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12. History of Dyslexia Part 6: Hinshelwood Ch 2 Part 2 · Learn Literacy Podcast

• Cheryl Urbanczyk: Hello everyone and welcome to this episode of the Learn Literacy Podcast, where we champion language for life by teaching literacy through language and structure. This is another installment in our History of Dyslexia series. I've been reviewing reading and reviewing Dr. James Hinschelwood's congenital word blindness book from 1917. It may be one of the first books written about dyslexia. And we're currently in chapter two. So if you haven't listened to the first three sessions on this topic from the book, no worries, you can jump in here and go back to them later. As a recap though, Dr. James was a Scottish ophthalmologist and started to see cases of children having difficulty in learning how to read. So he wrote many papers ⁓ in the of his career ⁓ and ⁓ 1917 Compiled a bunch of his research into this book. So the first chapter is about acquired word blindness, which he delves into to form the basis for congenital word blindness. So you get acquired word blindness through a stroke, brain injury, or something like that, where you had the ability read and then lost that. So based on that, they figured children who have trouble learning how to read have the same brain condition as those with acquired injury, but they were just born with it. So we started the first half ⁓ of two, where we looked at the cases that profiled And we read a bunch of cases and I shared some thoughts about the cases and his profiles are very interesting because they show a lot of consistency in the characteristics of dyslexia like average intelligence, oral language skills. Everyone thought the child was smart but just had this inexplicit inability to learn how to read. Okay. ⁓ So then we'll continue on with the chapter two and then in our further episodes we'll do other parts of the of of the book. ⁓ ⁓ so starting on chapter two on page 52. Okay, congenital word blindness. ⁓ it will be observed that all the cases recorded in this book that there was no defect whatever in the general intelligence in general intelligence of the children, nor in their powers of reasoning or observation. In some cases, even the parents maintained that the child affected was the most intelligent member of their family. It was this fact, particularly, which puzzled both teachers and parents that a child smart and intelligent in every other respect could not be taught to read like other children. defect in these children is then a strictly specialized one. Meaning a difficulty in acquiring and storing up in the brain the visual memories of words and letters. It may not extend beyond this special group of visual images. The power of retaining and storing up the visual memories of numbers and musical notes may be quite normal, though in some cases the defect may extend to these also. Such symptoms, although puzzling and inexplicible to those without a knowledge of word blindness due to disease. Become clear and in the light of our knowledge regarding the latter. We have seen in chapter one that the visual memories of words and letters, of numbers and of musical notes must be stored up in distinct cerebral areas as we find that each of these groups may be lost whilst the others are preserved. But since they are frequently lost simultaneously, they are probably very close together and may even be contiguous. Hence, we infer that in the case of these defective children, their difficulties in learning to read can most readily be explained on the ground of some defect in the special area of the brain where are stored the visual memories of words and letters. There is now a general agreement, we have seen in chapter one, that this area is the angular and supramarginal gyre of the left side of the brain and right handed people, and that The more important part of the center is situated in the angular gyrus. If there be any abnormality within this area, either to disease, to injury at birth, or to faulty development, it is easily conceivable how such a child should experience abnormal difficulty in learning to read. Any condition diminishing the number of cortical cells within this area or interfering with the blood supply would lower the functional activity of the center. And hence would diminish the power of retention of the visual images of words and letters, which is absolutely essential for successful accomplishment of the active reading. Varying degrees of damage to the cerebral center would account for the varying degrees of defect manifested by the different different cases. Okay, so a couple thoughts here. We know that dyslexia is a sliding scale, right? It can be mild to moderate to very severe. So he's indicating this ⁓ terms ⁓ areas in the brain and the degree to which they are affected. He also mentioned something about ⁓ visual images ⁓ of and letters. I I'm not quite sure what he means by this to be honest. So we know ⁓ currently through research that we have seen today ⁓ That we don't really store words as like images and pictures. Like our brain is relying ⁓ rapid automatic recognition of graphemes and the orthographic mapping concept. And so we'll we talk in the next section, it's ⁓ it's the next is titled Reading. He he describes