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Posted 13th June, 2013 by Sue Partridge

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Stein, J. and Kapoula, Z. (2012) Visual Aspects of Dyslexia, Oxford, OUP.

This book, published last autumn is a hard but very rewarding read.  I remember struggling to understand the magnocellular theory of dyslexia, as presented in the work of Professor John Stein, when doing my diploma qualification and later endeavouring to put the information across when teaching on the same diploma programme.

The book illustrates well how the theory behind visual facets of dysexia has developed, been debated furiously, drawn antagonists as well as advocates, widened in its applicability and still draws passionate and well-reasoned responses from its supporters.

John Stein and his co-editor Zoi Kapoula (based in Paris) have brought together a range of neuroscientists and researchers with a specialism in ophthalmology, each writing a chapter, which stands alone but together forms a story of the ramifications of this subject.  Stein provides a summary chapter of his own, bringing us up to date on his current stance.

Some highlights for me are as follows:

  • Furkhart Fisher (Chapter 2) explains the complex process of saccadic eye movements and fixations.  He investigates the way we move our eyes in a non-literacy scanning task, shows that subjects can be trained to improve this function, and wonders whether poor saccade control is a consequence of poor reading or a root cause.  He is open to a multi-faceted definition of dyslexia and the problems it can cause in reading.
  • Kapoula (Chapter 3) takes this this a step further, describing the range of experimental studies of eye movement and binocular function her group has undertaken with dyslexic children. She sees this specific difficulty as  “a sort of micro-dyspraxia related to magno-cellular and cerebellar misfunction.”
  • Arnold Wilkins (Chapter 4) and Elizaberth Conlon (Chapter 5) highlight how the nature of text is inherently disturbing and stressful to the visual system, especially under poor lighting conditions.
  • Chris Singleton (Chapter 6) attempts to explain the theory behind visual stress. He then links this to magnocellular deficit theory, but discovers that there are “contradictory results” on the nature of the beneficial effects of different coloured overlays, given that the magnocellular system is “relatively insensitive to colour.”  Singleton’s own theory is that of a threshold in visual sensitivity.  If a dyslexic reader has not gained automaticity in word recognition, then the intense scrutiny of individual words they need to undergo to make sense of reading may make them more susceptible to the effects of visual stress.
  • There then follows a series of chapters exploring the nature and impact of “visual attention” on dyslexia.  Valdois et al (Chapter 7) define visual attention as a function of “the amount of orthographic information that is extracted from the input letter string during reading and becomes available for processing.”  We may use different sizes of attention span for different types of reading (global reading (skimming?) and more detailed analytic reading).  Dyslexic readers are likely to have a smaller visual attention span.
  • Facoetti (Chapter 8) extends this theory to say that attentional decifits underly both visual and auditory aspects of dyslexia; “rapid and automatic attentional orienting and engagement onto auditory and visual objects.”  He offers hope that training to extend this specific form of attention, even in the form of playing video games, can help reduce the deficit. Pammer (Chapter 9) endorses the importance of brain training.
  • Vidyasagar (Chapter 10) offers a useful summary of all of the theories presented in this book.  Controversially he dismisses phonological deficits of dyslexia as a symptom rather than a cause, citing studies that have shown that training in orthography have led to improvements in phonology (implying that orthographical awareness is a more fundamental skill than phonological).  He also sees “temporal sampling deficit”  – a key aspect of visual attention – as a hypothesis underlying both visual and phonological difficulties.
  • Finally in Chapter 11, John Stein himself offers a very measured review of magnocellular deficit theory and how it links into the work of the contributors to this book. He also looks at different therapeuatic interventions – coloured overlays (including a fascinating explanation of why yellow and blue may help more than other colours!) and nutritional supplements.  In a section on genetics he makes an interesting link between dyslexia and autoimmunity.

I hope this review stimulates you to have a go at reading this academic text book.  It is well worth the effort.

Stein, J. and Kapoula, Z. (2012) Visual Aspects of Dyslexia, Oxford, OUP.

  • Sini

    sounds fascinating, thank you for sharing the link.

  • Yvonne

    Thank you for this Sue. Having just diagnosed SpLD in a highly able Postgraduate, even though she learnt to read before she started school, I am attracted to Kapoula’s “ sort of micro-dyspraxia related to magno-cellular and cerebellar misfunction.” You have made me want to read this book.

  • Sue Partridge

    Yvonne and Sini: I am glad you want to read the book. I have it electronically, otherwise I would lend it to you!

  • melanie knight

    Thank you Sue. Your review has definitely stimulated my interest. I was fascinated by Stein’s magnocellular theory of dyslexia , although I did have help from my mother to understand all the medical terms.

  • HI
    I just completed this book. The information therein needs to be shouted from the rooftops. In my professional work as an optometrist specializing in the field of LD I have evaluated the visual efficiency of over 11,000 patients.As is re-iterated in this text, vision is interfering with people’s ability to reach their learning potential. And it is NOT being addressed in eye clinics anywhere near enough.
    Let’s get the word out!
    Robert Lederman FCOVD

    • suepartridge

      Thank you, Robert. It is great to have an endorsement from a practising optometrist for this view. Perhaps you can tell us a bit more about your own research based on your experience. And if you let me know where you are based, maybe we can refer clients to you for assessment.

      • I am based in Jerusalem. I am actually presenting tomorrow at the Edmund Safra Brain Research Institute for two hours in vision and learning. There will be some prominent neuro-scientists present and my hope is to encourage them to take visual-motor skills very seriously. I don’t think the book actually has an essay that stresses that point enough..If Prof. Maryanne Wolf says that “it was never intended for man to read” (Proust and the squid) from a brain perspective, then I say it from a visual motor perspective.Being in clinic though, I am faced with that every day It was actually very heart-warming to see so many of the essays reflecting many of my own conclusions based on observations. This is not the place to write all that I have to say. I do visit the UK (just returned yesterday) and am always happy to lecture, as there are so few who can talk about vision and learning from such extensive clinical experience.

        • suepartridge

          I have looked briefly at your website, and you seem to be doing some great work over in Jerusalem. It is impressive to have an optometrist who is so committed to the looking at the effect of eyesight on learning. Other people may be interested to see what Dr Lederman is doing.
          Here in Birmingham, UK we are lucky to have a top optometry school at Aston University, where we can refer our dyslexic clients for specialist assessments.

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