Can't Spell, Can't Read

by J. ROSWELL GALLAGHER, M.D.

1

PARENTS, uncles, aunts, and teachers in constantly increasing numbers are asking what this talk about “left readers” and remedial reading really means. Is it all a fad? Or is it a fact that some children do have specific language disabilities? Do some children find it hard to learn to read and spell and write who have no difficulty with arithmetic and science? Many shrug all this off with the comment that there wasn’t any such nonsense in their day; that with good old-fashioned teaching such foolishness was unheard of; that anyone can learn to read or spell or write well if he will put his mind to it and try hard enough.

Johnny was fifteen when he entered the sophomore year of high school. Never before that time had he failed a course in school, but while mathematics had always been a “cinch” for him, English and Latin had taken a good deal of time, were “no fun,” and never yielded more than passing grades. He had never read more than his teachers demanded — reading was “too tedious.” When he had gone only a little way in his sophomore year he began to have trouble: school seemed much harder than ever before; history took much longer; he began to get failing grades in all his subjects except mathematics, and even that grade was lower than previously, probably because he was devoting almost all his time to his other subjects. The failures didn’t please Johnny a bit, and his parents not only became disgusted with him (they said he couldn’t be trying) but also blamed his previous school, saying it must have prepared him badly.

The stage was set for real trouble. If things had been allowed to drag on, it is almost certain that the boy would have lost confidence in his ability to do schoolwork, would have developed an apparent lack of interest in his studies, sought satisfactions in other fields, and, with continued disapproval, become alienated from his parents at a time when he was ready only to try his wings, but not ready to leave the roost. Luckily one of Johnny’s teachers was astute enough to suspect that something beyond the boy’s control was wrong, and suggested that the problem should be investigated. His parents reluctantly, and more out of desperation than approval, sent, him for a thorough examination.

Johnny was first given a few tests — a brief reading test, a spelling test, the writing of a short description of a simple picture, the reading aloud of a paragraph, and a test of arithmetical computation. At another time (for more than that amount of testing, even when well spaced and interspersed with other sorts of procedures, can become tiring and the results unreliable) he was given a WechslerBellevue test. This test attempts to measure basic intelligence and is little affected by previous schooling or one’s ability to read, both of which are very considerable factors in one’s performance on many of the written achievement tests — which are therefore inappropriate as instruments for the measurement of intelligence in anyone suspected of having a language disability.

Johnny’s tests were, from the diagnostician’s point of view, pleasingly clear-cut. His reading, though accurate, was rated by these tests to be at the fifth grade level, far below his placement (tenth grade) in school. His spelling not only was below the sixth grade level but showed such reversals, omissions, and confusions of letters and syllables as minotinus for monotonous, choaclet, clioachlet, choclet (no one can say he was not trying hard on that one!) for chocolate, bided for biped, strech for stretch. His handwriting was uneven and laborious, with many erasures and considerable evidence of variation in pencil pressure — all signs of insecurity and uncertainty at his task.

Johnny s arithmetic test, however, was finished with no errors and in less than the allotted time; it placed him well above his grade in school. In his written description of a simple family scene there was not only evidence of a limited vocabulary and a tendency to use short words (he probably thought of, but couldn’t spell, longer or more appropriate ones), but also hints of the family conflicts and antagonisms and his own frustration: the room had a “grim look,” the girl in the background “was making unhcpful [sic] suggestions” to her brother, who was “tired but studing [sic] hard.” In his oral reading a slight stutter was evident but his chief trouble came with words unfamiliar to him: acme baffled him completely. Johnny’s Wechsler-Bellevue Intelligence Quotient of 126, which ranks him in the top 3 per cent of the general population, was something which anyone who had seen his reading and spelling tests might find hard to believe.

This amount of testing and story has consigned many to remedial classes, and in Johnny’s case there was obviously enough evidence to indicate that special work to overcome his deficiency in handling language was what he needed.

Other factors, however, while not furnishing the main reason for a student’s trouble, might also contribute to it, and to determine their presence or absence prior to the adoption of a special program is the wise course to follow. What is the relation of his age to his school grade — although this is about average, is he young (from a developmental standpoint) for his years? Is he doing jobs or taking part in so many activities that they might interfere with his schoolwork? Is his vision good? Is his hearing all right? Does he like school or has he no real interest in it? How does he get along with the other boys at school — is he one of, or excluded from, the gang? Who else in his family has been a poor reader or speller or had any speech difficulty?

Johnny’s record contributed little on these points. He was of average age for his grade and of average size and maturity for his age. His eyes and ears were fine, and even an enthusiast would hesitate to suggest the need for determining his metabolic rate. He was doing no jobs and had only one or two outside activities besides athletics. There was no doubt about his interest in school and his desire to do well so that he could go on to college. He made friends easily, and gave every indication of being cooperative and industrious.

