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Saturday stream 4 Session 09.00 - 11.

10 Length 25 minutes

Reading difficulty characteristics in dyslexic and hearing-impaired

students (in Hebrew)

Ruth Engel and J. Rosenhouse

(1) Dept. of Technology and Science Education, Technion -I.I.T., Haifa 32000
Israel (2) , Dept. of General Studies, Technion - I.I.T., Haifa 32000 Israel


This study examines reading difficulty characteristics in Hebrew in three

reading-impaired populations. Two are groups of dyslexics: 100 readers with
impaired auditory perception and 100 readers with impaired visual
perception. The third group comprises 61 readers with deep/severe hearing
impairment. All were elementary schools students in the second to sixth
grades. The subjects were tested with a conventional Hebrew reading test. It
examined types of reading errors, (e.g., changes of phonetic structure or
word content), self-correction in reading, reading speed, sequential/holistic
reading, the effect of reading texts with and without the Hebrew diacritical
vowel signs ("punctuation"), and the effect of meaningful or meaningless text
material on the amount of reading errors. The literature describes distinctions
between various kinds of reading disability related to auditory impairment
and visual perception, and the definition of dyslexia as being one category or
including sub-groups. Our research hypothesis was that similar
characteristics of reading difficulties would be found amongst auditory
perception-impaired students and hearing-impaired students, and that they
would differ from those of students with impaired visual perception. Our
findings support this hypothesis. Many of the sub-tests revealed similarity in
the reading difficulties between the hearing impaired students and those with
impaired auditory perception vs. the visually impaired. An unexpected finding
revealed that 4th grade students in all the groups were a special sub-group
in each group. These findings suggest, in accordance with a major research
approach, that dyslexia should be defined in terms of dyslexia sub-groups
rather than as a single category.


Reading difficulties are examined among other features of reading research

in general (Just and Carpenter, 1987, Chall, 1982, Rayner, 1989), and the
study of processes in reading comprehension in particular (see, e.g., Cornoldi
and Oakhill, 1996, Morrow, 1989, Olson, 1994, Perfetti, 1994, Whitney et al.,
1995, Rosenhouse et al. 1997, Shanahan and Neuman, 1997). Reading
disability as a primary developmental feature of reading difficulty is examined
in its various aspects, including holistic or sequential reading, types of errors
in reading, reading which involves (or not) the semantic (content) factor,
reading rate, etc. Basically, reading disability is defined as a mismatch
between the phonetic and graphic structure of the word. Reading disability is
characterized in (at least) three different ways: 1) Content, when the reading
error is caused by substituting the word with a synonym in e.g., 'throw/fling';
2)Phonology, when the reader changes the phonological structure of the
word as in 'guest/just'; or 3) Form, when the reader wrongly replaces the
word with a wrong one which has a similar holistic graphical structure (e.g.,
of consonantal roots) 'fighter/fighting'.

The research of reading disability in Hebrew raises language-specific issues.

In Hebrew, most of the vowels are not indicated by letters as in the Latin-
based alphabet, but by diacritical points and marks . Usually, these marks
are omitted, except in texts for beginning readers and in some special texts
(mainly the Bible and poetry) (cf. Glinert, 1989). Thus, reading Hebrew
resembles going in a loop: In most cases, readers can decode the meaning of
a single word by the general context (of the sentence, the topic etc.). Due to
the above, the acquisition of Hebrew reading in the preliminary stages
requires the support of vowels or "pointing" (i.e., with diacritical vowel marks
- hereafter "pointing"), and only later students move on to reading
"unpointed" texts. In our examination of the mismatch between the graphic
and phonological structure, we therefore refer also to vowel pronunciation
(which actually changes the word), whether or not "pointing" appears in the
text .

Reading disability occurs due to a few reasons among which are the
motivational-emotive factor (Bentin, 1992), the environmental factor
(Vernon, 1979), the mental-cognitive factor (Rutter and Yule, 1975), the
psychological-sensory factor (Rudel and Denkla, 1976) and the neuro-
developmental factor (Geschwind, 1985). Dyslexia, as a reading impairment,
is often attributed to primary neuro-developmental damage. One of the
dilemmas in research is defining the dominant neuro-developmental cause
that explains dyslexia (Rahmany, 1990). Significant discussions between
researchers revolve around the dominance of auditory or visual perception as
causes of reading disability.

Auditory perception impairment is considered to be a cause for reading

disability (Vernon, 1966), and especially among hearing impaired populations
(Just and Carpenter, 1987). Auditory perception, which is involved in the
acquisition of reading skills, is usually related to phonological and phonetic
competence, to the ability to distinguish between similar speech sounds, to
identify the phonetic structure of the word, and to the competence in
grapheme-phoneme matching (Goswami and Bryant, 1990, Morais et al.
1986, Marschark and Harris, 1996).
Frith (1985), testing a dyslexic population, found support to the correlation
between the impairment in auditory perception and auditory discrimination
ability, and between reading disability. Frith (ibid.) examined their auditory
perception ability by tests which required identifying phonetic word
structures, identifying incomplete words (with deleted letters) and forming
words by joining letters, as well as by pronouncing meaningless (nonsense)

Bradley and Bryant (1983) found that it was possible to expect adequate
reading ability from children with good phonological awareness on the basis
of a test for identifying similar sounds. Children with poor phonological
ability, however, were slow and revealed difficulty in reading acquisition.
Birch and Belmont (1965), Jorm (1977), Holmes and Peper (1978) and
others support the correlation between reading disabilities and auditory
perceptual impairment.

