Current Directions in Psychological

Science
Children’s Reading Comprehension 20(3) 139-142
ª The Author(s) 2011
Difficulties: Nature, Causes, and Reprints and permission:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/0963721411408673
Treatments http://cdps.sagepub.com

Charles Hulme1 and Margaret J. Snowling1

Abstract
The goal of reading is to extract meaning from text, and this depends upon both decoding and language-comprehension skills. Recently
there has been growing interest in children who can read accurately but have poor comprehension. Reading-comprehension impair-
ment is relatively common, although it often goes unrecognized in the classroom. Children with reading-comprehension impairment
have a range of oral-language weaknesses, which impede their comprehension of both written and spoken language. Recent studies
indicate that these underlying oral-language difficulties can be ameliorated by school-based interventions, which can, in turn, improve
both reading- and listening-comprehension skills. Early interventions to reduce such language-learning weaknesses potentially have
very important educational, social, and economic implications.

Keywords
reading, decoding, comprehension, oral language, reading comprehension impairment, intervention

Teaching children to read accurately, fluently, and with their age but fail to understand much of what they read. Although
adequate comprehension is one of the main goals of early this condition has been studied for many years (e.g., Oakhill,
education. Reading is critical because a great deal of formal 1984), it still often goes unnoticed in the classroom, because
education depends upon being able to read with understanding. when such children are asked to read a passage aloud they may
Reading difficulties will inevitably create educational difficul- do so with ease and it is only when they are asked questions
ties, which, in turn, are a major source of economic and social about the meaning of what they have read that their problems are
disadvantage. But such difficulties may be reduced by suitable revealed. For this reason, reading-comprehension impairment
early intervention (Heckman, 2006). (and the language difficulties that underlie it) may often be a hid-
Reading comprehension depends on word recognition, den disability. It is likely that many such children and their
and these two skills correlate around. 70 in the early grades teachers are unaware that they have a reading problem.
(see, e.g., Juel, Griffith, & Gough, 1986). However, the
less-than-perfect correlation between word recognition and
reading comprehension implies that there will be children who The Nature and Prevalence of Reading
have deficits in just one of these skills. It is well established that Comprehension Impairment
both these forms of selective reading difficulty are relatively
common (see Cain, 2010; Hulme & Snowling, 2009; Stothard Reading-comprehension impairment is not identified in the
& Hulme, 1995; Yuill & Oakhill, 1991). The most widely Diagnostic and Statistical Manual of Mental Disorders, 4th
recognized form of reading disorder is often referred to as dys- Edition (DSM-IV; American Psychiatric Association, 1994),
lexia. Children with dyslexia find learning to recognize printed and in the current draft of DSM-5, children with this profile
words inordinately difficult. Dyslexia has been widely studied would be identified as having a form of language impairment.
and is now relatively well understood (Hulme & Snowling,
2009; Vellutino, Fletcher, Snowling, & Scanlon, 2004).
Corresponding Author:
In contrast to dyslexia, children with reading-comprehension Charles Hulme, Department of Psychology, University of York, Room PS/B105,
impairment (often simply referred to as poor comprehenders) Heslington, York, YO10 5DD, UK
can read aloud accurately and fluently at a level appropriate for E-mail: ch1@york.ac.uk

