Implications for Diagnosis and Remediation

Expert Paper Submitted to the United Nations
Disability Unit, Vienna
February, 1990

Robert Zenhausern, Ph.D.
Professor of Psychology
St. Johns University
Jamaica, NY 11439

 The paragraphs below are in the form of a satire based on the essay
by Jonathan Swift entitled "A Modest Proposal" in which he presented a
solution to the "Irish Problem". The parallel here is Learning Disability
and the inflexible ways these children are taught. It is the objective of
this paper to show that the problem of the learning disenfranchised is one
that can be solved by increasing the flexibility with which we teach.
 Another Modest Proposal:  A Swift Response to an Old Problem
 The purpose of this essay is to examine the possibility that we are
systematically doing a disservice to a large segment of the school
population. Students who have auditory or visual impairments have been
allowed to use artificial means, such as glasses or hearing aids, to
correct their deficits. Indeed, it is considered praiseworthy to identify
such problems early and then use the services of professionals who
prescribe optical or electronic devices which alleviate the deficiencies.
 The consequences of such actions, however, have not been considered
fully. Such children may become lazy and make no attempt to overcome their
problems. What motivation will they have to strengthen their perceptual
weaknesses when such devices make it unnecessary for them to do so? What
will such people do if, for whatever reason, such devices are not
available? It is the contention of this paper that artificial devices are
crutches which interfere with the complete development of the child. As
such, they should be eliminated.
 Some might argue (and not without a modicum of validity) that by
eliminating those "support systems," such children may not progress beyond
the elementary rudiments of learning. That, however, should be secondary to
the point that we are not dealing directly with a serious problem. The fact
that our present state of knowledge does not allow us to correct such
deficiencies should not dissuade us from this course of action. Eventually
specific techniques will be developed to meet the problems of poor eyesight
and hearing in much the same way that techniques were developed to
alleviate reading and mathematical difficulties -- and probably with as
much success. There is a minor problem in the fact that many of the
authority figures in the child's environment use those same artificial
devices and thus do not serve as good role models.
 Aside from the educational wisdom of this proposal, it has the
added advantage of eliminating the possibility of charges of
discrimination. Consider, for example, if someone raised the point that a
deficit in vision or hearing might be compared to a deficit in arithmetic
computation. They might argue that if vision can be corrected by glasses
why can a calculation deficit not be corrected by the use of a calculator?
It is difficult to counter these arguments since the two deficits have so
much in common. Even the poor role model problem has a parallel since most
of the authority figures whom the children contact would have some
difficulty in taking a square root or doing long division of decimals by
hand. The conclusion is clear: take away glasses and hearing aids and give
the children with sensory defects the same advantages given to children
with calculation defects!
                    *                   *                   *
*                   *
 The essay is clearly satirical, but its point is clear. In this
Decade of the Disabled it is essential to consider the human rights of the
Learning Disabled to an education that more closely fits their
capabilities. The problems of the Learning Disabled are unique because this
is the only disabled group which is held responsible for its disability.
"If he worked harder, he could do it", says the frustrated teacher. No one
expects a blind person to see, if he or she "worked harder". Furthermore,
to call a child "learning disabled" is to put the burden of responsibility
on the wrong person! It is our responsibility to teach much more than it is
the responsibility of the child to learn. It is we who should be called
teaching disabled. The purpose of this paper is to focus attention on
individual differences among both normal and learning disabled children and
to consider alternative approaches to education and thus eliminate our
teaching disability. The major emphasis will be on the theory and
remediation of reading disability based on a 10 year program of research
within a neuropsychological framework. The initial Chapter will introduce
the concepts of cerebral asymmetry and hemisphericity and put them in
perspective for education today. The second Chapter will discuss behavioral
and physiological measures of individual differences in neuropsychological
functioning. The third Chapter will describe a study that underlines the
importance of these individual differences in an educational setting. The
fourth and fifth Chapters will describe a series of studies dealing with
the theory, diagnosis and remediation of reading disability that has been
based on these neuropsychological concepts. The final Chapter will be a
summary that includes the basic information on the Direct Access approach
to reading with specific recommendations. It can serve as an abstract of
the whole paper.
 This Introduction ends with a short quote, found hanging on the
walls of an elementary school in Greensboro, North Carolina and attributed
to Ken Dunn.
"If children cannot learn the way we are teaching them, then we must teach
them the way they can learn."
 Recent work in the areas of neuropsychology, especially that of
Sperry who won the Nobel Prize, has popularized the notion of cerebral
asymmetry. That is, the two hemispheres of the brain are different in terms
of the cognitive processes in which they excel. There is clear evidence
that the Left Hemisphere has unique control of expressive speech and
operates using a sequentially organized system. The Right Hemisphere, on
the other hand, has systems that are more capable of spatially and
pictorially oriented processing.
 While there are clear differences between the hemispheres, these
differences have been overgeneralized into a new phrenology of brain
functions. A typical list of "Left Hemisphere Functions" reads something
like: logical, verbal, analytic, inductive, controlled; the Right
Hemisphere is often called: synthetic, emotional, deductive, intuitive, and
abstract. Some of these labels are self-contradictory. The Left Hemisphere
is called both analytic and inductive and the Right Hemisphere both
synthetic and deductive. The term "abstract" has two diametrically opposed
meanings: an article abstract versus abstract art. These inconsistencies
aside, this neo-phrenological approach must be rejected on the grounds that
it is atomistic. A hemisphere is neither verbal, logical, emotional, nor
creative; it is a person who has these characteristics! All behavior flows
from the integrated functioning of the whole brain. This does not mean,
however, that there are no individual differences associated with the
brain. The concept of Hemispheric Related Strategies provides a framework
on which to base an individual difference variable.
 For the most part, the two hemispheres do the same things but do
them using different approaches. Cerebral asymmetries reflect relative
efficiency rather than a "can do-can't do" dichotomy. There seems to be one
exception to this relative rather than absolute difference between the
hemispheres: for most people, only the left hemisphere is capable of speech
and of phonetic representation (Levy, 1974). The isolated Left Hemisphere
can tell whether the two words "though" and "blow" rhyme but the isolated
Right Hemisphere can not, even though it may understand their meaning.
Rhyming demands that the written word be converted to an auditory form and
only the left hemisphere has this capability.
 A second factor that differentiates the two hemispheres is their
type of processing systems: sequential for the left hemisphere and parallel
for the right hemisphere (see Bradshaw and Nettleton, 1981 for a review.)
Compare these two situations: 1) You are given a description of someone and
must then identify that person; and 2) You are shown a picture of the
person and then must select the person. The first task demands the
sequential system of the left hemisphere--the words, descriptive of the
various facial features, are read in sequence and must be combined into an
overall perception. The latter situation reflects the parallel system of
the right hemisphere -- the picture is seen as a whole and various facial
features can be extracted. The picture is seen all at once in parallel
while the verbal description must be sequentially processed. The sequential
processing system of the Left Hemisphere and its ability in speech
production are the characteristics that underlie the notion that the Left
