In this context a body of research has evolved on how children learn to read and why some fail (see Appendix). This research, sponsored at the federal level by the National Institute of  Child Health and Human Development (NICHD), has existed for more than thirty years (Lyon 1995; Lyon, Alexander, and Yaffe 1997). It is not the only existing research on the development of reading skills and reading failure, but it does represent a comprehensive research program that has attracted attention because of nationwide concern about children's ability to read. Perhaps the best indication of the interest in this research comes from a recent report to Congress, wherein the director of the NICHD, Dr. Duane Alexander, emphasized three major areas of progress: The first was research on reducing the incidence of sudden infant death syndrome by modifying infant sleep positions. The second was laboratory research on the role of  folate acid metabolism in causing spina bifida and other neural tube defects, which led to legislation requiring the addition of Vitamin B to bread. The third area was the NICHD research on reading and reading failure. Unfortunately, the NICHD research has not yet significantly affected how children are taught to read in school, so that a gap continues to exist between what we know about reading and how children are taught to read.
As Benita Blachman, a well known reading researcher, stated in testimony in Washington:
 

The good news is that there have been scientific breakthroughs in our knowledge about the development of literacy. We know a great deal about how to address  reading problems even before they begin.. The tragedy is that we are not exploiting  what is known about reducing the incidence of reading failure.  Specifically, the instruction currently being provided to our children does not reflect what we know from research. Direct, systematic instruction about the alphabetic code is not routinely provided in kindergarten and first grade, despite the fact that, given what we know the moment, this might be the most powerful weapon in the fight against illiteracy. (Blachman 1996, 66-67)

[The above comments about teacher preparedness and student training by them are unfortunately true.  The teachers wish they knew what to do and how to do it and  also wish they were given the opportunity to do what is right.  A new organization which when fully functional can fill the role of getting all teachers the information, but especially the extraordinary training they need  (and all thought they would receive when they went to college but did not receive it), has been formed.  See www.ldinstitute.org .  DMK]

The NICHD research supports a prominent role for explicit instruction in phonics and phonological awareness skills (i.e., alphabetic principle) [this should read explicit instruction in developing phonological awareness skills to be followed by explicit instruction in phonics.  DMK] for beginning reading instruction, particularly for children at risk for reading failure. It also shows how these skills are involved in learning to read for all children, regardless of how they are taught. The NICHD intervention research, however, is sometimes equated with either an exclusive phonics approach or research addressing only children with reading problems.  Both interpretations are inaccurate.
The intervention studies are consistent with the larger body of research in showing that explicitly
teaching phonics and phonological awareness skills is an important part of early reading instruction.
[Approximately 30% of the population will not respond to explicit instruction of phonics and must have brain preparation prior to phonics training where they can become phonologically aware and have adequate memory to handle the various tasks of  phonics instruction and use the skills in reading.   Becoming phonologically aware requires one or more changes in the  brain's capability(ies).  That/those capabilities may have up to that point been dictated by heredity, where the brain's necessary centers are not active or active enough, and/or process sounds slowly;  malfunction from interference due to middle ear infections during the formative ages, where sounds were learned inaccurately; and vestibular system dysfunction, which interferes with focus/concentration, balance, rhythm and further results in reducing necessary multi-tasking capabilities required in reading.  DMK]
 

Gains in early reading skills are mediated by the effect of the intervention on phonological processing abilities.

The interventions used in the NICHD studies, however, involve more than explicit teaching of phonics. They also include a major emphasis on reading and writing in environments that include good literature, reading for enjoyment, and other practices believed to facilitate the development of reading skills and literacy (Adams 1990). Hence, the NICHD studies are consistent with educational research highlighting the importance of balanced approaches to reading instruction (Adams, Treiman, and Pressley 1997). Moreover, these studies are based on a large body of NICHD research on how children learn to read. The intervention studies apply the findings of this research. If the NICHD had never funded a single study of intervention or learning disabilities, this research on normal processes of reading development would still have major policy implications for teaching children to read. 

In the remainder of this chapter, we outline some of the major findings of this research, which is now taking place in thirty-six sites in North America. The research that focuses on reading failure was based on earlier ongoing research, also funded in part by NICHD, that critically analyzed the nature of reading skills, how children learn to read, and the bases of reading failure (Lyon et al. 1997). In fact, the NICHD funds research on learning processes at all levels; cellular, experiential, neurological, and in humans and animals. The NICHD also funds research on many aspects of the reading process, such as eye movements in beginning and skilled readers, relationships of language and reading in non-impaired children and adults, social and biological factors in literacy, and other areas that affect reading but do not involve disability.

During the past thirty-three years, NICHD reading scientists have studied, at thirty-six research sites, the reading development of 34,501 children and adults, including 21,860 skilled readers and 12,641 impaired readers. As the titles of the selected research projects in the appendix indicate, approximately 50 percent of the current NICHD research effort in reading is devoted to research on how language, reading, and reading-related skills emerge in proficient readers; the other 50 percent addresses factors that impede the acquisition of those skills. As the titles of the research projects in the appendix indicate, multiple processes related to reading; phonological awareness, word recognition, reading fluency and automaticity, reading comprehension processes, and social and biological factors in literacy, are currently being addressed by the NICHD-sponsored research. There is also considerable research on reading and reading failure not funded by the NICHD, but our report focuses on findings obtained from NICHD research.