It was only from Johnny’s family history and from the boy’s own comments that any significant information came. How much the child himself can contribute is too often overlooked; he is usually able to make very helpful comments if one takes the time to let him tell his story. Johnny said he always had stuttered a bit, but that no one had ever mentioned it before — anyhow, it didn’t really bother him. He thought his reading was “awful slow’ — it takes me ages to get anything done.” “No, I never read books, they take too long.” His spelling was described by a single phrase which seems to offend most parents but for which I have developed a peculiar affection — perhaps because when I hear it I feel that we two are getting along together; maybe we can settle for “It smells.” “I don’t know why I spell so poorly — I’ve always studied hard, harder than other fellow’s — I just can’t seem to ’picture words.” “When I. write themes I look up a lot of words, but if I’m in a hurry I use easy ones. Maybe that’s why my teachers crab about my vocabulary but don’t say anything about my spelling.” Why, if he really studied hard and wanted to do well, was he such a poor speller and slow reader? “Well, maybe it’s got something to do with Dad. He’s a terrible speller.” “Well, yes, his brother, my uncle, is an awful stutterer, and my brother—if you think I’m bad you should see him. He’s in Tech now but he’s hopeless in English, and French slayed him.”

Johnny was fifteen when under the stress of keener competition and more difficult studies his handicap became obvious. But at a much earlier age he could, and should, have been given help. The fact that his disability went unnoticed as long as it did indicates that it was not a very severe one, suggests an answer to those who say that such things didn’t happen in their day (when a much higher proportion of children did not go so far in school), and makes one suspect that Johnny’s teachers were not familiar with these symptoms and not too interested in oral reading and spelling.

Specific language disability handicaps one boy in ten and is a relatively common cause of failure in school. Children who have this handicap do much more poorly in their studies, except arithmetic and science, than their intelligence level should permit; their handwriting is often uneven and slow; they are poor oral and silent readers; they spell badly; careful questioning may show that they were late in learning to talk, or they may have a slight stutter or lisp; and significantly, one usually finds within their families others who have trouble in handling language.

These children’s reading is not just slow: it is poor because of their tendency to read from right to left (was for saw); their omission, insertion, or transposition of letters or syllables (origional for original) ; their reversal or confusion of letters (radih for rabid); their confusion of words (faculties for facilities). Their spelling is not just incorrect, it is often bizarre: Jounior for Junior (with the capital reversed), hosipital for hospital, fineace for finance, heidous for hideous. Not. all children who have a specific language disability show all these signs of trouble, but each has enough to distinguish him from a child who is just a “slow reader.”

2

SPECIFIC language disabilities vary greatly in degree. Severe disabilities usually mean early scholastic failure; very mild disabilities may go unnoticed and be only a slight handicap. Not infrequently one will see schoolboys who are doing well in their studies and yet who are handicapped by a real language disability. If schools are to bring out the best in youngsters, it is well to remember that a language handicap can exist even if the scholastic record is good. The record would be better and the boy more efficient, particularly when the assignments get longer and the type of reading more difficult, if a greater facility in handling words were developed.

Sometimes a good student is reluctant to accept help; he feels that his reading is “good enough.” One such protest from a sixteen-year-old lad who read at a fifth grade level I shall not soon forget: “I’m all right, Doc. But when I read thorough, I read slow.” That remark has never had even close competition for the Understatement Prize.

Bill did very badly on a spelling test sprung on him by a teacher who thought such an exercise would break the monotony. It did. Bill would have done well had he had a chance to study the list, but this time he turned in a paper covered with erasures, letters traced over and crossed out, and a great series of such errors as bargian (bargain), cirular (circular), hurring (hurrying), gradatvde (gratitude), and frabicate (fabricate). Why did he do so badly? I should be permitted to answer a question in an Irishman’s way—by asking why does a stutterer stutter worse when he is unprepared; why does the public speaker stumble most when he feels the crowd is not with him; why do none of us do well when we are nervous?

Bill admitted that he was a terrible speller. “I’ve always spent a lot of time learning spelling lists — some of the dumbest guys don’t spend half as long as I do.” He said his father never read much and that his mother “couldn’t spell anything.” Bill’s reading was good (though not up to the level of his intelligence), he had no speech defect, and his handwriting, though irregular, was at least legible. Had he not been given an unannounced spelling test, his specific language disability might never have been discovered. Yet here was a sixtecn-year-old boy, with a high scholastic average and a WechslerBellevue Intelligence Quotient of 140, making such errors as desrible (desirable) and ingrucous (incongruous), alough (although) and collusion (collision), and telling me that his spelling was a nuisance and he wished someone would get interested in it.

