Reading Problems

Jimmy Kilpatrick (832) 814-7463

Recommended Battery of Testing for Suspected Reading Disabilities

Reading tests do not “rule out” problems.

Red Flag Reading Screening

Instead, reading tests are controlled observations of the processes that are needed to develop good reading skills (including accuracy, fluency, and comprehension). A variety of tests is used to identify strengths and weaknesses in the processes (such as attention, phonemic awareness, word retrieval) and knowledge (such as word identification, spelling).

The ultimate purpose of testing reading should be to direct intervention to where it will produce the greatest good. While there is a central core of tests that are generally useful, no student takes every available test.

Behavior Rating Inventory of Executive Function™ (BRIEF™)

Current theories hypothesize that deficits in executive functioning (EF) are responsible for the symptoms of ADHD and that specific patterns of EF deficits may be associated with different subtypes of ADHD. The present study evaluates the validity and clinical usefulness of the Behavior Rating Inventory of Executive Function, a behavior rating scale designed to assess dimensions of EF.

Comprehensive Test of Phonological Processing (CTOPP)

The CTOPP assesses phonological awareness, phonological awareness memory, and rapid naming. Persons with deficits in one or more of these kinds of phonological abilities may have more difficulty learning to read than those who do not. The CTOPP was developed to aid in the identification of individuals from kindergarten through college who may profit from instruction activities to enhance their phonological skills. A standard score fro each subtest is based on a mean of 10 and a standard deviation of 3. Composite scores are determined and based on standard scores with 100 as the mean and 15 as the standard deviation.

The CTOPP has four principal uses: (a) to identify individuals who are significantly below their peers in important phonological abilities, (b) to determine strengths and weaknesses among developed phonological processes, (c) to document an individual’s progress in phonological processing as a consequence of special intervention programs, and (d) to serve as a measurement device in research studies investigating phonological processing.

Gray Oral Reading Tests: Third Edition (GORT – 3)

The Gray Oral Reading Tests: Third Edition (GORT- 3; Wiederholt & Bryant, 1992) is an instrument that provides clinically useful information about a student’s oral reading in terms of speed and accuracy, comprehension, total oral reading ability, and oral reading miscues. The Gort – 3 yields a Rate, Accuracy, Passage Score (based on Rate and Accuracy), and Comprehension Score, each with a mean of 10 and a standard deviation of 3. A composite Oral Reading Quotient is also provided, with a mean of 100 and a standard deviation of 15.

Test of Written Spelling – 4

The revised TWS – 4 is a non-normed reference test of spelling administered using a dictated word format. The TWS was developed after a review of 2,000 spelling rules. The words to be spelled are drawn from 10 basal spelling programs and popular graded words.

The results of the TWS – 4 may be used for four specific purposes: to identify students whose scores are significantly below those of their peers and who might need interventions designed to improve spelling proficiency, to determine areas of relative strength and weakness in spelling, to document overall progress in spelling as a consequence of intervention programs, and to serve as a measure for research efforts designed to investigate spelling. The TWS – 4 yields a standard score with a mean of 100 and a standard deviation of 15. A grade level and spelling age are also estimated.

Test of Word Reading Efficiency

The Test of Word Reading Efficiency (TOWRE) is a nationally normed measure of word reading accuracy and Fluency. The TOWRE contains two subtests: the Sight Word Efficiency (SWE) subtest assesses the number of real printed words that can be accurately identified with 45 seconds, and the Phonetic Decoding Efficiently (PDE) subtest measures the number of pronounceable nonwords that can be accurately decoded in 45 seconds. Percentages, standard scores, and age and grade equivalents are provided. Subtest standard scores have a mean of 100 and a standard score deviation of 15. Age and grade equivalents show the relative standing if individuals’ scores.

Woodcock-Johnson III Tests of Achievement

The Woodcock-Johnson III Tests of Achievement, (WJ-III, Woodcock, McGrew, & Mather, 2000) is a comprehensive set of individually administered co-normed tests for the measurement of achievement. The tests may be used with individuals from age two through adulthood. The battery assesses the Curriculum Areas of Reading, Oral Language, Mathematics, and Written Language. Fourteen Cluster scores and four Cross-Academic Cluster scores provide broad estimates of achievement. Scores are reported in age equivalents, grade equivalents, percentile ranks, and standard scores. The standard scores are based on a distribution with a mean of 100 and a standard deviation of 15.


A “core deficit” has not yet been identified in Attention Deficit Disorder (ADD), which includes various forms of attention difficulty — focusing attention, sustaining attention, saliency determination, marshaling resources, and impulsivity. Diagnosis requires sufficient characteristic behaviors to be present for more than six months and in more than one setting (for example, school and home).

