Sunday 30 March 2014

How do you communicate with a communications company?


Big companies exist to make profits. They don't like paying tax and they don't like paying employees. They've learned that in the modern world, they can outsource many of their customer services to countries with cheaper labour, but they are even happier when they can dispense with people altogether to move on to automated systems.  These can be really efficient for dealing with routine enquiries. Problem is, when it comes to non-routine enquiries, they really suck.

I discovered this when I got a new mobile and a contract with TMobile. I signed up for monthly payments by direct debit and was happy when I received my first bill and it all seemed in order.  But I then got a mysterious text message that purported to come from 150, which is the number for Tmobile enquiries. It read:

"We recently contacted you regarding your unpaid T-Mobile bill. Just to remind you that payment can be made simply by dialling 360 from your handset."

This was odd because (a) I had no memory of a previous contact from them and (b) I was paying by direct debit and could not see how I had incurred an unpaid bill. I decided it was probably some kind of scam, but thought I should just check it out with TMobile. But here my problems began.
I thought the easiest thing would be to register for online billing, and so I tried the website on the bill. This immediately brought up a scary warning screen, as follows:

It seemed odd to me that a major UK company would have a web address that did this, so I did a bit of snooping around with Google to make sure this was really OK before over-riding the warning and going ahead. Usual thing of entering all my details, password, security questions and so on. Seemed OK and I was told I'd receive a PIN by text. And at that moment, sure enough, a message with a PIN came through on the phone. Nearly there, I thought.

Unfortunately, though, the webpage with the box for the PIN was greyed out and would not accept any input. I tried a few times, both with my original browser, and then with another one. Same problem (once I got past the scary warning message). Tried on my ipad, and this time the whole thing froze before I even got to the PIN bit.

Well, the bill suggested that if I needed help I could ring 150, so I did. This gave me four automated options: 1) make a payment; 2) get details of my first bill; 3) help setting up voicemail; 4) get date of mobile number move. Since none applied, I pressed * for other options. This gave me two options: 1) help with my mobile phone; and 2) help with home broadband. If you select neither or those, you just get a patient voice saying "Let me go through those options again..."

I'd previously battled with the TMobile website to try and find a phone number for human help, and completely failed. All the encouraging tabs offering help lead you to a hopeless set of FAQs that are totally irrelevant to the problem at hand - or they try to lure you down the 150 cul-de-sac.

I tried Twitter. It began well, with this exchange:

However, when I then sent details of the two problems (suspicious looking text message and inability to enter PIN in website), I got this:

Now, to me the idea of a firm asking you to give them your full details "for security" over Twitter is absurd. When I suggested I'd rather communicate secure information over email, I was told:

So there we have it. A communications company who will do anything other than communicate. Because employing people costs money, and they clearly don't care if their customers get stuck in a phone options cul de sac, or spend hours on the web trying to find how to fix a problem.

I've resorted to writing a letter to Customer Services, but I suspect I won't get a reply, or if I do, it will be written by a bot. Will let you know if I do!

Update: 1st April 2014
Probably not a good day to relate my further attempts to communicate with TMobile, but here we go:

I happened to be in town so, armed with my contract and invoice, I dropped in at the friendly Oxford Phones4U store where I'd bought my TMobile contract and explained the problem. They were immediately able to tell me that others were having the same problem and it seemed to be a glitch in the network. So why couldn't the @TMobileUK twitter people tell me that yesterday? It would have immediately have reassured me.

But Phones4U went further. They felt that for my peace of mind, they should phone TMobile so I could hear it from the horse's mouth. The patient young man who was trying to help me sat dialling numbers and jotting down other numbers. "It's very frustrating," he said. "I can't get past the automated system." He dialled some mega-number where he gave someone his store code: but still the advice was to call 150, the communications black hole. After 10 minutes I had to leave. He gave me the last number he'd been given, which he thought would get me through to a human, but I had a busy afternoon and have not had a chance to try it.

I got back and found that TMobileUK had been active on Twitter, perhaps stung by adverse comments from another Tweeter:

I checked out the link re websites. It did not refer to the two problems I'd had - i.e. security warning followed by unresponsive screen, but at least they seemed to be doing something.
We continued:

Ah, the elusive 'dedicated customer services team'. This got short shrift from another user and further queries from me:

So far, this has not elicited any other response. But I did find this message that TMobileUK had broadcast to the world a couple of hours earlier:

So at last, an admission that there was an 'on-going online bill issue'. That's all I needed to know. And they don't need anyone's private details in order to tell us about it.

