Reprint from February, 1929, The Journal of Educational Psychology.
THE “SIGHT READING” METHOD OF TEACHING READING,
AS A SOURCE OF READING DISABILITY
SAMUEL T. ORTON, A.M. M.D.
New York City

I feel some trepidation in offering criticism in a field somewhat outside of that
of my own endeavor but a very considerable part of my attention for the past four
years has been given to the study of reading disability from the standpoint of
cerebral physiology. This work has now extended over a comparatively large
series of cases from many different schools and both the theory which has directed
this work and the observations gained therefrom seem to bear with sufficient
directness on certain teaching methods in reading to warrant critical suggestions
which otherwise might be considered overbold.
I wish to emphasize at the beginning that the strictures which I have to offer
here do not apply to the use of the sight method of teaching reading as a whole but
only to its effect on a restricted group of children for whom, as I think we can
show, this technique is not only not adapted but often proves an actual obstacle to
reading progress, and moreover I believe that this group is one of considerable
educational importance both because of its size and because here faulty teaching
methods may not only prevent the acquisition of academic education by children of
average capacity but may also give rise to far reaching damage to their emotional
life. The sight reading method (or “look and say” of the English) has been credited
with giving much faster progress in the acquisition of reading facility than its
precursors and this statement I will not challenge if the measure of
accomplishment be the average progress of a group or class. Average progress of
large numerical units, however, makes no allowance for the study of effect in
individual, particularly if certain of them deviate to some degree from the others in
their methods of acquisition and therefore in their teaching requirements. To the
mental hygienist whose interest is focused on the individual and his problems
rather than on group progress the results as determined by average accomplishment
are of little value whereas the effect of a given method on the individual child is all
important.
Outstanding cases of so-called “congenital word blindness”—a complete
inability to learn to read—have been recognized and studied for a number of years
at first chiefly by physicians. It has also been recognized by teachers and
psychologists that there is a large group of children who have a much greater
difficulty in getting started in reading than would be expected from their ability in
arithmetic, from then ease in auditory acquisition and from their general alertness.
In the past there has been a tendency, at least among medical men, and to a
considerable degree among psychologists as well to exclude the minor cases of
slow learning in reading from the category of congenital word blindness. This
largely derives from the work of Hinshelwood1 who made the first extensive study
of these cases following the pioneer work of Kerry
and Morgan.

Hinshelwood’s
statement in this is “. . . the rapidity and ease with which children learn to read by
sight vary a great deal. No doubt it is a comparatively common thing to find some
who lag considerably behind their fellows, because of their slowness and difficulty
in acquiring their visual word memories, but I regard these slight defects as only
physiological variations and not to be regarded as pathological conditions. It
becomes a source of confusion to apply to such cases as has been done of late the
term of ‘congenital word blindness’ which should be reserved for the really grave
degrees of this defect which manifestly are the result of a pathological condition of
the visual memory center and which have proved refractory to all ordinary
methods of school instruction.” Unfortunately, Hinchelwood’s criterion is a
double one, neither part of which can be looked upon as of sufficient diagnostic
accuracy to establish a clear-cut entity. Not only has no pathological condition of
the visual memory center yet been substantiated in such cases but there are certain
neurological and clinical data which suggest that no such condition exists. Again,
the “ordinary methods of school instruction” does not prove to be an accurate
measure. Such methods vary widely and our own figures indicate that the number
of children who show a significant handicap in reading is to some degrees related
to the teaching method in use. Bachmann
has called attention to the looseness of
the concept of congenital word blindness and related to this the striking variation in
the frequency of such cases as recorded by various authors. Without some fairly
clear objective symptoms on which to establish the entity, the choice of cases to be
included naturally rests on the judgment of the examiner as to the severity of the
disability.

My own initial work
in this field led to a firm conviction that we were
dealing here, not with two separate groups—a physiological and a pathological—
but that those children who were specifically retarded in reading (thus excluding
cases of general mental defect) formed a graded series extending from the normal
to the extreme and that they showed consistent characteristic performance which
not only would serve for diagnosis but which also was highly suggestive of the
reason for their lack of progress and which gave excellent cues to methods for
retraining. I was convinced not only that the specific reading disability formed an
entity of much greater numerical importance than had been recognized before but
that it was (even in the extreme cases) an obstacle of a physiological nature rather
than a pathological condition and that therefore adequate special methods of
teaching should correct it.