Hemisphere is the verbal hemisphere. Language, by its very nature, is
sequential. Word order and syntax are essential to meaning-- language
cannot be easily processed in parallel. Thus the left hemisphere has been
labeled the "verbal" hemisphere because its sequential processing system is
compatible with the sequential nature of language, and its control of
auditory linguistic processes makes it essential for speech.
 For other tasks, even though the processing system of either
hemisphere is compatible with the task, one hemisphere is clearly superior.
The example of face recognition shows intuitively that the Right Hemisphere
pictorial approach is better than a Left Hemisphere written description.
Note, however, that the task can be done using Left Hemisphere strategies,
but it takes a thousand words to describe one picture. Spatial relations
tasks are also more easily handled using Right Hemisphere processes. Other
tasks can be handled equally well using the strategies of either
hemisphere. For example, a list of words could be learned by converting and
storing them as visual representations or in an auditory form. The term
Hemispheric Related Strategies can be used to describe this relationship
between observable behavior and its underlying neuropsychological bases.
Hemispheric Cognitive Style
 Two individuals, when faced with the same task, do not necessarily
use the same strategies, that is, people do things in different ways.
Sometimes those different approaches can be associated with processing
differences between the two cerebral hemispheres. These different
approaches can be termed Hemispheric Related Traits. Hemispheric Cognitive
Style is the tendency of an individual to use distinct patterns of
Hemispheric Related Traits. It does not imply that one hemisphere is used
exclusively, but that individuals tend to approach tasks in unique and
consistent ways. For example, if a group of individuals were asked to
remember the words "dog, cat, tree, table, chair", few would have
difficulty. If these same individuals were asked what strategies they used,
there would be wide variation. Some would report they repeated the words to
themselves, others that they "saw" the written form of the word, and others
would create images of the words.
 These differences in memory strategies can be related to
Hemispheric Related Traits. A person who would be more likely to use
imaginal strategies could be said to use a right Hemispheric Related Trait,
and a person who used auditory strategies could be said to use a left
Hemispheric Related Trait. Some individuals tend to use the Hemispheric
Related Traits associated with one hemisphere more than those of the other
hemisphere and others show little or no bias. Those who do favor the
Hemispheric Related Traits of one hemisphere can be said to have a Right or
Left Hemispheric Cognitive Style. It is important not to overgeneralize the
scope of Hemispheric Cognitive Style. The fact that a person tends to use
particular strategies implies neither a disuse nor deficiency in one
hemisphere of the brain. On a very simple level, a right Hemispheric
Cognitive Style individual has access to the speech centers of the left
hemisphere just as a left Hemispheric Cognitive Style individual has access
to the prosody centers of the right hemisphere. Thus both right and left
Hemispheric Cognitive Style individuals rely on the integrated functioning
of both hemispheres for expressive speech, and, in fact, all behavior. In
an intact individual, no task can be accomplished without the integrated
functioning of both hemispheres. To call an individual "left or right
brained" is to ignore the fact that all activity depends on the integrated
functioning of the whole brain. These differences, however, can be related
to different strategies with which people approach specific tasks. One
purpose of this paper is to show how these strategy differences can affect
the educational system. The next chapter will describe how differences in
Hemispheric Related Traits can be measured. The following chapters will
focus on the application of these traits to mainstream and learning
disabled education.
 Two distinct tools have been used in the measurement of Hemispheric
Cognitive Style, one behavioral and the other physiological. The behavioral
measure is a self rating questionnaire and the physiological measure relies
on the predominant direction of Lateral Eye Movement (LEM).
The Hemispheric Preference Questionnaire
 There are many questionnaires that have been used to measure
"hemisphericity" including many from popular magazines. Over the past 12
years I have developed an instrument that has been successfully used to
separate right and left Hemispheric Cognitive Styles. A copy of the
questionnaire and its scoring key has been included. The following studies
used the instrument successfully. Coleman and Zenhausern (1979) compared
those who used right and left Hemispheric Related Traits on a memory
retrieval task. They found the two groups differed on processing speed and
the extent of a left hemisphere bias induced by a verbal memory load. The
bias was four times stronger for the those who use left Hemispheric Related
Traits than for those who use right Hemispheric Related Traits. Zenhausern
and Nickel (1979) found that Right style individuals learned a finger maze
in fewer trials, in less time and with fewer errors than Left style
individuals. Zenhausern, Notaro, Grosso, and Schiano (1981) presented right
and left style individuals with auditory messages in which there was a
conflict between verbal content and emotional tone of voice. Overall, those
who used right Hemispheric Related Traits responded significantly more
often to the inflection cues and those who use left Hemispheric Related
Traits significantly more often to the verbal content. Zenhausern and
Dunivin (1981) found that left style subjects were more obsessive
compulsive, while right style subjects had more hysterical traits.
Zenhausern and Parisi (1983) have found that schizophrenics rate themselves
as using left while depressives rate themselves as using right hemisphere
related strategies. The instrument has been used in the area of reading
disability to distinguish two separate syndromes. Oexle and Zenhausern
(1980), Golden and Zenhausern (1981), Zenhausern and Sinatra (1983),
Maxwell and Zenhausern (1983) have found that 85% of reading disabled
children rate themselves as using more right than left hemisphere
strategies. A copy of the test and its scoring key can be found in Table
Lateral Eye Movements
 Research into the phenomenon of lateral eye movements (LEM) as a
behavioral measure of neuropsychological activity has been pursued along
two separate dimensions. LEM have been considered a measure of both
individual differences and task demands. From a neuropsychological
perspective, the individual difference aspects have been associated with
the concept of cognitive style and the effects of task demands with
hemispheric asymmetry. There is, however, considerable controversy as to
whether LEM do indeed have neuropsychological relevance. The importance of
LEM has been overgeneralized to the point of faddism, which has led to a
general reluctance on the part of the scientific community to give them
credence. In addition, researchers in the area have sometimes failed to
distinguish between these two different aspects of LEM.
Table 2.1
The Preference Test for Hemispheric Related Strategies
 Indicate your choice by assigning a number from 1 to 10 (with 1
being the lowest) on each question. To score the test, refer to the scoring
key below. Add the ratings for all the items that are to be scored right
and those that are to be scored left, subtract the two and divide by 10.
The larger number shows the predominant preference and the greater the
difference the larger the HRS preference. You should then develop your own
local norms, but as a rule of thumb a score of .7 or higher can be
considered a clear indication of a preference for a Hemispheric Related
Test Items
1)   Do you base your decisions on objective facts rather than feelings?
2)   Are you psychic?
3)   Do you like using symbols or images in solving problems?
4)   Are you artistically or musically creative?
5)   Are you logical?
6)   Are you good at solving crossword puzzles?
7)   Can you read quickly?
8)   Are your daydreams vivid?
9)   Can you think of synonyms for words easily?
10)  Do you remember dreams?
11)  Are your dreams vivid?
12)  Are you fluent in using words?
13)  Are you good at using images in remembering and thinking?
14)  Do you use a playful approach to problem solving?
15)  Do you use a serious, all business approach to problem solving?
16)  Do you like to keep experiences planned and structured?
17)  Do you like to read or think while sitting upright?
18)  How much does your thinking consist of words?
19)  How much does your thinking consist of mental imagery?
20)  Do you like to explain something using visual presentation?

