Academic literature on the topic 'Dyslexia – South Africa'

Models of the stages by which the acquisition of reading skills normally proceeds have been proposed by Frith (1985) and Seymour (1987). Based on these developmental models, a battery of psycholinguistic tests appropriate for English-speaking South African children was devised to identify the processing strategies which a child has and has not acquired. The procedure yields both qualitative and quantitative information and allows comparison of dyslexic children with average readers of similar Reading Age. Two cases of developmental dyslexia are discussed to illustrate different patterns of performance on the assessment. These patterns of performance are interpreted in the context of current models of the development of reading skills.

Widespread learning problems among South African children are associated with the apartheid era and show a need for effective reading programs. In selecting these programs, it is useful to differentiate between children with dyslexia and children whose reading is poor because teaching was inadequate. In this study, the Woodcock Tests of Reading Mastery-Revised and tests modelled on the Cognitive Assessment System were used to define a group of children with deficits in successive processing associated with dyslexia and a group of children with general reading delay. There were two girls and five boys in each group. For the children with successive processing deficit, the mean age was 9 yr., 8 mo. For the other group, mean age was 9 yr., 3 mo. Control groups were matched for age and sex and kind of reading difficulty. The first group received Das's PASS Reading Enhancement Program, and the second participated in a remedial program based on Whole Language principles. The treatment groups received 24 1-hr. long sessions. Gains in successive processing were shown for the first group, as measured by the tests modelled on Cognitive Assessment System subtests but not for the second group. Both groups showed gains in phonics and word identification, relative to their respective control groups, suggesting the respective intervention program was effective for each group.

Background: Reading difficulties constitute an impediment to the learning process and in the educational achievement of a child. Consequently, several studies examined the visual status of dyslexic children in the Caucasian populations. Such studies are lacking in the African populations.Aim: To determine the prevalence of vision defects and investigate if there is an association between dyslexia and vision in a South African population of dyslexic school children. Methods: This comparative study assessed the visual function of 62 children (31 dyslexic and 31 normally-reading children), mean age 13 ± 1.42 years and 11.90 ± 0.93 years respectively. The participants were matched for gender, race and socio-economic status. The visual functions evaluated and the techniques used were: visual acuity (LogMAR acuity chart), refraction (static retinos-copy), ocular alignment (cover test) near point of convergence (RAF rule), accommodation facility (± 2 D flipper lenses), amplitude of accommodation (push-up method) relative accommodation(trial lenses) accommodation posture (monocular estimation technique) and vergence reserves (prism bars). Results: In the following, results are provided for the dyslexic versus control: Refractive errors: (hyperopia 6.5% vs 3%,) (myopia 6.5% vs 6.5%), (astigmatism 10% vs 13%), (anisometropia 6.5% vs 6.5%) (amblyopia 6.5% vs 0%), (remote NPC 33% vs 48%) (esophoria at near 3% vs 0%) (exophoria at near 9.5% vs 0%), (accommodative infacility at near 54% vs 33%), lag of accommodation 39.28% vs 41,93%, (poor positive fusional amplitude at near, 25% vs 16%). Only the binocular accommodative facility at near was significantly associated with dyslexia (p=0.027). Conclusion: The prevalence of vision defects was similar between the dyslexic and non-dyslexic participants, which suggest that an association between dyslexia and vision variables investigated, cannot be inferred. This study provides a research perspective on the prevalence of vision defects in a Black South African population of dyslexic children and has clinical relevance and implications for the assessment, detection and management of vision anomalies in dyslexic schoolchildren. (S Afr Optom 2011 70(1) 29-43)

