476
Academic Achievement Characteristics of Adult Males Who Were Diagnosed as Dyslexic in Childhood
John G. Frauenheim, PhD
This article reports the skill attainment in reading, spelling, and arithmetic for a group of 40 adult males who were diagnosed as dyslexic in childhood. The results of the follow-up assessment indicate that severe residual learning problems are present despite the fact that much special educational attention was provided during school-age years. Test performance and reports from subjects further demonstrate that current learning difficulties are essentially identical to those evidenced at the time of diagnosis.
K
velopmental dyslexia may be briefly escribed as a disorder in which the capacity to learn to read is impaired despite adequate intelligence, appropriate education and sociocultural opportunity, and basic intactness in those sensory functions associated with "normal" learning. The dearth of longitudinal and follow-up studies limits our understanding
of the prognosis for reading proficiency and the general effects of the disability on individuals over a period of time. The purpose of this study was to obtain data on a group of adults who had been diagnosed as dyslexic in childhood in an effort to further assess some of the current assumptions about the disability and hopefully add insight regarding its developmental course. Four areas were investigated: academic achievement, occupational status, educational attainments, and general adjustment characteristics. This article, however, will deal only with the academic achievement characteristics of the group.
DEFINITION Dyslexia in the present article is viewed in accordance with the discussion and definition presented by Rabinovitch (1968) as part of the
Volume 11, Number 8, October 1978 Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
21
477 proceedings of the National Conference on Dyslexia. In classifying reading problems according to cause, Rabinovitch suggests that there are two groups: (1) those in which the reading retardation reflects a definitive neurologic dysfunction in the absence of history or signs of brain injury and is referred to as primary reading retardation or developmental dyslexia, and (2) those in which- the reading retardation is not primary but secondary, or reactive, to other pathology or problem, such as mental retardation or emotional disturbance. The first grouping, that of developmental dyslexia, is specifically defined by Rabinovitch as follows: A disorder in which the capacity to learn to read is impaired without definite brain damage suggested in the history or on neurologic examination. The defect is in the ability to deal with letters and words as symbols, with resultant diminished ability to integrate the meaningfulness of written material. The problem appears to reflect a basic disturbed pattern of neurologic organization, (p. 5). The condition is also noted in the presence of average or above-average intellectual potential and is usually accompanied by specific difficulties with other symbol systems (numbers, musical notation). Rabinovitch, for example, has found that dyslexic individuals evidence impaired functioning in arithmetic and spelling as well as reading. Further, on achievement testing, spelling generally is the most impaired area of functioning, with reading next and then arithmetic. (For additional learning characteristics, see Rabinovitch 1968.)
STUDY POPULATION All of the subjects participating in the study had been diagnosed as dyslexic, as defined above, at Hawthorn Center (a mental health facility in Michigan for children and adolescents) through a multidiscipline evaluative process that included professionals in education, psychology, and psychiatry. Records were examined regarding those children who at the time of data collection were 18 years of age or older. Only males were 22
included due to the large male-female ratio (15:1) and to avoid introducing an additional variable that might detract from individual and group data examination. In addition, test data relative to the diagnosis had to be present and included measures of intelligence and of performance in the academic areas of reading, arithmetic, and spelling. Initial record screening produced a list of 108 potential subjects. An attempt was made to contact each person, with an end result of 40 subjects who agreed to participate in the study. Of those not participating, the majority (55) could not be located, two were deceased, two were in the armed services, and nine were unwilling to participate for undetermined reasons. The subjects who did participate were from predominately middle-class communities of the Detroit metropolitan area. The mean age at diagnosis for the study group was 11 years 6 months, with an age range of 8 to 15 years. In adulthood the mean age was 21 years 10 months, with a range from 18 to 31 years. The average number of years between diagnosis and follow-up was 10 years 3 months. Intelligence test information was taken from the Wechsler Intelligence Scale for Children (WISC), which in most cases was administered at the time of the initial evaluation at Hawthorn Center. In some instances testing had been completed prior to referral by some other agency, such as a child guidance clinic or public school special education department, and was not repeated if current (within six months). In all cases a verbal, performance, and full-scale IQ was available. Table I summarizes the intelligence test data. Performance IQ scores for all subjects fall within the average to superior range. WISC fullscale scores ranged from dull normal to bright normal. Of statistical significance was a mean 19point discrepancy between verbal and performance IQ scores (p < .001). The subjects at the time of diagnosis had significant academic retardation in reading, spelling, and arithmetic. The mean grade-level Journal of Learning Disabilities
Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
478 TABLE I. Intelligencetest data at the time of diagnosis. Mean
Verbal IQ
III
wise
form. The sentence used — "The yellow pig saw the little baby" — is considered to be at a secondgrade level of difficulty.
