Psychology
2012. Vol.3, No.1, 36-44
Published Online January 2012 in SciRes (http://www.SciRP.org/journal/psych) http://dx.doi.org/10.4236/psych.2012.31006
36
Physical and Behavioral Markers Help Identify Written Language
Disability (WLD) Related to Attention Deficit Hyperactivity
Disorder (ADHD)*
Rowe A. Young#, Benson E. Ginsburg, Dawn Bradway
Department of Psychology Program/Behavioral Neuroscience, University of Connecticut Storrs,
Connecticut, USA
Received October 13th, 2011; revised November 12th, 2011; accepted December 13th, 2011
Rotation, its physiological processing, as well as how this lateralized direction of movement is sensed, is
regularly taken for granted and little appreciated when studying how learning develops. Preference for di-
rection of rotational movement and how one processes this information has been found to differ greatly
from one individual to another. This report discusses how bimanual rotational hand use preference and
reversed direction of body part and movement sensation detection may be utilized to help identify certain
currently unrecognized classroom learning difficulties. What we label Reversed Positioning Sensation
(RPS) is evidenced in our research and is found in many children and adults presently identified as
“learning disabled” and/or “hyperactive” or just those considered “bright underachievers”. Easily admin-
istered tests to help identify individuals who may be at risk are discussed. When RPS occurs without the
necessary sensory-motor accommodation or compensation, we theorize that written language disability
(WLD), as well as compromised organizational skills often identified as ADHD, result. In addition, this
paper discusses a summary of our findings examining families with biologically related family members
reporting primary difficulties related to organization and written language skills. Case studies from four of
the many families we have studied demonstrate how to determine if an individual is able to sense his/her
own body extremities in correctly functioning or maladaptive directional orientation. In some cases, just
changing a writing hand position has been shown to help overcome many of the problems of RPS. This
change is meant is to redirect the writing hand movement to sense a top/down orientation.
Keywords: Rotation; WLD; Written Language Disability; Motor Learning; Proprioception; Kinesthesia;
Reversal; Directional Movement Sense; Learning Disability; Attention Deficit Hyperactivity
Disorder; ADHD
Background
Members of a former research team from the University of
Connecticut Biobehavioral Research Laboratory worked for
many years to gain more understanding of academic under-
achievement involving motoric behavior from a bio-behavioral
perspective. Past results have shown comparative motor pat-
terns relate to academic underachievement (Bradway, 1999,
2003; Carter, 1977, 1982; Ginsburg, 1980; Sadick, 1978; Young,
1987, 1989, 1993).
From accumulated evidence in various fields, it is commonly
accepted that academic achievement is dependent upon the
proper neurological integration of visual, motor and aural capa-
bilities (Wolf, 1996). However, as Lyon, (1996) noted, “Cur-
rently, there are no universally accepted tests, assessment bat-
teries nor standards for identifying children with WLD (written
language disability)” (Lyon, 1996). More recently, Katusic and
colleagues stated that, “Since children with WLD are clearly a
heterogeneous group, additional research is needed to identify
specific interventions that target the specifics of writing prob-
lems” (Katusic, 2009)
In aiding this identification, it is suggested that a complex
(yet uniquely individual) kinesthetic movement integration
process is directly involved. This integration of the sense of
movement in symbolic comprehension, we hypothesize, is nec-
essarily aided by the feeling for proper directional orientation in
fine motor as well as gross movement behavior. This might
relate to the same spatial mapping in the hands as proposed by
LeDoux and colleagues, who stated that the “manipulo-spatial
function is neither motor nor perceptual, per se, but rather is
more appropriately viewed as the mechanism by which a spatial
context is mapped into the perceptual and motor activities of
the hands” (LeDoux, 1977).
As a confounder to this mechanism, the authors propose mo-
toric directional inverted sensation, which we label reversed
positioning sensation (RPS). The authors further suggest that
these patterns have their origins in the interconnected hemi-
spheric proprioception emanating from the parietal lobes which
sense where one’s body parts are spatially positioned (Adams,
1997; Cook, 2006).
One early participating female adult subject became aware of
specific unusual lateral body movement sensations as a result of
the project. This information was described to us. The descrip-
tion of the reversal of specific movement sensations was later
found to match an unusual arm and hand position. We then
were able to identify similar physical characteristics in many of
*Conflicts of Interest: The authors have no conflicts to report.
