Supporting Dyslexic Patients

 

Some very personal reasons prompted me to write a review of how inclusive our clinic processes are for the neurodiverse, specifically those with dyslexia and dyscalculia. While the pathways had been originally designed to be inclusive of everyone’s needs, personal circumstances caused a reassessment through fresh eyes. In doing so, it was surprising to see, because of a personal approach to learning, how many of these strategies had been ‘built in’ to existing systems and processes without being particularly cognisant of how these approaches create a more accessible and supportive environment for the neurodiverse patient.

 

 

Inclusivity is a critical aspect of healthcare, and it becomes even more crucial when seeing patients with dyslexia. Dyslexia is a complex learning diversity that affects approximately 10-20% of the population worldwide in different ways (NHS, 2023) (Yale, 2023).^1-2 While dyslexia is typically associated with difficulties in reading, writing, and spelling, it can also affect other cognitive processes such as memory, attention span, fine motor skills, and organisation. Additionally, dyslexia can present differently depending on the individual, making it a diverse and multifaceted condition. Understanding the complexity of dyslexia is essential for developing effective strategies for communication. Therefore, healthcare providers need to understand the unique needs of patients with dyslexia during clinical consultations. 

 

Critically dyslexia is not reflective of reduced intellect. It is concerning to see discrimination in action in massive ways where the assumption is that, because someone has a diverse learning style, they are not clever or bright enough to grasp various concepts (sadly, it is still a common belief in some schools). This is a huge misconception and one it is vital to address. In all circumstances, we should be sure that our information is presented and shared in ways that are accessible to all. We would ensure our patients with sight loss could access our information in a way they can receive it, and the same for those with deafness. Therefore, we must also ensure that we are all educated enough to understand how best to communicate with our dyslexic patients; it is generally about professionals being clever enough to grasp what this patient group needs from us and working to ensure we provide it. It is not the patient’s responsibility to try to understand the information presented in a way that does not work for them. 

 

As an example, Davis and Braun (2011)³ talk about how people with dyslexia struggle to visualise letters and therefore spelling things out ‘in the mind’ is almost an impossibility, but it is easy to visualise physical things. The challenge is with certain words that do not really have a ‘thing’ related to them. Words like ‘the’, ‘an’ etc. can lack meaning as there is nothing physical to relate them to, and therefore their meaning is meaningless in the context of dyslexic processing.

 

While people with dyslexia are often extremely gifted in many ways, there is a risk that they can be the subject of stigma and discrimination, which can make them feel uncomfortable or ashamed of their condition. By being inclusive, healthcare providers can create an environment where patients with dyslexia feel respected and valued. This, in turn, can increase patient trust, satisfaction, understanding and adherence to medical advice. Conversely, if someone needs help reading and understanding written information, this could lead to miscommunication between the healthcare provider and the patient. In some cases, this could lead to a lack of understanding of the patient’s medical history, which could result in incorrect diagnoses, improper treatments, and adverse health outcomes. As health professionals, we have a duty to ‘do no harm, by act or omission’ as discussed by (Sokol, 2013).⁴ If we omit to assess and communicate properly with our patients, we could be the perpetrators of harm by omission; therefore, we must get this right.

 

One of the key things is identifying patients who need to access our information differently (or, ideally, creating pathways which are inclusive in the first place). Do we routinely ask our patients about any neurodivergent conditions they may have? As providers, we need to be educated and equipped to offer explanations regarding treatment options, to give a visual rather than descriptive approach if this helps, to complete forms with the patient rather than expect them to do paperwork alone in the waiting room and to go through treatment approaches, benefits, and risks verbally. There is a strong argument that this is an approach we should use for all patients and that the inclusivity aspect here is around developing processes and approaches which are beneficial for everyone rather than wheeled out on the occasions when an issue is identified. 

 

 

Individuals with dyslexia may have difficulty processing complex or abstract language. Therefore, using clear and concise language when communicating with them is essential. Avoid using technical jargon, avoid lengthy, drawn-out explanations when they are not necessary and ensure the patient feels able to ask questions and raise their concerns.

 

Visual aids such as diagrams, charts, and pictures can be an effective way to communicate with individuals with dyslexia. Visual aids can help to illustrate concepts and ideas, making them easier to understand, for example, using a model of a head to help explain and theoretically demonstrate procedures, as well as anatomical diagrams to help explain complex anatomy and the dangers related to various treatments.

 

Individuals with dyslexia may need more time to process information and formulate their responses. Therefore, it is essential to be patient and allow them to take their time. Good practice for all patients is to avoid rushing them or interrupting them when they are speaking. Instead, give them the time they need to process the information and respond. Asking if there is ‘something else’ the patient would like to discuss is a good strategy. It keeps the door open as opposed to ‘Is there anything else’ they would like to discuss, which signifies moving towards the end of the conversation.

 

For individuals with dyslexia, traditional written formats may be challenging to read and understand; even something as simple as the background colour on a form may make it challenging to read. Therefore, it may be necessary to use alternative formats such as audio recordings, videos, or digital formats. This is standard good practice for all patients, and a library of short educational videos to which the patient can be signposted can be extremely helpful. Many of us have these already available within our social media channels; linking them to specific patient education can be really valuable and a brilliant form of repurposing material.

 

In conclusion, we need to ensure our patient pathways, documentation, and processes account for neurodiverse approaches and are designed to be as accessible for all. 

 

 

Visual explanations – use of models/diagrams /charts/video etc

Written information

Time, patience, and the use of reflective techniques to ensure the patient is fully aware of the intended treatment, treatment approach and understanding of the benefits and risks.

 

 

Made By Dyslexia – Redefining Dyslexia

 

Dyslexia charity - Assessments, tutoring, guidance, support, training, funding (dyslexiasparks.org.uk)

 

What is Dyslexia? - British Dyslexia Association (bdadyslexia.org.uk)

 

What is Dyslexia? - The Dyslexia Association - The Dyslexia Association

 

Dyslexia.uk.com – Everything you need to know about Dyslexia in the UK