READING DISABILITY (Paralexia, Dyslexia)

A general term applying to all cases in which a child’s reading skill is one or more years behind his intellectual development.Children with reading disability are not to be confused with “retarded readers,” whcr fall behind because of low intelligence. Instead, they have special difficulties of a psychological, physical, or social nature that interfere with their performance. A careful diagnosis must be made in each individual case before an effective remedial program can be undertaken.Between 10 and 15 per cent of elementary school children show mild or severe reading disability. The boys outnumber the girls by about three to one. In spite of the fact that there are many kinds of disability, these children have two things in common: their failure to read well is bound to interfere with almost all academic work, since reading is the one indispensable tool for learning; and their shortcoming will almost inevitably lead to feelings of inadequacy and discouragement. (Goldenson, 1957)The diagnosis of reading disability is a two-stage affair. First it is necessary to make a full evaluation of the child’s reading skills in order to locate his special weaknesses. The grade teacher or reading specialist uses informal procedures, trial lessons, and standardized tests of both oral and silent reading to determine the general reading level and to reveal such difficulties as poor comprehension, inadequate word recognition or word analysis skills, significant mispronunciation, lack of fluency in oral reading, slowness in silent reading, deficient vocabulary, consistent spelling errors, and faulty habit patterns such as mouthing words or backtracking. More severe disabilities require further diagnosis in which special tests and case studies are carried out by a psychologist or remedial specialist. The purpose is to isolate basic causes of the disability so that an effective remedial program can be planned. See ALEXIA, HANDEDNESS, STREPHOSYMBOLIA, APHASIA.A thorough diagnosis of reading disability requires several steps. An individual intelligence test must be given to determine the discrepancy between the child’s reading level and his intellectual capacity. After that, five sets of factors which represent common causes of reading disability must be examined and assessed. These are: physiological immaturity (“developmental lag”) producing such deficiencies as poor auditory or visual discrimination and “directional confusion” (reading from right to left); physical handicaps, such as low vitality, frequent illness, impaired vision or hearing, and in some cases, brain damage; emotional handicaps, such as tensions, anxieties, and feelings of inferiority or discouragement; environmental conditions, particularly a deprived home in which intellectual stimulation is lacking or a foreign language is spoken exclusively; and educational factors, which may include ineffective teaching, inappropriate reading materials, or a classroom climate unsuited to learning. In most cases of severe reading disability several of these factors are operative at once. See directional CONFUSION, PSEUDORETARDATION.After a full diagnostic study is made, the next step is to make and carry out a plan for reading improvement based upon the needs of the individual child. Simpler difficulties are handled by a corrective reading program, in the regular class. It consists of direct teaching of missing skills through word games, extra practice in phonics, and special attention to prefixes and suffixes, exercises that counteract regression, etc. A program of remedial reading, however, is required in cases of more severe disability. Individual children or small groups meet either with the class teacher during special periods, or with a reading specialist in the school or clinic or on a private basis. In many cases, consultants are called upon to deal with special difficulties that interfere with learning, such as visual and auditory handicaps or emotional problems. In all cases, however, the cooperation of the parents is sought, not only to provide additional reading practice and reading materials at home, but to modify faulty attitudes toward the child and improve the general atmosphere in the home.Remedial reading is a concentrated training procedure designed to overcome a child’s particular defects. Basic word analysis skills often have to be developed through special study of sight words, consonants and consonant combinations, short and long vowels, and division into syllables. Sight, sound, motor, and game techniques are used according to the child’s needs. Some children require special attention to root words, context clues, reversal errors (reading “no” for “on”), or spelling. Others need practice in oral reading to develop better comprehension, phrasing, and expression; while still others may require training that will expand vocabulary and improve study skills.There is considerable confusion today about the use of the term dyslexia. Many specialists accept the position of the 1961 lohns Hopkins Conference on Dyslexia, where