I can not here go fully into the details of the anatomical background for our
present theory of this disability but some presentation is necessary in order to
illustrate the basis for the criticism of teaching method which is here offered.
Only a small portion of the retina of the eye is used in acquisition of reading.
This is the focus of central vision or the macula lutea, so called because it is seen
as a yellow spot in ophthalmoscopic examinations. The rest of the retina receives
only general and less detailed impressions coming from outside the rather small
area to which we are directing our attention. This point is noteworthy because the
nervous connections of these two divisions of the retina are quite unlike. The
peripheral retina or outer zone has connections with only one-half of the brain
(there are some complexities here but these need not concern us). The macula
lutea, however, which receives impressions with greatest detail and which is hence
used exclusively in learning to read, has a double connection with the brain. The
nerve fibers arising here divide and one-half of those starting from each macula
lueta to the visual area of the hemisphere of the brain of the same side and the
other half to the corresponding area of the opposite hemisphere. Thus impressions
received by either eye, or by both eyes, are relayed simultaneously to both
hemispheres of the brain. This double implantation does not give us a double
sensation in consciousness, however, as a touch on both thumbs would do. The
simultaneous activity of both areas results in our seeing but a single image. The
visual sensation, however, is not a unitary function.

There is apparently need for
the simultaneous or additive activity of several parts of the visual cerebral
mechanisms to complete the linkage of a printed symbol with its meaning and the
steps in this process arc shown in relief by differential losses such as are seen when
certain parts of the back of the brain are destroyed by disease. When all of that
part of the brain which has to do with vision is destroyed the individual becomes
totally blind. The eyes, however, are not damaged and they can still be moved and
they will turn toward a sudden sound and the pupils will respond by closing and
opening to increase and decrease of the amount of light which strikes them. This
condition is known as cortical blindness, to differentiate it from blindness due to
disease of the eyes or optic nerves. We may, however, see things surrounding us
with sufficient clarity to avoid colliding with them, that is to guide our general
body movements but without being able to appreciate the meaning of things which
we see.

This was first demonstrated by Munk in dogs in which much of this part
of the brain had been removed. They were able to avoid collisions but did not
recognize their master or even food by sight alone, and did not cringe from a whip.
To this condition Munk gave the name of mindblindness and its parallel has since
frequently been recorded in cases of disease of the human brain. Apparently at the
first level the visual area of the brain serves as a very accurate guide to motion and
it probably also furnishes the element of awareness of the external origin of a
sensation (as contrasted to & memory). In psychological terms it furnishes the
pure perceptual element to sensation but simultaneous or additive activity in other
higher level visual areas are requisite to attach meaning and again we know that
this is not accomplished in one step. If destruction of brain tissue happens in a
certain area there results a condition in which the patient not only can see correctly
but can also understand the meaning of objects seen, but in which the ability to
read the printed or written word is entirely lost.

That vision in the ordinary sense
is normal, is shown by the fact that such a patient can copy printed material but
cannot read either the original or his copy. Thus we see from these differential
losses that the process of linking a printed word to its meaning passes through at
least three stages of elaboration in the brain before it is completed.
There are differences, however, in the brain destruction necessary to produce
losses at these different elaborative levels. Destruction in one hemisphere only is
not sufficient to produce either cortical blindness or mindblindness. At these first
two levels of elaboration, that is in perception and recognition of the meaning of
objects, apparently destruction must involve the areas subserving these functions in
both hemispheres before their loss results. The two hemispheres are apparently of
equal importance here as it apparently makes no difference which side is affected;
i.e., either hemisphere is alone adequate for these functions. Exception must be
taken to these statements in the case of peripheral vision but, as noted before, this
is not of interest to us here since central vision is used exclusively in learning to
read.

When we come to the third plane of elaboration, the situation is strikingly
different, this is the level at which the written or printed symbol is linked with its
meaning and hence it is variously described as the associative, concept, or
symbolic level. Here not only is damage to one hemisphere sufficient to destroy
function but it makes a difference which hemisphere is affected.

