Students with three types of severe reading disabilities: introduction to the case studies

Rebecca H. Felton

As a rubric for understanding reading problems, the “simple view” proposed by Gough and Tunmer in 1986 remains useful. In that view, reading is the combination of word identification and language comprehension, with both components being necessary for literacy. Numerous studies of students with reading problems have indicated that the word identification component is a major factor for the majority of poor readers. Research has shown that poor readers are often impaired in their ability to read words accurately; decoding has been identified as a critical weakness. This difficulty has been linked to weaknesses in phonological skills, particularly phonemic awareness. In addition, recognizing words automatically and reading text fluently have been recognized as areas in which many poor readers have difficulty. These problems have been linked to weaknesses in rapid naming of visually presented items.

Learning Disability: A Useful Label?

Skill in word identification has been found to characterize readers along a normal continuum rather than clearly delineating poor readers from those with specific learning disabilities in reading (e.g., Shaywitz, Escobar, Shaywitz, Fletcher, & Makuch, 1992). This finding has fostered debate concerning the validity of the learning disability label and has led some to question the need for special education services for students classified as learning disabled (e.g., Reynolds, 1991). In a recent attempt to address this important issue, Fuchs and colleagues (Fuchs, Fuchs, Mathes, Lipsey, & Eaton, 2000) carried out a meta-analysis of 79 studies investigating differences between poor readers with and without the learning disability label. The overall finding was that students with learning disabilities, on average, performed more poorly on a variety of reading measures than students who were low achieving. Of particular interest is the finding that the use of timed tests to measure reading skills greatly increased the differences between students with learning disabilities and low-achieving students. Students with the learning disability label were significantly more impaired than low-achieving students when the automaticity of word identification skills was measured.

Fuchs et al.’s (2000) meta-analysis did not, as they pointed out, reveal the precise nature of the differences between students with learning disabilities and low-achieving students, or whether the difference was qualitative or quantitative. However, the finding of more severe reading problems, particularly when automaticity was a factor, among students classified as learning disabled raises important educational and theoretical issues.

The severity and automaticity issues are reflected in current research concerning the underlying causes of reading disabilities and the implications for treatment. Although the importance of a core deficit in phonological processes that affects the ability to decode is well established in the reading literature, the importance of a separate naming-rate deficit was proposed by Wolf and colleagues (Wolf & Bowers, 2000). Students with both a phonological-core deficit and a naming-speed deficit, that is, a double deficit, have been found to be more severely impaired readers than students with either a phonological or a naming deficit alone (Lovett, Steinbach & Frijters, 2000; Manis, Doi, & Bahda, 2000). Both of these recent studies by Manis et al. and Lovett et al. point out the heterogeneity among students at the lower end of the reading distribution. In the Manis et al. study, students at or below the 25th percentile on a measure of word identification accuracy included students with deficits in naming speed only, deficits in phonemic awareness only, and deficits in both areas. The Lovett et al. study evaluated a large number of very impaired readers (i.e., students who were below the 20th percentile on at least four measures of reading) and found that the largest number of students met the criterion for a double deficit, with roughly equal numbers of students meeting criteria for a single deficit. The students with double deficits were significantly more impaired than those with single deficits on measures of single-word identification, nonword reading, and passage comprehension.

These findings suggest that the lack of a clear statistical cutpoint between poor and more severely impaired readers does not preclude meaningful differences between and within such groups. Within a group of the poorest readers, students with more pervasive deficits (across both phonological and naming domains) seem to have the more severe reading problems. A study by Meyer and colleagues (Meyer, Wood, Hart, & Felton, 1998) suggested that the presence of rapid naming deficits, in addition to phonemic awareness deficits, is a powerful determinant of students’ ability to develop word identification skills. This effect was found only for the most impaired readers, leading to the conclusion that severely impaired readers are qualitatively different from students within the normal range of reading ability.

Proper diagnosis and classification of students with reading problems is important primarily for purposes of providing appropriate treatment and intervention. Recent intervention studies (e.g., Foorman, Francis, Fletcher, Schatschneider, & Menta, 1998; Scanlon & Vellutino, 1997; Torgesen, Wagner, & Rashotte, 1997) have demonstrated that most students can be successfully taught phonological decoding skills. However, intervention researchers (e.g., Blachman, 1994; Torgesen, Wagner, & Rashotte, 1994) have identified students (characterized as “treatment resisters”) who fail to respond adequately to interventions that are sufficient for most poor readers. Wolf and colleagues (Deeney, Wolf, & O’Rourke, this issue) agree with the findings of the Meyer et al. (1998) study and suggest that treatment resisters may be students with deficits in the naming domain. The first large-scale intervention study addressing naming deficits (Wolf, Miller, & Donnelly, 2000) indicated that comprehensive instructional approaches can positively affect reading fluency, but much work remains to be done in this area of intervention.

