Academic Support Service Adaptations in Response to the Psychosocial Needs of Third Level Students with Dyslexia
Dyslexia is conventionally defined as a specific learning difficulty which affects reading, writing and spelling but perhaps less well known is the potential impact of these difficulties on an individual’s psychosocial functioning. Psychosocial functioning is broadly defined as psychological and social development, and encompasses factors such as wellbeing, self-esteem, emotional regulation, coping, resilience, social relationships and interconnectedness amongst others. The unique perspectives of the psychosocial experiences of adults with dyslexia are often lost, as it is more common to study individuals under a broader classification of learning difficulties (Nalavany, Carawan & Rennick, 2010). Despite this, research into the prevalence of struggles faced by those with dyslexia, beyond learning and academic performance, is growing steadily.
This article provides a brief overview of some of the research on psychosocial difficulties among third level students with dyslexia, suggests recommendations for practice based on this evidence, and outlines current practices developed by the National Learning Network (NLN) in a number of higher education institutions in response to these findings.
Links between dyslexia and mental health difficulties have been explored, and dyslexia has been identified as a specific risk factor for anxious and depressive symptomatology (Mugnaini et al., 2009), with apparent gender differences in the manifestation of these difficulties. Females with dyslexia have a tendency to report more symptoms of anxiety and depression (Carroll, et al., 2005; Hales, 1994; Nelson & Gregg, 2012), notwithstanding the greater preponderance of dyslexia among males (Berninger et al., 2008; Chan et al., 2007; Hawke et al., 2009; Miles, Haslum, & Wheeler, 1998). Distinct gender differences in coping styles are also observed among dyslexic students, with females opting for more emotional coping (for example a tendency to experience frustration; lack of confidence; self-doubt; sensitivity to criticism; self-blame, and aggressiveness) and avoidance-based coping (for example, avoiding tasks which highlight their difficulties; opting for simpler spellings) (Alexander-Passe, 2006). Males tend to use more task-based coping, for example, being pro-active, focusing on their strengths, being persistent, stubborn and determined (Alexander-Passe, 2006), however their difficulties must not be underestimated on an individual level. Whilst these findings are useful in providing an insight into the range of coping styles, support that focuses on strengthening coping skills and resilience is best determined on an individual basis and through collaborative planning with the student.
Understandably, individuals with dyslexia experience a higher level of academic anxiety than their peers without dyslexia; however they also experience significantly higher levels of social anxiety (Carroll & Iles, 2006). Schooling constitutes a large proportion of a person’s formative years and being a social situation in and of itself, anxiety related to academic performance may consequently generalise to social anxiety (Carroll & Iles, 2006). Although literacy difficulties are independent of level of intelligence in dyslexia, individuals report feeling ‘stupid’ and experiencing chronic feelings of low self-esteem (Undheim, 2003). A number of individuals also experience bullying at school as a result of their dyslexia which in turn can compound feelings of low self-worth (Ingesson, 2007). Evidence indicates that people with dyslexia are less likely to thrive socially in general (Mugnaini et al., 2009), which may lead to isolation and a lack of social support.
Although significant evidence points to the prevalence of psychosocial difficulties among individuals with dyslexia, there are third level institutions whose support services are perceived to fall short in addressing this issue. A UK study into dyslexia and psychosocial difficulties found that students do not believe university provides sufficient emotional support, despite the existence of disability services (Carroll & Iles, 2006). Reform and adaptation of disability supports in a number of colleges is warranted in order to provide a more holistic service that addresses psychosocial difficulties as well as the academic challenges. The National Learning Network (NLN) has recognised these concerns and has developed a service which provides social, emotional and organisational support as an adjunct to academic support.
The National Learning Network Approach
NLN employs Assistant Psychologists (APs) in three third level institutions, including Maynooth University, the National College of Art and Design, and the Institute of Technology, Blanchardstown. APs have qualifications at both undergraduate and masters level in psychology, in addition to experience working with populations experiencing psychological distress. APs receive close guidance and supervision from a Registered Educational Psychologist. The APs and Educational Psychologist in this service also work in close collaboration with a wider network of NLN rehabilitation psychologists who have expertise in a number of different areas. NLN invests in the ongoing continuous professional development and training of APs and rehabilitation psychologists in response to the demands of the service and the needs of the students.
Within the three third level centres, the APs facilitate a holistic needs assessment in the initial meeting with students in order to obtain a comprehensive overview of the student’s needs. This needs assessment process examines the student’s past educational experiences, current academic, social and emotional concerns, previous assessment history as well as an examination of any other diagnoses that may exist and how they impact on learning. For students with a mild to moderate level of psychosocial difficulties, the AP employs low-intensity interventions tailored to meet the student’s needs, which support achievement of academic potential, improvement of well-being and development of connectedness with their peers.