     Item    Scoring
Item    Scoring

     1         L
11        R

     2         R
12        L

     3         R
13        R

     4         R
14        R

     5         L
15        L

     6         L
16        L

     7         L
17        L

     8         R
18        L

     9         L
19        R

     10        R
20        R

 Individual Differences and LEM Research into whether LEM reflect
individual personality differences was initiated by Day (1964), who
reported that the direction of LEM was related to individual styles of
coping with anxiety. Bakan (1971) was the first to propose that the
direction in which a person consistently shifted gaze was related to which
of the cerebral hemispheres an individual used more often.
 The relationship between LEM and various dimensions of individual
differences has been explored. Tucker and Suib (1978) found that
left-movers had higher scores on the Performance tests of the WAIS and did
better with imagery oriented questions while right-movers had better scores
on the Verbal subtests of the WAIS and with questions that were letter and
number oriented (e.g., how many letters are in the word house). Gur and Gur
(1975) showed a relationship between direction of LEM and defensive style.
Predominantly rightward movers more often reported using projection and
"turning against others" as their main defenses, while predominantly
leftward movers reported using repression and denial more often. LEM were
again shown to be related to defensive styles in males as measured by the
Defense Mechanism Inventory (Krikorian and Rafales, 1983). This effect was
not replicated with females, however (Thompson, Greenberg, Fisher, 1982).
In addition, subjects who moved their eyes bidirectionally rather than
predominantly to the left or the right were shown to have better adaptive
coping styles ratings on the adjective check list (Parrott, 1984).
 Smokler and Shevrin (1979) showed that normal subjects with
hysterical tendencies made more leftward LEM than subjects with obsessive
compulsive tendencies. The latter group was more likely to show rightward
LEM. Gur (1978) and Schweitzer (1979) found that schizophrenics had
predominantly leftward LEM.
 The relationship between LEM and cognitive styles has also been
explored. Subjects, who scored as left or right style oriented on the
Laterality Preference Schedule, were shown to have consistent patterns of
LEM, indicating the existence of consistent patterns of information
processing (Breitling and Bonnet, 1985; Bruce, Herman, and Stern, 1982).
When using the Your Style of Learning and Thinking Test (SOLAT) to measure
style of thinking, however, no relationship was found between LEM and
thinking style preference (Alberts and McCallum, 1982). In addition, Owens
and Limber (1983) found no relationship between cognitive style and LEM.
 One area of interest in the cognitive style research is the
relationship between what are considered right style ways of thinking
(holistic and broad) and left style ways of thinking (analytic and narrow)
based on proposed functions of the individual hemispheres. In support of
the theory that eye movements indicate hemispheric activation, and that
left hemisphere activation is associated with more analytic and narrow
styles, Huang and Byrne (1978) showed that narrow categorizers based on the
Pettigrew's Category Width Scale made more leftward LEM than broad
 Another area of interest has been the relationship between the
ability to recall dreams and LEM. Predominantly leftward LEM have been
associated with the ability to vividly recall dreams in male subjects
(Leboeuf, Mckay, Clark, 1983), but the same has not been found with females
(Van Nuys, 1985). A related issue is that of creativity and LEM. Leftward
eye movement has been associated with thinking of more uses of objects on
the Uses Test, which is often used as a measure of creativity (Falcone and
Loder, 1984). Zenhausern (1987) has shown that LEM can differentiate
between two different types of reading disabled children. Specifically,
rightward LEM are characteristic of reading disabled children who are
unable to derive meaning from the written word despite being able to say
it. Leftward LEM are characteristic of reading disabled children who are
unable to pronounce the word despite understanding what it means. This
sampling of research indicates the scope of individual differences that
have been associated with LEM. In their critique of the LEM literature,
Ehrlichman and Weinberger (1978) concluded that LEM are reliable measures
of individual differences. They found that despite differences in
methodology and experimental situations the direction a person moves his or
her eyes is a consistent behavior of that individual. The individual
difference studies above indicate their behavioral relevance.
Functional Hemispheric Asymmetry and LEM
 A second perspective on the nature of LEM was introduced by
Kinsbourne (1972) who proposed that LEM reflect the task demands on the
subject. He suggested that those tasks that require input predominantly
from the left hemisphere resulted in rightward LEM, the direction away from
the left hemisphere; those tasks that required predominantly right
hemisphere functions resulted in leftward LEM, away from the right
hemisphere. There has been mixed support for this relationship between LEM
and question type. The critical variable has usually been whether rightward
LEM are associated with verbal questions, indicating a relationship between
a verbal task and left hemisphere activation. A wide variety of what have
been called "verbal" questions have been used, however.
 Galin and Ornstein (1974) reported a relationship between rightward
LEM and logical problems and leftward LEM and visual imagery tasks. Proverb
interpretation has been shown to be related to rightward LEM (Kinsbourne,
1972; Gur, 1975). Schwartz, Davidson and Maer, 1977, found a relationship
between LEM and task demands. There have been recent reports of
relationships between both rightward LEM and verbal questions (Hugdahl and
Carlgren, 1981; Ogorman and Siddle, 1981) and leftward LEM and visual
spatial tasks (Swinnen, 1984). In addition to the verbal/non-verbal
dichotomy, emotionally laden questions were used to elicit predominantly
leftward LEM (Krikorian and Rafales, 1983; Jamieson and Sellick, 1985).
 Not all studies have resulted in significant findings. In fact,
Ehrlichman and Weinberger concluded that the evidence for a relationship
between LEM and question type was not convincing on both empirical and
theoretical grounds. From the empirical point of view, they noted that of
the 21 studies reviewed, 10 resulted in rightward movement in response to
verbal questions, and 11 resulted in no difference in LEM to verbal and non
verbal questions. The authors concluded that the literature thus did not
offer strong support that LEM were related to question type.
 A re-evaluation of the empirical studies, however, indicates that
there is a consistent relationship found between the type of question asked
and the direction of LEM. In only one of the 21 studies reported by
Erhlichman and Weinberger did verbal questions lead to leftward LEM. While
the conclusion that verbal questions lead to rightward LEM may be in
question, the conclusion that verbal questions do not lead to leftward LEM
is strongly supported. There may be a relationship between task demands and
LEM, but it is not a simplistic "verbal question leads to rightward LEM
 There is clear evidence that LEM are related to both the type of
question asked and individual difference factors. Therefore, in any
situation, LEM reflect the type of question asked interacting with the
individual differences and it is essential to separate the two effects.
 Two distinct tasks were used in a study by Zenhausern and Kraemer
(1989) to investigage the dual nature of LEM. One task is purely
informational and cannot be uniquely connected with either hemisphere of
the brain. The second task involves rhyming of non- words which clearly
demands the speech centers of the left hemisphere. Two experimental
questions were addressed. 1) Is the direction of LEM consistent within an
individual both across time and across tasks? 2) Does the type of question
asked have an effect on the direction of LEM?
 A total of 50 adult subjects were tested. There were 16 males and
34 females, with an average age of 27 and a range of 16 to 50. The stimuli
for the rhyme task were four to five letter nonsense words printed in black
ink on white index cards and a series of prepared questions.
 The subjects were informed that they were participating in a study
involving the different ways in which people think. They were asked two
kinds of questions in a face to face encounter with the experimenter. The
subject responded yes or no with a nod or shake of the head and the initial
direction of eye movement to each of 40 questions was recorded for each
subject. These non-verbal responses were used to eliminate left hemisphere
involvement through speech which was unrelated to the task. The 20
informational questions did not call on any clearly defined brain areas (Is
Miami the capitol of Florida?). The 20 rhyme questions, on the other hand,
clearly demanded the auditory linguistic capabilities of the left
hemisphere. The subject was shown a nonsense word on an index card and told
to remember it. The card was removed and another nonsense word was verbally
spelled by the examiner and the subjects were asked whether the two words
rhymed. The subjects were tested in two blocks of 20 trials separated by 30
minutes. Within each block 10 informational and 10 rhyme questions were
 The data were first explored by means of a correlational analysis.
Both test-retest and split half reliabilities for informational questions
and for rhyme questions are shown in Table 2.2. In addition, the
correlation between rhyme and informational questions is also presented.
LEM are clearly a consistent measure of individual differences with
reliability coefficients averaging approximately .80 for the same type of
question. When the type of question was changed, however, there was a
dramatic drop in the consistency of LEM although the correlations were
still significant. The direction of LEM changed as a function of task
demands, but not to the extreme that would result in no correlation. Table
2.2 Intercorrelations Among LEM for Information and Rhyme Questions were
collapsed into a single set of questions. The data were then analyzed by
means of a split- plot analysis of variance with LEM Group (whether a
subject had predominantly rightward or leftward movement) as a between
factor and Task (Rhyme and Informational questions) and Direction of
Movement (Right, Left, and Stares) as between factors. Since the scores are
ipsative and the Grouping factor and dependent variable are related, only
the interactions are of interest in this design. There was a significant
interaction between the Direction of Movement and Task. The results are
shown in Table 2.3 below.
Table 2.3
Number and Direction of LEM as a Function of Type of Question
 The effects analysis indicated that the number of leftward LEM to
informational and rhyme questions were not significantly different, but
there were significantly more rightward LEM than leftward LEM to rhyme
questions. There were no interactions involving the LEM Group factor,
indicating that the effects of the type of question were the same for both
 These results lead to two conclusions. The first is a verification
of the Ehrlichman and Weinberger (p 1093) conclusion "...that LEM patterns
are reliable characteristics of persons." Individuals do move their eyes in
a consistent direction and direction of LEM is a reliable measure of
individual differences. The questions, however, remain as to whether LEM
differences can be related to behavior and whether these behaviors have
neuropsychological implications. Some of the research reported above has
shown the scope of the variables that have been related to differences in
LEM. (A fuller listing can be found in Beaumont, Young, and McManus, 1984).
Not every study has shown that LEM differences were related to differences