I'm still hoping that at some point I'll hear that they have fixed their website. But I suspect that they are much slower than most companies at responding to problems because there's no way anyone can actually tell them that there is a problem.

In this way, their cost-cutting strategy of replacing people with robots is counterproductive, as it can lead to major snarlups escalating much further than they need.

Update 3rd April 2014

Well, the good news is that my letter did receive a reply from one Phillip Wilson from EE Customer Service. The bad news is that it was no help at all.
He wrote:
I have reviewed your account and although there are no notes about an SMS being sent to you about your balance I can see that there is £xx outstanding which is now with our Collections Department. There is no Direct Debit set up on the account. Your number has been suspended for non payment since 29 March 2014. I am sorry to hear that you were unable to log onto the online account system. I would advise you to discuss your balance with the Collections Department on 08454122801.
Mr Wilson also rather sadly remarked: "I would have liked to discuss this issue with you, unfortunately I was unable to contact you so I am responding in writing." I know just how he feels.
I called the collections department and got through to a nice lady. I explained to her that I had all the paperwork for my direct debit, plus a first bill that stated "We will collect £11.00 on or around 22/4/14". Since she focused on debt collections, and did not apparently have any record of my account, she could not help. She said she'd put me through to the right department, but after five minutes of listening to awful tinny music I gave up and got back to the day job.
If anyone knows of a mobile phone company that has competent, efficient customer service personnel, please do let me know, as I rather urgently need to find one before I lose my sanity.

Update 9th April 2014
So, after the last abortive attempt to communicate with TMobile, I thought I'd give them one last chance. I wrote another letter, this time enclosing a copy of the direct debit mandate I had set up on March 6th, and also a copy of a bill from them that said they would be collecting payment for my next bill - implying they had a direct debit. 
Alas the only response I got was a peremptory demand for £11 and a statement that my phone had meanwhile been cut off for nonpayment.
I've had some suggestions from happy customers of alternative providers, but my only concern is that there seems a high probability that the minute I try and cancel the account, TMobile will suddenly discover and activate the direct debit. Watch this space....

11th April update
At last! A resolution!

When last in town, I'd found that O2 offered a good deal on a contract that would suit my phone, and I was keen to change. However, I realised it might not be easy to extricate myself from TMobile, and so I decided to ring the TMobile number I'd been given by Phones4U, which they claimed would lead to a person. It did begin with automated options, but one sounded relevant - changing my plan - and indeed this produced a human voice.

I explained the situation, only to be told that I was not in arrears, I had a direct debit set up, and my phone should now be working. Baffled, I asked about the date on which the direct debit had been activated. More waiting and tinny music, but eventually someone came on the line who seemed to know about my case. The direct debit had been activated the previous day and the suspension on my phone account lifted. And indeed, when I checked again, the phone was now operational.

I was surprised that nobody had bothered to tell me any of this, but later that afternoon, I did get another email from Phillip WIlson of EE Customer Services (my comments in red)

I am sorry for the delay in responding to you previously. I sent you a letter response yesterday which will arrive with you shortly. The letter I sent is below.
Thank you for your letter which I have received into the Customer relations Department today. The letter was in relation to the correspondence I sent you recently about the Direct Debit on your account. I would have liked to discuss this issue with you; unfortunately I was unable to contact you so I am responding in writing. [Would indeed be difficult to contact me as they had cut me off!]
I am sorry to hear that you were unable to speak with the Collections Department when calling the number I provided to you. [I did speak to the Collections Dept - they did not understand why I'd been given their number but tried to put me through to another dept]. I know it is frustrating when you have to wait on the line for an agent to answer. [Not just frustrating - quite impossible for anyone who has a demanding day job]. I can see from the account that the Direct Debit was set up when the account was created, however it failed to take the first bill as a Direct Debit does take 14 days to set up. [Bizarre - the direct debit was dated 6th March. I was cut off on 29th March]. The first bill always has to be paid manually using a Debit/Credit Card. [So why did nobody tell me that?!]. As the Direct Debit failed it was cancelled from the account. I have re-set the Direct Debit for you today. As a gesture for your issues I have also waived the £12 balance on the account.
I would be unable to disconnect your agreement for you as you are in contract until  6 March 2015. To early disconnect your agreement would cost  £15.61. As stated I have cleared the balance and set up your Direct Debit again for you.