The objective of this article is to explore how suitable Team-Based Learning (TBL) is for students with social and communication disabilities, such as those on the autism spectrum or with social anxiety. TBL is a structured form of Active Collaborative Learning, combining a flipped classroom approach with students working in permanent teams to apply concepts, models and theories into practice. The design of the study was based on an idiographic case study approach at Anglia Ruskin University, UK, treating each student as an individual rather than a representative sample. Towards the end of the academic year 2017/18, an electronic questionnaire was sent out to all students who had taken TBL modules at ARU during the preceding academic year, asking about various aspects of TBL experience. The questionnaire was repeated towards the end of the first semester of 2018/19. The questionnaire was analysed with a focus on questions relating to inclusivity, and the responses related to students who had declared a disability. The questionnaire was followed by semi-structured interviews with students with disabilities who had experienced TBL. We focused primarily on disabilities broadly related to communication, notably with dyslexia, dysgraphia, social phobia and autism that may impair students’ abilities to work in teams. Interviews were audio recorded and then transcribed. Transcriptions were thematically analysed by the research team using NVivo. The results of the study provide anonymized case studies for each of the students who took part in an interview, explaining their disability or condition, their coping strategies for studying in HE, and their experiences, both positive and negative, of the TBL modules they had taken. References Active Collaborative Learning. (2019). Scaling Up Active Collaborative Learning for Student Success. Project website. https://aclproject.org.uk. ARU. (2017). Equality, Diversity and Inclusion at our University. Annual Report. Anglia Ruskin University.https://web.anglia.ac.uk/anet/student_services/public/AngliaRuskinReport_2017_AW_ACCESSIBLE.pdf. ARU. (2018). Student Snapshots. Anglia Ruskin University. https://aru.ac.uk/about-us/equality-diversity-and-inclusion/equality-diversity-and-inclusion-for-students/aru-student-snapshots. ARU. (2020). Disability Support. Anglia Ruskin University. https://aru.ac.uk/student-life/support-and-facilities/study-skills/disability-support. ARU. (2020b). Inclusive Practices. Anglia Ruskin University. https://aru.ac.uk/about-us/equality-diversity-and-inclusion/equality-diversity-and-inclusion-for-students/inclusive-practices. Berkson, R., & Richter, U.M. (2019). Can Active Collaborative Learning Improve Equality? The European Conference on Education 2019 Official Conference Proceedings. https://papers.iafor.org/submission51859/. Berkson, R.G., & Richter, U.M. (2020). Barriers to scaling up active collaborative learning. IN S. Pratt-Adams, U.M. Richter & M. Warnes (Eds.), Innovations in Active Learning in Higher Education, Ch 7. Anglia Ruskin University (in press). Chenail, R. J. (2009). Interviewing the Investigator: Strategies for Addressing Instrumentation and Researcher Bias Concerns in Qualitative Research. The Qualitative Report, 13(4): 14-21. https://nsuworks.nova.edu/tqr/vol13/iss4/14/. Dearnley, Ch., Rhodes, Ch., Roberts, P., Williams, P., & Prenton, S. (2018). Team based learning in nursing and midwifery higher education; a systematic review of the evidence for change. Nurse Education Today, 60: 75-83. http://dx.doi.org/10.1016/j.nedt.2017.09.012. Eksteen, M.J. (2019). Does team-based learning develop essential generic skills in pharmacy students? South African Journal of Higher Education, 33(1). https://www.journals.ac.za/index.php/sajhe/article/view/1332. http://dx.doi.org//10.20853/33-1-1332. Haidet, P., Kubitz, K., & McCormack, W. T. (2014). Analysis of the team-based learning literature: TBL comes of age. Journal on Excellence in College Teaching, 25(3-4): 303-333. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643940/. Hefce. (2018). Differences in student outcomes. The effect of student characteristics. Data Analysis report March 2018/05. https://dera.ioe.ac.uk/31412/1/HEFCE2017_05%20.pdf HM Government. (2017). Industrial Strategy. Building a Britain fit for the future. UK Government White Paper. