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From: patth@sci.ccny.cuny.edu (Patt Bromberger) Newsgroups: misc.handicap Subject: Paper on Reading Disabilities Message-ID: 27023@handicap.news Date: 8 Jan 93 20:00:12 GMT Originator: wtm@sheldev.shel.isc-br.com Lines: 1736

Index Number: 27023

    NEUROPSYCHOLOGICAL BASES OF EDUCATIONAL DISABILITIES
         Implications for Diagnosis and Remediation
        Expert Paper Submitted to the United Nations
                   Disability Unit, Vienna
                       February, 1990
                  Robert Zenhausern, Ph.D.
                   Professor of Psychology
                    St. Johns University
                      Jamaica, NY 11439
                             USA
                        INTRODUCTION
   The paragraphs below are in the form of a satire based on the

essay by Jonathan Swift entitled "A Modest Proposal" in which he presented a solution to the "Irish Problem". The parallel here is Learning Disability and the inflexible ways these children are taught. It is the objective of this paper to show that the problem of the learning disenfranchised is one that can be solved by increasing the flexibility with which we teach.

Another Modest Proposal:
             A Swift Response to an Old Problem
 The purpose of this essay is to examine the possibility that we

are systematically doing a disservice to a large segment of the school population. Students who have auditory or visual impairments have been allowed to use artificial means, such as glasses or hearing aids, to correct their deficits. Indeed, it is considered praiseworthy to identify such problems early and then use the services of professionals who prescribe optical or electronic devices which alleviate the deficiencies.

 The consequences of such actions, however, have not been

considered fully. Such children may become lazy and make no attempt to overcome their problems. What motivation will they have to strengthen their perceptual weaknesses when such devices make it unnecessary for them to do so? What will such people do if, for whatever reason, such devices are not available? It is the contention of this paper that artificial devices are crutches which interfere with the complete development of the child. As such, they should be eliminated.

 Some might argue (and not without a modicum of validity) that

by eliminating those "support systems," such children may not progress beyond the elementary rudiments of learning. That, however, should be secondary to the point that we are not dealing directly with a serious problem. The fact that our present state of knowledge does not allow us to correct such deficiencies should not dissuade us from this course of action. Eventually specific techniques will be developed to meet the problems of poor eyesight and hearing in much the same way that techniques were developed to alleviate reading and mathematical difficulties – and probably with as much success. There is a minor problem in the fact that many of the authority figures in the child's environment use those same artificial devices and thus do not serve as good role models.

   Aside from the educational wisdom of this proposal, it has the

added advantage of eliminating the possibility of charges of discrimination. Consider, for example, if someone raised the point that a deficit in vision or hearing might be compared to a deficit in arithmetic computation. They might argue that if vision can be corrected by glasses why can a calculation deficit not be corrected by the use of a calculator? It is difficult to counter these arguments since the two deficits have so much in common. Even the poor role model problem has a parallel since most of the authority figures whom the children contact would have some difficulty in taking a square root or doing long division of decimals by hand. The conclusion is clear: take away glasses and hearing aids and give the children with sensory defects the same advantages given to children with calculation defects!

  • * *

The essay is clearly satirical, but its point is clear. In this Decade of the Disabled it is essential to consider the human rights of the Learning Disabled to an education that more closely fits their capabilities. The problems of the Learning Disabled are unique because this is the only disabled group which is held responsible for its disability. "If he worked harder, he could do it", says the frustrated teacher. No one expects a blind person to see, if he or she "worked harder". Furthermore, to call a child "learning disabled" is to put the burden of responsibility on the wrong person! It is our responsibility to teach much more than it is the responsibility of the child to learn. It is we who should be called teaching disabled. The purpose of this paper is to focus attention on individual differences among both normal and learning disabled children and to consider alternative approaches to education and thus eliminate our teaching disability. The major emphasis will be on the theory and remediation of reading disability based on a 10 year program of research within a neuropsychological framework. The initial Chapter will introduce the concepts of cerebral asymmetry and hemisphericity and put them in perspective for education today. The second Chapter will discuss behavioral and physiological measures of individual differences in neuropsychological functioning. The third Chapter will describe a study that underlines the importance of these individual differences in an educational setting. The fourth and fifth Chapters will describe a series of studies dealing with the theory, diagnosis and remediation of reading disability that has been based on these neuropsychological concepts. The final Chapter will be a summary that includes the basic information on the Direct Access approach to reading with specific recommendations. It can serve as an abstract of the whole paper.

   This Introduction ends with a short quote, found hanging on

the walls of an elementary school in Greensboro, North Carolina and attributed to Ken Dunn.

If children cannot learn the way we are teaching them, then we must teach them the way they can learn.

                          CHAPTER 1
THE CEREBRAL HEMISPHERES OF THE BRAIN AND THE NEW PHRENOLOGY
   Recent work in the areas of neuropsychology, especially that

of Sperry who won the Nobel Prize, has popularized the notion of cerebral asymmetry. That is, the two hemispheres of the brain are different in terms of the cognitive processes in which they excel. There is clear evidence that the Left Hemisphere has unique control of expressive speech and operates using a sequentially organized system. The Right Hemisphere, on the other hand, has systems that are more capable of spatially and pictorially oriented processing.

   While there are clear differences between the hemispheres,

these differences have been overgeneralized into a new phrenology of brain functions. A typical list of "Left Hemisphere Functions" reads something like: logical, verbal, analytic, inductive, controlled; the Right Hemisphere is often called: synthetic, emotional, deductive, intuitive, and abstract. Some of these labels are self-contradictory. The Left Hemisphere is called both analytic and inductive and the Right Hemisphere both synthetic and deductive. The term "abstract" has two diametrically opposed meanings: an article abstract versus abstract art. These inconsistencies aside, this neo-phrenological approach must be rejected on the grounds that it is atomistic. A hemisphere is neither verbal, logical, emotional, nor creative; it is a person who has these characteristics! All behavior flows from the integrated functioning of the whole brain. This does not mean, however, that there are no individual differences associated with the brain. The concept of Hemispheric Related Strategies provides a framework on which to base an individual difference variable.

   For the most part, the two hemispheres do the same things but

do them using different approaches. Cerebral asymmetries reflect relative efficiency rather than a "can do-can't do" dichotomy. There seems to be one exception to this relative rather than absolute difference between the hemispheres: for most people, only the left hemisphere is capable of speech and of phonetic representation (Levy, 1974). The isolated Left Hemisphere can tell whether the two words "though" and "blow" rhyme but the isolated Right Hemisphere can not, even though it may understand their meaning. Rhyming demands that the written word be converted to an auditory form and only the left hemisphere has this capability.

 A second factor that differentiates the two hemispheres is their

type of processing systems: sequential for the left hemisphere and parallel for the right hemisphere (see Bradshaw and Nettleton, 1981 for a review.) Compare these two situations: 1) You are given a description of someone and must then identify that person; and 2) You are shown a picture of the person and then must select the person. The first task demands the sequential system of the left hemisphere–the words, descriptive of the various facial features, are read in sequence and must be combined into an overall perception. The latter situation reflects the parallel system of the right hemisphere – the picture is seen as a whole and various facial features can be extracted. The picture is seen all at once in parallel while the verbal description must be sequentially processed. The sequential processing system of the Left Hemisphere and its ability in speech production are the characteristics that underlie the notion that the Left Hemisphere is the verbal hemisphere. Language, by its very nature, is sequential. Word order and syntax are essential to meaning– language cannot be easily processed in parallel. Thus the left hemisphere has been labeled the "verbal" hemisphere because its sequential processing system is compatible with the sequential nature of language, and its control of auditory linguistic processes makes it essential for speech.

