South China Morning Post Ltd. May 28, 2005

Through rose-tinted glasses; Although experts argue against, supporters say for some children with reading problems a controversial therapy holds the answer

By Amanda Watson

KRISTIAN MONTGOMERY sits on a table outside a Sheung Wan flat swinging his legs, showing off his cool blue tinted glasses. Ka Yan Gibbons, who sports cute oval pink ones, looks every bit a mod teenager from the 60s.

But these are eight-year-olds and the glasses are not intended to be fashionable. They are part of a controversial solution to a visual problem that is claimed to exacerbate reading problems.

The condition, known as Irlen Syndrome, was identified in the 1980s and involves the background of reading material interfering with the viewer's ability to concentrate and sometimes even identify words.

Also known as scotopic sensitivity syndrome (SSS), it is characterised by sensitivity to light, especially in high-glare conditions. That's where the tinted lenses come in.

"They saw words floating, merging together, swirling on the page, glowing and flashing in the background, a whole array of things," said psychologist, therapist, and learning disability specialist Helen Irlen of an early group identified with the condition.

It was 25 years ago, at California State University, that Ms Irlen, a graduate of Cornell University, first studied methods of helping children and adults with reading and learning disabilities.

That was when she noticed that a sub-group of individuals showed a marked improvement in their reading ability when material was covered with coloured acetate sheets. She spent the next five years developing diagnostic testing instruments and patenting her method.

"There were more than 1,500 adults in our initial research project who were reporting that reading was difficult for them, not because they didn't have the basic reading skills, but because they couldn't concentrate long enough to read," she said.

She sent the test group off to see a variety of specialists. "Whatever these specialists advised, the group tried for nine months, and at the end of that time we had 35 adults who still had the same problem to the same extent."

The basic problem, Ms Irlen said, was due to the backgrounds of what people were trying to read. The search for a stable perceptual system led to the concept of using colour.

Simple coloured plastic sheets were put over the printed page, but if the person was looking at a whiteboard or computer screen or traffic sign, overlays were of limited use. That's when she came up with the idea of coloured glasses.

But Ms Irlen, a former director of the Adult Learning Disabilities Programme and Assistant Professor of Adult Learning Disabilities at California State University, has come in for some harsh criticism over the years, with some experts even questioning whether vision therapy helps people with learning difficulties at all.

In a joint statement, the American Academy of Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology said on a website - www.aao.org/aao/member/ policy/disability.cfm - that there was "no evidence" to support it.

"Visual problems are rarely responsible for learning difficulties. No scientific evidence exists for the efficacy of eye exercises ('vision therapy') or the use of special tinted lenses in the remediation of these complex paediatric neurological conditions," the groups said.

They went on to add that "currently no scientific evidence supports the view that correction of subtle visual defects can alter the brain's processing of visual stimuli. Statistically, children with dyslexia or related learning disabilities have the same ocular health as children without such conditions."

Locally, Chris Dowson, education psychologist with the Hong Kong Institute of Education's Department of Educational Psychology, Counselling and Learning Needs, added his voice to those of the doubters.

"There's no solid evidence of any true validity or reliability of these tests, so I'd be pretty sceptical about tests designed to find something where it's aimed at a certain specific treatment," he said.

"There are people who report seeing rivers of white instead of words, but I'd take an approach of shared reading with these children, seeing if they could get the meaning of language in totality, rather than focusing on single words because we know that sort of approach doesn't lead to any growth in meaning."

Yet, despite the controversy, screening for SSS is now widely carried out in the US, Britain and New Zealand, as well as other parts of the world, and there are more than 80 Irlen clinics worldwide.

Ms Irlen, who was in Hong Kong recently to talk to the local dyslexia association about her therapy, said the approach she used was not being marketed as a cure for reading or learning difficulties generally but as an aid to help a "sub-group" of sufferers overcome a specific visual problem.

"We're not curing autism or reading problems or whatever. We're stabilising their perceptual system," she said.

She was keen to define the limits of her intervention.

"This is not a method of teaching reading. It's giving a basic foundation. You need a stable visual system and a stable perceptual system, and then you can talk about instruction and mediation and anything you want. We're dealing with a system that keeps print stable and clear {hellip} this occurs as a piece of a puzzle in 46 per cent of a specific population," she said.

The lenses, she said, were only an aid and other techniques, such as pointing a finger when reading, using graph paper for maths or writing in columns, could be used to reinforce the benefits.

What is her reaction to the controversy that still surrounds SSS?

"I agree that in the beginning we needed more research," she said. "But there's now a large body of both educational and neuro- scientific research published about the Irlen Syndrome." Current critics, she added, clearly hadn't been reading it.

"We're not saying if you have dyslexia, if you have reading problems, you need an overlay. We don't know. You may or may not," she said.

"We're saying everything that is being done and all approaches are important. I think you want to address as many pieces of the puzzle as you can, not get locked into your own perspectives."

Mr Dowson remained unconvinced. "The problem here is over- claim," he said. "There may be a very tiny proportion of students with learning difficulties who have perceptual difficulties that may be helped by some sort of mechanical aid, but it's a very tiny proportion, even of those children who are said to be dyslexic. It's better to start off looking at how one could support them through programme changes."

Marilyn Day, a committee member of the Hong Kong Dyslexia Association who has worked with special needs for the last 20 years, disagreed, saying she could see no harm in SSS.

"It's a bit of a quick-fix approach, but of course that's exactly what any parent would want. You'd do whatever you needed to do. If I was a parent of children with learning difficulties I would look at everything I could," she said.

Tehnaz Ragi, who runs the Sheung Wan clinic for children with specific learning difficulties, where Kristian and Ka Yan were showing off their glasses, screens children for SSS.

She came across Irlen Syndrome when a client sent her child for screening in Australia, although by then she had also noticed that there were many children whose spelling was far better than their reading. "I couldn't figure out why, and optometrists weren't really helping," she said.

When her client's child returned she found there had been a dramatic improvement and decided to train as a screener.

"It's not the answer to all learning difficulties but I've definitely seen kids change with this," she said.

But perhaps the last word in the controversy should go to someone who tried the therapy.

"When I'm wearing them, the words stop swirling around in circles. I can see what they mean when everything stands still," Kristian said.

His mum, Helen, agreed. "They've made such a difference to his reading. I ask him if they help and he says they do, and that's good enough for me," she said. "He does have other learning issues but these lenses have brought a big change."

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