Seeing the world through rose-colored glasses: Scotopic Sensitivity/Irlen Syndrome: Helen Irlen and her followers claim that dyslexia, attention deficit hyperactivity disorder, and autism are all associated with “Scotopic Sensitivity Syndrome,” and each can be effectively treated using colored lenses and overlays. The scientific evidence suggests otherwise
Alan D. Bowd
More than four thousand American schools have implemented a controversial approach claimed to assist children with reading difficulties sometimes known as dyslexia (Robinson 2003) and other disabilities, including autism. The Irlen method, named for its founder Helen Irlen, involves the use of colored lenses or overlays, which she argues improve reading skills, memory, and depth perception, as well as helping persons with learning disabilities and autism learn better. More than eighty thousand Americans, most of them children, have bought Irlen “filters” (Robinson 2003) despite a complete absence of scientific evidence for the existence of “Scotopic Sensitivity Syndrome,” which the filters supposedly treat. The story of Helen Irlen and her “Irlen Institute” seems like a case study in educational flimflam.
A school psychologist, Helen Irlen unveiled her theory of Scotopic Sensitivity Syndrome (also styled “Irlen Syndrome”) at the 1983 annual convention of the American Psychological Association. Her short paper, based on a sample of thirty-seven learning-disabled adults, claimed that most had reading difficulties because of visual perception problems. After a month of wearing “photopic transmittance lenses,” later known as “Irlen filters,” most subjects reported improved depth perception, reading speed, and reading comprehension. There was no control group, and the self-report technique used maximized a likely placebo effect. Nevertheless, Irlen claimed to have discovered the existence of “a previously unrecognized perceptual dysfunction” that her filters were able to treat effectively (Irlen 1983). She later claimed that Scotopic Sensitivity Syndrome (SSS) affects “up to 12%” of the general population and “a much higher percentage” of individuals with dyslexia, learning disabilities, attention deficit hyperactivity disorder (ADHD), and autism (Irlen 2000), although no evidence for these claims was offered.
Scotopic Sensitivity Syndrome
Just what is SSS? Writing in Latitudes magazine, Irlen (2000) claimed SSS is a visual-perceptual processing deficit, and that since there are no educational or medical tests to identify it, SSS is often mislabeled as learning disability or ADHD. However, she has never offered a formal definition of SSS.
In 1991 Irlen published Reading By the Colors: Overcoming Dyslexia and Other Reading Disabilities Through the Irlen Method. This self-help book was directed at the public to sell her products. Irlen’s lenses and overlays, her “standardized” tests, self-report inventories, and checklists are all available at a price, and it is repeatedly implied that most children with reading difficulties can benefit from Irlen’s screening and diagnostic procedures, available from trained “screeners.” An appendix lists addresses and telephone numbers for Irlen Clinics in the U.S. and five other countries.
The closest that Irlen has come to defining SSS is the following simplistic speculation in Reading By the Colors: “Scotopic Sensitivity Syndrome–and the sensitivity to full-spectrum light that forms the basis of the syndrome–possibly involves a structural brain deficit involving the central nervous system. If so, then signals sent to the brain would be inappropriately processed, resulting in perceptual problems. For those with SSS, full-spectrum light would distort what is perceived and processed by the brain” (57).
She went on to suggest that if certain wavelengths were reduced by colored filters, the brain would be able to “more effectively analyze and process information without interference” (57).
The book begins with a “self-rest” in which the reader, or “someone you know” (your child, perhaps?) is presented with fourteen questions about reading difficulties. Those who respond positively to three or more may very well have SSS. The “symptoms” presented are so general mad common it is likely that very many people would qualify. They include skipping words, rereading lines, losing place, taking breaks often, and reading close to the page. The test, for which no evidence of validity or reliability is presented, represents a clever hook to get the reader involved. The book has become a best seller.
Getting the Message Out
Reading By the Colors is a classic self-help book. It offers good news: the promise of an effective treatment for children with learning disabilities, particularly dyslexia. Irlen invents a syndrome, provides a simple, noninvasive way of ameliorating its effects, and holds out hope to the parents of children with learning disabilities. She also claims that her approach will help a wide range of exceptional youngsters who have visual and auditory perceptual disabilities, memory and motor problems, and attention deficit hyperactivity disorder. A brochure from the Irlen Institute titled “Understanding Scotopic Sensitivity Syndrome” (Irlen Institute 1990) also lists general characteristics of children’s writing, mathematics performance, musical ability, depth perception, and gross motor skills that supposedly may be symptoms of SSS. These include mistakes in writing when copying, in mathematics (“sloppy, careless errors”), playing music better by ear than from sheet music, and difficulty catching balls. (Autism was added to this list later.) With no indication of the age-appropriateness of these criteria, these characteristics fit nearly every youngster at one time or another. In case the reader may consider seeking advice elsewhere, the brochure points out that SSS cannot be detected by regular optometric, medical, psychological, or educational testing.
