May 13, 2019

Cassidy Urges Full Implementation of First Step Act Dyslexia Screening

WASHINGTON–U.S. Senator Bill Cassidy, M.D. (R-LA), member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, today called on the Federal Bureau of Prisons (BOP) Acting Director Hugh Hurwitz to fully implement the First Step Act, specifically as it pertains to screening prisoners for dyslexia. Cassidy was integral in the inclusion of the dyslexia screening provisions in the bill signed last year.

”For far too long there has been a significant misunderstanding of what dyslexia is and how it can be treated in a large capacity, such as in America’s prisons,” writes Senator Cassidy. “With approximately 180,000 inmates incarcerated throughout the 122 federal prisons, it is essential that the consultants BOP uses to develop an effective and efficient screener are experts in the field of dyslexia.”

The full text of the letter is below:

 Dear Acting Director Hurwitz:

Last year, President Donald Trump signed into law the First Step Act, which included critical provisions related to defining and screening prisoners for dyslexia. To ensure these provisions are properly implemented across all federal prisons, my office has been in communication with the Bureau of Prisons’ (BOP) Office of Legislative Affairs (OLA). I appreciate the cooperation of the OLA and their responding in a timely manner to my inquiries. I am writing today to express outstanding questions and concerns I have regarding BOP’s development of a dyslexia screening program, to ensure that the provisions in the First Step Act are properly implemented.

In April, my office spoke with BOP by phone to inquire about the status of implementing the First Step Act and, specifically, to learn about how the dyslexia provisions I included in the law were being implemented. Following the conversation, the below questions were posed to BOP: 

·         Was the definition of dyslexia that was included in the First Step Act used to inform the development of the screener?

·         Who was consulted in the development of the screener?

·         What metrics will the screener incorporate in the determination process?

·         Will there be a cost associated with administering the screener – if so, how much?  

In response to these questions, OLA provided my office with the attached document, which aims to address the above questions presented to BOP. In reviewing the document, I have the following concerns and questions:

Definitions:

In the First Step Act, dyslexia is defined as “an unexpected difficulty in reading for an individual who has the intelligence to be a much better reader, most commonly caused by a difficulty in the phonological processing (the appreciation of the individual sounds of spoken language), which affects the ability of an individual to speak, read, and spell.” [1] Understanding that dyslexia is already defined clearly in the First Step Act, it was surprising to see three other definitions used in the development of a dyslexia screener, alongside the above definition in the First Step Act. The document specifically lists the following sources for definitions: 

  • American Psychological Association’s definition of Specific Learning Disorder, found in its Diagnostic Statistical Manual, Fifth Edition (2013), in which dyslexia is considered a contributor to SLD. 
  • US Department of Education’s definition of Specific Learning Disability, found in the Individuals with Disabilities Education Act (1997; reauthorized 2004), in which dyslexia is considered a condition of SLD. 
  • International Dyslexia Association’s definition of dyslexia, retrieved online (see reference in 1. above).

The first two definitions listed are not specific to dyslexia; rather, they apply to the general category of Specific Learning Disabilities (SLD), of which dyslexia has historically been included for federal programmatic purposes. In fact, the historic inclusion of dyslexia as an SLD is one of the main reasons for including the definition of dyslexia in the First Step Act, so as to lessen the confusion about what dyslexia is and is not in federal prisons. 

The third definition listed, from the International Dyslexia Association (IDA), is outdated and does not encompass an appropriate definition of dyslexia, as was explained in my recent letter to the Department of Education, dated April 22. While the IDA definition recognizes the phonologic and unexpected nature of dyslexia, it implicitly blames teachers and classroom instruction as the reason why some individuals are dyslexic, by stating that dyslexia typically results from a deficit in the provision of effective classroom instruction. IDA’s definition is misleading and neglects the fact that individuals with dyslexia are born with the difficulty and have an inherently harder time than their non-dyslexic peers when learning to read and write well, and speak foreign languages.

Consultants:

Responding to the question of who was consulted when developing BOP’s dyslexia screener, the document provided to my office listed individuals with general background and vender experience in disability consulting and training, but not individuals with backgrounds specific to dyslexia. While I understand the need to consult with a vender for purposes of scalability and eventual deployment of an effective screener, I believe it is critical for BOP to consult with experts experienced in the studying, understanding, and overcoming of dyslexia.

For far too long there has been a significant misunderstanding of what dyslexia is and how it can be treated in a large capacity, such as in America’s prisons. With approximately 180,000 inmates incarcerated throughout the 122 federal prisons, it is essential that the consultants BOP uses to develop an effective and efficient screener are experts in the field of dyslexia. As such, it was concerning to see a study listed in the document, authored by a British consultant who focuses heavily on dyslexia-related visual stress, including “repeatedly losing their place, ‘glare’ from the page or screen, headaches, eye strain, blurring or apparent moving of text when attempting to read.”[2] Visual stress may certainly be an issue someone has when reading and may occur for a dyslexic reader, but in no way should it be associated as a symptom of dyslexia. 

Screeners:

When looking through the examples of screeners listed in the documents, some examples provided were for screening children for the risk of being dyslexic. As I am sure you understand, any screener used for adult inmates should be geared towards adults, not children. For the screeners listed in the document that pertain to adults, they lack evidence of proven psychometrics; in other words, they lack the evidence detailing the sensitivity, specificity, and overall accuracy of the screener. This is important because it would be counterproductive to deploy a screener that produces too many false-positives or false-negatives, thus skewing the accuracy of the results. It is also important because the text in the First Step Act explicitly requires the screener to be “evidence-based […] with proven psychometrics for validity.”[3] 

I also have concerns with how the screening checklist was determined and would like greater clarification in what the document means when it refers to “processing skills” and “perceptual problems.” Does the document mean to specify phonologic and phonemic processing skills? Or, does the document mean to be concerned with general processing skills, including visual, auditory, or cognitive processing? The reason for greater clarification is because dyslexia is specifically an issue of phonologic and phonemic awareness, meaning that the dyslexic reader often struggles with the sound structure of words and the ability to notice, identify, and manipulate and decipher phonemes, which is how we distinguish specific sounds in the words we read, speak, and hear.

Additionally, I am hopeful BOP can clarify what is intended by asking inmates about perceptual problems. An inmate’s perceptual problems can be the sign of a number of issues that are unrelated to dyslexia and I am concerned that including this in the questions asked of inmates will result in inaccurate or missed diagnoses. It is important that any screening program used in BOP is rooted in sound, evidence-based science with proven psychometrics, as is required in federal statute. 

I sincerely appreciate BOP taking this issue seriously and working hard to properly implement provisions related to dyslexia and the rest of the First Step Act. If we are to reduce recidivism by upskilling inmates, it is necessary that they know how to read or have an appropriate accommodation provided, because the ability to read is both necessary to hold a job in the 21stcentury workforce and because it is necessary if they pass any exams required to demonstrate educational attainment and aptitude. 

Thank you for considering the concerns listed in my letter and for BOP’s continued interest in reducing recidivism. If I can be of any further assistance, please do not hesitate to let me know. 

Sincerely,

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