Methods and Results of Teaching a Case of Congenital Word-Blindness
Charles A. Ford
State Bureau of Juvenile Research, Columbus, Ohio Congenital word-blindness is characterized, according to Hinshelwood,1 by normal or near normal intelligence, inability to read words, though other symbols such as music and numbers can be read, and the eventual development of a reading skill when the proper technique can be found. The frequency of this defect in the public schools is really unknown because of the inexact definition of how severe the defect must be to be dignified by such a name. Dr Wallin2 has estimated its frequency to be as great as epilepsy, but this is higher than most other estimates.
The important points concerning the condition are three. First, that such a condition is found now and again in the public schools. Second, that the children have approximately normal intelligence. And third, that the condition can be alleviated, somewhat, by education alone. This last condition is extremely important because it puts the problem of the social competency of the child squarely on the shoulders of the school staff.
This paper is an attempt to show a method used in the instruction of such a case, together with objective and subjective measures of the results of such instruction. As is so often the case with such cases, the gross result of Paul’s3 defect was far more than mere inability to read but extended into a severe social maladjustment that eventually brought him before a juvenile court. In our work with Paul, no attempt was made to develop his reading skill to the point of mastery. We only tried to find a method that would show that Paul could be taught to read and at the same time could be continued in his local school.
One of the outstanding facts in Paul’s case was his ability to identify a printed word when the name was given him but an utter inability to name the word when the word alone was seen. For instance, if we were asked to find such a word as “Rover” 1 Hinshelwood, James: Congenital Word Blindness (1917) a Wallin, J. E. W.: Clinical and Abnormal Psychology (1927) sFord, Chas. A.: “A Case of Congenital Word-Blindness Showing Its Social Implications”?Psychological Clinic May-June 1928, 17, pp 73-84. Paul’s case is to be found here, reported as a case study to show the method of diagnosis and the factors that contributed to his social mal-adjustment. in a page, he could do it, but shown the same word before or a few minutes later he could not pronounce it, and it carried no meaning for him. Yet he could analyze the word as far a? letters were concerned and he had some idea of the phonetic sounds of individual letters. Even when Paul would apply these sounds, he could not synthesize them so that the word as a whole had sufficient sound similarities to known words that he could recognize it. We are not yet certain that this condition is typical of the congenitally word-blind, but it has been found in many of the cases we have seen at the Bureau.
Paul’s feeling of inferiority, because of his inability to read, offered another big problem in selection of a method. Mistakes served to inhibit further responses and he would become very timid. Yet, as with any normal person, he had to see progress and marking time on the same material had the same effect as mistakes. For these reasons, it was essential that many arrangements of the same learned vocabulary were available so that he would have many contacts with it, without the feeling of having to do his work over.
Because of his severe reading defect, it was essential that a simple system be used. Phonics were essential, we felt, because he needed a power to attack new words. But the phonics system needed to be the very simplest devised because the feat of learning to read was hard for him even when a simple method was used. He had been given all his phonics training by the family method. Five years of this had shown its inability to meet his situation, so something else needed to be found. Furthermore, the material he was to use had to be attractive to one of his age. Too simple material would not stimulate him, but the usual material for eleven-yearolds was too difficult. In short, our method must be one that would give him the ability to recognize words easily; that would be so simple that mistakes would be few; that would allow him to see progress but offer much drill with new arrangements of the same vocabulary; and that would give him not only visual but kinaesthetic contacts with the same words. A further condition was that the method should be useable in his own school.
For these reasons the “Beacon”4 system of phonics was 1 The “Beacon” system is published by Ginn and Co. of Boston. The Phonics system is outlined in a teachers’ manual written to accompany the “Beacon Gate to Reading.”
adopted and the “Beacon” readers were used as basal readers. Modifications of the method were made to fit the particular case at hand, but these modifications were probably no greater than would have been needed for any other individual type of instruction. The advantage of this system over others was the simplicity of its phonics, and its well worked out flash cards.
Each morning and each afternoon, Paul was given a thirty minute period of individual instruction.5 By means of objects, or pictures of objects, and printed cards, a small working vocabulary was developed. The method was simply to show Paul a card with the name “ball” on it, explaining that the word was the same as the name of the object. Then a picture of ball would be shown and he would be asked what it was. The card with the name on it would be represented and it would again be explained that in this case the word “ball” rather served as a photograph of a ball. The words would then be written on the black board and Paul would be asked to trace the letters and pronounce the name. Then he would copy it and pronounce the name. And so on, until several nouns had been learned more or less thoroughly.