Irlen likes to associate her Institute, located in Long Beach, California, with universities, and the annual Irlen conferences are usually held at a prestigious campus. In her book, she writes that after an appearance on 60 Minutes, Dr. Paul Whiting (1) returned to Australia to open the first SSS clinic “at Sydney University.” Sydney is Alan D. Bowd’s alma mater, and on a recent trip there he decided to visit the Irlen clinic. It had been located in rented premises on campus and had since moved. He spoke with the director, who confirmed that the clinic had no relationship with the university.
The Irlen Institute, like nearly all questionable or “alternative” approaches in health and special education, uses testimonial evidence from “experts” to support its claims. At their Web site, a section titled “What do the experts say about the Irlen Method” (at www.irlen.com/testimonial_experts.htm), glowing accounts are posted, citing the value of Irlen lenses. The titles attached to these experts are meant to impress the public, but not all reflect expertise in the study of reading difficulties or visual perception. Special education administrators, school trustees, and psychologists make up the majority of those listed. Some also just happen to be Irlen screeners with a financial interest in promoting the Institute’s products. However, nowhere in the text or quoted words of endorsement is this mentioned.
The Irlen Institute seeks publicity primarily through press releases and television appearances that involve carefully crafted testimonial evidence. The cover of Irlen’s book proclaims that “because of this remarkable breakthrough [helping people suffering from SSS], Helen Irlen has been on two segments of 60 Minutes, the subject of two half-hour segments on go Minutes Australia, and the focus of a BBC special.” Since then she has had many more public appearances, and the Institute has issued numerous press releases. Screeners have been advised to target school systems in particular, in order to take the benefits of Irlen filters to as many students as possible.
Research Evidence
Much of the early research on the effects of Irlen filters is of dubious value. One group of scientists described it this way: “Many of these studies have been difficult to interpret due to design problems, such as selection bias, sample size, heterogeneity of subjects, subjectivity of results, financial interests of investigators, and a failure to consider such factors as placebo effect, controls, and opthalmic status of subjects” (Menacker et al. 1993). Given the absence of a scientific rationale, skepticism within the scientific community was quite predictable. The skepticism was also promoted by Irlen’s claim for the existence of Scotopic Sensitivity Syndrome since scotopic refers to the activity of the rods, receptors active in low levels of light, while her “syndrome” was identified in part as an intolerance for high luminosity.
Regarding autism, the Irlen Institute claims, “When the brain sees the world incorrectly and relays that information to the other senses individuals have difficulty interacting with the world around them.” This simplistic statement is from a Web page suggesting that many individuals with autism have “sensory sensitivity/inhibition problems” that can be treated effectively using the Irlen method. For a fee of $28, parents can receive an evaluation questionnaire and a report will be returned to them. If treatment is indicated, the Irlen Institute advises that only one or two sessions are needed for lenses to be fitted (with no mention of cost, at this stage). It further recommends that the individual should be re-evaluated every six to twelve months. Again, no reference is made to cost. The only evidence presented for these claims is the testimony of Donna Williams, “the first autistic individual to wear Irlen Colored Filters.”
Recent Scientific Research
It is ironic that the claims for a relationship between colored filters and reading improvement made by Irlen, and the methods used by her and her followers to market Irlen products, led most scientists to maintain a healthy degree of skepticism about a possible link. Irlen’s use of testimonials, the poorly controlled studies done in the first half of the last decade, together with the hypothetical SSS model, probably all contributed to the neglect of research concerning visual processes involved in reading, especially in mainstream special education.
At the time we began research for this article we had looked over Reading By the Colors and many of the brochures and checklists produced by the Irlen Institute, as well as a videotape featuring a testimonial by Donna Williams, an autistic adult, to an audience in a statement that reminded us of a religious revivalist meeting. As far as a relationship between colored filters and improved reading was concerned, we thought the research inconclusive and positive findings in some earlier studies best explained by a placebo effect.
In fact, more recently, researchers have provided some evidence that reading speed can be significantly improved for children with dyslexia in studies designed to eliminate placebo effects. However, the effects of color are most evident when text is small and closely spaced. With conventional print, color begins to make a difference only when the reader begins to tire (Wilkins 1996). These effects have been scientifically documented in a series of investigations by Arnold Wilkins at the University of Essex, England. However, while reading rate is an important component of reading, it is not appropriate to generalize to the complex behavior of “reading” from the number of words correctly identified in a timed period. Wilkins and his colleagues recommend that all children with reading difficulties be assessed for the benefit of overlays–a statement too far from the data in our view.
The London Institute of Optometry and the American Optometric Association have taken similar positions regarding the marginal relationship between vision and reading disability: “Although it is generally accepted that sight is not the main cause of dyslexia, certain visual complications do occur more often in dyslexic patients and these may contribute to reading and learning difficulties, especially for children.”
