Remedial cases in reading: their diagnosis and treatment

Front matter

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SUPPLEMENTARY EDUCATIONAL MONOGRAPHS

Table Of Contents

CHAPTER . PAGE-

I. Introduction . i

II. Significant, Types of Remedial Cases and Causes of Failure

Introduction

A SIGNIFICANT ILLUSTRATION

Two years ago it was found necessary for a fourth-grade boy to discontinue regular school work because of inability to read. His deficiency was so marked that his father feared for a time he would have to give up school work altogether. In the study which was made of his case it was found that he had never learned to move his eyes with speed and accuracy from the end of one line to the beginning of the next. Furthermore, he did not move his eyes regularly from left to right along the printed lines. At times the first fixation was near the end of the line; frequently it was near the middle; and sometimes it was near the beginning. The remaining fixations were irregular and followed no definite order.

Drill exercises which differed from ordinary printed material in two respects were prepared for use in establishing effective eye-movements. The lines were typewritten an inch apart to aid in developing accurate return sweeps from the end of one line to the beginning of the next. In order to develop regular movements of the eyes from left to right along the lines, three sets of exercises were prepared in which the spacings between words were wider than in ordinary print. In the first exercises, unrelated words were typewritten five letter-spaces apart. The boy was required to read these words in regular order for five minutes each day. After considerable progress had been made in the fluent recognition of unrelated words, a simple story was typewritten with five letter-spaces between words. After completing ten exercises of this type the words were grouped in thought units which were separated by five letter-spaces. Finally stories were read from books during the drill periods. The fluency and accuracy with which he soon read indicated that the graded exercises and the constructive suggestions which accompanied them had eliminated at least two of his major difficulties. Other problems, such as increasing the span of recognition and the development of independence in the recognition of words, were then undertaken. At the end of four months the boy was permitted to resume regular work with his class. One year later he was carrying fifth-grade work very successfully.

This case has been described at length because it is an excellent illustration of the fact that regular classroom instruction frequently fails to provide adequately for pupils who encounter unusual difficulties in reading. There are thousands of boys and girls in school each year who make little or no progress because of inaccuracies and personal handicaps which could be eliminated. These disabilities result in discouragement, retardation, and elimination in far too many cases. Society recognizes clearly that children differ widely in native endowment and learning capacity; it insists, however, that schools utilize every means possible to provide the most effective instruction for each child. If teachers meet this obligation successfully, they must make systematic detailed studies of the reading difficulties of children and they must provide appropriate remedial instruction. The importance of such a program is emphasized by a second illustration.

NEED OF CLASSROOM STUDIES OE READING DIFFICULTIES

Two fourth-grade pupils who were failing in their school work recently made equally low scores in a comprehension test. The same remedial exercises were given to them on the assumption that they encountered similar difficulties. At the end of four weeks they were tested again with little or no evidence of improvement. The suggestion was offered that a careful study be made of the errors which they made in reading in order to determine more accurately the nature of their specific difficulties. Accordingly, oral- and silent-reading tests were given and detailed records were kept of the errors made in class exercises.

A study of the information which was secured showed clearly that their difficulties were very different in character. Pupil A read fluently, but did not direct his attention to the content of what he read and consequently failed notably in interpretation. Pupil B, on the other hand, encountered numerous word difficulties and read very slowly. Because the problem of recognition required so much attention, he was unable to make a creditable record in comprehension. For a period of four weeks these pupils were given special remedial exercises. Pupil A was required to find the answers to specific questions, to select the important points of paragraphs, to reproduce what he read, and to follow directions. Pupil B, on the other hand, was given exercises in word analysis, in rapid recognition, and in grouping words in thought units. When the pupils were tested again each scored relatively high in comprehension.

INTRODUCTION 3

This illustration is significant because it shows clearly that a teacher must know more than the fact that a pupil ranks low in a reading test or fails in the preparation of an assignment in history. She will be able to improve the quality of his reading only when she knows the specific nature of his difficulty and provides appropriate remedial instruction. This implies that teachers should scrutinize the work of their pupils with great care, should give tests frequently, should record facts daily, and should provide instruction to meet the needs of pupils who encounter difficulties. The importance of these steps has been so widely recognized during recent years that they have been adopted as a part of the routine of instruction in many classrooms.