We generally ask parents to complete the Parent checklist (Connors 48), a behavioral checklist. A computerized Continuous Performance Test (Connors CPT) provides objective measures of some aspects of attention, distractibility, and impulsivity that are sensitive to medication effect. The CPT is useful in monitoring the response to medication.

Non-verbal processing

The Test of Non Verbal Intelligence (TONI) is a test of puzzle solving. The student chooses a geometric design that best fits a sequence. A non-verbal test is helpful in differentiating a language disorder from overall learning problems.


Vocabulary is a major factor in comprehension. Listening vocabulary (Peabody Picture Vocabulary Test, PPVT) requires the student to point to a picture that represents a spoken word. (“Point to the picture of the pagoda.”) Limited vocabulary will impair comprehension even if the words are read accurately. Speaking vocabulary (Expressive Vocabulary Test, EVT) requires that the student look at a picture and produce a synonym for a spoken word. (“What is another word for ‘blazing’?”) Low speaking vocabulary often shows as sparse language and limited choice of vocabulary in describing and writing.

Oral Comprehension (Token Test) is a test of understanding of oral directions. It uses very limited vocabulary (5 colors, big and little, square and circle), but puts a greater emphasis on the understanding of syntax. (“Put the yellow square behind the red circle.”)

A general language-screening test may be used to determine whether administering a battery of language tests is likely to uncover a primary language disorder. The Clinical Evaluation of Language Fundamentals (CELF) is a battery of language tests that are used to document significant difficulties in receptive, expressive and total language.

Working memory is the label used for a temporary holding place in memory. A student with low working memory may correctly “sound out” each sound in a word, but leave out a sound when trying to blend them together. (/b/ /l/ /a/ /k/ –> “back”) Another student may read the words correctly, but flatly, without expression. Because he doesn’t recognize how words group together into logical units, comprehension and retention may be impaired. (“Early in the morning” “before dad left for work” “the street cleaners” “were busy sweeping the confetti” “that had rained down” “during the parade.”) Normally a sentence of many words breaks into a much smaller group of ideas (or thematic units), each of which provokes related memories. A group of thematic units that provokes widespread activation may be analyzed deeper and retained better. It is not surprising then that short-term memory measures are dependent on the meaningfulness of what is to be remembered.

The CELF-R Recalling Sentences subtest asks the student to repeat sentences that increase gradually in length and complexity. Memory for Digits (repeating number sequences: 9-4-7 3-5-1-8 etc) and Non- Word Repetition (repeating nonsense words of increasing length) are subtests of the Comprehensive Test of Phonological Processing. They are used to calculate the Phonological Memory Composite.

Manipulating sounds in syllables

Phonemic awareness is defined as the awareness of the number, type, and order of sounds within a syllable. (“Green” consists of 4 sounds — /g/ /r/ /ee/ /n/.) A level of phonemic awareness is necessary for the student to be explicitly aware of the sounds in a word. With that awareness, he can map the sounds to the available letters and extend his knowledge of sound-symbol and symbol-sound relationships. (The student’s thought process might go like this: “Clean” makes sense here and it has four sounds: /k/ /l/ /ee/ /n/. I have seen the /k/ sound written as the letter c, and I know what l and n stand for. There is only one sound left, the /ee/ sound, so the letters ea might be another way of writing the /ee/ sound. Cool!”) The student gradually masters the alphabetic principle, is able to read new words that he has never seen before, and discovers new sound-symbol associations.

To have sufficient phonemic awareness to provide a stable foundation for reading, the student needs to be able to divide words into syllables orally and to manipulate five-sound syllables accurately and easily. 90% of students can do the first with little or no instruction; it is the latter (awareness of sounds within syllables) that is the initiating problem for most poor readers.

Auditory conceptualization(LAC, Lindamood Auditory Conceptualization test, Form X) assesses the student’s ability to represent with colored blocks the number, order, and type of speech sounds made by the examiner. The nonsense word /stip/ would be represented by four different colored blocks. Changing /stip/ to /stis/ would require replacing the fourth block with a block matching the first block’s color. It is an abstract test (colored blocks, no letters, nonsense words) that can be quite difficult for a kindergarten student.

The Rosner Test of Auditory Analysis is a test of Elision.(“What is hat without the /h/? — /at/”). Elision requires working memory to hold the original word, segmenting to cut off a sound, and blending to build the resulting new word. It uses real words. Some older students with poor phonemic awareness can score relatively well if they have memorized some of the words on the test. Nonsense word spelling can help detect these students.

