Implications and consequences of the Mind-Body-Mismatch

The wright / write hand mismatch, if present is ‘allowed’ to emerge during the course of conducting an assessment / examination / diagnosis. In the majority of cases, where it is present, it is the client who realizes  then vocalises their writing hand is not their wright hand. The aim is to seek to eliminate this Mind-Body-Mismatch  as a co-factor in the presenting problem. If it were to be present discussion would take place over its ‘treatment’ and its implications. It should come as no surprise to learn that this aim is currently never used by other psychologists, psychiatrists or educational consultants when  conducting assessments for individual, educational, medico-legal, and legal purposes. Of course, if it is not present, there is no need to discuss its implications and consequnces

 

 

Illustration 1 (Table)

The table below details the variety of problems where the MBM has been identified as a co-factor in many presenting problems.

Illustration 1 (Table)
Individuals

Individuals and solicitors and courts sought help for a variety of reasons: as summarised in TABLE I 

Families

Typically, parents seek help with their children’s schooling when: 

 

  • their child has not made expected progress, 
  • not satisfied with existing IEPs, / EHCPs, 
  • need to sort out problems before their child moved onto secondary schooling, 
  • had already changed schools hoping that new school could sort out problems yet failed to do so 

 

Table I indicates the variety of cases where I’d identified the MBM as being a co-factor. It is only because I followed a puzzling approach instead of the BPsS discipline-based or even Popper’s problem-driven approach that I was unable to eliminate it as a co-factor. I  recommend that treatments that failed to take account of this finding would be less than adequate and unnecessarily costly.   

 

Dyslexia

To set the context and to illustrate the subtle influence of the hegemony of the right in ’debates’ about dyslexia:  

“It is really important that we do not assume that assistive technology will solve all problems but, used correctly and with the right support, it can make a life-changing and life-chance-changing difference. The noble Lord, Lord Addington, highlighted that it should be the right tool at the right time.” Assistive technology and SEN debated in the House of Lords, Wednesday 31 May 2023 [My italics] 

 

‘Dyslexia’ is defined as much by politicians with vested interests as it socially defined.. 

The Guardian, Thursday 17th September 2020, Siri Kale 

 

In 2018, two local authorities – Staffordshire and Warwickshire – announced that they would no longer differentiate between children with dyslexia and children with literacy difficulties. “It is widely accepted that the diagnosis of dyslexia is scientifically questionable,” the guidance – which outlined both local authorities’ provision for children with literacy difficulties – explained. 

 

Despite the success of the earlier pilot scheme, there was strong opposition to Staffordshire and Warwickshire’s announcement in 2018. In October, the BDA president Lord Addington raised the issue in the House of Lords. Addington is a hereditary peer and, since 2011, chair of Microlink, a company that has received £132.3m in government contracts since 2003 to supply assistive technology to students with disabilities, including dyslexia. During the ensuing debate, one peer wondered whether Warwickshire and Staffordshire had “also advised their residents that the Earth is actually flat and that there is no such thing as global warming”. Anxious parents besieged the phone lines of at least one local dyslexia charity, asking whether their dyslexic children would no longer receive help; the BDA gave statements to the specialist education press and the Telegraph, alleging that both local authorities were simply looking to cut costs. 

 

 

It is claimed that dyslexia quite often co-occurs with other Special (sic) Learning Difficulties – SpLDs. For instance it is claimed that it is not unusual for dyslexia to co-occur with attention deficit disorder (ADD), developmental coordination disorder (commonly known as dyspraxia), autistic spectrum disorder (ASD), dyscalculia, or speech, language and communication difficulties.   

 

So much for the specificity of the label! 

 

Primary research of 1,300 parents of children with dyslexia for a report on dyslexia found: 

95 percent of parents feel they lacked the skills and knowledge to support their dyslexic child, 

Nearly half of parents reported that they spent over £1,000 extra per year because of their child’s dyslexia, 

58 percent of parents report their children try to avoid discussing their dyslexia, a staggering 82 percent of parents report their children try to hide their difficulties relating to dyslexia and 85 percent of parents report their children feel embarrassed by their dyslexia. 

 

Providing evidence on the long-term psychological effects of growing up with dyslexia, Pennie Aston, Director of GroOops, a charity specialising in providing counselling support to adults with dyslexia, said: “It is not that dyslexia means people are less able to cope with complex emotions than their neurotypical cousins, but that they are having to cope with far more unresolved problems from the past where the focus had been on deficit. Also, few understood the presentations of dyslexia other than a difficulty with reading and writing. The result is that dealing with the emotional repercussions of dyslexia is dealing with trauma.” 

