feeling completely ‘thick’…It also can communicate what that child needs in terms of intervention,” she says. 

Carroll agrees. “The term ‘dyslexia’ isn’t perfect and people use it in different ways,” she says, but the label is “useful for helping people understand that it’s not that they are not trying hard enough or not clever enough, that it’s a particular pattern of difficulties”.

Snowling talks about having a brother with dyslexia who “suffered in the system by not being identified or properly looked after”.

“I’ve seen so much in my clinical work what a great relief it [being identified as having dyslexia] can be,” she says.

That said, she does have concerns: “I worry that it is overused.”

For Elliott, the label of dyslexia “might be useful for some people, but the question is: is it useful for our society and how scientifically valid is it?”

In schools, the label “prioritises a small group of children who get that label and takes the pressure off the system to do anything about the other kids who have [reading] problems,” he argues.

And the dyslexia label is more likely to be applied to children from middle-class families, with the resources to pay for a private diagnosis, or the know-how to press schools and local education authorities into an EHC needs assessment, Elliott and some other researchers argue. 

One analysis - co-authored by Cathryn Knight, lecturer of education in Swansea University’s School of Education, and looking at children in the longitudinal Millennium Cohort Study identified as having dyslexia by a teacher by age 11 - found that “gender, season of birth, socioeconomic class and parental income [were] significant predictors of the dyslexia label”: if parents had a managerial or professional job, the chances of the dyslexia label being applied to their child were much higher.

Muter counters that this doesn’t mean dyslexia is a “middle-class” condition - it instead means that we need better systems to diagnose every child in need. 

“Let’s screen all kids so we don’t just pick up the middle-class kids with parents who go into school to complain a lot,” she argues.

If you’re looking for clarity, then, the academic debate gives you clear arguments, but no clear answer. As a result, how are schools tackling the issue?

‘No magic recipe’

One Sendco at a mainstream secondary school, who asked to remain anonymous, describes how her school has a procedure for dyslexia screening that results in a “risk quotient” - a number that might describe a pupil being “at risk of dyslexia”. 

That said, in all its teaching, the school puts the emphasis “more on the individual child and what the individual child is going to need, regardless of their diagnosis”, in making the curriculum accessible for children with needs such as dyslexia.

While the school will use the term “dyslexia” if parents have obtained a formal diagnosis, it stresses that it cannot provide a diagnosis and will only use the phrase “at risk of dyslexia” in relation to the results of its own screening tests.

“Part of it is protection for us, because we’re seeing such increasing numbers” of parents with concerns about dyslexia, says the Sendco. “After Covid, the whole thing has gone nuts.”

She adds: “We have to protect ourselves in terms of the expectation of parents and students that it [a label of dyslexia] is going to give them access to something additional or different.

“And the way, obviously, that SEND [special educational needs and disability] in schools is going is that only the kids with the most complex needs have access to that education, health and care plan or something additional.”

This approach is by no means the norm. Talking to multiple Sendcos, it is clear that the way schools react to - and intervene for - dyslexia is highly variable. At one end of the spectrum, the school will hand out coloured overlays and roll out specific intervention plans; at the other, dyslexia is distrusted as a term and largely absent from the classrooms. 

There are some local authorities trying to tackle this variability. Cambridgeshire County Council is trying to take a systematic approach in its support for schools, setting out its approach in the updated guidance for teachers and parents on “literacy difficulties/dyslexia” mentioned earlier and published in 2019. 

This was partly an attempt to offer clarity in response to assumptions among some parents that Cambridgeshire did not recognise the term “dyslexia”. Alongside the guidance, the council published a comprehensive overview of the academic research on dyslexia - looking at how “understanding, awareness and theory around dyslexia have undergone multiple paradigm shifts since its early inceptions” and arguing that the “nascent but growing body of agreement [is] that the term ‘dyslexia’ is of itself amorphous and unhelpful on the grounds that it is so difficult to tightly define”.

Cambridgeshire’s approach is “very much an emphasis on the social justice model, of meeting the needs of all young people with literacy difficulties - making sure [those difficulties] can be identified and addressed regardless of whether they have a label or not,” says Kirsten Branigan, its principal educational psychologist.

The guidance aimed to make it clear “that we did use the term [dyslexia], but the term was not going to give you any access to resources that not using the term would give you… [that] getting a diagnosis of dyslexia doesn’t give you access to a special, magic recipe of interventions that can only be used for children with that diagnosis,” she adds.

The guidance document is described as having been “co-produced with parents and carers of children with dyslexia, young people with dyslexia and professionals working in the field of dyslexia”, aiming to “enable parents and schools/settings to have a common understanding of dyslexia and current best practice in order to achieve the best outcomes for children”.

Branigan says: “The term ‘dyslexia’ is irrelevant within that, to some extent. The bottom line is: what do we need to do to make things better?”

To that end, Cambridgeshire offers guidance on assessments (including an “assessment library” where smaller schools without high level of resources can find assessments) and interventions (the guidance refers to interventions identified in academic research, while the county has also developed some of its own). The council also provides training for teachers in assessment and interventions, without schools having to pay for it.

Staffordshire, Warwickshire and Essex are further examples of local education authorities that do not draw a distinction between dyslexia and literacy difficulties. 

“In terms of catering for children who struggle to learn to read, there is no meaningful educational difference between the reading difficulties shown by pupils who are considered to have dyslexia and poor readers who do not receive this label,” says Essex County Council’s guidance for schools.