Prevalence and Outcomes
One set of issues addressed by NICHD research involves the number of children with reading problems and the long-term course of reading difficulties, which led Congress in 1985 to authorize NICHD to expand its research program on reading and disabilities in reading and learning. The magnitude of the reading problem is significant. From NICHD and non-NICHD research, we know that at least 10 million school-age children in the United States are poor readers. Reading problems occur with equal frequency in boys and girls; in schools, however, boys are identified as learning disabled in reading four times more often than girls, largely on the basis of behavioral characteristics that lead to referral of the child for special education (Shaywitz et al. 1990). The prevalence of reading disability is approximately 20 percent of school-age children depending on how disability is defined and where it is studied (Shaywitz et al. 1992). It may be higher than in previous  epidemiological studies in the 1970s (Benton and Pearl 1978), but variations in definition and the absence of comparable assessments over the past twenty years make that difficult to establish (Lyon 1995; Lyon et al. 1997). Whether rates of reading failure are increasing or decreasing begs the question of the significance of reading failure rates. The number of children who are identified as disabled or who do not meet basic levels of proficiency on reading assessments such as the National Assessment of Reading Proficiency (more than 40 percent in 1994) should be cause for alarm regardless of whether the rate is changing.
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Long-term outcomes of early reading difficulties are poor.
In one recent study, 74 percent of children who were poor readers in the third grade remained poor readers in the ninth grade.
Figure 1, which displays growth in reading skills in a large group of children studied from kindergarten through ninth grade, indicates that most poor readers never catch up on their reading skills (Francis et al. 1996). This pattern is apparent even before the third grade. In another study, Juel (1988) found that word recognition skills at the end of the first grade were strongly related to reading proficiency at the end of the fourth grade. Indeed, almost nine of ten children who were deficient in reading in the first grade were poor readers in the fourth grade. Similarly, Torgesen et al. (1997) reported that more than eight of ten children with severe word reading problems at the end of the first grade performed below the average range at the beginning of the third grade. [Lyon has made a statement in other articles and in speeches which, when taken out of context, sounds as if a person will never catch up if they have never gotten proper training/treatment before 4th grade.  The research just shows that early intervention is important and in fact easier, so that the kids who are still getting help after that won't catch up without proper procedures provided mostly through one-on-one instruction.  Our experience and those of some other clinics throughout the country is that remediation is possible at any age.  DMK]  Hence, it is not surprising that special education figures from the U.S. Department of Education (Office of Special Education Programs 1993) show that less than 25 percent of children in special education were identified as learning disabled before 1980. [The figure is now well over 50% and would be higher if clever ways of raising the statistical requirements, excluding children from testing or lowering standards of exiting criteria had not been found.  Many children, especially adolescents also become humiliated by being in these programs, or their parents decide to pull them out because the program never fulfilled its promise.  A few lucky ones found their way to clinics like ours and are okay now.   But, they are the exception rather than the rule.  Most unfortunately develop many problems and usually drop out.   The programs are still overloaded, because no one who is truly LD ever gets remediated.  The LD teachers are supposed to be specially trained, but most are not.  Even if they were, they are not allowed to do the type of one-on-one training required.  Nor are paraprofessionals being given the training, which can assist the teachers and the students, in ways that would make this type of required training possible.  A large number of LD students could receive what they deserve, be remediated, and therefore be able to go back to the regular classroom and be successful.  Some of the research reported below and a newly published article in February's Journal of Learning Disabilities, by Joseph Torgesen, et al, speak to these crucial elements and at least in Dr. Torgesen's article, proposes the changes.  DMK]

In Figure 2, we see the number of children identified for different eligibility categories in special education from 1977 to 1993. By 1993 more than 50 percent of eligible children were in the learning disabled category. Many factors underlie this increase (Allington 1991),  [See above. DMK]  but instruction should be considered. [No Doubt, but those who did not get the appropriate preventative or instructional approaches who were truly LD and went to the Special Program did not become remediated and therefore did not "Catch Up".  DMK]  Of particular interest is the report that, of all children identified as learning disabled by public schools, 70-80 percent are primarily impaired in reading; 90 percent of those children have difficulties with word recognition skills (Lerner 1989). Critical questions are how word recognition skills are learned, and why poor readers have difficulty with single-word skills. The answers to these questions reside in research on the relationship of language and reading. 
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Language and Reading
What we know about reading and language begins with a simple observation made by the noted speech scientist Alvin M. Liberman, who has long argued that reading is dependent on language but is not a natural outgrowth of language. 

As Liberman (1997, 4-5) recently observed:
A proper theory of speech is essential to an understanding of how people read.  The most relevant consideration arises out of the deep biological gulf that separates the two processes. Speech, on the one side, is a product of biological evolution, standing as the most obvious, and arguably the most important, of our species-typical behaviors. 
However, reading and writing did not evolve biologically, but are developed (in some cultures) as a secondary response to that which evolution had already produced. A consequence is that we are biologically destined to speak, not to read or write. 
Accordingly, we are all good at speech, but disabled as readers and writers.  The difference among us in reading and writing is simply that some are fairly easy to cure and some are not.
In other words, oral language, which humans have possessed for millions of years, usually unfolds as a natural biological progression. It is not an automatic unfolding, however, as is commonly believed. Environmental factors also have significant influences on early language development. The difference is that most children develop language proficiency through interactions that are not explicitly intended to teach the child to talk. In contrast, written language is an artificial construction built on oral language. Thus, reading, which humans have possessed for only about four thousand years, does not reflect a biological process that emerges naturally. Although children vary in how explicitly reading must be taught, even children who seem to learn to read at an early age have a period in which the nature of print and its relationship to language is brought explicitly to their attention (Gough and Hillinger 1980; A. M. Liberman 1997). 

Given that reading must be taught, how else would we explain illiteracy in literate cultures?  The questions that NICHD and other researchers have puzzled over are:

1.  What aspects of reading must be taught? 
2.  Why do children fail to learn to read? 
3.  How do you best teach poor readers to read? 