   For other tasks, even though the processing system of either

hemisphere is compatible with the task, one hemisphere is clearly superior. The example of face recognition shows intuitively that the Right Hemisphere pictorial approach is better than a Left Hemisphere written description. Note, however, that the task can be done using Left Hemisphere strategies, but it takes a thousand words to describe one picture. Spatial relations tasks are also more easily handled using Right Hemisphere processes. Other tasks can be handled equally well using the strategies of either hemisphere. For example, a list of words could be learned by converting and storing them as visual representations or in an auditory form. The term Hemispheric Related Strategies can be used to describe this relationship between observable behavior and its underlying neuropsychological bases.

Hemispheric Cognitive Style

   Two individuals, when faced with the same task, do not

necessarily use the same strategies, that is, people do things in different ways. Sometimes those different approaches can be associated with processing differences between the two cerebral hemispheres. These different approaches can be termed Hemispheric Related Traits. Hemispheric Cognitive Style is the tendency of an individual to use distinct patterns of Hemispheric Related Traits. It does not imply that one hemisphere is used exclusively, but that individuals tend to approach tasks in unique and consistent ways. For example, if a group of individuals were asked to remember the words "dog, cat, tree, table, chair", few would have difficulty. If these same individuals were asked what strategies they used, there would be wide variation. Some would report they repeated the words to themselves, others that they "saw" the written form of the word, and others would create images of the words.

   These differences in memory strategies can be related to

Hemispheric Related Traits. A person who would be more likely to use imaginal strategies could be said to use a right Hemispheric Related Trait, and a person who used auditory strategies could be said to use a left Hemispheric Related Trait. Some individuals tend to use the Hemispheric Related Traits associated with one hemisphere more than those of the other hemisphere and others show little or no bias. Those who do favor the Hemispheric Related Traits of one hemisphere can be said to have a Right or Left Hemispheric Cognitive Style. It is important not to overgeneralize the scope of Hemispheric Cognitive Style. The fact that a person tends to use particular strategies implies neither a disuse nor deficiency in one hemisphere of the brain. On a very simple level, a right Hemispheric Cognitive Style individual has access to the speech centers of the left hemisphere just as a left Hemispheric Cognitive Style individual has access to the prosody centers of the right hemisphere. Thus both right and left Hemispheric Cognitive Style individuals rely on the integrated functioning of both hemispheres for expressive speech, and, in fact, all behavior. In an intact individual, no task can be accomplished without the integrated functioning of both hemispheres. To call an individual "left or right brained" is to ignore the fact that all activity depends on the integrated functioning of the whole brain. These differences, however, can be related to different strategies with which people approach specific tasks. One purpose of this paper is to show how these strategy differences can affect the educational system. The next chapter will describe how differences in Hemispheric Related Traits can be measured. The following chapters will focus on the application of these traits to mainstream and learning disabled education.

                          CHAPTER 2
       THE MEASUREMENT OF HEMISPHERIC COGNITIVE STYLE
   Two distinct tools have been used in the measurement of

Hemispheric Cognitive Style, one behavioral and the other physiological. The behavioral measure is a self rating questionnaire and the physiological measure relies on the predominant direction of Lateral Eye Movement (LEM).

The Hemispheric Preference Questionnaire

   There are many questionnaires that have been used to measure

"hemisphericity" including many from popular magazines. Over the past 12 years I have developed an instrument that has been successfully used to separate right and left Hemispheric Cognitive Styles. A copy of the questionnaire and its scoring key has been included. The following studies used the instrument successfully. Coleman and Zenhausern (1979) compared those who used right and left Hemispheric Related Traits on a memory retrieval task. They found the two groups differed on processing speed and the extent of a left hemisphere bias induced by a verbal memory load. The bias was four times stronger for the those who use left Hemispheric Related Traits than for those who use right Hemispheric Related Traits. Zenhausern and Nickel (1979) found that Right style individuals learned a finger maze in fewer trials, in less time and with fewer errors than Left style individuals. Zenhausern, Notaro, Grosso, and Schiano (1981) presented right and left style individuals with auditory messages in which there was a conflict between verbal content and emotional tone of voice. Overall, those who used right Hemispheric Related Traits responded significantly more often to the inflection cues and those who use left Hemispheric Related Traits significantly more often to the verbal content. Zenhausern and Dunivin (1981) found that left style subjects were more obsessive compulsive, while right style subjects had more hysterical traits. Zenhausern and Parisi (1983) have found that schizophrenics rate themselves as using left while depressives rate themselves as using right hemisphere related strategies. The instrument has been used in the area of reading disability to distinguish two separate syndromes. Oexle and Zenhausern (1980), Golden and Zenhausern (1981), Zenhausern and Sinatra (1983), Maxwell and Zenhausern (1983) have found that 85% of reading disabled children rate themselves as using more right than left hemisphere strategies. A copy of the test and its scoring key can be found in Table 2.1.

Lateral Eye Movements

   Research into the phenomenon of lateral eye movements (LEM)

as a behavioral measure of neuropsychological activity has been pursued along two separate dimensions. LEM have been considered a measure of both individual differences and task demands. From a neuropsychological perspective, the individual difference aspects have been associated with the concept of cognitive style and the effects of task demands with hemispheric asymmetry. There is, however, considerable controversy as to whether LEM do indeed have neuropsychological relevance. The importance of LEM has been overgeneralized to the point of faddism, which has led to a general reluctance on the part of the scientific community to give them credence. In addition, researchers in the area have sometimes failed to distinguish between these two different aspects of LEM.

                          Table 2.1
   The Preference Test for Hemispheric Related Strategies

Indicate your choice by assigning a number from 1 to 10 (with 1 being the lowest) on each question. To score the test, refer to the scoring key below. Add the ratings for all the items that are to be scored right and those that are to be scored left, subtract the two and divide by 10. The larger number shows the predominant preference and the greater the difference the larger the HRS preference. You should then develop your own local norms, but as a rule of thumb a score of .7 or higher can be considered a clear indication of a preference for a Hemispheric Related Strategy.

                         Test Items

1) Do you base your decisions on objective facts rather than

   feelings?

2) Are you psychic? 3) Do you like using symbols or images in solving problems? 4) Are you artistically or musically creative? 5) Are you logical? 6) Are you good at solving crossword puzzles? 7) Can you read quickly? 8) Are your daydreams vivid? 9) Can you think of synonyms for words easily? 10) Do you remember dreams? 11) Are your dreams vivid? 12) Are you fluent in using words? 13) Are you good at using images in remembering and thinking? 14) Do you use a playful approach to problem solving? 15) Do you use a serious, all business approach to problem solving? 16) Do you like to keep experiences planned and structured? 17) Do you like to read or think while sitting upright? 18) How much does your thinking consist of words? 19) How much does your thinking consist of mental imagery? 20) Do you like to explain something using visual presentation?

                         SCORING KEY
   Item      Scoring
   1         L
   2         R
   3         R
   4         R
   5         L
   6         L
   7         L
   8         R
   9         L
   10        R
                                      Item      Scoring
                                      11        R
                                      12        L
                                      13        R
                                      14        R
                                      15        L
                                      16        L
                                      17        L
                                      18        L
                                      19        R
                                      20        R

Individual Differences and LEM

Research into whether LEM

reflect individual personality differences was initiated by Day (1964), who reported that the direction of LEM was related to individual styles of coping with anxiety. Bakan (1971) was the first to propose that the direction in which a person consistently shifted gaze was related to which of the cerebral hemispheres an individual used more often.

   The relationship between LEM and various dimensions of

individual differences has been explored. Tucker and Suib (1978) found that left-movers had higher scores on the Performance tests of the WAIS and did better with imagery oriented questions while right-movers had better scores on the Verbal subtests of the WAIS and with questions that were letter and number oriented (e.g., how many letters are in the word house). Gur and Gur (1975) showed a relationship between direction of LEM and defensive style. Predominantly rightward movers more often reported using projection and "turning against others" as their main defenses, while predominantly leftward movers reported using repression and denial more often. LEM were again shown to be related to defensive styles in males as measured by the Defense Mechanism Inventory (Krikorian and Rafales, 1983). This effect was not replicated with females, however (Thompson, Greenberg, Fisher, 1982). In addition, subjects who moved their eyes bidirectionally rather than predominantly to the left or the right were shown to have better adaptive coping styles ratings on the adjective check list (Parrott, 1984).