Downloaded from cdp.sagepub.com at PENNSYLVANIA STATE UNIV on March 5, 2016

A simple definition of reading-comprehension impairment is suggests that word recognition and listening comprehension
that a child must show a deficit in reading comprehension that are subject to genetic influence, which together fully account for
is markedly discrepant with their reading accuracy. Many the genetic influences on reading comprehension (Keenan, Betje-
widely used tests (e.g., Wechsler Individual Achievment Test, man, Wadsworth, de Fries, & Olson, 2006). Finally, as children
WIAT-II; Wechsler, 2005) contain separate measures of read- get older, the correlation between reading-comprehension and
ing accuracy and reading comprehension that have been stan- decoding skills tends to decrease somewhat, while the correlation
dardized on the same population, making them ideally suited between reading comprehension and listening comprehension
to identifying these children. It must be emphasized, however, increases—suggesting that at older ages, reading comprehension
that not all standardized reading-comprehension tests are comes to depend relatively more on language-comprehension
equivalent and that some tests appear to assess primarily ability and less on the ability to decode print (Gough, Hoover,
decoding accuracy rather than broader aspects of language & Petersen, 1996).
comprehension (see Keenan, Betjeman, & Olson, 2008). Given that children with reading-comprehension impair-
In practice the criteria used to identify poor comprehenders ment are defined by having adequate reading accuracy (decod-
have differed widely between studies. Furthermore, given that ing) coupled with deficient reading comprehension, it follows
reading-comprehension skills show a continuous distribution in from the simple view of reading that these children should
the population, the cutoff used to define an impairment is to show deficits on measures of language comprehension. A great
some degree arbitrary (Hulme & Snowling, 2009). Neverthe- deal of evidence bears out this prediction.
less, evidence indicates that reading-comprehension impair- Catts, Adlof, and Ellis-Weismer (2006) conducted a large-
ments are relatively common. Perhaps the best evidence we scale study of eighth graders, many of whom had language
have comes from the standardization of a new reading test in impairments. Of the 182 children who took part, 57 had a
the United Kingdom (York Assessment for Reading & Com- reading-comprehension impairment (poor comprehension in
prehension; Snowling et al., 2009) involving a representative relation to word-reading ability), 27 had decoding problems
sample of 1,324 UK primary-school children. Of the children (poor word reading in relation to reading-comprehension abil-
in this sample, 10.3% showed a greater than 1 standard devia- ity), and 98 were typically developing children of the same age.
tion deficit in reading comprehension compared to reading As expected from the simple view, the children with reading-
accuracy. This figure includes some children with average to comprehension impairment showed deficits on a wide range
good reading-comprehension ability but who have exception- of language measures. We can express the size of the problems
ally good decoding skills. To identify children with clinically shown by the poor comprehenders in terms of effect sizes
significant reading-comprehension difficulties, we can select (Cohen’s d; the size of the difference between groups in stan-
only those children who show this discrepancy and whose dard deviation units). There were very large effect sizes when
reading-comprehension standard scores are equal to or below comparing the receptive-vocabulary (d ¼ 1.47), grammatical-
90 and whose reading-accuracy scores are 90 or above; 3.3% understanding (d ¼ 1.15), and listening-comprehension
of the sample met this arguably quite stringent set of criteria for (d ¼ 1.26) skills of the poor comprehenders to typically devel-
defining a reading-comprehension impairment. Some 28% of oping children of the same age. In contrast, the poor compre-
these poor comprehenders were children with English as a sec- henders showed essentially normal performance on measures
ond language, compared to just 14% of the rest of the sample of phonological (speech-sound) skills, whereas children with
(see also Lervåg & Aukrust, 2010). In summary, there is little decoding difficulties showed deficits on these measures but not
doubt that reading-comprehension impairment is relatively on measures of vocabulary, grammatical understanding, and
common (and more common in children who are learning to listening comprehension. This contrasting profile of language
read in a second language). strengths and weaknesses between poor comprehenders and
poor decoders shows that these are two different forms of reading
The Causes of Reading-Comprehension problem that arise from different underlying language difficulties.
Another interesting feature of this study was that data were
Impairment available for the same children when they had been tested
According to the simple view of reading (Gough & Tunmer, earlier in kindergarten and second and fourth grade. A retro-
1986) reading comprehension (R) is equal to decoding (D) spective analysis showed that the poor comprehenders showed
‘‘multiplied by’’ linguistic comprehension (R ¼ D  C). In this poor language scores at all these previous test times. This
view, adequate reading comprehension depends critically upon shows that these children had a stable language deficit and one
the ability both to decode print (translate written language into that might plausibly be a cause of their problems in understand-
speech) and to understand spoken language. If either of these ing what they read. Furthermore, approximately 30% of the
components (decoding or linguistic comprehension) is defi- poor comprehenders met the diagnostic criteria for having a
cient, problems of reading comprehension will ensue. Studies language impairment, compared to approximately 5% of the
of typically developing children show that variations in typical readers.
reading-comprehension skills are strongly predicted by varia- A similar pattern emerged from an earlier study by Nation,
tions in decoding and listening comprehension, as claimed by the Clarke, Marshall, & Durand (2004), which used a more strin-
simple view of reading. In addition, behavior-genetic evidence gent criterion for identifying children as poor comprehenders.

