In the nineteenth century, Horace Mann began "the reading wars" when he raged against instruction in phonics, calling the letters of the alphabet "bloodless, ghostly apparitions." In the 1930s, the publisher Scott Foresman introduced its "Dick and Jane" readers, which taught children to read by memorizing the look of words rather than the sound of letters. In 1955, Rudolf Flesch's Why Johnny Can't Read attacked Scott Foresman's "look-say" approach. In 1995, California passed its "ABC" laws requiring instruction in phonics and spelling skills. Californians acted after their state, which had been using a "whole language" approach since 1987, received the lowest fourth-grade reading scores in America.
In 1997, the U.S. Congress made its presence felt. Concerned about the growing split between parents and educators, Congress set up the National Reading Panel. Its charge was to determine, from existing research, the most effective approaches for teaching children how to read, in the hopes that the panel's findings might influence the teaching of the children in schools and the home. The National Reading Panel delivered its final report on April 13, 2000.
Navigator has asked James J. Campbell, a New York pediatrician with a deep concern for childhood education, to give us his assessment of the panel's findings, but first to relate some of the personal experiences that have provoked his concern—and his anger.
The number of children referred from the schools for medical evaluation and treatment of Attention Deficit Disorder (ADD) and Attention Deficit/Hyperactivity Disorder (ADHD) has been increasing substantially each year. Paralleling this development, the use of psychostimulant medications in children has risen dramatically. Assessing these children in a general pediatric practice over the past several years, I have become aware that, for a rather large portion of these children, the cause of their problems is the failure of the school's instructional program to teach reading rationally and effectively.
More tragically still, authorities and teachers in the schools do not acknowledge this fact and refuse to make the appropriate changes for the individual child. Instead, there is vehement denial that the instructional program could be at fault. Therefore, corrective measures are not taken, and the child and family are made to suffer continuing blame and humiliation.
Parents are told that their children have disabilities, when in fact they do not. Families are subjected to misinterpretations of their children's abilities and behavior. They are told that they do not provide enough attention to their children; that family stress is the cause of the child's trouble; that the child lacks self-esteem; that psychological or social services are necessary. They are told that medications are required to correct the child's ability to "focus," or "stay on task." In many instances, all of this is false. The child merely needs to be taught how to read.
Let me describe some typical cases of this phenomenon.
An eight-year-old boy near the end of second grade was brought in by his mother at the prompting of school officials, who were convinced that he had Attention Deficit Disorder. He had been generally healthy and had always been considered a bright, intelligent boy. His behavior at home was typical for a child his age. In his second year in school, however, teachers complained that he would "not stay on task," was "unruly," interrupted the class often, and "couldn't stay in his seat." His performance in school worsened. He was given extra reading, at which he made "adequate progress." The mother was told that she did not spend enough time reading to him, although, in fact, he read together with family and relatives nearly every day. (This was greeted with frank skepticism by the school.) His behavior in school became very bad. He would scream at the teacher and at the principal. He pulled down a bookstand. When the school psychologist evaluated him, he had a very high Conners Scale rating (an index of hyperactivity and distractibility). Finally, the family were told that he must have a medical evaluation and should be put on medication.
I found that he was perfectly normal and healthy. On inquiry, I learned that he did enjoy reading with someone, but that he would quickly abandon the activity if he were expected to read to any significant extent. If he were pressed to read more, he would become unruly. It was reported that he would often ask his mother and grandparents if they thought he was "smart." He was worried that he was "dumb." I determined that much, if not all, of his behavior problems in school occurred during reading classes.
i suspected that he could not read. His mother was shocked. He was tested outside of the school, and it was determined that he was reading only at an early first-grade level. He had virtually no phonetic skills. In fact, he had been explicitly told by his teacher not to sound out words. His reading teacher was asked what program was being used, and she answered Language Arts (Whole Language). In his remedial class, the same program was used, despite the fact that he still could not read after nearly two years of instruction. The teachers, however, expressed satisfaction with his reading progress, noting that he was going at his own pace. When the teacher was asked if a systematic phonetic approach should be used, the answer was an emphatic no, with the assertion that this would be inappropriate and that the school would not allow such a thing.
