Centra Articles

By: Gail Silverstein, PhD

People can have problems with reading in one or more of three related areas: 1) Decoding - sounding out words. Decoding problems are usually caused by weaknesses in phonological processing - the association of letters with letter-sounds. To decode, you need to be able to take words apart and put them back together. Spelling is the other side of the coin from decoding. To spell correctly, instead of taking words apart you need to retrieve the letter sounds from memory and put the words together. Poor readers are generally poor spellers and poor spelling can be a sign of a reading problem. 2) Fluency - the ability to read rapidly, accurately and automatically. Fluency cannot happen without good decoding skills. Even with a good memory for sight vocabulary, sooner or later the reader will come across unfamiliar words and struggle to sound them out. 3) Reading Comprehension - the ultimate goal of reading. Reading comprehension calls on a number of skills, including good decoding and fluency skills. If reading is dysfluent or if the reader has to frequently stop to sound out unfamiliar words, reading takes longer and the reader has a harder time remembering the beginning of what he or she has read so as to integrate it with the ending.

Early Warning Signs

There are some early warning signs for reading problems. However, some children with reading problems have never shown any of these signs and having some of these signs does not necessarily mean that reading problems will develop. Speech may be delayed so that the child doesn't say single words until 15 months of age or later or speak in phrases until after age 2. There may be persistent articulation problems or “baby talk” which continues past age 5 or so. Syllables may be sequenced incorrectly and result in the child saying, for example, “aminal” instead of “animal” or they may leave off the beginning sounds of words. The child may have difficulty determining which words rhyme and which do not. In fact, studies have shown that familiarity with nursery rhymes is one of the best predictors of later reading ability. Preschoolers who later go on to develop reading problems often have difficulty learning the alphabet and letter sounds, color names, and/or their address or phone number. They may have more difficulty finding the words to express what they want to say than their peers and end up using a lot of vague words such as “thing” or “stuff”. It is not true that they always reverse letters or words such as “saw” and “was”, although some dyslexic children do. Males who are left-handed or who have left-handed family members, and people with auto-immune disorders, such as allergies, excema, asthma, and fibromyalgia (or whose families have other members with auto-immune disorders) are at higher risk for developing reading problems.

How Reading Problems Change Over Time

Reading problems often seem to come and go over the years. This has more to do with changes in the nature of the expectations people have for the child than with changes in the child.. The child may have difficulty learning to decode in first grade and then finally seem to master the skill. Then, in third grade or so, when the emphasis in school changes from “learning to read” to “reading to learn”, the child may begin to struggle again, and then again settle down. In fifth or sixth grade, more writing is usually required. At that point, writing often becomes the problem. The child may try to avoid and/or become upset by writing assignments. He or she may have trouble coming up with enough words, sentences, or paragraphs to meet the requirements of the assignment. What they do write may have many grammatical and spelling errors. Particularly common errors take the form of omitted words or syllables, or reversals, such as “per” for “pre”. At the beginning of middle school, the beginning of high school, and in college, there are big jumps in the amount of abstract material the person is expected to cope with as well as big jumps in the amount of reading and writing that they are expected to do. To complicate matters, at each of these times, there are also increased expectations for independence. The person may begin to struggle again and grades may go down. And, of course, there are emotional changes at these times as well, and this complicates matters further. By the time a person with reading problems reaches adolescence or adulthood, often there are few obvious signs left of the reading problem. They can read as well as anyone else and comprehension is often unimpaired. However, reading generally is slower and more laborious than it is for other people. This may show itself as an avoidance or dislike of reading, becoming tired when reading, or developing headaches or other bodily symptoms when reading.

What to do About Reading Problems

Reading problems can be diagnosed by neuropsychological testing any time from kindergarten or first grade onward. Early diagnosis is important because studies have shown great benefits from early intervention. Children who are not reading fluently by age 9 or third grade have significantly more trouble becoming fluent readers later on, even with help. However, that does not mean that it is pointless to intervene after third grade. Reading can still be improved. Further, accommodations can be made by the school for children with reading problems. For example, having extra time for tests can mean the difference between success and failure for some children. Equally important is the benefit to the child’s self-esteem in understanding (and having those around them understand) that reading problems have nothing to do with intelligence and do not have to prevent success in life. Albert Einstein, Winston Churchill, and F. Scott Fitzgerald were all dyslexic as are many other high-achieving people.

Some bright people with reading problems are able to compensate and get through high school or even further with good grades by working harder and longer than their peers. Some of these people do not exhibit any significant problems until they take the SAT or similar standardized test and find that their scores are lower than anyone expected. Slower reading speed means that fewer questions can be attempted within the time limits of the test. Again, extra time can make all of the difference. The accommodation of extra time will be granted for the SAT, GRE, LSAT, MCAT, GMAT, and similar tests with proper documentation. Such documentation can be provided by neuropsychological testing.