Next, he would be shown a ball and asked what he saw and he would say: “I see a ball.” Then a card would be shown, reading, “I see a ball” and it would be explained that the card said the same thing he had said. Then he would be asked to point to the word “ball” on the card; asked to write it, etc. Then the sentence would be taken apart so that the card reading, “I see” was by itself and it would be explained what the card said, etc., through the same order as in learning the nouns. Then a book having the same sentence would be shown and he would be asked to read it. And so on with word and phrase after word and phrase. After he had learned several cards, he would be given them to play with and encouraged to build new sentences with them, then to tell Mr. Bell or others what the sentence said. Each period consisted in presenting, in a random order, all the cards he had learned up to that time. He was told never to guess but if he did not recognize a card to say nothing. By this device, errors were kept at a minimum. After he had learned the cards, they were not just shown an indefinite time for him to look at ibut they were flashed so that he would attain speed in the recognition of his vocabulary built upon the “look and say method.” B This instruction was given by Mr. Eric F. Bell, an assistant psychoclinician at the Bureau of Juvenile Research. The cards used were the “Beacon” flash cards, so that his vocabulary would correspond to available books. As soon as the necessary vocabulary for a story had been attained, he was given the book to read. Following this, he would be given construction work with the same vocabulary. So that his contact with the words were many and various.
In eight weeks of such drill, Paul had learned the vocabulary of the “Beacon Gate to Beading,” finished the constructive seat work that accompanies it, and had attained considerable facility in recognizing the words in new places, although he was far from perfect in this ability. It was apparent that the contextual setting of the word assisted him greatly in recognizing it.
While he had fair ability in word recognition of learned words, he had no ability to pronounce or get the meaning of new words. It was therefore essential that phonics be introduced. Because of a variety of circumstances, it was necessary to change teachers at about this time, so the entire phonic development was left for a new person.6
This change in teachers also necessitated a new time arrangement. Three fifty-minute periods were arranged, one each Monday, Wednesday, and Friday morning. Had it been possible for the same time distribution to have continued as in the previous period, better results could probably have been attained, but even under these adverse arrangements, it is interesting to see the progress that was made.
The methods used from this time on were to have: (1) drill on Beacon phonies; (2) written work with oral spelling of words as they were written; (3) drill on word reading (continuation of flash card method); and (4) drill on the various exercises, with the known vocabulary. Each of these were used for short periods so as to prevent exhaustion. Letter names, consonant sounds, and consonant combinations had been fairly well learned before this time. The vowels, which are the main phonetic elements in the Beacon system gave the most trouble:
A, O, and I, were presented in the manner outlined in the Beacon Manual, in a twenty-minute period. The next day A and 0 were recalled but I was not. That day, I and E were taught. ” Miss Lois Weaver, a special reading teacher of the Dayton, Ohio public schools was selected for this work because of her interest in the problem and experience with reading methods, although she had had no previous experience with the “Beacon” system. Next day, A, 0 and I were recalled but E was not. That day, I, E and U were drilled. Next day all vowels were recalled except U which has consistently remained troublesome. The method of teaching was to write the vowel and sound it, then Paul would do the same. Then words having that phonetic sound would be written and pronounced. Paul would then be asked to add words to the list that had that sound and they too would.be written and pronounced. The same method was used in presenting digraphs.
The combinations ar, or, er, ir, and ur, were then presented. Next came oo, all, aw, au, then ow, ou, oy, and oi. Daily reviews were carried on with combinations that proved difficult. The method was for the instructor to first write them, then Paul would say them and mark each one he would miss. He would then go back and correct the ones he had missed. The next step was to have him write the combinations as they were dictated. Combinations were in every case first presented in words then later they were isolated. Despite, this, he found it easier to recognize the isolated combination unit than the same unit in words. This phonic work was given during the first part of the fifty minute period and consumed an average time of twenty minutes. It was not an invariable time but as soon as Paul showed any fatigue or lack of interest, the next part of the lesson was started.
The second section was given to reading, mostly oral. During this period much encouragement had to be given him as he was quite reluctant to re-try words that he failed to pronounce correctly the first time. He would say, “I know all the sounds but can’t put them together.” This was usually true and when he was asked to sound them aloud, he could usually put them together without further difficulty. The greatest trouble was his reading from context. All too often he would call “father,”?”daddy” or “papa” or insert a word that could as well be there as the one that was actually there. In short his speaking vocabulary was developed far beyond his reading vocabulary. The remaining part of the fifty minute period was spent in answering questions in two ways. (1) by doing things, and (2) by writing things. In each case the questions were written. He had to read them and then carry out the directions. The questions, to which he was to write answers, were about pictures from magazines pasted at the top of the page. On either side of the picture was a vocabulary concerning the picture. Under the picture were the questions with spaces left for the answers. Doing this work he showed his greatest spontaneity and would pronounce words that were expected to be difficult. This ability to pronounce the words was probably because of the cues offered by the pictures. His outstanding difficulties ran true to type. His most difficult vowel sound was “u” which he often sounded as “i” or “e.” In single consonant sounds, it was “d” which he would call either “p,” “b” or “t.” There was a constant tendency to pronounce “s” as”sh” and to insert “1” and “r” in words not having them, such as “biggerst” for “biggest,” and “black” for “back.” There was also difficulty in changing a vowel sound from short to long. Words beginning and ending in the same letters were troublesome. It was exceedingly difficult for him to remember words and when they were sounded out at the top of the page, they were equally as difficult at the bottom of the page. To pronounce a word he had to sound it orally and there was an utter disability to do it without sounding the syllables aloud and a further difficulty, in that, though he sounded out words correctly, he often mispronounced them by combining the sounds into meaningless words. But usually context helped to pronounce words after they were sounded.