it was defined as a genetic, neurological dysfunction uncomplicated by other factors. Many others would agree that there is a malfunctioning of the nervous system, but would broaden the term to include not only cases in which the child appears to have a genetic neurological defect that makes reading difficult, but also cases in which there is evidence of birth injury, early disease, or developmental disorder, as discussed under the topic.Illustrative Case:Jimmy was an attractive nine-year-old in the high third grade. He had failed to make progress in the remedial reading group, and had been referred to the City College Educational Clinic by a mental health clinic which had been working with him and his family. During his first visit he became nauseous and vomited, an indication of emotional upset; later on he was more relaxed and responsive. His speech was flat, indistinct, and nasal, with a marked lisp and difficulty in pronouncing the letters 1, r, j, g, and sh. Movement of his tongue was somewhat restricted by a tongue-tie condition, for which he had been operated on three times. Jimmy had a long history of illness: pneumonia at three months, removal of infected tonsils and adenoids at fourteen months, frequent colds and digestive upsets, a broken bone requiring many hospital visits.Intelligence tests revealed an IQ of 117, but reading tests placed him at a beginning second grade level. His oral reading was slow, inaccurate, full of mispronunciations, and his knowledge of phonics was meager. He confused m and n, n and v, b and d, and tended to pronounce all vowels as uh. In both classroom and remedial work, he had been taught by a completely visual method. His spelling was on high first grade level, but his arithmetic was high fourth grade. Because of illness he had attended kindergarten only eleven days, and when he entered first grade he showed no interest in reading but only wanted to play.Conditions in Jimmy’s home were poor. His parents had quarreled for years, and had separated when the boy was three. His mother was nervous, sickly, and hard- pressed for food and clothing. Jimmy keenly felt the lack of a regular father, and could not get along with his older brothers and sisters. His mother frequently criticized him and threatened to give him away, but when he cried, sulked, or had temper tantrums, she would let him have his way. A psychiatrist at the mental health clinic concluded that his behavior difficulties were entirely due to feelings of rejection and disturbing experiences in the family. As a result of this investigation, arrangements were made for Jimmy to attend the Remedial Reading Service twice a week, and to receive medical help for his bearing loss and tongue-tie. He was also to continue visiting the clinic.At the Remedial Reading Service, Jimmy was assigned to men because it was felt that he would more willingly accept instruction from men than from women. He received twenty-seven lessons over a period of five months. Reading material consisted of pre-primers, primers, firtt and second readers, and selected workbook exercises. To develop phonics ability, he was taken through reading drills which emphasized letter-by-letter sounding and blending, with particular attention to hearing and pronouncing words correctly. He soon learned to analyze new words and build word families from them. Each new word was printed on a card and put in an envelope marked either “do know” or “do not know,” and treated as a game. Because of his speech and hearing defects, considerable time was spent in oral reading. The tutor spoke with exaggerated distinctness and encouraged Jimmy to do likewise. He willingly took books home, and a progress chart was used as an incentive for extra silent reading.Since Jimmy had a mental age of eleven years, his ability to understand was well advanced, and comprehension exercises at a second-grade level were soon introduced. No attention was given to speed, except near the end of the tutoring, when he was encouraged to give up pointing with his finger and received special practice in phrase reading. At his own request he was also given instruction in spelling. A visual-motor method was used, in which he printed each word on a card, looked at it, said it, then closed his eyes and printed it from memory.The tutors who worked with Jimmy shared his interest in sports and evoked his competitive spirit by keeping score on his progress. They also showed respect for his intelligence and gave him generous praise. They tried to change his mother’s critical attitude toward him by repeatedly expressing confidence in his ability when she called for him.At the end of the five-month period, Jimmy had advanced to a third-grade level in spelling, high third grade in paragraph reading and vocabulary, and fourth-grade level on silent reading tests. He had developed an efficient method of attack on new words, and his general progress was reflected in an air of confidence, marked improvement in conduct and personality ratings, and average grades of B plus for the following two years. (Harris, 1961)