Reading Disorder: Comprehension

Dawson’s Story:
Dawson is in the 4th grade. He reads avidly and can pronounce words at a sixth grade level. But anytime he takes a quiz on his AR reading he gets one or zero of the possible points. Even on class assignments, on his grade level, he has a hard time picking out main ideas and answering questions about what he has read. This was a problem for him in both 3rd and 2nd grade as well. If he reads an AR book on a 2nd grade level right now he is able to get the points, but no level higher than that. What should his teacher or parents do to help him?

What is a Reading Comprehension Disorder:
• A Reading disorder is a learning disorder that involves significant impairment of reading comprehension to the extent that the impairment interferes with academic achievement or activities of daily life.
• People with reading disorder perform reading tasks well below the level one would expect on the basis of their general intelligence, educational opportunities, and physical health.
• Reading disorder is most commonly called dyslexia. Dyslexia, however, usually includes deficits in spelling and writing as well as reading.
• Reading disorder is a learning disorder characterized by a significant disparity between an individual's general intelligence and his or her reading skills.
• Reading comprehension problems occur when there is an inability to grasp the meaning of words, phrases, and paragraphs.
• Comprehension problems include one or more of the following: (1) identifying the main idea; (2) recalling basic facts and events in a sequence; and (3) making inferences or evaluating what has been read.


Prevalence:
• The prevalence of reading disability is another issue on which there is no consensus. The lack of consensus is due, to a large degree, to variability in defining reading disability. For example, studies vary in the cutoff score used for identifying poor reading and in the size of the discrepancy between reading and expected level used for such identification.

• About 80% of people with a learning disorder have reading disorder.

• Other studies suggest that about 4% of school-age children have reading disorder.

• People with reading disorder are more likely to have a parent or sibling with the disorder.

• Between 60% and 80% of children diagnosed with reading disorder are boys.

• For various reasons often related to behavior, boys tend to be referred more frequently to special education classes, which suggest that girls with reading disorder may be under diagnosed. Some experts think that this disparity comes about because boys are more often disruptive in class.

Characteristics of Students:

Reading disorder can cause severe problems in reading, and consequently in academic work, even in people with normal intelligence, educational opportunities, motivation to learn to read, and emotional self-control. Common problems in people with reading disorder include:

• reading speed and fluency
• general vocabulary skills
• poor comprehension when reading material either aloud or silently
• omission of words while reading
• reversal of words or letters while reading
• difficulty decoding syllables or single words and associating them with specific sounds (phonics)
• limited sight word vocabulary
• problems understanding the sounds in words, sound order, or rhymes
• letter and word recognition

How is this Disability Identified:
• Learning disabilities are often identified by school psychologists, clinical psychologists, and neuropsychologists through a combination of intelligence testing, academic achievement testing, classroom performance, and social interaction and aptitude.

• Other areas of assessment may include perception, cognition, memory, attention, and language abilities. The resulting information is used to determine whether a child's academic performance is commensurate with his or her cognitive ability. If a child's cognitive ability is much higher than his or her academic performance, the student is often diagnosed with a learning disability.

• There are three basic classroom tests you can use to determine if there might be a reading comprehension problem- Cloze testing, Questioning, and Retelling.

• Assessments that measure multiple domains of reading include Gray's Diagnostic Reading Tests–2nd edition (GDRT II) and the Stanford Diagnostic Reading Assessment. Assessments that measure reading sub-skills include the Gray Oral Reading Test IV – Fourth Edition (GORT IV), Gray Silent Reading Test, Comprehensive Test of Phonological Processing (CTOPP), Tests of Oral Reading and Comprehension Skills (TORCS), Test of Reading Comprehension 3 (TORC-3), Test of Word Reading Efficiency (TOWRE), and the Test of Reading Fluency. A more comprehensive list of reading assessments may be obtained from the Southwest Educational Development Laboratory.

• The most commonly used comprehensive achievement tests include the Woodcock-Johnson III (WJ III), Weschler Individual Achievement Test II (WIAT II), the Wide Range Achievement Test III (WRAT III), and the Stanford Achievement Test–10th edition. These tests include measures of many academic domains that are reliable in identifying areas of difficulty.

How do these Learners Receive their Education:
• Any child, however, who has a diagnosed learning disability, including reading disorder or dyslexia, should be eligible for an Individual Education Program (IEP) that provides customized instruction at school designed to address the disability.
• By participating in general education classrooms with the help of an aide.
• Resource Room instruction regarding reading in addition to the general education instruction.
• Simply participating in general education classrooms.

What are the Best Educational Practices:
The main programs in use today include Project READ, the Wilson Reading System, and programs based on the Herman method. There are many successful programs to address individual reading needs. In general, all good programs are:

• Sound/symbol (phonics)-based. They break words down into their smallest visual components: letters and the sounds associated with them.
• Multi-sensory. Good programs attempt to form and strengthen mental associations among visual, auditory, and kinesthetic channels of stimulation. The student simultaneously sees, feels, and says the sound-symbol association. For example, a student may trace the letter or letter combination with his or her finger while pronouncing a word out loud.
• Highly structured. Remediation begins at the level of the single letter-sound; works up to digraphs (a pair of letters representing a single speech sound); then syllables; then into words and sentences in a systematic fashion. Repetitive drill and practice serve to form necessary associations between sounds and written symbols.
• Buddy Reading, Think Pair Share, One Chapter or Section at a Time, Read Aloud by Teacher, Guided Reading, Modeling, and Teaching Reading Habits (questioning, predicting, etc.) and Small Group Reading are also good practices.

