Elizabeth McPike of the American Federation of Teachers has written that if you do not learn to learn to read, you simply do not make it in life. The research that we conduct and support at the National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) bears this out in spades. A number of ongoing long-term longitudinal studies carried out by NICHD supported scientists show that approximately 17-20 percent of our nation’s children have substantial difficulties learning to read.
In contrast to what was once thought to be conventional wisdom, we have found that almost as many girls as boys manifest reading disabilities. Boys do seem to be identified more readily by the public school system as having difficulties in reading because they tend to be a bit more active and boisterous than their female agemates. Since it is typically the child’s behavior, rather than academic difficulties, that prompt teachers to refer youngsters for special education services, the difficulties girls have in reading are frequently overlooked because they are generally well-behaved and socially adept.
Nevertheless, as we watch these boys and girls grow up, the negative effects of their reading difficulties are abundant and clear. During the early grades when they should be learning to read, their difficulties are quite embarrassing to them. This early humiliation portends a predictable decrease in self-esteem and motivation for schooling. Over the years I have become increasingly saddened by the fact that little kids are not as resilient as I once thought they were. They are tender individuals, easily frustrated and ashamed of deficient reading skills once they notice that many of their classmates read so effortlessly. During the later grades, when youngsters are done with learning to read and should be reading to learn, their knowledge and interests in areas such as literature, science, mathematics and history are constrained simply because they can not acquire the concepts readily via print.
However, the consequences of reading failure go far beyond these academic outcomes. Anywhere from 10-15 percent of children with reading disabilities drop out of school prior to high school graduation. Of those who do graduate, less than 2 percent attend a four-year college, despite the fact that many are above average in intelligence. A quick survey of adolescents and young adults with histories of delinquent or criminal conduct indicates that approximately half have reading difficulties, and similar rates of reading failure are seen among kids with substance abuse problems. No doubt, occupational and vocational independence and success are compromised. As such, reading disability is not only an educational problem, it is a major public health and economic concern. It is for these reasons that the NICHD has aggressively sought to understand reading disabilities better—to discover what causes them, how long they last, and what we can do to prevent and remediate them. Over the past 20 years, we have learned a good deal, but we clearly need to learn more.
The problem
In essence, most reading disabilities can be observed as a person attempts to read the words on a page of print. The signs of disability are: a labored approach to decoding or “sounding out” unknown words and a repeated misidentification of known words. Reading is hesitant and characterized by frequent starts and stops and multiple mispronunciations. If asked about the meaning of what was just read, the individual frequently has little to say. Not because he or she isn’t smart enough; in fact, many people with reading disabilities are very bright. In the main, their poor comprehension occurs because they take far too long to read the words, leaving little energy for remembering and understanding what they have read. Simply put, their reading of words is extremely plodding and inaccurate rather than automatic and fluent.
Even individuals with relatively “mild” difficulties reading will tell you that they do not read for pleasure. Why? Because it takes far too much work to be fun, and the reading simply takes too long for the reader to remain interested in the material at hand.
Unfortunately, there is no way to bypass this decoding and word recognition stage of reading. A deficiency in these skills cannot be appreciably offset by using context to figure out the meaning of the misread words, particularly if the reading speed is low and the errors many. In essence, while one’s purpose in learning to read is to derive meaning from print, the key to comprehending what is read starts with the immediate and accurate reading of words.
Difficulties in decoding and word identification, while at the core of most difficulties, are not the only type of reading disability that can be observed. To be sure, some children can cipher words in a very rapid manner, yet still have difficulties comprehending what they have read. This type of reading comprehension disorder is now being studied by a number of NICHD supported scientists, and we’re beginning to understanding of how best to identify and address the problem.
The causes
If the ability to gain meaning from print is dependent on fast, accurate and automatic decoding and word identification, what kinds of things hinder the acquisition of these basic literacy skills? No doubt, young children who have a limited exposure to both oral language and print before they enter schooling are at risk for reading failure. However, many youngsters whose early linguistic inexperience make learning to read difficult can be brought to appropriate literacy levels with early, intensive and informed instruction in kindergarten and first and second grades.
What is more puzzling are the reading difficulties that are observed among children who have average to above average intelligence, robust oral language experience and frequent interactions with books—children frequently referred to as learning disabled or dyslexic. Many children that are examined in our NICHD supported studies have been read to regularly since infancy. Their speaking vocabularies are well developed and when read to, they can quickly understand and discuss the content in rich detail. However, when asked to read material appropriate for their age, they flounder.
Over the past decade, we have begun to understand why. The English language is an alphabetic one, meaning that to read our language, one must unlock the relationships between sounds and letters. Thus, a good reader knows the connections between the 40 or so sounds of spoken English (called phonemes) and the 26 letters of our alphabet. What our NICHD research has taught us is that in order for a beginning reader to learn how to map or translate printed symbols (letters and letter patterns) to sound, he or she must intuitively understand that speech can be segmented and that segmented units of speech can be represented by printed forms. This understanding is termed “phonological awareness” and is a critical prerequisite skill for decoding and word recognition, which, in turn, are essential for reading comprehension.
Why is phonological awareness so critical? Because if children cannot perceive the sounds in spoken words—for example, if they cannot “hear” the “at” sound in “fat” and “cat” and perceive that the difference between these sound segments lies in the first sound—they will have significant difficulties decoding words accurately and fluently. This awareness of the sound structure of our language seems so easy and commonplace that we take for granted that most youngsters need to develop it. But many do not and for some interesting reasons. Unlike writing, our speech does not consist of separate sounds in words. For example, while a written word like “cat” has three letter-sound units, the ear only hears one sound, not three, when the word is spoken aloud. This merging and overlapping of sounds into a speech “bundle” makes oral communication much more efficient. Think how long it would take to have a conversation if each of the words we uttered were chopped into their sound segments. We now have strong replicated evidence that it is not the ear that helps the child understand that a spoken word like “cat” is divided into three sounds and that these sounds can be mapped onto the letters c-a-t, it is the brain. And, in many individuals the brain is not processing this type of linguistic phonological information in an efficient manner.