   Smokler and Shevrin (1979) showed that normal subjects with

hysterical tendencies made more leftward LEM than subjects with obsessive compulsive tendencies. The latter group was more likely to show rightward LEM. Gur (1978) and Schweitzer (1979) found that schizophrenics had predominantly leftward LEM.

   The relationship between LEM and cognitive styles has also

been explored. Subjects, who scored as left or right style oriented on the Laterality Preference Schedule, were shown to have consistent patterns of LEM, indicating the existence of consistent patterns of information processing (Breitling and Bonnet, 1985; Bruce, Herman, and Stern, 1982). When using the Your Style of Learning and Thinking Test (SOLAT) to measure style of thinking, however, no relationship was found between LEM and thinking style preference (Alberts and McCallum, 1982). In addition, Owens and Limber (1983) found no relationship between cognitive style and LEM.

   One area of interest in the cognitive style research is the

relationship between what are considered right style ways of thinking (holistic and broad) and left style ways of thinking (analytic and narrow) based on proposed functions of the individual hemispheres. In support of the theory that eye movements indicate hemispheric activation, and that left hemisphere activation is associated with more analytic and narrow styles, Huang and Byrne (1978) showed that narrow categorizers based on the Pettigrew's Category Width Scale made more leftward LEM than broad categorizers.

   Another area of interest has been the relationship between the

ability to recall dreams and LEM. Predominantly leftward LEM have been associated with the ability to vividly recall dreams in male subjects (Leboeuf, Mckay, Clark, 1983), but the same has not been found with females (Van Nuys, 1985). A related issue is that of creativity and LEM. Leftward eye movement has been associated with thinking of more uses of objects on the Uses Test, which is often used as a measure of creativity (Falcone and Loder, 1984). Zenhausern (1987) has shown that LEM can differentiate between two different types of reading disabled children. Specifically, rightward LEM are characteristic of reading disabled children who are unable to derive meaning from the written word despite being able to say it. Leftward LEM are characteristic of reading disabled children who are unable to pronounce the word despite understanding what it means. This sampling of research indicates the scope of individual differences that have been associated with LEM. In their critique of the LEM literature, Ehrlichman and Weinberger (1978) concluded that LEM are reliable measures of individual differences. They found that despite differences in methodology and experimental situations the direction a person moves his or her eyes is a consistent behavior of that individual. The individual difference studies above indicate their behavioral relevance.

Functional Hemispheric Asymmetry and LEM

   A second perspective on the nature of LEM was introduced by

Kinsbourne (1972) who proposed that LEM reflect the task demands on the subject. He suggested that those tasks that require input predominantly from the left hemisphere resulted in rightward LEM, the direction away from the left hemisphere; those tasks that required predominantly right hemisphere functions resulted in leftward LEM, away from the right hemisphere. There has been mixed support for this relationship between LEM and question type. The critical variable has usually been whether rightward LEM are associated with verbal questions, indicating a relationship between a verbal task and left hemisphere activation. A wide variety of what have been called "verbal" questions have been used, however.

   Galin and Ornstein (1974) reported a relationship between

rightward LEM and logical problems and leftward LEM and visual imagery tasks. Proverb interpretation has been shown to be related to rightward LEM (Kinsbourne, 1972; Gur, 1975). Schwartz, Davidson and Maer, 1977, found a relationship between LEM and task demands. There have been recent reports of relationships between both rightward LEM and verbal questions (Hugdahl and Carlgren, 1981; Ogorman and Siddle, 1981) and leftward LEM and visual spatial tasks (Swinnen, 1984). In addition to the verbal/non-verbal dichotomy, emotionally laden questions were used to elicit predominantly leftward LEM (Krikorian and Rafales, 1983; Jamieson and Sellick, 1985).

   Not all studies have resulted in significant findings. In

fact, Ehrlichman and Weinberger concluded that the evidence for a relationship between LEM and question type was not convincing on both empirical and theoretical grounds. From the empirical point of view, they noted that of the 21 studies reviewed, 10 resulted in rightward movement in response to verbal questions, and 11 resulted in no difference in LEM to verbal and non verbal questions. The authors concluded that the literature thus did not offer strong support that LEM were related to question type.

   A re-evaluation of the empirical studies, however, indicates

that there is a consistent relationship found between the type of question asked and the direction of LEM. In only one of the 21 studies reported by Erhlichman and Weinberger did verbal questions lead to leftward LEM. While the conclusion that verbal questions lead to rightward LEM may be in question, the conclusion that verbal questions do not lead to leftward LEM is strongly supported. There may be a relationship between task demands and LEM, but it is not a simplistic "verbal question leads to rightward LEM relationship".

   There is clear evidence that LEM are related to both the type

of question asked and individual difference factors. Therefore, in any situation, LEM reflect the type of question asked interacting with the individual differences and it is essential to separate the two effects.

   Two distinct tasks were used in a study by Zenhausern and

Kraemer (1989) to investigage the dual nature of LEM. One task is purely informational and cannot be uniquely connected with either hemisphere of the brain. The second task involves rhyming of non- words which clearly demands the speech centers of the left hemisphere. Two experimental questions were addressed. 1) Is the direction of LEM consistent within an individual both across time and across tasks? 2) Does the type of question asked have an effect on the direction of LEM?

   A total of 50 adult subjects were tested.  There were 16 males

and 34 females, with an average age of 27 and a range of 16 to 50. The stimuli for the rhyme task were four to five letter nonsense words printed in black ink on white index cards and a series of prepared questions.

   The subjects were informed that they were participating in a

study involving the different ways in which people think. They were asked two kinds of questions in a face to face encounter with the experimenter. The subject responded yes or no with a nod or shake of the head and the initial direction of eye movement to each of 40 questions was recorded for each subject. These non-verbal responses were used to eliminate left hemisphere involvement through speech which was unrelated to the task. The 20 informational questions did not call on any clearly defined brain areas (Is Miami the capitol of Florida?). The 20 rhyme questions, on the other hand, clearly demanded the auditory linguistic capabilities of the left hemisphere. The subject was shown a nonsense word on an index card and told to remember it. The card was removed and another nonsense word was verbally spelled by the examiner and the subjects were asked whether the two words rhymed. The subjects were tested in two blocks of 20 trials separated by 30 minutes. Within each block 10 informational and 10 rhyme questions were asked.

   The data were first explored by means of a correlational

analysis. Both test-retest and split half reliabilities for informational questions and for rhyme questions are shown in Table 2.2. In addition, the correlation between rhyme and informational questions is also presented. LEM are clearly a consistent measure of individual differences with reliability coefficients averaging approximately .80 for the same type of question. When the type of question was changed, however, there was a dramatic drop in the consistency of LEM although the correlations were still significant. The direction of LEM changed as a function of task demands, but not to the extreme that would result in no correlation.

Table 2.2 Intercorrelations Among LEM for Information and Rhyme Questions

                       Split Half          Test Retest

Rhyme .85 .78 Information .79 .83 Rhyme with Information .59

   An initial analysis on the two 20 question blocks indicated

no significant differences and the two were collapsed into a single set of questions. The data were then analyzed by means of a split- plot analysis of variance with LEM Group (whether a subject had predominantly rightward or leftward movement) as a between factor and Task (Rhyme and Informational questions) and Direction of Movement (Right, Left, and Stares) as between factors. Since the scores are ipsative and the Grouping factor and dependent variable are related, only the interactions are of interest in this design. There was a significant interaction between the Direction of Movement and Task. The results are shown in Table 2.3 below.