What Must Be Taught
The critical component of reading that must be taught is the relationship of print to speech.  Many other components of reading, particularly those that relate to comprehension, are outgrowths of the child's facility for language. For example, in what is described as the "simple view" of reading, Gough and Tumner (1986) proposed that reading consists of two primary components: decoding, or word recognition, and language comprehension, both of which are necessary for reading proficiency. [This is indeed "simple". The Ability to read is  "ROCKET SCIENCE" as is so aptly stated by Dr. Louisa Moats.  But simply put, this leaves out one of the most important large component parts --- Memory.  Whole Word Memory, where words can be learned with or without decoding, is a part of the big triad not dyad, of necessary training of reading.    Decoding is vital because it is helpful even with "sight words", which are words that are not phonetically "pure" (48% of words).  Many of these have patterns which come from other languages and these can be learned (McCabe, www.avko.org) but many have to be memorized.  DMK] Children do not become proficient readers unless both components are fully developed. In other words, children who cannot decipher the words on a page in a fluent and accurate manner will struggle to comprehend the meaning of the text; without proficient language comprehension skills, even children who recognize the words may not necessarily understand their meaning. Word recognition skills are intrinsic to reading, reflecting the need to decipher print, whereas language comprehension pervades all areas of literacy. Reading comprehension skills can (and should) be taught (Adams et al. 1997), but word recognition skills are essential for the child to become proficient.  [This is essentially true, from a research and clinical practice perspective, as well.  And something not yet from a research perspective is that there are a lot of people who read words very proficiently and can't comprehend or comprehend very poorly.  Even after a lot of comprehension skills training.  why?  From the discussion on these pages you would think it would be rare for those who could read the words well.  But it's not.  The reason stems from whether a person has been able to and whether they can now make vivid, accurate and complete mental imagery (mental movies) of what they read and as well what they hear.  DMK]  Hence, in the simple view, reading proficiency is the product of word recognition and language comprehension skills [Making vivid, accurate and complete imagery.  DMK]; some of the controversy among reading professionals is not whether both sets of skills must be mastered but how children master these skills and how explicitly these skills must be taught. The broader underlying issues involve philosophical views on learning and development, such as whether children master skills or construct knowledge. The NICHD research clearly stems from a skills perspective.  Research supported by the NICHD shows that learning to read is a developmental process children go through in acquiring proficiency. Because proficient readers employ processes that are different from beginning readers, research on good readers may not fully apply to beginning readers. Skilled readers do not gloss or skip over words when reading text; they sample nearly every word. Phonological codes that involve the sounds of words and help the reader decipher the words are activated early in word recognition in beginning and skilled readers (Rayner, Sereono, Lesch, and Pollatsek 1995). However, the task for the beginning reader is to move from the early phases of "sounding out" words to the more skilled phase in which word recognition occurs almost instantaneously. This developmental change allows the word recognition process to occur fluently, automatically, and rapidly enough to allow for the abstraction of meaning from text. Without efficient (automatic) word recognition skills, comprehension is impaired even when the underlying comprehension processes are well developed.

How do children learn word recognition skills (i.e., decode)? The answers have their origins in research from the NICHD-supported Haskins Laboratories in New Haven, Connecticut, that extends over a thirty-year period (see Brady and Shankweiler 1991; A. M. Liberman 1996; Lyon et al. 1997). In the late 1960s and early 1970s, investigators at the Haskins Laboratories were studying the relationship of speech and language. Through a series of experiments, they discovered that how speech is articulated influences the relationship between spoken and written language (A. M. Liberman 1996). This relationship involves how the sound structures of language are represented in speech (i.e., phonology). Speech can be broken down into sounds smaller than the word or the syllable called phonemes, the smallest parts of speech that make a difference in the meaning of a word. A critical discovery was that phonemes overlap, or are co-articulated, in the speech stream (Liberman, Cooper, Shankweiler, and Studdert-Kennedy 1967). As Blachman (1997) reports, the late Isabelle Y. Liberman and her colleagues (I. Y. Liberman 1971, 1973) expanded this discovery to the processing of speech, observing that a fundamental task for the beginning reader is understanding not only that speech can be broken down into phonemic segments but that these segments are represented by the alphabet in printed form. Liberman and her colleagues undertook a series of studies of how children learn to read, showing that beginning readers must become aware of the phonological structure of oral language (i.e., phonological awareness) in order to appreciate how print represents speech (Brady and Shankweiler 1991; A. M. Liberman 1996; I. Y. Liberman et al. 1989). Developing this awareness, however, is not automatic because phonemes are not separated in producing speech, which makes the phonetic structure of speech obscure. Yet being aware of how print represents the phonological structure of spoken words is the key skill specific to reading that children must learn. That awareness is the basis for scaffolding written language onto oral language.
The early (and continuing) work of investigators at the Haskins Laboratories; the cornerstone of the research supported by NICHD on reading failure, has had international influence leading to a large accumulation of data supporting the key role of phonological awareness. That research also led to non-NICHD-supported longitudinal studies of preschoolers in Great Britain and Sweden showing that early activities involving phonological awareness skills (i.e., rhyming and alliteration games) helped reading skills later in school relative to the reading skills of children who did not receive these activities (Bradley and Bryant 1983; Lundberg, Frost, and Peterson 1988). Other NICHD and non-NIHD studies of children who varied in reading levels, socioeconomic backgrounds, and literacy experiences have also shown that explicit training in phonological awareness skills before first grade is associated with better reading skills later (Byrne and Fielding-Barnesly 1995; Torgesen 1997).
Phonological awareness is only one, albeit large, component of learning to read. Many processes and experiences are critical for the development of beginning reading skills (Adams 1990; Adams et al. in press; Share and Stanovich 1995). These include not only phonological awareness skills but also letter and print awareness, early language experiences, and a literacy background. As Adams (1990) pointed out, however, these early processes are only a means to ends, with one goal being efficient word recognition. In addition, as Gough and Tumner (1986) noted, the second goal, comprehension, depends not only on word recognition skills but also on the child's general capacities for language comprehension, as well as other cognitive processes involved in processing text, such as short-term memory. These processes can be fostered through effective teaching of strategies and can be understood as the construction of meaning, representing an active process in which the reader, teacher, and text interact (Brown, Pressley, Van Meter, and Schuder 1996). Text reading processes, however, do not explain why most children fail to learn to read. In the next section we review NICHD research on reading failure, for it is with poor readers that the importance of word recognition processes and phonological awareness skills are most apparent.
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Why Children Fail to Read - Word Recognition Deficits
Fundamental to this question of reading failure is a set of observations that make it possible to approach poor reading scientifically. Although we know that reading problems occur primarily at the level of the single word and involve the ability to decode printed words (Shaywitz 1996; Torgesen 1997; Vellutino 1979, 1991), the basis of this problem was not clearly established until more recently. Research on developing reading skills in non-disabled children, and word recognition skills in poor readers, established that word recognition problems arise from problems breaking apart words and syllables into phonemes. This relationship is apparent in the majority of poor readers, including children, adolescents, and adults at all levels of IQ and in children and adults from linguistically and culturally diverse backgrounds. To reiterate, reading is alphabetic, which means that, for languages such as English and Spanish, the code is in the alphabet. Even in languages that are not alphabetic, like Chinese, the code is still based on phonology and relationships of phonemes to the characters (logograms) of Chinese writing.
Simply put, word recognition, or decoding, is looking at a word and cracking a code. The code is in the print but is essentially an alphabetic one whereby the child must learn to relate phonological structures in spoken words to print. Thus, proficient readers can come close to pronouncing words never before heard, much less seen, and can even pronounce pseudo-words (i.e., nonsense words) with a phonetic structure, such as crad. Hence, when children develop word recognition skills they become aware that words have an internal structure based on their sounds and represented by the alphabet. Comprehension of the word thus becomes almost instantaneous.
When children learn how print represents the internal structure of words, they become accurate at word recognition; when they learn to recognize words quickly and automatically, they become fluent. Many children seem to figure out these relationships regardless of how they are taught. For some children, the actual percentage is difficult to estimate, but it is probably at least 20 percent and most likely more - this relationship is not straightforward and may need to be explicitly taught; hence the problem we have today. 
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Causes of Poor Reading
The NICHD research has not found the processes underlying reading disability to be qualitatively different from those processes associated with early reading proficiency. Reading problems occur as part of a natural, unbroken continuum of ability. What causes good reading also leads to poor reading when the processes are deficient (Shaywitz et al. 1992). Many factors underlie the cognitive deficiencies associated with reading failure. Although these causes are multiple, most children's problems occur at the level of the single word. 