In most cases, researchers include auditory discrimination ability and

auditory analysis in testing auditory perception of dyslexics (Jorm, 1977). In
such cases, a dyslexic student reveals difficulty in splitting a word into its
components while maintaining, i.e., the sequence of speech sounds in
auditory word completion. Sharan and Sharan (1978) refer to a particular
visual-auditory generalization causing readers to exchange a written word
(whose meaning they know), with another word, e.g., "grass" for "herb", and
to split a word into its components (syllables), e.g., "cet" / "faucet".
Correlation between impaired auditory short-term memory and poor reading
is also mentioned in Sharony, 1990.

The idea that auditory perception is the dominant reason explaining reading
difficulties has met with opposition by other researchers who suggest visual
perception as the dominant reason for dyslexia. According to these
researchers, due to the impaired visual perception, readers have difficulties
with the holistic perception of the word which they read sequentially. Their
reading errors include changing the order of letters (graphemes) in a word,
or letter (phoneme) deletion and insertion (Kinsbourne and Warrington,
1962, Warrington and Rabin, 1971, Warrington and Shallice, 1979,
Bradshaw, 1975).

These findings led to new approaches distinguishing between categories of

reading disability according to the involved perceptual impairment. Instead of
"dyslexia" as one category, sub-groups of dyslexia have been suggested.
Boder (1973) for example, distinguishes auditory-phonological dyslexia from
visual dyslexia. A similar approach is found in Marshall and Newcomb (1973)
and in Shallice and Warrington (1975) who define "deep" (phonemic)
dyslexia and "superficial" dyslexia. The "deep" dyslexia is related to the
auditory perceptual impairment, whereas the "superficial" dyslexia relates to
the visual perceptual impairment. The following error types characterize deep
(phonemic) dyslexia (Shallice and Warrington, 1975):
1. The subject's errors are semantic rather than phonological. S/he
substitutes the written word by another word related to the content of the

2. Word type affects the errors: The subject can read a word better when it
represents an object and not function words (prepositions).

3. The dyslexic subject shows difficulty in reading meaningless words. Frith

(1985) who stresses the perceptual-auditory factor as a cause for reading
difficulties in dyslexics, deals with the problem also from the point of view of
hearing-impaired readers. In his opinion, beyond the argument about reading
comprehension, most of the children gradually move on to holistic reading.
This process is due to the change from a visually distinguished logographic
strategy to a phonological or alphabetic strategy, in which letters are
translated into phonemes since they (the graphemes) represent the
phonological system. This phenomenon explains according to Frith (ibid.) the
difficulties of hearing-impaired readers who are usually known to have poor
phonological abilities.

The hearing-impaired person, whether growing in a hearing or in a deaf

home where one or both parents are deaf, was found to have lower
phonological skills than those of the hearing population. Waters and Doehring
(1990) found in seven to twenty years old hearing-impaired subjects
difficulty in phonological coding ability, which is one of the abilities examined
in auditory perception functioning in dyslexics. Harris and Beech (1995)
found in hearing-impaired subjects poorer phonemic awareness than in
hearing subjects. The same study claims that up to the age of seven years,
the hearing-impaired child hardly relies on phonological coding. Gradually,
with age, the child acquires this skill based on developing "inner language".
Evidence for difficulties which characterize hearing-impaired readers also
exists in other studies (cf. Truax, 1978, Soderbergh, 1985,).

Bellugi (quoted in Geschwind, 1985) presented evidence that deaf children,

born in deaf families, acquired sign language at a rate parallel to that of oral
language acquisition in normal hearers. Hence, relying on Geschwind's
definition of reading as the ability to "derive meaning from any kind of visual
representation of language" (Geschwind, 1985:198) the hearing-impaired
child is expected to read, as it were, without any difficulty. Still, it has been
found that reading is the most difficult academic challenge for the hearing-
impaired child (Marschark and Harris, 1996).

DiFrancesca (1972) found that reading skills of hearing-impaired children

increase only by 0.2 score per year. Vernon (1972) found that between the
age of 10-16 years, the hearing-impaired student's reading achievement
increases by little more than 0.1 score. Also Alan (1983) and Marschark
(1997) explain this population's reading difficulty as caused by their impaired
phonological channel.
Such findings support the theory about the role of impaired auditory
perception in reading disability and determine the background for the
comparison between two populations with reading disability: dyslexics with a
good peripheral hearing system, but whose auditory perception is impaired,
and a non-dyslexic hearing-impaired population whose peripheral hearing
system is impaired. These dilemmas and research findings are the basis of
our present research.

The Assumptions and Aims of the Present Research

Our research examines the assumption that there exist three different types
of reading disabilities related to different types of impaired perception: an
impaired auditory perception, an impaired visual perception, and an impaired
peripheral hearing system. Our research assumptions were that if, indeed,
different types of dyslexia (by perception channel) existed, we would find: 1)
similar characteristic reading difficulties in subjects with reading disability
due to auditory perception impairment and hearing-impaired subjects, who
suffer from reading difficulties. 2) We expect these impairment types to be
different from those of the dyslexic subjects with impaired visual perception.
This leads to the major research question in this study: Is it possible to find
in the framework of a comparative study similar characteristics of reading
difficulties in these populations, based on a physiological source, on the one
hand, and on a neuro-developmental (auditory or visual) perception
impairment, on the other.

