Learning Disabilities || Relating Remedial Strategies to Diagnostic Considerations

Relating Remedial Strategies to Diagnostic ConsiderationsAuthor(s): Aaron LiptonSource: The Reading Teacher, Vol. 23, No. 4, Learning Disabilities (Jan., 1970), pp. 353-359Published by: Wiley on behalf of the International Reading AssociationStable URL: http://www.jstor.org/stable/20196317 .

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Aaron Lipton is an Associate Professor of Education, State

University of New York at Stony Brook.

Relating remedial strategies to

diagnostic considerations

AARON LIPTON

how one treats reading disabilities depends upon how one views

the process of reading. Many reading specialists view reading disa

bility as a disability relating clearly to the reading skill. Thus,

reading is perceived as a skill that is learned either adequately or

not; and if not learned adequately, then those facets of skills not

learned need to be taught, re-taught, and sometimes drilled in

order to remedy the reading problem. Another perception of reading is that reading is a caused be

havior. One reads adequately or not depending upon many under

lying factors. Some underlying factors in a child's development and

environment cause him to be a good reader, and some deviations

within these factors cause him to be a less-than-adequate reader.

Language factors, emotional factors, socio-economic conditions,

physiological, and neurological development all are underlying factors that affect how a child reads.

From this perception of reading, remedial strategies will

evolve that are closely related to each child's total development rather than merely to the child's acquisition or level of reading skill. However, while most reading specialists suggest or even

encourage the examination of the underlying factors in a child's

development, their remedial prescriptions, in fact, do not really utilize the information gleaned from such explorations. Too often

the diagnosis is based on standardized reading tests and reference

to cumulative folders. These diagnostic procedures are sometimes

not only minimal in value, but can have negative implications as

well, since cumulative records more often reveal the prejudices of

the teachers than the essence of teacher-pupil interaction and

actual pupil functioning. Moreover, standardized silent reading tests

rarely tell the teacher more than the fact that a child has answered a question rightly or wrongly.

Pursuing the point of relating remedial strategies to diagnostic considerations, certain basic concerns need to be delineated. 1. Reading is perceived as a language-related process which

353



354 THE READING TEACHER Volume 23, No. 4 January 1970

thus must be diagnosed in a frame of reference that analyzes

reading problems through a multi-scopic projector?a pro

jector which casts light on the many possible underlying rea sons for children's reading difficulties: emotional problems,

linguistic problems, neuro-physiological conditions, and the

interrelationship of all these at the point at which children use their reading behavior to reflect these underlying prob lems. This view of reading does not imply that skills are not

important as elements to be taught. Implicit in this view is

that methodology or strategy of approach must depend on the

child, not merely on the skills he lacks.

2. Diagnosis is perceived in a circular and spiraling relationship to remedial strategies. Once a diagnosis is done, it is not

forgotten, but is on-going and intertwined in all aspects of

remediation. In essence, as treatment proceeds, new facets of

diagnosis are opened and perceptions of the children are

broadened with each experience with the children.

3. Focus for diagnosis and remediation must be on the total

child. Treating the symptoms of the disorder (e.g. word

recognition skills, comprehension skills) does not consider

the child in terms of his total environment but considers only the maladaptation of the child. This partial view of the child

necessarily leads to superficial treatment, if indeed, any treat

ment can be effected. 4. Among the environmental factors that would enable broader

perception of the child is his role as an entity within a family group. His life styles, his behaviors, attitudes, and responses to learning to read are related to his function and participation in this family constellation, as well as to his uniqueness as an

individual (Ehrenwald, 1963; Levenson, et al, 1967). 5. The relationship established between the reading specialist

and the child is crucial to the effectiveness of the remedial

process (Lipton, 1969).

CASE STUDIES

Two children with whom the author has worked individually are discussed in reference to diagnostic considerations as they relate to strategies for remediation. Tools used for diagnosis were

an informal reading inventory, an interview questionnaire pre

pared by the author, several interviews between parents and the

author, and the remedial sessions with the children. As implied, the substance of the remedial session was not always reading skills.

Sometimes the remedial session consisted of discussions relating to the child's feelings about reading, school, home conditions, or

other events which might have had an impact on the child's



lipton: Relating remedial strategies to diagnostic considerations 355

reading ability. Other sources of information were psychiatric or

psychological reports, school reports, test data, and teacher con

ferences.

james G. James was referred by the school principal at the age of nine because of severe reading disability. He was in the third

grade, having repeated one grade. Both parents were college gradu

ates; Mr. G., a successful business man. James' I.Q. score on a

Wechsler for children was 140. His gross reading level was begin

ning first grade. He could identify very few words in material pre sented in meaning-bearing units, such as sentences or phrases. A

few nouns, verbs, and some function words were also recognized out of context. His basic reaction to reading was succinctly stated:

"I hate to read. My mother is always making me read." This re

sponse, in itself, was unusual. Most children during the early part of

a teacher-pupil relationship will say they like to read?regardless of

how they really feel?because they perceive this reaction to be what

the adult wants to hear.

