UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Experimental investigation into reading ability in relation to reversal errors in spelling and the Gerstmann… Howorth, Anne Elizabeth 1970

Your browser doesn't seem to have a PDF viewer, please download the PDF to view this item.

Notice for Google Chrome users:
If you are having trouble viewing or searching the PDF with Google Chrome, please download it here instead.

Item Metadata

Download

Media
831-UBC_1970_A8 H68.pdf [ 6.75MB ]
Metadata
JSON: 831-1.0104115.json
JSON-LD: 831-1.0104115-ld.json
RDF/XML (Pretty): 831-1.0104115-rdf.xml
RDF/JSON: 831-1.0104115-rdf.json
Turtle: 831-1.0104115-turtle.txt
N-Triples: 831-1.0104115-rdf-ntriples.txt
Original Record: 831-1.0104115-source.json
Full Text
831-1.0104115-fulltext.txt
Citation
831-1.0104115.ris

Full Text

AN EXPERIMENTAL INVESTIGATION INTO READING A B I L I T Y IN RELATION TO REVERSAL ERRORS IN SPELLING AND THE GERSTMANN SYNDROME by Anne E . Howorth .H.E., The U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1952 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF M a s t e r o f A r t s i n E d u c a t i o n i n t h e F a c u l t y o f E d u c a t i o n We a c c e p t t h i s t h e s i s as c o n f o r m i n g t o t h e r e q u i r e d s t a n d a r d THE UNIVERSITY OF A p r i l , BRITISH COLUMBIA 1970 In p r e s e n t i n g t h i s t h e s i s in p a r t i a l f u l f i l m e n t o f the r e q u i r e m e n t s f o r an advanced degree at the U n i v e r s i t y o f B r i t i s h Co lumb ia , I a g ree t h a t the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e and s tudy . I f u r t h e r agree tha p e r m i s s i o n f o r e x t e n s i v e c o p y i n g o f t h i s t h e s i s f o r s c h o l a r l y purposes may be g r a n t e d by the Head o f my Department o r by h i s r e p r e s e n t a t i v e s . It i s u n d e r s t o o d t h a t c o p y i n g o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l not be a l l o w e d w i t h o u t my w r i t t e n p e r m i s s i o n . Department o f The U n i v e r s i t y o f B r i t i s h Co lumbia Vancouver 8, Canada ABSTRACT The r e l a t i o n s h i p between r e a d i n g and s p e l l i n g a b i l i t y and t h e f o u r symptoms o f t h e Gers tmann syndrome was s t u d i e d . A s p e l l i n g t e s t was c o n s t r u c t e d t o measure t h e t e n d e n c y o f f i f t h g r a d e c h i l d r e n t o make k i n e t i c and s t a t i c r e v e r s a l e r r o r s i n s p e l l i n g . The s p e l l i n g t e s t was a d m i n i s t e r e d t o 343 g r a d e f i v e c h i l d r e n i n R i c h m o n d , B . C . The r e a d i n g a c h i e v e m e n t l e v e l f o r each c h i l d was o b t a i n e d f rom t h e r e a d i n g s c o r e s on t h e S t a n f o r d A c h i e v e m e n t T e s t . The c h i l d r e n were d i v i d e d i n t o f o u r g roups on t h e b a s i s o f r e a d i n g a c h i e v e m e n t s c o r e s above and b e l o w 4 .0 and t h e p r e s e n c e o r absence o f r e v e r s a l e r r o r s i n s p e l l i n g . N i n e t y c h i l d r e n , ' s e l e c t e d a t random f rom t h r e e g r o u p s , and s e v e n c h i l d r e n , who c o m p r i s e d t h e f o u r t h g r o u p , were t e s t e d f o r t h e f o u r symptoms o f t h e Gers tmann syndrome. The t e s t s u sed t o d e t e r m i n e t h e p r e s e n c e o r absence o f each symptom w e r e : (1) d i s o r i e n t a t i o n f o r r i g h t and l e f t - e i g h t d i r e c t i o n a l commands, (2) f i n g e r a g n o s i a - K i n s b o u r n e and W a r r i n g t o n ' s t e s t f o r f i n g e r d i f f e r e n t i a t i o n , (3) d y s c a l c u l i a - an a r i t h m e t i c t e s t t o d e t e r m i n e a b i l i t y i n w r i t i n g numbers c o r r e c t l y and c o m p u t i n g a c c u r a t e l y , p l u s c o n f i r m a t i o n o f t h e l a t t e r s k i l l by t h e a r i t h m e t i c a c h i e v e m e n t s c o r e on t h e S t a n f o r d A c h i e v e m e n t T e s t , and (4) d y s g r a p h i a - M y k l e b u s t f s P i c t u r e S t o r y Language T e s t . A s t a t i s t i c a l analysis of the data by the chi-square method indicated a s i g n i f i c a n t r e l a t i o n s h i p , at the.grade f i v e l e v e l , between reading retardation one or more years below grade placement, reversal errors i n s p e l l i n g , and the concomitant presence of two or more symptoms of the Gerstmann syndrome. V i v TABLE OF CONTENTS Page A b s t r a c t . . • i i T a b l e o f C o n t e n t s i v L i s t o f T a b l e s • • • v i i L i s t o f F i g u r e s v i i i CHAPTER I . NATURE AND PURPOSE OF THE STUDY. 1 I n t r o d u c t i o n 1 The P r o b l e m 4 D e l i m i t a t i o n s 5 D e f i n i t i o n o f T e r m s . ' 5 S u b j e c t s 6 Sample 6 T e s t i n g 7 Need i n t h e S t u d y . 