The NICHD has evaluated the following factors:
1.  Neurological
2.  Familial
3.  Cultural and Linguistic Diversity
4.  Instructional

Neurological
Brain activity when reading for the sounds of words, such as whether they rhyme, is different in good and poor readers (see Lyon and Rumsey 1997). Specific areas of the brain are involved, but a distinct neural signature has not yet been defined. Research on brain structure in poor readers shows subtle variations that are not consistent across studies. Much of this research has been done with adults who have a history of reading problems. Needed studies of young readers are under way. Recent studies using new technologies for measuring brain functions are promising but only beginning to emerge (Shaywitz 1996). A key question is whether improved reading may actually result in changes in brain functions. 

Familial
Reading problems run in families and cut across all sociocultural groups. These problems can have a genetic component, but several different genes are involved (Cardon et al. 1994; Grigorenko et al. 1997). In addition, genetic factors account for only about half of the variability in reading skills, which means that the environment has a significant influence on reading outcomes. For example, adults who read poorly may be less likely to read to their children. The quality of reading instruction may be more critical for children when there is a family history of poor reading.

Cultural and Linguistic Diversity
Both NICHD and non-NICHD studies show that print exposure, levels of parental literacy, and reading to the child are important (Adams 1990). Recent research, however, suggests that these influences are somewhat overestimated because intervention studies have been successful in culturally and linguistically diverse populations where home literacy experiences are often limited (Foorman et al. 1997a, 1997b, 1998; Torgesen 1997).  [Reading to a young child is great for developing the child's listening and for the strengthening of the bonding/rapport with the person who is reading, but only marginally helpful for the child who will struggle with reading.  Just ask a parent who did this extensively and the child still can't read.  The teaching and learning of reading is "Rocket Science". DMK]

Instructional
The influence of instruction in reading has been underestimated, as we will see when we turn to intervention studies. What is important is that the skills that prevent poor reading must be taught early-in kindergarten, grade 1, and grade 2. For many children, these skills may need to be taught explicitly over several years.
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Teaching Poor Readers to Read
The NICHD has supported several studies of how to prevent reading failure and how to intervene with poor readers. These studies have been coordinated by centers at Bowman-Gray Medical School, Florida State University, the State University of New York at Albany, the University of Colorado, and the University of Texas-Houston Health Science Center. The studies have taken place in multiple settings and include children with identified reading problems (Felton 1993; Torgesen 1997; Wise and Olsen 1995), children served in Title I programs (Foorman et al. 1998), kindergarten children at risk for reading failure (Foorman et al. 1997a; Torgesen 1997), and children reading poorly in populations that are predominantly middle class with relatively good literacy experiences (Scanlon and Vellutino 1996; Vellutino et al. 1996). In addition, more recent NICHD-supported investigations have been initiated at Georgia State University, Tufts University, Syracuse University, the Hospital for Sick Children in Toronto, and the University of Washington.  The primary goals of the intervention studies have been to (1) identify the conditions, abilities, and processes that must be available for a child to develop robust word recognition and reading comprehension skills and (2) identify for which children with reading difficulties are different instructional factors and  components most beneficial and at which stages of reading development (Lyon and Moats 1997). With these goals in mind, these studies share common features, including the assessment methodologies. The studies are based on research (described above) showing how normal children learn to read and applying this research to the study of reading failure. Hence, the studies share an emphasis on the effectiveness of teaching word recognition skills, usually through phonics or phonological awareness training or both.  In many studies, the research was designed to evaluate the degree of explicitness required to teach word recognition skills. Instruction in word recognition skills, however, occurs along with opportunities for applications to reading and writing, exposure to literature, and other practices believed to facilitate the development of reading skills in proficient readers. This reflects one of the oldest observations of any form of teaching or training-a targeted skill cannot be learned without opportunities for practice and application. Because of the interest in these studies, each NICHD site will be discussed separately.
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The Bowman-Gray Reading Intervention Studies
Brown and Felton (1990) and Felton (1993) compared the efficacy of interventions defined as code-based, which emphasized identification of words based on letter-sound associations and patterns, and meaning-based, which emphasized identification of words based on context supplemented by partial letter-sound cues (i.e., beginning and ending sounds). The children were identified at the end of kindergarten as at risk for reading failure based either on deficient phonological awareness skills from tests administered by the researchers or by teacher identification or both. In addition, children were also followed who received the school's standard instructional program. Thus, kindergarten children were randomly assigned to one of two reading instruction programs for first and second grade, along with a third group who received the school's standard curriculum. Children were taught in small groups in regular classrooms within the child's home school.  The meaning-based approach used a basal reading program, whereas the code-based approach explicitly taught phonics. These programs were selected because they taught similar word recognition skills in the first- and second-grade curriculums but varied as to whether the instruction in word recognition skills was explicitly presented by the teacher. At the end of the second grade children who had received the code-based instruction earned significantly higher mean scores than children who had received the meaning-based approach on measures of word recognition and spelling. Felton (1993) concluded that five elements were critical to a beginning program for children at risk of reading failure: 

