Tag Archives: The Checklist Manifesto

The Dyslexia Debate and a Response by Sir Jim Rose

IFERI is pleased to present a new paper by Sir Jim Rose, which was written as a response to Professor Julian Elliott’s recent presentation at Macquarie University, Australia.

Please click here to watch the presentation: The Dyslexia Debate

Sir Jim Rose

The Dyslexia Debate: A Response by Sir Jim Rose

The range and depth of enlightened thinking that DDOLL (Developmental Disorders of Language and Literacy Network) colleagues have brought to this discussion is riveting. It transcends historic wrangles over the term dyslexia that have done little to take us forward. Belatedly, I should like to add a couple of wild cards to this captivating exchange of views. The purpose in so doing is to explore further what might done to make sure far more of the children within the frame of so-called ‘instructional casualties’ receive consistently high quality teaching of reading and related aspects of literacy. Arguably, if schools could achieve this the benefits to children would be enormous and the need for costly intervention programmes reduced.

First, given that the education profession has access to a vastly greater knowledge of reading development than ever before, why is it that we continue to see confusion, not to say dissent, in schools and teacher training, about the teaching of reading, particularly in respect of phonics and dyslexia?

In the UK, although there has been considerable progress over the last decade, we still suffer from outbreaks of phonic phobia and tiresome tensions between fake opposites, such as, phonics v ‘reading for meaning’. Despite the enactment of a National Curriculum which makes such teaching mandatory, we have not yet achieved universal agreement in schools that teaching children how the alphabet works for reading and writing is crucially important.

The mantra ‘one size does not fit all’ is often chanted against phonics. This suggests that some continue to regard phonics as one of several ‘methods’ from which to select and match to discredited notions of ‘learning styles’, rather than a body of core knowledge and skills that has to be taught and practised. In the case of phonic work, if teachers are not convinced of the value of a regularly applied systematic approach it is hardly surprising that mediocre and poor practice persist. What more might be done to make plain what high quality teaching looks like in this domain?

As Alison Wolf (Review of Vocational Education 2011) said, ‘If assessing learning is hard, assessing the quality of teaching is harder’. Because the latter assessment brings with it concerns about ‘blaming teachers’ for children’s failures in reading it leads to reluctance to tackle what are often straightforward, improvable aspects of practice within the control of the teacher and the school.

England may not top the international league tables of pupil performance but we must be among world leaders in the amount of inspection and testing that takes place in our schools, starting in the primary years. Many years spent as a school inspector observing teaching in England and elsewhere convinced me that there is far more variation in the quality of teaching literacy, including reading, between and within schools than there ought to be. Further, we know the distance between leading and trailing edge teaching is associated with unacceptable variations in pupil performance, and that the impact of poor teaching on children who enter school already behind their peers amplifies their difficulties.

Is it beyond our capabilities to assess the quality teaching without blaming teachers?

My second wild card is to ask what we might learn from other professions. Anecdotes are sometimes useful so here goes…

Last year an unfriendly tree wrote off my car. I survived the crash due to the incredible expertise of the medical profession. This unwelcome event had an upside, however, in that it gave me an opportunity to compare the performance of two life changing professions: medicine and education. I had lots of time to catch up on reading about reading while experiencing our National Health Service at its best. Further, I was able to listen to the 2014 Reith lectures by the acclaimed surgeon Atul Gawande. He declared that he was in ‘the disturbance business’ and explored thorny issues, such as, ‘Why doctors fail’. I then read his book: ‘The Checklist Manifesto – How to get things right’ and watched with his TED talk: ‘How do we heal medicine?checklist-6-319x479Many of Gawande’s insights apply to getting things right in education. As a frontline surgeon, he drew upon keenly observed and detailed analyses of medical practice. His concept of our ‘necessary infallibility’ has much to commend it should we dare to explore more forensically why teaching fails while making sure teachers know that the purpose of so doing is to work with them to improve the quality of teaching and achieve better outcomes for children.

Medicine and education are ‘person-to–person’ services subject to human fallibility and to human ingenuity for solving problems: success is won by learning from our mistakes. Both professions look to research for solutions. They also rely on knowledgeable and skilled practitioners to make sure that as far as possible decisions are ‘evidence-based’ and ‘proven’ in practice. Equally important, they must be capable of making sound judgements when faced with the hard question: ‘what should we do when research is inconclusive, evidence is lacking and doing nothing is not an option?’