ACHIEVEMENT TESTING IN ADULTHOOD
86
Performance IQ
105
90-127
Full-scale IQ
94
80-112
Verbal-performance difference
19* N = 40
•f score = 14.30; p < .001
scores in these areas were as follows: reading, 2.3; spelling, 1.6; and arithmetic, 3.4 — which, based on expected achievement for mental age, represents 3.5 years retardation in reading, 4.6 years in spelling, and 2.4 years in arithmetic.
PROCEDURE All of the subjects were seen individually by the author in a fairly lengthy interview-test situation. Academic testing was done using the same instruments that were administered at the time of diagnosis, which included three formal measures of reading performance and one each in spelling and arithmetic. The reading tests included the oral reading section of the Gates-McKillop Reading Diagnostic Test (1962) and the vocabulary and comprehension sections of the Gates Beading Tests (1958). The reading scores reported here are the average of the three tests. The spelling and arithmetic tests were the achievement sections of the Group Diagnostic Reading Aptitude and Achievement Tests (Monroe-Sherman 1939). In addition, an informal sentence-to-dictation requirement was also administered to obtain a sample of handwriting and spelling in sentence
Testing in adulthood found that subjects continued to experience severe difficulty in all three academic areas and that relatively little progress had been made between diagnosis and follow-up (see Table II). In addition, many of the same types of basic skill difficulties/errors evidenced in childhood persisted into adulthood.
Reading The adult mean reading score (grade 3.6) is based on an average of the oral, vocabulary, and silent reading comprehension tests. The averaged reading scores ranged from a low of 1.5 to a high of 8.4. The subject who reached the 8.4 grade level was the only person who read above a sixth-grade level; the next highest scores were 6.6 and 6.3, with the remaining 37 subjects (92S) scoring at fifth grade or below. Twenty-five subjects (63%) obtained a reading score below fourth grade, the level of functional literacy. When compared with the average reading level for adults (approximately grade 10.5), the amount of retardation remains extremely serious. Further, a comparison of initial reading levels and those at follow-up demonstrates that minimal overall progress of 1.3 years was made during the interim 10-year period. Adult reading attainment was further analyzed in relation to two variables: the amount of specialized reading assistance received and the age at which special reading assistance was begun. Specialized reading assistance was defined minimally as assistance provided by a specially trained person, such as a reading specialist, two or more times per week in a group of 10 or less outside the regular classroom. The semester unit normally associated with the traditional school
Volume 11, Number 8, October 1978 Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
23
479
TABLE II. Mean reading, spelling, and
I
Test
Initial score
SD
Follow-up score
SD
Gain
Reading
2.3
.6
3.6
1.5
1.3
Spelling
1.6
1.2
2.9
1.3
1.3
Arithmetic
3.4
1.0
4.6
1.2
1.2
TABLE III Relationship between the amount of special reading assistance and reading levels in adulthood.
TABLE IV. Relationship between age at initial reading intervention and adult reading level.