#Corresponding author.

R. A. YOUNG ET AL.
the other individuals with written language difficulties (Young
& Ginsburg, 1993).
From our findings, RPS is further defined as the inverted re-
versal of the directional sense of feeling for movement occur-
ring in both the fine and the large motor control of the body.
This condition may occur laterally and differently between an
arm, hand and/or fingers and the leg, foot and/or toes. This may
or may not occur in the same way in one or all of the limbs of
the body, with or without the presence of movement. It may
also include a physical appearance as well as the sensory-motor
manifestation. To better understand the effects of RPS, it might,
e.g., be compared with looking through a transparent piece of
writing material from the backside and trying to read what has
just been written from the opposite side. This would be repre-
sentative of a similar comprehensive effect, only visually.
The purpose of this research has been to both explore the
development of methods both to help identify and to remediate
the potential maladaptive affects of RPS. We theorize that this
invisible reversal of movement sensory difficulty confounds
basic learning and overall organization resulting in ADHD.
Early academic skills are theorized to be the most impacted.
We suspect those affected eventually learn to cope by using
other learning capabilities. This is not without the trauma of the
misunderstanding of why the learning of basic skills is so dif-
ficult.
Through observation of many subjects, our research has
identified that in a significant portion of a population, rota-
tional movement patterns differ from commonly expected be-
havioral patterns. We’ve explored this finding by testing over
one thousand subjects coming from several (elementary through
college) school populations, as well as an opportunistic sample
of volunteers and several multi generational families (Young,
2006, 2008).
The test we developed for this research is called the Young-
Ginsburg Lateral Direction Assessment and Spatial Test (YGLD).
After having seen these patterns commonly present in family
members with a diagnosed learning disability (LD) most often
found to be WLD because of the motoric aspects of the identi-
fication. We now theorize that RPS occurs for genetic reasons.
In order to measure these observations in a controlled behav-
ioral manner, we set up experiments, to see if we could behav-
iorally identify WLD family members compared to non-WLD
members based upon these criteria.
Methods
Participants
The original opportunistic pool of several family groups were
selected after we were made aware that there were one or more
members in a family who had been diagnosed with a learning
disability. Upon reviewing both school records and self reports,
problems with first learning to read, spelling, and penmanship
appear to be the most common factors of academic difficulties
reported. The label WLD, and what it implies today, might be
more appropriate.
We administered our test battery to all of the family members
who were available and agreed to participate in our study. Par-
ticipants from these families were tested in different parts of the
United States. These family members were generally from well
educated backgrounds.
This present report has been formed around four selected
members from four family groups taken out of the many fami-
lies we have tested. The four case studies being focused on
were selected as a result of experimental remediation to try and
reverse the directional confusion identified. Only one of these
four families had enough participants (n = 64) to perform a
statistical analysis.
Study Design
The subtests administered included: direction preference for
different types of rotation of both fine and large motor move-
ments, visual and manual interactive hand use and asymmetri-
cal arm and movement identification, using a combination of
paper and pencil testing, interview and observation techniques.
The family members used in this report were also all tested for
reversed body sensations in their arms and hands.
Only the YGLD tests relating to this present report will be
described herein. Participants also filled out a questionnaire
regarding their academic achievement where no school records
were available. While much information was self-report, school
records and testing were provided wherever possible.
Test 1. Fine Motor Bimanu a l R otation Tes t
A small bottle with a one inch in diameter cap is used in this
test. The participant is first asked to unscrew the lid from the
bottle. The examiner then marks what method that was used.
Next, the subject is asked to watch as each of seven methods to
unscrew the lid of the bottle is demonstrated.
Following the demonstration, the subject tries each of the
methods. Only the technique(s) that appear natural and com-
fortable to the subject and that the subject says they would use
are marked. Three possible designations are based upon the
answers that are given for the test items having to do with fine
motor bimanual rotation:
1) Exclusive Left Hand Top: counterclockwise movement
with no bottom right hand movement or right hand movement
in tandem with the top left hand.
2) Bottom Turn Hand: hold the bottle in a stationary manner
with the top hand and turn with the bottom hand. This can be
by using either hand and in conjunction with any other turning
methods that are found comfortable.
3) Exclusive Right turning hand on the top with a stationary
left or tandem left hand on the bottom, or Right and Left hand
on Top: with a stationary hold or tandem movement on the
bottom.