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/664563/industrial-strategy-white-paper-web-ready-version.pdf. Kent, S., Wanzek, J., Swanson, E.A., & Vaughn, S. (2015). Team-Based Learning for Students with High-Incidence Disabilities in High School Social Studies Classrooms. Learning Disabilities Research & Practice, 30(1): 3-14. https://onlinelibrary.wiley.com/doi/abs/10.1111/ldrp.12048. Koles, P.G., Stolfi, A., Borges, N.J., Nelson S., & Parmelee, D.X. (2010). The impact of team-based learning on medical students' academic performance. Academic Medicine: Journal of the Association of American Medical Colleges, 85(11): 1739-1745. https://pubmed.ncbi.nlm.nih.gov/20881827/ http://dx.doi.org/: 10.1097/ACM.0b013e3181f52bed. Michaelsen, L. K., Davidson, N., & Major, C. H. (2014). Team-based learning practices and principles in comparison with cooperative learning and problem-based learning. Journal on Excellence in College Teaching, 25(3&4): 57-84. https://www.lhthompson.com/uploads/4/2/1/1/42117203/team_based_learning_-_group_work.pdf. Michaelsen, L. K., Knight, A. B., & Fink, L. D. (2004). Team-based learning: A transformative use of small groups in higher education. Sterling, VA: Stylus. McNeil, J., Borg, M., Kennedy, E., Cui, V., Puntha, H., Rashid, Z., Churchill, T., Howitt, E. and Trivedy, K., (2019a). SCALE-UP Handbook 2019-20 (3rd ed). Centre for Academic Development and Quality, Nottingham Trent University. https://www.ntu.ac.uk/__data/assets/pdf_file/0033/906927/FINAL-SCALE-UP-Handbook-2019-20.pdf. McNeil, J., Borg, M., Kerrigan, M., Waller, S., Richter, U., Berkson, R., Tweddell, S., & McCarter, R. (2019b). Addressing barriers to student success. Scaling up Active Collaborative Learning for Student Success. Final Report, 28 March 2019, Updated 28 October 2019. https://aclproject.org.uk/wp-content/uploads/2019/07/NTU-ABSS-Final-Report-revised-Oct-2019.pdf. OECD. (2019). OECD Future of Education and Skills 2030. OECD Learning Compass 2030. A Series of Concept Notes. OECD. http://www.oecd.org/education/2030-project/contact/OECD_Learning_Compass_2030_Concept_Note_Series.pdf. Office for Students. (2019a). Addressing Barriers to Student Success programme. https://www.officeforstudents.org.uk/advice-and-guidance/promoting-equal-opportunities/addressing-barriers-to-student-success-programme/ Office for Students. (2019b). Beyond the bare minimum: Are universities and colleges doing enough for disabled students? OfS Insight Brief 4. https://www.officeforstudents.org.uk/publications/beyond-the-bare-minimum-are-universities-and-colleges-doing-enough-for-disabled-students/#participation. Roulston, K., & Shelton, St. A. (2015). Reconceptualizing Bias in Teaching Qualitative Research Methods. Qualitative Inquiry, (21)4: 332-342. https://journals.sagepub.com/doi/10.1177/1077800414563803. Sangwan, P., & Sangwan, S. (2011). Inclusive Education: A Developmental Approach in Special Education. Journal of Indian Education, 36(4): 18-32. http://www.ncert.nic.in/publication/journals/pdf_files/iea/JIE_FEB2011.pdf#page=20 Sibley, J., & Ostafichuk, P. (2014). Getting Started with Team-Based Learning. Sterling, VA, USA: Stylus. Sisk, R. J. (2011). Team-based learning: systematic research review. Journal of Nursing Education, 50(12): 665–669. https://pubmed.ncbi.nlm.nih.gov/22007709/. Vaccaro, A., Daly-Cano, M., & Newman, B. M. (2015). A sense of belonging among college students with disabilities: An emergent theoretical model. Journal of College Student Development, 56(7): 670-686. https://muse.jhu.edu/article/597267 Vaughn, S., Danielson, L., Zumeta, R., & Holdheide, L. (2015). Deeper Learning for Students with Disabilities. Students at the Center. Deeper Learning Research Series. Boston, MA: Jobs for the Future. https://files.eric.ed.gov/fulltext/ED560790.pdf. Wanzek, J., Vaughn, S., Kent, S.C., Swanson, E.A., Roberts, G., Haynes, M., & Solis, M. (2014). The Effects of Team-Based Learning on Social Studies Knowledge Acquisition in High School. Journal of Research on Educational Effectiveness. 7(2): 183-204. https://www.tandfonline.com/doi/abs/10.1080/19345747.2013.836765. Williams, M., Pollard, E., Helena Takala, H., & Houghton, A-M. (2019). Review of Support for Disabled Students in Higher Education in England. Report to the Office for Students by the Institute for Employment Studies and Researching Equity, Access and Participation. IES Report. Institute for Employment Studies and Researching Equity, Access and Participation. https://www.officeforstudents.org.uk/media/a8152716-870b-47f2-8045-.fc30e8e599e5/review-of-support-for-disabled-students-in-higher-education-in-england.pdf World Economic Forum. (2018). The Future of Jobs 2018. Insight Report. Centre for the New Economy and Society. http://www3.weforum.org/docs/WEF_Future_of_Jobs_2018.pdf.