Special reading assistance, semester units
Subject frequency
Mean adult reading level
Intervention age
Subject frequency
Adult reading means
9
3.9
6-10
14
3.7
11-15
11
3.4
7 8 9 10 11 12 13
2 15 8 6 4 2 3
3.7 3.6 3.1 4.6 3.1 4.7 3.1
16-24
6
3.4
9
A/ = 40
X = 3.6
1
"5
year, including the summer period, was used in determining the amount of special help received by a subject. The amount of specialized reading assistance varied considerably. The number of total semesters ranged from two to 24, with a mean of 10.6. Table III summarizes these data. One subject was receiving special reading help on a weekly basis at the time of follow-up. Overall, the amount of special reading assistance was not significantly related to adult reading level. These data suggest that for dyslexic children the amount of special reading help will not necessarily determine the level of reading com24
tic scores at diagnosis and follow-up.
X=
petency they will attain and that some may not reach a level of functional literacy. All of the subjects, however, acquired some reading skill, and one can surmise that, whatever their final status, they were helped by the assistance they received. The age at which special reading assistance was initiated was not significantly related to adult reading level either. The ages at which subjects first began to receive special reading assistance ranged from 7 to 13. The mean age of initial intervention was 9 years. Table IV summarizes these data. The reading performance of subjects merits some discussion. It was noted, for example, that Journal of Learning Disabilities
Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
480 all 40 subjects still occasionally reversed letters or small similar words such as on/no and was/saw. In 13 instances this specific difficulty was evidenced in reading performance, and in all of the remaining cases, subjects acknowledged, in interview, that they still experienced such problems. ITie nature of this problem, as described by subjects, relates to a specific difficulty in being unable to establish a consistent and automatic recall and association for words and letters. In the process of reading, words like was/saw, on/no and letters such as h/d are easily confused due to their similar structure and the fact that they are not firmly established in ones memory for written symbols. In no instance was there any suggestion or indication that these "reversals" were the result of seeing letters or words in a confused or incorrect manner. Visual discrimination was perfectly accurate with the breakdown apparently occurring at the associational level. In the past, some professionals have suggested that dyslexic individuals literally see some words and other symbols in an atypical fashion. Interviews with these subjects simply refute this position. All subjects continued to experience difficulty in the auditory as well as visual skill areas associated with reading. Phonic skills as evidenced in oral reading were poor and seemed to reflect a basic difficulty with sound-symbol association. This problem was further demonstrated in spelling responses where misspelled words lacked good phonetic components.
Spelling The results of the spelling test and sentence : todictation demonstrated that serious residual problems remained in this area of functioning for all subjects. The mean grade level score on the spelling test was 2.9; scores ranged from 1.3 to 6.6, and 70$ scored at grade 3 or below. Spelling in adulthood was the most seriously impaired area of academic functioning, with 80$ of the subjects scoring lowest in this area. An additional two subjects received the same score in reading and spelling. These results are similar
to those found at the time of diagnosis where 92$ of the subjects experienced the most difficulty in spelling. Errors in spelling, both on the spelling test and with the sentence given in dictation, although varied, seemed to typify the kinds of problems associated with dyslexia. When attempting to spell an unknown word, many subjects seemed to have difficulty translating the sounds into letter symbols, resulting in misspellings that lacked good phonetic components to the point that they might be considered "bizarre." The problem is less pronounced overall when a comparison between childhood and adulthood written responses is made; however, the difficulty is obviously present and remains significantly atypical. Letter reversals were evidenced in the written responses made by 11 adults. Several examples of spelling test responses are as follows: Key word
Response
study
sludn, stedid, staddy, sduey, shaen, stied, sitd
kitchen
chin, kinl, kengun, ckin
city
stiy, ciedy, deit, caiy
black
billk, blane, ballk
The general quality of the written responses to this sentence, "The yellow pig saw the little baby," was poor. Thirty-seven subjects (92%) made one or more errors. The average number of misspelled words was 2.8. The written responses to sentence dictation would seem to substantiate Critchley's (1970) impression that "disorders of writing are always considerable in cases of developmental dyslexia though they have not attracted the same attention. . . . Although every child who is dys-
Volume J7, Number 8, October 1978 Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
25
481
John Performance Verbal
\p-~* * *^y
CA IQ IQ 1
/ * &
^i
4&
Academic Achievement Characteristics of Adult Males Who Were Diagnosed as Dyslexic in Childhood
John G. Frauenheim, PhD
This article reports the skill attainment in reading, spelling, and arithmetic for a group of 40 adult males who were diagnosed as dyslexic in childhood. The results of the follow-up assessment indicate that severe residual learning problems are present despite the fact that much special educational attention was provided during school-age years. Test performance and reports from subjects further demonstrate that current learning difficulties are essentially identical to those evidenced at the time of diagnosis.
