CHAPTER 31
Reading Difficulties
Reading difficulties affect up to 10% of children and adolescents and
are of particular interest to psychiatrists because of the relatively strong
links between reading difficulties and disruptive behavioural problems.
Nearly all these reading difficulties are developmental in origin, though
brain damage in childhood or adolescence can result in acquired reading
disorders, and dementias lead to progressive deterioration in reading skills.
Poor reading skills have a detrimental effect on children and adolescents’
general academic trajectory and on their employment in adulthood. Chil-
dren and adolescents who do poorly on reading tests are also more likely
to perform poorly in other subjects, they have lower academic and reading
self-concepts, and are more likely to leave school with no qualifications.
Poor readers do not enjoy reading and they spend less time engaged in it,
contributing to the continuation of poorer reading skills.
Background information about normal reading
When they start to read, children learn to recognise a small number of
very familiar words (such as their own name) on the basis of visual
clues from the overall shape of the word. At this early stage, they are
generally unable to decipher new words. Subsequently, as they come to
understand the principles of letter–sound correspondence, they acquire
a phonological strategy for deciphering less familiar words. Eventually,
as reading becomes fluent, most words are recognised as a single entity
without the need for phonological decoding.
Though many linguistic and perceptual skills are involved in fluent
reading, individual variation in reading ability is more closely related to
linguistic than to perceptual abilities. In particular, preschool children’s
phonological awareness as indexed, for example, by their sensitivity to
rhyme and alliteration, is a good predictor of how well they will sub-
sequently learn to read (even when the effect of IQ is allowed for).
Improving phonological awareness enhances subsequent reading skill.
Child and Adolescent Psychiatry, Third Edition. Robert Goodman and Stephen Scott.
©c2012 Robert Goodman and Stephen Scott. Published 2012 by John Wiley & Sons, Ltd.
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