RECENT PROGRESS IN REMEDIAL INSTRUCTION

During the last year more than thirty cities have made detailed reports of diagnostic and remedial studies. Progressive teachers and supervisors of many other cities have reported that they have given a considerable amount of time to remedial instruction. The significant results secured in such cities as Stoughton, Wisconsin, Rochester, New York, and Seattle, Washington, furnish convincing evidence of the value of such work. In order to provide classroom teachers with expert help, several cities have established educational clinics where detailed diagnostic studies are made and have also provided special rooms where remedial instruction is given. Other cities, of which Los Angeles, California, is an excellent illustration, have given considerable attention to the development of materials of instruction appropriate for different types of cases. These constructive steps are very important inasmuch as the problems of group instruction are so numerous that classroom teachers find it impossible, without expert assistance, to give adequate attention to pupils who are seriously retarded in reading.

PROBLEMS FOR SOLUTION

Wherever diagnostic and remedial studies have been undertaken, four problems have been encountered which are in urgent need of solution. In the first place, there is need of specific information concerning important types of remedial cases. Detailed descriptions of the characteristics of the various types will help teachers to recognize more quickly and to classify more accurately the pupils under their instruction who encounter difficulties in reading. In the second place, there is need of detailed information concerning appropriate instruction for remedial cases. In this connection methods of teaching and drill devices are needed which will enable teachers to give remedial instruction economically and effectively. In the third place, the technique of diagnosis should be developed in greater detail; it should be refined to the point of accuracy and precision; and it should be simplified sufficiently to enable teachers to make frequent studies of individual cases. Finally, there is urgent need for teachers who are thoroughly trained to engage in diagnostic and remedial work effectively. A clear realization of the significance of these problems has recently stimulated investigators to make detailed studies of difficulties encountered by pupils in reading.

PURPOSE OF THIS INVESTIGATION

The series of experiments which are reported in this monograph were undertaken with three major purposes in mind: (a) to discover as many types of remedial cases in reading as time and resources would permit; (b) to determine the causes and distinguishing characteristics of each type; and (c) to develop appropriate methods of remedial instruction in each case. Although considerable attention was given to the technique of diagnosis, the causes of unusual difficulties in reading and appropriate remedial measures received most consideration. Use was made in many cases of methods of diagnosis which have been reported in previous investigations. These methods were supplemented by others which were planned specifically for use in this investigation.

MAJOR STEPS IN THE INVESTIGATION

The pursuit of this investigation has involved four distinct steps, (i) A summary was prepared of the remedial cases which have been published and which were submitted by superintendents, . supervisors, and teachers. (2) Plans were organized for diagnosing individual cases and for carrying on remedial instruction. (3) Twenty-seven pupils who encountered unusual difficulties in reading were studied at or near the University of Chicago for the purpose of securing detailed information concerning remedial cases. In this connection the writer was assisted in the diagnoses by Miss Laura Lucas and Miss Delia Kibbe, members of the Faculty of the Elementary School of the University of Chicago, and by Mr. L. W. Miller, a graduate student. The remedial instruction was given entirely by these co-operators with the aid of such advice as the writer was able to give them as he observed their teaching. (4) Studies were made of twenty-six retarded pupils in Toledo, Ohio, for the purpose of determining effective methods of organizing and directing diagnostic and remedial work in cities. Permission to undertake this

INTRODUCTION 5

work in Toledo was secured through the courtesy of Superintendent Charles S. Meek. The diagnoses were made with the co-operation of Miss Estaline Wilson, Assistant Superintendent of Schools, Miss Florence E. Hawkins, Primary Supervisor, and Miss Flora Nettleman, Intermediate Grade Supervisor. The remedial work was carried on by ten special teachers under the direction of Miss Wilson.

The four major steps of the investigation will be discussed in detail in subsequent chapters in the order in which they have been outlined.

Chapter II Significant Types Of Remedial Cases And Causes Of Failure

IN READING

The purpose of this chapter is to describe briefly five significant types of remedial cases in reading and fourteen causes of failure which have been reported in previous investigations. Such descriptions were of great value in recognizing and classifying many of the remedial cases which are reported in later chapters.