The American Optometric Association’s policy statement points out that “Vision therapy does not directly treat learning disabilities or dyslexia. Vision therapy is a treatment to improve visual efficiency and visual processing, thereby allowing the person to be more responsive to educational instruction. It does not preclude any other form of treatment and should be part of a multidisciplinary approach to learning disabilities” (American Optometric Association 2003).
Another statement from the American Optometric Association, “The Use of Tinted Lenses for the Treatment of Dyslexia and other Related Reading and Learning Disorders” (available at the association’s Web site www.aoa.org) is even more forthright in its assessment: “Current research does not support the validity or presence of an actual visual perceptual dysfunction termed ‘scotopic sensitivity syndrome.’ Therefore the use of this term is meaningless.” And: “It is the position of the American Optometric Association that: There is currently no scientific research to support the ‘scotopic sensitivity hypothesis.'”
Despite the positions taken by professional organizations and the absence of credible evidence supporting the claims of Helen Irlen and her Institute, vulnerable parents and some teachers continue to place their hope (and their dollars) in colored overlays, lenses, and, more recently, contact lenses. Helen Irlen encourages parents to continue with her lenses, even when they are apparently ineffective: “Parents also should not be frightened when they see little improvement as their [autistic] child grows older. From what I have seen over the years, one cannot put an age limit on progress and change. You should never give up hope–maturation and growth can occur at any time, even when the individual is in their 20s, 30s or older” (Edelson 2003).
It might help, of course, to have your child regularly re-evaluated by “professionals trained and certified in the Irlen method”–if you are prepared to continue to pay for something that doesn’t work. And, as long as parents of children with special needs maintain them in a treatment program of questionable value, they are denied the opportunity to seek help from one that has scientific credibility.
Note
(1.) Dr. Whiting has pointed out that all the money made at the Sydney clinic went into college, now Faculty of Education, funds (personal communication, September 5, 2003).
References
American Optometric Association. 2003. Vision, Learning and Dyslexia: A Joint Organizational Policy Statement of the American Academy of Optometry and the American Optometric Association. Available at www.children-special-needs.org/parenting/dyslexia_dyslexic.html.
American Optometric Association. 2004. The Use of Tinted Lenses for the Treatment of Dyslexia and other Related Reading and Learning Disorders. Available at www.aoa.org/eweb/DynamicPage.aspx?site=AOAstage&WebCode=PediatricsTinted.
Edelson, S.M. 2003. An interview with Helen Irlen. Retrieved from www.autism.org/interview/irlen.html.
Irlen, H. 1983. Successful treatment of learning disabilities. Paper presented at the annual meeting at the American Psychological Association, Anaheim, California.
–. 1991. Reading By the Colors: Overcoming Dyslexia and Other Disabilities through the Irlen Method. Garden City Park, N.Y.: Avery.
–. 2000. The world of misperception–Irlen colored filters. Latitudes, 2(5). Retrieved from www.latitudes.org/prnffnd/learn02_prn.html.
Irlen Institute. 2001. Autism & the Irlen Method: Sensory Inhibition and Overload. Available at www.irlen.com/autism_main.htm.
–. 1990. Understanding Scotopic Sensitivity Syndrome. Pamphlet published by Irlen Institute, Long Beach, California.
Menacker, S.J., M.E. Breton, M.L. Breton, I. Radcliffe, and G.A. Cole. 1993. Do tinted lenses improve the reading performance of dyslexic children? Archives of Opthalmology, 111, 213-218.
Robinson, G. 2003. Australasian Association of Irlen Consultants, Inc. Available at http://members.ozemail.com.au/~trevordt/Research-Summary.htm.
Scott, L., H. McWhinnie, L. Taylor, N. Stevenson, P. Irons, E. Lewis, M. Evans, B. Evans, and A. Wilkins. 2002. Coloured overlays in schools: orthoptic and optometric findings. Ophthalmic and Physiological Optics, 22, 156-165.
Wilkins, A. 1996. Helping reading with colour. Dyslexia Review, 7(3). Available at www.essex.ac.uk/psychology/overlays/reading%20disorders%20OC2.htm.
–. 2002. Coloured overlays and their effects on reading speed. Opthalmic and Physiological Optics, 22, 448-454.
Wilkins, A.J., E. Lewis, F. Smith, E. Rowland, and W. Tweedle. 2001. Coloured overlays and their benefit for reading. Journal of Research in Reading, 24(1), 41-64.
Alan Bowd is Regional Director of the Centre of Excellence for Children and Adolescents at Lakehead University and a professor in the Faculty of Education. His research interests include educational psychology and special education. Address: Centre of Excellence for Children and Adolescents with Special Needs, Lakehead University, Thunder Bay, ON, Canada P7B 5E1.
Julia O’Sullivan is National Director of the Centre of Excellence for Children and Adolescents with Special Needs and Dean of Education at Lakehead University. Her research interests include cognitive psychology and early reading.
COPYRIGHT 2004 Committee for the Scientific Investigation of Claims of the Paranormal
COPYRIGHT 2004 Gale Group