 

 

Examples of barriers that are put in place to try and stop young people with  

dyslexia receive the specialist support they are entitled to include: 

   

1. Schools telling parents or carers that their child needs to be at least two 

years behind their peers for attainment levels of literacy. This is not the 

case in law, the Children & Families 2014 act has no such stipulation. This 

delays the process and immediately removes those children who whilst 

people with dyslexia are working extremely hard to keep up. Equally it 

discriminates against those parents or carers who are able to supplement 

school education through home-based support. 

2. Schools carrying out “assessments” without the specialist knowledge

required and then providing parents or carers with inaccurate information.

 

3.Schools telling parents or carers that the local authority (LA) will not

recognise dyslexia and therefore, will not provide any support for it. 

4. Schools refusing to accept the findings of diagnostic assessments carried out

privately and also refusing to implement support recommendations that 

have been made by specialists. 

 

The British Dyslexia Association can arrange assessments which are funded by schools, local authorities, universities, organisations and employers. The cost of an assessment is £660 (£550 + VAT) with a specialist teacher. Our specialist teacher/assessors have a current Assessing Practicing Certificate (APC). An assessment with an psychologist is £700 (VAT exempt). All associate psychologists are registered with the Health and Care Professional Council (HCPC). The locations that we can offer are listed in the booking pack, these are kept up to date, if we do not have an assessor in your area we can offer a remote assessment by remote video platform. Assessors are booking many months in advance. 

 

Poor literacy and basic skills as a result of undiagnosed dyslexia costs the UK economy £1bn a year, the Dyslexia Institute said today. 

 

The daily cost of £2.75m is accounted for in the hidden costs to the welfare state: People who are dyslexic and undiagnosed are far more likely to be excluded from school, unemployed for long periods of time or imprisoned. 

 

The annual cost is £34 per taxpayer, the institute said. Some 5.2 million have poor literacy skills and 6.8 million adults have poor numeracy skills, according to government figures. The government estimates that adults with poor literacy and numeracy skills could earn up to £50,000 less over their lifetime and are more likely to have health problems. 

ADHD: the medicalization of interactional behaviour

If we accept the characterization of ADHD as being ill-at-ease (primarily but not exclusively because of the mis-match between the writing and the adept hand) the name of the ADHD industry’s founder is rather ironic: : 

Sir George Frederick Still (1868-1941) The father of British paediatrics. 

England’s first professor in child medicine presented on 4th, 6th and 11th March 1902 a series of three lectures to the Royal College of Physicians in London, under the name “Goulstonian lectures” on ‘some abnormal psychical conditions in children’, which were published later the same year in the Lancet. He described 43 children who had serious problems with sustained attention and self-regulation, who were often aggressive, defiant, and resistant to discipline, excessively emotional or passionate, who showed little inhibitory volition, had serious problems with sustained attention and could not learn from the consequences of their actions; though their intellect was normal. 

He wrote “I would point out that a notable feature in many of these cases of moral defect without general impairment of intellect is a quite abnormal incapacity for sustained attention. 

He concluded: “there is a defect of moral consciousness which cannot be accounted for by any fault of environment” When Still was talking about Moral Control, he was referring to it as William James had done before him, but to Still, the moral control of behaviour meant “the control of action in conformity with the idea of the good of all” 

 

In casting ADHD as a physical condition that needed to be treated with psychiatric therapy and medication, the role of social interaction was at best ignored and at worst denied. In respect of medication it is held that some medicines need to be taken every day, but for school children some can be taken just on school days. Treatment breaks are occasionally recommended to assess whether the medicine is still needed. 

 

It is also suggest starting a group-based, ADHD-focused parent training or education programme. The same point that Prof Uta Frith made about autism and parenting is also made about ADHD: The need for a parent training and education programme does not mean bad parenting, claims the BDA. Exactly the same claim was made by Prof. Uta Frith in respect of parents of autistic children. The reason for the success of this ‘not bad parenting’ philosophy is that it takes responsibility away from accepting that it may be a consequence of a different style of parent-child interaction.. 

 

For adults to be diagnosed with ADHD, their symptoms should  have a moderate effect on different areas of their life, such as: 

 

  1. underachieving at work or in education 
  2. driving dangerously 
  3. difficulty making or keeping friends 
  4. difficulty in relationships with partners 

         

        Those not diagnosed until adulthood are advised to discuss with a GP and specialist which medicines and therapies are suitable treatments 

        . 