a little bit more about how people learn how to read. But ⁓ we need to keep in mind this book was written in 1917, and thus there may be some dated language and understanding compared to what we know today. All Okay, so then he goes through different areas ⁓ of of ability reading, math, and musical notes. So we have seen even from the very early writings about ⁓ children with the inability to learn how to read, they've looked at various forms of what they consider to be reading, right? Not just words only. Okay. Okay, moving on. Reading. To understand clearly the nature of the defect in these children, we must analyze a little more precisely the cerebral visual processes concerned in the act of reading and consider the manner in which an individual learns to read. The following remarks, of course, apply to the old-fashioned method of learning to read. Here, what he means by old-fashioned is phonics. Okay. He is a proponent of phonics and of phonics remediation. He goes on to say of the 12 cases reported in this book, all had been trained in this way, meaning in phonics, unless case 12, who was trained on the look and say system. The look and say system is memorizing words as whole pictures. And you at it, you've memorized that word as ⁓ an image, and you say that word. And so the look and say system regarding which we will make some remarks in the chapter on treatment. The first stage in the old method is to store up in the visual memory the individual letters of the alphabet. When we have stored in our visual memory the visual images of the letters of the alphabet, we can recall them into consciousness at will and see them as clearly as if printed on the pages of a book, even when the book is absent. It is by comparison with these permanent visual images of the letters and words stored in the cerebral center that we are able to recognize the printed letters and words on the page of the book. If this cerebral area is destroyed by disease, Then the individual loses this power of recognition and becomes letter and word blind, as we have seen exemplified in chapter one. Under normal circumstances, this first stage accomplished with comparative ease and rapidity, there being only 26 letters in our alphabet or taking capital and small letters, 52 visual images, and all to be acquired. The memory of words is first registered in our auditory memory center. Situated in the temporosphenoidal lobe and of course intimately connected with the visual memory center as all the cerebral centers involved in language are connected with one another. So it's interesting here that he mentions a different modality. We have the visual one and we have the auditory one. So we've seen how ⁓ ⁓ writings he has referenced different multisensory components. And he's doing so again here. We are able to spell the words before we are able to recognize them by sight. When the individual has stored up in the center in his left angular gyrus the visual memories of the individual letters of the alphabet and his auditory center the spelling of the words, he is then able to enter on the second stage of reading. He is now able to read words by spelling them. Aloud letter by letter, and thus by appealing to his auditory memory, he gets the proper word. Or sometimes he may simply be seen to move his lips, spelling silently each letter, and thus appealing to his memory of speech movements or a glossokinesthetic memory, as it has been called by Bastion, or he may sometimes be seen tracing the letters with his fingers on the table and thus appealing to his writing center. Again, fascinating early documentation of multi-sensory, multimodal input. do this in OG with the visual drill where you trace the letters on the table. That orthographic coding through motor muscle memory is so important. Saying ⁓ the letter names loud in the visual drill. A apple ⁓ will you will you say and trace it? We have early documentation here of precursor to this practice. sometimes even when a student is challenged in blending a word, I'll ask them to tell me the letter names in the word. If it's C ⁓ A N and struggling, okay, tell me the letter names, C A N. And sometimes that prompt helps them. So ⁓ very fascinating. Okay. To reach the third or final stage in the art of reading is a much more formidable task and requires for its accomplishment a much longer period of time. third stage consists of the gradual acquirement and storage of the visual memories of words. When this is accomplished, the individual reads not by analyzing each word into its individual parts, but by recognizing each word as a separate picture. So, ⁓ to our modern understanding, I'm not Quite sure what he means by that. Is he referring ⁓ the orthographic mapping piece of reading when he's talking about words as a picture? As opposed to like memorizing a word as a picture. So, he's on to something there, but not quite sure exactly ⁓ what the reference is. The then cease to be such an individual simply a combination of letters. Each word is regarded rather as an ideogram, picture, or symbol which suggests a particular idea. The individual now recognizes a word just as he recognizes a landscape or a familiar face by its general outline and form without resolving it into its constituent details. He has now learned to read by sight alone. When