7 P r o c e d u r e s 10 C o n s t r u c t i o n and A d m i n i s t r a t i o n o f t h e S p e l l i n g T e s t 10 A d d i t i o n a l D a t a C o l l e c t e d . 11 G r o u p i n g o f . S u b j e c t s 11 I n d i v i d u a l T e s t i n g f o r t h e Gers tmann Syndrome 12 T r e a t m e n t o f t h e D a t a 13-' Summary. 14 I I . RELATED RESEARCH 16 H i s t o r i c a l B a c k g r o u n d 16 A l t e r n a t e P r o p o s a l U n d e r l y i n g a R e a d i n g D i s a b i l i t y . 30 V CHAPTER Page I I . ( C o n t i n u e d ) The Gers tmann Syndrome . . 31 R e l a t e d S t u d i e s . 33 Summary 44 I I I . DEVELOPMENT AND ADMINISTRATION OF THE INSTRUMENTS 46 The S p e l l i n g T e s t 46 C o n s t r u c t i o n o f t h e S p e l l i n g T e s t . . . . . . 47 A d m i n i s t r a t i o n o f t h e S p e l l i n g T e s t . . . . . . 49 S c o r i n g o f t h e S p e l l i n g T e s t . . . . . . . . . 50 G r o u p i n g and S e l e c t i o n o f C h i l d r e n t o be T e s t e d f o r t h e Gers tmann Syndrome. , . . . . . 51 G r o u p i n g o f t h e C h i l d r e n 51 S e l e c t i o n o f C h i l d r e n t o be T e s t e d for.. t h e Ger s tmann Syndrome . . . . . . 52 T e s t i n g f o r t h e Gers tmann Syndrome 53 S e l e c t i o n o f T e s t s 53 A d m i n i s t r a t i o n o f t h e T e s t s . . . . . . . . . . 56 S c o r i n g o f t h e T e s t s . . . 61 T r e a t m e n t o f t h e D a t a 62 Summary . . . . 63 I V . PRESENTATION AND INTERPRETATION OF THE DATA. . . 65 P a r t A - R e l a t i o n s h i p o f R e a d i n g and R e v e r s a l s i n S p e l l i n g 65 P a r t B - I n d i v i d u a l Gers tmann Symptoms i n R e l a t i o n t o Group M e m b e r s h i p , R e a d i n g A b i l i t y , S p e l l i n g A b i l i t y , Number o f v i CHAPTER Page I V . ( C o n t i n u e d ) R e v e r s a l E r r o r s , A d d i t i o n a l V a r i a b l e s , and C l u s t e r i n g o f Symptoms by G r o u p . . . . . 71 I n d i v i d u a l Symptoms and A d d i t i o n a l V a r i a b l e s . 80 C l u s t e r i n g o f Ger s tmann Symptoms by Group . . . . . . . . . 82 P a r t C - D i s c u s s i o n and I n t e r p r e t a t i o n . . . . 88 Summary 92 V . SUMMARY, FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS 95 The P r o b l e m 96 P r o c e d u r e s . 97 C o n s t r u c t i o n and A d m i n i s t r a t i o n o f t h e S p e l l i n g T e s t . . • 97 S e l e c t i o n o f C h i l d r e n t o be T e s t e d f o r t h e Gers tmann Syndrome 98 T e s t i n g f o r t h e Gers tmann Syndrome 99 T r e a t m e n t o f t h e D a t a . 101 F i n d i n g s and C o n c l u s i o n s 101 Recommendat ions . . . . . . . . 105 BIBLIOGRAPHY . . . . . 109 APPENDICES - 116 A . The S p e l l i n g T e s t 116 B . F i n g e r D i f f e r e n t i a t i o n T e s t 117 C . T e s t f o r R i g h t - L e f t O r i e n t a t i o n and F i n g e r A g n o s i a . 119 D . A r i t h m e t i c T e s t . . 121 E . R e p r i n t o f P i c u t r e u sed i n M y k l e b u s t ' s P i c t u r e S t o r y Language T e s t 122 F . R e c o r d S h e e t . . . . . . " . . ,: " . 123 G . M a r g i n a l T o t a l s f o r C h i - s q u a r e C a l c u l a t i o n s . Shown i n T a b l e s I V , V , V I , and V I I I . . . . . 124 v i i L I S T OF TABLES TABLE Page I . D i v i s i o n o f C h i l d r e n i n t h e T o t a l Sample on t h e B a s i s o f S p e l l i n g and R e a d i n g A b i l i t y . . . . 66 I I . R e v e r s a l E r r o r s i n S p e l l i n g i n R e l a t i o n t o R e a d i n g A b i l i t y . . . . . . . . 68 I I I . C h i l d r e n i n Each Group T e s t i n g P o s i t i v e l y forr_^ E a c h Ger s tmann Symptom by Number and by P e r : c e n t . 72 I V . D i f f e r e n c e Between Groups 1 and 4 , 1 and 2 and 2 and 4 f o r t h e P r e s e n c e o f E a c h Gers tmann Symptom . . . . . . . • 73 V . D i f f e r e n c e Between R e v e r s a l and N o n - R e v e r s a l Groups f o r t h e P r e s e n c e o f Each Gers tmann Symptom . 75 V I . D i f f e r e n c e Between P o o r and B e t t e r Readers f o r t h e P r e s e n c e o f E a c h Ger s tmann Symptom. . . . 76 V I I . Number o f C h i l d r e n i n Groups 1 and 2 T e s t i n g P o s i t i v e l y f o r E a c h Symptom i n t h e Gers tmann Syndrome i n R e l a t i o n t o t h e Number o f R e v e r s a l E r r o r s made i n S p e l l i n g 78 V I I I . R e l a t i o n s h i p o f E a c h Ger s tmann Symptom t o Sex and t o C h r o n o l o g i c a l Age .' 81 I X . P e r c e n t a g e o f C h i l d r e n W i t h i n Each G r o u p * D e m o n s t r a t i n g V a r i o u s C l u s t e r s o f t h e Gers tmann Symptoms. . . . . . . . . . . 