Table 2.3 Number and Direction of LEM as a Function of Type of Question

Task Direction of LEM

                  Right          Left      Stare

Rhyme 6.82 7.64 4.92 Information 5.50 7.50 6.50

   Simple effects analysis indicated that the number of leftward

LEM to informational and rhyme questions were not significantly different, but there were significantly more rightward LEM than leftward LEM to rhyme questions. There were no interactions involving the LEM Group factor, indicating that the effects of the type of question were the same for both groups.

   These results lead to two conclusions.  The first is a

verification of the Ehrlichman and Weinberger (p 1093) conclusion "…that LEM patterns are reliable characteristics of persons." Individuals do move their eyes in a consistent direction and direction of LEM is a reliable measure of individual differences. The questions, however, remain as to whether LEM differences can be related to behavior and whether these behaviors have neuropsychological implications. Some of the research reported above has shown the scope of the variables that have been related to differences in LEM. (A fuller listing can be found in Beaumont, Young, and McManus, 1984). Not every study has shown that LEM differences were related to differences in performance, but no one should expect LEM to be related to all behavior.

   The final question remains, however, as to whether LEM have

neuropsychological implications. In a very general sense, all behavior results from brain activity and thus all behavior has neuropsychological implications. From a more focused point of view, LEM have been related to behaviors that neuropsychologists have associated with the brain. The problem has been, however, that the association of the behavior with the brain has not always been clearly specified. Logical problems, proverbs, and spelling have all been used as verbal tasks. These tasks are extremely complex and clearly involve both hemispheres of the brain, even though there may be a portion of the task that is especially dependent on left hemisphere processing. This was clearly shown in the present study since the rhyming task demanded the unique ability of the left hemisphere to create the sound of the printed word. The information task had no such clear connections to either hemisphere of the brain. Both the correlations and analysis of variance results pointed to the fact that LEM were different for the two tasks, with an increase in the number of rightward movements for the rhyming task. This change, however, was relatively subtle. Even though the task demanded specific left hemisphere input, subjects did not make predominantly rightward LEM; there was only a shift in that direction. A subject who made predominantly leftward movement continued to do so, but the number of rightward movements increased and the number of stares decreased.

   Lateral Eye Movements have been shown to be a reliable measure

of individual differences, as well as a response to the type of questions asked. The importance of both aspects, however, should not be overemphasized. The individual difference aspect must be investigated from a more behavioral point of view. Rather than comparing a lawyer or a scientist with an artist, determine whether a courtroom lawyer has more in common with an actor or a corporate lawyer, or whether a geometrician has more in common with an artist or an algebraist.

   The LEM response to task demands must also be considered in

conjunction with the fact that any task demands the integrated functioning of the whole brain. The variable extent to which a task places special emphasis on one hemisphere must be considered within this integrated functioning. LEM can be a useful tool, but their value and meaning can be misunderstood all too easily. The next Chapter provides evidence of the usefulness of LEM within a normal classroom setting.

   This chapter has presented the evidence that Hemispheric

Related Strategies can be measured by means of questionnaires and LEM. The following chapters will provide evidence that this individual difference variable has significance for education.

          Chapter 3
      THE INTERACTION OF HEMISPHERIC RELATED STRATEGIES
                 AND INDIVIDUAL DIFFERENCES
   The purpose of this Chapter is to provide evidence that the

individual difference aspect of LEM has meaningful behavioral correlates in an educational setting. No assumptions were made as to the neuropsychological substrate of LEM. They were used simply as a means of dividing subjects into two groups: those who move their eyes predominantly to the right and those who move them predominantly to the left. Half of the right movers were taught a learning strategy involving verbal rehearsal and the other half a learning strategy involving imagery. The same procedure was followed for the left movers. The question was whether there is a relationship between the typical direction of LEM and the effectiveness of the two learning strategies.

   The subjects were drawn from a pool of 120 average or above

average fifth and sixth graders in a suburban school system. A series of verbal, spatial, imaginal, and informational questions were asked in a face to face situation and the 72 subjects who had the most extreme number of left movements and the most extreme number of right movements participated in the study. The subjects were divided into equal numbers of male and female right and left movers.

   Seventy-two words appropriate to fifth and sixth graders and

matched for abstractness, concreteness, and imagery were chosen from the list provided by Pavivo, Yuille, and Madigan (1968). Two equivalent sets consisting of 18 pairs, created from this list, served as the learning stimuli. Two distractor lists of 12 pairs each were also created using the same procedure. Each pair was then photographed and developed as 35mm slides.

   Each subject, tested individually, was seated approximately

4 ft. from a screen on which the 18 pairs of words were presented by means of a slide projector for 4 sec. The child was then asked to recall as many pairs of words as possible and the number of correct pairs served as one dependent variable. The subjects were then shown 24 pairs of words, half of which they had already seen and half of which were distractors. These slides were then presented and the subject had to indicate by switch closure whether they had seen the word pair. Both accuracy and response time (in milliseconds) were measured. Following this pre-training procedure, half of the subjects whose LEM were predominantly leftward and half whose LEM were predominantly rightward, were taught a verbal rehearsal strategy in order to improve performance. They were instructed to repeat the pairs of words as many times as possible during the 4 sec interval between pairs. They were then given six practice trials. The remaining subjects were instructed on how to form an integrated image from the word pairs. They were also given six practice trials. The subjects were then tested on 18 new pairs of words using the same procedures as in the pre- training condition. This effectively created four groups: right movers taught to use either imagery or verbal rehearsal strategies and left movers taught the same strategies.

   There were three dependent measures that were analyzed in this

study: the number of pairs recalled, the number of pairs recognized, and the response time for recognition. The design for all three variables was a split plot factorial with Direction (leftward or rightward LEM) and Strategy (verbal rehearsal or imagery) as the between factors and Time (before or after training) as the within factor. The mean number of correct pairs recalled under all conditions is shown in Table 3.1.

Table 3.1 Mean Number of Word Pairs Recalled for Right and Left Movers Under Verbal Rehearsal and Imagery Instructions

   Set                 Pre Test        Post Test

Verbal

   Left Movers         3.39                1.78
   Right Movers        1.89                2.61

Imagery

   Left Movers         2.61                3.28
   Right Movers        2.39                2.56
   The analysis of variance indicated no significant differences

involving Direction or Strategy, but there was a significant interaction of Direction, Strategy. and Time. Simple effects analysis indicated that children with rightward LEM did not change as a result of imagery instructions, but made a significant improvement as a result of verbal rehearsal instructions. Children with leftward LEM made a significant improvement as a result of imagery instructions, but showed a significant decrement as a result of verbal rehearsal instructions.

   Mean performance for the recognition scores is presented in

Table 3.2. The analysis of variance again indicated a significant interaction between Direction, Strategy and Time.

Table 3.2

Set Pre Test Post Test

Verbal

   Left Movers              29.28               27.61
   Right Movers             28.11               29.44

Imagery

   Left Movers              29.56               30.67
   Right Movers             29.89               29.44
   The simple effects analysis indicated that children with

rightward LEM showed a significant improvement using a verbal rehearsal strategy and children with leftward LEM showed a significant decrement using a verbal rehearsal strategy. The mean reaction times for the recognition task is shown in Table 3.3. The analysis of variance indicated that there was an overall decrease in reaction time from pre to post testing and the same significant three way interaction of Direction x Strategy x Time.

Table 3.3 Mean Reaction Times (in milliseconds) for the Recognition Task

Set Pre Test Post Test

Verbal

   Left Movers         2059                2118
   Right Movers        2447                1894

Imagery

   Left Movers         2244                1829
   Right Movers        1846                1627
   Statistical analysis indicated that children with rightward

LEM were significantly faster using a verbal rehearsal strategy and children with leftward LEM were significantly slower using a verbal rehearsal strategy. The analyses of the three variables lead to the single conclusion that children who have predominantly leftward LEM should not be taught by a verbal repetition strategy.