Elision and Blending subtests, from the Comprehensive Test of Phonological Processing, combine to form a Phonological Awareness Composite.

For planning instruction, it is useful to know the actual level of syllables (2-5 sounds) that the student can handle. This is determined with informal measures of blending (/c/ /a/ /t/ à cat), segmentation (cat – > /c/ /a/ /t/), and elision (cat without /c/ à at). For example, if it is determined that a student can handle 3 sound words but needs help with 4-sound words, fluency instruction would start at the 3-sound level and decoding instruction at the 4-sound level.

Retrieval from memory: Rapid Automatic Naming (RAN) is measured by timing the student while he “reads” a series of numbers, letters, or colored dots (no words involved) as quickly as possible. It is considered a measure of the speed at which the sound codes for words can be retrieved from memory. At a minimum, slow word retrieval will slow reading rate. If retrieval is even slower, the student will attempt to decode words that are already in memory (but he doesn’t realize it because they have not yet been retrieved). Rapid word retrieval allows the student to read some new words by comparing to words already known. For example, a student knows the word “light” and comes across the (to him) new word “slight.” The word “light” is retrieved and placed in working memory. The phonological processor adds the sound /s/ to the sound code for “light” and the student recognizes “slight.” This is a much faster process than decoding the word from left to right. Rapid word retrieval is an important part of the mechanism by which the student generalizes word attack skills – develops and learns to apply an array of over 600 sound-symbol relationships that are needed to decode new words.

In later grades, slow word retrieval can impair comprehension. In science, history, or other content course books, as the length of sentences and the percentage of new words increase, slow retrieval produces a logjam in working memory. Words cannot be recognized quickly enough to group together into logical units in working memory, and text becomes a string of words, rather than a string of ideas. The student may “see the trees” (read the words accurately, albeit slowly) but “miss the forest” (miss the idea). Slow reading impairs comprehension, just as looking at a famous painting though a pinhole in a card may not allow one to identify what you are seeing, or hearing 2 second snippets of a song may not allow one to identify it.

Finally, spelling is affected. The “that doesn’t look right” phenomenon that guides good spellers to try an alternative spelling or check a word in a dictionary, does not happen if words don’t fly out of memory while one is proof reading.

Rapid Digit Naming and Rapid Letter Naming, which form the Rapid Naming Composite, are new standardized measures from the Comprehensive Test of Phonological Processing.

Slow retrieval speed is often (but not invariably) associated with inaccurate retrieval. The Test of Word Finding (TWF) provides a measure of the accuracy of retrieval.

Word level reading skills: At the most fundamental level, Names for letters asks the student to identify by name the letters of the alphabet. The Sounds for symbols test asks the student to “read” 50 basic symbol-sound associations: What sound would you “read” if you saw “p” on the paper? “oy”? “ai”? “eigh”? etc.

In federal law terminology, word level reading skills can be referred to as “basic reading” (which is a separate category from reading comprehension). Basic reading consists of word attack and word identification skills, from which a basic reading index is computed. The test of basic reading that is most commonly used in research is the Woodcock Reading Mastery (WRM).

Word attack is a measure of the ability to read unknown words. It is always measured using nonsense words (“bem,” “nin”). Also called phonemic or alphabetic reading, word attack is the single most reliable predictor of future growth in basic reading skills.

Word identification is an estimate of the store of words that the student can read relatively quickly. It consists of words that the student can decode by word attack skills (/b/ /a/ /t/ -> “bat”), by analogy to a known word (reading “slight” by adding /s/ to “light”), and by immediate recognition (“sight words” in the sense of words read automatically and without conscious thought). (If the student takes a full 5 seconds to read each word, he receives full credit. If all words were read that slowly, reading rate would be 12 words per minute, extremely slow.)

The Basic Reading Clusteris computed from word attack and word identification. Good word attack and word identification are necessary for reading accuracy, the first step toward reading proficiency. (Grade-level reading proficiency requires that accuracy, rate, and comprehension be at grade level.)

Word attack is a useful skill for discussing an appropriate use of Grade Equivalent (GE). Let us suppose that George, a fourth-grade student, has word attack skills at a 2.0- grade equivalent level. George’s fourth-grade teacher sends George to the second-grade classroom to find an average second-grade reader – one who is just average for second grade. George brings this average second-grade student back to the fourth-grade class. The teacher hands the second-grader the fourth-grade science book and tells the student to start reading aloud to the class. Because both George and the second-grader have word attack skills at the 2.0 grade level, each has the same statistical probability of correctly reading the new words of the textbook. (This would be child abuse.)