K
velopmental dyslexia may be briefly escribed as a disorder in which the capacity to learn to read is impaired despite adequate intelligence, appropriate education and sociocultural opportunity, and basic intactness in those sensory functions associated with "normal" learning. The dearth of longitudinal and follow-up studies limits our understanding
of the prognosis for reading proficiency and the general effects of the disability on individuals over a period of time. The purpose of this study was to obtain data on a group of adults who had been diagnosed as dyslexic in childhood in an effort to further assess some of the current assumptions about the disability and hopefully add insight regarding its developmental course. Four areas were investigated: academic achievement, occupational status, educational attainments, and general adjustment characteristics. This article, however, will deal only with the academic achievement characteristics of the group.
DEFINITION Dyslexia in the present article is viewed in accordance with the discussion and definition presented by Rabinovitch (1968) as part of the
Volume 11, Number 8, October 1978 Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
21
477 proceedings of the National Conference on Dyslexia. In classifying reading problems according to cause, Rabinovitch suggests that there are two groups: (1) those in which the reading retardation reflects a definitive neurologic dysfunction in the absence of history or signs of brain injury and is referred to as primary reading retardation or developmental dyslexia, and (2) those in which- the reading retardation is not primary but secondary, or reactive, to other pathology or problem, such as mental retardation or emotional disturbance. The first grouping, that of developmental dyslexia, is specifically defined by Rabinovitch as follows: A disorder in which the capacity to learn to read is impaired without definite brain damage suggested in the history or on neurologic examination. The defect is in the ability to deal with letters and words as symbols, with resultant diminished ability to integrate the meaningfulness of written material. The problem appears to reflect a basic disturbed pattern of neurologic organization, (p. 5). The condition is also noted in the presence of average or above-average intellectual potential and is usually accompanied by specific difficulties with other symbol systems (numbers, musical notation). Rabinovitch, for example, has found that dyslexic individuals evidence impaired functioning in arithmetic and spelling as well as reading. Further, on achievement testing, spelling generally is the most impaired area of functioning, with reading next and then arithmetic. (For additional learning characteristics, see Rabinovitch 1968.)
STUDY POPULATION All of the subjects participating in the study had been diagnosed as dyslexic, as defined above, at Hawthorn Center (a mental health facility in Michigan for children and adolescents) through a multidiscipline evaluative process that included professionals in education, psychology, and psychiatry. Records were examined regarding those children who at the time of data collection were 18 years of age or older. Only males were 22
included due to the large male-female ratio (15:1) and to avoid introducing an additional variable that might detract from individual and group data examination. In addition, test data relative to the diagnosis had to be present and included measures of intelligence and of performance in the academic areas of reading, arithmetic, and spelling. Initial record screening produced a list of 108 potential subjects. An attempt was made to contact each person, with an end result of 40 subjects who agreed to participate in the study. Of those not participating, the majority (55) could not be located, two were deceased, two were in the armed services, and nine were unwilling to participate for undetermined reasons. The subjects who did participate were from predominately middle-class communities of the Detroit metropolitan area. The mean age at diagnosis for the study group was 11 years 6 months, with an age range of 8 to 15 years. In adulthood the mean age was 21 years 10 months, with a range from 18 to 31 years. The average number of years between diagnosis and follow-up was 10 years 3 months. Intelligence test information was taken from the Wechsler Intelligence Scale for Children (WISC), which in most cases was administered at the time of the initial evaluation at Hawthorn Center. In some instances testing had been completed prior to referral by some other agency, such as a child guidance clinic or public school special education department, and was not repeated if current (within six months). In all cases a verbal, performance, and full-scale IQ was available. Table I summarizes the intelligence test data. Performance IQ scores for all subjects fall within the average to superior range. WISC fullscale scores ranged from dull normal to bright normal. Of statistical significance was a mean 19point discrepancy between verbal and performance IQ scores (p < .001). The subjects at the time of diagnosis had significant academic retardation in reading, spelling, and arithmetic. The mean grade-level Journal of Learning Disabilities
Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
478 TABLE I. Intelligencetest data at the time of diagnosis. Mean
Verbal IQ
III
wise
form. The sentence used — "The yellow pig saw the little baby" — is considered to be at a secondgrade level of difficulty.