Accommodations:
• Shorter books
• Longer time to complete reading
• An aide to help with the reading and comprehension worksheet
• Paired or Partner Reading

Inclusive Practices:
• Paired or Partner Reading
• Strategy Cue Cards (questioning, predicting, etc.)
• Use of a reading program such as Wilson during a resource time.
• One to One reading with the teacher doing Echo reading.

Continuum of Extent or Severity in Youngsters:
• Difficulties in reading can occur on many levels, and reading disorder may have several causes that manifest in different ways.

• How well a person compensates for this disorder depends on the severity of the impairment and the type of educational remediation that he or she receives.
• Generally, people who are identified as having a reading disorder before grade three and who receive intensive reading education can do well.
• There is, however, a great deal of variation among people in intelligence, educational opportunities, and the will to overcome a reading disorder, as well as in the type and severity of the problem.
• All these factors combine to determine the ultimate outcome of this disorder. The prognosis is usually good if the condition is diagnosed early and the person is enrolled in a good remedial program.
• Strong self-esteem, together with supportive family, friends, and teachers also improve a person's chances of overcoming this disorder.

• The extent can range from not comprehending reading at all to comprehending reading one grade level below their chronological age.

Special Challenges for General Education:
• This can be a disability that has no challenges to a disability that has one large challenge, depending on severity.
• A general education classroom may not have the time in a school day necessary to give extra help or instruction.
• There may need to be an aide or peer to work with these students one on one during reading class or other classes requiring reading.

Assistive Technology Accommodations:
• Audio Books
• Optical Character Recognition

Wraparound Service:
• There are reading comprehension wraparound services available through public schools and other summer programs.

Is this a School Issue or a Life Issue:
• Reading disorder is a learning disorder that involves significant impairment of reading comprehension to the extent that the impairment interferes with academic achievement or activities of daily life.
• Learning to read is a complex task. It requires coordination of the eye muscles to follow a line of print, spatial orientation to interpret letters and words, visual memory to retain the meaning of letters and sight words, sequencing ability, a grasp of sentence structure and grammar, and the ability to categorize and analyze.
• In addition, the brain must integrate visual cues with memory and associate them with specific sounds. The sounds must then be associated with specific meanings. For comprehension, the meanings must be retained while a sentence or passage is read. Reading disorder occurs when any of these processes are disrupted. For that reason, the roots of reading disorder have proved difficult to isolate, and may be different in different individuals.

How does this Affect Home:
• At home there is more assistance needed with any homework or projects that require reading.
• There may also be assistance and careful observation needed so that very young students don’t get into trouble with poisons and harmful objects that they can’t identify through reading ability.

Name someone who has Achieved Greatness:
• Many famous and successful people have suffered from reading disorders, including at least two Presidents of the United States.
• Bruce Jenner won a gold medal in the Olympic decathlon.
• Robin Williams became an actor and comedian.

How Can You Make a Difference for the Child:
• Read to them.
• Practice Reading Comprehension Strategies with them.
• Be Patient.
• Give time to complete tasks requiring Reading.

How Can You Support Parents:
• Limit the amount of reading sent home with a child whose parents work a lot.
• Give them strategy lists that they can use with their student at home.
• Be patient and explain that with help their student can surpass this difficulty.
• Send books home that they can read with their child when they have time.

Other Resources:
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text revised. Washington DC: American Psychiatric Association, 2000.
• Hales, Robert E., Stuart C. Yudofsky, and John A. Talbot. The American Psychiatric Press Textbook of Psychiatry. 3rd ed. Washington, DC: American Psychiatric Press, 2000.
• Sadock, Benjamin J. and Virginia A. Sadock, eds. Comprehensive Textbook of Psychiatry. 7th ed. Vol. 2. Philadelphia: Lippincott Williams and Wilkins, 2000.
• Bower, Bruce. "Dyslexia Tied to Disrupted Brain Network." Science News 153 (7 March 1998): 150.
• Matvy, Mike. "A Silicon Bullet for Dyslexia: A new Solution for an Old Problem." The Exceptional Parent 30 (November 2000) 52-56.
• Learning Disabilities Association. 4156 Library Rd., Pittsburgh, PA 15234. (412) 341-1515. <http://www.ladnatl.org> .
• National Center for Learning Disabilities. 381 Park Avenue South, Suite 1401, New York, NY 10016. (212) 545-7510. <http://www.ncld.org> .
• Dyslexia Resources on the Web. <http://home.clara.net/ghrow/subjects/dyslexia.html> . Extensive links to dyslexia resources; updated frequently.

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