These three groups are used to form the analysis of our pri-
mary data of Family D. Exclusive Right and Either top (both
exclusive right and both right and left top) have been combined,
as the results in our data produce the same effect between the
division of WLD and non-WLD.
Test 2. Arm and Hand Positioning Test (For
Asymmetry and/or an Arm Shifting Position)
Questions to determine how the arms compare to one another
were used to determine if the two arms are alike or different.
The examiner first tells the participant: “Stand up straight, let
your arms and hands hang loosely by your sides. Let’s look at
both of your arms in a relaxed position”. The first part of the
identification is looking at the position of the relaxed arms. The
side of the arm (below the elbow) that matches the back of the
hand is observed. The backs of some arms and hands are facing

R. A. YOUNG ET AL.
forward, while some are facing sideways. In some cases, one
arm faces in one direction and the other arm in another direc-
tion. Other cases are observed to be in non-alignment, i.e., an
outward facing back of the arm with a forward facing hand.
Occasionally an arm and/or hand will naturally position itself in
a backward facing position.
Next, the participant is asked, “Stretch your arms down at
your sides as stiffly, as you can”. Some subjects are found to
have a different positioning of the arms in a stiffened position.
We were also looking for a shift of arm position that does not
affect the position of the hand. The participant's so defined
different arm position characteristics when compared to the
other arm are classified, as being asymmetrical.
The four case studies discussed were also asked for percep-
tion of arm, hand and finger positions. This was done by having
the subject stretch out their arms from the elbows to the hands,
with palms rested palms on a table. Subjects were asked to
concentrate on the feel of both arms and hands with their eyes
closed. They then were asked to compare if their hands felt as if
they are both facing downward or upward. The subjects were
then asked if one hand felt like it was facing downward while
the other felt like it was facing upward. Lastly, subjects were
asked to compare their arms to one another. Could one lower
arm feel as if it was facing downward and the other upward? If
differences were found, they were then asked to explain the
difference.
As some of the family study D members were not tested for
perception of body part position characteristics; we were not
able to compare this variable in this family statistically.
Using the following test sequence, the arm hand/eye domi-
nance test identifies which eye is dominant when sighting a
target using the arm hand/eye combinations described:
Test 3. Arm Hand/Eye Dominance Test
Begin each test with arm being used out stretched
Circle—Find the eye that stays aligned to the (ten feet away)
target and in the circle that the subject has made with their
thumb and index finger.
(Start with both eyes open, find the target, set position, and
then close one at a time.)
1) Using the right arm; the eye on the target is (mark one):
a) right _____ b) left _____ c) neither______
2) Using the left arm; the eye on the target is (mark one)
a) right _____ b) left _____ c) neither______
Point—Repeat the procedure above in but now, point to the
target
Now use the index finger and line it up to the target
1) Using the right arm; the eye on the target is (mark one):
a) right _____ b) left _____ c) neither______
2) Using the left arm; the eye on the target is (mark one)
a) right _____ b) left _____ c) neither______
Results
Case Studies
Long term results of this 25-year project, are the results of
remaining involved with some of the families with identified
LD members, as well as with other family members demon-
strating the characteristics of RPS.
Following are excerpts from the information collected from
these four cases studies from the four different participating
families which are discussed in the present report.
Family A (n = 7), Ca se S tudy 1
An adult male was referred to us by his former high school
teacher. She could not understand how such an “intelligent”
student could not learn to read and write at grade level. This
subject also brought us his three oldest children for participa-
tion in the study. These four family members, all with reading
and writing problems, also displayed inconsistency of preferred
use of the bottom hand turning in the lid unscrewing activity
designed for our experiment. The father both used and inverted
his left hand when he wrote. The father and his sons all dis-
played unusual asymmetrical rotated arm positions, evidenced
when the arms are stretched out, as illustrated in Figures 1 and
2. The four family members all displayed as well as reported in-
verted directional bi-manual movement preference.
The seven-year-old son wrote with his right arm-inverted
hand position, in a claw like grasp. He expressed feelings of
reversal of direction sensation in his right arm and hand.
The six year old son also had feelings of the right arm and
hand feeling upward when compared to the left arm and hand
when both were in a down-ward position.
The 8-year-old expressed feelings of inverted feelings in dif-
ferent areas of his extremities.