ACHIEVEMENT TESTING IN ADULTHOOD
86
Performance IQ
105
90-127
Full-scale IQ
94
80-112
Verbal-performance difference
19* N = 40
•f score = 14.30; p < .001
scores in these areas were as follows: reading, 2.3; spelling, 1.6; and arithmetic, 3.4 — which, based on expected achievement for mental age, represents 3.5 years retardation in reading, 4.6 years in spelling, and 2.4 years in arithmetic.
PROCEDURE All of the subjects were seen individually by the author in a fairly lengthy interview-test situation. Academic testing was done using the same instruments that were administered at the time of diagnosis, which included three formal measures of reading performance and one each in spelling and arithmetic. The reading tests included the oral reading section of the Gates-McKillop Reading Diagnostic Test (1962) and the vocabulary and comprehension sections of the Gates Beading Tests (1958). The reading scores reported here are the average of the three tests. The spelling and arithmetic tests were the achievement sections of the Group Diagnostic Reading Aptitude and Achievement Tests (Monroe-Sherman 1939). In addition, an informal sentence-to-dictation requirement was also administered to obtain a sample of handwriting and spelling in sentence
Testing in adulthood found that subjects continued to experience severe difficulty in all three academic areas and that relatively little progress had been made between diagnosis and follow-up (see Table II). In addition, many of the same types of basic skill difficulties/errors evidenced in childhood persisted into adulthood.
Reading The adult mean reading score (grade 3.6) is based on an average of the oral, vocabulary, and silent reading comprehension tests. The averaged reading scores ranged from a low of 1.5 to a high of 8.4. The subject who reached the 8.4 grade level was the only person who read above a sixth-grade level; the next highest scores were 6.6 and 6.3, with the remaining 37 subjects (92S) scoring at fifth grade or below. Twenty-five subjects (63%) obtained a reading score below fourth grade, the level of functional literacy. When compared with the average reading level for adults (approximately grade 10.5), the amount of retardation remains extremely serious. Further, a comparison of initial reading levels and those at follow-up demonstrates that minimal overall progress of 1.3 years was made during the interim 10-year period. Adult reading attainment was further analyzed in relation to two variables: the amount of specialized reading assistance received and the age at which special reading assistance was begun. Specialized reading assistance was defined minimally as assistance provided by a specially trained person, such as a reading specialist, two or more times per week in a group of 10 or less outside the regular classroom. The semester unit normally associated with the traditional school
Volume 11, Number 8, October 1978 Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
23
479
TABLE II. Mean reading, spelling, and
I
Test
Initial score
SD
Follow-up score
SD
Gain
Reading
2.3
.6
3.6
1.5
1.3
Spelling
1.6
1.2
2.9
1.3
1.3
Arithmetic
3.4
1.0
4.6
1.2
1.2
TABLE III Relationship between the amount of special reading assistance and reading levels in adulthood.
TABLE IV. Relationship between age at initial reading intervention and adult reading level.
