On 1 January 2009, the diagnosis and treatment of children with dyslexia (born after 2000) will be included in the basic health care package. Wied Ruijssenaars, Professor of Orthopedagogy at the University of Groningen, thinks this is a good thing. He explains why it has taken so long for this step to be taken. Ruijssenaars thinks that schools are coping better and better with dyslexia. ‘They are much more aware of the scientific treatment methods.’
Ruijssenaars believes that a great deal of progress has been made in recent decades in research into the treatment and support of children with dyslexia. ‘Treatment is important. If you don’t do it, you’re basically destroying capital because these are children with lots of potential. They only have problems with reading and writing without making mistakes. And that’s very difficult to cope with. Since the emergence of the computer, it’s become ever more important to be able to scan information quickly.’
But who is actually going to treat children with dyslexia? Should it be done by the educational or the health care side? For a long time it was the first option in the Netherlands. At a certain moment in time, however, it became clear that education had neither the means nor the expertise to treat children with serious types of dyslexia properly and in good time. Schools can do a lot, but they can’t do it all alone. Ruijssenaars: ‘The Dyslexia Committee of the Health Council, of which I was chairman, issued an advice in 1995 asking for dyslexia to be tackled from the health care side as well.’ This strategy, whereby the Ministry of Education and the Ministry of Health, Welfare and Sport (VWS) would have to work together, never got off the ground, however. According to Ruijssenaars this was due to miscommunication between the ministries: ‘They did not talk to each other and it turned out to be impossible to create a system of financing with both parties making a contribution.’
Ruijssenaars: ‘But something had to be done. Eventually, and after a great deal of discussion, the problem was passed on to the Care Insurance Board. This resulted in an advice to the Minister of VWS to include dyslexia in the basic package. However, this assistance from the health care package is only available to serious, i.e. persistent, cases whereby the educational approach is insufficient. I think that’s a very good thing.’ These children will receive intensive treatment from qualified orthopedagogues or psychologists, usually with separate training in how to deal with the sound structures in Dutch.
The treatment is based on scientifically anchored principles. The children also practice making word recognition automatic and linking letters to sounds. ‘That is something that dyslexics have a great deal of difficulty with. But each treatment is partially made to measure. Each child needs an adapted approach, depending on previous knowledge and specific needs. There is no fixed programme for going from A to B, but there is a protocol that guides the choices and decisions of the treatment provider.’ Treatment can never completely solve dyslexia, says Ruijssenaars. ‘But there are tools to help compensate. Just think of all the IT applications available, and constantly being updated, such as the Reading Pen, a sort of marker pen that can read words aloud, and audio books. In addition, you need to pay a lot of attention to remotivating the child if that aspect has been affected.’
Ruijssenaars, unlike some others, is not afraid that the new regulation will be misused. ‘Before this specific treatment can be considered, the school has to document precisely what has been done and a thorough diagnosis also has to be made. It’s not enough for the parents just to say that their child has dyslexia.’
Ruijssenaars emphasizes that it’s important to spot dyslexia as early as possible. ‘Help in good time has the most effect. It’s the best way to prevent children grinding to a halt later on, with all that that implies. Ideally you want to spot children with dyslexia before they start to learn to read and write. Sadly that’s not really possible at the moment. We can only reliably diagnose dyslexia from Group 3 on (6-7 years old), although the chances of a child with a dyslexic parent also having dyslexia are pretty high.’
Schools play a major role in spotting dyslexia. ‘School staff are generally well able to recognize the most important signs of dyslexia. All schools now have protocols setting out in detail what needs to be done next. Dyslexia is not a trend. People are also much more aware of the scientific treatment methods. The belief in miracle products, like fish oil and special glasses, is luckily becoming a thing of the past.’
Ruijssenaars thinks that it’s most important to have a normal attitude to dyslexia. ‘Dyslexia is no fun. It’s bad luck if you have it, but there are things that can be done about it and it can be dealt with. That’s the message we should be sending.’
Aloysius J.J.M. (Wied) Ruijssenaars (1951) studied Orthopedagogics at the Radboud University Nijmegen where he gained his PhD in 1984 with a thesis entitled Leergeschiktheid en leertests. Een leertestonderzoek bij eersteklassers in het gewoon lager onderwijs. He then became University Reader in Nijmegen in the department of Psychodiagnostics. He has also been an orthopedagogue at a LOM school [school for children with learning and behavioural difficulties] and in a child revalidation centre as well as a lecturer at a teacher-training college. In 1987 Ruijssenaars became Professor of Orthopedagogics at the K.U. Leuven, and was guest professor there between 1993 and 1995. From 1993 until his appointment at the University of Groningen, Ruijssenaars was Professor of Orthopedagogics at the University of Leiden. In 2004 he was appointed Professor of Orthopedagogics, in the domain of people with multiple disabilities, at the Faculty of Behavioural and Social Sciences of the University of Groningen.
Prof. A.J.J.M. Ruijssenaars
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