At the time we first saw this family, the youngest two child-
ren were not yet identified as learning disability LD; however,
they were all identified LD by their school the following year.
There were also two daughters in this family who reported in-
verted sensations in their arms and displayed the inverted bi-
manual rotation characteristic. There was no asymmetry seen in
their arms.
All five children were found to be of normal intelligence and
diagnosed by their school psychologist as having LD. The more
standard experimental remediation we attempted with these
family members did not appear to have any lasting effect.
The only other member tested of this family was the mother
and found to have none of the RPS symptoms. She also was
found to have no history of any learning difficulties.
Family B (n = 7), Case Study 2
Another target subject from a family we were opportunisti-
cally invited to test. This was an eight year old gifted female
with written language problems. Her arms displayed the asym-
metrical arm positions we have described (Figure 3).
Case Study 2, as well as her mother, father, and brother, all
demonstrated and reported the inverted preference for the bi-
manual rotation activity. There however were also no asymme-
tries observed. They all however, reported some written lan-
guage difficulties. Three other members of this family were
tested and did not have any of the characteristics of asymmetry
or bi-manual inversion preference.
Of her own choice, Case Study 2 reportedly changed from
writing with her left hand to using her right hand in kindergar-
ten. She was tested to have a full scale IQ of 139 on a revised
edition of the Wechsler Intelligence Scale for Children
(WISC-R). The Stanford Diagnostic reading test revealed her
total reading capabilities at less than a 50th percentile rank. On
the Test of Written Language (TOWL) she scored at the 50th
percentile in spelling and at the ninth percentile in handwriting.
She had a total written language score of 110. She was placed
38

R. A. YOUNG ET AL.
(a)
(b)
(c)
Figure 1.
Family A, Case Study 1: asymmetrical stretched
arm positions in a father (a) and his sons aged 7
years (b) and 6 years (c).
(a) (b)
Figure 2.
Family A, 8-year-old male in stretched (a) and then relaxed (b) arm
position.
Figure 3.
Family B, Case Study 2: female in a stretched arm position displaying
an asymmetrical position in both arms.
in the high performance groups in school, where her grades
were barely average. The head of the program considered drop-
ping her from the program when we started seeing her, even
though she worked very hard at her studies.
As a remedial experiment she was encouraged to place her
pencil between her second and third fingers to change the posi-
tion of her hand when writing. After having used the position
for four years she reported to us that she was aware of the re-
verse feeling in her hand and arm when she used her old hand
writing position. She had now risen to the top 20th percentile of
her class. This student was now achieving all A’s and B’s in-

R. A. YOUNG ET AL.
stead of predominantly C’s.
Today, many years later, she is a school administrator. In a
recent correspondence, she told us “It seems, upon reflection,
that by using the modified grip for my pen/pencil, my thoughts
became more organized and clear and I had to write down the
plan for any essay I was creating so as to not lose them. This
became my standard practice in college as I had many essay
exams/papers to write, [double major in English and psychol-
ogy]. Overall, the modified hand grip had mechanical and cog-
nitive benefits that I can clearly remember even today, almost
25 years later”.
Family C (n = 8), Ca se S tudy 3
A teacher who was aware of our project referred to us a
ten-year-old boy. He was identified by his school as being both
LD and having ADHD. He was tested to have a full scale IQ of
130/136 on WISC-R. On the Wide Range Achievement Test
(WRAT-R), his word recognition was at the 4th percentile and
spelling was at the 19th percentile. On the Woodcock Johnson
Reading Cluster his total reading score was at the (17th percent-
tile) 2.0 grade level. We tested him and found him to have both
the asymmetrical arm and reversed bimanual opening charac-
teristics. Figure 4 illustrates Case Study 3 with his right arm
stretched in a hyper-extended position and Table 1 details his
physical and sensory markers that appear to be characteristic of
RPS. [A maternal grandmother was the only member of the
seven members of his family we tested who demonstrated the
inverted bimanual rotation. However, no educational report was
available.]
As a remedial experiment, we changed the position of his
hand by putting the pencil between his second and middle fin-
ger so as to move clockwise and feel a top down sensation.
Figure 4.
Family C, Case Study 3: Male with arms in the stretched position dis-
playing right arm asymmetry.
Table 1.
Family C, Case Study 3: Physical and sensory markers characteristic of
RPS observed in male with arms in the stretched position displaying
right asymmetrical hyper-extended arm.