he looks at the words on the printed page, he can now interpret them by comparison with the visual word memories stored in his angular gyrus, and there is no need for further appeal as before to his auditory memory or glossokinesthetic or writing centers. He has now successfully attained the final stage of the art of reading, meaning the power of reading by sight alone. So he adds some explanation here. ⁓ When he's saying that ⁓ to be for an individual simply a combination of letters, I'm not sure, don't believe that that phrase is supported by our current evidence, right? We know the orthographic mapping theory, other ideas about show us that our brain is looking for those meaningful graphemes. And That's what those combinations of letters are, like a T C H E A vowel team, so forth and so on. So when he's saying each word is regarded rather as an ideogram or picture, we see through orthographic mapping the various components of the word, and then those ⁓ are combined to meaning that word. So again, keeping in mind this is a book from nineteen seventeen. ⁓ We learned a lot since then and ⁓ we we know we are not accessing words as like visual forms. Okay. Alright, moving on. But even in those who have reached this stage, meaning the final stage of reading, there are different degrees of proficiency. Many who have reached this stage of reading by sight can do so only very slowly and with some degree of effort, whilst others can skip over the pages of a book with great rapidity and ease. There are slow readers and quick readers. Very great differences are observed in this respect. No doubt the amount of practice is a most important factor in producing these differences, some people only reading very rarely and others being engaged with books from morn till night. But I think the degree of development of the visual memory center is also a contributory factor. We are not all furnished at the start of life with visual memories of the same capacity, and this influences us more or less through our whole existence. So he's talking about the role of practice how that ⁓ influences the to read as well as brain faculties and how they support All right, moving on. ⁓ With this knowledge the process involved in acquiring the art of reading by sight, our cases become quite clear and intelligible. And all of these, the difficulties began even in the first stage. meaning in learning the letters of the alphabet. This at once reveals a very grave defect in the visual memory center, as the number of visual memories to be registered was only twenty-six, or taking both capital and small letters fifty-two in all. The degree of difficulty varies, but in all it is very it is very great, and in case three, the mother of the child told us that it would took nine months persevering effort to acquire the letters of the alphabet. Most of the cases recorded in this book, however, had acquired after a considerable effort the visual memories of the letters of the alphabet and had reached stage two in the art of reading. They could read if allowed to spell out the words letter by letter and so make appeal to their auditory memory, which had already been furnished with the spelling of the words. In all, the auditory memory was good and they were all able to spell well with one exception. Case 12, where the boy was educated on the look and say system in which they are not taught to spell. In the two cases five and six, they were able to recognize many of the words if allowed to move their lips and spell them silently. Thus appealing to their memory of speech movements glossokinesthetic center. Although in all these cases the abnormal difficulties of the children were manifest in the very first stage, it was in their attempt to reach the third stage, reading by sight alone, that their defect became conspicuously manifest. In order to accomplish this with any degree of proficiency, a very large number of visual memories of words has to be acquired. In all the cases recorded, the children, even after years of the ordinary training at school, had only managed to acquire at the most the visual memories of a few short familiar words such as the two of, etc., and had been unable to get beyond the second stage, meaning reading words by spelling aloud and appealing to the auditory memory. There is thus manifest in these children such a striking contrast between the capacity of the auditory and the visual memories. That it at once reveals a condition which is abnormal, that it can only be regarded as pathological in the sense that it's detrimental, right? It is thus in their failure to acquire the art of reading by sight alone and without appeal to any other cerebral centers than the visual, that this defect becomes conspicuously manifest. a really interesting statement because he's trying to get at. the fact that if you rely on visual memory only, ⁓ and you don't appeal, let's say, to auditory memory, motor memory. motor memory be a couple things. The hand movement. He talked about the tracing of letters. It could be what your lips, teeth and tongue are doing, those glossokinesthetic articulation and and voicing features. that that you are not as successful. Okay. have been unable, like the other children, to furnish their visual memory center with the visual memories of words, and