SOURCES OF INFORMATION

The sources of information for this summary were (a) published reports of diagnostic and remedial cases and (b) descriptions which were received from more than thirty school systems. The studies which have been published were made in university laboratories, educational clinics, and elementary-school classrooms. The following illustrations describe typical conditions under which the investigations were carried on. (i) Miss Katherine McLaughlin, while working in the laboratories of the School of Education, the University of Chicago, studied individual cases through the use of tests and an elaborate apparatus for photographing eye-movements. As soon as specific difficulties were discovered, remedial instruction was given, and the results were determined through careful, scientific measurements. (2) Dr. Clara Schmitt, of the Department of Child Welfare of the Chicago public schools, made clinical studies of individual cases, referred them to special teachers for remedial instruction, and determined the progress which had been made at various times during the training period. (3) Superintendent C. J. Anderson and Miss Elda Merton made at Stoughton, Wisconsin, several very interesting diagnostic studies through the use of standardized tests. After specific difficulties had been determined, remedial instruction was given by classroom teachers. These studies are of very great value because they show clearly that diagnostic and remedial work can be carried on effectively in city systems.

The second source of information included reports of cases which were received from school officers. In the spring of 192 1 a reprint of an article 1 entitled, "The Diagnostic Study of an Individual Case in

1 William S. Gray, "The Diagnostic Study of an Individual Case in Reading," Elementary School Journal, XXI (April, 1921), 577-94. ,

Reading" was sent to eight hundred superintendents, principals, and supervisors in various sections of the country, with a request for descriptions of remedial cases under their supervision. Fifty descriptive reports were received from thirty school systems. These reports included a wide variety of interesting types, many of which will be reported in later sections of this chapter.

NATURE OF REPORTS AND DESCRIPTIONS

The descriptions of remedial cases which are available can be classified into two distinctly different groups. In some descriptions the phase or phases of reading in which difficulty occurred was emphasized. The following titles are significant in this connection: "A Sixth-Grade Boy Who Cannot Read Primer Material Fluently"; "A Fluent Oral Reader in the Fourth Grade Who Comprehends Very Little Read Silently"; "The Rapid Reader Who Neglects Details." In other descriptions the specific cause of failure was emphasized, as indicated by the following titles: "A Third-Grade Boy Who Was Unable to Read Orally Because of Defective Vision"; "The Foreign Child Who Is Handicapped in Third-Grade Reading Because of a Meager Vocabulary"; "An Analytical Study of a Case of Alexia." In the summary which follows general types of remedial cases are presented first. These are followed by descriptions of specific causes of failure in reading. Each case is described briefly with emphasis on its most significant characteristics. No attempt was made to include descriptions of all cases which have been reported. A very careful selection was made, however, in order to present a wide variety of different types.

GENERAL TYPES OF REMEDIAL CASES

There are striking differences in the accomplishments of children who encounter difficulties in reading. Some read intelligently but very slowly; others read rapidly but fail to give adequate attention to the content of what is read; still others can understand anything they are able to read, but encounter serious difficulty in recognizing words. A complete list of these cases would be of great value to a teacher in recognizing and classifying pupils who encounter serious reading difficulties. The fist which follows is complete because it is based entirely on cases which have been reported. As investigation continues it will no doubt be possible to add other significant types to the list.

Case I: A third-grade boy who was seriously retarded in all phases of reading.-— Pupils in each grade, including the high school, have been reported as notably weak in all phases of reading accomplishment.

They are discovered most frequently in the third and fourth grades because their difficulties in reading begin to interfere at that time with their progress in other subjects. In some cases the causes of their difficulties are evident, such as poor eyesight, low native intelligence, or poor instruction; in other cases, the causes of unsatisfactory progress are difficult to determine. The case which is reported in the following paragraph was submitted by J. F. Robinson, Nims School, Muskegon, Michigan, and describes weaknesses in all phases of reading.