 Feeling shorter limbs on the right side
 Right hand writing position that follows the hyper-extended turn of
the right arm
 Direction confusion with just the right hand
 Using index finger on the left hand to point out direction
 Avoids using the index finger on the right hand
 Names and points to an eye as the one being used when it is not
being used
After coming for experimental remediation once a week for a
year he was retested on the Woodcock-Johnson Reading
Cluster Test. His total reading score was found to be at the (38th
percentile) 4.0 grade level. Upon following up his case two
years later, we found no change from the last time that we saw
him; his reading ability was still at 4.0 grade level and he
continued to have trouble with written assignments. We also
found that he had not stayed with the changed handwriting
position. He again had the direction of a rotation confused. As
an example, he identified a clockwise rotation from the bottom
of the rotation as going left.
Family D (n = 64), Case Study 4
There were fifteen cases of learning difficulties related to
written language reported to us from this opportunistically
found family consisting of four generations. The female in ge-
neration one of Family D was tested and was found to not to
have the symptoms of RPS. Members from her parent’s family
(n = 10), who were available also tested, did not have these
symptoms. The first generation male member, her husband, and
his parent’s family were not available for testing.
A generation 2 family member was a gifted pianist and com-
poser, but could not read or write music and had other written
language disability symptoms. She was tested and found to be a
bimanual inverted rotator with a shifting in the right arm, as
illustrated in Figure 5.
As a reportedly presumed result of her own written language
struggles, she went on to develop an early on Pre First program
for bright underachievers in the school district in which she
taught.
A third generation member of this family group (Case 4; one
of our first remediation experiments), was a 48-year-old woman
with a LD history we call “A.L”. Case 4 was A.L. displayed
many of the symptoms itemized on the Wender Utah Criteria
for Adult ADD (Wender, 1990), i.e., persistent hyperactivity
shown by restlessness; the inability to relax, being “always on
the go,” lack of organization, impulsively, and chronic stress.
Her major academic problems were described as the result of
reading fatigue, i.e., she bit her nails when reading and had
handwriting difficulties, made spelling errors. In spite of these
problems, she managed to graduate from college.
We assessed A.L. to be left-handed and left footed and mixed
eye dominant (using a left, right, left, left pattern). In spite of
her direction confusion difficulties, we found this subject to be
perceptually within normal limits. We became more interested
in her fine motor laterality difference when she related these
experiences. Unknowingly, A.L. taught herself to use a com-
40

R. A. YOUNG ET AL.
(a) (b)
Figure 5.
Family Study D: (a) Generation 4 male diagnosed with LD demon-
strating asymmetry of the right arm; (b) Generation 2 female with re-
ported WLD demonstrating hyper-rotation of the right arm.
puter mouse upside down so as to operate a cursor on the com-
puter in reverse. This was so the cursor would work in the op-
posite direction than her dominant left hand was moving. When
she moved the mouse left, the cursor moved right, and when
she moved downward the cursor moved upward (a computer
instructor has informed us that he has had one or two students
in each class who do this). After it was brought to her attention,
by switching it to her right hand, she found she could direction-
ally operate it correctly.
After accidentally injuring a finger on her dominant left hand,
the subject found that, by using her right hand, she now could
identify direction correctly. When using her dominant left hand,
she never could remember how to use a key to lock or unlock a
door correctly.
We worked with A.L. for approximately one year and she
learned to use her right hand for other directional tasks. We also
taught her to transfer a sense of direction from one hand to the
other. We accomplished this by having her concentrate on how
the movement would feel with the right hand while performing
with the left. She also practiced her writing movement in the
reverse direction from which she had always used. This is a
clockwise top down direction movement, accomplished by
tracing the letters with her non-writing hand; the hand, we had,
found that she could use to tell direction. She then wrote over
what she had learned with the writing hand. In time, she re-
ported “feeling” the words, how they are seen and heard.
Eventually, she permanently shifted to a non-inverted and
non-resting hand position by imitating the directional move-
ment sensation of the right hand when writing out a word. What
seemed to be of special help was turning the paper to the right
instead of to the left, as she had grown accustomed to doing.
After going to an exercise class for approximately one year, she
told us that at first she became increasingly aware of how dif-
ferent the exercises felt between the two sides of her body. This
was because the class consisted of many alternating of sides
activities. When she was stretching and flexing, she had no
trouble with her left arm, feet, toes, and leg.