After a discussion of alternatives with the parents, a direct and systematic instruction of reading using a phonetic approach was provided by private tutoring twice weekly. Within three months, the boy was reading at a late fourth-grade level and all of his behavior problems had been resolved. At the end of fourth grade, he was reading at nearly a seventh-grade level and was regarded as a "reading master"! Comments on his report card rated his behavior as wonderful. His achievement in all of his subjects improved dramatically. In conference, school personnel were happy with his progress. When the mother disclosed that he had had phonetic tutoring, the reading teacher indignantly remarked that this fact had nothing to do with his improvements. According to her, he had simply "matured into reading."
Another child was brought in at nine years old, at the end of fourth grade. He was passing school, but was not "performing to potential." He had attention problems in school, but his behavior was not terrible. He was, however, particularly disruptive and hyperactive at home. His mother remarked that he had always been taught to respect adults, but, over the past year or two, had developed quite a negative attitude about his teachers and about adults in general. He liked school but mostly the activity periods. When asked, "If you are in reading class and the teacher calls upon you, how does it make you feel?" he started immediately to cry. He left the examination bench, went over to his mother, and cried on her shoulder. He looked at her and said, "Mommy, I can't read." The school would not consider a phonetic teaching program, claiming that they "employ phonetics" in their program. After two months on a phonetic program, he showed marked improvements. In fifth grade, he enjoyed school much more and was reading above grade level. His after-school anger and hyperactivity totally ceased.
Then there was a nine-year-old boy who came to evaluation because of serious behavior problems in school. He was making a ruckus in the classroom. He was aggressive towards others, and, in a sign of his own depression, had been engaged in some self-destructive behaviors. He was also doing poorly in class. I determined that he was somewhat over two years behind in his reading. But he was getting "remedial help," and the school authorities were satisfied with his progress. They did not accept the thesis that his behavior had anything to do with his reading problems.
Although skeptical, his parents enrolled him in a learning center, which confirmed his reading level and his lack of fundamental phonetic knowledge about reading. He was tutored twice weekly using a phonetic method. Reading is now this child's favorite activity. Over the summer, his reading came up to grade level, and he attended school the following year with a good attitude and no behavior problems. The family moved out of the school district because of the district's attitudes about reading instruction.
I also had an eleven-year-old patient who was preparing to go into the sixth grade and who had been considered as having ADHD for some years. He had been on and off medications, and now the school was insisting that he be put back on medication and that "something be done." When tested in my office, we discovered that he was reading at a preschool level. He had no concept of how the alphabet works and in a first-grade reading sample could only read the word "in." I suggested that he should be in school only for half-days and only for reading activities; and that he be put back into the classroom when his reading proficiency allowed him to function in a fourth- or fifth-grade classroom. School authorities wanted him removed from his home and put into a detention home. For several months, he was in school with phonetic tutoring on the outside and was brought to the third-grade level. His confidence level was increasing and his behavior somewhat improved. He then lost his outside reading tutorials, and the school would not provide a phonetic program. He was maintained in a full-day, fifth-grade class, and his reading fell back. Tragically, his behavior again deteriorated, and he was put into a detention home.
Lastly, a young lady came to my office for evaluation because of depression after having flunked her first semester in college. She was always considered to be a bright child, but had trouble with reading. The school was aware of her reading problems, but did not consider these serious, particularly since they saw "steady progress." Therefore, her reading grades were not bad. When tested, however, she proved to be reading at a sixth-grade level. She found it difficult to accept that her reading skills were so poor, despite having graduated from high school. After much discussion and encouragement, however, she was finally motivated to begin tutoring in a phonetic program, and she was able to improve her reading level by several grades in a short time. She returned to college the following year, and the college agreed to continue her tutoring program for a year.
Such cases occur in a medical practice on a continuing basis. Some are more dramatic and disheartening. The general characteristics of these cases can be summarized into two broad groups: (I) children from kindergarten to approximately fifth grade; and (II) children from fifth grade to high school.
The characteristics of the first group are: (1) Usually, but not uniformly, the child did not have serious behavior problems before going to school. (2) The child is disruptive and does not stay on task. (3) The child has poor attention skills. (4) He often misbehaves. (5) The behavior problems often occur in association with reading or reading-related tasks. (6) The child is angry at, or dislikes the teacher, but cannot give a good reason why. (7) The child may develop negative attitudes toward adults in general. (8) Hyperactive behavior occurs in school and/or at home. (9) The child may have been identified as having trouble with reading, but the school does not think this is a problem. (10) The level of reading deficiency is often not described accurately or specifically. (11) Annual achievement-test results are lower than would be expected from the report-card reading evaluation. (12) If tested, the child is significantly delayed in reading skills. (13) Phonetic and decoding skills are typically absent or very poor. (14) The child has great difficulty spelling. (15) The child is confused about letters. (16) Sometimes, the child does not even understand that reading proceeds from left to right, and top to bottom. (17) The child often thinks that he is "not smart enough," or "dumb." (18) When asked how he feels in reading class, the child responds "I feel sad," "I feel dumb," or "I'm embarrassed."