87 / v i i i L I S T OF FIGURES FIGURE Page 1. P e r c e n t a g e o f C h i l d r e n i n Each R e a d i n g A c h i e v e m e n t L e v e l M a k i n g R e v e r s a l E r r o r s i n S p e l l i n g . 70 2 . D i f f e r e n t C l u s t e r s by t h e Gers tmann Symptoms as D e m o n s t r a t e d by V a r i o u s Number o f C h i l d r e n i n E a c h Group . 83 3 . Number o f C h i l d r e n T e s t i n g P o s i t i v e f o r None , One , C o m b i n a t i o n s o f Two and T h r e e , and A l l F o u r o f t h e Gers tmann Symptoms by Group . . . 85 CHAPTER I NATURE AND PURPOSE OF THE STUDY INTRODUCTION Ov e r t h e p a s t s i x t y y e a r s , r e s e a r c h i n r e a d i n g has examined t h e c a u s a l f a c t o r s o f r e a d i n g r e t a r d a t i o n . Of t h e s e , c e r t a i n v i s u a l , a u d i t o r y , e m o t i o n a l , o r e n v i r o n m e n t a l f a c t o r s have b e e n f o u n d t o r e l a t e t o r e a d i n g d i f f i c u l t y . When t h e o v e r t s i g n s o f t h e s e f a c t o r s a r e n o t p r e s e n t , d i a g n o s i n g t h e c a u s e o f r e a d i n g r e t a r d a t i o n becomes more, complex. Some p s y c h o l o g i s t s t o d a y b e l i e v e t h a t t h i s d i f f i c u l t y i n l e a r n i n g t o r e a d a r i s e s f r o m a p r i m a r y o f endogenous n e u r o l o g i c a l c o n -d i t i o n w h i c h c a n n o t be a s c r i b e d t o any known damage i n t h e c e n t r a l n e r v o u s system."^" R e c e n t l y t h e t r e n d i n d i a g n o s i n g r e a d i n g r e t a r d a t i o n 2 3 has b e e n t o l o o k f o r c o r r e l a t e s o r c l u s t e r s o f symptoms R a l p h D. R a b i n o v i t c h , " R e a d i n g P r o b l e m s i n C h i l d r e n : D e f i n i t i o n s and C l a s s i f i c a t i o n , " i n D y s l e x i a : " D i a g n o s i s a n d  T r e a t m e n t o f R e a d i n g D i s o r d e r s , e d . A r t h u r K. Keeney and" V i r g i n i a T. Keeney Tst. L o u i s : The C.V. -Mosby Company, 19 6 8 ) , p . 5. 2 C o r i n e K a s s , "Some P s y c h o l o g i c a l C o r r e l a t e s o f S e v e r e R e a d i n g D i s a b i l i t y ( D y s l e x i a ) , " i n S e l e c t e d S t u d i e s on t h e  I l l i n o i s T e s t o f P s y c h o l i h g u i s t i c A b i l i t y ( U r b a na, I l l i n o i s : I n s t i t u t e f o r R e s e a r c h on E x c e p t i o n a l C h i l d r e n , U n i v e r s i t y o f I l l i n o i s , 1 9 6 3 ) , pp. 87-96. 3 A r c h i e A. S i l v e r and Rosa H a g i n , " S p e c i f i c R e a d i n g D i s a b i l i t y : D e l i n a t i o n o f t h e Syndrome- and R e l a t i o n s h i p t o C e r e b r a l Dominance," C o m p r e h e n s i v e P s y c h i a t r y , 1:126-134, 1960. 2 w h i c h p o i n t t o an u n d e r l y i n g n e u r o l o g i c a l b a s i s f o r t h e p r o -b l e m . However, t e s t i n g c h i l d r e n w i t h a r e a d i n g p r o b l e m b a s e d on c l u s t e r s o f symptoms becomes t i m e c o n s u m i n g and o f t e n r e -q u i r e s a b a t t e r y o f t e s t s a d m i n i s t e r e d by s p e c i a l l y t r a i n e d p e r s o n n e l . F o r t h e c l a s s r o o m t e a c h e r , a more d i r e c t method o f a s s e s s i n g a r e a d i n g p r o b l e m o f n e u r o l o g i c a l o r i g i n may be p r o v i d e d by t h e i d e n t i f i c a t i o n o f t h e f o u r symptoms o f t h e 4 G e r s t m a n n syndrome. Hermann has s u g g e s t e d t h a t c h i l d r e n who, f o r no a p p a r e n t r e a s o n , e x p e r i e n c e d i f f i c u l t y i n l e a r n i n g t o r e a d have a " h e r e -5 d i t a r y G e r s t m a n n syndrome." The f o u r symptoms o f t h i s syndrome: a d i s o r i e n t a t i o n f o r r i g h t and l e f t , f i n g e r a g n o s i a , d y s c a l c u l i a , and d y s g r a p h i a , a r e e x h i b i t e d by a d u l t s who s u f f e r a l e s i o n i n t h e p a r i e t o - o c c i p i t a l r e g i o n o f t h e d o m i n a n t h e m i s -p h e r e . The c o m b i n a t i o n o f symptoms known as t h e G e r s t m a n n syndrome e x h i b i t e d by some a d u l t s i s s i m i l a r t o t h e symptoms e x h i b i t e d by some c h i l d r e n w i t h l e a r n i n g , d i f f i c u l t i e s . The s i m i l a r i t y o f symptoms s u g g e s t s an u n d e r l y i n g r e l a t i o n s h i p o f n e u r o l o g i c a l o r i g i n . I n h i s s t u d y o f - c h i l d r e n w i t h a " r e a d i n g d i s a b i l i t y " Hermann f o u n d , i n a d d i t i o n t o t h e f o u r G e r s t m a n n symptoms, J o s e f G e r s t m a n n , "Syndrome o f F i n g e r A g n o s i a , D i s o r i e n -t a t i o n , f o r R i g h t and L e f t , A g r a p h i a , and A c a l c u l i a , " A r c h i v e s  o f N e u r o l o g y and P s y c h i a t r y , 39:398-408, 1940. 