It was an entirely different story with the right side of her
body. She said that she had long thought that the limbs of her
right side felt shorter than the left side of her body. A few other
people from our large sample have also described this, claiming
to have similar feelings in different parts of their bodies. In
A.L.’s case, the foot pointing and flexing exercises allowed her
to see the problem differently. At first, as we had previously
discussed with her, she believed that she suffered from a “dis-
placement” of arm and leg location.
She told us: “The realization finally struck me that the leg
did not feel shorter, it was that the right foot actually feels as if
it is going in the opposite direction of how it is moved that
causes the sensations” (i.e. if she points, her right toes down,
they feel as if they are moving up). She also said: “My right leg
also feels backwards. And, when my right arm is downward, it
actually feels up. The hand and fingers on my right side how-
ever have normal sensations feeling up and down. The left arm
felt like it was in a normal position while the hand felt back-
ward.
Only after A.L. became aware of these sensory differences
did we make a unique observation. It became apparent to us
that her right arm can be easily turned in a different position
than her left arm. It was as though the right arm was turned
around. The muscle development was different and this arm
hung quite naturally in this position. The fingers of both hands,
however, tried to maintain their forward to backward position.
The arms, in a relaxed hanging position, appeared normal for-
ward to back. This unusual right arm position is achieved by
stretching the arms down at each side.
Case 4. Had two sons (generation 4), both diagnosed with
LD at five years of age. One of the two sons displayed the in-
verted bimanual movement behavior. At fourteen, he tested at
142 verbal and performance 121 full scale, 136 very superior
on the Wechsler. He also had a history of ADHD behavior. The
other son displayed a left bimanual top down rotation. This son,
a good mathematician as evidenced by an 800 on his math SAT,
always had trouble writing out the math problems and proving
them on paper. Both sons, while graduating from college, ex-
perienced organizational difficulties as well as continued hand-
writing problems, a common symptom of WLD.
As the families from the first three cases we tested were ten
members or fewer participants, the only family with a large
enough population, Family Study D (n = 64) was used to make
both physiological and behavioral comparisons. This was when
specifically looking for suspected markers related to this type
of learning difference. Four generations are represented.
(a) (b)
Figure 6.
Case 4. Family D; in relaxed and then stiffened positions demonstrating
asymmetry.

R. A. YOUNG ET AL.
42
The biological members were separated from the non-bio-
logical members for comparison. The family members de-
scribed as “biological” all have biological connections to the
male or female in generation one. The non-biological group
consisted of those persons (“in-laws”) marrying into the family
created by generation one.
The YGLD test results for Family D (N = 64) are summa-
rized in Tables 2 and 3.
Test 1. Fine Motor Bimanu a l R otation Tes t
The first analysis compared the 3 groups on the 3 rotation
preferences (Table 2). The chi square with df = 4 was χ2 =
38.47; p < 0.001. This indicates that the distribution of rotation
preference differs significantly from what would be expected
by chance alone. Specifically, there is a strong tendency for
“exclusive right or either top rotation” in both the Biological
Non-WLD and Non-Biological Non-WLD groups. In contrast,
there is a strong tendency for “inverted bimanual rotation” in
the Biological WLD group. In this analysis there is a mode-
rately strong association between group membership and rota-
tion preference, Cramer’s V = 0.55.
Test 2. Arm and Hand Positioning Test (For
Asymmetry and/or an Arm Shifting Position)
The first analysis compared the 3 groups on arm asymmetry
(Table 3, middle column, shaded in gray) with the chi square
goodness of fit test. The chi square with df = 2 was χ2 = 12.18;
p < 0.01. This indicates that the distribution of arm asymmetry
differs significantly from what would be expected by chance
alone. Specifically, most of the cases of asymmetry appeared in
the Biological WLD group, with very few cases of asymmetry
in either the Biological Non-WLD or non-biological, non-WLD
groups.
Test 3. Bimanual Arm Hand/Eye Dominance Test
The second analysis compared the 3 groups on eye/arm
sighting use (Table 3, right column, unshaded) with the chi
square goodness of fit test. The chi square with df = 2 was χ2 =
5.64; p =0.06. This result is just short of statistical signifi-
cance. Although it is notable that there were no cases of right
eye/arm or left eye/arm in the Biological WLD group, this
finding does not differ from what could be expected by chance
alone. Given the relatively rare occurrence of this phenomenon,
resulting in low frequencies, a larger sample would be required
to verify this finding.