Method of Work


Three research groups participated in this study, all studying in the 2nd to
the 6th elementary school grades. They were selected from the 2nd grade
up, since in the first grade children usually struggle with basic reading

The first group included 20 children per grade, that is, 100 children, who
were diagnosed as dyslexic by the first author and suffered only from
impaired auditory perception.

The second research group included 53 hearing-impaired students in the

same grades who were diagnosed as having normal visual perception. The
breakdown of this group by class is as follows: 2nd grade - 8 students; 3rd
grade - 20 students; 4th grade - 11 students; 5th grade - 10 students; 6th
grade - 4 students (see Table 1.). Their hearing impairment was severe or
deep, with a hearing level decrease ranging between 70-115 dB, and most of
the values ranging between 90-100 dB.

The control group consisted of 100 (20 per grade) dyslexic students (also
dignosed by the first author) who suffered from impaired visual perception.
The dyslexic groups had received no corrective intervention prior to the tests.
The dyslexic children came from Haifa and Northern Israel, as did about half
of the hearing impaired children. The latter were students in an integrative
school in Haifa. The rest of the hearing impaired students came from various
places in the center of Israel, and were tested in the "Shema'" Center for the
Hearing-Impaired in Tel-Aviv. Some of the hearing-impaired children talked at
a near-normal quality, but others had considerable speaking problems.
Therefore, a teacher was always present during the tests, and stopped the
reading whenever an error occurred and specified the error to the observing
researcher. This procedure was not necessary with the dylsexic groups.

The three groups will be henceforth referred to as follows:

Auditory - the dyslexics with auditory perception impairment;

HI - the hearing-impaired group, and

Visual - the dyslexics with visual perception impairment.


The subjects who were diagnosed as reading impaired were examined by a

Hebrew diagnosing kit for auditory perception functioning. Following Jorm
(1977) and Sharan (1978) we were assisted by the auditory perception tests
included in Kidron (1987) which are accepted for most of the diagnosing
tasks in Israel: the auditory discrimination test (based on Wopman adapted
by Hoga), auditory distinction between syllables (following Dar'in) and the
auditory classification test (identification of opening, medial and final speech
sounds in a word). The dyslexia diagnosing tests (in the Kidron set, 1987)
involve also visual perception functioning tests based on the MVPT test, and
include the examination of shape fixation, distinction of form and
background, holistic perception, visual sequence and visual memory.

The examination of the students' reading skills included the following

categories of reading characteristics and difficulty types:

1. Reading meaningful and meaningless text. By this test, a comparison

between reading aloud a list of (15) meaningful vs. (15) meaningless (nonce,
artificial) words was done. In this part we compared reading of words with
and without meaning by the number of errors made by the subjects during
reading. Each error was marked numerically for scoring and statistical
analysis as follows (cf. Figure 1):

-1 - In reading meaningful texts there are more errors than in reading

meaningless texts; 0 - In reading meaningful and meaningless texts the
number of errors is the same; 1. 1 - In reading meaningful texts there are
less errors than in reading meaningless texts.
2. Sequential or holistic reading. The length of the passage (ranging between
100-189 words) was adapted to the student's grade. The term "sequential"
means a reading technique which takes single graphemes, unit by unit,
uniting them only at the end of the word into a sense unit (i.e., a word), e.g.
reading the word 'general' as [ge-ne-ra-l]. The term "holistic" refers to
reading the word as a whole, relying on its visual pattern. Figure 2(a,b,c)
summarizes the findings.

3. Self-correction in reading. This variable measures the number of

spontaneous stops each child made in order to correct any kind of errors in
his/her reading (aloud). This measure involves the child's control over the
text s/he reads, which requires the use of semantic contextual analysis by an
auditory/semantic feedback system.

4. Reading rate. This variable was measured by the number of words read
aloud per minute(WPM) as in Engel (1997). The student's reading was
stopped after one minute. The raw numbers of each group were averaged by
groups and by classes (with standard deviations) is shown in Table 2 and in
Figure 5.

5. "Pointed" vs. "unpointed" text: Comparison between the effect of reading

texts with or without "pointing". The texts were taken from Engel (1987),
and Kidron (1977). The analysis was also done by group and grade, as in the
rest of the variables, and raw results were marked by the following coding
(cf. Figure 4(a,b,c)):

-1 - the "pointed" text involves more reading errors;

0 - the "pointed" and "unpointed" texts yield the same number of errors;
1 - the "pointed" text involves less reading errors.
6. Reading errors: Tests and analysis were made for the following categories
of reading errors. (See Figure 6 a, b, c):

a - wrong pronunciation of vowels. This is a more or less language specific

feature, since as noted, in Hebrew vowels ("pointing") are not written as
consonant letters, and errors in vowels may change the word (even if
consonants are correctly read).

b - reading errors in suffixes and "b/k/l/m" prefixes (for this term see
endnote iv). c - errors due to the child's changing the visual form of the
word; cf. e.g. Hebrew /hitbonen/ '(he) looked at' vs. reading it wrongly as
/hitlonen/ '(he) complained'.

d - change in the auditory form (the sound pattern) of the word; cf. e.g.
Hebrew [he'etik] '(he) copied' vs. reading it as [ekita] (a non-word).

e - change in the content or meaning of the word as a result of the error,

changing it into a totally different word.

