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Meares-Irlen syndrome: the controversy and challenges
Opinions around Meares-Irlen syndrome and its treatment are divided. Karen Russell-Graham takes a closer look
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As defined by the US-based Irlen Institute, ‘Meares-Irlen syndrome is a perceptual processing disorder. It is not an optical problem. It is a problem with the brain’s ability to process visual information'.
Also known as Irlen syndrome, scotopic sensitivity syndrome or visual stress, it gives rise to visual distortions and these can take many different forms.
Difficulties related to spatial awareness and depth perception can also be an issue, causing the person to trip up, struggle with ball games and generally appear clumsy. Never having known anything else, they will believe that their view of the world is normal and that everyone shares their discomfort. As a result, the condition often goes undetected or is attributed to other conditions such as dyslexia and ADHD.
Problems that may be caused or exacerbated by the condition include:
- physical discomfort
- low motivation and achievement
- attention difficulties
- reading difficulties
- failure to start or complete a task
- poor behaviour.
The simplest test is to give them a range of coloured overlays and let them experiment to see if a particular colour stops words from appearing fuzzy or floating about on the page.
Likewise, when writing, they may find that coloured paper reduces the dazzle of black on white, while their computer can be adjusted to find the optimal setting for their particular needs.
However, that only provides relief when they are focusing on the printed page or computer screen. If they can't decipher text on the whiteboard or have issues relating to depth perception, these problems will persist.
Moreover, the Irlen Institute insists that just providing a child with a self-selected coloured overlay is not the answer and that coloured filters need to be prescribed with great care, as the exact colour required to achieve optimum relief varies from one individual to another and can change over time.
The institute is adamant that its patented testing to select colour combinations is not the same as obtaining coloured lenses from an optometrist, and Irlen diagnosticians in the UK must send the glasses to America to be dipped.
Although the Irlen Method has been in use for many years, it is still the subject of some debate.
As recently as 2011, the results of a control study of struggling readers in Scottish primary schools published in the Official Journal of the American Academy of Pediatrics purported to reveal that Irlen coloured overlays 'have no immediate effect on reading ability in children with reading difficulties.'
The institute responded by taking issue with the choice of 'immediate effect' as a measure of impact, since the children in the study had been identified as poor readers. 'Overlays and filters remove the barrier preventing [basic reading] skills from being acquired,' it emphasised, 'but are not a replacement for instruction and practice which develop the necessary foundation required to read.'
Meanwhile, writing in the British Medical Journal in July 2014, Gwyn Samuel Williams expressed concern that parents of children with reading difficulties and patients with undiagnosed ophthalmic disorders that might be amenable to treatment were being misled and exploited. 'The medical profession must be united in its stand against pseudoscientific nonsense such as Irlen syndrome,' he stated.
His article drew a mixed response online, with some people hotly disputing its conclusions while others agreed with the author. A search on other forums and threads reveals similar divisions, often centring on the proposition that the root of the problem lies, not in the eyes, but in a processing malfunction of the brain.
One person who is a passionate advocate of the Irlen Method is Marie Smith, a former primary school Senco and now director of Irlen South East.
Her discovery of the syndrome was accidental. 'One day a dyslexic child in my class chose blue paper to write on,' she recalls. 'Suddenly he was really excited. His work looked better and he could read his own writing.'
'Speed of reading is not necessarily a good measure of impact, as comprehension and retention can vary enormously,' she explains. 'It’s more an emotional and behavioural response. When a child reports that his "kill/death ratio" in a computer game has shot up or that "the pattern on the floor has stopped moving", then you know it is making a difference.'
'Children with Irlen syndrome can’t always see the detail in a picture,' she adds. 'When they put on the glasses and see what the rest of us see, it can be very emotional.'
Parents understandably want to move quickly when an initial screening has indicated that their child could benefit. However, Ms Smith encourages the use of overlays for six to 12 weeks to encourage a 'tuning-in' to light sensitivity and to evaluate the impact on headaches and/or behaviour. She is painstaking in her approach – testing takes time and must include the various light conditions where the glasses will be used. 'In four years I have not had two children requiring exactly the same combination of filters,' she reports. 'Even tiny variations in colour can make a big difference.'
Today, optometrists can also use a Intuitive Colorimeter, invented by Professor Arnold Wilkins of the University of Essex in the 1990s, to determine the exact hue, saturation and brightness a patient requires. They then send these details to a specialist laboratory, which produces lenses that can be incorporated into a normal spectacle frame.
The two methods both pursue the same goals, just by different means, and more double-blind studies are required to prove whether one is more effective that the other.
Not everyone with dyslexia experiences visual stress (although many do), and people who don't have dyslexia can still suffer from the condition.
Under NHS provision, every school-ages child should receive a full vision test to rule out other conditions which can impede reading. Yet, 'there are thousands of children in classrooms throughout the UK with unidentified and untreated vision deficits, including visual stress,' says Ms Fitzmaurice, a parent of a young adult with Meares-Irlen syndrome.
The problem is who is responsible for funding a full assessment if the test shows that this would be desirable? At the moment, this falls to parents and sometimes schools, we can only hope that the situation will improve as the SEND reforms begin to take hold.
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This article is taken from Special Children Magazine, issue 223. Find out how to subscribe. PDF versions of the magazines are available to download in the My Account area under My Magazines for subscribers of the Knowledge Centre and Premium CPD.
Last Updated:30 Jun 2015