5 Knud Hermann and E d i t h N o m e , " I s C o n g e n i t a l Word-B l i n d n e s s a H e r e d i t a r y Type o f Gerstmann's Syndrome,", P s y c h i a t r i a and N e u r o l o g i a , 136:59-73, 1958. 3 d i s t u r b a n c e s i n d i r e c t i o n a l o r i e n t a t i o n t o m u s i c a l n o t a t i o n , t o .'Morse c o d e , i n t h e use o f t h e compass , and i n s p e l l i n g . D i r e c t i o n a l d i s t u r b a n c e s i n s p e l l i n g i n v o l v e d s t a t i \ C r e v e r s a l s ( "b" f o r "d " ) and k i n e t i c r e v e r s a l s ( "Londno" f o r " L o n d o n " ) . These s p e l l i n g e r r o r s were n o t d i f f e r e n t f rom t h o s e made by " n o r m a l " c h i l d r e n , b u t p e r s i s t e d l o n g e r and were more d i f f i c u l t t o c o r r e c t i n c h i l d r e n w i t h a " r e a d i n g d i s a b i l i t y . " He c o n -c l u d e d t h a t t h e d i f f i c u l t y t h e s e c h i l d r e n e x p e r i e n c e i n r e a d i n g , w r i t i n g , and s p e l l i n g " . . . may a l l be t r a c e d t o a d i s t u r b a n c e o f t h e m e n t a l f u n c t i o n : d i r e c t i o n i n s p a c e . " R e v e r s a l e r r o r s i n s p e l l i n g have been a s s o c i a t e d i n t h e p a s t w i t h r e a d i n g p r o b l e m s . O r t o n n o t e d a r e l a t i o n s h i p between r e v e r s a l e r r o r s i n s p e l l i n g and a r e a d i n g p r o b l e m . He s u g g e s t e d c l e a r c u t c e r e b r a l dominance f o r l anguage had n o t y e t been e s -7 t a b l i s h e d i n c h i l d r e n who m a n i f e s t e d t h e s e two symptoms. . However , r e s e a r c h r e l a t e d t o O r t o n ' s t h e o r y has n o t c o n s i s t e n t l y s u p p o r t e d h i s p o s i t i o n . C e r e b r a l dominance as t h e u n d e r l y i n g cause o f r e v e r s a l e r r o r s i n s p e l l i n g and r e a d i n g p r o b l e m s r e m a i n s a c o n t r o v e r s i a l s u b j e c t . I f t h e f o u r symptoms o f t h e Ger s tmann syndrome, were f o u n d more f r e q u e n t l y when b o t h f a c t o r s , r e v e r s a l e r r o r s i n s p e l l i n g and a r e a d i n g p r o b l e m were p r e s e n t , t h a n when o n l y one 6 I b i d . 7 Samuel T . O r t o n , " ' W o r d - B l m d e s s ' i n S c h o o l C h i l d r e n , " A r c h i v e s o f N e u r o l o g y and P s y c h i a t r y , 1 4 : 5 8 1 - 6 1 5 , 1925 . 4 or none of these f a c t o r s was p r e s e n t , a simple, d i a g n o s t i c procedure f o r i d e n t i f y i n g a c h i l d with a "reading d i s a b i l i t y " would be a v a i l a b l e to the s c h o o l s . For these reasons the f o l l o w i n g study was proposed. THE PROBLEM T h i s study sought to e s t a b l i s h the r e l a t i o n s h i p between r e a d i n g a b i l i t y , r e v e r s a l e r r o r s i n s p e l l i n g , and the symptoms of the Gerstmann syndrome i n c h i l d r e n a t the grade f i v e l e v e l . I t attempted to answer the f o l l o w i n g q u e s t i o n s : 1. For c h i l d r e n a t the grade f i v e l e v e l what • r e l a t i o n s h i p e x i s t s between r e v e r s a l e r r o r s i n s p e l l i n g ( s t a t i c and k i n e t i c ) and r e a d i n g a b i l i t y ? 1.1 What percentage of c h i l d r e n who make these e r r o r s have a r e a d i n g problem? 1.2 Of the c h i l d r e n with a r e a d i n g problem what numerical r e c u r r e n c e of r e v e r s a l e r r o r s might.be i n d i c a t i v e of a "reading d i s a b i l i t y " ? 2. What r e l a t i o n s h i p e x i s t s between r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g a b i l i t y , and the Gerstmann syndrome? 2.1 How f r e q u e n t l y are the f o u r symptoms of the syndrome found i n r e l a t i o n to r e v e r s a l e r r o r s i n s p e l l i n g and a r e a d i n g problem? 5 2.2 What c l u s t e r i n g o f symptoms w o u l d be s i g n i f i c a n t i n i d e n t i f y i n g a " r e a d i n g d i s a b i l i t y " a t t h i s g rade l e v e l ? 3. To what e x t e n t m i g h t t h e f o u r Gers tmann symptoms be r e l a t e d t o t h e v a r i a b l e s o f sex and c h r o n o -l o g i c a l age? DELIMITATIONS D e f i n i t i o n o f Terms . F o r t h e p u r p o s e s o f t h i s s t u d y t h e f o l l o w i n g terms were i n t e r p r e t e d as m e a n i n g : Read ing , P r o b l e m . - A r e a d i n g p r o b l e m was d e f i n e d as t h e r e t a r d a t i o n i n r e a d i n g a b i l i t y one f u l l y e a r o r more b e l o w grade p l a c e m e n t . R e a d i n g D i s a b i l i t y . A r e a d i n g d i s a b i l i t y was d e f i n e d as n e u r o l o g i c a l i n o r i g i n b u t n o t r e l a t e d t o c e r e b r a l damage. Gers tmann Syndrome. The f o u r " m a j o r symptoms o f t h e g Gers tmann syndrome were d e f i n e d as f o l l o w s : 1. D i s o r i e n t a t i o n f o r r i g h t and l e f t was a c o n f u s i o n o f r i g h t and l e f t t o t h e p e r s o n ' s own body a n d / o r t o t h a t o f a n o t h e r p e r s o n . 