in performance, but no one should expect LEM to be related to all behavior.
 The final question remains, however, as to whether LEM have
neuropsychological implications. In a very general sense, all behavior
results from brain activity and thus all behavior has neuropsychological
implications. From a more focused point of view, LEM have been related to
behaviors that neuropsychologists have associated with the brain. The
problem has been, however, that the association of the behavior with the
brain has not always been clearly specified. Logical problems, proverbs,
and spelling have all been used as verbal tasks. These tasks are extremely
complex and clearly involve both hemispheres of the brain, even though
there may be a portion of the task that is especially dependent on left
hemisphere processing. This was clearly shown in the present study since
the rhyming task demanded the unique ability of the left hemisphere to
create the sound of the printed word. The information task had no such
clear connections to either hemisphere of the brain. Both the correlations
and analysis of variance results pointed to the fact that LEM were
different for the two tasks, with an increase in the number of rightward
movements for the rhyming task. This change, however, was relatively
subtle. Even though the task demanded specific left hemisphere input,
subjects did not make predominantly rightward LEM; there was only a shift
in that direction. A subject who made predominantly leftward movement
continued to do so, but the number of rightward movements increased and the
number of stares decreased.
 Lateral Eye Movements have been shown to be a reliable measure of
individual differences, as well as a response to the type of questions
asked. The importance of both aspects, however, should not be
overemphasized. The individual difference aspect must be investigated from
a more behavioral point of view. Rather than comparing a lawyer or a
scientist with an artist, determine whether a courtroom lawyer has more in
common with an actor or a corporate lawyer, or whether a geometrician has
more in common with an artist or an algebraist.
 The LEM response to task demands must also be considered in
conjunction with the fact that any task demands the integrated functioning
of the whole brain. The variable extent to which a task places special
emphasis on one hemisphere must be considered within this integrated
functioning. LEM can be a useful tool, but their value and meaning can be
misunderstood all too easily. The next Chapter provides evidence of the
usefulness of LEM within a normal classroom setting.
 This chapter has presented the evidence that Hemispheric Related
Strategies can be measured by means of questionnaires and LEM. The
following chapters will provide evidence that this individual difference
variable has significance for education.
Chapter 3
 The purpose of this Chapter is to provide evidence that the
individual difference aspect of LEM has meaningful behavioral correlates in
an educational setting. No assumptions were made as to the
neuropsychological substrate of LEM. They were used simply as a means of
dividing subjects into two groups: those who move their eyes predominantly
to the right and those who move them predominantly to the left. Half of the
right movers were taught a learning strategy involving verbal rehearsal and
the other half a learning strategy involving imagery. The same procedure
was followed for the left movers. The question was whether there is a
relationship between the typical direction of LEM and the effectiveness of
the two learning strategies.
 The subjects were drawn from a pool of 120 average or above average
fifth and sixth graders in a suburban school system. A series of verbal,
spatial, imaginal, and informational questions were asked in a face to face
situation and the 72 subjects who had the most extreme number of left
movements and the most extreme number of right movements participated in
the study. The subjects were divided into equal numbers of male and female
right and left movers.
 Seventy-two words appropriate to fifth and sixth graders and
matched for abstractness, concreteness, and imagery were chosen from the
list provided by Pavivo, Yuille, and Madigan (1968). Two equivalent sets
consisting of 18 pairs, created from this list, served as the learning
stimuli. Two distractor lists of 12 pairs each were also created using the
same procedure. Each pair was then photographed and developed as 35mm
 Each subject, tested individually, was seated approximately 4 ft.
from a screen on which the 18 pairs of words were presented by means of a
slide projector for 4 sec. The child was then asked to recall as many pairs
of words as possible and the number of correct pairs served as one
dependent variable. The subjects were then shown 24 pairs of words, half of
which they had already seen and half of which were distractors. These
slides were then presented and the subject had to indicate by switch
closure whether they had seen the word pair. Both accuracy and response
time (in milliseconds) were measured. Following this pre-training
procedure, half of the subjects whose LEM were predominantly leftward and
half whose LEM were predominantly rightward, were taught a verbal rehearsal
strategy in order to improve performance. They were instructed to repeat
the pairs of words as many times as possible during the 4 sec interval
between pairs. They were then given six practice trials. The remaining
subjects were instructed on how to form an integrated image from the word
pairs. They were also given six practice trials. The subjects were then
tested on 18 new pairs of words using the same procedures as in the pre-
training condition. This effectively created four groups: right movers
taught to use either imagery or verbal rehearsal strategies and left movers
taught the same strategies.
 There were three dependent measures that were analyzed in this
study: the number of pairs recalled, the number of pairs recognized, and
the response time for recognition. The design for all three variables was a
split plot factorial with Direction (leftward or rightward LEM) and
Strategy (verbal rehearsal or imagery) as the between factors and Time
(before or after training) as the within factor. The mean number of correct
pairs recalled under all conditions is shown in Table 3.1.
Table 3.1
Mean Number of Word Pairs Recalled for Right and Left Movers Under
Verbal Rehearsal and Imagery Instructions
 The most important question, however, is whether LEM have any
relationship to brain organization. Individuals who had predominantly
rightward LEM showed better retention when using the left hemisphere
oriented strategy of verbal rehearsal and individuals who had predominantly
leftward LEM showed decreased retention when using the left hemisphere
oriented strategy. These are the facts, and while it is premature to draw
firm conclusions, these facts are consistent with the existence of a
relationship between LEM and brain organization. The clearest conclusion
from these findings is that children differ in the extent they can benefit
from a verbal repetition strategy in learning. From the educational
perspective it is clear that there are children in schools who not only do
not benefit from a verbal rehearsal strategy, but whose performance is
actually decreased. Spelling and arithmetic tables are examples of subjects
that usually stress a rote memorization based on oral repetition. One
alternative would be to have the child repeatedly image the letters of the
word or number facts without verbalizing them. When it came time to use the
word or number fact the child would recall the image. Educators must become
more aware of the individual differences in the way people learn. This
becomes even more evident in the next chapter where these individual
differences can be seen to be at the heart of what has been called reading
Chapter 4
 Although there is general agreement that reading disability is not
a single entity, there is considerably less than a consensus as to the
number of different syndromes that actually exist. Neuropsychological
assessment, the types of errors made with verbal material, cognitive tests,
and differences in processing strategies have all been used in the
classification of the reading disabled into symptom-related subtypes. As
many as five different subtypes of reading disability have been found
through the use of neuropsychological tests.
 For example, Mattis, French and Rapin (1978) reported three groups
and Doehring, Honshko, and Byans (1979) distinguished four types. Fisk and
Rourke (1979) Petroskas and Rourke (1979) have identified subgroups which
were consistent. These subtypes, however, can be considered in terms of the
presence or absence of auditory linguistic deficits, a distinction reported
throughout the reading disability literature. Subtypes that include
auditory linguistic deficits comprise 80 to 90 percent of the total
population of reading disabled children. The smaller group has usually been
reported to show deficits in visual spatial processing.
 Boder (1973) examined the nature of the spelling errors made by
reading disabled children. She used the term dysphonetic to describe the
type of reading disability marked by linguistic and phonetic difficulties;
and the term dyseidetic to describe the type which had difficulties with
the overall visual spatial aspects of the written word. Boder estimated
that the dysphonetic group was four to five times more prevalent than the
dyseidetic group. Pirozzolo (1979) used ratings, writing samples, and
psychological and neuropsychological tests to separate two reading
disability groups that were similar to those suggested by Boder. Bakker
(1982) proposed a similar distinction that he related to hemispheric
functioning. The auditory linguistic disabled reader was not effective in
the use of left hemisphere related tasks. There was also an association of
the visual spatial disabled reader and the effective use of right
hemisphere related strategies.
 Zenhausern (1987) distinguished these two types on the basis of
both reading related tasks and the predominant direction of their lateral
eye movements. He found that the majority of children with leftward lateral
eye movements had difficulty determining whether words in their sight
vocabulary did or did not rhyme. He also found that a group of children
with predominantly rightward lateral eye movements had no difficulty in
determining whether two words rhymed, but were deficient in determining
whether words and pictures represented the same concept. The auditory
linguistic group had difficulty converting a word to its sound and the
smaller group showed deficits in converting a word to its meaning. He used
the terms Phonetic and Semantic to describe this distinction. From a
behavioral perspective, phonetic disabled readers are the children who
struggle with every word when they read aloud and thus lose continuity in
the text. They are frequently anomic and have a general difficulty with the
auditory linguistic aspects of reading, especially the grapheme to phoneme
conversion. The Semantic disabled reader, on the other hand, is the child
who will give a perfect word for word rendition of text, but has no
comprehension of the meaning of that text. The Semantic disabled readers
can convert words into their phonetic representation, but this
representation is not converted into its meaning. They have no problems
with the sound of a word but are at deficit for tasks involving the meaning
of words.
 The original study was based on 13 Phonetic and 13 Semantic readers
from the second to fourth grades. One purpose of this research was to
determine whether these Phonetic and Semantic subtypes would replicate
across the entire elementary school population. A second goal of this study
was to replicate the second finding of the original study. The Phonetic
disabled readers moved their eyes predominantly to the left and Semantic
disabled readers predominantly to the right. This second purpose was an
attempt to determine whether lateral eye movements can be used as a marker
variable for the two types of reading disability.