Where psychological distress is pervasive or complex and needs are high, the AP refers the student to a mental health professional in order for them to access intensive support. This is akin to the stepped care approach in many primary care psychological services where a wide range of individuals can avail of low intensity psychological therapies, reducing the need for specialist supports as a first line of intervention.
These low-intensity psychological interventions are drawn from a number of psychological approaches with a strong evidencebase. In order to provide the student with a set of functional and beneficial coping strategies, key concepts from the Wellness Recovery Action Planning approach are used, namely the ‘Wellness toolbox’ (WRAP; Copeland, 2002). Wellness tools may include recognizing personal strengths and developing coping strategies - fundamental factors for achieving success (Nalavany, Carawan, & Rennick 2011). For students whose emotional difficulties are rooted in negative thinking patterns, APs draw from Cognitive Behavioural Therapy (CBT; Beck 1967). CBT is used to address the thought processes and assumptions that underlie their difficulties, a strategy that is particularly helpful at targeting an individual’s beliefs about his or herself, others, and the world. It works to solve current problems and change unhelpful thinking and behavior that antecede and perpetuate psychosocial difficulties.
Managing, regulating and coping with emotions is also targeted, using skills such as distress tolerance and mindfulness, drawn from Dialectical Behaviour Therapy (DBT; Linehan, 1987). Mindfulness is a well-established and evidence-based intervention which is not only effective in reducing stress for students (Beddoe & Murphy 2004; Rosenzweig et al. 2003; Shapiro, Schwartz, & Bonner 1998), but can also significantly improve reading comprehension, working memory capacity, and focus (Mrazek et al. 2013).
The service recognises the pressure on students to be able to cope with keeping up with college work, living away from home and self-management. Individuals with dyslexia commonly struggle with organisational skills which compounds the stress of trying to manage assignments and study (Peer & Reid, 2013). APs at the National Learning Network work with students to help develop personalised strategies for time management, organising belongings and meeting deadlines.
Given the evidence for lower levels of self-esteem and social anxiety, individuals may struggle to make friends and establish a social network. The importance of social interconnectedness is an essential aspect of building resilience (Bernier & Meinzen-Dick, 2014). To this end, support is provided by the AP’s around social skills, which targets the improvement of conversation skills and development of confidence and assertiveness, with the aim of helping students integrate into college life.
Evaluation is a central practice in this inclusive academic support service. NLN has analysed trends in service use and feedback both quantitatively and qualitatively, the results of which have been presented at higher education conferences (McCarthy, Byrne & Larkin, 2014a; McCarthy & Byrne, 2014b; McCarthy and Byrne, 2014c; Byrne, 2014; Kennedy & Stewart, 2014). The service has recently adopted an outcome measure (Student Outcome Star™; ‘About us - Outcomes Star,’ n.d.) specific to student psychosocial functioning which is designed to measure the overall progress made by the students, not only in an academic sense but in all areas of typical adult development including: practical skills, communication and social skills, learning skills, physical health, living skills, friends and relationships, well-being, social responsibility and work readiness. Evaluation serves to guide the service in its adaptation and development to meet students’ needs and is essential to maintaining a high standard of service delivery.
The need for a holistic support service to be made widely available for students is abundantly clear, and a number of recommendations for practice can be made. Students with dyslexia should be made aware that their academic life is often intertwined with their social and emotional wellbeing, and therefore engaging with supports on all of these levels can create positive change.
The NLN service has found that an assessment of psychosocial functioning as part of the initial meeting with a student provides a valuable indicator of the type of support needed. Providing a service informed by research and grounded in psychology allows students to seek help in relation to their perhaps less visible difficulties and access low intensity interventions to improve wellbeing, coping, self-esteem and confidence; manage stress and anxiety, and foster social interconnectedness.
These practices have been successfully adapted by NLN in three Higher Education Institutes (HEI’s) to create an inclusive academic support service which the organisation continues to evaluate, develop, and expand in order to meet the complex needs of the increasing population of students with dyslexia in third level. Finally, it is recommended that the inclusion of holistic supports is not only studied in terms of its effects on psychosocial development, but also in relation to academic achievement, student retention and the overall third level student experience.
About us - Outcomes Star. (n.d.). Retrieved April 13, 2015, from http://www.outcomesstar.org.uk/who-we-are/
Alexander-Passe, N. (2006). How dyslexic teenagers cope: an investigation of selfesteem, coping and depression, Dyslexia, 12(4), 256–275.
Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. Hoeber Medical Division, Harper & Row.
Beddoe, A. E., & Murphy, S. O. (2004). Does mindfulness decrease stress and foster empathy among nursing students? The Journal of Nursing Education, 43(7), 305–312.