This ten-year-old boy was so retarded in reading that he was classified as a medium first-grade reader although his assignment was for the third grade. His reading was monotonous, jerky, and colorless, lacking any evidence of fluency and intelligent interpretation. The rudimentary reading habits apparently had not been formed effectively. The remedial problem was to determine a new starting-point and to awaken keen interest in reading. Therefore, simple exercises in a first reader were assigned. The aim was to develop fluency. When the second reader was begun, blackboard work was introduced as an aid in thought getting. The sentences which were used were carefully chosen. They proved very helpful in developing confidence and in making him an intelligent fluent reader. When a third reader was introduced, blackboard work was discontinued and silent reading substituted. As soon as he was able to read to himself effectively, supplementary readers, short stories, and library books were provided. His progress was very rapid after he began to read extensively.

Case II: A fluent oral reader in the fourth grade who comprehended nothing read silently. 1 — Pupils frequently learn to recognize words fluently and accurately and to express themselves satisfactorily in oral reading without understanding the content of the passages read. This is due to various causes, such as failure to direct attention to the content, lack of interest and attention, a limited meaning vocabulary, a narrow background of experience, ineffective habits of thinking, low native intelligence, or poor instruction. Whatever the cause may be, this type of case presents a serious problem because progress in other subjects will be retarded until intelligent habits of reading have been established. The following case is a good illustration of failure to develop the habit of reading for content.

This fourth-grade girl was described by her teacher as slow and indifferent . In the Gray Oral Reading Test she made a score of 41.25 which is 5.75 below the standard for fourth-grade pupils. In the silent-reading test she read slowly and was unable to reproduce what she read or to answer questions. "To discover if mechanics of reading was causing the difficulty, she was asked

1 C. J. Anderson and Elda Merton, "Remedial Work in Reading," Elementary School Journal, XX (May, 1920), 687-92.

to read the same material orally. She read fluently and with expression at

the rate of 1.01 words per second, making only four errors " After

studying the case carefully the following conclusion was reached in regard to her difficulties. "Knowledge of the rudimentary mechanics permitted her to read material far beyond her comprehension. She read words as names and not as symbols of ideas. The problem was plainly that of training her to read for content." 1

Remedial exercises included passages cut from second- and third-grade readers. The first of a series was very short; each succeeding passage was somewhat longer and made increasing demands on the reader to get the meaning. The following quotation describes the method which was employed in directing her attention to the content. "After she had given a reproduction of the 'story' and had answered a number of specific questions about it, she was asked to re-read the selection in search of any thoughts she had overlooked during the first reading. She then gave a second reproduction. This last reproduction was, no doubt, largely a result of the specific questions. Nevertheless, it was valuable in training the pupil to see the richness of content in the selection." At the conclusion of the training period the tests showed that she had improved in both oral and silent reading and that her interpretations were "fairly efficient."

Case III: A third-grade boy who was relatively strong in ability to interpret but who was greatly retarded in the mechanics of reading. — This case is practically the reverse of Case II. It is a very significant type because pupils who are thus handicapped will be unable to take full advantage of their powers of interpretation until they have learned to read fluently. The original report was submitted by Superintendent W. C. French and Miss Eleanor M. Johnson, Drumright, Oklahoma. The summary report which follows describes the fundamental lines along which remedial instruction was organized.

The subject in this case was nine years and nine months old. According to the Binet-Simon Intelligence Tests his I.Q. was 97. An examination of his reading accomplishments through the use of oral- and silent-reading tests showed clearly that he was very weak in the mechanics of reading but relatively strong in ability to interpret. His specific difficulties were (a) inability to recognize unfamiliar words, (b) repetitions, due to carelessness, periods of confusion, and inability to group words, (c) inaccurate return sweeps of the eyes from the end of one line to the beginning of the next, (d) a limited span of recognition, and (e) vocalization in silent reading. Remedial instruction was carried on for two thirty-minute periods each day for a month. Distinct and different types of exercises were given during each of the daily reading periods. In the morning an attempt was made (a) to increase his span of recognition, (b) to increase his ability to recognize words independently and

1 A condensed summary of the original report.

IO REMEDIAL CASES IN READING

accurately, and (c) to assist him in grouping words in thought units. During the afternoon period exercises were conducted (a) in oral reading to develop independence in recognizing words fluently, and (b) in silent reading to increase his rate of reading and also his ability to interpret. The tests at the end of the training period showed a notable increase in both oral and silent reading.