The following is a summary of bio-behavioral identifications
found in Family D:
1) WLD was not identified or reported in the non-biological
group.
2) Eighty-seven percent (n = 27) of the biological, non-WLD
group demonstrate “exclusive right or either top rotation”.
3) Eighty percent (n = 12) of the biological WLD demon-
strated inverted rotation as well as any other method(s) as re-
ported or as observed being used.
4) Seventy-seven percent (n = 14) of non-biological, non-
WLD demonstrate “exclusive right or either top rotation”.
5) Arm asymmetry and/or arm shift was identified in four
percent (n = 49) of the non-WLD groups.
6) Arm asymmetry and/or arm shift was found in sixty-seven
percent (n = 15) of the WLD group.
7) Twenty-two percent (11 of 49) biological and non-bio-
logical WLD subjects tested used their right arm hand/eye and
their left arm hand/eye in both sighting positions.
8) There was no arm hand/eye lateral consistency in the
WLD population.
The physical asymmetrical characteristics described have
been observed in eleven of the (n = 46) other biologically re-
lated family members who we have tested. All but two were
WLD identified. The reversed behavioral lid movement un-
screwing test produced fourteen identifications in the biologi-
cally related group, of which all but two were identified as
having written language problem history. The asymmetrical
arm identification occurred in none of the other (n = 17) non-
biologically related family members tested. The reversed be-
havioral lid unscrewing movement characteristic was observed
in one subject in this group. No LD identification was reported
Table 2.
Number of subjects with type of rotation preference, n.
Preferred behavioral marker
Family D, family grouping (N = 64)
Inverted Bottom Rotation Exclusive Left Top Rotation Exclusive Right or Either Top Rotation
Biological non-WLD (n = 31) 2 2 27
Biological WLD (n = 15) 12 2 1
Non-biological non-WLD (n = 18) 1 3 14
Table 3.
Number of subjects with arm asymmetry and arm/hand/eye sighting consistency, n.
Physical markers
Family D, family grouping (N = 64)
Asymmetrical arms Right arm, hand and eye Left arm, hand and eye use consistency
Biological non-WLD (n = 31) 2 6
Biological WLD (n = 15) 9 0
Non-biological non-WLD (n = 18) 0 5

R. A. YOUNG ET AL.
in this non-biological member.
Discussion
Our data indicate that there is a significant correlation be-
tween reported written language learning difficulties and re-
versed bimanual movement behavior. Asymmetrical arms and
other reversed physical characteristics have also been identified.
The authors have previously reported evidence of a motoric
link to written language disabilities and suggested that neural
mechanisms for the control of timing precision and serial or-
dering in speech and language overlap extensively with neu-
ronal processes for temporal organization of uni-manual and
bimanual motor skills at a neuroanatomical, physiological, and
behavioral level of description (Young & Ginsburg, 1993).
Our present data indicate that there is a significant correla-
tion between reported written language learning difficulties and
inverted bi manual movement behavior and asymmetrical
physical arm characteristics. A good example was found in case
4, “A.L.” in Family 4. We theorize that the actual reason for AL
being left handed was: that the left dominant arm, controlled
the hand she first learned to write, however, as the left hand
took control, it subsequently reverted to its naturally inverted
sensing position. The asymmetry as shown in the right arm, we
theorize, is a marker for the inverted sensation occurring in this
region of her right arm.
By teaching this subject to straighten the left hand and teach
her to the feel how her correctly sensing right hand felt the
shape of letters and symbols, she was now able to correctly
sense the feel of the shape of the symbols she was trying to
learn to use. She too has expressed remarkable improvement in
her written language abilities since this experimental remedial
approach was implemented.
Due to our present small sample for arm hand/eye consis-
tency, the data did not reach significance in Family D. However,
it is notable that there were no cases of right arm hand/eye and
left arm hand/eye consistency in the Biological WLD group.
This finding does not differ from what could be expected by
chance alone. Given the relatively rare occurrence of this phe-
nomenon, resulting in low frequencies, a larger sample would
be required to verify this finding.