In essence, the ongoing research has taught us that reading disabilities occur much more frequently than initially thought, and that most of these disabilities reflect a specific language disorder that makes it tough for some children to understand that spoken words are made up of sound units that can be mapped onto letters and letter patterns so that they can “unlock” words that have never been read before. Without phonological awareness and the ability to rapidly label patterns of print with the appropriate sounds, children cannot develop useful letter-sound knowledge and will continue to guess at, rather than decode and recognize the words on the page.
The genetic link
When children display language-based reading disabilities, one begins to wonder about the origins of such difficulties. If the reading deficits cannot be explained by a lack of exposure to language patterns and literacy-based materials during the preschool years, a question that frequently arises is are genetics involved? That is: Are the disabilities inherited? In addition, are the difficulties associated with how the brain functions? The answer is a qualified yes to both questions, although certainly not for all poor readers. Over the past 20 years, data obtained from family, twin and chromosomal studies supported by the NICHD provide compelling evidence that reading disability aggregates in families, is heritable and is most likely caused by one or more genes having a major effect on neural development. The data suggest that these genetic effects influence the transmission of phonological deficits that produce the decoding, word recognition and reading comprehension difficulties described earlier.
The specific mechanisms by which genetic factors predispose someone to reading disability are not fully clear. One possibility is that genetic alterations influence the nature and quality of brain development in the neural systems that are responsible for identifying sounds in speech. Several recent NICHD supported studies have found that deficits in phonological awareness are associated with atypical functioning in specific brain regions. Clearly, this research information can be considered only suggestive at this time. Nevertheless, the recent technological explosion in the development of neuroimaging methods that can be used safely with children bodes favorably for scientific understanding of the neurobiological foundations of reading development and disabilities.
Can these children be helped?
Indeed they can. Several ongoing NICHD supported reading intervention studies have found that many youngsters can learn to read quite well if the appropriate instruction is provided early enough. In these longitudinal studies, we have found that both early and informed intervention is critical. Why early? Because it seems that unless children are identified and provided with appropriate interventions by the second or third grade, their chances of “catching up” in reading are reduced dramatically. This does not mean that we cannot succeed with older students. We can, but the cost in both time and money is essentially tripled.
A number of NICHD studies being conducted at different research sites have all reported that a balanced instructional program composed of direct instruction in phonological awareness, phonics and contextual reading is necessary for gains in reading skills to be achieved. Without a doubt, we have found that teaching methods that are based upon only one philosophy such as “the whole language approach” or “the phonics method” are counterproductive for children with reading disabilities. No matter how bright the child and how interesting the reading material, a child will not learn to read unless he or she understands how print is translated into sound. Likewise, no matter how much phonological awareness and phonics knowledge a youngster has, the child will not want to engage in reading and writing unless it is meaningful and interesting and taught in an exciting and vibrant fashion.
Unfortunately, many teachers have not been adequately prepared to understand how reading develops and how to teach children to read using a balanced and integrated instructional approach that insures mastery of the sound structure of the language, phonics principles and contextual reading comprehension strategies. Frequently, teachers are trained in a “one size fits all” philosophy of instruction, which clearly leads to reading failure in many of our children. In addition, the majority of youngsters who are identified in public schools as having difficulties learning to read are typically not given appropriate types of reading instruction until they have failed for at least two years. This is simply too late and reflects an unfortunate gap between what we know from our research and what is practiced in school.
Our NICHD-supported research has led to discoveries that can help us identify many children who will have difficulties learning to read as early as the kindergarten year. The ongoing research has also led to the development of a number of powerful teaching methods that can be applied during kindergarten, first and second grade to prevent and remediate reading failure. We must work harder to insure that schools, teachers and parents have this information.
G. Reid Lyon is chief of the Learning Disabilities, Cognitive and Social Development Branch of the NIH’s National Institute of Child Health and Human Development.
Recommended reading
Available at no public cost
The NICHD Learning Disabilities/Reading Disabilities Information Packet: Research Discoveries—Clinical Applications. Available from the National Instituteof Child Health and Human Development/NIH. Contact: Rosa Jones, 301-496-5097.
Learning Disabilities. Available from the National Institute of Mental Health. Contact: 5600 Fischers Lane, Room 7C02, Rockville, MD 20857
Learning to Read—Reading To Learn, Information Kit - Available on LD OnLine
Effective Strategies for Teaching Beginning Reading, by Ed Kameenui and others (1995). Available from the National Center to Improve the Tools of Educators.Contact: 541-346-1646
Phonological Awareness: Curricular and Instructional Implications for Diverse Learners, by S.B. Smith and others (1995). Available from the National Center to Improve the Tools of Educators. Contact: 541-346-1646
The Learning Disabilities Association Information Packet. Available from the Learning Disabilities Association of America. Contact: Jean Petersen, 412-341-1515.
Commercial publications
Beginning to Read: Thinking and Learning About Print, by Marilyn J. Adams (MIT Press, 1990).
Learning To Read: Schooling’s First Mission, edited by Elizabeth McPike (American Educator, 1995). Available from the American Federation of Teachers. Contact: Beth Bader 202/879-4561.
The Orton Dyslexia Society Emeritus Series (Monographs dedicated to specific issues in dyslexia). Available from the Orton Dyslexia Society. Contact: 410-396-0232
Lyon, G. Reid. “Why Johnny Can’t Decode.” The Washington Post 27 October 1997, Sunday ed.