I am delighted to be able to report this resolution of my problems, and I appreciate that TMobile at last has shown some recognition of the snarl-up by waiving the outstanding sum.

But really, it's not about money. It's about a catastrophic fail in customer relations that allowed a trivial issue to escalate into a prolonged exchange with numerous TMobile staff, damaging my sanity and TMobile's reputation - and presumably costing them far more than £12 in staff time.

In the sequence of events above, there are no less than six points at which this issue could have been resolved, yet TMobile failed to act appropriately every time:

  • The most pressing need is for a telephone help line that had a non-automated option for non-standard problems. TMobile's 150 number is hopeless in this regard. Their website is just as bad - everything automated and no opportunity to contact a person.
  • The staff manning the Twitter account @TMobileUK should have been able to sort out my problem, but they were unwilling or unable to communicate with me by phone or email, which severely limited their effectiveness, especially when they expected me to provide confidential information.
  • The @TMobileUK staff showed a striking lack of initiative in failing to respond to my request for instructions how to contact a human operator via 150. Even if they did not know how to do this, they could have explored the options themselves to give me the sequence of keystrokes I had requested. They did not.
  • The initial letter from Customer Services was remarkably unhelpful. Having said he had tried to contact me by phone, Mr Wilson should have given me a number where I could get back to him. Had he done so, I suspect this could have been sorted out promptly. Instead, I was referred to the debt collections department.
  • If Mr Wilson had told me in his first letter that there was a time lag on direct debits and that I needed therefore to pay by credit card I would have done so. Instead, he said I did not have a direct debit and implied I was untruthful in saying I had one.
  • When I called the Collections Department, I had given them all my details including a landline number where I could be reached. After I gave up waiting for a reply, they could have called me back but did not.
The final paragraph of the last letter from Mr Wilson does, of course, explain everything. Once you've signed the contract, you are stuck with them, unless you are willing to pay to terminate it. So they have absolutely no incentive to treat customers well, and their customer service department is set up like an obstacle course to deter all but the most persistent people.  

I am so sick of TMobile's lack of regard for its customers that I was tempted to terminate the contract anyhow, and blow the expense, but of course that would all take time and it's the one thing I don't have much of. So for the moment,  sticking with the current contract is the least bad option. I just hope that the increasing power of the internet enabling customers to document experiences like mine might eventually trickle through to affect the company's policy.


Thursday 20 March 2014

My thoughts on the dyslexia debate


During February, there was widespread media coverage of a forthcoming book by Julian Elliott and Elena Grigorenko called The Dyslexia Debate. I've seen an advance copy of the book, whose central message is to argue that the construct of dyslexia lacks coherence. Quite simply, dyslexia does not constitute a natural category, in terms of cognitive profile, neurobiology or genetics.

The authors' arguments are backed by a large body of research: people have tried over many years to find something distinctive about dyslexia, without success. Some children are good at reading and others are not, but it's arbitrary where you place a cutoff to specify that a child has a problem. There's a popular belief that you can identify dyslexics in terms of a particular ability profile, and that affected children have a particular kind of brain organisation that makes them do things like reverse letters (b vs d) or have left-right confusion. In fact, those types of problem are common in typically-developing children at early stages of learning to read and appear to be as much a symptom as a cause of reading problems. Researchers have found neurobiological and genetic correlates of developmental reading problems, but the effects tend to be small and inconsistent from person to person: you could not currently diagnose dyslexia on the basis of brain scans or genetic analysis. It is, of course, possible that one day we may hit upon a new diagnostic test that does clearly differentiate a dyslexic subgroup from other poor readers, but many of us in the field are dubious as to whether this will ever happen.
The first thing to get clear is that Elliott and Grigorenko are not denying the reality of children's reading problems. Their point is a much more specific one about the way we conceptualise reading difficulties and how this affects access to services in everyday life. Their concern is that "dyslexia" implies we are dealing with a specific medical syndrome. Their view is that no such syndrome exists and it is not helpful to behave as if it does. How should we respond to this? I think we need to distinguish three questions:

1. Should we identify those in need of extra help?

Children vary in the ease with which they learn to read. Some need only the briefest exposure to books to crack the code; others struggle for years despite skilled help from expert teachers.
I think most people who have spent time with poor readers (and I would include Elliott and Grigorenko among these) would conclude that the answer to question #1 is yes. It doesn't matter whether those in the latter group have a distinct medical syndrome or not: It is up to us to ensure that all get the best teaching.