1. Direct instruction in language analysis.
2. Explicit teaching of the alphabetic code.
3. Reading and spelling must be taught simultaneously.
4. Reading instruction must be sufficiently intense for learning to occur.
5. Using decodable words and texts enhanced automaticity.

In another study, children with identified reading disabilities in grades 2 and 3 who were provided services in special education resource rooms received one of two programs in which phonics was taught explicitly. Children in these two groups were compared with a group that received an intervention that involved training to read words on sight (Foorman et al. 1997b).  Although children who received one of the phonics programs showed better gains in phonological analysis and word reading skills at the end of one year of intervention, the differences in word reading skills were not apparent when verbal intelligence scores-higher in this group-were controlled in the analysis. In fact, the best predictor of outcomes in all three groups was the child's initial status in word-reading ability, which suggests that the programs were not effective because the child's end-of-year reading ability could be predicted solely on how well he or she read at the beginning of the year. The results of this second study, which contrast with the results from Florida State University and the State University of New York at Albany, may reflect the use of a pullout model in which small groups of children were instructed (Foorman et al. 1997b), rather than receiving instruction in a one-to-one setting. It also may take more intensity to establish the types of gains observed in the Torgesen (1997) and Vellutino et al. (1996) studies.

The third study involved children identified as eligible for Title I services in eight of ten Title I-eligible schools in the district (Foorman et al. 1997a). These children, who were culturally and linguistically diverse and generally economically disadvantaged, received classroom-level interventions in an attempt to evaluate the degree to which the alphabetic principle must be taught explicitly to facilitate gains in reading skills. The 375 children in the eight schools received classroom-based instruction that involved :
The district's standard context-based, meaning emphasis instructional program, with staff development and supervision provided by district personnel.  A context-based, meaning emphasis approach where professional development and monitoring were provided by research  staff.  A program in which phonological awareness and phonics skills were taught using letter patterns embedded in the reading material.  Or a program that included explicit instruction in phonics, applications in reading and writing, and exposure to literature.
The analyses in Foorman et al. (1998) involved only the 285 children who received tutorial services.  Foorman et at (1997b) provided preliminary results on the entire sample.
At the end of one school year, the children who received the approach that included explicit phonics instruction with application in literature showed significantly greater gains in word reading and reading comprehension than children who received the other forms of instruction. The results can be seen in figure 3, which shows the growth in word reading over the school year for the four groups. Unfortunately, many children in the other instructional programs-particularly those with poor phonological awareness skills-showed few gains in reading ability. Children who received the combined approach had word reading and reading comprehension skills that approximated national averages at the end of the year. The overall failure rate of children who received this approach represents 5.5 percent of the population from which these children were selected.
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Conclusions:
Intervention Studies
Studies of Reading Failure Can Improve Classroom Reading Practices.
Complete Approaches to Reading Instruction.

Intervention Studies
The promising experimental intervention programs described above provide hope for children who read poorly. More research is needed, including long-term follow-up to see whether the gains are maintained. Much needed additional research on identifying specific components of effective programs, such as the use of decodable versus predictable text and training in automaticity, is in progress. In many of these studies, phonological awareness training and explicit instruction in phonics lead to improved word recognition skills. The Issue of transfer of the training results to reading ability independently of the training - apparent in some but not all studies - is clearly important, however, and requires additional research. This issue is relevant not only for transfer to real-word reading but also for the development of reading comprehension skills. Skilled reading is more than just efficient decoding. Development of word recognition skills is a necessary but not sufficient condition, for reading proficiency is defined as the ability to understand reading materials. Once children develop accurate word recognition skills, they must be able to decode words rapidly; comprehension processes are separable and can be taught. It does not seem reasonable, however, to expect proficiency in comprehension, much less literacy, if the child cannot decode words in isolation or in text.
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Studies of Reading Failure Can Improve Classroom Reading Practices.
In considering how studies of reading failure can lead to improved classroom instruction, we must recognize that the intervention studies described in this brief summary have their origins in studies of beginning and skilled readers; thus the principles derived from these studies tend to focus on processes that are part of the early development of reading skills because beginning reading skills are the level at which most poor readers fail. One goal has been to identify where most poor readers have difficulty (i.e., word recognition and phonological awareness skills) and to use that information as the basis for intervention. As the intervention studies show, applying these findings potentially [See comments below.  DMK] translates to lower failure rates in overall school populations through classroom instruction and tutorial programs.  [Potentially!  Ladies and gentlemen there is no potentially about it.  Our 15 years of success and that of others we know, as well as, the wealth of evidence from NICHD research means that most assuredly there would be a major reduction not only in the failure rates, but in the LD identification rates and the rates of the many things which result when you have people of very low self-esteem trying to make it in the world.  DMK] 