 The subjects in this study were 160 children from the second to the
eighth grades. All were of at least average intelligence. Forty children
were selected at grades 2 or 3, grades 4 or 5, grades 6 or 7, and grade 8.
Of the 40 children at each age level, 20 were at or above grade level and
20 children were at least one year below grade level in reading. Half of
each group were chosen on the basis of showing rightward LEM and half
leftward LEM. The predominant direction of LEM was determined individually
for each child. A series of 20 informational questions were asked in a face
to face situation and the predominant direction of LEM was noted. Normal
readers split evenly between right and left movers, but 84% of the disabled
readers were left movers.
 There were four kinds of reading related tasks that used words
selected from the individual sight vocabulary of each child. A rhyme task
stressed the auditory linguistic aspects of the written word and the
remaining three tasks placed more emphasis on the meaning of the words.
     1) The rhyme stimuli consisted of 10 each of four types of word pairs:
     a) words which neither rhymed nor had similar orthography (tree/eats);
     b) words which were both phonetically and orthographically similar
     c) words which were orthographically similar, but did not rhyme
(bone/gone); and
     d) words which were orthographically dissimilar, but rhymed (by/tie).
     2) The word match stimuli consisted of 20 word pairs, one in upper
case the other in lower case which did or did not represent the same word
(TREE/tree, TREE/eats).
     3) The word/picture stimuli consisted of 20 word and picture pairs, in
which the word and picture did or did not represent the same concept.
     4) The synonym/antonym pairs consisted of words which meant either the
same or the opposite.
 Each stimulus was presented on 35 mm slides and projected for 130
ms. The subjects were tested individually and responded verbally as to the
whether the words rhymed in the rhyme condition and whether they matched or
meant the same in each of the three other conditions. All words used in the
study were determined to be in the sight vocabulary of all subjects on the
basis of prior testing.
 The number of correct responses for all children on the four grade
levels was subjected to an analysis of variance for each of the four tasks.
The grouping factors included Grade Level, Reading Ability, and Eye
Movement Direction. The normal readers achieved virtually perfect
performance on all tasks and their results were not included in the tables.
The interaction of eye movement group and the rhyme task was significant.
The mean number of correct responses for the interaction are presented in
Table 4.1.
Table 4.1
Mean Number Correct on the Rhyme Task for Disabled Readers with
predominately Right and Left LEM at Four Grade Levels
] 18.60     19.30
          8         19.90     19.80          19.10     19.70
Left      2-3       16.10      5.90           7.40     14.40
          4-5       16.10     10.30          10.20     17.30
          6-7       16.80     13.60          12.50     18.50
          8          9.60     12.00          10.40     17.60
] three tasks are presented in Table 4.2.
Table 4.2
Mean Number Correct on the Uppercase/lowercase, Word/picture and
Synonym/antonym tasks for Disabled Readers with Right and Left LEM
at Four Grade Levels
 It was the reading disabled readers with predominantly rightward
LEM who were the significantly more disabled group for these tasks. They
were significantly inferior on the word matching task, the word picture
task and the synonym antonym task. These children could create the sound of
a word from its orthography, but did not understand the meaning of that
word. This is a replication of a second type of disabled reader, a Semantic
subtype whose deficit involves the meaning of words rather than their
phonology. Rightward lateral eye movements are a marker for this subtype.
In the past, this subtype has often been identified with visual spatial and
perceptual problems. This may be true but it is incidental to their reading
disability since they had no difficulty in perceiving the words in the
rhyme task. These results support the existence of two subtypes of reading
disability. The Phonetic disabled reader has difficulty converting the
written form of a word to its phonetic counterpart. The Semantic disabled
reader can convert a word to its sound, but not its meaning.
 There were two distinct patterns of errors made by the Phonetic and
Semantic disabled readers, but what is the relationship between these
patterns and reading disability? The answer to this question lies in the
way we teach reading. The next chapter is a discussion of how these two
deficits interact with current reading methods and the effectiveness of a
different approach to the reading process.
 Current teaching methods almost invariably use an indirect
phonological route to meaning in which the written word is converted to its
phonological counterpart so that meaning derives from auditory
comprehension. In practice, a child comes to school with auditory
comprehension, that is, hearing the word "ball" leads to the concept of "a
round, bouncy thing". In reading, the letters b-a-l-l must lead to the
concept of "a round, bouncy thing". In virtually every case, the child is
taught to see the word, say it, and understand it from its sound. This is
an effective technique for two reasons. First, it takes advantage of the
existing auditory comprehension of children; second, it provides the
background for the future decoding of new words. As effective as this
procedure is for most children, a significant number of individuals are not
able to learn under this protocol and they comprise the majority of the
children we term "reading disabled."
 The Phonetic disabled reader has difficulty with the first step of
this indirect phonological route to reading, converting the graphemic form
of the word into its phonological counterpart. The Semantic reading
disabled readers have no difficulty with this first step; they can make the
grapheme to phoneme conversion. For whatever reason, however, the sound of
the word does not lead to its comprehension.
 The standard methods of teaching reading are well-entrenched and
educators sincerely believe that this indirect phonological route to
meaning is the best. Therefore, remediation for these "disabled readers"
means an intensification of what was not successful in the past. Extensive
drilling in phonetic skills has led to an emphasis on teaching to weakness,
rather than strength. The imbalance is reflected in reading curricula and
standardized tests that stress phonetic decoding at the expense of
comprehension. Phonetic decoding is a means to the end of comprehension; it
has become an end in itself.
 A new approach, Direct Access, has been developed which achieves
comprehension without the necessity of decoding. The Direct Access method
has one basic principle: the meaning of the printed word should not be
derived from the sound of that word. Any procedure that avoids the grapheme
to phoneme conversion is consistent with this approach. The child is never
required to read aloud, but asked to explain what a passage meant. Trivial
deviations in verbiage, e.g., "jet" for "plane", are de-emphasized. The
stress is on comprehension rather than a slavish word for word decoding.
 One of the simplest procedures used in the method involves pairing
words and pictures until the written word triggers a concept directly,
rather than indirectly through its sound. The child can then construct
sentences composed of pictures in parallel with sentences composed of
words. Children automatically fill in words like "a", "the", "in", etc.
when they comprehend the sentence. In a very short period, the pictures are
no longer needed and the written word is understood on its own.
 Several techniques are available for more abstract concepts. One
possibility involves a class discussion of, for example, our legal system.
The teacher can then show the class the word "justice" and ask the children
to draw a picture of justice. It is not the picture itself that is
important, but it serves as a link between the written word and its
conceptualization by the child. Another possibility is a homework
assignment requiring the child to bring pictures to school that represent
specific concepts. Direct Access places only one constraint on the
creativity of teachers: Do not teach reading by deriving the meaning of a
word from the way it sounds. Phonic decoding is a skill that should be
developed, but it should not serve as the usual reading strategy for these
two groups of readers.
 Maxwell and Zenhausern (1983) applied the method to First Grade
children who were "at risk" during the second semester. After 25 half-hour
sessions, the children increased their comprehension scores from the 26th
to the 56th percentile on the Metropolitan Achievement Test and increased
their sight vocabulary by over 100 words. A comparable control group showed
no gain in comprehension. Minardi, Zenhausern, and Maxwell (1984) found
similar results with Junior and Senior High School children. Using the same
regimen of 25 half-hour sessions, the Junior High School students gained an
average of 7 months and the Senior High School students an average of 1.4
 The previous research on the Direct Access method of reading has
been limited to a small number of children taught by a single teacher. The
purpose of this study was to apply the method in a large scale basis, using
a broad range of grades and teachers. A total of 209 children from grades 1
through 10 (with the exclusion of Grade 9) who were at least one year below
grade level in reading and 240 children who were reading at least on grade
level were the subjects in this study.
 A workshop explaining the theory and practice of the Direct Access
reading method was presented to teachers throughout a 32 school District in
suburban North Carolina. After the workshop was completed, those teachers
who were interested were given further experience. There were no absolute
procedures specified, but the teachers were shown various possibilities and
were told to use any techniques that did not depend on the indirect
phonological route to meaning. Following these sessions the children in the
classes taught by the teachers were given the Metropolitan Achievement Test
Form L as a pretest measure of their reading ability. The teachers then
used the Direct Access method exclusively for 10 weeks, after which time
the children were retested on the Metropolitan Achievement Test Form M.
 The results of the reading disabled children and a control group
are presented in Table 3. The average gain across the whole group was
almost 1 year and several grades showed gains of over 2 years. Individual
gains of 4 or more years were not uncommon. Given that these results were
obtained during only a 10-week period, the Direct Access approach is
clearly an effective strategy to use with Phonetic and Semantic reading
disabled children. In addition to these objective gains, the teachers
reported an extremely positive reaction on the part of the students and
have commented on the effects of the method on both spelling and writing
 During the past year (1988-89) Greensboro and High Point, North
Carolina used the Direct Access approach. The average gain on the State
mandated California Achievement Test was over 20 percentile points for
those children. As a result, High Point has mandated the Direct Access
approach as the treatment of choice for children who are "at risk" for
reading. The approach has been used in Currituck, North Carolina since
September, 1989 and at Public School 102 in New York City since January,
1990. There are plans for incorporating Direct Access into a psychiatric
hospital for children, a Parochial school in New York City, and a school
system in East Greenwich, Rhode Island by February, 1990.
Table 1
Total Gains in Percentile and Grade Equivalent Scores for Direct
Access and Controls
]      10    0.34
Grade 2
DA (21)       17   1.76      32   2.15      15    0.39
Control (36)  54   2.89      58   3.19      40    0.3