Tesis voorgelê volgens die vereistes van die M.Ed.: Onderwys Vir die Fakulteit van Onderwys en Sosiale Wetenskappe te Kaapse Skiereiland Universiteit van Tegnologie 2014
Reading is the interaction between author and reader. To be able to read, the reader has to decode the message in order to read with comprehension/understanding. Reading consists of two components, namely word recognition and reading comprehension. Word recognition is the ability to recognise words as quickly as possible. Reading comprehension is the ability to store the meaning of the message in words in the brain. To be able to read the learner must be able to recognise the message and to understand what he/she reads. The ability to read is very important, because a good reading ability is the key to success in a learner’s studies at school. Reading problems occur due to the lack of phonological processing of written material. Reading problems are caused by various factors such as emotional factors, sensory factors and limited cognitive ability – to mention but a few. The purpose of this research was to determine whether a multi-sensory reading method such as the Silverman approach to reading could have a positive influence on the reading and studying abilities of a learner with dyslexia combined with an instructional design. A literature review was done on reading and reading problems, a multi-sensory approach, and well-known multi-sensory approaches such as the Davis method, Orton Gillingham method and the Silverman method. A Grade 8 learner who had been diagnosed with dyslexia was evaluated according to the ESSI reading and spelling tests to determine his reading and spelling levels. His parents and he had to complete questionnaires to determine his scholastic and social progress. After that, the learner was helped by using the Silverman spelling method to enhance his spelling and reading abilities. The duration of the course was thirteen weeks and the learner attended hourly sessions two times per week. The instructional design was used to adjust the sessions according to the learner’s needs. The quantitative research method, namely the ESSI reading and spelling tests, was used as well as the qualitative method. The researcher also used journal inscriptions to observe the sessions in order to change the programme should it be deemed necessary. After completion of the course, the learner was evaluated according to the ESSI test once more and his parents and he had to complete the questionnaire again to ensure reliability and validity. The results of the qualitative tests and the quantitative information pointed out that the learner successfully progressed in his reading and spelling abilities. Die praktiese ondersteuning van ’n leerder met disleksie deur middel van ’n instruksie-beplanningsproses vi It is thus possible to deduct that a multi-sensory reading and spelling method such as the Silverman method had a positive influence on the learner’s reading and spelling abilities. A shortcoming in the research was that the researcher was restricted to only four months to complete the research project. Should the research have begun from the beginning of the year, the results might have differed completely. The researcher has also made recommendations about the training of teachers, as well as recommendations to the Department of Education.

The aim of this study is to develop an understanding of how Grahamstown teenagers are affected by the label ʹdyslexiaʹ; by providing a space in which their feelings about being labelled dyslexic and their experiences can be voiced. Historically much international and local research has focussed on causation and remediation of dyslexia and has neglected the social aspects of the diagnosis. Causation and remediation are categories which form part of the medical or educational models. A social model of dyslexia needs to be applied. Due to the paucity of South African literature on the social experiences of dyslexic teenagers, this research thesis aims to add to the body of knowledge and hopefully provide an avenue for more research within the context of Sociology. This is a micro study, situated in Grahamstown Eastern Cape, South Africa, and the author recognizes that responses cannot be generalized to the greater dyslexic population. All human environments consist of objects which are given meaning through social interaction. Meaning is central to human behaviour and therefor explains the ways in which humans conduct their lives based on these meanings. For this reason George Herbert Mead’s (1934) and Herbert Blumers (1969) symbolic interactionist positions have framed the theoretical approach to this research. Qualitative methods of interviewing provide an opportunity for dyslexic individuals to discuss the meaning dyslexia gives to them, from their perspective and in their own words. The following conclusions have been arrived at: Educational psychologists in Grahamstown are reticent to diagnose individuals as dyslexic. This lack of identification hinders early intervention which can be very detrimental to individuals struggling with reading, writing and spelling as well as the associated co-morbid conditions of dyslexia. Teenagers who have had early diagnosis and intervention with support structures in place identify with their dyslexic identity more positively as they are able to make sense of their struggles of a dyslexic nature.