Downloaded from cdp.sagepub.com at PENNSYLVANIA STATE UNIV on March 5, 2016

In this study, once again, there were very large effect sizes only oral-language work and no reading or writing. The
when comparing the vocabulary (d ¼ 1.74) and morphosyntac- interventions were delivered in the children’s schools by
tic (d ¼ 1.09) and receptive and expressive language (d ¼ 1.02) specially trained teaching assistants in three 30-minute sessions
skills of the poor comprehenders to those of typically develop- each week over 20 weeks. The children’s reading and language
ing children of the same age. Some 35% of the poor compre- skills were assessed before the intervention began, immediately
henders in this study met the criteria for having a language after the intervention was completed, and again some
impairment. Finally, in another study by the same group 11 months later.
(Nation, Cocksey, Taylor, & Bishop, 2010), a small sample The effects were very clear. Immediately after the intervention
of 8-year-old poor comprehenders showed substantial deficits was completed, all three intervention groups showed reliable
on measures of vocabulary (d ¼ .82), listening comprehension improvements of equivalent size in reading comprehension (as
(d ¼ .88), and grammatical knowledge (d ¼ .99 – 1.22) in com- measured by the WIAT-II) in comparison to the control group
parison to age-matched normal readers, and longitudinal data (increases of approximately 3.5 to 4.5 standard score points;
showed that these deficits were highly stable. effect sizes between d ¼ .59 and d ¼ .99). However, at delayed
In summary, the evidence reviewed clearly shows that poor follow up, 11 months after the intervention had been completed,
comprehenders display broad language difficulties that are the advantage of the OL group had increased to 7.9 standard score
present before reading develops and that are therefore likely points compared to the untreated control group (d ¼ 1.24—a very
causes of their later reading-comprehension difficulties. These large effect), and this group was now showing a larger gain than
early-emerging language problems include weak vocabulary either the TC or COM groups (gains of 5.2 and 4.7 standard-score
knowledge, difficulties in processing grammatical information points, respectively). Furthermore, it appeared that the effects of
in spoken language, and poor performance on general measures the OL and COM interventions were at least partly accounted for
of language comprehension. For most of these children, their by changes in a measure of vocabulary that had been taught in
language difficulties are not severe enough for them to be diag- these interventions. The children in the OL intervention also
nosed as having a language impairment, but a reasonable view showed statistically reliable improvements at the end of the inter-
would be that most of these children have a subclinical language vention in a standardized test of vocabulary knowledge involving
difficulty, which is manifested clearly in their reading- words that had not been taught in the intervention. This, together
comprehension problems. We should note that a wide range of with the increased size of reading-comprehension advantage at
other explanations for these children’s reading-comprehension follow-up for this group, suggests that the intervention had
difficulties have been considered, including deficits of working resulted in some generalized improvements in these children’s
memory, problems in making inferences, and problems in mon- oral-language comprehension abilities.
itoring their comprehension of what they are reading (see Cain, The Clarke et al. (2010) study provides support for the idea
2010; Hulme & Snowling, 2009). In our view, many of these that the language weaknesses that characterize poor compre-
other putative causes may reduce to more basic limitations in henders can be ameliorated by suitable teaching. It will be
oral language comprehension, which are the direct cause of important to see such results replicated and preferably extended
these children’s reading comprehension difficulties. If this is the to interventions of longer duration. The children in this study
case, interventions to improve oral language comprehension were 8- to 9-year-olds who were in their fourth year of
skills should improve these children’s reading comprehension. full-time education. A natural question is whether a similar
oral-language-intervention program delivered earlier in
development could prevent the development of such language-
Treatments for Reading-Comprehension
and reading-comprehension difficulties. Bowyer-Crane et al.
Impairment (2008) compared the effects of a phonology-with-reading
The evidence about how best to treat reading-comprehension program (teaching letter-sound knowledge, phonological
impairment is so far limited, but the results from a recent ran- awareness, and early reading skills) and an OL program (involv-
domized controlled trial paint an optimistic picture (Clarke, ing vocabulary instruction, listening comprehension exercises,
Snowling, Truelove, & Hulme, 2010; see also the Reading for and narrative skills) in 4- to 5-year-old children with weak OL
Meaning Project, 2010, for more details of the methods and skills at school entry. The results from this randomized con-
materials used in this study). After initial screening of 1,120 trolled trial showed clearly that the program was effective in
children in 23 school classes, 160 children were identified boosting children’s vocabulary and grammatical skills and that
(8 children in each of 20 classes) as having a relative weakness these effects were maintained 5 months after the trial had ended.
in reading comprehension compared to reading accuracy. However, at this point in development, these children’s reading-
The children selected were randomly allocated to four comprehension skills were still at a very basic level, and there
groups; three groups received an intervention immediately, was no reliable difference in reading-comprehension skills
while the fourth group waited until the first three groups had between the groups. Nevertheless, the form of training used in
completed their intervention. The three interventions were this trial shows clear similarities to the OL program delivered
text-comprehension (TC) training, oral-language (OL) training, by Clarke et al. to older children with reading-comprehension
and a combined (COM) oral-language and text-comprehension impairments. It seems a high priority for future studies to assess
training. It is important to note that the OL program involved the extent to which early OL enrichment programs could