In this section we summarize mainly verbally the findings of each reading

category. Altogether we had six test variables, three groups of subjects, five
grades per group, and the interactions amongst them. Due to the large
number of statistical tests which analyze the many different variables by
different methods, we do not present numerical tables. Let us note here that
Kruskall-Wallis test was used to analyze ordinal distributions (X square) such
as the reading of meaningful/meaningless words, the effect of pointing, and
the holistic/sequential reading style. Two-tailed ANOVA, Wilcoxon, and
Duncan tests were used for multi-population comparisons when the variables
were sequential as in, e.g., the reading rate. When the interaction between
the variables was significant, one-tailed ANOVA was used.


Inter-grade comparison

The HI group There is no clear evidence that the distribution of the difference
in error quantity in reading meaningful or meaningless text changes with
time. That is to say, the distribution is fixed in time (p=0.154). In the 3rd,
4th and 6th grades (but not in the 2nd and 5th grades) HI significantly tend
to a situation where they make more errors in reading meaningful than
meaningless words. In the 2nd and 5th grades there is no statistical evidence
for this trend.

The Auditory group The distribution of the difference in reading meaningful

vs. meaningless texts is not fixed throughout the grades (p=0.02). The
contribution of the 4th grade is a major source contributing to this effect, for
in this grade there are more reading errors in reading meaningful texts than
meaningless texts than would be expected by the equal distribution
hypothesis. In all the grades, except in the 4th grade, there is no significant
difference in the errors made in reading meaningful and meaningless texts.
In the 4th grade reading meaningful texts raises significantly the rate of
reading errors (p=0.008).

The Visual group There is no clear evidence that the content has a different
effect along the grades (p=0.10) (in the place test comparison p = 0.48). In
all the grades except in the 4th grade it is possible to say that in reading
meaningful texts there are significantly less errors than in reading
meaningless texts. In the 4th grade this is not significantly evident (p=0.10).

Inter-Group Comparison

Grades 2,4,5: At the 5% level of significance the visual group tends to

improve its reading when the text is meaningful compared to the HI and
Auditory groups. There is no significant difference between the HI and the
Auditory groups.
Grade 3: There is no significant difference between the HI and the Auditory
groups and between the Auditory and Visual groups. The difference between
the Visual and HI is significant: The Visual group tends to make less errors in
reading meaningful text than the HI.

Grade 6: At the 5% level of significance the three populations differ from one
another: The Visual group tends to read meaningful texts with less errors
than the HI and Auditory groups; the Auditory group reads meaningful texts
with less errors compared to the HI. That is to say, the probability that HI
would read meaningful texts with many errors is higher than the matching
probability of the Auditory group.

Considering all grades together, at the 5% level of significance, the Visual

group tends to read a meaningful text with less errors than the Auditory
group, and the Auditory group - with less errors than the HI group.

Figure 1 shows that there is hardly any interaction between the dyslexics
(both Visual and Auditory groups) and grade. (The above finding, based on
all the grades together, is therefore valid).


Inter- grade comparison

The HI group A significant difference was found between the grades

(p=0.045). The source of this difference is mainly in the 2nd grade, where
the prevalent reading style is sequential, whereas in the other grades, the
holistic type is dominant. Between grades 3 to 6 there is no significant
difference (p=0.384) (cf. Figure 2).

The Auditory group A significant difference along the grades was found
(p=0.001), but without the findings of grade 2 the difference is not
significant (p=0.465).

The Visual group There is a significant difference in reading style along the
grades (p=0.001), but without grade 2 the difference is not significant
(p=0.062). In grade 2 the prevalent reading style is sequential, and it
remains so in the higher grades

Inter-Group Comparison

For this comparison the three reading styles were scored as follows:

1- sequential reading; 2 - mixed (sequential and holistic); 3 - holistic.

At the 5% level of significance in the 2nd grade, no difference was found

between the HI and the Auditory group. The HI group, more than the Visual
group, tends towards the holistic reading style. In addition, the Auditory
group tends to be significantly more holistic than the Visual group. The HI
and the Auditory groups differ in this respect from the Visual group

Third-sixth grade: There is a difference between the groups in reading style

distribution (p=0.001). At the 5% level of significance, there is no difference
between the HI and the Auditory groups. Each of the HI and the Auditory
groups tend to read in the holistic style more significantly than the Visual
group. Relating to all the grades and inter-group differences, the Auditory
and HI groups read significantly more holistically than the Visual group.
There is no significant difference between the HI and the Auditory group


Inter-grade comparison

Self-correction in reading was also examined statistically (cf. Figure 3). No

significant difference in the probability to self-correction was found between
groups in the 2nd through 6th grades. The hypothesis that each population
had a fixed probability to self- correction was not refuted (HI: p=0.206;
auditory: p=0.756; visual: p=0.876).

In the HI population the probability for self correction was especially low in
the 3rd grade. Inter-group comparison As to inter-group differences in this
test, at the 5% level of significance this probability is not the same in all the
groups and at least two are different. The probability estimation for self
correction is as follows:

HI: 0.38, Auditory: 0.58, Visual: 0.55

At the 5% level of significance only the difference between the HI and the
Auditory groups is significant (p=0.016). Likewise, there is a significant
difference between both dyslexic groups (together) and the HI (p=0.013). In
both cases, the HI have a lower probability for self-correction. In the 5th and
6th grades there was no difference between the three groups at the 5% level
of significance (p=0.792).


In a two-tailed ANOVA examination which was made in order to study the

effect of grades, the studied group and the interaction between group and
grade, we found an interaction at the 5% level of significance (p=0.0001). In
other words, inter-group differences in reading rate depend on the grade.