   From the theoretical perspective, these results support the

findings of Ehrlichman and Weinberger that LEM are a reliable measure of an individual difference variable. It also provides evidence of the validity of LEM; individuals who differed on LEM showed differences on a relevant behavioral measure – verbal learning. The most important question, however, is whether LEM have any relationship to brain organization. Individuals who had predominantly rightward LEM showed better retention when using the left hemisphere oriented strategy of verbal rehearsal and individuals who had predominantly leftward LEM showed decreased retention when using the left hemisphere oriented strategy. These are the facts, and while it is premature to draw firm conclusions, these facts are consistent with the existence of a relationship between LEM and brain organization. The clearest conclusion from these findings is that children differ in the extent they can benefit from a verbal repetition strategy in learning. From the educational perspective it is clear that there are children in schools who not only do not benefit from a verbal rehearsal strategy, but whose performance is actually decreased. Spelling and arithmetic tables are examples of subjects that usually stress a rote memorization based on oral repetition. One alternative would be to have the child repeatedly image the letters of the word or number facts without verbalizing them. When it came time to use the word or number fact the child would recall the image. Educators must become more aware of the individual differences in the way people learn. This becomes even more evident in the next chapter where these individual differences can be seen to be at the heart of what has been called reading disability.

                          Chapter 4
             THE DIAGNOSIS OF READING DISABILITY
   Although there is general agreement that reading disability

is not a single entity, there is considerably less than a consensus as to the number of different syndromes that actually exist. Neuropsychological assessment, the types of errors made with verbal material, cognitive tests, and differences in processing strategies have all been used in the classification of the reading disabled into symptom-related subtypes. As many as five different subtypes of reading disability have been found through the use of neuropsychological tests.

   For example, Mattis, French and Rapin (1978) reported three

groups and Doehring, Honshko, and Byans (1979) distinguished four types. Fisk and Rourke (1979) Petroskas and Rourke (1979) have identified subgroups which were consistent. These subtypes, however, can be considered in terms of the presence or absence of auditory linguistic deficits, a distinction reported throughout the reading disability literature. Subtypes that include auditory linguistic deficits comprise 80 to 90 percent of the total population of reading disabled children. The smaller group has usually been reported to show deficits in visual spatial processing.

   Boder (1973) examined the nature of the spelling errors made

by reading disabled children. She used the term dysphonetic to describe the type of reading disability marked by linguistic and phonetic difficulties; and the term dyseidetic to describe the type which had difficulties with the overall visual spatial aspects of the written word. Boder estimated that the dysphonetic group was four to five times more prevalent than the dyseidetic group. Pirozzolo (1979) used ratings, writing samples, and psychological and neuropsychological tests to separate two reading disability groups that were similar to those suggested by Boder. Bakker (1982) proposed a similar distinction that he related to hemispheric functioning. The auditory linguistic disabled reader was not effective in the use of left hemisphere related tasks. There was also an association of the visual spatial disabled reader and the effective use of right hemisphere related strategies.

   Zenhausern (1987) distinguished these two types on the basis

of both reading related tasks and the predominant direction of their lateral eye movements. He found that the majority of children with leftward lateral eye movements had difficulty determining whether words in their sight vocabulary did or did not rhyme. He also found that a group of children with predominantly rightward lateral eye movements had no difficulty in determining whether two words rhymed, but were deficient in determining whether words and pictures represented the same concept. The auditory linguistic group had difficulty converting a word to its sound and the smaller group showed deficits in converting a word to its meaning. He used the terms Phonetic and Semantic to describe this distinction. From a behavioral perspective, phonetic disabled readers are the children who struggle with every word when they read aloud and thus lose continuity in the text. They are frequently anomic and have a general difficulty with the auditory linguistic aspects of reading, especially the grapheme to phoneme conversion. The Semantic disabled reader, on the other hand, is the child who will give a perfect word for word rendition of text, but has no comprehension of the meaning of that text. The Semantic disabled readers can convert words into their phonetic representation, but this representation is not converted into its meaning. They have no problems with the sound of a word but are at deficit for tasks involving the meaning of words.

   The original study was based on 13 Phonetic and 13 Semantic

readers from the second to fourth grades. One purpose of this research was to determine whether these Phonetic and Semantic subtypes would replicate across the entire elementary school population. A second goal of this study was to replicate the second finding of the original study. The Phonetic disabled readers moved their eyes predominantly to the left and Semantic disabled readers predominantly to the right. This second purpose was an attempt to determine whether lateral eye movements can be used as a marker variable for the two types of reading disability.

   The subjects in this study were 160 children from the second

to the eighth grades. All were of at least average intelligence. Forty children were selected at grades 2 or 3, grades 4 or 5, grades 6 or 7, and grade 8. Of the 40 children at each age level, 20 were at or above grade level and 20 children were at least one year below grade level in reading. Half of each group were chosen on the basis of showing rightward LEM and half leftward LEM. The predominant direction of LEM was determined individually for each child. A series of 20 informational questions were asked in a face to face situation and the predominant direction of LEM was noted. Normal readers split evenly between right and left movers, but 84% of the disabled readers were left movers.

   There were four kinds of reading related tasks that used words

selected from the individual sight vocabulary of each child. A rhyme task stressed the auditory linguistic aspects of the written word and the remaining three tasks placed more emphasis on the meaning of the words.

   1) The rhyme stimuli consisted of 10 each of four types of

word pairs: a) words which neither rhymed nor had similar orthography (tree/eats); b) words which were both phonetically and orthographically similar (pool/cool);

   c) words which were orthographically similar, but did not

rhyme (bone/gone); and d) words which were orthographically dissimilar, but rhymed (by/tie). 2) The word match stimuli consisted of 20 word pairs, one in upper case the other in lower case which did or did not represent the same word (TREE/tree, TREE/eats).3) The word/picture stimuli consisted of 20 word and picture pairs, in which the word and picture did or did not represent the same concept.

   4) The synonym/antonym pairs consisted of words which meant

either the same or the opposite.

   Each stimulus was presented on 35 mm slides and projected for

130 ms. The subjects were tested individually and responded verbally as to the whether the words rhymed in the rhyme condition and whether they matched or meant the same in each of the three other conditions. All words used in the study were determined to be in the sight vocabulary of all subjects on the basis of prior testing.

   The number of correct responses for all children on the four

grade levels was subjected to an analysis of variance for each of the four tasks. The grouping factors included Grade Level, Reading Ability, and Eye Movement Direction. The normal readers achieved virtually perfect performance on all tasks and their results were not included in the tables. The interaction of eye movement group and the rhyme task was significant. The mean number of correct responses for the interaction are presented in Table 4.1.