2. How should we identify those in need of extra help?

Elliott wrote a piece in the Times Higher Education where he argued that dyslexia diagnoses in Universities were skyrocketing, and that some people were unfairly exploiting the system in order to get accommodations such as a laptop computer and extra time in exams. To my mind, the problem here is less to do with the "dyslexia" label, and more to do with the haphazard way in which individuals are identified, and the lack of consistent criteria for determining who needs extra help. Like Elliott, I think it is entirely right that we should make accommodations for students who have serious difficulties in processing written information at speed. However, as he highlights, the current system is based on an unsustainable idea that "dyslexia" is a distinct disorder that can be reliably identified, and which is often diagnosed on the basis of supposed markers of dyslexia that have no scientific basis. So the current system is both invalid and unfair. Instead, it would be sensible to settle on consistent criteria for allocating extra help to students who are struggling, and to ensure that extra resources are directed to those who are most needy. As Castles and colleagues have noted, there are guidelines that can be used to identify those with severe and persistent problems, but they are not well-known or widely applied.

3. What terminology should we use to refer to those we identify?

So can we just agree that we need to find consistent ways of identifying poor readers and do away with the term "dyslexia"? While this might seem a logical response to the evidence, I think we should not underestimate the implications in practice. On the positive side, we'd get rid of the idea that we're dealing with a special condition that forms a distinct syndrome. Since few scientists would attempt to defend that notion, this would be a good thing. But we should also be aware of negative consequences.

Those commenting on the dyslexia debate so far have talked about it as if it is a particular issue relating to literacy difficulties, but in fact it's just one instance of a much more pervasive problem.  Other neurodevelopmental disorders such as autism spectrum disorder, specific language impairment, attention deficit hyperactivity disorder, developmental dyspraxia and dyscalculia are all beset by the same issues: there is no diagnostic biomarker, the condition is defined purely in terms of behaviour, different disorders overlap and there's no clear boundary between disorder and normality.
Similar issues have been much discussed in relation to adult psychiatric disorders, which are also diagnosed in terms of behavioural features rather than biological tests. In a fascinating paper, Kendell and Jablensky (2003) came to the conclusion that the categories of schizophrenia and depression are massively problematic in terms of validity and reliability – that is to say, just like dyslexia, they don't constitute natural categories clearly demarcated from other disorders, and furthermore, people can't even agree on who merits these diagnoses. So should we just stop using the labels? Kendell and Jablensky considered this possibility but concluded it would be impossible to abandon terms like schizophrenia and depression, on the grounds that they have utility. These labels have been used for many years by practitioners to determine the most effective intervention, and by researchers interested in discovering the underlying causes and likely outcome of a disorder. Similarly, using the construct of "dyslexia" we have discovered much about the nature of the cognitive deficits that characterise many poor readers, about underlying causes, about outcomes, and about effectiveness of intervention. For instance, we know that genes play a part in determining who is a poor reader, and that many children who have poor literacy skills also have subtle problems with oral language.
This argument, though, is not really watertight. We may congratulate ourselves on what we have learned, but on the other hand, it could be argued that there are also barriers to progress that arise from continued use of imprecise terms. It's clear to anyone who knows the research literature that findings can vary from study to study and from child to child within a study. This does not necessarily invalidate the research – it's rare to obtain perfect consistency of findings even within mainstream medicine – but it does make many people wonder whether we might obtain clearer results if we took a different approach. But then we have to consider what alternative approach would be better.

I suggested a few years ago that it might be helpful to treat neurodevelopmental disorders differently, as multidimensional composites, rather than regarding problems with reading, language, arithmetic, attention, motor skills and social behaviour as separate conditions. However, I did not really expect anyone to embrace this idea, as it would be too radical a change, and we are too wedded to current terminology.

Here too, comparisons with psychiatry are interesting. Last year, Tom Insel, director of the US National Institute of Mental Health, ruffled feathers by stating that his organisation would be reorienting its research away from traditional psychiatric diagnostic categories, to develop Research Domain Criteria, i.e. "new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures." Yet the domains that are proposed seem to me just as arbitrary as the original diagnostic categories, and the associations between genetic, neurobiological and behavioural measures are mostly weak and poorly understood. So although Insel's vision might seem a rational way of trying to make sense of psychiatric disorders, it is years away from being clinically applicable – as he is the first to admit.  Even though multivariate, dimensional classification seems more logical, our current categories of autism, schizophrenia and dyslexia, though imperfect, may be as good as we can manage in terms of utility in day-to-day clinical practice.