        There are 5 types of medicine licensed for the treatment of ADHD: 

         

        1.   methylphenidate 
        2.   lisdexamfetamine
        3.   dexamfetamine
        4.   atomoxetine 
        5.   guanfacine 

                 

                It is stated that these medicines are not a permanent cure for ADHD but may help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills. 

                 

                If the adult or child is prescribed one of these medicines, they’ll probably be given in small doses at first, which may then be gradually increased. The adult or child will need to see a GP for regular check-ups to ensure the treatment is working effectively and check for signs of any side effects or problems. 

                 

                Such medical treatments are not problem-free as is made clear by the advice that it’s important to let the GP know about any side effects and talk to them about the need to stop or change treatmen 

                 

                The costs 

                Guardian 2018 15th Feb 

                 

                “Attention deficit hyperactivity disorder, or ADHD, could be costing the UK billions of pounds a year, according to a new report that says awareness of the condition in adults in particular is very poor and many people go undiagnosed and untreated. 

                 

                According to the thinktank Demos, ADHD is a major socio-economic burden. The costs to the nation of the disorder in adults who are unable to work or hold down a full-time job are high. 

                Demos was calling for the government to launch an awareness campaign, to make adult ADHD more visible to the public and get help for those affected. It is thought that 5% of children and 2.5% of adults are affected by the disorder, although Demos says this could be an underestimate. 

                 

                Most people think of ADHD as a disorder of childhood, which causes children – most often boys – to become hyperactive and unable to focus and learn in class. But 65% of children with the condition do not shrug it off as they become adults. They can end up in low-paid jobs, if any, and may have difficulty forming relationships with people in and outside of the workplace. 

                 

                Evidence suggests that adults with ADHD are less likely to be in full-time, paid work than those without the condition, and that their on-the-job productivity may also be reduced. This has implications for individuals, employers and the state, as a result of reduced tax-take and increased expenditure on welfare benefits,” says the report. 

                 

                It talks of lost talent and opportunities. “People with ADHD can be creative, energetic and dynamic,” it says. But too many people go through life without the support they need.” 

                 

                Handedness: a sensible recommendation for left handers 

                Oral exams ‘would make school system fairer for left handers’The Telegraph,  10th May 2010.  By Heidi Blake  

                 

                 

                Pupils should undergo oral as well as written exams to make the system fairer to left-handed children who find it harder to write legibly, a leading headmaster has said. 

                 

                Antony Clark, headmaster of Malvern College, said left-handers are at a disadvantage in conventional exams because they find handwriting awkward. 

                 

                He suggested that oral exams should be introduced in subjects such as English and History in order to redress the balance. 

                  

                “When I see students writing,  sometimes with difficulty – and many left-handers have difficulty with script – one imagines that they write less and therefore perhaps achieve lower grades than those who write more, because they have simply put less on paper,’ he told The Daily Mail. 

                 

                The headmaster said left-handers are better at verbal communication because they polish their oral skills to compensate for their difficulties with writing. 

                 

                “I’m wondering if a focus on left-handedness and the fact that left-handers are perhaps more articulate might lead to a slightly different method of examining,” he added. 

                 

                “Should we actually be having oral examinations in areas like English and history?” 

                 

                Mr Clark proposed the idea ahead of a conference on left-handedness to be held at his school next week. 

                 

                His remarks follow research at Bristol University and Imperial College London which tracked 12,000 children from birth and found left-handers were behind when they started school and in tests at 11 and 14.  

                 

                A virtually cost-free alternative

                Lessons from Terre des Jeunes, Marrakech workshops 

                Anthony Clark’s views have to be posed alongside the lessons learned from conducting two half-day workshops in the pedagogic mode, first with a group of 10 and then 23, male and female 15-24 year old students, close by Marrakech in Morocco in December 2009.  I had anticipated watching them being instructed. After a brief chat with the director I was led into a vast hall and told “There’s the group, for you to work with!” I introduced myself and the topic by telling the students that my pre-occupation was researching what the obstacles to academic progress might be. And that one way into the topic was to take , then debug, the phrase “Write right (properly) with your right hand!” The relevant details include: 

                 

                 First workshop 

                1.  out of a total of 67 students attending Terre des Jeunes only 2 were acknowledged by the director to be left handed. This is not surprising given the importance of the right hand in Islamic culture as it is in so many others. 
                2.  in the first group of 10 students, all wrote Arabic, French and / or English with their right hand, 
                3.  they wrote Arabic from right to left and French and English from left to right, 
                4.  the case for acknowledging a distinction between a writing and an adept hand was easily accepted by all, 
                5.  as a result of a variety of unfamiliar manipulo-spatial tasks the group of 10 established among 

                        themselves that four were adept right handers, four were adept left handers. It was difficult, within the time constraints for them to determine the adept hand of  the remaining two students.. 