Included in the challenges possibly faced by those with dyslexia, is the acquisition of literacy skills. Despite 21st century advancements made in technology, literacy skills remain central to education and day-to-day living. Therefore, it is essential to meet the learning needs of those with dyslexia, as failure herein could impact negatively on their lived experiences and on the attainment of their needs. The main aim of this transcendental phenomenological study was to explore, and describe the first-hand lifelong experiences of adults living with dyslexia. The study utilised the theoretical and conceptual frameworks of Bronfenbrenner’s Ecological Systems Theory and Maslow’s Hierarchy of Needs. Following a multistage procedure, a criterion-based sampling strategy was used to select study participants, comprising of eight South African adults between the ages of 18 and 40, who were formally diagnosed with dyslexia. Data collection included semi-structured one-on-one in-depth interviews and the researcher’s reflective journal. Data analysis, following the principles of phenomenology, resulted in the formation of five themes. Findings reveal that dyslexia is viewed positively by adults diagnosed with it, and used as a driving force to succeed and obtain set goals. Various professionals were consulted with the aim of obtaining a diagnosis; however, obtaining a diagnosis and hence an explanation for their learning challenges, was a stressful experience for both the participants and their parents. Families provide much assistance with school work, although all participants revealed negative schooling experiences caused by schools not acknowledging dyslexia and not meeting their specific learning needs. Although living with dyslexia presents challenges, coping mechanisms are in place for overcoming anticipated challenges. Whilst self-confidence is not negatively affected, dyslexia appears to negatively affect the self-esteem of some. This study found that the dyslexia label is preferred to that of having additional learning needs, as the dyslexia label is viewed as referring to specific challenges and not to entire learning abilities. Finally, this study hopes to provide a deeper understanding of the experiences of those living with dyslexia and fill the existing gap in South African literature.
Psychology
Ph. D. (Psychology)

The main aim of this study was to assess teachers’ awareness levels of dyslexia, their perceptions of their ability to identify and manage dyslexia, and their perceptions of the adequacy of their pre-service and in-service training in dyslexia. The sample comprised teachers at 16 mainstream high schools in the Western Cape. A Likert type scale questionnaire was used to collect data that were analysed by means of a sign test of difference and a Kruskal-Wallis test of variance. The results indicated that teachers had adequate knowledge of dyslexia, believed they are able to identify and manage dyslexia, and believed that they received little or no pre-service and in-service training in dyslexia. The main conclusion that can be drawn is that teachers need on-going adequate pre-service and in-service training in the field of dyslexia.
Department of Psychology
M.A. (Psychology)

Dyslexia is one of the most common learning disabilities and learners affected by it are found in both mainstream and specialist schools. The aim of this study was to explore and describe the school experiences of learners who had been diagnosed with dyslexia and attended a long-term remedial school. A phenomenological research design was followed. Six learners in grades 6 to 9, who were attending a long term remedial school, were the participants. Semi-structured individual face-to-face interviews were held to collect data, posing questions that focused on the learners’ experiences with their educators, peers, written and verbal school work, as well as homework. From the data collected themes were formed. The findings showed that participants believed most of their teachers were aware of and knowledgeable about suitable methods to use when teaching dyslexic learners. The results also indicated that the school understood the challenges faced by the dyslexic learners and it was doing well in attempting to provide them with an educational environment suitable for their academic and personal needs.
Psychology of Education
M. Ed. (Psychology of Education)

Abstracts in English, Afrikaans and Xhosa
The purpose of this study was to explore reading barriers of Foundation Phase learners in IsiXhosa Home Language in the Lady Frere district in the Eastern Cape Province (ECP). The qualitative single case study of one Junior Secondary school in the chosen district was studied. The empirical research was done through interviews with the teachers and lesson observations. The findings suggested that there was some concern with regards to the reading ability of learners in the District. The lack of parental involvement, high turnover of teachers, lack of training and support of teachers were identified as attributing factors to reading barriers of learners. Measures to address these factors were suggested. The measures included capacity building of teachers, parents or care givers of learners, and ways of retaining teachers in schools to reduce the high turnover of staff. In conclusion, it is anticipated that the findings and recommendations of this study will provide valuable contribution to the district officials to be able to address the teaching and learning gaps and empower and support both teachers and learners in the Eastern Cape Province.