Among other things, Gawande suggests that doctors fail through lack of knowledge and, or, ineptitude, that is to say, insufficient skill in applying knowledge. He counts himself among them in these respects. He sees mistakes as opportunities: ’we have an opportunity before us, not just in medicine but in virtually any endeavour. Even the most expert among us can gain from searching out the patterns of mistakes and failures and putting a few checks in place. But will we do it? Are we ready to grab onto the idea? It is far from clear’.

The notion that we should actively build a school and classroom culture that enables teachers and, equally important, enables children as learners, to learn from patterns of mistakes is an idea worth grabbing. Moreover, his ‘Manifesto’ embraces a set of ethical principles and expectations worth taking on board:

“First is an expectation of selflessness: that we who accept responsibility for others – whether we are doctors, lawyers, teachers, public authorities, soldiers or pilots – will place the needs and concerns of those who depend on us above our own. Second is an expectation of skill: that we will aim for excellence in our knowledge and expertise. Third is an expectation of trust-worthiness: that we will be responsible in our personal behaviour toward our charges.

Aviators, however, add a fourth dimension, discipline: discipline in following prudent procedure and in functioning with others.”

For Gawande professional ‘discipline’ is aided by a ‘checklist’ which transforms ‘cowboys into pit crews’. That is indeed a powerful idea – but you must Google his short TED talk to understand it. (Or click at the end of this post to watch it.)

I have rambled on long enough save to ask: is there anything to be said for embracing some of these ideas, including, perhaps, developing a ‘checklist’ for teaching systematic, synthetic phonics?

With special thanks to Macquarie University for allowing us to distribute and use the link to Professor Julian Elliott’s presentation.

‘Why Children Fail to Read’ – a new paper by Sir Jim Rose – 1st June 2015

Why children fail to read

‘’We have an opportunity before us, not just in medicine but in virtually any endeavour. Even the most expert among us can gain from searching out the patterns of mistakes and failures and putting a few checks in place. But will we do it? Are we ready to grab onto the idea? It is far from clear.’’ (Atul Gawande: The Checklist Manifesto – How to get things right)

The internationally acclaimed surgeon Atul Gawande said that he was in the ‘disturbance business’. His riveting 2014 Reith Lectures, drew upon detailed case histories as he explored such disturbing issues as: ‘Why doctors fail’ despite  the track record of astonishing success of the medical profession.

Much like medicine, education is a ‘person-to–person’ service subject to human fallibility and to human ingenuity for solving problems: success is won by learning from our mistakes. Both professions look to research for solutions. They also rely on knowledgeable and skilled practitioners to make sure that decisions are ‘evidence -based’, and who are capable of making sound judgements when faced with the hard question: ‘what should we do when research is inconclusive, evidence is lacking and doing nothing is not an option?’  From the standpoint of teaching primary children with dyslexia and reading difficulties, this paper explores a small corner of what these two highly valued, life-changing endeavours might learn from each other.

While the quip that ‘Dyslexia is like Marmite, you either love it or hate it,’ may be true it does not help to resolve the debate on why some children have far more serious difficulties learning to read than others. We know for sure that Marmite exists. ‘Dyslexia’, however, continues to come under fire as a myth. At its unkindest, this myth portrays dyslexia as an expensive invention to ease the pain of largely but not only middle class parents who cannot bear to have their child thought of as incapable of learning to read for reasons of low intelligence, idleness, or both. What we can be sure of is that the deep anxiety suffered by parents and children when these stubborn reading difficulties persist is most certainly real and not imagined.

Labelling children to place them into fixed categories is always risky and calls for a separate discussion. Meanwhile, this debate has at least highlighted the question of how, so-called, ‘within the child’, inherited characteristics associated with dyslexia might be disentangled from reading difficulties associated with environmental factors ‘outside the child’, such as, poor quality teaching, weaknesses in parenting, disadvantageous socio-economic circumstances, or a sticky mix of all these conditions that obstruct learning to read. The hardly surprising consensus from research seems to be that both environmental and genetic factors influence reading ability. Further, where ‘genes were strongly implicated, it was more likely that the reading problem would be accompanied by broader difficulties with oral language  …’, [1]

‘Learn to read and read to learn’ is a familiar slogan worthy of a T-shirt. It encapsulates the obvious truth that the goal of reading is not only to sound out but also to understand the meaning of the words on the page. Those children who reach the expected standard in English at the end of their primary education have attained a good level of language comprehension as well as fluent, accurate word reading. Our national tests assess both attributes. The tests also allow us to assemble a picture of how well children spell and write and thus convey meaning to others. Another useful slogan is, ‘If they can’t say it they can’t write it.’ This reminds us of the importance of developing the spoken word and attentive listening, thereby enriching children’s vocabulary so that they have a good stock of words on which to draw.