When NICHD and other research suggesting an important role for explicit instruction in word recognition skills is examined by some reading professionals and the media, arguments arise over whether children should be taught with phonics methods or through meaning-based approaches (Chall 1967, 1983). In general, the NICHD research does not lead to extreme positions on either side of this debate. Most of the NICHD-supported intervention studies employed programs that include important elements from context or meaning-based (so-called Whole Language) programs as well as explicit instruction in the alphabetic code. In fact, the NICHD research supports approaches embedded in both phonics and Whole Language approaches. The tendency to interpret the NICHD research, often in the name of "science," as supporting phonics instruction as a panacea for literacy problems is particularly disturbing.  [Indeed.  This comes from the detractors who have something to gain by continuing our ignorance.  Once we establish a clear-cut research based curriculum there won't be a change in philosophy and thus a change of books every 6 to 10 years.  What if you have made a name for yourself theorizing in other directions and that the answer to reading problems in some place else.  Big businesses and lots of people stand to lose a lot of money and "prestige".  DMK]  For example, materials distributed by the National Right to Read Foundation, as well as a report that purports to summarize NICHD research (Center for the Future of Teaching and Learning 1996), exaggerate the findings of these studies, especially the extent to which the intervention results support the instructional recommendations in the reports. NICHD researchers have used a variety of phonics techniques, often as part of a comprehensive approach to intervention. No NICHD data support a single approach to phonics, much less a specific sequence, number, or set of rules that must be learned, or an essential role for decontextualized drills. We lament the reliance on ideology and invective as opposed to the more difficult task of completing the research that will help educators and policy makers implement effective reading practices. No simple, single message can be obtained from the NICHD research.

The NICHD studies do support a role for instruction in the alphabetic principle, including phonological awareness skills and phonics, as an essential and necessary (but not sufficient) part of early reading instruction. In addition, the research suggests that for children at risk for reading failure or who are poor readers, phonics knowledge should be presented explicitly and in an orderly progression. Such instruction in the early grades may actually prevent reading failure, which is why we feel it should be part of regular classroom practices for all children.  In many classroom settings, obtaining this type of instruction is a problem.
As Adams and Bruck (1995) and Pressley and Rankin (1994) point out, however, Whole Language practices have come to predominate in regular classroom instruction in reading today for some good reasons. For example, the emphases on meaning, comprehension, writing, and the general philosophy of integrating reading and writing to enhance meaning have had positive influences on literacy instruction. Research evaluating Whole Language practices shows that some children, who otherwise might not see a reason to read, learn to enjoy reading and writing when provided with these types of programs. The Whole Language movement has increased the quality of literature in schools, provided more emphasis on library resources, and shifted the goal of reading instruction toward meaningfulness and enjoyment. Children and their families are encouraged to spend more time reading and writing, which dearly facilitates improved ability and interest. Positive attitudes toward reading are associated with Whole Language practices. At the same time, some advocates of Whole Language practices who are opposed to putting any emphasis on phonological awareness skills, phonics skills, and word recognition processes have done many students a disservice. [Indeed, this is sadly true.  Steve Truch in his book,  the missing parts of whole language  (which we will be glad to share)  gives a thorough discussion of all the issues discussed on these pages and the problems which have arisen because of a "whole language only" approach.  DMK] illustrate, Goodman (1986) argues that segmenting words to learn to read was unnatural and hindered learning: 
 

This view is not only incorrect but potentially destructive, particularly for the many children at risk for reading failure because of deficits in phonological awareness skills. Pressley and Rankin (1994) discovered that experienced and highly successful teachers, including many who view themselves as whole language teachers, teach phonics, often explicitly, but tend not to rely on commercial phonics programs. Many who espouse the principles of whole language, however, are openly critical of teachers who teach phonics.  Indeed, the view put forth by many Whole Language proponents-that reading is a process as natural as learning to speak-is inconsistent with contemporary cognitive science. 
This inconsistency was clearly outlined in a letter to the commissioner of education in the
state of Massachusetts signed by forty well-established scientists from major higher education institutes in Massachusetts, many of whom study language and reading. In that letter, the authors observed that "learning how to decode the speech sounds notated by the writing system ('phonics') is fundamental to reading." The authors also observed that the hypotheses concerning the nature of language central to some Whole Language viewpoints are not supported by linguistic research. The authors specifically rejected "the view that the decoding of written words plays a relatively minor role in reading compared to strategies such as contextual guessing. This latter view treats the alphabetic nature of our writing system as little more than an accident, when in fact it is the most important property of written English-a linguistic achievement of historic importance." The state of the science relevant to the role of alphabetic coding in beginning reading was summarized succinctly by Stanovich (1994), who stated  that "direct instruction in alphabetic coding facilitates early reading instruction is one of the most well established conclusions in all of behavioral science".

Conversely, the idea that learning to read is just like learning to speak is accepted by no responsible linguist, psychologist, or cognitive scientist in the research community. (pp. 285-86) The most credible solution to reducing reading failure is much like that proposed by Adams (1990) who endorsed a balance between literature based (meaning oriented) instruction and systematic and explicit instruction in phonological awareness, phonics, and other processes underlying word recognition skills. The extent to which these concepts can be used depends on the level of reading development in an individual child. No reading program is equally beneficial for all children. Successful teachers include elements of code-based instruction with a rich, meaning-based context to develop the skills for reading success. 
A major question is how to become a successful teacher of reading. The research summarized in Pressley and Rankin (1994) indicates that teacher preparation is an important component in preventing reading failure. Recent reports have raised concerns about how well teachers are prepared to teach reading, particularly beginning reading and those processes involving language and word recognition skills (Moats and Lyon 1996). These reports have been oriented toward poor readers, and many factors influence outcomes with poor readers that don't involve classroom instruction, such as the amount of time spent on reading, the match of the classroom and the remedial program, and administrative policies (Allington 1991). Many skilled teachers, who often developed their effective approaches to reading instruction after college-through in-service programs, courses, and work with experienced mentors-regard their preparation in reading as inadequate. These issues are important because current evidence shows that effective classroom instruction can prevent reading
failure in many children (Blachman 1996, 1997; Foorman et al. 1998).
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Complete Approaches to Reading Instruction.
To prevent reading failure, classroom instruction must incorporate what we know about how children learn to read and why children fail to learn to read (Blachman 1996, 1997; Torgesen 1997). As the NICHD research shows, children need to master word recognition skills; many children require explicit instruction in word recognition skills based on early assessments of each child's phonological awareness and reading skills. Such instruction must also be integrated with the rapid processing of words, spelling skills, and reading comprehension skills. This report advocates not an overemphasis on decontextualized phonics but rather an emphasis on developing word recognition skills as part of a complete approach to reading instruction.