Purpose of This Special Issue

While experimental studies of groups of students provide important information concerning intervention, one premise in the field of special education is that each student has an individual profile of strengths and weaknesses that must be addressed educationally. The purpose of this special series is to present case studies of students who illustrate the diversity among individuals with severe reading disabilities. Each student’s particular profile of reading disability is described, as well as the educational approaches that were used and the outcomes.

The case presented by Deeney et al. in this issue is the first case to be published describing a child with a naming-speed deficit only. B. H. is a 9-year-old boy who has adequate phonemic awareness skills but severe naming-speed deficits and who participated in a formal NICHD-sponsored intervention study during the second grade. The case described by Wise involves an 11-year-old girl with a severe phonological deficit. This article details K. C.’s response to instruction provided jointly by Wise, who worked individually with the student over a 2-year period, and the child’s mother, who actively participated in the remediation. The case presented by Miller and Felton is an example of a high school student who has deficits in both phonological awareness and naming (both rate and accuracy), as well as other language processing weaknesses. D. W. was identified in first grade as a student with learning disabilities and received special education services for several years with little success. His participation in an intervention program designed by Miller and implemented within the public school over a 4-year period is described.

These cases are presented as examples of students who are appropriately considered as disabled in reading and who require truly specialized approaches to instruction. Such instruction can be delivered only by highly trained teachers who have the knowledge, skills, and opportunity to address a variety of reading problems. As Moats (1999) so eloquently stated, “Teaching reading IS rocket science,” and this is particularly true when the students in question have severe disabilities. Teachers in the private and public sectors must be equipped to both recognize and effectively treat students with severe problems in reading. This requires specialized training and provision of appropriate settings for instruction that fall outside of the purview of the regular classroom.


Blachman, B. A. (1994). What have we learned from longitudinal studies of phonological processing and reading, and some unanswered questions: A response to Torgesen, Wagner, and Rashotte. Journal of Learning Disabilities, 27, 287-291.

Foorman, B. R., Francis, D. J., Fletcher, J. M., Schatschneider, C., & Menta, P. (1998). The role of instruction in learning to read: Preventing reading failure in at-risk children. Journal of Educational Psychology, 90, 37-55.

Fuchs, D., Fuchs, L. S., Mathes, P. G., Lipsey, M. E., & Eaton, S. (2000). A meta-analysis of reading differences with and without the disabilities label: A brief report. Learning Disabilities: A Multidisciplinary Journal, 10, 1-3.

Gough, P. B., & Tunmer, W. E. (1986). Decoding, reading, and reading disability. Remedial and Special Education, 7, 6-10.

Lovett, M. W., Steinbach, K. A., & Frijters, J. C. (2000). Remediating the core deficits of developmental reading disability. Journal of Learning Disabilities, 33, 334-358.

Manis, F. R., Doi, L. M., & Bahda, B. (2000). Naming speed, phonological awareness, and orthographic knowledge in second graders. Journal of Learning Disabilities, 33, 325-333, 374.

Meyer, M. S., Wood, F. B., Hart, L. A., & Felton, R. H. (1998). Selective predictive value of rapid automatized naming in poor readers. Journal of Learning Disabilities, 32, 106-117.

Moats, L. C. (1999). Teaching reading IS rocket science: What expert teachers of reading should know and be able to do. Washington, DC: American Federation of Teachers.

Reynolds, M. C. (1991). Classification and labeling. In J. W. Lloyd, A. C. Repp, & N. N. Singh (Eds.), The Regular Education Initiative: Alternative perspectives on concepts, issues, and models (pp. 29-41). Sycamore, IL: Sycamore.

Scanlon, D. M., & Vellutino, F. R. (1997). A comparison of the instructional backgrounds and cognitive profiles of poor, average, and good readers who were initially identified as at risk for reading failure. Scientific Studies of Reading, 1, 191-216.

Shaywitz, S. E., Escobar, M. D., Shaywitz, B. A., Fletcher, J. M., & Makuch, R. (1992). Evidence that dyslexia may represent the lower tail of a normal distribution of reading ability. The New England Journal of Medicine, 326, 145-150.

Torgesen, J. K., Wagner, R. K., & Rashotte, C. A. (1994). Longitudinal studies of phonological processing and reading. Journal of Learning Disabilities, 27, 276-286.

Torgesen, J. K., Wagner, R. K., & Rashotte, C. A. (1997). Prevention and remediation of severe reading disabilities: Keeping the end in mind. Scientific Studies of Reading, 1, 217-234.

Wolf, M., & Bowers, P. G. (2000). Naming speed processes and developmental reading disabilities: An introduction to the special issue on the double-deficit hypothesis. Journal of Learning Disabilities, 33, 322-324.

Wolf, M., Miller, L., & Donnelly, K. (2000). Retrieval, automaticity, vocabulary elaboration, orthography (RAVE-O): A comprehensive, fluency-based reading intervention program. Journal of Learning Disabilities, 33, 375-386.


COPYRIGHT 2001 Gale Group

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