Inter-grade comparison
In the 2nd grade there is no difference between the populations. In the
higher grades, the number of WPM of the HI increases with the grade. In the
Visual group the increase in reading rate is the most moderate. In the
Auditory group the increase is moderate and then, after the 4th grade, their
reading rate becomes equal to that of the HI.

In the 2nd and 4th grades there is no significant difference between the
groups. In the 3rd grade, the HI group has a significantly higher number of
WPM than the Visual or Auditory groups. In the 5th and 6th grades there is
no significant difference between the HI and the Auditory groups, and the
Visual group differs significantly from the other two groups.

Inter-group comparison (in WPM)

The HI group In the 2nd grade the reading rate is especially low. It is also
lower than that of the other groups. In the 3rd and 4th grades the number of
words is equal, and higher than in the 2nd grade. In the 5th and 6th grade,
the average number of WPM is significantly higher than in the lower grades.

The Auditory group The number of WPM in the 4th grade is significantly
different from both the lower and higher grades. In the 5th and 6th grades
the number of WPM is different from and significantly higher than in the 4th

The Visual group The number of WPM in the higher grades (4th through 6th
grades) is significantly higher than that of the lower grades (2nd and 3rd


Inter-grade comparison

The HI group At the 5% level of significance the effect of pointing on the

number of reading errors is not equal for all the grades. In the 2nd and 6th
grades there were less errors with pointed texts than could be anticipated
according to the hypothesis of equal distribution per grade. When the five
grades are examined together, there is no statistical evidence to support the
hypothesis that pointing affects the number of errors.

The Auditory group At the 5% level of significance the pointing effect on the
number of reading errors is not equal for all grades. Two facts contributed to
this finding: In the 2nd grade there were too many cases in which "pointing"
helped reading (i.e., less reading errors) and in the 6th grade there were too
many errors in reading "pointed" texts . Throughout the grades there is a
growing tendency to make more errors in "pointed" texts. Apparently
"pointing" interferes with the reading process (cf. Figure 4), although this has
not been statistically tested.
In the 2nd grade reading a pointed text decreased significantly the number of
reading errors; in the 3rd and 5th grades there was no statistical evidence
for a difference between reading "pointed" and "unpointed" texts. In the 4th
and 6th grades there was statistical evidence that reading "pointed" texts
increased the number of errors. In general, throughout the grades, in this
group "pointing" had an interfering factor.

The Visual group There is no statistically significant difference between the

2nd through 6th grades in the distribution of the effect of "pointing" on the
errors (p=0.243). In all the grades there are less errors when reading
"pointed" texts than "unpointed" texts. In the 2nd and 3rd grades there are
significantly less errors in reading "pointed" texts (p=0.0001, and p=0.0003
respectively). The same findings are true for the 5th grade. For the 4th and
the 6th grades there is no statistical evidence of this trend.

Inter-Group Comparison

At the 5% level of significance, in 2nd, 3rd and 5th grades the HI

andAauditory groups are similar. The Visual group tends to make significantly
less errors while reading "pointed" texts compared to reading "unpointed"
texts than the HI and Auditory groups. In the 4th grade, at the 5% level of
significance, only the difference between the Visual and Auditory groups is
significant in that the Visual group tends to make significantly less errors in
reading "pointed" texts than the Auditory group. There is no significant
difference between the HI and the Visual or Auditory groups in this grade.

In the 6th grade, at the 5% level of significance, there is a significant

difference between the HI and the Auditory group, as well as between the
Auditory and the Visual groups. The Auditory group tends to make
significantly more errors in reading pointed texts. There is no significant
difference between the HI and the Visual group in this grade.

Considering all grades together at the 5% level of significance, the Visual

group tends significantly to read "pointed" texts with less errors than the HI
and the Auditory groups. There is no significant difference between the HI
and the Auditory groups.


Inter-grade comparison In both the 2nd and 3rd grades there is a significant
inter-group difference in the error type distribution. At the 5% level of
significance all the groups differ: In the HI the most prevalent error types are
categories a, b, c; In the Auditory group the most prevalent error type is
category c; In the Visual group the most prevalent error types are categories
a, d. In the 2nd grade category no. e does not occur at all in the HI and
Auditory groups. In this grade it is found in only one Visual subject. In the
3rd grade of the HI no errors of category d and e occur.
In the 4th grade at the 5% level of significance the HI differ significantly
from the Auditory and Visual groups, between whom there is no significant

In the 5th grade at the 5% level of significance there is significant difference

between the groups: In HI, errors from categories b, c are frequent, whereas
errors of categories d, e do not occur at all.; in the Auditory group there are
no category b errors; in the Visual group there are more category d errors
than in the HI and the Auditory groups. The Visual and Auditory groups also
differ regarding errors of category c.

In the 6th grade at the 5% level of significance there is no difference

between the HI and the Auditory groups. Errors of category b were not found
at all. The Visual group differs from the Auditory one: More category c errors
were found in the Auditory group whereas errors of category d are more
frequent in the Visual group. Errors of category b were not found in the
dyslexic groups, but in the HI it is found in all except the 6th grade. In the
5th and 6th grades of the HI no errors of categories d and e were found.