Bernier, Q., & Meinzen-Dick, R. (2014). Social capital and resilience. Resilience for Food and Nutrition Security, 169.
Berninger, V. W., Nielsen, K. H., Abbott, R. D., Wijsman, E., & Raskind, W. (2008). Gender differences in severity of writing and reading disabilities. Journal of School Psychology, 46(2), 151–172.
Byrne, H. (2014). Assisting on the Journey through Third Level Education: An Exploration of an Academic and Wellbeing Support Service. Poster presented at the Association for Child and Adolescent Mental Health -Transitions in Youth Mental Health Conference, Cork, Ireland.
Carroll, J. M., & Iles, J. E. (2006). An assessment of anxiety levels in dyslexic students in higher education. British Journal of Educational Psychology, 76(3), 651–662.
Carroll, J. M., Maughan, B., Goodman, R., & Meltzer, H. (2005). Literacy difficulties and psychiatric disorders: evidence for comorbidity. Journal of Child Psychology and Psychiatry, 46(5), 524–532.
Chan, D. W., Ho, C. S., Tsang, S., Lee, S., & Chung, K. K. (2007). Prevalence, gender ratio and gender differences in reading-related cognitive abilities among Chinese children with dyslexia in Hong Kong. Educational Studies, 33(2), 249– 265.
Copeland, M. (2002b). Wellness recovery action plan. Dummerston, VT: Peach Press.
Hales, G. (1994). The human aspects of dyslexia. Dyslexia Matters: A Celebratory Contributed Volume to Honour Professor TR Miles, 172–183.
Hawke, J. L., Olson, R. K., Willcut, E. G., Wadsworth, S. J., & DeFries, J. C. (2009). Gender ratios for reading difficulties. Dyslexia, 15(3), 239–242.
Ingesson, S. G. (2007). Growing Up with Dyslexia Interviews with Teenagers and Young Adults. School Psychology International, 28(5), 574–591.
Kennedy, S. & Stewart, A. (2014). Student Central, Paper presented at Into the Real World: What does the best Higher Education experience for a student with a disability look like? Dublin, Ireland.
Linehan, M. M. (1987). Dialectical Behavior Therapy for borderline personality disorder: Theory and method. Bulletin of the Menninger Clinic. Retrieved from http://psycnet.apa.org/ psycinfo/1987-32134-001
McCarthy, S., Byrne, H. & Larkin, F. (2014a, March). An Example of an Inclusive Academic Support Service for Higher Education Students. Paper presented at Into the Real World: What does the best Higher Education experience for a student with a disability look like?, Dublin, Ireland.
McCarthy, S. & Byrne, H (2014b, June). Supporting Students with Special Educational Needs with Transition to Third Level. Paper presented at Irish Association of Teachers in Special Education Conference, Dublin, Ireland.
McCarthy, S. & Byrne, H (2014c, November). An exploration of students’ experiences of an academic, social and well-being support service. Paper presented at 44th Annual Conference of the Psychological Society of Ireland, Kilkenny, Ireland.
Miles, T. R., Haslum, M. N., & Wheeler, T. J. (1998). Gender ratio in dyslexia. Annals of Dyslexia, 48(1), 27–55.
Mrazek, M. D., Franklin, M. S., Phillips, D. T., Baird, B., & Schooler, J. W. (2013). Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychological Science, 0956797612459659.
Mugnaini, D., Lassi, S., La Malfa, G., & Albertini, G. (2009). Internalizing correlates of dyslexia. World Journal of Pediatrics, 5(4), 255–264.
Nalavany, B. A., Carawan, L. W., & Rennick, R. A. (2011). Psychosocial experiences associated with confirmed and self-identified dyslexia: A participant-driven concept map of adult perspectives. Journal of Learning Disabilities, 44(1), 63–79.
Nalavany, B.A, Carawan, L.W, & Rennick, R.A (2010). Psychosocial experiences associated with confirmed and selfidentified dyslexia: A participant driven concept map of adult perspectives. Journal of Learning Disabilities, 1-18.
Nelson, J. M., & Gregg, N. (2012). Depression and anxiety among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Journal of Attention Disorders, 16(3), 244–254.
Peer, L. & Reid, G. (2013). An Introduction to Dyslexia Oxford: Routledge.
Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2003). Mindfulness-based stress reduction lowers psychological distress in medical students. Teaching and Learning in Medicine, 15(2), 88–92.
Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of mindfulnessbased stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21(6), 581–599.
Undheim, A. M. (2003). Dyslexia and psychosocial factors. A follow-up study of young Norwegian adults with a history of dyslexia in childhood. Nordic Journal of Psychiatry, 57(3), 221–226.