If the hemisphere
which is known as the dominant happens to suffer, a complete loss of this function
results and the patient becomes word blind. If, on the other hand, the damage
occurs in the other hemisphere—the non-dominant—nothing apparently happens.
So entirely without result is a destruction here that this area of the brain takes its
place with certain others among those which the surgeons called the “silent areas”
of the brain. Obviously, the visual records implanted in both halves of the brain
are not requisite for reading. This situation also exists in the field of understanding
of the spoken word, and of speech and of writing. In all four of these functions
destruction in the dominant hemisphere in the so-called language zone is
meaningful while destruction in exactly similar parts of the opposite hemisphere is
meaningless.

Thus we learn to understand, to read, to speak, and to write words from sensory
records or engrams of one hemisphere only. This fact is so striking that we have
been prone to overlook what must happen in the inactive side. We believe today
that the completed growth and development of nerve coils is largely a result of
stimulation. If cells do not receive stimuli they do not reach their full
development. The two sides of the brain do not show much, if any, difference in
size or complexity and certainly no such difference as we see in function as
outlined above. To account for equality of growth we must accept equality of
stimulation—equal nervous irradiated of the two sides—and if they are equally
irradiated, records must be left behind in each; i.e., engrams must be formed in the
non-dominant as well as in the dominant hemisphere.

To account then for the
difference in effect of damage in the two sides we must assume that the engrams of
one side become the controlling pattern through establishment of a physiological
habit of use of that set and that the other set of recorded engrams is latent or elided.
Variations in the completeness of this physiological selection, i.e., failure of elision
of the non-dominant engrams, forms the kernel of my conception of the reading
disability. Such a theory conforms nicely to our observations that these cases are
not to be divided into two categories, that is, cases of word blindness and cases
of slow acquisition of reading, but that they form a series graded in severity
according to the degree of confusion which exists in choice of engrains and it also
offers an explanation of certain errors and peculiarities which characterize their
performance.

The two halves of the body are strictly antitropic, that is, reversed or mirrored
copies of each other. The muscles and joints of the right and left hand, for
example, are alike but reversed in arrangement. This is also true of the groups of
nerve cells in the spinal cord which control the simpler motor responses (spinal
reflexes) and also of the cells in the brain which combine or integrate these simpler
spinal units into more complex acts.

The movements of the left hand, therefore,
which are the exact counterpart of the right will give a mirrored result. Thus, the
movements of sinistrad (mirror) writing with the left hand are exactly comparable
to those of dextrad writing with the right hand and it seems therefore highly
probable that the engrams which are stored in the silent areas of the non-dominant
hemisphere are opposite in sigh, i.e., mirrored copies, of those in the dominant. If
then these opposite engrams are not elided through establishment of consistent
selection from one hemisphere we would expect them to evince themselves by
errors or confusion in direction and orientation and this is exactly what we find in
cases of delayed reading.

This description is really “putting the cart before the horse” as our observations
of tendency to reversals came first and the theory developed therefrom but this
method of presentation has been adopted for the sake of clarity. Many workers
with word blind children have noted their tendency to reversals but none, so far as
I am aware, have offered an adequate explanation of it.
My original studies in a small group of cases convinced me that there were
certain “symptoms” in reading disability which seemed to characterize the whole
group and these were confusions between lower case b and d and between p and q,
uncertainty in reading short pallindromic words like was and saw, not and ton, and
on and no; a tendency to reverse parts of words or whole syllables as when gray is
read as gary, tarnish as tarshin and tomorrow as tworrom; a greater facility than
usual in reading from the mirror, and frequently a facility in producing mirror
writing.

These observations have been adequately supported in an extended study
of a much larger group of cases. Many other types of errors are to be found in the
performance of retarded readers but they appear to me to be secondary effects due
to the failure of association which has resulted from the obstacle presented by
confusion in direction. The relation of the cardinal symptoms to the theory as
above outlined is obvious and I think has direct bearing on the teaching method.
Visual presentation will, hypothetically at least, result in the implantation of paired
engrams and certain other factors must determine which of these is selected for
associative linkage.