Comparison of visual and auditory pattern errors (categories c, d)

This comparison examines the difference in the distribution of errors of

category c and d throughout the grades in altogether 207 students. At the
5% level of significance the distribution of these errors was not the same in
all the three groups. Dependency was found between group and category
type as follows:

No significant difference was found between HI and auditory groups;

Each of HI and auditory groups differed significantly from the visual group;

These findings result from the fact that in the HI and Auditory groups errors
of category c are frequent, whereas in the Visual group many category d
errors occur. It should also be noted that in the Auditory and Visual groups
the difference in error distribution along grades is not significant, i.e., the
distribution is stable throughout the grades. In contrast, in the HI group a
significant difference was found which is due to the fact that in the 4th grade
category c errors were not found at all and in the other grades almost only
category c errors were found.

Testing each grade separately at the 5% level of significance yielded the

following findings:

In the 2nd grade - the difference between the HI and Auditory groups is not
significant. The HI and the Auditory groups differ from the Visual group
(mainly due to category 3 vs. category d errors).

In the 3rd grade, the difference between the HI and Auditory groups is not
significant (in both mainly category c errors occur). The difference between
the Auditory and Visual groups is significant (p=0.011). The Visual group
differs significantly from the HI (the Visual group has mainly errors of
category 4, whereas in the HI group mainly errors of category c occur).

In the 4th grade - HI and Auditory groups differ significantly (HI have mainly
category 4 errors, the Auditory group has mainly category c errors). The HI
and Visual groups are not significantly different (mainly category d errors
occur); neither are the Auditory and Visual groups.

In the 5th and 6th grades HI and Auditory groups are not significantly
different. But both HI and Auditory groups differ significantly from the Visual
group (mainly due to errors in category c in the HI and Auditory groups vs.
errors of category d in the Visual group).

Discussion and summary

General reference to the research hypotheses

1. The hypothesis about the similarity in reading difficulty characteristics of

populations with auditory perceptual channel impairment (due to
physiological or neuro-developmental origins, i.e., the HI and Auditory
groups) has not been refuted.
2. Our findings do not disclaim the hypothesis that the HI and Auditory
populations, impaired in their auditory perception, share characteristics of
reading difficulties which differ from those of the population with visual
perception channel impairment.
3. The findings of this research support hypotheses of previous studies which
distinguish between reading difficulties due to impairment of the auditory vs.
the visual perceptual channels. Thus, this research also supports the
description of dyslexia as consisting of sub-categories instead of viewing it as
a single category.

Discussion of the findings

Reading meaningful texts The Visual group reads meaningful better than
meaningless texts. The HI group reads meaningless better than meaningful
texts. The Auditory group is not affected by the presence or lack of meaning
in the text, although in the 4th grade the presence of meaning detracts from
their reading quality. This picture may be explained by different causes.

The HI: Since their reading is mainly holistic-structural, they probably search
their internal vocabulary for a similar pattern (word); when they fail to find
it, they linger on the meaningless word and then decode it more accurately.

The Visual group members read sequentially and take rather a long time in
reading; understanding the meaning of the text (when there is a meaning)
supports the sequential reading process.
The Auditory group, on the other hand, reads holistically and faster and does
not dwell on the meaning. It falls, in fact, between the HI and the Visual
groups, since its auditory channel is impaired, but its hearing system is
better than that of the HI. Therefore, compared to the HI, it has better
linguistic skills which help it in reading meaningful texts, but not to the same
extent as it helps the Visual group.

Sequential and holistic reading In the 2nd grade all the students use the
sequential reading strategy. Later on, the Visual group continues to use this
strategy, while the HI and the Auditory groups move more and more towards
holistic reading. We offer two explanations for this phenomenon, related to
the different kinds of impairment: Normal readers pass on to global reading
after acquiring (seqential) technical reading. Since the Visual group members
have an impaired visual perception channel, which limits their ability to
perceive whole elements, these students continue reading in the sequential
style. The HI and the Auditory groups, on the other hand, due to their
impaired auditory perception channel, use a sight-based (visual) reading
technique which is not mediated by speech sounds or generalization of
sounds and graphic symbolization.

Self-correction in reading The findings of this variable refute the hypothesis

that there would be similarity between the auditory and HI groups and
difference between them and the Visual group. The HI tend less than the two
other groups to self correction in reading, but this difference is not
statistically significant. In addition, there is no significant difference in this
respect in all the grades (i.e., development along years). Up to 5th and 6th
grades, the lowest self-correction rate is that of the HI. This finding is in
conformance with the fact that their reading is not semantic, and they do not
rely on the content to correct errors. In the 5th-6th grades there is no
significant difference between the groups in terms of self-correction. Still, the
HI have the lowest probability for self correction. In this case also we may
explain this finding by the lack of semantically-supported reading. On the one
hand, this is a feature which characterizes the communication of HI: To a
large extent, they tend to apply technical-automatic reading "oral Hebrew"
which they know less well as it may be considered their second language
compared to Hebrew Sign Language. The fact that in the higher grades there
is no significant difference between the groups could be explained by the fact
that the HI, too, begin at this stage to be aided by the semantic component
of the text. They are also probably able to control themselves better than in
earlier grades as a result of their maturation and general progress in studies,
including language and literacy. This hypothesis, and whether this trend
continues later on, should be tested with older subjects.

Reading rate In the 2nd grade, reading rate is similar in all the three groups.
This finding matches the sequential reading style of all three groups. In the
3rd grade the HI are the fastest readers (in reading aloud). In the 5th and
6th grades the reading rate of the HI and the Auditory groups is similar. It
differs, however, from the Visual group, which has the slowest reading rate.
It should be noted that all the subjects read at a slower rate than the
average normal readers (Engel, 1997), even after the 2nd grade, which is the
stage when the HI (and the Auditory group) move on to holistic reading. In
the two dyslexic groups the slow rate can be explained by the combined
effect of various reading difficulties. The Auditory group cannot use the
contribution of semantic content efficiently, whereas the Visual read
sequentially, which slows down their processing of the material; thus both
groups lack the reading flow and speed of the normal reader who already
identifies and reads the following word while still processing previous words.