Table 4.1 Mean Number Correct on the Rhyme Task for Disabled Readers with predominately Right and Left LEM at Four Grade Levels

LEM Grade Similar Dissimilar

                  Rhyme   Non-Rhyme        RhymeNon-Rhyme

Right 2-3 17.80 15.20 14.80 14.00

        4-5       17.80     17.80          16.40     17.89
        6-7       17.80     18.60          18.60     19.30
        8         19.90     19.80          19.10     19.70

Left 2-3 16.10 5.90 7.40 14.40

        4-5       16.10     10.30          10.20     17.30
        6-7       16.80     13.60          12.50     18.50
        8          9.60     12.00          10.40     17.60
  On the basis of the simple effects analysis, those children who

had predominantly leftward eye movements were significantly more impaired than those who moved predominately to the right. This was particularly true on those conditions for which the orthography and phonology of the words were inconsistent (bye/tie or bone/gone). Those children with predominantly leftward lateral eye movements are the Phonetic disabled readers who have difficulty with the auditory linguistic aspects of reading. The analyses of variance for the semantic tasks indicated a significant difference between disability groups. The results from the three tasks are presented in Table 4.2. Table 4.2 Mean Number Correct on the Uppercase/lowercase, Word/picture and Synonym/antonym tasks for Disabled Readers with Right and Left LEM at Four Grade Levels

LEM Grade Case Word Synonym

Right 2-3 15.70 7.90 8.65

        4-5            17.50        7.80         6.55
        6-7            18.80       13.40        13.05
        8              15.90       15.90        15.00
Left    2-3            19.00       17.50        17.15
        4-5            19.30       19.30        17.45
        6-7            18.10       19.10        18.75
        8              17.40       19.70        17.40
 Again the normal readers performed almost flawlessly and the

disabled readers were inferior at every grade level. It was the reading disabled readers with predominantly rightward LEM who were the significantly more disabled group for these tasks. They were significantly inferior on the word matching task, the word picture task and the synonym antonym task. These children could create the sound of a word from its orthography, but did not understand the meaning of that word. This is a replication of a second type of disabled reader, a Semantic subtype whose deficit involves the meaning of words rather than their phonology. Rightward lateral eye movements are a marker for this subtype. In the past, this subtype has often been identified with visual spatial and perceptual problems. This may be true but it is incidental to their reading disability since they had no difficulty in perceiving the words in the rhyme task. These results support the existence of two subtypes of reading disability. The Phonetic disabled reader has difficulty converting the written form of a word to its phonetic counterpart. The Semantic disabled reader can convert a word to its sound, but not its meaning.

 There were two distinct patterns of errors made by the Phonetic

and Semantic disabled readers, but what is the relationship between these patterns and reading disability? The answer to this question lies in the way we teach reading. The next chapter is a discussion of how these two deficits interact with current reading methods and the effectiveness of a different approach to the reading process.

                         CHAPTER 5
      THE THEORY AND REMEDIATION OF READING DISABILITY
 Current teaching methods almost invariably use an indirect

phonological route to meaning in which the written word is converted to its phonological counterpart so that meaning derives from auditory comprehension. In practice, a child comes to school with auditory comprehension, that is, hearing the word "ball" leads to the concept of "a round, bouncy thing". In reading, the letters b-a-l-l must lead to the concept of "a round, bouncy thing". In virtually every case, the child is taught to see the word, say it, and understand it from its sound. This is an effective technique for two reasons. First, it takes advantage of the existing auditory comprehension of children; second, it provides the background for the future decoding of new words. As effective as this procedure is for most children, a significant number of individuals are not able to learn under this protocol and they comprise the majority of the children we term "reading disabled."

 The Phonetic disabled reader has difficulty with the first step

of this indirect phonological route to reading, converting the graphemic form of the word into its phonological counterpart. The Semantic reading disabled readers have no difficulty with this first step; they can make the grapheme to phoneme conversion. For whatever reason, however, the sound of the word does not lead to its comprehension.

 The standard methods of teaching reading are well-entrenched and

educators sincerely believe that this indirect phonological route to meaning is the best. Therefore, remediation for these "disabled readers" means an intensification of what was not successful in the past. Extensive drilling in phonetic skills has led to an emphasis on teaching to weakness, rather than strength. The imbalance is reflected in reading curricula and standardized tests that stress phonetic decoding at the expense of comprehension. Phonetic decoding is a means to the end of comprehension; it has become an end in itself.

 A new approach, Direct Access, has been developed which achieves

comprehension without the necessity of decoding. The Direct Access method has one basic principle: the meaning of the printed word should not be derived from the sound of that word. Any procedure that avoids the grapheme to phoneme conversion is consistent with this approach. The child is never required to read aloud, but asked to explain what a passage meant. Trivial deviations in verbiage, e.g., "jet" for "plane", are de-emphasized. The stress is on comprehension rather than a slavish word for word decoding.

 One of the simplest procedures used in the method involves

pairing words and pictures until the written word triggers a concept directly, rather than indirectly through its sound. The child can then construct sentences composed of pictures in parallel with sentences composed of words. Children automatically fill in words like "a", "the", "in", etc. when they comprehend the sentence. In a very short period, the pictures are no longer needed and the written word is understood on its own.

 Several techniques are available for more abstract concepts.

One possibility involves a class discussion of, for example, our legal system. The teacher can then show the class the word "justice" and ask the children to draw a picture of justice. It is not the picture itself that is important, but it serves as a link between the written word and its conceptualization by the child. Another possibility is a homework assignment requiring the child to bring pictures to school that represent specific concepts. Direct Access places only one constraint on the creativity of teachers: Do not teach reading by deriving the meaning of a word from the way it sounds. Phonic decoding is a skill that should be developed, but it should not serve as the usual reading strategy for these two groups of readers.

 Maxwell and Zenhausern (1983) applied the method to First Grade

children who were "at risk" during the second semester. After 25 half-hour sessions, the children increased their comprehension scores from the 26th to the 56th percentile on the Metropolitan Achievement Test and increased their sight vocabulary by over 100 words. A comparable control group showed no gain in comprehension. Minardi, Zenhausern, and Maxwell (1984) found similar results with Junior and Senior High School children. Using the same regimen of 25 half-hour sessions, the Junior High School students gained an average of 7 months and the Senior High School students an average of 1.4 years.

 The previous research on the Direct Access method of reading has

been limited to a small number of children taught by a single teacher. The purpose of this study was to apply the method in a large scale basis, using a broad range of grades and teachers. A total of 209 children from grades 1 through 10 (with the exclusion of Grade 9) who were at least one year below grade level in reading and 240 children who were reading at least on grade level were the subjects in this study.

 A workshop explaining the theory and practice of the Direct

Access reading method was presented to teachers throughout a 32 school District in suburban North Carolina. After the workshop was completed, those teachers who were interested were given further experience. There were no absolute procedures specified, but the teachers were shown various possibilities and were told to use any techniques that did not depend on the indirect phonological route to meaning. Following these sessions the children in the classes taught by the teachers were given the Metropolitan Achievement Test Form L as a pretest measure of their reading ability. The teachers then used the Direct Access method exclusively for 10 weeks, after which time the children were retested on the Metropolitan Achievement Test Form M.

 The results of the reading disabled children and a control group

are presented in Table 3. The average gain across the whole group was almost 1 year and several grades showed gains of over 2 years. Individual gains of 4 or more years were not uncommon. Given that these results were obtained during only a 10-week period, the Direct Access approach is clearly an effective strategy to use with Phonetic and Semantic reading disabled children. In addition to these objective gains, the teachers reported an extremely positive reaction on the part of the students and have commented on the effects of the method on both spelling and writing composition.

 During the past year (1988-89) Greensboro and High Point, North

Carolina used the Direct Access approach. The average gain on the State mandated California Achievement Test was over 20 percentile points for those children. As a result, High Point has mandated the Direct Access approach as the treatment of choice for children who are "at risk" for reading. The approach has been used in Currituck, North Carolina since September, 1989 and at Public School 102 in New York City since January, 1990. There are plans for incorporating Direct Access into a psychiatric hospital for children, a Parochial school in New York City, and a school system in East Greenwich, Rhode Island by February, 1990.