The second group comprises children from fifth grade to high school. In this group, one observes a transition to increasing negativity, alienation, and morbidity. The child moves from disliking his teacher, to disliking reading, to alienation from reading and learning. He moves from worrying that he is dumb, to being convinced he cannot learn, to being depressed and angry with school and adults. The characteristics seen in this group are: (1) The child has poor attention skills. (2) Over time, the child becomes oppositional rather than simply disruptive. (3) The child comes to hate reading and seldom reads on his own or with anyone else. (4) Older children in this group no longer like school. They would rather not be there, or they like only specific activities. (5) The child cannot concentrate well. (6) The child often forgets what he has read almost immediately. (7) The child will not admit that he has reading difficulties. (8) He begins to skip school. (9) He is less and less interested in undertaking a different type of reading program because he thinks it is pointless.
The children in these two groups are perfectly normal. Classified and managed as disabled, they are not disabled. Instead, they have failed to learn phonetic skills because the school does not teach them these skills explicitly and systematically. Furthermore, the schools do not acknowledge these deficiencies or correct them with direct systematic teaching.
Typically, the child is promoted to higher and higher grades no matter what the level of deficiency or confusion is present. But each higher grade requires more efficiency in reading mechanics and comprehension. Thus, the child is put into a double bind: His reading skills are ignored, but the demands on his reading skills are continually increasing. Children begin to feel that they are dumb and unable to learn, and the actions of the schools and teachers convince them that this is true.
The younger children are still in the stage where they believe that adults are all-powerful and all-knowing. Their perception is that the teacher "knows" that they cannot read. Thus, the mere fact that the teacher calls on them to read makes them feel that he is being mean or picking on them. In order to avoid public disclosure of their inability to read, they act out, or take various measures to avoid being called upon. Since they cannot read well, they cannot follow the work in class, and they appear to be "not on task," and "inattentive." They are not paying attention—because they cannot. As time goes on and years go by, not paying attention becomes a mental habit and an escape. Thus the fundamental skill of the mind—focusing attention—is insidiously corrupted. And as the amount of reading skill required in class work increases, the child is "lost" for a larger and larger fraction of the day. He becomes disruptive. (Imagine your emotional state after spending an obligatory six hours a day in an environment in which you could not "connect" and in which you felt largely incompetent.) In the end, the child is intellectually and emotionally alienated from learning and from school, and his behaviors show this quite clearly. He loses any commitment to academic activities, or may even become truant from school as a young teenager.
In this story, the ignorance starts at the top. It is too far afield from the plight of these children to discuss the story here. But it is important for parents to realize that most education schools have, for over thirty years, demeaned or failed to teach phonetics to teachers. Reports, including a recent report from the National Institutes of Health, document that few teachers know how to teach phonetics in the direct, systematic, intensive fashion required for success. This is another basic reason that schools and teachers take the positions they do. In any case, even if teachers do not agree with the schools' policies on reading instruction, they are under an obligation to teach in accordance with them.
Another area of confusion is on the medical side. Parents should understand that most physicians know little about pedagogical issues. They tend to take for granted the fundamental validity of educational and related psychological evaluations coming from the schools. They then search for a known medical condition that might cause the reported problems. Often, behaviors are grouped together into a syndrome most commonly known as ADD or ADHD, and these medical categories are used to rationalize the behavior of ill-instructed children.
Thus, anyone with a child who has been given the label of ADD or ADHD should have that child's reading evaluated by someone with a thorough knowledge of phonemic and phonetic teaching. If the child's reading skills are significantly less than they should be at his age, the child should be taught reading using a direct, systematic phonetic approach, and his response monitored. If the child's problem has in fact been mislabeled, the response to such instruction is often early and dramatic. But remember: for a sustained result, the instruction must be continued, and educators may attempt to interfere, limit, or compromise the phonetic teaching.