Defining and getting to grips with the reading problems we are trying to fix are not about ‘blaming’ children, teachers, parents or poverty. Rather, we should start from a picture that is more reliable than dubious headlines about falling standards of reading in England.

According to the Government’s latest statistics [2], the great majority of children in England (nearly 90%) now learn to read to the standard expected of them by the age of eleven: ‘the 2014 figure for level 4 is the highest ever.’ This was far from the case in 1997 when only 69% did so. Should we be content with that rate of progress? The answer is no. We must strive for more because the figures mask patterns of serious under-achievement by vulnerable minority groups. Moreover, some schools in the most unpromising circumstances demonstrate that more is achievable, hence a fair judgement on the state of play might be: so far so good but not yet good enough.

To what might we attribute the rising trend in reading standards? At least four elements have come together to make a positive impact on children’s progress. First, there has been a powerful political and professional drive to prioritise and strengthen literacy, especially through the systematic teaching of reading in primary schools, and in the training of teachers. Secondly, this momentum has been backed by an unprecedented growth of good commercial and government-funded resources for teaching reading, with due attention to phonic work designed to make sure that children understand how the alphabet works for reading and writing. Thirdly, there has been a spectacular growth of excellent children’s literature by our world-class authors. Finally, the last decade or so has seen advances from research, for example, in neuroscience and cognitive psychology that have given us a better understanding of dyslexia, reading disorders and how the brain learns to read. It is often said that learning to read is a complex and difficult task but it is often forgotten that the brain is a complex and highly adaptable endowment that is well-capable of coping with that task in the great majority of children by the age of seven.

Because it is teachers whose knowledge and skills harness these resources to best effect for each child, we are told repeatedly that no education system can exceed the quality of its teachers. In recent years, someone coined the term ‘instructional casualties’ to describe a broad swathe of children who struggle to read because the quality of teaching they receive is simply not good enough, for long enough, for them to become fluent readers. Attaching percentages to the incidence of dyslexia, as factors within the child, compared to instructional failure, as weaknesses in teaching, is far from a precise science. However, it is safe to say that more children fetch up in the latter than in the former category. Moreover, overcoming instructional failure is within the control of the school whereas other factors, such as parenting and background conditions, though amenable to influence by the school, are much less so.

This era of ‘self-improving’ schools has thrown into sharp relief the urgency of strengthening the quality of teaching based on robust evidence of how successful learning is achieved. It is hardly surprising therefore that self-improving teachers are at the heart of self-improving schools. Acceptance of the virtue of reflective, self-improvement is a no-brainer. It should be an ethical principle which applies to all those who provide, and those who provide for, education, including teachers, school leaders and governors, as well as the recipients of education, that is to say, the pupils themselves. Willingness to ask: ‘What do I need to do to improve?’ is a positive and courageous acknowledgement of our ‘necessary fallibility’, irrespective of whether we are leading-edge surgeons or leading-edge teachers. For pupils, too, we ought to foster a strong ‘can do’ attitude and an appetite for self-improvement through which they learn to teach themselves worthwhile things.

Further, schools like hospitals know full well that there is no escape from professional accountability. OFSTED style inspections and published performance data, for example, are now common to both services. Where schools achieve an outstanding OFSTED report and high national test results parents   beat a path to their door in pursuit of a place for their child. Fail badly on these measures and heads will most likely roll, or resign. Within the context of accountability, recent statutory requirements, such as, the introduction of Education, Health and Care Assessments and plans which focus upon how well schools meet the needs of children with learning difficulties have been thrown into sharp relief and somewhat resemble Gawande’s enlightened idea of a safe-guarding checklist.