Table 1 Total Gains in Percentile and Grade Equivalent Scores for Direct Access and Controls

            Pre            Post           Gain
            Per  Grade     Per  Grade     Per   Grade

Grade 1 DA (38) 7 1.09 32 1.55 25 0.46 Control (27) 46 1.79 56 2.13 10 0.34 Grade 2 DA (21) 17 1.76 32 2.15 15 0.39 Control (36) 54 2.89 58 3.19 40 0.3

Grade 3 DA (28) 16 2.33 31 2.99 15 0.66 Control (28) 56 4.49 61 4.94 5 0.45

Grade 4 DA (52) 15 2.59 31 3.28 16 0.69 Control (53) 60 5.82 61 5.97 1 0.15 Grade 5 DA (20) 21 3.63 38 5.01 17 1.38 Control (38) 56 6.53 60 7.09 4 0.56

Grade 6 DA (13) 3 2.36 15 3.68 12 1.32 Control (17) 71 9.58 74 9.9 3 0.32 Grade 7 DA (21) 8 3.39 26 5.45 18 2.068 Control (18) 35 6.57 36 6.64 1 0.07 Grade 8 DA (9) 5 3.38 21 5.61 16 2.23 Control (10) 34 6.94 35 7.36 1 0.42 Grade 10 DA (7) 17 5.58 26 6.65 9 1.07 Control (13) 15 5.25 18 5.6 3 0.35

Total Exper.(209) 12 2.27 29 3.22 17 0.95 Control (240) 52 5.35 56 5.71 4 0.36

  This chapter has outlined some of the successes that have been

attributed to the Direct Access approach. The next Chapter is a discussion of some of the methods that are consistent with Direct Access.

                         CHAPTER 6
            SUMMARY, CONCLUSIONS, RECOMMENDATIONS

Summary

  Current teaching methods almost invariably use an indirect

phonological route to meaning in which the written word is converted to its phonological counterpart so that meaning derives from auditory comprehension. A child comes to school knowing that the sound "ball" means the concept "a round, bouncy thing". In reading, the letters b-a-l-l must lead to the concept of "a round, bouncy thing". In virtually every case, the child is taught to see the word, say it, and understand its meaning from its sound. This is an effective technique for two reasons. First, it takes advantage of the existing auditory comprehension of children; second, it provides the background for the future decoding of new words. As effective as this procedure is for most children, a significant number of individuals are not able to learn under this protocol and they comprise the majority of the children we term "reading disabled."

  Kaliski, Zenhausern, and Andrews have shown that there are two

groups of children who have unique deficits that interact with these standard strategies used for teaching reading. It is this interaction that directly leads to reading disability. All the children in grades 1 to 8 who were reading at least one year below grade level were screened for inclusion in the study. The majority of the reading disabled group (85 per cent) fall into the category of children who have to struggle to pronounce every word and thus lose all continuity in reading. They were termed Phonetic disabled readers. The smaller group of reading disabled children can "read" aloud fluently, but do not comprehend what was "read". These children were called Semantic disabled readers. The final sample consisted of 80 children, 40 Phonetic and 40 Semantic disabled readers, spread evenly across the 8 grades. The authors showed that the Phonetic children could not determine whether two words (which were known to be in their sight vocabulary) did or did not rhyme. The Semantic group had no difficulty with a rhyme task, but made considerably more errors than the normal readers and Phonetic disabled readers in determining whether a word and a picture represented the same concept. These two deficits can be directly related to the indirect phonological approaches to the teaching of reading. The Phonetic disabled reader can not convert the word to its sound and thus can not take the first step required by these reading methods. The Semantic disabled reader can perceive the words and translate them to their sound but has difficulty in comprehending the meaning of the written word from this sound. This disabled reader can take the first step and convert the written word to its phonological counterpart, but the sound does not lead to meaning. The results of this study can be seen in Figures 1 and 2.

  The standard methods of teaching reading are well-entrenched

and educators sincerely believe that this indirect phonological route to meaning is the best. Therefore, remediation for these "disabled readers" means an intensification of what was not successful in the past. Extensive drilling in phonetic skills has led to an emphasis on teaching to weakness, rather than strength. The imbalance is reflected in reading curricula and standardized tests that stress phonetic decoding at the expense of comprehension. Phonetic decoding is a means to the end of comprehension; it has become an end in itself. An alternative approach to reading which does not depend on an indirect phonological approach to comprehension, called Direct Access, has one basic principle: the meaning of the printed word should not be derived from the sound of that word. Any procedure that avoids the grapheme to phoneme conversion is consistent with this approach. The child is never required to read aloud, but is asked to explain what a passage meant. Trivial deviations in verbiage, e.g., "jet" for "plane", are de-emphasized. The stress is on comprehension rather than a slavish word for word decoding. Specific Direct Access techniques will be discussed later in this chapter.

  The first study involving Direct Access was by Maxwell and

Zenhausern (1982) who applied the approach to First Grade children "at risk" in reading by the second half of the year. After 25 half- hour sessions, the children increased their scores from the 26th to the 56th percentile on the Metropolitan Achievement Test and increased their sight vocabulary by over 100 words. A comparable control group showed no gain. Minardi, Zenhausern, and Maxwell (1983) found similar results with Junior and Senior High School children. Using the same regimen of 25 half-hour sessions, the Junior High School students gained an average of 7 months and the Senior High School students an average of 1.4 years on the Reading Comprehension scale of the Metropolitan Achievement Test.

  During the Spring of 1988, over 200 reading disabled children

in grades 1 through 10 from 8 schools within the Guilford County School System in Greensboro NC used the Direct Access approach. The children were tested on the Metropolitan Achievement Test before and after 10 weeks of using the approach. The average gain was .95 years and every grade from Grade 6 onward gained at least 1 year, with the 7th and 8th grades showing gains of over 2 years. In the Fall of 1988, High Point NC used the approach with 73 reading disabled children. After 7 weeks, there was an average gain on the Woodcock Johnson of 15 months. The Kindergarten group showed a 12 month gain; the primary, a 7 month gain, and the middle school a 21 month gain. Both Greensboro and High Point, North Carolina used Direct Access for the past year. On their State mandated California Achievement Test, those children on Direct Access instruction showed an average gain of 17 percentile points above last year's scores.

              SELECTED DIRECT ACCESS TECHNIQUES
  The results of the demonstration project and the use of Direct

Access in the past year in North Carolina clearly show that reading disabled children can benefit from the Direct Access method of teaching reading. To be able to read means that one can get meaning from the printed word. The indirect phonological route attempts to accomplish this by having the reader convert the written word to its phonological counterpart and from this sound derive meaning. Converting the word to its sound is a means to the end of comprehension, not the comprehension itself. Direct Access attempts to derive the meaning of the printed word not via its sound, but directly. The stress is on comprehension, not decoding.

  One of the first and most basic Direct Access techniques

consists of pairing an index card which contains a word and one that contains a picture so that the child can consistently make the pairing. At that point the child can read the word, that is, the child can comprehend the printed word. Note that this is true whether or not the child can say the word correctly or not. The pictures can be provided by the teacher, cut from magazines for homework by the child, or even drawn by the child. The question of abstractions and hard to picture words at first seems insurmountable, but it is surprising how easily a child will develop and remember appropriate pictures. In connection with this aspect, games can be developed to strengthen the connection between the words and the pictures. Variations of Concentration and Old Maid have been used successfully.

  This pairing, however, is only the beginning of the Direct

Access approach. The typical reaction at this point is, "This is nothing new." or "We tried that 20 years ago and it did not work." The next step is the most critical. The words and pictures must be combined into sentences. A word sentence can be covered by the appropriate picture and vice versa. The child should not be asked to read the sentence aloud, word for word. Rather, have the child summarize the sentence, point to a picture from a series that corresponds to it, or even draw a picture of the sentence. The stress should always be on whether the child has understood the basic meaning of the sentence rather than a word for word rendition of it.

  There are two important side benefits of this approach.  One

is an increase in spelling skills. The second advantage is the ease with which children can do creative writing using the cards. It is a simple way to separate penmanship from writing. The child could be asked to write the funniest (most exciting, etc.) sentence they can from their words. The step from sentences to paragraphs is minimal.