The most important item in attempting to teach any child is the child’s attitude. This was even more true of Paul. Because of his difficulty he had developed a feeling of inferiority and had lost confidence in himself. He was timid, afraid to assert himself, afraid to make mistakes, and was never sure of anything. A mistake, if made, slowed the whole process. New words, new stories and new situations were nearly overwhelming because of the possibility of error. It was this attitude that made his teaching difficult. “With such an attitude toward life, encouragement and praise in large doses is the best medicine. As far as possible, Paul was kept from making errors by being given timely help. He was allowed to select the stories he read. He was praised for all that he did, was given extra institutional privileges, and taken to places that might interest boys of his age. Though he enjoyed this, he was not exuberant about it as were other boys who went with him.
Despite his attitudes, and the meager time allowance for instruction, it was gratifying to see how much he improved. Detailed, objective tests of his ability before training will be found in the case study previously mentioned. Suffice it here to say that his reading ability was near a zero plane, and as far as serviceable reading ability was concerned it was absolute zero. One of the outstanding things in his case was his ability to recognize words when they were pronounced but an inability to pronounce the same words himself. After his training period which lasted, in all, about five months, but with some lost time because of sickness, there was an apparent measurable improvement not only in reading but in social attitudes.
On the Pressey “First Grade Reading” scale, Form A, he succeeded in a perfect score and could read all words and sentences he had circled. Previous to his training he circled 21 words and 12 sentences correctly and could read none of them. On the Los Angeles Primary Word Recognition Test, Form 1, Part 1, which requires lines to be drawn from a word to the correct element of a picture, he made a perfect score. On the Pressey Second Grade Reading Test, Form A, Test 1, he did 22 lines in twenty minutes (Standard time three minutes from whole test). This test is to cross out nonsense syllables from a line of words. He was successful in only 12 of the 22 lines. This simply shows that words outside a contextual setting carry very little meaning for him. On the Gates Primary Reading Test, Type 2, Form 1, he missed only two of the twenty-five parts of the test. This test is to circle pictures answering a description printed above. Tests such as these last three were impossible previous to his training as he could read nothing. But his reading was very slow and far from accurate. On some non-standard reading tests designed for practice work, it took him eight to ten minutes to do what it would ordinarily take a first grade youngster two or three minutes to do. These consisted of typed simple directions followed by pictures to which he was to do something. For instance, one said, “Put a tail on the animal that barks” and was followed by a drawing of a dog and a cat. He read it “Make a tail on the animal Ted backs” but actually put the tail on the dog. This performance illustrates his reading from context and his substitution of letters. In addition to these improvements in ability, he succeeded in raising his Stanford-Binet mental age from 9 years, 5 months to 10 years and 6 months in the five month period. On both Stanfords he failed the tests involving reading. But it was gratifying to note that while he couldn’t read any of the material in the first test, he read much of it in the second, even though too slowly to be credited. There was also a noticeable change in his spontaneity and playground activities. So marked was the change that his parents wrote after his return to them: ‘’ He has changed so much that he does not seem like the same boy.”
We felt that this short and rather inconsistent training period had demonstrated two things rather clearly. First, Paul could be rehabilitated and made into a socially competitive being, and second, a usable method for his instruction in reading had been devised. Our recommendations were largely along the line of outlining a continuation of the instructional method and suggesting certain family adjustments that would be apparent from the complete case study. Some time after Paul’s return home, it was the writer’s good fortune to be in his city. It was gratifying to know what had been done concerning his case. First, the family situation was changed, as had been suggested. Second, a school supervisors’ meeting had been called and it was decided to place Paul in a borderline class where special emphasis could be placed on reading methods. After a short period of this, he was placed in the second grade and sent into other rooms for more advanced work when possible. At the time of the visit, for instance, he was doing third grade reading, fourth grade arithmetic and geography, and fifth grade history. Practically nothing but hand work was done in his home room and in this he was doing very well. The principal of his school reported him as being “very comfortable in his present placement.” He had not been truant from school a single time nor had he been a disciplinary problem.
His home was visited at the same time and his family was very much pleased with the results obtained. He no longer was timid and retiring but occupied his leisure time by building air planes and engaging in all sorts of group activities with children his own age. He had caused them no trouble and they felt confident of his ultimate successful adjustment.
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