James' behavior in school was characterized as disruptive and annoying to others. His teacher indicated an intense antipathy towards this boy, and reported that the boy's classmates felt the same way. One might wonder how much the teacher encouraged this response from the children or whether, indeed, she was pro

jecting her feelings onto the children.

James was constantly involved in his mother's struggle to

make a student of him. She was trying to build him into an ideal

boy to win the approval of her husband's mother, who, in turn, saw the daughter-in-law as an intruder into her family constella tion. The husband, in his early fifties, had married late, and

against his dominating mother's wishes. He reacted ambivalently to James, seeing in him something of himself and trying to em

pathize, yet caught in his wife's design and siding with her in

attempts to prove her worth (perhaps in response to his need to

prove his self worth to his mother by presenting her with a compe tent wife). In all likelihood, the mother's feelings were being mis

read by her son and daughter-in-law. Competent or not, the daugh ter-in-law was unwanted.

James' younger sister (by two years) was reading at third level and doing very well at school. She had won the approval of both parents and was not used in the mother-wife-husband triangle. In most families the neurotic patterns of the parents are visited

upon one of the children to a greater extent than upon the other

siblings though rarely do any of them escape at least some aspect of the family's interactional problems.

Diagnosis thus indicated that the learning disability was

possibly more a symptom of emotional upset than a discrete read

ing failure, even though James seemed to lack reading skills. There




was no evidence of neurological dysfunction (difficult to ascertain, at best) and no language disability. Further investigation revealed

that the child viewed his parents as monsters who were always after him to do something?to read, to listen to their lecturing, to

be good, to be like his sister.

The remediative approach arrived at considered these influ

ences on the child : the boys' relationship at home, other adults' re

sponses to him, and his own feelings about reading. Since he was

very bright and verbal, he was able to utilize the communication

process effectively. He did not like to read, but he liked to have

stories read to him. He particularly liked "monster" stories, tales of

horror, and stories wherein he could phantasize himself as the con

queror of the "evil" ones?his parents. To meet his need to have an adult recognize his feelings, without judgment, many stories

were read to him. He liked some of Poe's horror tales. The story of

Beowolf from a fifth grade reader was read many times. Stories

of giants and giant killers were always on his read-to-me list.

After six months of hearing these stories, with efforts at en

couraging him to read failing consistently, he picked up a fourth

grade book and read a story with almost no miscues. Subsequent to

that, he became an avid reader and his problems in school dimin

ished considerably. His problems at home were not much improved, but with counseling of his parents, tensions were a bit eased.

Thus, in this boy's case, a careful diagnosis led to a rather

unique remediative action program. His inadequacy with reading skills was seen as symptomatic of James' emotional tension, and

could not be dealt with during the greater part of the remedial

experience. Perhaps, unconsciously, James had learned the reading skills but refused to use them as a way of protecting himself or defending himself against what he perceived as punitive and

demanding authority figures who were needful of gratifying their

needs rather than his. bill w. Bill was eight years old when referred by a psychiatrist

for remedial reading. He was in second grade for the second time.

His score on a Wechsler for children was 79, and his reading level was at beginning pre-primer. Bill's family was of a relatively high economic status although neither parent had gone beyond high school. The psychiatrist indicated possible brain damage resulting from a birth trauma and some operations Bill underwent during his first and second years of life. As with many cases of diagnosis of brain damage, there was conflicting evidence. Similar sympto

matic manifestations may be ascribed to brain damage, emotional

conflict, or developmental differences. A psychologist who admin

istered the Bender-Gestalt Test, Rorschach,and Thematic Aper

ception Test concluded that Bill's behavior showed no evidence of

brain damage, but that his behavior was more a function of



lipton: Relating remedial strategies to diagnostic considerations 357

emotional disturbance.

Furthermore investigation into Bill's background revealed

certain conditions which may have had considerable bearing on

his learning to read. While both parents were verbal and com

municative, Bill's mother tended to be the dominant influence both

in the household and even during interview sessions. Mr. W., while

successful economically, did not feel successful personally. He saw

himself as a failure in the eyes of his parents and brothers as well

as his wife. His son reflected this failure in his own image of

himself. In addition, Bill's early illnesses created a situation for

him in which he was constantly overprotected by his mother.

This overprotection, as happens in many instances where

children are very ill early in life, caused certain negative responses

by the mother. Hidden hostility to the child for disturbing her

life situation, greater subtle demands on the child to grow up and

not need the mother so much, and unconscious comparisons be

tween the husband and son, both of whom make excessive demands

on the mother, all cause the child to develop a weak self-concept,

inadequacy in communication and inability to attack new situa

tions?like reading and school?with any degree of success and

assertive behavior. The demands on the child to grow up and be

on his own create serious conflicts for the child. He feels the

hostility of the mother and its concomitant feelings of rejection and thus is not gratified in having his dependency needs met.

Under such conditions, he is reluctant to meet new situations with

any positive or asserting feeling. It is this lack of assertiveness that

often contributes to a child's reading disability. When he sees

words, he sees unknown symbols. He is afraid to "attack" them.

