Saturday, June 16, 2012

COMMENTS ON THE DSM-5


Learning Disabilities Association of Michigan Public Comment
June 15, 2012
The Learning Disabilities Association of Michigan is an all volunteer 501(c)3 non- profit organization representing families and educators of persons with learning disabilities. Our offices are located at 200 Museum Drive, Ste. 101, Lansing, Michigan 48933.
Our mission is to enhance the quality of life for all individuals with learning disabilities and their families through advocacy, education, training, service and support of research. Our organization supports initiatives that encompass prevention, early identification, and access to the necessary supports to allow full participation of our constituents as citizens.

Our stakeholders represent a diversity of perspectives regarding the particulars for educating students with learning disabilities, but are unified by the conviction that, despite the range of learning problems subsumed under this category, these problems share the common trait of appearing to be breakdowns in the neurological processes of executive functioning which affect listening, oral expression, reading decoding, reading comprehension, written expression, mathematical calculation or mathematical reasoning resulting in evidence of unexpected underachievement in one or more of these areas.
Picture source: http://www.rainbowreaders.com/
The Learning Disabilities Association of Michigan welcomes this opportunity to publicly comment on the proposed revisions related to Specific Learning Disabilities in the DSM-5.  Although many of our concerns are related to the early identification of these breakdowns in the context of early childhood academic settings, we also recognize that these breakdowns extend into adulthood and affect life activities beyond educational settings.  Therefore, we recognize that a DSM-5 diagnostic code reflects broader parameters than those observed solely in school settings.  Further, we recognize that although these breakdowns exist, the function of diagnosis is to identify these breakdowns while offering beneficial insights about the external and environmental barriers that exacerbate the expression of these neurological breakdowns. Therefore, if medical diagnosis is to be useful, some attention needs to be paid to the educational and functional implications of the existence of these neurological breakdowns. In our society, where a high level of literacy is considered essential for individual success, it is important that we understand and help to improve access for those people identified with “dyslexia”. Access includes early intervention, as well as the provision of alternative forms of access, especially to text, for those identified with “dyslexia”.
In the United States, much of the research on Specific Learning Disabilities has focused on “dyslexia”, which is a specific learning disability that encompasses language processing, multiple aspects of the processes involved in reading, and also may include processes involved in spelling and written expression. Of the roughly one in seven people identified with Specific Learning Disabilities, 70 percent are thought to warrant a diagnosis of “dyslexia” (Lyon, 2001; Lyon, Shaywitz & Shaywitz, 2003; International Dyslexia Association, 2012).  This means that in Michigan, of the over 73 thousand children identified with Specific Learning Disabilities, one can estimate that more than 51 thousand are dyslexic (Michigan Compliance Information System for 2010-2011).  Or, in other words, roughly one out of every four children with special educational needs (n=217 thousand) in Michigan may be considered “dyslexic”.  In the education context, accessible text providers prefer a quasi-medical diagnosis of “dyslexia” as opposed to the more generic term, “specific learning disability” when authorizing the use of their services. Most notably, Bookshare, the largest provider of accessible textbooks, recognizes the term “dyslexia” as a qualifier for its’ services.

A large community of researchers in the neurosciences (c.f.: Bennett and Sally Shawitz, G. Reid Lyon, Jack Fletcher and others) have focused their attention on the causes, traits, interventions, and outcomes for persons with “dyslexia” and attach special meaning to the term as a separate set of conditions from other forms of reading failure because of its’ prevalence and intractability (see for example the comments of Michael Ryan, Ph.D. at http://dyslexiahelp.umich.edu/, and the statement of the International Dyslexia Association, http://www.interdys.org/).  Internationally, too, the term “developmental dyslexia”, as found in the ICD-10 (WHO, updated 2011), holds special significance.  In order to compare incidence of various disorders and diseases internationally, common terminology with common meaning is required.  To remove the term “dyslexia” from the DSM-5 is to put the U.S. data-reporting out of step with the rest of the world.  Increasing global interdependence requires that we be able to communicate using common terminology in order to share scientific findings, and to work toward overall improvement in the education and lives of all humankind.  
In summary, the use of the term “dyslexia” holds significance as a diagnostic term, in research on its’ causes, characteristics, interventions and outcomes, and as a shared descriptor in the international community.  Therefore, the Learning Disabilities Association of Michigan supports the continued use of the term “dyslexia” in the DSM-5.
Submitted on behalf of the Board of Directors of LDA of Michigan,
Florence Curtis, Acting Executive Director

Board of Directors

President—Byron Vorce, Bellevue
President Elect—Regina Carey, Okemos
Secretary—Betsy Schrage, Grosse Pointe
Treasurer—John Carter, Ann Arbor
Past President—Lori Parks, Plymouth
Newsletter Editor—Kathleen Kosobud, Ann Arbor
Healthy Child Director—Amy Winans, Lansing
Dawn Bentley, East Lansing
Linda Clark, Novi
Renee Craig, East Lansing
Edna Felmlee, Williamston
Glenda Hammond, Lansing
Delia Laing, Ann Arbor
Judith New, Ann Arbor
Annette Puleo, East Lansing
Rosanne Renauer, Lansing
Mary Rivera, Lansing
Kristen Toadvine, Mulliken
Kendra Tobes, West Bloomfield
Annette Lalley Trautz, Lowell
Vicki White, Lansing

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