‘The term is irrelevant, to some extent. The bottom line is: what do we need to do to make things better?’

But back among the academic arguments, there is a position that says that not having the label could be detrimental. 

“At the end of the day, it’s a neurodevelopmental difficulty,” says Snowling. “There has to be a recognition that these kids don’t really catch up. They are rather different. That’s not a bad thing.”

She adds: “We are wasting a lot of talent. Many people with dyslexia have got all sorts of talents that are not traditionally academic. Artists, musicians, chefs - loads of chefs are dyslexic.”

But others think that kind of view unjustly limits possibilities for children with literacy difficulties. Elliott argues that there is no evidence to back up the idea that people with dyslexia are inherently more creative or entrepreneurial - it’s just that people with reading difficulties gravitate to jobs in which those difficulties will cause them fewer problems.

Teachers “need to know that kids with reading difficulties can be really high IQ, can be low IQ or average - therefore they need to make sure that if they are teaching a child who is really bright, they don’t underestimate the intellectual challenge they would give that child because that child is a poor reader,” Elliott says.

Another analysis of Millennium Cohort Study data by Knight, of Swansea University, found that children “labelled with dyslexia hold lower beliefs about their ability in English and maths than their matched peers without this label”; that they were “also significantly less likely to say that they would go to university”; and that “teachers and parents held lower aspirations for children labelled with dyslexia”.

If all this seems to pose more questions than it answers, then the good news is that there is some hope of the literature moving towards compromise. 

Elliott’s book argued for ditching the term “dyslexia”, but he says now: “We could use the term ‘dyslexia’ if we want to use it as a synonym for poor reading - complex, severe reading problems. But don’t believe you can subdivide poor readers into dyslexics and non-dyslexics.”

Meanwhile, Muter dropped the term “dyslexia” from the title of her latest book, Understanding and Supporting Children with Literacy Difficulties, partly to avoid the debate over the term. “You can call it ‘dyslexia’, you can call it ‘struggling with reading’, you can call it ‘literacy difficulties’ - I don’t think it matters what you call it,” she says. “The label is not that important.

“The important thing is to identify a child who is struggling to learn to read, to monitor their progress carefully, to give them high-quality teaching and intervention.”

Elliott argues that teachers should know “there is no treatment or intervention for a dyslexic child that is additional to or different from what you would do for any poor reader”. But, like Muter, he puts the stress on teachers needing to know that “they must identify kids who are struggling to learn to read and try and intervene - the earlier the better”.

In Cambridgeshire County Council’s education support, “we do use the term ‘dyslexia’, but very much as the evidence shows, it’s used interchangeably with ‘literacy difficulties’ at the word level,” says Branigan. She adds that the term can be helpful for individuals and to entirely “remove the label ‘dyslexia’…would take it back to more of an unhelpful emphasis on the whole dyslexia debate, rather than actually looking at dyslexia, literacy difficulties, what support is needed for children with those needs”.

Interestingly, the British Dyslexia Association offered a statement of support in Cambridgeshire’s guidance, praising its “excellent, evidence-based” offer. It did also say that “although we would argue that the terms are not interchangeable” - which is exactly what Cambridgeshire does argue - “all struggling readers, whether dyslexic or not, should receive interventions appropriate to their individual needs”.

The problem of funding

And it’s important not to lose sight of a bigger picture here: the SEND funding crisis and its impact on a school’s ability to explore and roll out reading interventions.

Snowling refers to her training teaching assistants to carry out one-to-one and small-group teaching in an early intervention programme for four- and five-year-olds falling behind on language skills - one judged highly effective in a randomised controlled trial supported by the Educational Endowment Foundation. Effective interventions often focus on “a combination of highly structured phonics with training in phonological awareness, the ability to reflect on speech sounds”, but in the context of reading “real books and real language”, where given the right training and support, “teaching assistants can be used very effectively”, she says.

But that’s only possible “if the school can afford a teaching assistant”, she points out.

Branigan says: “I think teachers work so incredibly hard. If you want to do group interventions and individual interventions, that takes capacity - good teaching assistants who are well placed to undertake interventions.”

But faced with the well-documented funding crisis for schools, teaching assistants are a resource that some schools are finding it increasingly hard to afford.

Then there’s the impact of cuts to local authority funding on their support for schools on SEND.

“From a local authority point of view, I think [the number of] children needing an education, health and care needs assessment is so significant now, and for educational psychologists it leaves less time for early intervention and support,” says Branigan. “Capacity and funding are huge issues.”

The more the debate focuses on dyslexia, the less room there is for highlighting the above issues of funding reading interventions. Would Hancock’s screening check help or hinder the situation?

Snowling says she has told Hancock that “we’ve got a screening test” already. “It’s called the phonics screening check, it’s at the end of Year 1, it’s a statutory assessment. The problem is, if a child is identified as not meeting the standard, they need intervention. That’s what schools are meant to do, but with schools’ budgets so stretched, they can’t really do much.”

If you are looking for consensus in this area, it is here. While there are clear points of discord within the dyslexia debate - as laid out above - there is agreement around the fact that the focus should be on funding, not on the complexity of labels. It is important that, as in Cambridgeshire, teachers have full awareness of the various arguments around the term “dyslexia”. Ultimately, though, teachers can do nothing to help struggling readers - whether they have dyslexia or not - if there is no money to fund support. 

John Morgan is a freelance journalist