2. F i n g e r a g n o s i a was an i n a b i l i t y t o d e t e r m i n e w h i c h f i n g e r s were t o u c h e d on e i t h e r hand w i t h p a r t i c u l a r emphas i s on t h e m i d d l e t h r e e f i n g e r s . G e r s t m a n n / l o c . c i t . 6 3. Dysgraphia was a d i f f i c u l t y i n expressing ideas i n writing as r e f l e c t e d by a limited output. 4. Dyscalculia was a d i f f i c u l t y i n writing numbers cor r e c t l y and/or i n cal c u l a t i n g accurately. Reversal Errors i n Spe l l i n g . This term defined s p e l l i n g errors of both s t a t i c reversals ("doy" for "boy", "mouth" for "month") and k i n e t i c reversals ( " g r i l " for " g i r l " , "panio" for "piano"). Subjects The subjects were grade f i v e children from f i v e elemen-' tary schools i n Richmond School D i s t r i c t , B r i t i s h Columbia. Children, who had a known physical (sight, hearing, or motor d i s a b i l i t y which had not been corrected), emotional or neuro-l o g i c a l condition (suspected or known to have brain damage) were eliminated from the tes t r e s u l t s . Children who were re-cent immigrants were also excluded. Sample Permission was given by the Richmond School Board to test the grade f i v e students i n f i v e elementary schools. The 46 8 children i n the f i v e elementary schools selected repre-sented a socio-economic l e v e l ranging from below average to 9 above average as defined by B e l l . L.I. B e l l , Metropolitan Vancouver . . . An Overview for  Soci a l Planners ( B r i t i s h Columbia: Community Chest and Councils of the Greater Vancouver Area, 1966), p. 7. 7 T e s t i n g The r e a d i n g and a r i t h m e t i c a c h i e v e m e n t l e v e l s o f each c h i l d were d e t e r m i n e d f rom h i s s c o r e s on t h e S t a n f o r d A c h i e v e -ment T e s t (Form W I n t e r m e d i a t e B a t t e r y ) a d m i n i s t e r e d a t t h e end o f g r a d e f o u r . " ' " 0 The c h r o n o l o g i c a l age o f each c h i l d was o b t a i n e d f rom t h e i n d i v i d u a l p r o g r e s s r e c o r d c a r d s . NEED OF THE STUDY One o f t h e m a j o r r e s p o n s i b i l i t i e s o f t h e e l e m e n t a r y s c h o o l i s r e a d i n g i n s t r u c t i o n . However , changes i n t e a c h i n g m e t h o d s , and i n r e a d i n g programs have n o t e l i m i n a t e d t h e p r o -b l e m o f c h i l d r e n who f a i l t o r e a d a t g r a d e p l a c e m e n t . T o d a y , some c h i l d r e n s t i l l e x p e r i e n c e d i f f i c u l t y i n l e a r n i n g t o r e a d . Awareness o f t h e many causes w h i c h c o n t r i b u t e t o r e a d i n g f a i l u r e has e n c o u r a g e d t h e s c h o o l s t o i n s t i t u t e s p e c i a l programs t o h e l p c h i l d r e n w i t h l e a r n i n g d i f f i c u l t i e s . I f a c h i l d has v i s u a l a n o m a l i e s , a h e a r i n g d e f i c i t , o r a speech p r o b l e m t e a c h e r s a r e a l e r t e d t o t h e s e c o n d i t i o n s , p a r e n t s a r e i n f o r m e d , and t h e c h i l d i s r e f e r r e d t o a s p e c i a l i s t f o r a S t a n f o r d A c h i e v e m e n t T e s t , Form W I n t e r m e d i a t e B a t t e r y , (New Y o r k ! H a r c o u r t , B r a c e , and W o r l d I n c o r p o r a t e d , 1964) . "'""'"John Money, e d . , The D i s a b l e d Reader ( B a l t i m o r e : J o h n H o p k i n s P r e s s , 1 9 6 6 ) . 8 more c o m p l e t e d i a g n o s i s . H i s d i s a b i l i t y i s r e c o g n i z e d and he i s h e l p e d t o overcome i t by a p r e s c r i b e d c o r r e c t i v e d e v i c e o r by s p e c i a l i n s t r u c t i o n . I f e m o t i o n a l o r s o c i a l m a l a d j u s t m e n t appear s t o be t h e c a u s e , t h e t e a c h e r , o t h e r t r a i n e d p e r s o n n e l , and t h e p a r e n t s work t o g e t h e r t o e f f e c t more adequate a d j u s t -m e n t . C h i l d r e n whose b a c k g r o u n d i s c u l t u r a l l y d i f f e r e n t a r e h e l p e d t o " c a t c h u p " t h r o u g h s p e c i a l programs p r o v i d e d f o r them. When n o n e , o f t h e s e f a c t o r s i s a p p a r e n t i n c o n t r i b u t i n g t o t h e c h i l d ' s r e a d i n g p r o b l e m s p e c i a l h e l p f rom t h e s c h o o l s i s n o t a l w a y s a v a i l a b l e . F r e q u e n t l y , c h i l d r e n w i t h a s p e c i a l t y p e o f r e a d i n g p r o b l e