The effect of reading "pointed" text The visual group reads "pointed" texts
better than both the HI and Auditory groups. Between the latter two groups
there is no significant difference. "Pointing" does not help the HI's reading,
and it actually detracts from the reading quality in the auditory group.
Phrased differently: the higher the grade, the more interfering factor
"pointing" becomes for the HI.

A likely explanation for the difference between the populations apparently

involves (again) the different reading styles of the groups: The Visual group
reads sequentially, and therefore pays attention to every mark in the written
line; it takes longer to read and process the additional vowel-indicating
marks, but they do add information to enable better reading. The other two
groups read globally, holistically. In the process of word identification,
comparing a word with the existing vocabulary in their long-term memory,
the "pointing" adds more data than needed for processing. This increases the
information load, and becomes a detracting factor.

Reading errors types Similarity was found between HI and Auditory groups in
that most of their errors relate to the visual form of the word. These groups
differ from the Visual group whose main errors involve the word's auditory
pattern (sound pattern). It may be possible to explain the type of errors in
the HI and the Auditory groups by the fact that these groups do not have
sound mediation and rely mainly on the visual channel in their reading.
Accordingly, they cannot assess fast enough the link between the read letter
and its phonological-linguistic meaning, nor do they trace errors in words
through the auditory channel. In contrast, the Visual group is mainly aided
by auditory information, since its visual channel is impaired.

Unlike the Visual and the Auditory groups, the HI have also errors in vowels,
suffixes, and "b,k,l,m" prefixes. Regarding this kind of error we suggest an
explanation linking the structure of the Hebrew language and speech with
their specific impairment. Due to the use of the Hebrew Sign Language,
which differs in many respects from oral Hebrew, HI children are not
sufficiently proficient in the rich morphological structure of Hebrew in the first
grades of school and make morphological errors in both reading and
spontaneous speech. They do not always use the "b,k,l,m letters" since these
are not part of the lexemic word indicated by the root consonants. (They are
also morphological, syntactic and semantic elements, i.e., morphemes and
syntagms with certain meanings, which they do not perceive well enough.)
As soon as they identify the written word by its consonantal root letters,
which in Hebrew supply it its basic meaning, they think they understand it
(by linguistic and non-linguistic contextual cues) and do not pause to study
its (partly redundant) morphological pattern. Only for the 6th grade we did
not find such errors in the HI group. Maybe at this stage their linguistic
knowledge (expressed in general oral language and literacy) is already more
deeply rooted, so that it may actively contribute to decoding the written text
more than in earlier grades.

Comparison with Shallice and Warrington (1975)

Shallice and Warrington (1975) focused on reading disability and impaired

auditory perception and suggested a sub-group of dyslexia, i.e., phonemic
dyslexia. Since our research touches upon this question from a different
aspect, we are comparing here our findings with those of Shallice and
Warrington (1975):

1. These scholars found about 33% semantic errors in their study vs. 66% of the
"visual" kind in their subject. Our research seems to support this finding. The
HI (mainly) do not rely on the content and therefore their reading is not
"semantic", and they make many semantic errors; the Auditory group does not
show preference to reading meaningful or nonsense texts, but nevertheless
make also semantic errors. However, the Visual group is significantly
different from both those groups in use of the semantic content of the text
(and closer to the results of Shallice and Warrington (1975)).
2. Shallice and Warrington (1975) refuted the hypothesis of "auditory" (sound)
errors in their subject. Our findings corroborate this view regarding the HI
and Auditory groups (and are in contrast with the Visual group's results).

Findings concerning the HI

This study sustains the view that reading is the "most difficult academic
challenge for the hearing impaired" (Marschark and Harris, 1997).We found
that in comparison with the other two populations, which can be defined as
reading impaired, the HI group was even weaker. Although its reading rate
was the highest of the three groups, this finding was significant only in the
3rd grade. The HI population's reading was the least supported by the
meaning of the text, so that their reading was not semantic, and they were
least prone to self-correction of reading errors, and the types of errors they
made were the most heterogeneous of the three studied groups, and
included prefixes such as "b,k,l,m" and word suffixes. These difficulties seem
to result from the correlation between their reading and language knowledge
expressed in their speaking skills.

Is the 4th grade special?

The 4th grade revealed specific features when the parameters and groups
findings were crossed. These findings include the following:

1. Reading meaningful and nonsense texts: The Auditory group had an increase
of errors when reading meaningful texts. In the other grades of this group
there is no difference between reading meaningful or nonsense texts. As to the
Visual group, no significant evidence was found in the 4th grade that in
reading a meaningful text there were less errors compared to the other grades.
2. In the Auditory group: Reading rate in this grade is statistically related neither
to the lower nor to the higher grades.
3. In the 4th grade of the Auditory group "pointing" contributes to the errors,
contrary to the other grades of this group. Also from the point of view of
inter-group differences, in this grade there is significant difference only
between the Visual and the Auditory groups (unlike other reading
4. In the 4th grade of the HI group, there are hardly any visual pattern (category
c) errors. In the other grades almost only visual form errors occur.
5. In comparing reading errors of category c and category d in the 4th grade with
these types of errors in the other grades, the HI and Auditory group differ. The
HI and the Visual group, however, do not differ significantly between
themselves, nor do the Auditory and Visual groups differ from each other.