He either asks for help or does not get involved at all. Thus, his

word attack skills appear deficient. In reality, he is unable to

attack new and unknown stimuli for fear of failure and because he is not ready to be "on his own in reading." His dependency be comes manifested in an area that is important to his mother, who

does not want him to be a failure like his father. Moreover, the

father's failure feelings cause him to identify with his son and say to himself, "I guess he's just like me," almost pleased, too, that

his son will not outdo him in an important area (Levinson, et al,

1967). In reference to Bill's learning to read, he seemed quite moti

vated to learn despite three years of failure in school. His reading behavior seemed to manifest some of the despair generated by three failing years. He would not try any new words. Those he

knew were words that had object referents. He could not recognize

any function words beyond the, and, and a. When reading sent

ences within his syntactical frame of reference, he was unable to

recognize this, that, who, where, when, etc.




The remedial strategy that evolved was to work with stories

told by Bill. His motivation to read seemed to override his con

stant failure. His motivation may be explained by the feelings his parents had for him and the genuine desire they had for him

to get help. Despite the interpersonal difficulties, there was a

genuineness of love for Bill that came through to him from both

parents. While they may not have understood the dynamics of

the interpersonal conflicts in the home, the basic feeling tones

within the family constellation were positive and were truly felt

by Bill. After each story Bill told, and then read, he worked with

some of the function words that were so troublesome. The words

were put into new sentences, word games were made up and

sometimes the words were traced, copied and recopied. For five

months, three times a week, Bill would forget the words soon after

going over them. Meanwhile, his ability to recognize and remember

nouns and verbs kept improving, despite his continuing inability to match sound-symbol relationships. He seemed to learn words

by having them told to him, then by his copying them. Ultimately, he began to recognize the function words, first in context and then

in phrases. Finally he could recognize them in individual graphemic units.

Thus, after one year of remedial work, Bill was able to read

in a second grade basal reader. He comprehended everything he

read and finally grasped the concept that specific symbols repre sented specific sounds. This conceptualization probably was a

manifestation of his developing independence which came about as a result of his feelings of success and actual success.

Bill is still not without reading problems, however. At the

termination of the remedial relationship he was reading fourth

grade books in the sixth grade, but he was more involved and more independent in his approach to reading.

While basic family patterns have not altered and parental

anxiety still persists, remedial intervention did alter Bill's reading

patterns, possibly because of the accepting and non-judgmental

relationship established. Additional factors of importance were

accommodation to Bill's learning style, accepting Bill's dependency without forcing independence, continued counseling to help dimin

ish parental anxiety, and counseling teachers to help them develop

greater acceptance of Bill and his learning behavior, seemingly

divergent from that of many children in their classes.

CONCLUSION

The uniqueness of individuals is brought into focus by careful,

differential diagnosis. The strategies for remediation, including



lipton: Relating remedial strategies to diagnostic consideratio?is 359

reading skills to be taught, how to teach them, and when to teach

them, must be determined by initial and on-going diagnosis of

each child in reference to his position in the family constellation, his intra-psychic dynamics, his learning styles, his attitudes

towards learning, his feelings about himself and adults, and his

perception of his place in the school setting.

REFERENCES

Ehrenwald, J. Neurosis in the family. New York: Harper and Row, 1963.

Levenson, E., Stockhamer, N., and Feiner, A. Family transactions in the eti

ology of dropping out of college. Contemporary Psychology, 1967, 3 (2), 134-139.

Lipton, A. Teacher rigidity and its relation to progress of retarded readers. In

J. Figurel (Ed.) Reading and realism. Proceedings of The International Reading

Association, 1969, 13, 757-763.

Psychodynamics in the special school (Continued from Page 330)

the use of everyday academic material. The teacher consistently introduces the child to reading situations and makes the effort to

share and convey a vicarious appreciation of the feelings being

expressed by characters in specific story situations. As an auxiliary

technique the teacher and child may also find opportunities to

focus on his specific behavior in class and relate this to the feelings

being discussed concerning a story character.

CONCLUSION

As a means of improving the teaching milieu in the special school, developmental psychodynamics and the impact of affect

on the child's ability to learn must be emphasized as important areas of knowledge for the special teacher (as well as regular school teachers). A stratagem approach which emphasizes the

desirability of flexibility in the approach to a child as well as

focuses on the role of the teacher as a "learning therapist" is most

important. The teacher is as pointedly attentive to the child's feel

ings in her classroom as the psychotherapist is in his office. Under

lying the various approaches in this article is the deeply felt con

viction that the teacher can convey to the child an empathie awareness of his role in relation to others by the quality of her

behavior toward him.

REFERENCES

Newman, Ruth G., Bloomberg, Claire, Emerson, Ruth, Keith, Marjorie, Kitch

ner, H., and Redi, F. Technical assistance. In Long, Morse, and Newman (Eds.)

Conflict in the classroom. Belmont, Calif.: Wadsworth Publishing Co., 1965.

Redi, F. The concept of the life space interview. In Long, Morse, and Newman

(Eds.) Conflict in the classroom. Belmont, Calif.: Wadsworth Publishing Co., 1965.



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Learning Disabilities || Relating Remedial Strategies to Diagnostic Considerations