Disorders of Reading and Writing

Below are descriptions of reading, writing, and spelling disorders. Although these descriptions are listed separately, individuals can experience combined deficits in more than one area. For example, deficits in word recognition and reading comprehension often co-occur as readers must not only recognize words but also make inferences about implicit situations in the text (Castles et al., 2018). Spelling impairment and difficulties expressing ideas in written form can affect both reading and writing; difficulty or progress in either spelling or word reading can influence performance in the other area. The terms “poor readers” or “garden variety readers” are sometimes used to describe readers with generalized difficulties in reading comprehension. Similarly, a person can have difficulty with the writing process as well as with generating the written product.

Deficits in reading, writing, and spelling can affect one or more language domains (see below). For a detailed description of the language domains as they relate to spoken and written language, see Language In Brief.

Labels for reading disorders include dyslexia, reading disability, reading disorder, specific reading disorder, and specific reading comprehension deficit. Writing disorder labels also vary, with some being dysgraphia, writing disability, writing disorder, and specific writing disorder.

Areas to consider in assessing and treating written language disorders as well as differentially diagnosing within and across spoken and written language disorders are also included below. For more comprehensive lists, see the Assessment and Treatment sections of the Written Language Disorders Practice Portal page.

Reading: Word Recognition

Word recognition deficit is sometimes referred to as dyslexia. It is characterized by difficulty with reading despite instruction and without coexisting intellectual, sensory, or neurological difficulties. A person with word recognition deficits typically has relatively intact language comprehension but may have difficulties with

• accurate and/or fluent word recognition and
• poor spelling.

Focus of Assessment/Treatment

• Alphabet/letter knowledge
• Phonological awareness (rhyming, segmenting and blending, awareness of sounds and syllables in words)
• Morphological awareness (inflections, derivations, and compounds)
• Sound–symbol correspondence
• Sight word knowledge
• Reading decoding
• Reading fluency
• Spelling
• Vocabulary

Reading Comprehension

Reading comprehension deficit is sometimes referred to as specific comprehension deficit or hyperlexia. Hyperlexia can be differentiated from precocious reading, in that individuals with hyperlexia have significant problems in listening and reading comprehension.

A person with reading comprehension deficits may have difficulties with

• adequate or advanced word recognition skills;
• reading fluency; and
• social, cognitive, or linguistic skills.

Focus of Assessment/Treatment

• Print awareness
• Knowledge of basic story structure and story components
• Vocabulary knowledge, including
  • multiple-meaning words,
  • synonyms, and
  • antonyms
• Morphological awareness (inflections, derivations, and compounds)
• Understanding meaning from context
• Figurative language and ambiguities in text, including
  • multiple-meaning words and
  • ambiguous sentence structures
• Paraphrasing and summarizing
• Making inferences
• Knowledge of different text structures and genres
• Use of strategies to facilitate comprehension, including
  • skimming,
  • rereading, and
  • taking notes
• Using strategies to self-monitor comprehension
• May need to address spoken language difficulties

Dysgraphia

Dysgraphia may refer to either difficulty with language or spelling-based aspects of written expression. Dysgraphia can occur alone or can co-occur with dyslexia and/or other learning disabilities.

The cognitive–linguistic aspects of dysgraphia are involved in the writing process and the writing product.

Writing Process Deficit

Writing process deficits are problems with the cognitive–linguistic aspects of writing and may be described under the umbrella term dysgraphia.

Dysgraphia, as it relates to the writing process, involves difficulty

• planning,
• drafting,
• reflecting on writing,
• revising,
• editing own writing, and
• with discourse planning and organization.

Focus of Assessment/Treatment

• Using pictures to tell stories
• Writing for different purposes, including writing to
• entertain,
• persuade, and
• inform
• Writing for different audiences
• Planning, including
• brainstorming,
• use of story maps, and
• webbing
• Drafting, including
• referring to story maps,
• making webs, and
• writing planning notes
• Using digital technologies (e.g., Internet) to gather information for writing
• Revising and editing content
• Spelling

Writing Product Deficits

Writing product deficits are sometimes described under the umbrella term dysgraphia. For more information, please visit the International Dyslexia Association’s page on Understanding Dysgraphia.

Dysgraphia, as it relates to the writing product, involves

• difficulty organizing and adequately expressing thoughts in writing,
• difficulty constructing grammatically correct sentences of varying types and difficulty using writing conventions (e.g., capitalization and punctuation),
• limited written fluency,
• syntactic formulation problems (complexity and correctness impacted),
• word choice limitations (in variety and appropriateness), and
• numerous words spelled incorrectly.

Focus of Assessment/Treatment

• Pretend writing
• Writing letters of the alphabet
• Printing first and last name
• Labeling pictures
• Producing text via handwriting and/or keyboarding
• Copying text
• Writing from dictation
• Writing a variety of grammatically correct sentence types
• Judging correctness of grammar and morphology and correcting errors
• Writing cohesively, including
• providing detail,
• linking ideas, and
• elaborating
• Using conventions of writing correctly, including
• capitalization and
• punctuation
• Knowledge of different text structures and genres

Spelling

Deficits in spelling are sometimes called dysorthography. Such deficits involve difficulty with encoding phonological information. Spelling difficulties can affect both reading and writing and are an area of weakness for most individuals with dyslexia. Spelling deficits include

• difficulty representing the phonological structure of regularly spelled words,
• difficulty remembering and reproducing the patterns of irregularly spelled words,
• lack of morphemic awareness in spelling, and
• difficulty spelling and inflecting words correctly in sentences.

Focus of Assessment/Treatment

• Using letter–sound knowledge to spell words as they sound
• Understanding the phonological, morphological, and orthographic aspects of regular and irregular spellings
• Correcting spelling errors

Spoken and Written Language

Deficits in spoken and written language can affect reading, writing, and spelling. Such deficits may be referred to as oral and written language learning disability.

These deficits involve marked difficulty with oral language and involve problems of similar severity that cross multiple systems. Deficits in spoken and writing language may result in difficulty with

• pronouncing complex words,
• reading fluency,
• word recognition/decoding,
• spelling, and
• language comprehension.

Focus of Assessment/Treatment

Treatment should address areas of difficulty in reading, writing, and spelling as indicated. Treatment should match the degree to which sound/word structure knowledge and sentence/discourse level knowledge are impaired across spoken and written modalities—listening, speaking, reading, and writing.

Language Domains Primarily Affected

References

Castles, A., Rastle, K., & Nation, K. (2018). Ending the reading wars: Reading acquisition from novice to expert. Psychological Science in the Public Interest, 19(1), 5–51. https://doi.org/10.1177%2F1529100618772271

Chung, P. J., Patel, D. R., & Nizami, I. (2020). Disorder of written expression and dysgraphia: Definition, diagnosis, and management. Translational Pediatrics, 9(Suppl 1), S46–S54. https://doi.org/10.21037/tp.2019.11.01