Downloaded from cdp.sagepub.com at PENNSYLVANIA STATE UNIV on March 5, 2016

improve children’s OL and reading-comprehension skills. Gough, P.B., & Tunmer, W.E. (1986). Decoding, reading and reading
Current evidence suggests that this is a realistic possibility. We disability. Remedial and Special Education, 7, 6–10.
should also emphasize that many children experience difficulties Heckman, J.J. (2006). Skill formation and the economics of investing
with both word-recognition and language-comprehension skills, in disadvantaged children. Science, 312, 1900–1902.
and such children may require interventions that address both Hulme, C., & Snowling, M. (2009). Developmental disorders of
of these problems (i.e., a combination of the two approaches to language, learning and cognition. Chichester, England: Wiley-
intervention that were evaluated by Bowyer-Crane et al., 2008). Blackwell.
Juel, C., Griffith, P.L., & Gough, P.B. (1986). Acquisiton of literacy:
Recommended Reading A longitudinal study of children in first and second grade. Journal
Carroll, J.M., Bowyer-Crane, C., Duff, F., Hulme, C., & Snowling, of Educational Psychology, 78, 243–255.
M.J. (2010). Effective intervention for language and literacy in the Keenan, J., Betjeman, R., & Olson, R. (2008). Reading comprehension
early years. Oxford, England: Wiley-Blackwell. An accessible tests vary in the skills they assess: Differential dependence on
account of a large-scale intervention study concerned with boost- decoding and oral comprehension. Scientific Studies of Reading,
ing children’s early reading and language skills, written to be 12, 281–300.
intelligible to teachers, practitioners, and policymakers. Keenan, J., Betjeman, R., Wadsworth, S., de Fries, J., & Olson, R.
Catts, H., Adlof, S., & Ellis-Weismer, S. (2006). (See References). (2006). Genetic and environmental influences on reading and lis-
Documents clearly the different language profiles of children with tening comprehension. Journal of Research in Reading, 29, 75–91.
dyslexia and reading-comprehension impairment. Lervåg, A., & Aukrust, V.G. (2010). Vocabulary knowledge is a crit-
Clarke, P., Snowling, M., Truelove, E., & Hulme, C. (2010). (See ical determinant of the difference in reading comprehension
References). Presents the results of the first randomized controlled growth between first and second language learners. Journal of
trial to evaluate effective interventions for children with reading- Child Psychology & Psychiatry, 51, 612–620.
comprehension impairment. Nation, K., Clarke, P., Marshall, C.M., & Durand, M. (2004). Hidden
Hulme, C., & Snowling, M. (2009). (See References). Provides an language impairments in children: Parallels between poor reading
overview of current understanding of different developmental comprehension and specific language impairment? Journal of