What these factors are as a whole, we can not consider here
although it may be well to suggest that heredity probably plays a part in the
establishment of dominance here comparable to that which it plays in stuttering
and in left-handedness. Undoubtedly training influences may be brought to bear
on this process of choice, however, and from the theoretical standpoint the most
promising of these should be that of kinesthetic training by tracing or writing while
reading and sounding and by following the letters with the finger (a method under
taboo today) to insure consistent direction of reading during phonetic synthesis of
the word or syllable.

Under a grant from the Rockefeller Foundation, an extended field study was
carried out in 1926-27 in Iowa by the organization, as a part of the research work
of the State Psychopathic Hospital, of a Mobile Mental Hygiene Unit to visit
schools in various communities and a Laboratory Unit to study selected cases more
intensively. Fuller reports of these studies are to appear elsewhere but certain
observations may be quoted here. In my original group of reading disability cases,

I was surprised at the large proportion of these children encountered. Fifteen out
of one hundred twenty-five children sent by their teachers to our experimental field
clinic for a variety of problems6 seemed to me to show evidence of this trouble. In
our extended work we have found in every community visited no less than two per
cent of the total school population to be retarded readers showing this
characteristic picture. Our studies were not carried out as a survey and hence these
figures probably fall far below the actual numbers.

There was however a difference
in the numbers of cases encountered in certain communities which seemed to bear
directly on the subjects here considered. Of two communities of about the same
constituent population, in one we found about two per cent of the school
population to be retarded in reading to a significant degree and to show
symptomatic evidence of the specific disability, while in the second we found more
then double this percentage. In the community with the lesser number of cases,
sight reading methods were employed but when children did not progress by this
method, they were also given help by the phonetic method. In the town with the
larger number, no child was given any other type of reading training until he or she
had learned ninety words by sight.

Aside then from theoretical considerations, this strongly suggests that the sight
method not only will not eradicate a reading disability of this type but may actually
produce a number of cases. Moreover, our retraining experiments7
seem to indicate clearly that such children can be trained to read properly with adequate
special methods devised to eradicate the confusion in direction and in orientation
and this has also been borne out by the remedial efforts of other workers.
Our studies of children with reading disabilities has also brought to light certain
other aspects of the problem which are of educational importance but which can
not be elaborated here.

Among these were notably the effect of this unrecognized
disability, upon the personality and behavior of the child. Many children were
referred to our clinics by their teachers in the belief that they were feeble-minded,
others exhibited conduct disorders and undesirable personality reactions which
upon analysis appeared to be entirely secondary to the reading defect and which
improved markedly when special training was instituted to overcome the reading
disability.

In brief, while “sight reading” may give greater progress when measured by the
average of a group, it may also prove a serious obstacle to educable children who
happen to deviate from the average in the case of establishment of a clear-cut
unilateral brain habit. These physiological deviates form a graded group extending
in severity from the normal to extreme cases (congenital word blindness). They
can be detected by appropriate examinations and trained to overcome their
handicap by specific methods of teaching. While the number of children who
suffer from such a severe grade of the disability as to be practically uneducable by
ordinary methods is quite small, the number in whom the disability exists to a
sufficient degree to be a serious handicap to school performance and to wholesome
personality development probably is of real numerical importance and moreover
there seems to be reason to believe that even those who make a spontaneous
adjustment without special training, and thus learn to read, may never gain a
facility in this accomplishment commensurate with their ability in other lines.

REFERENCES
1. Hinshelwood, James: “Congenital Word Blindness.” Lewis, London 1917.
2. Kerr, James: The Howard Price Essay of the Royal Statistical Society, 1896.
3. Pringle, Morgan W.: “A Case of Congenital Wordblindness.” British Medical Journal,
July 11, 1896.
4. Bachmann, Fritz: “Uber Kongenitale Wortblindheist.” Karger, Berlin, 1927.
5. Orton, S. T.: “Wordblindness” in School Children. Archives of Neurology and Psychiatry,
Vol. XIV, Nov., 1925.
6. Lyday, June F.: The Greene County Medical Clinic. Mental Hygiene. Vol. X, No. 4,
October, 1926.
7. Monroe, Marion: Genetic Psychology Monograms. Oct.-Nov. Nov., 1928.
Edited by Donald L. Potter on 5/31/03 from an OCR scan of a Reprint.
www.donpotter.net

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