So far nothing has been said of girls. Neither discourtesy nor oversight, but the fact that fewer females than males have this disorder, explains my seeming negligence. Only about one per cent of girls suffer from this difficulty. The evidence suggests that there is a hereditary factor which is apparently sex linked and more frequently produces the tendency to a specific language disability in males than in females. Stuttering and defects in color vision arc also more common among boys than among girls.

How can one tell whether a child’s school failures develop out of a specific language disability? A specific language disability isn’t an acute brief illness which may cure itself before an accurate diagnosis can be made: it, isn t like Influenza A, which can t be positively distinguished from Influenza li until after the patient is well and back at work. It is a long-drawn-out affair and so is its treatment. It is wise to take time to make sure the diagnosis is correct.

More than one factor may be present: a retraining program which depends in part on what the child can learn by ear and eye should not be started until his hearing and vision have been examined. Someone—teacher, family physician, pediatrician, psychologist, neurologist, or counselor — should make an objective estimate of the situation and the child, and leave no stone unturned to get at all the possible causes or contributing factors. All this need not be too time-consuming or expensive or require special skill or training. No hairline distinctions need be made; a slight diminution in hearing, a little variation from normal vision, are certainly not significant.

Emotional disorders are important; but unfortunately homes completely equipped with persons expert in the field of interpersonal relationships are not numerous. The fact that Father is frequently “unavoidably detained” at the office or props his breakfast paper against the anniversary flowers, or that Mother has “sick headaches” whenever Uncle Charlie comes to visit, need not be significant. More often it is the child’s own feelings of frustration, developing out of his inability to improve his low standing in school, which produce his emotional difficulties. These begin to clear up as soon as he believes he is in the hands of someone who understands his problem and is helping him to conquer his schoolwork.

Too often parents seem to forget that large numbers of children who are nowadays subjected (or exposed!) to advanced schooling would have gone no further than the fourth grade in Grandfather’s day. Most would have had only a little of the three R’s and then gone to carpentering or clerking in the store — something that would help to send Willie (the bright, delicate one who was always reading) off to Yale to learn to be a preacher. In those days Big Brother didn’t have to go on to college because Dad graduated from Amherst and Mother from Smith, or because Mom wanted him to have all the advantages which Pa did so nicely without; so there weren’t all these problems about getting him through school.

All those big brothers now go on beyond the fourth grade, and many of those who have a specific language disability get into trouble. And so do a good many others who have neither the superior intelligence nor the interest in going to school which are necessary for success. It may be very desirable to increase the extent of everyone’s education, but it should be evident that the extension of this policy may explain the apparent increase in the number of persons who have a language disability, there probably were just as many in the old days.

3

So MUCH for what one can do to determine whether a child has a specific language disability, and for the question of whether this condition is increasing. Those who have this handicap to academic success can be helped, and to a very considerable extent, but what can be done to prevent its development? Is enough known of its cause so that methods of prevention and treatment can be devised?

The cause of the development of a specific language disability has not been undisputedly proved, and there is considerable disagreement among those who have studied the problem. However, a working hypothesis suggesting methods of treatment and of prevention has been developed. The term “specific. language disability” should be applied only in those instances in which a child’s ability to write, spell, read, or talk is definitely below the level of his general intelligence and his skill in dealing with numbers, and within whose family one finds others who lack facility in the handling of words. From this it should be clear that we are not including within this group all who perform poorly, on spelling, writing, or reading tests; many of these perform poorly because of poor previous training, lack of interest, or low intelligence. Obviously there can be just as wide a range in reading skill as in other skills: poor skill is not the same as disability.

The nature of the errors, as well as the fact that there is usually trouble in more than one aspect of handling words, indicates that the primary cause is to be found in some variation of the cerebral language mechanism from the norm. Thirty years ago an Englishman, James Hinshelwood, suggested that children who had trouble in learning to read might have some developmental disorder in the area of the brain from which words are recalled; and more than twenty years ago Samuel T. Orton, an American neurologist, began his researches into the cause of specific language disabilities. It is he who developed the theory that reversals, mirror writing, and confusions in spelling and reading result from a failure to develop a distinct dominance of one cerebral hemisphere over the other. He believes that an impression of every word is stored in the language center in each hemisphere of the brain, and that the word as stored in one half of the brain is the mirror image of that stored in the other. In most persons words will be consistently recalled from one side of the brain and no confusion will result, but in those who have not developed a dominance of one hemisphere over the other, letters or words which are the mirror images of their counterparts may occasionally be recalled from the opposite hemisphere, thereby producing the delays, the confusions, and the reversals which we have been discussing.