it is the great and persevering efforts which are necessary to repair this failure and to remedy this defect, which makes their educational career so different from that of the ordinary child. And that's his kind of ⁓ summary on reading. ⁓ he he goes to ⁓ talking about the effects on arithmetic. All right. Of the 12 cases recorded in this book, I should note he divides these 12 cases some at the beginning of chapter two and some at the beginning of next chapter. So if you're wondering why I did I miss some cases, no you didn't. He just them up. Of the 12 cases recorded in this book, in three only, cases one, four, and eleven, did the defect extend also to the recognition of figures, figures numbers. In the other nine cases, no difficulties were experienced in learning to read figures, and the children were able to keep up with the others in the subject of arithmetic. In two, cases five and ten, the children were said to be good at arithmetic and markedly above the average. This was a feature in these cases which naturally puzzled very much the parents and schoolmasters. It does seem an extraordinary thing that a child manifesting such abnormal difficulties in the attempt to read words and letters could Should experience none in the reading of figures or in performing the various mental processes involved in arithmetic. Of these 12 children, four had reached the compound rules, and as we have seen, two actually excelled in the subject. However, in those who are familiar with the symptoms manifested in acquired word blindness, which we studied. in the first chapter. This facility in the reading and manipulation of figures manifested in the great majority of cases of congenital word blindness excites no surprise. However, in those who are familiar with the symptoms manifested in acquired word blindness, which we studied in the first chapter. In the light of the knowledge this acquired, the explanation is clear and simple. We saw that in acquired word blindness, the power of reading figures Is preserved intact with great frequency. This was well exemplified by the fact that they're stated that only of eight cases of acquired word blindness recorded by me at various periods, the power of reading figures was preserved intact in six cases. We also saw that the legitimate inference from the facts supplied by recorded cases of acquired word blindness was that the visual memories of words and figures were deposited in distinct cerebral areas. But that these were probably close together and probably contiguous. This affords a clear explanation of the facts observed in these 12 cases of congenital word blindness. When the congenital defect of development was strictly limited to the word center alone, the children possessed the power of reading figures, as was seen in nine out of our 12 cases. But when the defective development was more extensive and thus involved a figure area, Then the inability to read included both words and figures as well as was well exemplified in cases 1, 4, and 11. It may be interesting to recall what I said on this subject in a communication to the British Medical Journal in November 1896. That's many years the 1917 book, comment on the symptoms of the first case of congenital word blindness which had been recorded by Dr. Morgan. Amongst other remarks, I made the following on the topic of the reading of figures. In a paper read by me at the Glasgow Medico Churchurgical Society and subsequently published in the Lancet of december twenty first, eighteen ninety five, discussed in detail a case in which the patient with normal visual acuity was unable to read any printed or written characters which With which he was previously familiar, with the exception of Arabic numerals which he read fluently. quoted five additional cases where with word blindness the power of reading figures was preserved intact. Professor Gardner of Glasgow has since informed me of similar cases occurring in his own experience. Dr. Morgan's case lends additional confirmation to the remarkable fact that the visual memory for words and letters is completely independent of that for figures. Clinical experience has already taught us that the one form of visual memory may be completely lost whilst the other remains intact. Dr. Morgan's case supplies the additional fact that the visual memory from words may be congenitally defective, whilst that for numbers presents nothing abnormal. So, you can go back a previous episode if you're not familiar with Dr. Morgan's case on. ⁓ a student that he saw named Percy. And then I also have an episode where Hinchelwood writes his response to Dr. Morgan in a follow-up letter in the British Medical Journal. ⁓ So could listen to those. ⁓ But just ⁓ really interesting how he's tracing case studies and and collecting this evidence to document what may or may not lost. In terms of numbers, word reading letters and all these kinds of things, and connecting them to brain regions. Experience teaches that either form of visual memory may be developed ⁓ to abnormal degree without the other manifesting any corresponding development or even with the other remaining below normal. I think we are compelled to infer from such complete functional independence. These two groups of visual memories and anatomical independence. We can as yet only