I’m a bit mad, harassed and upset. There was actually a moment or two today when I considered giving up the advocacy gig. But luckily I’m hard wired for a fight and I won’t back down.
This week I’ve been under attack for posting the RANZCO media release titled “No scientific evidence that Irlen Syndrome exists, say ophthalmologists.” RANZCO media release 2018 https://ranzco.edu/media-and-advocacy/media-centre/media-releases/media-release-articles/no-scientific-evidence-that-irlen-syndrome-exists-say-ophthalmologists.
“What is the verdict?
Due to a critical lack of scientific evidence that Irlen Syndrome exists or that treatment methods do anything to improve an individual’s performance, RANZCO cannot endorse treatment of the condition.” RANZCO POSITION STATEMENT 2018 https://ranzco.edu/ArticleDocuments/176/Irlen%20Syndrome%20RANZCO%20Position%20Statement%20260418.pdf.aspx?Embed=Y
Lack of evidence supporting Irlen or vision therapies for Dyslexia or reading difficulties is not new. But I think RANZCO has been the of first organisation in Australia to come out and say what is on everyone’s lips… “no scientific evidence that Irlen Syndrome exists!” There I’m brave enough to say it! I’m saying it out loud!
“Despite 35 years having elapsed since the initial description, neither the
International Classification of Disease (ICD-10; World Health Organisation) nor the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric
Association) list visual stress as a recognised disorder. Similarly, neither of these
widely used diagnostic manuals makes any reference to visual-perceptual
distortions as being associated with reading difficulty. The ability of coloured filters
to improve reading performance in individuals who report symptoms of visual
stress has been widely contested [6-11] and the practice has even been listed
among ‘neuromyths in education’. ” The effect of coloured overlays and lenses on reading: a systematic review of the literature, Griffiths http://onlinelibrary.wiley.com/doi/10.1111/opo.12316/full
I received a bit of twitter abuse and the usual “I’ve seen it work” “It worked for me”. But the most venom came from our parent members. I understand that it is hard for someone to say to you that the intervention you picked for your child was probably a waste of time and money. This is exactly while anecdotes are so unreliable. People need to believe. I understand that you need to desperately cling to the idea that you have found your solution. I understand I’m a parent of a child with multiple learning difficulties. Posting evidence is not a criticism of your parenting skills. My job as an administrator of an evidenced based group is to inform parents of the latest information so others don’t merrily skip down the wrong path.
Irlen has a moral responsibility to prove that Scoptic sensitivity exists and that their remediation works. They have had decades. Professionals have a moral responsibility to families that the best information is made available so that they can make the best used of limited intervention time and financial resources. “As doctors, ophthalmologists have a responsibility to help families make the best use of limited resources. We should steer families away from unproven interventions that consume resources and thus interfere with the implementation of proven methodologies such as educational and language based therapy.” RANZCO Eye2Eye Spring 2016
In our support groups we have certainly tried to be gentle and take the line of “not a remediation for Dyslexia”, “Dyslexia not caused by vision or visual processing issues”. But with many Irlen franchises in Australia including the word Dyslexia in their title, diagnosing “visual dyslexia” and including Dyslexia in their long list of things Irlen remediates, it was time someone drew a line in the sand.
Scientific research has shown Irlen is no better than a placebo. In fact a recent research study showed girls had preference for pink, rose and purple which certainly leans towards a placebo rather than an actual intervention. This article discusses in detail the likely placebo effect of Coloured lenses https://www.researchgate.net/publication/320468142_Coloured_filters_show_gender_differences_and_poor_repeatability
“Consistent with previous reviews and advice from several professional bodies, we
conclude that the use of coloured lenses or overlays to ameliorate reading
difficulties cannot be endorsed and that any benefits reported by individuals in
clinical settings are likely to be the result of placebo, practice or Hawthorne effects.”
The effect of coloured overlays and lenses on reading: a systematic review of the literature
Authors Philip G. Griffiths, Robert H. Taylor, Lisa M. Henderson
Unfortunately Irlen is not a harmless placebo. We get many parents who have wasted valuable time, money and dented their children’s self esteem riding the Irlen rainbow. In fact everyone of our 3 admin bunt their fingers on either behavioural optometry or Irlen before finding structured literacy and evidenced based paths. Opportunity cost is significant when the importance it early intervention in reading difficulties is well established. Often parents are sent to an Irlen centre as their first port of call by professionals and teachers. This often delays literacy remediation. Sometimes years pass before appropriate evidenced based intervention is received.
“Ineffective,controversial methods of treatment such as vision therapy may give parents and teachers a false sense of security that a child’s learning difficulties are being addressed, may waste family and/or school resources, and may delay proper instruction or remediation.” Joint Statement of the American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus and American Academy of Ophthalmology, 2009 (reaffirmed 2014)
Vision and visual processing – The research and evidence
There is a large body of research that does NOT support the theory that dyslexia is caused by visual abnormalities or visual processing difficulties. Irlen Lenses, coloured glasses and overlays are NOT evidence based interventions for reading difficulties. Irlen lenses are NOT recommended by AUSPELD, Learning Difficulties Australia (LDA), Macquarie University Special Education Centre (MUSEC) or the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) or The Australian Dyslexia Association for the remediation of reading difficulties.
“Currently, there is no adequate scientific evidence to support the view that subtle eye or visual problems cause learning disabilities. Furthermore, the evidence does not support the concept that vision therapy or tinted lenses or filters are effective, directly or indirectly, in the treatment of learning disabilities.” Joint Statement of the American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus and American Academy of Ophthalmology, 2009 (reaffirmed 2014)
“There is no evidence that Irlen, Wilkins, or Chromagen filters/lenses improve reading comprehension or speed.” 2017 American Academy of Opthamology, Learning Disabilities, Droste https://www.aao.org/pediatric-center-detail/learning-disabilities
Vision should be certainly assessed by an optometrist or if any major concerns an ophthalmologist. Reducing glare certainly helps anybody read better but that is no reason to diagnose a condition.
Don’t shoot the messenger.
Providing information to parents is what I do.
Informed decisions are good decisions.
I won’t apologise for my stance as it is firmly grounded in research evidence.
For even more research links see https://www.dropbox.com/s/nibdxvvgsohz83n/Vision%20and%20dyslexia%20the%20facts%20and%20research.pdf?dl=0
For a simple fact sheet see https://www.dropbox.com/s/vwobf5ljr1ais5f/Vision%20Fact%20Sheet.pdf?dl=0