The NICHD reading research shows that many children do not develop adequate word recognition skills and thus supports the important role of explicit instruction in phonics and phonological awareness [Note comment at the beginning of this article.  DMK] skills. 
 

Failure rates of the magnitude we observe today are not acceptable. The intervention studies suggest that these failure rates can be reduced significantly with explicit instruction in word recognition skills as part of a complete reading program.   Programs that identify, and are applied on a child-by-child basis are expensive. [Expensive?  For whom?  If the person fails, it affects the school, others going to school there, the teachers, the family and friends of the individual and now and later the society in which this person functions.  What about those "expensive" costs?  When performed in private clinics, the training is monetarily expensive, in the short run, but this changes the person's life forever!  And it changes all  those other situations forever, as well.  There is a lot of money being spent on children in regular education and even more (per student) if they are LD.  We must change the way instructors are trained, yes, but once they are trained right, they need to deliver the service in the ways that it will work.  The ways that an "appropriate" education can be given so that remediation is possible.  The LD programs throughout America have 6% of the  school population in resource, self-contained or inclusion  programs.  If they truly gave an appropriate education to each of these pupils the research referred to on these pages suggests a reduction of 17 to 65%.  Most are suggestive of at least 50%.  Joseph Torgesen et al's recent article specifically showed an actual 40% reduction because of their remedial efforts.  The Kurtz Center and a few others who are ahead of the curve, although thankfully not as far as we have been, believe that 50 % is a reasonable albeit conservative expectation.  It might take a while, but it would seem that even the monetary costs would over a fairly short time be reduced rather than be more "expensive".  DMK]

The current magnitude of reading failure is too widespread to permit implementing the programs of the sort employed by Torgesen (1997) and Vellutino et al. (1996) unless the failure rate is initially reduced through effective classroom instruction (Foorman et al. 1998).
[Yes, it is imperative that we get classroom instruction where it needs to be, but who will train the trainers and well enough that these things can be done not only in reading but in all subjects.  The system of teacher training is seriously broken and in-service, piecemeal approaches are not going to work as well as we need to have this work (see web site below).  That we can't implement programs such as those by Torgesen and Vellutino is simply not true, except through short sightedness.  We can implement these programs, if we dive into the solution.  One that will work for both teacher training, but especially for trainer training and can make it happen sooner than later is proposed at www.ldinstitute.org .  DMK]

More research is needed to help develop cost-effective models for early identification, prevention, and intervention. [We may find the quick and even the group way to fix or at least minimize these problems.  In the meantime, lets assume that we have a vehicle that will work and not wait for the Mercedes bus.  We have many miles to travel and many lives to save. Let's get going with what we've got.  DMK]   We need to be able not only to distinguish between those who cannot be easily remediated and those who will need prolonged remediation but also to maintain gains in children who respond to intervention.
 

Learning to read is a lengthy and difficult process for many children, and success is based in large part on developing language and literacy related skills early in life. Reading failure reflects the lower end of reading proficiency; no qualitative characteristics distinguish the poor reader from the good reader. Since reading failure exists on a continuum, we must provide interventions on a continuum and adjust the emphases as the child develops proficiency.

A massive effort needs to be undertaken to inform parents, and the educational and medical communities, of the need to involve children in reading from the first days of life; to engage children in playing with language through nursery rhymes, storybooks, and writing activities; and, as early as possible, to bring to children the wonder and joy that can be derived from reading. Parents must be aware of the importance of vocabulary development and verbal interactions with their youngsters for enhancing grammar, syntax, and verbal reasoning. In addition, preschool children should be encouraged to learn the letters of the alphabet, to discriminate between letters, to print letters, and to attempt to spell words that they hear.  Introducing young children to print will increase their exposure to the purposes of reading and writing, their knowledge of the conventions of print, and their awareness of print concepts. 
Reading aloud to children is important for language development (Adams 1990). We must understand, however, that reading to children is not a demonstrably necessary or a sufficient means for teaching reading [See previous comments.  DMK]. Again, the ability to read requires a number of skills that, in many children, must be developed via direct and informed instruction provided by properly prepared teachers. In addition, spending more time reading and writing is key to enhancing literacy levels even in children who are disabled in reading.  Effective instruction early in development may ameliorate the effects of poor preschool literacy experiences [Should read "Will ameliorate the effects of poor preschool literacy experiences."  DMK].   The NICHD prevention and early intervention studies speak to the importance of early identification and intervention with children at risk for reading failure.
 

Procedures now exist to identify such children. This information needs to be widely disseminated to schools, teachers, and parents. Kindergarten programs should be designed so that all children will develop the prerequisite phonological, vocabulary, and early reading skills necessary for success in the first grade. [Not just kindergarten, but preschool and head start programs as well.  The Kurtz Center has developed a program called "Preparing the Brain for Learning to Read and Spell Efficiently and Effectively".  This program offers the things you have read about and much more. We have been offering it for several years and each time we do training the teachers are surprised, overwhelmed with what they never knew, but mostly very appreciative that for as long as they teach they will truly make a difference and feel wonderful about themselves because they are great teachers.  DMK]

More specifically, beginning reading programs should ensure that adequate instructional time is allotted to the teaching of phonemic awareness skills, phonics skills, and spelling and orthographic skills. As the child develops proficiency with word recognition, reading fluency, automaticity, and comprehension strategies should be emphasized. All of these components of reading are necessary but not sufficient components of a complete approach to reading instruction. For children having difficulty learning to read, it is imperative that each of these components be taught in an integrated fashion and that ample practice in reading nstructional-level material be afforded. 