Die doel van hierdie studie was om leeshindernisse van leerders in die Grondslagfase, met Xhosa as huistaal, in die Lady Frere distrik in die Oos-Kaap Provinsie te ondersoek. Die kwalitatiewe, enkele gevallestudie het die bestudering van een Junior Sekondêre skool in die gekose distrik behels. Die empiriese navorsing is gedoen deur onderhoude met die onderwysers te voer en deur waarnemings van lesse. Die bevindings dui daarop dat daar kommer bestaan oor die leesvermoë van leerders in die distrik. Afwesige ouerbetrokkenheid, die hoë omset van onderwysers en die gebrek aan voldoende opleiding en ondersteuning aan onderwysers word identifiseer as die moontlike oorsake van leeshindernisse van leerders. Maatreëls om die faktore wat leeshindernisse veroorsaak aan te spreek, is voorgestel. Die maatreëls behels onder meer kapasiteitsbou van onderwysers, ouers of versorgers van leerders, asook maniere om onderwysers in skole te behou en sodoende die hoë personeelomset te verminder. Ten slotte, die verwagting is dat die bevindings en aanbevelings van hierdie studie ‘n waardevolle bydrae aan die distriksbeamptes sal lewer om die leemtes vir voldoende onderrig en leer te kan aanpak en sodoende beide onderwysers en leerders in die Oos- Kaap te bemagtig en te ondersteun.
Injongo yoluphando yayikukuphonononga izithintelo kufunda zamabanga aphantsi kulwimi lwasekhaya lwesiXhosa kwisithili saseCacadu kwiphondo laseMpuma-Koloni. Kwaphononongwa isifundo secala elinye elinoqeqesho kwisikiolo samabanga aphakathi kwisithili esikhethiweyo. Kwenziwa uphando olunamandla kusetyenziswa udliwanondlebe nootitshala kunye nokujonga. Iziphumo zabonisa ukuba kukho ukuxhalaba ngendlela abafundi besithili esikhethiweyo babefunda ngayo. Oko kwakudalwa kukungazibandakanyi kwabazali emfundweni yabantwana babo, ukutshintsha nokushiya kootitshala izikolo nesebe lezemfundo ngokubanzi nokunqongophala koqeqesho nenkxaso yootitshala. Kwacetyiswa amadondolo okulungisa imiba echaphazela iingxaki zokufunda . Lamadondolo ayecebisa ukuba kujongwane nemiceli mingeni eyayisele iboniwe, enje ngophuhliso lweetitsshala, abazali okanye abagcini bantwana, iindlela zokugcina abasebenzi ezikolweni, ukunciphisa ukutshintsha izikolo nokuyeka ukufundisa kootitshala. Ukuphetha, kuyabonakala ukuba iziphumo nezindululo zoluphando zizakuba negalelo elingathethekiyo kumagosa ezemfundo. Loo nto iyakuwanceda amagosa lawo akwazi ukuqaphela nokuqubisana nezikhewu ekufundeni, baphuhlise baxhase ootitshala nabantwana kwiPhondo leMpuma-Koloni.