m s t r u g g l e a l o n g a t . t h e b o t t o m o f t h e i r c l a s s , b e i n g a c c u s e d o f c a r e l e s s n e s s , i n a t t e n t i o n , o r l a c k o f e f f o r t . O f t e n t h e y d e v e l o p i n t o d i s c i p l i n e problems- because t h e f r u s -t r a t i o n o f t r y i n g t o cope w i t h an u n t e n a b l e l e a r n i n g s i t u a t i o n 12 becomes t o o g r e a t . The c h i l d r e n h a v i n g t h e most d i f f i c u l t y w i t h r e a d i n g may be s i n g l e d o u t f o r r e m e d i a l i n s t r u c t i o n , i f i t i s a v a i l a b l e , b u t u s u a l l y t h e s e c h i l d r e n a r e e i t h e r p r o -moted i n t h e hope t h a t t h e d i f f i c u l t y w i l l ou tg row i t s e l f n a t u r a l l y o r t h e y r e p e a t t h e g r a d e i n t h e h o p e . t h a t a s econd y e a r i n t h e same g r a d e may p r o v e b e n e f i c i a l i n a l l o w i n g them a chance t o c a t c h u p . These c h i l d r e n do n o t u n d e r s t a n d why t h e y f i n d r e a d i n g so d i f f i c u l t and n e i t h e r do t h e i r p a r e n t s o r t e a c h e r s . Because t h e i r p r o b l e m i s so b a f f l i n g , t h e 12 Samuel T . O r t o n , " A n Impediment t o L e a r n i n g t o Read -a N e u r o l o g i c a l E x p l a n a t i o n o f t h e R e a d i n g D i s a b i l i t y , " S c h o o l  and S o c i e t y , 2 8 : 2 8 6 - 2 9 0 , 1928 . 9 p r o v i s i o n made f o r them by the schools can be l e s s than ade-quate. The percentage of read i n g problems which are thought t o be n e u r o l o g i c a l i n o r i g i n v a r i e s depending on the d e f i n i t i o n 13 of the term "reading d i s a b i l i t y " . As w e l l , the exact nature of or reason f o r t h i s d i s a b i l i t y i s not understood, but the 14 e x i s t e n c e of such a c o n d i t i o n i s wi d e l y accepted. For the s c h o o l s , a simple, d i a g n o s t i c means of d e t e c t i n g c h i l d r e n with a "reading d i s a b i l i t y " has not been found. Much of the i n f o r -mation on a "reading d i s a b i l i t y , " r e p o r t e d i n the l i t e r a t u r e , comes from s e l e c t e d groups of c h i l d r e n r e f e r r e d t o a c l i n i c because of t h e i r d i s a b i l i t y . To date, a study has not been c a r r i e d out on a group of "normal" c h i l d r e n , which i n c l u d e s both good and poor r e a d e r s , t o determine a more p r e c i s e r e l a -t i o n s h i p between r e a d i n g a b i l i t y , r e v e r s a l e r r o r s i n s p e l l i n g , and a l l f o u r symptoms of the Gerstmann syndrome. I f a combination of the Gerstmann symptoms was found to be a s s o c i a t e d w i t h a r e a d i n g problem and r e v e r s a l e r r o r s i n s p e l l i n g , c h i l d r e n with these n e u r o l o g i c a l symptoms, c o u l d be r e a d i l y i d e n t i f i e d by the classroom teacher. Depending on the 13 L l o y d J . Thompson, Reading D i s a b i l i t y ( S p r i n g f i e l d , I l l i n o i s : C h a r l e s C. Thomas, 1966), pp. x i i - x v i . 14 . ••; . ••" . John Money, ed., Reading D i s a b i l i t y : Progress and Research Needs i n D y s l e x i a (Baltimore: The John Hopkins P r e s s , 1962) . ) 10 s e v e r i t y o f t h e d i s a b i l i t y , a d j u s t m e n t s i n c l a s s r o o m t e a c h i n g p r o c e d u r e s c o u l d t h e n be made o r t h e c h i l d c o u l d be r e f e r r e d f o r s p e c i a l h e l p . U n d e r s t a n d i n g o f t h e c h i l d ' s p r o b l e m by h i s t e a c h e r s , h i s p a r e n t s , and by t h e c h i l d , h i m s e l f , w o u l d do much t o r e l i e v e t h e p r e s s u r e he f e e l s i n t r y i n g t o p e r f o r m a t a l e v e l above h i s i m m e d i a t e c a p a b i l i t i e s . Once t h e cause o f a r e a d i n g p r o b l e m has been e s t a b l i s h e d s c h o o l s w o u l d be i n a b e t t e r p o s i t i o n t o p r e s c r i b e c o r r e c t i v e m e a s u r e s . PROCEDURES The g e n e r a l p r o c e d u r e s f o l l o w e d i n t h e s t u d y were (a) c o n s t r u c t i o n and a d m i n i s t r a t i o n o f a s p e l l i n g t e s t ; (b) c o l l e c -t i o n o f a d d i t i o n a l d a t a f r o m each c h i l d ' s i n d i v i d u a l p r o g r e s s r e c o r d c a r d s ; (c) g r o u p i n g o f t h e s u b j e c t s on t h e b a s i s o f s p e l l i n g and r e a d i n g a b i l i t y ; and (d) i n d i v i d u a l t e s t i n g f o r t h e f o u r symptoms o f t h e Ger s tmann syndrome . , Each o f t h e s e s t e p s w i l l be d i s c u s s e d b r i e f l y . C o n s t r u c t i o n arid A d m i n i s t r a t i o n o f t h e S p e l l i n g T e s t An i n i t i a l s e l e c t i o n o f 200 words w h i c h were c o n s i d e r e d l i k e l y t o cause k i n e t i c and s t a t i c r e v e r s a l e r r o r s i n s p e l l i n g was made f rom D o l c h ' s l i s t o f 2 ,000 Commonest Words f o r 15 S p e l l i n g . Two t e s t s each c o n t a i n i n g f i f t y w o r d s , s e l e c t e d Edward W. D o l c h , B e t t e r S p e l l i n g (Champaign , I l l i n o i s : The G a r r a r P r e s s , 1 9 4 2 ) , p p . 