These findings about the 4th grade raise questions as to the origin and
explanation of these differences. Can we consider the dyslexic and HI
population at this grade as being in a special developmental stage, at least
concerning reading skills? Is it in any way related to the fact that the 4th
grade is an important stage of maturation for the child, as implied by the
structure of syllabi for this grade in elementary schools? A possible research
question for further study would, thus, be whether the 4th grade begins a
new stage in the development of reading skills among reading-impaired
children as those studied here.


This research studied three groups of children with impairments that lead to
reading difficulties. We found differences between the groups with impaired
auditory or visual perception. These differences support the approach which
considers dyslexia as an "umbrella" term which includes sub-groups of
various kinds of reading impairment. The research revealed typical features
for the reading difficulties of members of each of these groups. These
differences depended both on impairment type and on grade, i.e., the child's
developmental stage. In these respects, the HI and Auditory groups are more
similar to each other than any of them to the Visual group. Our research
hypotheses were thus corroborated.

The HI children were found to have the lowest reading scores among the
three groups. This finding was, in fact, anticipated, since reading acquisition
problems in HI children are still considered their greatest academic
challenge, which teachers, educators and researchers all over the world have
not solved so far.

The study is relevant to other research topics such as the study of language
problems among HI (with various levels of impairment), the study of reading
processes in general, development stages of impaired beginning readers, the
passage from the first stage, i.e., technical reading, to higher reading skills,
differences between sequential and holistic readers, differences between
reading patterns of male and female readers, etc.

The findings of this research may have implications on intervention manners,

e.g., in the strategies of teaching reading to members of the studied
populations. When dealing with Hebrew, for example, one should consider
using "pointing" with impaired visual-perception students even in the higher
grades and avoiding the use of "pointed" texts in HI and students with
impaired auditory perception, due to the different reactions to "pointing" in
these populations. It might be also advisable to train members of the HI and
the Auditory groups to read meaningful texts and use "reading
comprehension" techniques, especially in the 4th grade, and meticulously
train sequential reading to members of the HI and Auditory groups in order
to decrease their reading errors. The findings about 4th grade students in the
three groups of our research are very interesting, and deserve a separate
future study, as do our findings about errors specific to the Hebrew language.


This study was supported partly by a Technion VPR grant no. 2001576 for the
Enhancement of Research, and partly by the Ministry of Education.
The authors extend their thanks to the hundreds of dyslexic and hearing
impaired children in Haifa and Tel-Aviv, the school principals and Shema' Tel-
Aviv director, for their invaluable help in conducting the experiments.

The authors cordially thank Prof. A. Cohen, Head of the Statistical Consulting
Laboratory, at the Technion School of Industrial Engineering and
Management, and especially Dr. O. Barnett, for their help with the statistical


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Table 1. Breakdown of Hearing Impaired subjects per grade and region

Grade Haifa Region Tel-Aviv Region Total

2nd 7 1 8
3rd 7 13 20
4th 6 5 11
5th 5 5 10
6th 4 --- 4
Total 29 24 53

group 2nd grade 3rd grade 4th grade 5th grade 6th grade
average 14 49.6 50.8 61.3 66.41
STD 5.4 5.4 11.2 15.8 17.9
average 17.40 20.95 43.2 59.9 61.3
STD 7 10.8 13.4 15.7 15.6
average 17.85 20.75 42.5 43.3 48.4
STD 6.2 12.34 15.7 19.4 16.6

Figure Captions

Figure 1. Effect of reading meaningful or meaningless text in the three

groups by grades
(High scores indicate that meaningful text helps reading. The asterisk marks

Figure 2. Sequential, holistic and combined reading in the three groups by

a: Hearing Impaired (HI), b: Auditory Perception (AP), c: Visual Perception

Figure 3. Proportion of self-correction in reading in the three groups

Figure 4. Effect of reading "pointed" and "un-pointed" text in the three

groups by grades
a: Hearing Impaired (HI), b: Auditory Perception (AP), c: Visual Perception

Figure 5. Average number of words per minute (WPM) in the three groups by

Figure 6. Technical reading errors by the "Hearing Impaired" in the three

groups by grades
a: Hearing Impaired (HI), b: Auditory Perception (AP), c: Visual Perception


a - In Classical Hebrew all the vowels were indicated by diacritical signs, in

addition to 4 letters used to indicate long vowels ("mater lectionis"). In
Modern Hebrew, new rules have been added by the Academy of the Hebrew
Language, so that the use of these "mater lectionis" letters has expanded to
more cases than in the past.

b - It was later found that hearing impaired and deaf children often acquire
sign language even earlier than hearing children acquire oral langauge.

c - The ages of children of this group varied more than in the dyslexic
groups, because as is well known, hearing impaired children are generally
slower in developing their language and literacy skills than hearing children.
We therefore ignore individual ages in this study and refer to grades only.

d - "Too many" compared to their occurrence probability according to the

equal distribution hypothesis.

e - Probably as a result of the mediation of the structure of Hebrew Sign

Language they do not cosnider it important to distinguish between, e.g.,
/lamad/ ??? (he studied) and /lamda/ ???? (she studied) where the last letter
is not pronounced at all, or between /lamad/??? (he learnt) and /lilmod/
????? (to learn) where the first letter heads the infinitive form of the root.