disorders of language, learning, and cognition. Speech, Language, and Hearing Research, 47, 199–211.
Nation, K., Cocksey, J., Taylor, J., & Bishop, D.V.M. (2010). A longitu-
Declaration of Conflicting Interests dinal investigation of early reading and language skills in children
The authors declared no potential conflicts of interest with respect to with poor reading comprehension. Journal of Child Psychology &
the research, authorship, and/or publication of this article. Psychiatry, 51, 1031–1039.
Oakhill, J. (1984). Inferential and memory skills in children’s compre-
References hension of stories. British Journal of Educational Psychology, 54,
American Psychiatric Association. (1994). Diagnostic and statistical 31–39.
manual of mental disorders. (4th ed.) Washington, DC: Author. Reading for Meaning Project (2010). Reading for meaning. Retrieved
Bowyer-Crane, C., Snowling, M.J., Duff, F.J., Fieldsend, E., from http://readingformeaning.co.uk
Carroll, J., Miles, J.N.V., et al. (2008). Improving early language Snowling, M.J., Stothard, S.E., Clarke, P., Bowyer-Crane, C.,
and literacy skills: Differential effects of an oral language versus Harrington, A., Truelove, E., et al. (2009). York Assessment of
a phonology with reading intervention. Journal of Child Psychol- Reading for Comprehension. Passage Reading. London, England:
ogy & Psychiatry, 49, 422–432. GL Publishers.
Cain, K. (2010). Reading development and difficulties. Chichester, Stothard, S., & Hulme, C. (1995). A comparison of phonological skills
England: Wiley-Blackwell. in children with reading comprehension difficulties and children
Catts, H., Adlof, S., & Ellis-Weismer, S. (2006). Language deficits in with decoding difficulties. Journal of Child Psychology &
poor comprehenders: A case for the simple view of reading. Jour- Psychiatry, 36, 399–408.
nal of Speech-Language-Hearing Research, 49, 278–293. Vellutino, F.R., Fletcher, J.M., Snowling, M.J., & Scanlon, D.M.
Clarke, P., Snowling, M., Truelove, E., & Hulme, C. (2010). Amelior- (2004). Specific reading disability (dyslexia): What have we
ating children’s reading comprehension difficulties: A randomised learned in the past four decades? Journal of Child Psychology &
controlled trial. Psychological Science, 21, 1106–1116. Psychiatry, 45, 2–40.
Gough, P.B., Hoover, W., & Petersen, C.L. (1996). Some observations Wechsler, D. (2005). Wechsler Individual Achievement Test, 2nd
on the simple view of reading. In C. Cornoldi & J. Oakhill (Eds.), Edition (WIAT II). London, England: The Psychological Corp.
Reading comprehension difficulties. (pp. 1–13). Mahwah, NJ: Yuill, N., & Oakhill, J. (1991). Children’s problems in text compre-
Erlbaum. hension. Cambridge, England: Cambridge University Press.

Downloaded from cdp.sagepub.com at PENNSYLVANIA STATE UNIV on March 5, 2016