We previously presented evidence for visual/motor domi-
nance pattern differences between LD and non-LD, in which
4% of a population (N = 1120) tested demonstrated right arm
hand/eye and left arm hand/eye dominance consistency (Young
2006, 2008). There was one case of diagnosed LD with this
visual motor pattern out of the (n = 50) subjects found with this
hand/eye pattern. He also was found to have the bi manual in-
verted rotation marker. This subject was a high achieving pri-
vate middle school student scoring at the 99.9th national per-
centile rank on his Educational Records Bureau (ERB) total
aptitude score. Using this measurement, the non-WLDs in the
Family D population were almost at 22% representation. None
of these consistent hand/eye dominance patterns were found in
the WLD population.
Interestingly, the only two bimanual inverters in the biologi-
cal non-WLD group both had this less common arm hand/eye
dominance consistency. The mother of Case 2 also had this
same arm hand/eye dominance pattern. She reported spelling
problems, yet was a Harvard graduate. This may suggest a
learning advantage with the biologically consistent right arm
hand/eye and left arm hand/eye laterality dominance combina-
tion.
Our one non biological family D MEMBER reporting in-
verted bimanual behavior had a right/left-right/right visual pat-
tern. She did however report “messy” hand writing. There were
no cases of LD reported out of the twenty-eight cases from our
prior data base of n = 1120 with this visual pattern. This is an-
other example where arm eye/handedness may play an impor-
tant part in better understanding learning disabilities.
Our few attempts at remediation by changing a hand position
to sense a top down position when writing have shown to be
successful. As the remedial experimentation was with a just a
small number of participants, these results cannot be considered
conclusive. However, the evidence does make it suggestive.
Although early academic skills would be most affected by
RPS, each new learning process, such as moving into new
symbolic information learning (e.g., different math subjects and
foreign languages) would be consequently slowed down. This
would put affected individuals at continual risk. We further
suggest, the reversal sensation affecting movement behavior in
RPS is a logical possibility and primary cause for certain
ADHD behaviors identified with these learning difficulties.
None of the non-biologically related family members of the
first generation (n = 17) were found to have a history of WLD,
whereas 38% of the biologically connected part of the family
group reported as LD. This would suggest a genetic connection.
The father and his 3 sons in Family A displayed asymmetry,
and bimanual inversion was found in all 5 of his children as
well as himself. It has been recently reported to us that their 6th
(male) child, who we did not test, also shares the characteristics
along with an LD label. While ADHD was noted in many of
these participants, no direct measurement of the label was at-
tempted.
DNA testing of many of the WLD and non-WLD members
was attempted and results were inconclusive. Unfortunately,
when those studies were carried out we lacked the methods that
are now available. It is our hope that in light of this continued
research, that a DNA study will be reattempted for further
characterization of RPS.
The majority of the RPS-affected cases that we have fol-
lowed have managed to succeed in their various academic pur-
suits. If proper understanding and remedial help for those sus-
pected to have this undiagnosed learning problem were admin-
istered, we suggest that far less stress for both students and
teachers would result.
Conclusion
The evidence supports that both behavioral as well as physic-
cal markers for written learning difficulties possibly related to
ADHD do exist. Aiding in the early identification of specific
learning problems in such a way may lead to future successful
remedial action. Ways to create a feeling of an interpretable,
top down writing sensation for symbolic information would
identifiably differ from one subject to another. After proper
identification of where reversed sensations occur, a change of
sidedness e.g. from right to left as well as left to right writing
handedness is not as unthinkable as it sounds. In some cases
just a hand repositioning has been found to be effective. Learn-
ing the feeling of a top/down directional sensation when writing
would be important when learning and remembering symbolic
information. Not correctly feeling what is seen and heard logi-
cally would be confusing and consequently disruptive to basic

R. A. YOUNG ET AL.
organization. Interceding once reversal of movement perception
was identified and encouraging adoption of corrected move-
ment repositioning might, especially in preschool and the early
grades, greatly improve overall achievement and consequently
eliminate further remedial effort. For the benefit of those with
these unrecognized learning disadvantages, we are arguing for
further exploration of a possibly efficient new way to both
identify and treat RPS, an invisible contributor to both WLD as
well as ADHD.
Acknowledgement
The authors would like to thank Chris Segrin, Ph.D., Univer-
sity of Arizona for assistance with statistical analysis and Penny
Baron, M.S., for editorial assistance in the preparation of this
manuscript.
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