Case IV: A fifth-grade boy who read very slowly. 1 — 'Pupils who are able to recognize words accurately frequently fail to recognize them quickly or in large units and therefore read very slowly. Group silent-reading tests show that pupils who make equivalent comprehension scores differ widely in their rates of reading. This may be due to any one of a large number of causes, such as difficulties in recognition or inaccurate habits of eye-movements. In the case which follows slow rate of reading was attributed to the fact that the subject recognized a single word rather than a group of words at each fixation of the eyes.

Frequent tests and observations revealed the fact that this pupil read very slowly because he recognized words individually rather than in groups. "In order to provide training in the rapid recognition of groups of words, eight phrase books were prepared in which a phrase was pasted on each page. The first book contained ten very simple phrases cut from a primer. Each succeeding book in the series contained a similar number of longer and more difficult phrases. The eighth book contained phrases from a sixth reader. In conducting drill exercises the teacher flashed each page so quickly that the pupil had time for only one fixation. As soon as a phrase had been exposed, the pupil immediately told what he had seen. A grade of ten was given for each entirely correct response." Fourteen exercises were conducted with these drill books. A given book was not discontinued until a score of ioo had been made in two successive lessons. At the close of each lesson the boy was assigned a selection from his reader. At the end of a minute he was asked to indicate how much he had read. His scores showed that his rate of reading had increased from 60 words' per minute on the first day to 105 words per minute on the fourteenth, which was clear evidence of the effectiveness of the drill exercises. 2

Case V: A rapid reader who neglected details. 3 — Many pupils read very rapidly, neglecting many important details. This results in

1 William S. Gray, "Individual Difficulties in Silent Reading in the Fourth, Fifth, and Sixth Grades," Twentieth Yearbook of the National Society for the Study of Education, Part II, pp. 48-49.

2 A condensed summary of the original report.

3 Charles H. Judd, Reading: Its Nature and Development, Supplementary Educational Monographs, II, No. 4 (July, 1918), 160-61.

SIGNIFICANT TYPES AND CAUSES OF FAILURE n

inaccurate oral reading or failure to get all of the significant points in silent reading. In the case which is here described inaccurate habits of reading were due to failure to receive systematic training in reading while the subject was a youth.

The subject finds that he can read familiar matter at a rate as high as eight words per second. Difficult matter involves more effort and reduces his rate to two or three words per second. His eye-movements in silent reading are long, often covering phrases. In oral reading his eye-movements are more numerous to the line than in the case of most adults and involve many regressive movements. '• This person is a poor oral reader. He is conscious of inability to sound new words such as proper names. In silent reading he sees only the length of the proper name and a few conspicuous letters; he never gets the details. He learned to read as a child without' being taught — picked up reading, as it is said. He is a poor speller. He is quite irregular in his mistakes in spelling; this shows that he does not have wrong associations between sounds and letters but is lacking in stable associations. In mature years this person substituted a knowledge of the derivation and structure of words for sound associations. As a result he has improved somewhat in spelling but is easily confused and is never quite sure that he is right. He finds that if he must read a passage out loud it is very desirable that he practice it.

The case is significant for this report chiefly as a warning against the picking up of the reading habit by children. The danger is that the habits of seeing words and phrases will get established firmly and will include in some cases a sufficient vocabulary to remove all disposition to learn the details of word structure through phonic or letter analysis.

Only five types of cases have been described. Others which differ only in certain details might have been included. The following titles are illustrations: "The Slow Reader Who Compensates by Hard Work"; "A Sixth-Grade Boy Who Was Unable to Understand First-Grade Material"; "A Fourth-Grade Girl Who Was Unable to Apply Phonetic Training " ; and "A Sixth-Grade Boy Who Confused Many Words Which Were Similar in Form." These cases were not included in this report because it seemed advisable to emphasize at this time types of cases which are distinctly different from each other. It will prove helpful to teachers who begin diagnostic work to classify poor readers at first into groups such as the following: (a) poor in all phases of reading; (b) weak in the mechanics of oral reading; (c) poor in interpretation; (d) slow in silent reading; and (e) neglect important details. As investigation continues the number of distinct types will increase and the characteristics of each will be more fully known.