Grade 3
DA (28)       16   2.33      31   2.99      15    0.66
Control (28)  56   4.49      61   4.94      5     0.45

Grade 4
DA (52)       15   2.59      31   3.28      16    0.69
Control (53)  60   5.82      61   5.97      1     0.15
Grade 5
DA (20)       21   3.63      38   5.01      17    1.38
Control (38)  56   6.53      60   7.09      4     0.56

Grade 6
DA (13)        3   2.36      15   3.68      12    1.32
Control (17)  71   9.58      74    9.9      3      0.32
Grade 7
DA (21)        8   3.39      26   5.45      18    2.068
Control (18)  35   6.57      36   6.64      1     0.07
Grade 8
DA (9)         5   3.38      21   5.61      16    2.23
Control (10)  34   6.94      35   7.36      1     0.42
Grade 10
DA (7)        17   5.58      26   6.65      9     1.07
Control (13)  15   5.25      18    5.6      3     0.35
]tive technique for two reasons. First, it takes advantage of the existing
auditory comprehension of children; second, it provides the background for
the future decoding of new words. As effective as this procedure is for
most children, a significant number of individuals are not able to learn
under this protocol and they comprise the majority of the children we term
"reading disabled."

 Kaliski, Zenhausern, and Andrews have shown that there are two
groups of children who have unique deficits that interact with these
standard strategies used for teaching reading. It is this interaction that
directly leads to reading disability. All the children in grades 1 to 8 who
were reading at least one year below grade level were screened for
inclusion in the study. The majority of the reading disabled group (85 per
cent) fall into the category of children who have to struggle to pronounce
every word and thus lose all continuity in reading. They were termed
Phonetic disabled readers. The smaller group of reading disabled children
can "read" aloud fluently, but do not comprehend what was "read". These
children were called Semantic disabled readers. The final sample consisted
of 80 children, 40 Phonetic and 40 Semantic disabled readers, spread evenly
across the 8 grades. The authors showed that the Phonetic children could
not determine whether two words (which were known to be in their sight
vocabulary) did or did not rhyme. The Semantic group had no difficulty with
a rhyme task, but made considerably more errors than the normal readers and
Phonetic disabled readers in determining whether a word and a picture
represented the same concept. These two deficits can be directly related to
the indirect phonological approaches to the teaching of reading. The
Phonetic disabled reader can not convert the word to its sound and thus can
not take the first step required by these reading methods. The Semantic
disabled reader can perceive the words and translate them to their sound
but has difficulty in comprehending the meaning of the written word from
this sound. This disabled reader can take the first step and convert the
written word to its phonological counterpart, but the sound does not lead
to meaning. The results of this study can be seen in Figures 1 and 2.
 The standard methods of teaching reading are well-entrenched and
educators sincerely believe that this indirect phonological route to
meaning is the best. Therefore, remediation for these "disabled readers"
means an intensification of what was not successful in the past. Extensive
drilling in phonetic skills has led to an emphasis on teaching to weakness,
rather than strength. The imbalance is reflected in reading curricula and
standardized tests that stress phonetic decoding at the expense of
comprehension. Phonetic decoding is a means to the end of comprehension; it
has become an end in itself. An alternative approach to reading which does
not depend on an indirect phonological approach to comprehension, called
Direct Access, has one basic principle: the meaning of the printed word
should not be derived from the sound of that word. Any procedure that
avoids the grapheme to phoneme conversion is consistent with this approach.
The child is never required to read aloud, but is asked to explain what a
passage meant. Trivial deviations in verbiage, e.g., "jet" for "plane", are
de emphasized. The stress is on comprehension rather than a slavish word
for word decoding. Specific Direct Access techniques will be discussed
later in this chapter.
 The first study involving Direct Access was by Maxwell and
Zenhausern (1982) who applied the approach to First Grade children "at
risk" in reading by the second half of the year. After 25 half- hour
sessions, the children increased their scores from the 26th to the 56th
percentile on the Metropolitan Achievement Test and increased their sight
vocabulary by over 100 words. A comparable control group showed no gain.
Minardi, Zenhausern, and Maxwell (1983) found similar results with Junior
and Senior High School children. Using the same regimen of 25 half-hour
sessions, the Junior High School students gained an average of 7 months and
the Senior High School students an average of 1.4 years on the Reading
Comprehension scale of the Metropolitan Achievement Test.
 During the Spring of 1988, over 200 reading disabled children in
grades 1 through 10 from 8 schools within the Guilford County School System
in Greensboro NC used the Direct Access approach. The children were tested
on the Metropolitan Achievement Test before and after 10 weeks of using the
approach. The average gain was .95 years and every grade from Grade 6
onward gained at least 1 year, with the 7th and 8th grades showing gains of
over 2 years. In the Fall of 1988, High Point NC used the approach with 73
reading disabled children. After 7 weeks, there was an average gain on the
Woodcock Johnson of 15 months. The Kindergarten group showed a 12 month
gain; the primary, a 7 month gain, and the middle school a 21 month gain.
Both Greensboro and High Point, North Carolina used Direct Access for the
past year. On their State mandated California Achievement Test, those
children on Direct Access instruction showed an average gain of 17
percentile points above last year's scores.
 The results of the demonstration project and the use of Direct
Access in the past year in North Carolina clearly show that reading
disabled children can benefit from the Direct Access method of teaching
reading. To be able to read means that one can get meaning from the printed
word. The indirect phonological route attempts to accomplish this by having
the reader convert the written word to its phonological counterpart and
from this sound derive meaning. Converting the word to its sound is a means
to the end of comprehension, not the comprehension itself. Direct Access
attempts to derive the meaning of the printed word not via its sound, but
directly. The stress is on comprehension, not decoding.
 One of the first and most basic Direct Access techniques consists
of pairing an index card which contains a word and one that contains a
picture so that the child can consistently make the pairing. At that point
the child can read the word, that is, the child can comprehend the printed
word. Note that this is true whether or not the child can say the word
correctly or not. The pictures can be provided by the teacher, cut from
magazines for homework by the child, or even drawn by the child. The
question of abstractions and hard to picture words at first seems
insurmountable, but it is surprising how easily a child will develop and
remember appropriate pictures. In connection with this aspect, games can be
developed to strengthen the connection between the words and the pictures.
Variations of Concentration and Old Maid have been used successfully.
 This pairing, however, is only the beginning of the Direct Access
approach. The typical reaction at this point is, "This is nothing new." or
"We tried that 20 years ago and it did not work." The next step is the most
critical. The words and pictures must be combined into sentences. A word
sentence can be covered by the appropriate picture and vice versa. The
child should not be asked to read the sentence aloud, word for word.
Rather, have the child summarize the sentence, point to a picture from a
series that corresponds to it, or even draw a picture of the sentence. The
stress should always be on whether the child has understood the basic
meaning of the sentence rather than a word for word rendition of it.
 There are two important side benefits of this approach. One is an
increase in spelling skills. The second advantage is the ease with which
children can do creative writing using the cards. It is a simple way to
separate penmanship from writing. The child could be asked to write the
funniest (most exciting, etc.) sentence they can from their words. The step
from sentences to paragraphs is minimal.
 There are two basic approaches to class recitation within a Direct
Access framework. The phonetic disabled reader would be asked to summarize
a passage for the class and the teacher and classmates could discuss the
errors of omission and commission. It also opens the door for class
discussion on any relevant issues. The semantic disabled reader would read
aloud, but be required to do so with expression to assure that the meaning
and not only the words were being read. Of course, any child could be given
the opportunity to use either approach.
 Flash cards are a standard part of the classroom and can be used
within a Direct Access framework. Let the children have their pictures in
front of them when the words are flashed. They will serve as a cue and
minimize the chance of failure. As the children progress, they can turn the
pictures face down on the desk and only turn them over as needed. This will
strengthen skills and continue to minimize the chance of failure. This
technique could easily be converted into a game where more points accrue if
a card is not turned over, but the child will always get some points.
 What happens when children come across a word they have never seen
before? This is the usual response of people who first encounter Direct
Access. There are several approaches to this. First and foremost, the child
should be encouraged to determine the meaning of the word from the context
of the whole passage.
 Second, the teacher can tell the child the word and immediately
have the child cut out or draw an appropriate picture for that word.
 Third, the child can be encouraged to look it up in the dictionary
just like anyone else who comes across a word with which they are
unfamiliar. The child may not be able to pronounce the word, but its
meaning will be known.
 Fourth, phonetic decoding should be an essential part of any
reading program. It is an important skill and should not be neglected. On
the other hand, it should not be the main approach to deriving meaning from
the printed word for some children. There is a temporary remediation
procedure to use with Semantic disabled readers. Have the child read aloud
into a tape recorder. Then the child can play back the tape while reading
from the text material. Although this is an awkward procedure it will allow
the child to get meaning from the printed word. Direct Access has a
technique for the teaching of spelling and number facts. It has been shown
that some children not only do not learn by verbally repeating the word and
letters (e.g. "cat, C-A-T, cat", "6 times 3 is 18") but this procedure can
actually interfere with learning. As an alternative have the child look at
the word and practice forming an image of the letters without saying
anything (This is essential!!). When it comes time to spell the word, have
the child bring back the image of the letters and copy them.
 The Direct Access approach does not depend on a rigid structure
that the teacher must follow slavishly, but is a general principle that can
lead to unique and creative techniques. Furthermore, the method is not
limited to the disabled population, but may be an effective strategy for
all readers since it has some similarities to "speed reading" techniques.