Inclusive Education
M. Ed. (Inclusive Education)

Dyslexia is a neurological disorder with genetic origin that affects a person’s word processing ability, their spelling, writing, comprehension and reading, and results in poor academic performance. As a result, optometrists are consulted for assistance with the diagnosis and treatment of a possible vision condition. Optometrists are able to assist with treatment as part of a multidisciplinary management approach, where optometric support is necessary. International studies have indicated that up to 20% of Caucasian school children are affected by dyslexia, while there are no similar figures for African children. Studies have been done to assess the extent of visual defects among Caucasian dyslexics, but not among African dyslexic children. The aim of the study is therefore to determine the prevalence of vision conditions in an African South African population of dyslexic school children, and to investigate the relationship between dyslexia and vision. The possible relationship between dyslexia and vision conditions has been recognized as an important area of study, resulting in research being conducted in many countries. Studies have been undertaken by optometrists and ophthalmologists, who differ in their approach and attitude on how vision conditions affect dyslexia. A review of the literature revealed three broad areas of vision that may impact on reading ability, these being acuity defects, binocular vision and ocular pathology. Acuity defects consist of visual acuity and refractive error. Areas of binocular vision evaluated in the literature include near point convergence, heterophoria, strabismus, accommodative functions, vergence facility and reserves. Hyperopia was the only vision variable that was found to be consistently associated with difficulties with reading, but not causally while findings on other variables were inconclusive. However, all the studies acknowledged the complexity of the condition, and the need for a comprehensive multidisciplinary management approach for its diagnosis and management. The study was undertaken in the city of Durban, South Africa, using a case-control study of two groups of African school children between the ages of 10 and 15. Both study groups consisted of 31 children of normal intelligence, who were matched in gender, race and socio-economic status. The case group attended a school for children with learning disabilities, while the control group attended a mainstream school. At the time of the study, only one school catered for African children with learning disabilities, and only 31 of its pupils were diagnosed with dyslexia. Ethical approval was obtained from the University of KwaZulu-Natal; permission to undertake the study in the identified schools was obtained from the Department of Education, and the school principals consented on behalf of the learners, as it was not always possible to reach the individual parent. The researcher (an optometrist) visited both schools by appointment where rooms were made available to do the testing, and the tests were explained to all participants. The LogMar Acuity Charts were used to assess visual acuity, and static retinoscopy was used to assess refractive error. Binocular vision was tested using the cover test for ocular alignment, the Hirschberg test for strabismus, RAF rule for near point of convergence, ± 2 D flipper lenses for accommodation facilities, Donder’s push up methods, using the RAF rule for amplitude of accommodation, plus and minus lenses for relative accommodation, monocular estimation technique for accommodation posture, and prism bars for vergence reserves. Ocular pathology was assessed using a direct ophthalmoscope. The dyslexic group presented with the following: Refractive errors: hyperopia 6.5%, myopia 6.5%, astigmatism 10%, anisometropia 6.5%, remote near point of convergence 33%, esophoria at near 3%, exophoria at near 9.5%, accommodative infacility 54% and lag of accommodation 39.28%. The dyslexic group had relatively reduced fusional reserve compared to the control group. The control group presented with the following: Refractive errors: hyperopia 3%, astigmatism 13%, anisometropia 6.5%, remote near point of convergence 48%, esophoria at near 0%, exophoria at near 0%, accommodative infacility 33% and lag of accommodation 41.93%. The prevalence of a remote NPC was higher in the control group than in the dyslexic group and there was a statistically significant difference between the two groups: NPC break (p=0.049) and recovery (p=0.046). The prevalence of poor binocular accommodation facility at near was higher in the dyslexic group than in the control group and there was a statistically significant difference between the two groups (p = 0.027). Vision defects such as hyperopia, astigmatism, accommodation lag, convergence insufficiency, poor near point of convergence and accommodative infacility were present in the dyslexic pupils, but they were no more at risk of any particular vision condition than the control group. This study provided the prevalence of vision conditions in a population of African dyslexic children in South Africa, the only vision variable that was significantly more prevalent in the dyslexic population being the binocular accommodation facility at near, although the study was unable to find a relationship between dyslexia and vision. The statistically significant difference may not imply clinical significance due to the small sample size. However, it is recommended that any vision defects detected should be appropriately compensated for as defective vision can make reading more difficult for the dyslexic child. The sample size may have been a limitation; however, this was comparable with studies reviewed, most of which had sample sizes of less than 41. Due to the range of possible ocular conditions that could affect dyslexia, it is recommended that a larger sample size be used to ensure more conclusive results. Testing for relative accommodation with a phoropter would provide more accurate results, and accommodation facility and fusional reserves would be better assessed with suppression control. The study provides information and an indication of research needs regarding the prevalence of vision defects in an African South African population of dyslexic children.
Thesis (M.Optom.)-University of KwaZulu-Natal, Westville, 2010.