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The most frequent characteristic observed among children and adults with reading disabilities is a slow, labored approach to decoding or "sounding-out" unknown or unfamiliar words and frequent misidentification of familiar words. Oral reading is hesitant and characterized by frequent starts and stops and multiple mispronunciations.
One of the most powerful predictors of reading comprehension abilities is the speed and accuracy of reading single words. Likewise, one of the most powerful predictors of speed and accuracy in reading single words is the strength of phonemic awareness skill development.
In contrast to good readers who have discovered that letters and letter patterns represent segmented units of sound (phonemes), poor readers have substantial difficulty developing this principle. As noted in the discussion of reading development, the major factor impeding the development of the alphabetic principle and thus decoding and word reading skills is a lack of facility in phonemic awareness.
Phonemic awareness skills assessed in kindergarten, in combination with assessment of the child's ability to provide letter and number names and letter sounds, are strong predictors of difficulties learning to read. Deficits in phoneme awareness skills impact the ability to develop accurate and fluent word reading capabilities which significantly degrade comprehension of what has been read.
In addition to being negatively affected by phonological and word level deficits, reading comprehension is impeded by, among other factors: (1) vocabulary deficits; (2) inadequate background knowledge relevant to the information presented in text; (3) lack of familiarity with semantic and syntactic structures that can be employed to predict and better understand word and grammatical relationships; (4) lack of knowledge about different writing conventions that are employed by the author to achieve different purposes via text (humor, explanation, dialogue, etc.); (5) lack of verbal reasoning ability which enables the reader to "read between the lines"; and (6) the ability to remember and/or recall verbal information.
Motivational factors are clearly relevant to reading development and reading disorders, given that the improvement a disabled reader may make in learning to read is highly related to their willingness to persist despite difficulties. Unfortunately, little is specifically known about the exact timing and course of motivational influences in reading development.
There is strong converging evidence for a genetic cause of some types of reading disability with deficits in phonemic awareness being the greatest hereditary factor. Family history is one of the most important risk factors, with 23 to as much as 65 percent of children who have a parent with reading disability having the same difficulties. A rate among siblings of affected persons of approximately 40 percent and among parents ranging from 27 to 49 percent provides opportunities for early identification.
Converging evidence suggests that at least one type of reading disability can be linked to the HLA region of chromosome 6 reflecting a possible association with autoimmune disorders. Evidence obtained from twin and kindred siblings with severe deficits in reading performance support a Quantitative Trait Locus on chromosome 6. Chromosome 15 has recently been linked to individual differences in word reading skills.
Phonemic awareness and word reading deficits can also result from a lack of oral language and literacy exposure and interactions following birth and through the preschool years. If children are not provided opportunities to listen to and interact with language in multiple contexts, their background knowledge about sounds, print concepts, and vocabulary concepts will be negatively affected. Whether or not limited oral language exposure is reflected in differences in neural development during the early years is not yet known.
A range of neurobiological investigations employing post-mortem brain specimens, brain morphometry, functional brain imaging, and electrophysiology suggests there are differences in the temporo-parieto-occipital neural regions between some individuals with reading disability and those who are not reading-impaired. Additional studies suggest differences in the striate or extrastriate cortex, converging with a large body of literature describing anatomical lesions in posterior brain regions in acquired alexia, most prominently located in the angular gyrus.
How Can We Help Most Children Learn to Read? Specifically, for Which Children Are Which Teaching Approaches and Strategies Most Beneficial at Which Stages of Reading Development?
Evidence and Findings
A massive effort must be undertaken to inform parents and caretakers of the importance of providing oral language and literacy experiences from the first days of life - to engage children in playing with language through nursery rhymes, storybooks, and as they mature, early writing activities. Parents and caretakers must become intimately aware of the importance of vocabulary development and must interact verbally with their children to enhance verbal reasoning, semantic, and syntactical abilities.
Reading out loud to children is a proven activity for developing vocabulary and language expansion characteristics, and plays an important role in developing receptive and expressive language skills. Reading out loud to children can also help to enhance children's background knowledge of new concepts that will appear in both oral and written language.
NICHD prevention and early intervention studies continue to provide converging evidence on the importance of developing accurate and fluent word reading skills, given the significant importance of such skills in developing reading comprehension abilities.
Prevention and early intervention studies in Tallahassee, Gainesville, Syracuse, Albany, Houston, Seattle, and Washington, DC are providing converging evidence that for those children who are at risk for reading failure, highly direct and systematic instruction to develop phoneme awareness and phonics skills, reading fluency and automaticity, and reading comprehension strategies within a literature-rich environment will be required to obtain maximum gains. It is also imperative that each of these reading components be taught within an integrated context and that ample practice in reading familiar material be afforded to enhance fluency and automaticity. Likewise, the most effective interventions provide ample opportunities to read and discuss authentic literature.
NICHD and substantial non-NICHD research does not support the claim that the use of context is a proxy for applying decoding strategies to unknown or unfamilar words. To guess the pronunciation of words from context, the context must predict the words. But content words - the most important words for text comprehension - can be predicted only 10 to 20 percent of the time. Instead, the strategy of choice among well developing good readers is to decode letters to sound in an increasingly complete and accurate manner, which is dependent upon robust development of phonemic and phonics skills.
Without a doubt, early identification and intervention is essential to maximizing treatment success in children who are at risk for reading failure. NICHD studies have led to the development of accurate and reliable identification procedures that are linked to prevention programs. NICHD studies have clearly demonstrated that the intensity and duration of reading interventions must increase exponentially as children get older just to achieve the same degree of improvement attainable during kindergarten and the first grade.
One factor that impedes effective instruction with children at risk for reading failure is current teacher preparation practices. Many teachers have not had the opportunity to develop basic knowledge about the structure of the English language, reading development, and the nature of reading difficulties. Major efforts must be undertaken to ensure that colleges of education develop preparation programs to foster the necessary content and pedagogical expertise at both preservice and inservice levels.
This document was prepared for the Keys to Successful Learning Summit held in May 1999 in Washington, D.C. Keys to Successful Learning is an ongoing collaboration sponsored by the National Center for Learning Disabilities in partnership with the Office of Special Education Programs (US Department of Education) and the National Institute of Child Health & Human Development (National Institutes of Health).
The purpose of this initiative is to translate research and policy on learning disabilities into high standards for learning and achievement in the classroom, and to take action at the local, state and federal levels to ensure that all students, including those with learning disabilities, are afforded the highest quality education.
Keys to Successful Learning is supported by a coalition of national and regional funders as well as a broad range of participating education organizations.