Perhaps the strongest arguments in favour of retention of a term like "dyslexia" come not from science but from public perception. Like it or not, "dyslexia" has been around for over 100 years. In that time, a range of organisations have sprung up to help people with this diagnosis. Some of the most passionate defences of the dyslexia label come from those who have built up a sense of identity around this condition, and who feel they benefit from being part of a community that can offer information and support – see, for instance, this comment by the International Dyslexia Association to the suggestion that "dyslexia" be removed from the DSM5.

One could, of course, argue, that we shouldn't stick with a label just because it has always been there – if we were to adopt that line of argument, we'd still be talking about "maladjusted" and "educationally subnormal" children. But it's clear that many of those diagnosed with dyslexia do see this label as positive. In particular many people worry that if they were to simply switch to a more neutral, less medical term, such as "poor readers", this could trivialise reading problems, and lead people to assume that the difficulties are just caused by poor teaching. Furthermore, legal entitlement to special help under disability legislation could disappear. This, I think, is a key part of the problem, which can get overlooked when just focusing on the scientific evidence: what you call a condition determines two things: how seriously people take it, and where they place blame for the difficulties and responsibility for doing something about it.

To illustrate my point, see this recent piece in the Daily Mail by Peter Hitchens, which appeared under the headline: "Dyslexia is NOT a disease. It is an excuse for bad teachers". This displays a remarkably simplistic world view in which a poor reader either has a "disease", in which case they are blameless victims of an external force, or else it is someone's fault – in this case lacklustre teachers.

In his triumphalist piece against the "pseudoscience and quackery" of dyslexia, Peter Hitchens achieves exactly the opposite of what he intends. This is because he demonstrates one negative consequence of removing the label, which is that many people will no longer think that children who struggle to read need any kind of special help. Instead, we'll be told that "What they need, what we all need, is proper old-fashioned teaching."

A rather more sophisticated version of the same argument was given in the Green Paper that introduced the Government's proposed revision to legislation for Special Educational Needs (SEN) (see: my blogpost on this). There it was stated that too many children were being over-identified with SEN: “Previous measures of school performance created perverse incentives to over-identify children as having SEN. There is compelling evidence that these labels of SEN have perpetuated a culture of low expectations and have not led to the right support being put in place.” (point 22).

We really need to escape this polarised view of children's problems being caused either by a medical disease or by poor teaching. Yes, some children's reading may be held back because their teachers either don't know about or reject evidence-based methods of teaching, but it is seldom black and white, and some children fail despite intensive, high-quality teaching.

My concern is that those holding the purse-strings have a strong incentive to blame all problems on bad teaching or bad parenting, as it absolves them of any responsibility to do anything about them. We need to recognise that for most children, the causal influences are likely to be complex and may involve both constitutional factors and aspects of home and school environment. Unfortunately, most people don't seem able to deal with this complexity, and the language we use determines how problems are viewed. At present we are between a rock and a hard place. The rock is the term "dyslexia", which has inaccurate connotations of a distinct neurobiological syndrome. The hard place is a term like "poor readers" which leads people to think we are dealing with a trivial problem caused by bad teaching.

As Allen Frances argued in the case of psychiatry, we need to resist a growing tendency to use medical labels for what is essentially normal behaviour. However, he wisely notes that this should not blind us to the reality that there are people with problems that are severe, clearcut, and unlikely to go away on their own.  In the current debate, several commentators have made this point and have added that it doesn't really matter what we call them; the more important issue is to ensure affected individuals get appropriate help. But I'd suggest it does matter, because the label we use does much more than just identify a subset of people: it carries connotations of causation, blame and responsibility. While I can see all the disadvantages of the dyslexia label outlined by Elliott and Grigorenko, I think it will survive into the future because it provides many people with a positive view of their difficulties which also helps them get taken seriously. For that reason, I think we may find it easier to work with the label and try to ensure it is used in a consistent and meaningful way, rather than to argue for its abolition.

Kendell, R., & Jablensky, A. (2003). Distinguishing between the validity and utility of psychiatric diagnoses American Journal of Psychiatry, 160 (1) DOI: 10.1176/appi.ajp.160.1.4

This article (Figshare version) can be cited as:
Bishop, Dorothy V M (2014): My thoughts on the dyslexia debate. figshare