2 5 7 - 2 7 0 . a t random f rom t h e 200 words were c o n s t r u c t e d . Each o f t h e t e s t s was a d m i n i s t e r e d t o a d i f f e r e n t g r o u p o f g r a d e f i v e s t u d e n t s . From t h e two p r e l i m i n a r y s p e l l i n g t e s t s , f o r t y -f o u r words w h i c h had e l i c i t e d s t a t i c and k i n e t i c r e v e r s a l e r r o r s and w h i c h had n o t c a u s e d a d i s p r o p o r t i o n a t e number o f g e n e r a l m i s s p e l l i n g s were c h o s e n f o r t h e f i n a l t e s t . The f o r t y - f o u r words were p a i r e d on t h e b a s i s o f s i m i l a r l e t t e r c o m b i n a t i o n s w i t h i n , t h e w o r d s , and one word i n each p a i r was a s s i g n e d t o t h e f i r s t o r s e c o n d h a l f o f t h e t e s t . The t e s t was t h e n a d m i n i s t e r e d t o a n o t h e r g roup o f g r a d e f i v e s t u d e n t s and a s p l i t - h a l f c o r r e l a t i o n o f r e l i a b i l i t y d e t e r m i n e d . T h i s f i n a l t e s t was a d m i n i s t e r e d by t h e same e x a m i n e r t o 46 8 g r a d e f i v e s t u d e n t s d u r i n g t h e l a t t e r h a l f o f J a n u a r y , 1969 . A d d i t i o n a l D a t a C o l l e c t e d A d d i t i o n a l d a t a c o l l e c t e d f rom t h e I n d i v i d u a l p r o g r e s s r e c o r d c a r d s i n c l u d e d t h e r e a d i n g and a r i t h m e t i c s c o r e s f rom t h e S t a n f o r d A c h i e v e m e n t T e s t and t h e c h r o n o l o g i c a l age o f each c h i l d . G r o u p i n g o f S u b j e c t s Two g roups were formed b a s e d on t h e r e s u l t s o f t h e s p e l l i n g t e s t . One g r o u p c o n s i s t e d o f c h i l d r e n who had made one o r more r e v e r s a l e r r o r s i n s p e l l i n g ; t h e s e c o n d g r o u p c o n -s i s t e d o f c h i l d r e n who had n o t made any r e v e r s a l e r r o r s . A f u r t h e r d i v i s i o n w i t h i n t h e s e two g roups was made ba sed on r e a d i n g a b i l i t y . As t h e S t a n f o r d A c h i e v e m e n t T e s t had been 12 administered at the end of the previous school year, a reading l e v e l of 4.0 or below was used as the div i d i n g point for c h i l -dren reading one or more years below grade placement. This d i v i s i o n resulted i n the following four groups: Group 1 - children who had made reversal errors i n s p e l l i n g and were reading at a grade l e v e l of 4.0 or below. Group 2 - children who had made reversal errors i n s p e l l i n g and were reading at a grade l e v e l of 4.1 or above. Group 3 - children who had made no reversal errors i n s p e l l i n g and were reading at a grade l e v e l of 4.0 or below. Group 4 - children who had made no reversal errors i n s p e l l i n g and were reading at a grade l e v e l of 4.1 or above. Individual Testing for the Gerstmann Syndrome Of the 46 8 children who were tested for s p e l l i n g a b i l i t y , 125 were omitted from the sample as t h e i r progress record cards lacked s u f f i c i e n t data. The remaining 343 children were divided into the four groups based on reading and s p e l l i n g a b i l i t y as indicated above. Thirty were selected at random from each of Groups 1, 2, and 4. As Group 3 contained only seven children, a l l seven were included i n the i n d i v i d u a l t e s t i n g : In t o t a l , ninety-seven children were tested for the four Gerstmann symp-toms i n the l a t t e r half of A p r i l , 1969. To determine the presence or absence of the four symptoms i n the syndrome the following tests were used: (a) di s o r i e n -t a t i o n for r i g h t and l e f t - eight d i r e c t i o n a l commands; 13 (b) f i n g e r a g n o s i a - K i n s b o u r n e and W a r r i n g t o n ' s t e s t f o r 16 f i n g e r d i f f e r e n t i a t i o n ; (c) d y s c a l c u l i a - an a r i t h m e t i c t e s t w h i c h i n c l u d e d e i g h t numbers, r a n g i n g from f o u r t o e i g h t d i g i t s i n l e n g t h , w r i t t e n t o d i c t a t i o n and seven c o m p u t a t i o n a l q u e s t i o n s ; and (d) d y s g r a p h i a - M y k l e b u s t ' s P i c t u r e S t o r y 17 Language T e s t . Treatment o f t h e Data The d a t a f o r t h e t o t a l sample w&re a n a l y s e d f o r t h e p e r -centage o f c h i l d r e n