localize the visual memory of words and letters, but from the frequency with which the visual memories of words and numbers are simultaneously lost, we can infer that the areas affected, though not identical, are probably very close together. I wish to call particular attention to this little known fact of clinical experience in the hope that a more widely diffused knowledge may increase the number. Of accurately observed cases of word blindness. So he's writing this in the very late 1800s in the hopes of calling out to ask for more cases. So when we fast forward now to his nineteen seventeen book, he is, compiling a lot of evidence and and bringing all these things together. These words, written more than 20 years ago in reference to the first reported cases of congenital word blindness, have been amply verified by all subsequent experience of the condition. The power of reading figures has been found to be preserved so frequently that it is now regarded as a valuable aid to the diagnosis in cases of congenital word blindness. So that's interesting. So, if we stop here and think about that, he's talking about building a profile. you know, or a diagnostic criteria that you can read figures, but you can't read like letters and words, and that this could be clue to congenital word blindness. Because ⁓ you lose both, it could be something else. But he's that this could be a diagnostic criteria. Okay, we are going to fast forward through the rest of the math section because he just profiles different cases ⁓ of people who are strong in math but not in reading and and maybe as germane to our conversation. So we'll move on to the section on writing. All our cases learn to write, so meaning the cases of people with congenital word blindness. They learned to form correctly the written characters and could copy a piece of writing which was put before them, but as a rule they failed when they were asked to write to dictation. Okay. So what is he assessing here? He's assessing the mechanical motion of of handwriting, that activity itself. that those children could learn to write the letters, there meaning there's no ⁓ dysgraphia or maybe challenge with motor control or fine motor control, that they could copy a piece of writing. He wasn't asking them to read it or spell it, but just, copy it. Okay? ⁓ as rule, they failed when they were asked to write to dictation. Meaning when you a dictation is when you say a sentence and then ask the student to write it and spell it out on their own. It seems strange at sight that a child knowing how to form the individual letters and also knowing how to spell the words is yet unable to write correctly to dictation. Not sure what he means by spell the words. Maybe he just means copy them. ⁓ because if you know how to spell the word, you should be able to write correctly to dictation. explanation is to be found in our knowledge of the facts of acquired word blindness, and I would refer to the discussion on this point to be found in my remarks on the postmortem examination of the brain in the appendix to chapter one. I I didn't read. The appendix to chapter one is not part of our series because just technical anatomy and physiology. We there saw that the graphic motor center is not stimulated directly from the auditory but requires the intervention of the visual memory center wherein are revived the visual images of words. Hence, in cases where the visual memory center was destroyed by disease, the patient could no longer write to dictation. As he could no longer revive in his mind the visual memories of words which are necessary to stimulate the graphic motor center. Our congenitally word-blind children are practically in the same condition. Although this visual memory center is not destroyed, it is functionally in abeyance as it has not yet been furnished with the visual memories of words, and hence stimulation of the graphic center is impossible. It is only when we have furnished this visual memory center with a fair supply of visual word memories the child is able to accomplish anything satisfactory in the way of writing to dictation. As its stock of visual word memories increases, so does its proficiency in writing to dictation. So again, I I feel we have some discrepancy between our current understanding of what's happening in spelling. compared to his 1917 understanding. So I I wouldn't use the term visual word memories. I may use the term phonemographium correspondences instead, that we know the phonological component is one of deficits students with dyslexia and there could be morphological as And understanding those phony morphological ⁓ correspondences to written forms is ⁓ challenging students with dyslexia. We see ⁓ it really in So that could be what he means with visual word memories is those ⁓ meaningful graphemes and morphemes that we need for spelling. Okay. Then he goes on To talk about music. We know from our very initial papers that we read that they talked about reading in a variety of ways. It wasn't just reading they looked at figures or numbers and musical notes as different ways of taking reading input into the brain. So he has music as a small section at the end of chapter two. Okay, in case two, the boy made good progress in music. His teacher expressing great satisfaction with his musical