SPECIFIC CAUSES OF FAILURE IN READING

An effective diagnosis includes more than the determination of the general type of difficulty which a pupil encounters. The most important task of anyone who makes a diagnosis is to discover specific causes of a pupil's disability. McCall 1 has listed the following "common fundamental breeders of ability defects"; insufficient practice; improper methods of work; deficiency in fundamental skills; absence of interest; physical defects; and subnormal intelligence. Although a knowledge of these general causes of difficulty is valuable it is necessary to carry a diagnosis far enough to locate specific causes of failure in a particular phase of reading. For illustration, investigations have determined the following causes of failure in interpretation: inadequate mastery of the mechanics of reading, a limited meaning vocabulary; a narrow range of experience;, poor habits of thinking; and low native intelligence.

In the summary which follows no attempt has been made to include all the causes of failure which have been reported or to classify tbem either under the five general types of remedial cases, or under the "fundamental breeders of ability defects" as listed by McCall. Although the advantages of each of these classifications were fully appreciated, neither was attempted in this chapter because the data available were not sufficiently detailed or reliable to guarantee a scientific classification. The descriptions which follow are of greatest value in pointing out specific causes of failure in reading which must be considered in making diagnostic studies.

INFERIOR LEARNING CAPACITY

The fact is commonly recognized that many mentally defective children are unable to learn to read. In a large number of schools these pupils are assigned handwork and constructive occupations of one type or another in order to train them, if possible, to earn a living. On the other hand, there are many children of low native intelligence who have sufficient capacity to learn to read effectively, but who fail because they do not receive appropriate instruction. The following report 2 of a second-grade boy who had been in school for several years without learning to read emphasizes the importance of appropriate classification and very simple remedial instruction.

1 William A. McCall, How to Measure in Education, pp. 109-11. New York: Macmillan Co.,' 1922.

2 E. E. Keener, "Use of Measurements in a Small City School System," Journal of Educational Research, III (March, 1921), 204.

In one second grade the intelligence tests showed that the pupils ranged from moron to very superior in ability. They were arranged into groups as homogeneous as possible, taking into account the results of the tests, the scholarship records, and the judgment of the teacher. The members of the slowest group learned much more rapidly when taken from the regular classes. One boy with an I.Q. of 52 had been in school for a number of years without being able to read at all. In a group where other children were not greatly superior to him, he learned to read easy material. Until this arrangement was made the teaching went entirely over his head. On the other hand, the brightest group did much more than the normal amount of work for the second grade. Six of the brightest pupils were put into the next higher grade, and their present success indicates that they will continue to advance at more than the normal rate.

CONGENITAL WORD BLINDNESS

Some children who are otherwise normally endowed experience extreme difficulty in learning to recognize printed or written language. This difficulty has been denned as congenital word blindness, or dyslexia. It refers to inability to understand and interpret symbols rather than to inability to see them and is attributed to imperfections or lack of development of those areas of the brain which normally serve as centers for recording images or memories of printed or written symbols. The fact that cases of dyslexia have been found in several generations of the same family suggests that it is a hereditary trait. The following report 1 illustrates some of the important characteristics of a somewhat serious case.

L. R. at the first examination, age 9 years, graded 7.8 by the 191 1 Binet, being retarded 1.2 years (I.Q. 87), and about 8 years by the Seguin form-board, according to the writer's norms {Psycho-Motor Norms for Practical Diagnosis, 1916, Tables XL VIII and XLIX). At the age of n.i he graded 9.3 by the Stanford (or 9.6 by the 191 1 and 9.8 by the 1908 scale), being retarded 1.8 years (I.Q. 84), and about n. 5 by the Seguin. After six years in school (with frequent absences) he was reported as doing II-2 successfully. He was reported to be of "slow mentality," indifferent, lacking in sustained attention, and did his best work in arithmetic and poorest in reading and spelling. He required i' 53" to read to "near" in the Stanford selection (12 words), receiving aid on six words and read "the" for "three." He was diagnosed as a case of dyslexia, very backward in intelligence, but not feeble-minded.