An impediment to serving the needs of children demonstrating difficulties learning to read is current teacher preparation practices in many colleges of education. Many teachers lack basic knowledge and understanding of reading development and the nature of reading difficulties. Major efforts should be undertaken to ensure that colleges of education possess the expertise and commitment to foster expertise in teachers at both pre-service and in-service levels. Strong knowledge and skills-based training programs with formal board certification for teachers of reading should be developed. [A way for trainers to be the best so that the instructors can be the best is to have them experience the training in an intensive residency/practicum type program.  For the idea whose time has come see www.ldinstitute.org . DMK] 

The sad irony is that we have known about reading development and reading difficulties for more than the past thirty years. The ophthalmologist Hinshelwood, who was one of the earliest students of reading failure, observed, like most of his colleagues at the time, that people who read poorly had problems at the level of the single word-they called it word-blindness. He was wrong about the basis of the problem-he thought it was attributable to visual deficits when we now know that reading is a language-based skill and that poor reading is primarily due to language-based difficulties. But Hinshelwood was absolutely correct about the importance of understanding why children do not learn to read and about doing something about reading failure:
 

It is a matter of the highest importance to recognize the cause and the true nature of this difficulty in learning to read which is experienced by these children, otherwise they may be harshly treated as imbeciles or incorrigibles and either neglected or flogged for a defect for which they are in no wise responsible.  The recognition of the true character of the difficulty will lead the parents and teachers of these children to deal with them in a proper way, not by harsh and severe treatment, but by attempting to overcome the difficulty by patient and persistent training (1902, p. 99). That is as true today as it was almost a century ago. [AMEN.  DMK]

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Appendix
Selected NICHD Studies of Normal Reading Development and Reading Disorders
Research Topic Principal Investigator
(NR) = Normal Reading
(RD) = Reading Disorders
Reading Disability and Early Language Impairments (RD) D.M. Aram
Prevention and Treatment of Reading Disabilities (RD) V.W. Berninger
Handwriting, Spelling and Composition Skills (NR/RD) V.W. Berninger
Development of Reading Curricula for LD Children (RD) V.W. Berninger
Teacher Training in Reading Development and Disorders(NR/RD) V.W.Berninger
Gestures as Phonological Units (NR) C. Best
Phonologically-Based Remediation for RD Students (RD) B.A. Blachman
Development of Word Recognition Processes (NR) J.R. Booth
Colored Computer Displays Effects on Reading (NR/RD) L.H. Boyd
Neuroimaging Analysis of Reading Disability (RD) J.S. Duncan
EEG Studies of Disabled Readers (RD) R.A. Dykman
fMRI of Phonological and Sensory Processing in Dyslexia(RD) G.F. Eden
Analytic Processes Unique to Phonology (NR) L. Feldman
Behavioral Definition and Subtyping of Dyslexia (RD) F. Wood
A Longitudinal Study of Normal Reading Development (NR) D. Flowers
Early Interventions for Children At-Risk for RD (RD) B. Foorman
Phonological Development and Development of Literacy(NR) A. Fowler
Phonetic Gestures and Their Perceptions (NR) C. Fowler
Language Comprehension and Reading (NR) L. Frazier
Cognitively Based Treatments of Acquired Dyslexia (RD) R. Friedman
Acquired Dyslexia or Alexia After Stroke (RD) M. Friend
Cross-Domain Comprehension Processes (NR) P.J. Holcomb
Brain Morphology and Dyslexia (RD) G.W. Hynd
Epidemiology of Learning Disability (RD) S.K. Katusic
Common Phonology of Speech and Reading (NR) L. Katz
Interactive Reading/Spelling and Comprehension Software(NR/RD) P. Lindamood
Perceptual, Linguistic & Computational Basis of Dyslexia(RD) F.R. Manis
Examining the Strategic Processing Of Text (NR) S.M. Mannes
Syntactic Processes in Reading Development (NR) L. Maurais
Teacher Training for Reading Intervention (NR/RD) D. McCutcheon
Acoustic Structure of Speech to Young Children (NR) J.L. Morgan
Treatment of Developmental Reading Disabilities (RD) R.D. Morris
Schooling and Cognitive/Literacy Development (NR) F.J. Morrison
Language and Literacy in Bilingual Children (NR) D.K. Oller
Reading and Language Processes (NR/RD) R K. Olson
Computer-Based Remediation of Reading Disabilities (RD) R.K. Olson
Computer-Speech Feedback for Dyslexic Children (RD) R.K. Olson
rCBF and Behavior: Adult and Second Generation Dyslexia(RD) D.L. Pauls
Comprehensive Test of Phonological Awareness (NR/RD) A.A. Pearson
Social Relationships and Early Literacy Development (NR) A.D. Pelligrini
Linguistic Phenotype in Familial Dyslexia (RD) B.F. Pennington
Brain Morphometry and Reading-Disabled Twins (RD) B.F. Pennington
Language, Learning Ability and Language Development (NR) S. Pinker
Genetic Contributions to Learning Disability Subtypes (RD) W. Raskind
Foveal and Parafoveal Codes in Reading (NR) K. Rayner
Language Processing During Reading (NR) K. Rayner
Perceptual and Cognitive Processes in Reading (NR) K. Rayner
Emergence of Literacy in Sociocultural Context (NR) R. Serpell
Distribution and Typology of RD (RD) B. Shaywitz
Developmental Phonological Disorders (RD) L. Shriberg
Shape Bias in Children's Word Learning (NR) L.B. Smith
Genetic Linkage Analysis for Dyslexia (RD) S.D. Smith
Coordinating Information in Sentence Processing (NR) M. Tannenhaus
Prevention and Remediation of RD (RD) J.K. Torgesen
Phonological Processes in Reading Individual Words (NR) M.T. Turvey
Preventing Experientially-Based Reading Disability (RD) F. Vellutino
Reading-Related Phonological Processes (NR/RD) R.K. Wagner
Information Processing in LD Children (NR/RD) P.H. Wolff
Physiological Measures of Dyslexia (RD) F.B. Wood