studies. This fact is in perfect harmony with our experience in cases of acquired word blindness, which I have discussed in chapter one. We have there given examples of acquired word blindness where the patient, unable to read words and letters, retained intact the power of reading musical notes. We saw that the visual memory for musical notes is quite distinct from the visual memory of words. Since the one form of memory may be entirely lost whilst the other is not changed or modified in any way. And that is, this complete functional independence entitles us to infer an anatomical independence, just as in the case of figures. Hence, when, as in case two, the congenital defect was strictly limited to the word center, there was nothing surprising in the fact that the boy made good progress in his music as well as in his arithmetic. Both of which are dependent upon the functional activity of different areas of the brain. One of the five cases recorded by Dr. E or by Mr. E. Nettleship, puzzled the parents was the fact that whilst their child had the greatest difficulty in learning to read print, he could read music well. ⁓ And he ends with a very interesting section titled Imparted by Oral Instruction. And this is neat because we've seen in many of the documented cases the have observed and teachers and parents observed that if the instruction was given entirely orally without reading and writing, the student would be ⁓ one the top in the class. ⁓ Okay. ⁓ subjects by oral instruction. We have seen that in all our cases, the children possess good auditory memories. A fact of the very greatest importance from the point of view of the prognosis and treatment, as we shall see later. In some of the cases, as in 1, 4, 5, and 8, the auditory memory was exceptionally good and was well shown by the incident mentioned in the history of these cases, that they concealed their defect for some time by learning their reading book by heart from listening to others. you know, a good compensatory strategy. if everyone in the class is using the same basal reader, what these students were doing was using their strong oral to memorize the passage and could compensate by saying it from memory and keeping track of, where their turn would be and so forth. Hence in all subjects where information can be imparted them orally, their progress was quite satisfactory. On analyzing our cases, a final fact appears which is worthy of notice. he's summing up here. The much greater frequency of this defect in boys is compared with girls. Out of the 12 cases recorded in this book, 10 occurred in boys and only two in girls, meaning cases 3 and 10. Sidney Stevenson had noted this point in his first communication on the subject and observed that of the 16 cases reported up till then, 13, that is 81.25%, had been met with in males. This great difference in the incidence of this condition in the two sexes has been confirmed by the experience of all latter observers or later observers, but no explanation has been suggested so far as I am aware to account for this striking frequency of congenital word blindness in the male sex. that that's an interesting final note in the chapter and I I have some of my own thoughts on that. ⁓ I think we have to consider the time frame ⁓ of these cases studies from the late eighteen hundreds to the early nineteen hundreds. It it could be that when boys could not learn to read, it was taken more seriously than for girls. at this time in history there were different expectations in terms of roles and and learning and that kind of thing for boys and girls and so families may have seen it as more important to take their sons to the doctor because men were more responsible at at time for working and livelihood ⁓ and in school. And so think ⁓ when we consider some of the historical factors like that, it it shed some light ⁓ why they were seeing more boys as opposed to girls. I modern evidence does not necessarily to this that there are more boys than girls having dyslexia ⁓ or learn language learning I I think we could think about it in terms ⁓ of maybe like I said, factors education between boys and girls and ⁓ and the different roles that they had in society at the time and why parents may be bringing Boys versus girls to the doctor to be seen. Okay, so that wraps up chapter two. So this chapter was an introduction to the subject of congenital word blindness. in the next episode is chapter three, ⁓ and it's very interesting chapter. Again, all cool stuff here, and it's titled Hereditary Congenital Word Blindness. ⁓ So in that chapter, dives into the remainder of the cases that he presents where he talks about congenital word blindness within family units. And so that's kind of neat because that's some of our ⁓ early documentation in history of factors. And we do know that current evidence supports hereditary links to dyslexia and and and ⁓ things like that. ⁓ Well thank you for in. if you're interested in learning more about learn literacy and the things I do, please go to learnliteracy dot com ⁓ or social media at learn one or at Cheryl Erbanzik one and keep ⁓ working hard to our students with their literacy. We support the cause of language for life by teaching literacy through language and structure. And we everyone to be on board with this cause. Thank you. ⁓