 Reading Disability is as much a physical disability as blindness,
deafness and paralysis but a person with such a disability has not received
the help offered to those suffering from the latter disorders. The reading
disabled child is considered responsible for the disability. The purpose of
this paper is to point out that these children can learn to read if only we
are willing to change the methods with which we teach reading.
 The standard approaches to reading demand that the child convert
the written word to its sound and, from that sound, derive the meaning. It
was shown that 85% of the children we call reading disabled have difficulty
making that first step and the remaining 15% can convert the word to its
sound, but this still does not give them meaning. The Direct Access
approach to reading can help both types of children because meaning is not
derived by converting the printed word to its sound. Rather, the sound of
the word is derived from its meaning. Several specific techniques using
this approach have been discussed earlier in this Paper.
 Our brain is capable of many fascinating and wondrous things. Our
conscious awareness of our surroundings is somehow derived from light of
various wavelengths falling on our retina and causing neurons to fire and
not fire. It is this pattern of neuronal activity that gives us conscious
experience. Even more amazing is the ability to create literary, musical,
and visual works of art. It is the brain that is responsible for all of
this. The brain also has a rather obscure function. It can take an
arbitrary series of symbols (printed words) and convert them into an
equally arbitrary set of sounds (spoken words). This function pales
alongside literary and artistic masterpieces. Why have we made it the basis
of our educational system?
 There are two major administrative recommendations that flow from
this paper. The first concerns the establishment of a centre for learning
disability to be associated with the Centre for Social Development and
Humanitarian Affairs. The second concerns the development of a pilot
project to investigate the effectiveness of the Direct Access approach to
1) A center for the dissemination of information and training in learning
disabilities should be established which would be called the Learning
Enhancement Centre of the Disabled Persons Unit. The purpose of the
Learning Enhancement Centre would be to research and disseminate
information on the theory and remediation of educational disabilities and
to provide training in the remediation of these disabilities. The scope of
this training would include all educational approaches that stress the
individual styles of learning with a particular emphasis on the Direct
     1) ongoing workshops open to teachers from all member countries; and
      2) visiting teams which would provide on-site training for those
teachers who cannot travel to the Centre. In addition, new teaching
techniques would constantly be developed and evaluated in real classroom
situations. These teaching techniques would take advantage of the latest
technology, but the effective use of more basic strategies would also be
investigated. The Centre would publish a newsletter to promulgate its
activities and share the latest innovations in teaching techniques.
2) A large scale pilot study should be initiated by the Learning
Enhancement Centre to evaluate the effectiveness of the Direct Access
approach across a wide variety of cultures. The Learning Enhancement Centre
would provide a series of workshops to train teachers in the theory and
practice of Direct Access. These teachers would consist of individuals from
various countries who would then develop Direct Access projects in their
country. Consultants from the Learning Enhancement Centre would visit the
project sites to provide ongoing feedback to the teachers. These same
teachers can provide on site training for countries who are unable to send
teachers to the Centre. In addition to these administrative
recommendations, there are several educational recommendations that are
aimed at eliminating all forms of learning disability. The aim of the
Learning Enhancement Centre is to implement these recommendations.
3) Individual preferences in learning strategies should be taken into
consideration in selecting teaching strategies. Both lateral eye movements
and Hemispheric Preference Test data should be collected on all children.
Strategies of teaching that are compatible with the learning strategies
associated with these Hemispheric Related Strategies should be incorporated
into the classroom. In addition, other measures of individual differences
in learning styles should be incorporated into the framework of the Centre.
4) A testing program aimed at identifying individual differences in
learning styles should be developed at the Centre and disseminated among
the various member nations. Children can be tested for Phonetic and
Semantic reading disability by means of a test derived from the results
presented in Chapter 4. The Phonetic Semantic Reading Scale (PSRS) requires
a child to match written and pictorial material on the basis of their sound
or on the basis of their meaning. The point would be to identify
individuals who do well on one portion of the test and poorly on the other
to make a differential diagnosis between the Phonetic and Semantic disabled.
5) The techniques described in the Selected Direct Access Technique section
above should be applied to these children.
These would include, but not be limited to:
a) Alternative forms of class recitation
b) De-emphasis of phonics
c) Use of word picture vocabulary cards
d) Emphasis on comprehension rather than decoding
6) The criteria for success should reflect the capabilities of the child in
conjunction with the demands of the culture rather than artificial
These would include, but not be limited to:
a) Speed should be de-emphasized
b) Tests should be given on an "open book" basis.
c) Calculators should be allowed on mathematics tests.
Note that these changes actually reflect the way people operate in the real
world. No successful business places unrealistic time limits on workers or
denies them use of tools and references.
7) An essential aspect of the Centre will be to develop new and creative
techniques aimed at the elimination of all forms of learning disabilities.
 While the emphasis at present is on developmental disabilities, it
is expected that this will expand to cover acquired disabilities,
especially those related to head injuries. The same principles of
educational remediation will be applied to cognitive remediation. The major
recommendation of this paper is that learning disability should be
recognized as a true disability and treated in the same way as the more
physical disabilities such as deafness, blindness and paralysis. The
learning disabled child should not be considered at fault for the disorder,
but should be recognized as a person in need of special help. It is our
responsibility to supply that special help.
 The emphasis must be on individualizing instruction rather than
finding the "one true method". The good from all approaches must be used
with those who find it good and avoided for those who find it not good.
Only by tailoring our teaching to the unique style of each student do we
maximize their strengths rather than trying to strengthen their minima.
Alberts, F. L., & McCallum, R. S. (1982). The relationship among three
measures of cognitive style. Clinical Neuropsychology,4, 70-71.
Bakker, D. (1982) Cognitive deficits and cerebral asymmetry. Journal of
Research and Development in Education, 150, 49-54.
Beaumont, J., Young, A., & McManus (1984) Hemisphericity: A critical
review. Cognitive Neuropsychology, 1, 191-212.
Boder, E. (1973) Developmental dyslexia: A diagnostic approach based on
three atypical reading-spelling patterns. Developmental Medicine and Child
Neurology, 15, 663- 687.
Bradshaw, J. & Nettleton, N. (1981) The nature of hemispheric
specialization in man. Behavior and Brain Sciences, 4, 51-97
Breitling, D., & Bonnet, K. (1985). Lateralization of GSR, lateral eye
movements and a visual half-fields recognition task. International Journal
of Clinical Neuropsychology, 7, 140-143
Bruce, P. R., Herman, J. F., & Stern, J. (1982). Lateral eye movements and
the recall of spatial information in a familiar, large-scale environment.
Neuropsychologica, 20, 505-508.
Coleman, S. & Zenhausern, R. (1979) Processing speed, laterality patterns,
and memory encoding as a function of hemispheric dominance. Bulletin of the
Psychonomic Society, 14, 357-360.
Day, M. E. (1967) An eye-movement indicator of individual differences in
the psychological organization of attentional process and anxiety. Journal
of Psychology, 66, 51-62.
Denckla, M.B. (1979) Childhood learning disabilities. In. K.M. Heilman and
E.M. Valenstein (Eds.), Clinical Neuropsychology, New York: Oxford