Anyone who has spent time working on the frontline, or as a recipient, of either of these two services will quickly conclude that lack of time to do the job well is often, in itself, a serious problem that bears upon the twin concerns raised by Gawande, notably, lack of professional knowledge and ‘ineptitude’: the latter being a failure to apply knowledge effectively.

The title of the memorable ‘Rag Trade’ TV series: ‘Never mind the quality feel the width’ might well describe the curriculum prior to its recent revisions. Unwittingly expanding the curriculum, under the banner of ‘breadth and balance’, has been a besetting sin of curriculum reviews. In consequence, slimming down the curriculum to make it more manageable and resistant to overload have been unmet goals of earlier reforms. Has the new National Curriculum and its assessment succeeded in meeting these goals where earlier attempts have failed? It seems the jury is still out. But the issue should be kept under review not least because of the heightened risk of failure that lack of time presents for those pupils who often need more regular, skilled teaching to become literate. Numeracy, too, should be held up to the same light.

Whatever else they do, primary teachers know full well that it is crucial to induct pupils into the symbolic system of language in its various manifestations because: ‘Language is the core symbolic system underpinning human cognitive activity, vastly increasing the efficiency of memory, reasoning and problem solving. Symbolic systems (language, writing, numbers, pictures, maps) enable the individual to develop a cognitive system that goes beyond the constraints of biology…’ [3]

Reading music, too, requires understanding its code, as indeed does computing where ‘coding’ is now embedded in the new primary curriculum. Making sufficient time for children to learn these various codes is a sizeable challenge for teachers and schools.

As the great edifice of inspection, assessment and testing, curriculum expansion and laudable attempts to co-ordinate services goes up, arguably, outstripping that of our allegedly more successful international counterparts, we may have forgotten that school time is finite. If so, we must find ways to prioritise the essential from the desirable and do less to achieve more. Though easier said than done, this suggests, that accountability for children’s success should extend beyond the frontline in schools.

For ‘instructional casualties’, as for ‘dyslexic casualties’, early identification through comparison with their typically developing peers, combined with good assessments, such as, the recently introduced ‘phonics check’ are invaluable starting points for teaching on a regular, daily basis and from which to plan for continuity. Further, one–to–one teaching interventions for reading need to be ‘quality assured’ and mesh with the rest of the curriculum to make sure that the total experience is coherent from the standpoint of the child.

One of the best recent summations on dyslexia is provided by Professor Dorothy Bishop [1]:

‘A genetic aetiology does not mean a condition is untreatable

Could genetic findings be useful in intervention? All too often it is assumed that if genetic effects are found, the child will be untreatable. Yet, high heritability does not imply immutability: it implies that the range of environmental experiences that is usually encountered in everyday life does not have much impact on a trait, but says nothing about potential impact of novel environmental experiences. When, for instance, a child has the heritable myopia, we do not treat them as passive victims of their genetic destiny. Instead, they are given spectacles: an intervention that is out- side the range of normal environmental experiences, but which is tailored to counteract the genetic effect. Similar logic can be applied in the case of dyslexia: if there are genetic variants that affect how children learn, we need to find out how they work to affect brain development and function. That will allow us to develop ways of intervening to over- come the problem—interventions that may need to be different from regular teaching experiences. We are still a long way from knowing how to do this, but genetic information points us towards the right path. It is not helpful to assume that all poor readers are the consequence of poor teaching and that additional or earlier reading instruction will fix the problem. We need studies that examine which kinds of reading instruction are most effective for children at high genetic risk, who often have disproportionate difficulties with aspects of speech sound analysis and associative learning that other children find easy. Genetic research does not lead us to write off children who are poor readers, but rather to recognize that they may need more individualized instruction tailored to their specific needs.’

Dyslexia is not yet well enough understood as an extreme reading disorder for which we have precise solutions. Pretending it is a myth, however, risks burying our heads in the sand and giving up the search. 

[1] The interface between genetics and psychology: lessons from developmental dyslexia: D.V. M. Bishop Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, UK.  Proc. R. Soc. B 282: 20143139. http://dx.doi.org/10.1098/rspb.2014.3139

[2] Department for Education: National curriculum assessments at key stage 2 in England, 2014 (Revised)

[3] Foresight Mental Capital and Wellbeing Project (2008) Jim Rose 01.06.15

Download a PDF of the paper.