Special reading assistance, semester units
Subject frequency
Mean adult reading level
Intervention age
Subject frequency
Adult reading means
9
3.9
6-10
14
3.7
11-15
11
3.4
7 8 9 10 11 12 13
2 15 8 6 4 2 3
3.7 3.6 3.1 4.6 3.1 4.7 3.1
16-24
6
3.4
9
A/ = 40
X = 3.6
1
"5
year, including the summer period, was used in determining the amount of special help received by a subject. The amount of specialized reading assistance varied considerably. The number of total semesters ranged from two to 24, with a mean of 10.6. Table III summarizes these data. One subject was receiving special reading help on a weekly basis at the time of follow-up. Overall, the amount of special reading assistance was not significantly related to adult reading level. These data suggest that for dyslexic children the amount of special reading help will not necessarily determine the level of reading com24
tic scores at diagnosis and follow-up.
X=
petency they will attain and that some may not reach a level of functional literacy. All of the subjects, however, acquired some reading skill, and one can surmise that, whatever their final status, they were helped by the assistance they received. The age at which special reading assistance was initiated was not significantly related to adult reading level either. The ages at which subjects first began to receive special reading assistance ranged from 7 to 13. The mean age of initial intervention was 9 years. Table IV summarizes these data. The reading performance of subjects merits some discussion. It was noted, for example, that Journal of Learning Disabilities
Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
480 all 40 subjects still occasionally reversed letters or small similar words such as on/no and was/saw. In 13 instances this specific difficulty was evidenced in reading performance, and in all of the remaining cases, subjects acknowledged, in interview, that they still experienced such problems. ITie nature of this problem, as described by subjects, relates to a specific difficulty in being unable to establish a consistent and automatic recall and association for words and letters. In the process of reading, words like was/saw, on/no and letters such as h/d are easily confused due to their similar structure and the fact that they are not firmly established in ones memory for written symbols. In no instance was there any suggestion or indication that these "reversals" were the result of seeing letters or words in a confused or incorrect manner. Visual discrimination was perfectly accurate with the breakdown apparently occurring at the associational level. In the past, some professionals have suggested that dyslexic individuals literally see some words and other symbols in an atypical fashion. Interviews with these subjects simply refute this position. All subjects continued to experience difficulty in the auditory as well as visual skill areas associated with reading. Phonic skills as evidenced in oral reading were poor and seemed to reflect a basic difficulty with sound-symbol association. This problem was further demonstrated in spelling responses where misspelled words lacked good phonetic components.
Spelling The results of the spelling test and sentence : todictation demonstrated that serious residual problems remained in this area of functioning for all subjects. The mean grade level score on the spelling test was 2.9; scores ranged from 1.3 to 6.6, and 70$ scored at grade 3 or below. Spelling in adulthood was the most seriously impaired area of academic functioning, with 80$ of the subjects scoring lowest in this area. An additional two subjects received the same score in reading and spelling. These results are similar
to those found at the time of diagnosis where 92$ of the subjects experienced the most difficulty in spelling. Errors in spelling, both on the spelling test and with the sentence given in dictation, although varied, seemed to typify the kinds of problems associated with dyslexia. When attempting to spell an unknown word, many subjects seemed to have difficulty translating the sounds into letter symbols, resulting in misspellings that lacked good phonetic components to the point that they might be considered "bizarre." The problem is less pronounced overall when a comparison between childhood and adulthood written responses is made; however, the difficulty is obviously present and remains significantly atypical. Letter reversals were evidenced in the written responses made by 11 adults. Several examples of spelling test responses are as follows: Key word
Response
study
sludn, stedid, staddy, sduey, shaen, stied, sitd
kitchen
chin, kinl, kengun, ckin
city
stiy, ciedy, deit, caiy
black
billk, blane, ballk
The general quality of the written responses to this sentence, "The yellow pig saw the little baby," was poor. Thirty-seven subjects (92%) made one or more errors. The average number of misspelled words was 2.8. The written responses to sentence dictation would seem to substantiate Critchley's (1970) impression that "disorders of writing are always considerable in cases of developmental dyslexia though they have not attracted the same attention. . . . Although every child who is dys-
Volume J7, Number 8, October 1978 Downloaded from ldx.sagepub.com at UNIVERSITE DE MONTREAL on June 7, 2015
25
481
John Performance Verbal
\p-~* * *^y
CA IQ IQ 1
/ * &
^i
4&