University Press.
Dunn, R., Price, G., Bacilious, Z., & Zenhausern, R. (1983) Learning Style
-- a predictor of school achievement. Momentum, 13, 47-48.
Dunn, R., Zenhausern, R., Cavanaugh, D., & Eberle, B. (1982) Hemispheric
preference the newest elements of learning style. Journal of the National
Association of Biology Teachers, 44, 291-294.
Dunn, R, White, R. & Zenhausern, R. (1984) Do educators create some
discipline problems? Illinois School Research and Development Journal, 34,
Ehrlichman, H., & Barrett, J. (1984) Right hemisphere specialization for
mental imagery: A review of the evidence. Brain and Cognition, 2, 55-76.
Ehrlichman, H., & Weinberger, A. (1978) Lateral eye movements and
hemispheric asymmetry: A critical review. Psychological Bulletin, 86,
Falcone, D. J., & Loder, K. (1984). A modified lateral eye movement
measure, the right hemisphere, and creativity. Perceptual and Motor Skills,
58, 823-830.
Fisk, J. & Rourke, B. (1979) Identification of subtypes of learning
disabled children at three age levels: A neuropsychological, multivariate
approach. Journal of Clinical Neuropsychology, 1, 289-310.
Furst, C. EEG asymmetry and visuospatial performance. Nature, 260, 254-255.
Galin,D., & Ornstein, R. (1972) Lateral specialization of cognitive mode:
An EEG study. Psychophysiology, 9, 412-418.
Galin, D., & Ornstein, R. (1975) Hemispheric specialization and the duality
of consciousness. Laterality and brain function. Springfield, IL:
Golden, M., & Zenhausern, R. (1983) Grapheme to phoneme conversion: The
basis of reading disability? International Journal of Neuroscience, 20,
Gur, R.E. (1978) Left hemisphere dysfunction and left hemisphere
overactivation in schizophrenia. Journal of Abnormal Psychology, 87,
Gur, R. E., & Gur, R. C. (1975). Defense mechanisms, psychosomatic
symptomatology, and conjugate lateral eye movements. Journal of Consulting
and Clinical Psychology, 43, 416-420.
Gur, R.E., Gur, R.C., & Harris (1975) Cerebral activation, as measured by
subjects' lateral eye movements is influenced by experimenter location.
Neuropsychologia, 13, 35-44. Gur, R.C.,
Packer, I, Hungerbuhler, J., Reivich, M., Obrist, W., & Amarner, W.(1980)
Differences in the ion of grey and white matter in the human cerebral
cortex. Science, 207, 1226-128.
Huang, M. S., & Byrne, B. (1978). Cognitive style and lateral eye
movements. British Journal of Psychology, 69, 85-90.
Hugdahl, K., & Carlgren, H. E. (1981). Hemispheric asymmetry as indexed by
differences in direction of initial conjugate lateral eye movements (CLEMS)
in response to verbal, spatial, and emotional tasks. Journal of Mind and
Behavior 2, 259-270.
Jamieson, J. L., & Sellick, T. B. (1985) Effects of subject-to-
experimenter distance and instructions on lateral eye movement. Perceptual
and Motor Skills, 60, 155-159.
Kaliski, M., Zenhausern, R., Andrews, R. (1989) The direct access method of
teaching reading and the diagnosis and remediation of reading disability.
International Journal of Neuroscience, 44, 103-109.
Kinsbourne, M. (1972) Eye and head turning indicate cerebral
lateralization. Science, 176, 539-541.
Kinsbourne, M., & Warrington, E. (1963) Developmental factors in reading
and writing backwardness. British Journal of Psychology, 54, 145-156.
Krikorian, R., & Rafales, L. (1983). Emotional stimulation, defensive
orientation, and hemispheric activation. Brain and Cognition, 1, 371-380.
Leboeuf, A., McKay, P., & Clarke, K. (1983). Lateral eye movements and
dream recall in males: a reappraisal. Imagination, Cognition, and
Personality, 3, 61-68.
Lenhart, R. E. (1985) The effects of distance between interactants and
subject anxiety on conjugate lateral eye movements. Brain and Cognition,
4(3), 328-337.
Levy, J. (1974) Psychobiological implications of bilateral asymmetry. In S.
Dimond & J. Beaumont (Eds.) Hemispheric function and the human brain. New
York: Wiley
Markman, S. & Zenhausern, R. (1988) The interaction of hemispheric related
strategies and individual differences in learning. International Journal of
Neuroscience, 43, 165-170.
Mattis, S., French, J., & Rapin, I. (1975) Dyslexia in children and young
adults: three independent neuropsychological syndromes. Developmental
Medicine and Child Neurology, 17, 150-163
Maxwell, M. & Zenhausern, R. (1983) Teaching reading to disabled readers by
eliminating the necessity for grapheme to phoneme conversion. Paper
presented at the Eastern Psychological Association, Philadelphia.
Minardi, A., Zenhausern, R., & Maxwell, M. (1984) The remediation of
reading disability: a new approach. Paper presented at the International
Neuropsychology Convention, Houston.
Oexle, J. & Zenhausern, R. (1981) Differential hemispheric activation in
good and poor readers. International Journal of Neuroscience, 15, 31-36.
Ogorman, J. & Siddle, D. (1981). The effects of question type and
experimenter position on bilateral differences in electrodermal activity
and conjugate lateral eye movements. Acta Psychologica, 49, 43-51.
Owens, W., & Limber, J. (1983). Lateral eye movement as a measure of
cognitive ability and style. Perceptual and Motor Skills, 56, 711-719.
Parrott, C. A. (1983). Personality characteristics associated with lateral
eye movement patterns. Perceptual and Motor Skills, 58, 867-874.
Paivio, A., Yuille, J., & Madigan, S. (1968) Concreteness, imagery and
meaningfulness values for 925 nouns. Journal of Experimental Psychology
Monographs, 76, (1 pt. 2).
Petroskas, R. & Rourke, B. (1979) Identification of subtypes of retarded
readers: A neuropsychological, multivariate approach. Journal of Clinical
Neuropsychology, 1, 17-37.
Pirozzolo, F. (1979) The neuropsychology of developmental reading
disorders. New York: Praeger.
Schwartz, G., Davidson, R., & Maer, F. (1977). Right Hemisphere
Lateralization for Emotion in the Human Brain: Interactions with cognition.
Science, 190, 286-288.
Schweitzer, L. (1979). Differences of cerebral lateralization among
schizophrenic and depressed patients. Biological Psychiatry, 14, 721-733.
Smokler, I. A., & Shevrin, H. (1979). Cerebral lateralization and
personality style. Archives of General Psychiatry, 36, 949-954.
Swinnen, S. (1984). Some evidence for the hemispheric asymmetry model of
lateral eye movements. Perceptual and Motor Skills, 58, 79-88.
Thompson, M., Greenberg, R. P., & Fisher, S. (1982). Defense mechanisms,
somatic symptoms, and lateral eye movements in females. Perceptual and
Motor Skills, 55, 939-942.
Tucker, D. M., Antes, J. R., Stenslie, C. E., & Barnhardt, T. M. (1978).
Anxiety and lateral cerebral function. Journal of Abnormal Psychology, 87,
Tucker, G. H., & Suib, M. R. (1978). Conjugate lateral eye movement (CLEM)
direction and its relationship to performance on verbal and visuospatial
tasks. Neuropsychologica, 16, 251-254
Tucker, D. (1981) Lateral brain function, emotion, and conceptualization.
Psychological Bulletin, 89, 19-46.
Van Nuys, D. (1985) Lateral eye movement and dream recall: II sex
differences and handedness. International Journal of Psychosomatics, 31,
Weiten, W., & Etaugh, C. F. (1974) Lateral eye movement as related to
verbal and perceptual-motor skills and values. Perceptual and Motor Skills,
36, 423-428.
Zenhausern, R. (1978) Imagery, cerebral dominance, and style of thinking: A
unified field model. Bulletin of the Psychonomic Society, 12, 381-384.
Zenhausern, R. (1982) Rights and lefts and how they learn. Early Years, 12,
Zenhausern, R. (1983) Lateralized presentation and hemispheric integration.
American Psychologist, 38.
Zenhausern, R. (1987) The relationship of reading disability and the
techniques of teaching reading. International Journal of Neuroscience, 34,
Zenhausern, R. (1988) Eyes Right. Teaching K through 8, 23, 76-78.
Zenhausern, R. & Dunivin, D. (1981) Differential hemispheric activation and
handedness and hysterical and obsessive personality styles. Bulletin of the
Psychonomic Society, 17, 23-25.
Zenhausern, R., & Dunn, R. (1984) How brainy are you about the brain? Early
Years, 15, 46-49.
Zenhausern, R., Dunn, R., Cavanaugh, D. & Eberle, B. (1981) Do right and
left brained students learn differently. Roeper Review, 4, 35-39.
Zenhausern, R. & Nickel, M. (1978) Hemispheric dominance in recall and
recognition. Bulletin of the Psychonomic Society, 13, 50-54.
Zenhausern, R. & Gebhard, M. (1979) Hemispheric dominance in recall and
recognition. Bulletin of the Psychonomic Society, 14, 71-73.
Zenhausern, R., Notaro, J. Grosso, J. & Schiano, P. (1980) The interaction
of hemispheric preference, laterality, and sex in the perception of
emotional tone and verbal content. International Journal of Neuroscience,
13, 121-126.
Zenhausern, R. & Parisi, I. (1981) Brain dis-integration in psychosis.
Paper presented at International Neuropsychology Society, Atlanta.
Zenhausern, R. & Sinatra, R.(1983) The rapid identification of poor readers
with a grapheme to phoneme deficit. Eastern Psychological Association,