  There are two basic approaches to class recitation within a

Direct Access framework. The phonetic disabled reader would be asked to summarize a passage for the class and the teacher and classmates could discuss the errors of omission and commission. It also opens the door for class discussion on any relevant issues. The semantic disabled reader would read aloud, but be required to do so with expression to assure that the meaning and not only the words were being read. Of course, any child could be given the opportunity to use either approach.

  Flash cards are a standard part of the classroom and can be

used within a Direct Access framework. Let the children have their pictures in front of them when the words are flashed. They will serve as a cue and minimize the chance of failure. As the children progress, they can turn the pictures face down on the desk and only turn them over as needed. This will strengthen skills and continue to minimize the chance of failure. This technique could easily be converted into a game where more points accrue if a card is not turned over, but the child will always get some points.

  What happens when children come across a word they have never

seen before? This is the usual response of people who first encounter Direct Access. There are several approaches to this. First and foremost, the child should be encouraged to determine the meaning of the word from the context of the whole passage.

  Second, the teacher can tell the child the word and immediately

have the child cut out or draw an appropriate picture for that word.

  Third, the child can be encouraged to look it up in the

dictionary just like anyone else who comes across a word with which they are unfamiliar. The child may not be able to pronounce the word, but its meaning will be known.

  Fourth, phonetic decoding should be an essential part of any

reading program. It is an important skill and should not be neglected. On the other hand, it should not be the main approach to deriving meaning from the printed word for some children. There is a temporary remediation procedure to use with Semantic disabled readers. Have the child read aloud into a tape recorder. Then the child can play back the tape while reading from the text material. Although this is an awkward procedure it will allow the child to get meaning from the printed word. Direct Access has a technique for the teaching of spelling and number facts. It has been shown that some children not only do not learn by verbally repeating the word and letters (e.g. "cat, C-A-T, cat", "6 times 3 is 18") but this procedure can actually interfere with learning. As an alternative have the child look at the word and practice forming an image of the letters without saying anything (This is essential!!). When it comes time to spell the word, have the child bring back the image of the letters and copy them.

  The Direct Access approach does not depend on a rigid structure

that the teacher must follow slavishly, but is a general principle that can lead to unique and creative techniques. Furthermore, the method is not limited to the disabled population, but may be an effective strategy for all readers since it has some similarities to "speed reading" techniques.

                 SUMMARY AND RECOMMENDATIONS

Summary

  Reading Disability is as much a physical disability as

blindness, deafness and paralysis but a person with such a disability has not received the help offered to those suffering from the latter disorders. The reading disabled child is considered responsible for the disability. The purpose of this paper is to point out that these children can learn to read if only we are willing to change the methods with which we teach reading.

  The standard approaches to reading demand that the child

convert the written word to its sound and, from that sound, derive the meaning. It was shown that 85% of the children we call reading disabled have difficulty making that first step and the remaining 15% can convert the word to its sound, but this still does not give them meaning. The Direct Access approach to reading can help both types of children because meaning is not derived by converting the printed word to its sound. Rather, the sound of the word is derived from its meaning. Several specific techniques using this approach have been discussed earlier in this Paper.

  Our brain is capable of many fascinating and wondrous things.

Our conscious awareness of our surroundings is somehow derived from light of various wavelengths falling on our retina and causing neurons to fire and not fire. It is this pattern of neuronal activity that gives us conscious experience. Even more amazing is the ability to create literary, musical, and visual works of art. It is the brain that is responsible for all of this. The brain also has a rather obscure function. It can take an arbitrary series of symbols (printed words) and convert them into an equally arbitrary set of sounds (spoken words). This function pales alongside literary and artistic masterpieces. Why have we made it the basis of our educational system? Recommendations

  There are two major administrative recommendations that flow

from this paper. The first concerns the establishment of a centre for learning disability to be associated with the Centre for Social Development and Humanitarian Affairs. The second concerns the development of a pilot project to investigate the effectiveness of the Direct Access approach to reading. 1) A center for the dissemination of information and training in learning disabilities should be established which would be called the Learning Enhancement Centre of the Disabled Persons Unit.

  The purpose of the Learning Enhancement Centre would be to

research and disseminate information on the theory and remediation of educational disabilities and to provide training in the remediation of these disabilities. The scope of this training would include all educational approaches that stress the individual styles of learning with a particular emphasis on the Direct Access approach in reading. There would be two main educational foci:

  1) ongoing workshops open to teachers from all member

countries; and 2) visiting teams which would provide on-site training for those teachers who cannot travel to the Centre. In addition, new teaching techniques would constantly be developed and evaluated in real classroom situations. These teaching techniques would take advantage of the latest technology, but the effective use of more basic strategies would also be investigated. The Centre would publish a newsletter to promulgate its activities and share the latest innovations in teaching techniques. 2) A large scale pilot study should be initiated by the Learning Enhancement Centre to evaluate the effectiveness of the Direct Access approach across a wide variety of cultures. The Learning Enhancement Centre would provide a series of workshops to train teachers in the theory and practice of Direct Access. These teachers would consist of individuals from various countries who would then develop Direct Access projects in their country. Consultants from the Learning Enhancement Centre would visit the project sites to provide ongoing feedback to the teachers. These same teachers can provide on site training for countries who are unable to send teachers to the Centre. In addition to these administrative recommendations, there are several educational recommendations that are aimed at eliminating all forms of learning disability. The aim of the Learning Enhancement Centre is to implement these recommendations. 3) Individual preferences in learning strategies should be taken into consideration in selecting teaching strategies.

  Both lateral eye movements and Hemispheric Preference Test data

should be collected on all children. Strategies of teaching that are compatible with the learning strategies associated with these Hemispheric Related Strategies should be incorporated into the classroom. In addition, other measures of individual differences in learning styles should be incorporated into the framework of the Centre. 4) A testing program aimed at identifying individual differences in learning styles should be developed at the Centre and disseminated among the various member nations. Children can be tested for Phonetic and Semantic reading disability by means of a test derived from the results presented in Chapter 4. The Phonetic Semantic Reading Scale (PSRS) requires a child to match written and pictorial material on the basis of their sound or on the basis of their meaning. The point would be to identify individuals who do well on one portion of the test and poorly on the other to make a differential diagnosis between the Phonetic and Semantic disabled.

5) The techniques described in the Selected Direct Access Technique section above should be applied to these children.

  These would include, but not be limited to:

a) Alternative forms of class recitation b) De-emphasis of phonics c) Use of word picture vocabulary cards d) Emphasis on comprehension rather than decoding 6) The criteria for success should reflect the capabilities of the child in conjunction with the demands of the culture rather than artificial restrictions.

  These would include, but not be limited to:

a) Speed should be de-emphasized b) Tests should be given on an "open book" basis. c) Calculators should be allowed on mathematics tests.

  Note that these changes actually reflect the way people operate

in the real world. No successful business places unrealistic time limits on workers or denies them use of tools and references. 7) An essential aspect of the Centre will be to develop new and creative techniques aimed at the elimination of all forms of learning disabilities.

  While the emphasis at present is on developmental disabilities,

it is expected that this will expand to cover acquired disabilities, especially those related to head injuries. The same principles of educational remediation will be applied to cognitive remediation. The major recommendation of this paper is that learning disability should be recognized as a true disability and treated in the same way as the more physical disabilities such as deafness, blindness and paralysis. The learning disabled child should not be considered at fault for the disorder, but should be recognized as a person in need of special help. It is our responsibility to supply that special help.

  The emphasis must be on individualizing instruction rather than

finding the "one true method". The good from all approaches must be used with those who find it good and avoided for those who find it not good. Only by tailoring our teaching to the unique style of each student do we maximize their strengths rather than trying to strengthen their minima.

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For more information contact: Robert Zenhausern, Ph.D. Internet: drz@sjuvm.stjohns.edu St. John's University Bitnet: drz@sjuvm.bitnet SB 15 Marillac Phone: 718-990-6447 Jamaica, NY 11439 Fax: 718-990-6705

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