The Woodcock Reading Masteryprovides a another interesting measure that helps to understand why George no longer likes school and says he’s dumb, etc. It is called the Relative Performance Indicator (RPI). Let’s say that George has an RPI for word identification of 40/90. This means that George reads correctly only 40% of the words that his age-peers are reading with 90% accuracy. Such a gap is a set up for stress, failure, and loss of self-esteem. Yet it is silently tolerated or even defended by adults who at other times proclaim the virtues of “early detection and intervention” and of “preparing the child for the future.”

The reading part of the Wide Range Achievement Test (WRAT)is similar to the Woodcock Reading Mastery word identification measure. However, the student has a 10 full seconds to read each word! A good score of this test indicates accuracy, but could cover up a significant lack of fluency. (If a student took 10 seconds to read each word, his reading rate would be only 6 words a minute!)

Sight Word Efficiency and Phonemic Decoding Efficiencyare timed measures of how many real words (sight word efficiency) and nonsense words (phonemic decoding) the student can read in 45 seconds. According to the authors, any score below 30%ile on these efficiency measures suggests a high risk for reading problems that will interfere with the student’s ability to make adequate progress in school.

Text level read skills. The Gray Oral Reading Test (GORT)is commonly used in research and clinical testing because it provides standardized measures of rate, accuracy, and comprehension. While comprehension is the goal of reading, “adequate” comprehension scores do not mean that the student has compensated and that basic reading issues can be ignored. In the first place, reading comprehension is a separate category from basic reading under federal law. Secondly, there are difficulties in measuring comprehension that limit its value as a overall measure of the student’s reading skill or as a predictor of future reading progress. Reading comprehension measures are not pure measures of reading comprehension, but are usually strongly contaminated by oral language comprehension. In the case of the GORT, the comprehension questions are read aloud to the student. The format is multiple choice, requiring recognition (not production) of a correct answer. The test does not control for the student’s prior knowledge (background knowledge) and therefore can’t measure what information actually came from reading. For example, most people can answer this question (only minimally altered from the GORT), based on their prior knowledge and without reading the required text: “How does a farmer feel when blackbirds wipe out his corn crop? a) indifferent, b) defeated, c) enthused, d) inferior.” Finally, comprehension questions based on narrative (story) text is not measuring the same degree of skill as is needed with expository (e.g. science, history) text. “Grade-level” comprehension of stories does not imply grade-level comprehension of the more difficult expository text that predominates content area courses.

The Scholastic Reading Inventory (SRI)is a new methodology (the Lexile Framework) for assessing student comprehension and the readability of text (text difficulty). Its measurement ultimately depends on the vocabulary and sentence structure of the passage. It appears particularly useful for selecting reading material that matches a student’s reading needs. (One level is chosen for the objective of challenging the student to build vocabulary and comprehension skills. A quite different level is chosen for the objective of improving reading fluency.) It provides a standardized, “unit interval” score of comprehension, but does not provide a grade equivalent. Before using the Lexile Framework to guide reading selections, however, the student should have adequate decoding skills. Students with decoding problems should work with “decodable texts” to improve accuracy and fluency, before switching to the Lexile Framework to guide reading. Decodable text is defined as texts in which 95% of the words can be decoded using the decoding skills that have been taught.

For high school and college students, the Nelson-Denny Reading Testprovides measures of vocabulary, reading comprehension, and reading rate. The reading passages on this test are from actual high school and college textbooks (expository text). The Nelson-Denny provides a useful foretaste of the reading requirements of community college, technical school, and university.

Spelling:Beginning spelling requires awareness of each sound that is in a word (phonemic awareness) and awareness of a basic way to represent each sound. The core symbols test checks the student’s knowledge of basic ways to write the sounds of English. The student is asked, “What would you write for the sound /p/?” The pseudowords test requires the student to integrate phonemic awareness and core-symbol knowledge to write a readable representation of nonsense words. (“How would you spell the silly word ‘blim’? They bought a new blim at K-Mart.”) Transitional spelling requires (in addition) understanding of meaning units (morphemes). (The final /t/ sound of bat and walked are different.) Formal spelling requires memory of specific words (orthographic knowledge). (See A Reading Crisis? for a brief description of the phonologic and orthographic challenges in learning to read and write English.) The Test of Written Spelling is a nationally standardized measure of formal spelling. The student is asked, “Spell ‘hospital.’ They took the injured player to the hospital.”) Spelling is the single best measure of the depth of a student’s knowledge of English orthography, the complicated sound- symbol system of our language. A well-developed orthographic system is both the result of reading and what makes proficient reading possible.

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