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Saturday, January 7, 2012

But Aren’t All Babies Born Illiterate?

In school, I learned some important lessons about science. Two of the most important are these: 
  • If you don’t want to get confused about what something really is, think carefully about what you call it
  • If you want to know why something happens, look at where and when it happens. 
Recently, I read something that reinforced both of those lessons. It was an article by Samuel Orton, AM, MD, published in 1929 in the Journal of Educational Psychology about a problem that was being called “congenital word blindness.” It referred to children who were having trouble learning to read.

The term “congenital word blindness” immediately caught my attention. It made no sense. The word “congenital” means present from birth. How could an inability to read be considered a congenital problem? Aren’t all babies born illiterate? It’s illogical to use the word “congenital” to describe a problem that nobody can detect until the child is six years old.

Dr. Orton explained that the term “congenital word blindness” was being used to refer to a complete inability to learn to read. Physicians had been studying the problem for several years. Teachers and psychologists were also aware that many children were having much greater difficulty in learning to read than would be expected from their ability to learn arithmetic, their ability to learn from listening, and their general alertness. Orton wanted to know what was going wrong in cases where otherwise seemingly normal children were having so much trouble learning to read. 

In his initial studies, he found that many children with reading difficulties seemed to have the same problems. They tended to reverse letters and words. For example, they’d mistake the letter “d” for the letter “b” or mistake “p” for “q.” They also tended to get confused between short palindromic words, such as misreading “was” for “saw.” They also tended to reverse parts of words, such as reading “tworrom” instead of “tomorrow.” Today, this problem is called dyslexia.

Under a grant from the Rockefeller Foundation, Orton carried out an extended field study of this problem in communities in Iowa in 1926 and 1927. What he found was disturbing. The problem wasn’t equally common everywhere, and the problem seemed to result from the way the children were being taught to read.

All of the children were being taught to read by the “whole-word” or “look-say” method. This meant that they were taught to recognize whole words, as if English words were like Egyptian hieroglyphs or Chinese characters. In the town where reading disabilities were more common, the children were given no other kind of reading instruction, such as help in sounding out the letters of a word, until they had memorized about 90 words. In the other town, where reading disabilities were only half as common, children were initially taught with the look-say method but were given special instruction in how to sound out the words if they started falling behind. 

Orton concluded that the children’s learning disabilities were probably the result of using the look-say method to teach children to read. He also concluded that the problem could be remedied by giving children special help to eliminate their confusion about the direction and orientation of letters and words. Thus, Orton revealed that the cause of the problem was not a defect in the child's brain but a defect in the educational system.

When I was growing up, I was told that dyslexia was genetic. Yet Orton’s work showed that this “genetic” disorder seemed to cause problems mainly where a stupid method for reading instruction was being used. It could be remedied by using effective methods to teach a child to read. Maybe genetics could help one predict which children are going to find it particularly hard to learn to read when the look-say method is used. Maybe. But that’s no excuse for using a method that predictably causes learning disabilities. The damage done to a child in his or her first few years of schooling causes a great deal of suffering and can have lifelong effects.

Orton wrote that many children had been referred to his clinic because they were having trouble learning to read. In many cases, the child’s teacher had thought that the child was feeble-minded or had complained that the child was misbehaving. In Orton’s experience, the children could be taught to read if proper methods were used. He also found that the children’s behavior problems typically resulted from the reading problem. The children’s behavior improved dramatically after they learned to read.

Orton’s warning that difficulty in learning to read is the predictable result of bad educational approaches fell on deaf ears. The people at the Rockefeller Fund provided the funding for Orton’s research, but then they ignored its results. Instead of advocating effective methods for teaching reading, they went on to provide substantial support for advocates of the “look-say” method, despite the evidence that it was causing learning disabilities. The look-say method became even more popular in the 1930s. It was part of the “whole language” approach applied systematically in the public schools in California in 1987, with disastrous results. Within a few years, California’s fourth-grade reading scores fell to practically the lowest in the United States, ahead of only Louisiana and Guam. 

Today, we no longer hear the term “congenital word blindness,” but we hear a lot about dyslexia. We also have lots of other labels that are applied to children. I wonder how many of the children who are given labels such as ADD, ADHD, and oppositional defiant disorder are simply expressing frustration and anger at how badly they are being treated, and how badly they are being taught? If that’s the real problem in a particular case, I can’t see how drugging the child would solve it.

I decided to discuss Orton’s study in my nutrition blog, even though his study has nothing to do with food, because his study illustrates an important point about how people fail to use scientific knowledge. Orton provided evidence of the obvious cause and simple cure for a serious problem. He provided this information to people who had enormous influence on public policy, and yet they ignored what he had to say and went on promoting harmful policies. We see similar problems in the field of nutrition. We are told that diseases like coronary artery disease and type 2 diabetes are genetic, even though they seem to cause problems only where people are eating the wrong kind of food. Although those diseases can easily be cured if the obvious cause is removed, the diseases are treated chronically with pills. Even though the scientific evidence provides clear lessons, these lessons are not being used to guide policy decisions or even being communicated to the general public.

Wednesday, January 4, 2012

Defuse the Time Bomb In Your Intestines

A friend of mine recently had a brush with death. She was unknowingly carrying a time bomb in her large intestine, and when it went off, it nearly took her with it. She had a diverticular abscess, which burst and thus allowed the bacteria to get into her abdominal cavity. That caused a problem called peritonitis.

All things considered, she got off easy. She had to have emergency surgery to remove the damaged portion of her large intestine and clean up the mess in her abdomen. She may have a fierce-looking scar, but she’s alive, and she can still go to the bathroom normally, instead of into a colostomy bag on her side.

The problem started when part of the wall of her large intestine “ballooned out” to form a little pouch called a diverticulum. When you have these diverticula, the condition is called diverticulosis. Here's what diverticulosis looks like, from inside the large intestine:

About half of Americans over 50 years of age have diverticulosis and don’t even know it. Diverticulosis may cause mild, intermittent symptoms of pain and bloating in the lower left side of the belly. It may cause bouts of diarrhea and constipation. It is a common cause of rectal bleeding in people over 40 years of age. Or it may cause no symptoms at all. If one of the diverticula gets infected, the condition is called diverticulitis. It’s just like appendicitis, except that the symptoms are worse on the lower left, rather than the lower right, side of the belly. If the inflamed diverticulum bursts, you can end up with life-threatening peritonitis.

Diverticular disease is common in the United States. However, it's rare in places like Africa and Asia, where people eat a high-fiber, plant-based diet. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the best treatment for most cases of diverticulosis is a high-fiber diet. Both soluble and insoluble fiber are helpful, because they retain water and make the stool softer and easier to pass. If the muscles of the large intestine don't have to strain so hard, they won't generate the high pressure that can cause a diverticulum to form. 

Some doctors say that people with diverticulosis should avoid eating small seeds, such as those in tomatoes or raspberries. However, the NIDDK says that there is no scientific information to support that recommendation.

Some experts warn that dairy products increase the risk for diverticulosis by causing constipation. When dairy protein is digested, it can produce morphine-like compounds that slow down the muscles that are supposed to push food through the intestines.

To prevent diverticulosis, prevent constipation. Eat lots and lots of unrefined starches and vegetables. Avoid dairy products. A diet like that is also good for maintaining a healthy weight, controlling your cholesterol and blood sugar, and preventing osteoporosis.