This hypothesis does not suggest any abnormality or deficiency of the brain or its language mechanism, but only a hereditary tendency to fail to develop complete dominance of one cerebral hemisphere. There has been considerable disagreement with this theory, and much misunderstanding of the relation of handedness to cerebral dominance and to language disabilities. It is a fact that the actions of one hand are guided by nerve centers on the opposite side of the brain, but the Orton theory has never suggested that left-handed children are very likely to have language disabilities! It does, however, seem to be true that in those children and families where language disabilities exist, there is more apt to be ambidexterity and mixture of eyedness, handedness, and footed ness (all suggesting that a complete dominance of one hemisphere is not present) than in other children and their families.

Such disagreement as there has been seems to have grown out of a misunderstanding of the postulated relationships between degree of cerebral dominance — as shown in inconsistencies of eyedness and handedness — and language disabilities; and also out of fundamental differences in definition of the term “specific language disability.” If one cannot accept the Orton theory as the correct one, at least it should be accepted as an excellent working hypothesis. It has offered implications for treatment which have proved invaluable.

Teaching methods which will ultimately permit children with a specific language disability to read aloud and to themselves satisfactorily, to spell without reversing the letters of words or confusing such letters as b and d, and to write more fluently must be designed firmly to impress and reimpress visual, auditory, and kinesthetic memories of letters, syllables, and words upon one hemisphere so that these records will be vivid and dominant. Letters and words must be seen, heard, spoken, and written; by repetitious drill, with the teacher always watching what the pupil’s hand writes, one can gradually but steadily develop memory associations for sounds and words which later can quickly be recalled without confusion. This is the basis of remedial training for those with a specific language disability. It is tedious, time-consuming—and productive of very gratifying results.

It implies, too, a method of prevention. If all children in their first year at school could be divided into those who show and those who do not show evidence of a language disability, much grief might be avoided. To select at an early age children who lack facility in handling words is not easy, but it can be done by an astute, trained person experienced in dealing with young children.

That these children should not be forced to learn to read until they are emotionally and physiologically more mature, and that they must be taught by the “old-fashioned” phonetic method of teaching reading rather than by the whole-word flashcard method, is obvious. A willingness to recognize and help these children without resorting to methods which label them as queer or problems should help to prevent the unfortunate emotional complications which so frequently develop when this type of disability goes untreated.

At the present time there are four great obstacles to progress. First, we must discriminate carefully between those children who are merely slow readers and those whose difficulty is the more complex language disability which is manifested not only by slow reading but also by “left, reading,” reversals, bizarre spelling, and other signs of inability to deal with words in a satisfactory manner. To fail to distinguish between these two groups, and to fail to give a different type of remedial work to the second, is to furnish them with little hope of improvement.

Making a good reader out of a slow reader and making a better reader (as well as talker, writer, and speller) out of a child who has a specific language disability arc assignments which call for quite different treatments. The slow reader needs a few suggestions and practice; whereas the other boy needs to develop confidence, coordination, and rhythm. He must have a long period of drill on fundamentals — on the component parts of his final activity — before he can be told, with just a few hints as to method, to “go practice.”

A second stumbling block to progress is some teachers’ reluctance, if not inability, to pick out early those children who have a true disability. Some are uninformed; others seem to feel it a criticism of their teaching if such lads exist in their classes. In too many instances special help may not be available; but if the cause of failure is recognized, allowances can be made, programs modified so that superior aptitude for mathematics and science can be exploited, and an explanation be made to parents so that the child need not have punishment and discouragement piled upon handicap.

The third obstacle is parents’ resistance to any explanation of their offspring’s failure which involves even a hesitant use of the word hereditary or neurological or brain. The inexperienced counselor who flippantly suggests that the child was careless in his choice of parents will quickly find that his brand of humor is unappreciated, but usually one can convince the parent that nothing queer or abnormal is implied, and that the sensible thing is to be thankful that the child has inherited a tendency which can be alleviated. Even if it is not remedied, but is just properly understood and properly managed, it will not prevent his being a very useful and happy citizen. Until all parents seek and accept in an objective, unemotional fashion this sort of advice and information, many youngsters will be deprived of help and understanding.

The fourth, but not the least important, hindrance is the dearth of well-trained remedial teachers and the fact, that many schools, both public and private, do not furnish special teachers for those who represent between 5 and 10 per cent, of their students. Sometimes the “budget” is the reason; sometimes it is the unenlightened “We don’t want to be known as a refuge for problems” (it would seem that a reputation is insecure indeed if the accusation of helping industrious and intelligent but handicapped children will destroy it!); often it is reluctance to take on something unfamiliar to a principal. Centers for the proper training of remedial teachers arc not numerous, but more can be developed and the capacity of existing centers can be increased, if there is a persistent demand from parents and educators and if funds sufficient for their support are made available.

Intelligent, industrious children who have a specific language disability can be helped. Try to recognize and then to understand such children. Given proper remedial aid, many of them have done fine work in our best colleges and professional schools. They are not queer, they are not problems. They offer the teacher a challenge and an opportunity.