                        1.  one student asked whether the mis-match would make it difficult for him to listen to tutors’ lectures and simultaneously write his notes? 
                        2.  another student asked whether the condition would affect all aspects of one’s life (reflecting Dr Sattler’s conclusions), 

                           

                          Second workshop 

                          1.  in the second group of initially 18 but eventually 23 students the following additional details emerged 
                          2. for the first three-quarters of the session only one male and one female student from session-1 were present, 
                          3.  these two students were co-opted as co-tutors, 
                          4.  the female student demonstrated mastery of many manipulation and orientation tasks in the second session which she failed in the first. The male student had already achieved mastery in session-1 
                          5.  the group, which expanded to 23 in the fourth quarter, themselves established that 8 were unequivocally adept with the right hand, 8 with their left and it was difficult to establish which the remaining 7 were within the time and resources available 
                          6.  as the session ended, one of the two self-defined left-handers, joined the dispersing group and introduced herself to me, 
                          7. the remaining students were keen to establish whether she was indeed adept with her left hand? They agreed she was! 
                          8. the group introduced me to some of their own ‘stones throwing and catching’ games, 
                          9. together we created sets of activities to consolidate learning of the English alphabet, using the vowels A E I O U as pivots, because in Arabtterstterstowels are indicated, not by letters but by diacritical marks above or below consonants 
                          10. With infinitely fewer resources than Malvern College, the students at Terre des Jeunes, studying for the Baccalaureate, demonstrated the ability to speak as well as write English, French, Berber and Classical Arabic, all but two with the right hand. 

                                             

                                            The director told me that those students who volunteered to attend the afternoon sessions after their formal schooling in the mornings achieved higher grades in their Baccalaureate than those not attending Terre des Jeunes. 

                                             

                                            The lessons to be learned from this comparison are that: 

                                             

                                            1.  the critical issue is not whether one writes with the right or the left hand but whether one writes with the adept hand. 
                                            2. that Anthony Clark’s students, if writing, from left to right with their adept left hand then they will be writing in a mirror fashion to millions of Arabs, whose script is right to left, writing with their adept right hand, 
                                            3.  handwriting problems occur amongst right and left handers, not because of the hand used to write with but when the writing hand is not the adept hand. 
                                            4.  two Terre des Jeunes students went beyond the simple observation of the mis-match between the writing and the adept hand and saw what the British Psychological Society couldn’t: the implications for affecting thinking and life in general! 
                                                  Summary overview

                                                  The following Table I indicates the variety of contexts in which the MBM has been found to be a co-factor. 

                                                   

                                                  Contexts 

                                                  Directly Affected 

                                                  School 

                                                  Literacy & Numeracy 

                                                  Teachers: SENCOs 

                                                  School exclusions: Behaviour management 

                                                  Educational psychologists 

                                                  Obesity / Anorexia 

                                                  Mental Health Professionals 

                                                   

                                                   

                                                   

                                                   

                                                  Prison 

                                                  Young Offenders / Old Timers 

                                                  Recidivism 

                                                  Probation Service: Prison Officers:  

                                                  Forensic Psychologists 

                                                  Enhanced Thinking Skills Programmes 

                                                  Screened to see if capable of benefitting 

                                                  Cognitive Behaviour Therapy Programmes 

                                                   

                                                  Drug abuse, Anger management Programmes 

                                                   

                                                  Offender Assessment System 

                                                   

                                                   

                                                   

                                                   

                                                  Parents 

                                                  Family breakdown as a result of dealing with child problems 

                                                   

                                                  Cost of private psychological assessments 

                                                  British Psychological Society 

                                                  Child custody disputes 

                                                  Family Courts 

                                                  Fitness to work  

                                                  Employment Tribunals 

                                                  Solicitors 

                                                  Human Resource Professionals 

                                                   

                                                  Reasonable adjustments in the work place 

                                                   

                                                  What Is the Problem

                                                  What is the Mind-Body-Mismatch Problem?

                                                  Find out More

                                                  Who can Identify it?

                                                  Why focus on the mis-match between the writing and the wright or adept hand

                                                  Find out More

                                                  Mind-Body Mismatch

                                                  Institutional Inertia

                                                  Path to Discovery

                                                  Awareness and Advocacy

                                                  Treatment and Implications

                                                  Identification and Support