making r e v e r s a l e r r o r s i n s p e l l i n g i n r e l a t i o n t o r e a d i n g a b i l i t y and f o r t h e d i s t r i b u t i o n and f r e -quency o f r e v e r s a l e r r o r s i n r e l a t i o n t o r e a d i n g a b i l i t y . The d a t a f o r t h e n i n e t y - s e v e n c h i l d r e n t e s t e d f o r t h e f o u r symptoms o f t h e Gerstmann syndromewerebanalysed by a c h i - s q u a r e t e s t o f s i g n i f i c a n c e f o r between group d i f f e r e n c e s . The number o f r e v e r s a l e r r o r s , the r e a d i n g and a r i t h m e t i c s c o r e s from t h e S t a n f o r d Achievement T e s t , and the p r e s e n c e o r absence o f each o f t h e f o u r symptoms o f t h e Gerstmann syndrome were t a b u l a t e d f o r each o f the n i n e t y - s e v e n c h i l d r e n . b y group, and t h e d i f f e r -ences between groups f o r t h e pr e s e n c e o f t h e f o u r symptoms c a l c u l a t e d . R e s u l t s were c o n s i d e r e d s i g n i f i c a n t a t t h e .05 M. K i n s b o u r n e and E l i z a b e t h K. W a r r i n g t o n , "The Development o f F i n g e r D i f f e r e n t i a t i o n , " Q u a r t e r l y J o u r n a l o f Experimenta1 P s y c h o l o g y , 15:132-137, 1963. 17 Helmer R. M y k l e b u s t , Development and D i s o r d e r s o f  W r i t t e n Language, v o l . 1 (New York: Grune & S t r a t t o n , 1965), pp. 92-93. 14 l e v e l . A d e s c r i p t i v e a n a l y s i s was u sed t o show t h e c l u s t e r s o f symptoms o f t h e Gers tmann syndrome i n r e l a t i o n t o g r o u p m e m b e r s h i p . SUMMARY T h i s c h a p t e r has p r e s e n t e d a s t a t e m e n t o f t h e p r o b l e m , t h e q u e s t i o n s t o w h i c h answers were s o u g h t , and a b r i e f a c c o u n t o f t h e p r o c e d u r e s f o l l o w e d i n c o l l e c t i n g and a n a l y s i n g t h e d a t a . E a c h o f t h e s e a r e a s w i l l be expanded upon i n t h e f o l l o w -i n g c h a p t e r s . C h a p t e r I I w i l l p r e s e n t t h e r e s e a r c h r e l a t e d t o t h e m a j o r . a r e a s on i n t e r e s t i n t h i s s t u d y . The f i n d i n g s r e l a t e d t o a n e u r o l o g i c a l b a s i s f o r a r e a d i n g p r o b l e m , t o r e v e r s a l e r r o r s i n s p e l l i n g , and t o t h e Gers tmann syndrome as f o u n d i n a d u l t s and i n c h i l d r e n w i l l be r e v i e w e d . C h a p t e r I I I w i l l p r o v i d e a d e t a i l e d a c c o u n t o f t h e t e s t s u s e d i n t h e s t u d y : t h e i r s e l e c t i o n , c o n s t r u c t i o n , a d -m i n i s t r a t i o n , and s c o r i n g . I t w i l l a l s o e x p l a i n t h e g r o u p i n g and s e l e c t i o n o f c h i l d r e n i n t h e s t u d y . C h a p t e r I V w i l l p r e s e n t and i n t e r p r e t t h e f i n d i n g s o f t h e two p a r t s o f t h e s t u d y . I t w i l l p r o v i d e an a n a l y s i s o f t h e i n f o r m a t i o n g a i n e d when 343 c h i l d r e n were t e s t e d f o r . s p e l l i n g a b i l i t y i n r e l a t i o n t o r e a d i n g a b i l i t y , and. when n i n e t y - s e v e n c h i l d r e n , who c o m p r i s e d f o u r g roups i n t h e s t u d y , 15 based on reading and s p e l l i n g a b i l i t y , were tested for the four symptoms of the Gerstmann syndrome. Chapter V w i l l summarize the study and i t s findings and present recommendations for the application of these f i n d -ings as they may relate to diagnosing a "reading d i s a b i l i t y , " providing guidance for remedial i n s t r u c t i o n , and suggesting further research. CHAPTER II RELATED RESEARCH During the p a s t seventy y e a r s , an i n c r e a s e d i n t e r e s t i n c h i l d r e n w i t h r e a d i n g problems has been e v i d e n t i n the l i t e r a t u r e . I n d i v i d u a l , c l i n i c a l , l a r g e group, and l o n g i t u d -i n a l s t u d i e s have, been conducted i n an attempt to i s o l a t e the f a c t o r s which are r e l a t e d to or are symptomatic of a r e a d i n g problem. During t h i s p e r i o d of time t h e o r i e s s u p p o r t i n g a n e u r o l o g i c a l b a s i s of a r e a d i n g problem were proposed, gained acceptance, and then f e l l i n t o d i s f a v o r as accumulated data p r o v i d e d c o n f l i c t i n g r a t h e r than s u p p o r t i n g evidence f o r them. Today, a n e u r o l o g i c a l b a s i s as the c a u s a l f a c t o r i n . a "reading d i s a b i l i t y " i s again advocated, one aspect being r e l a t e d to the f o u r a s s o c i a t e d symptoms of the Gerstmann syndrome. The p r e s e n t chapter reviews the l i t e r a t u r e r e l a t e d t o (1) the h i s t o r i c a l background of r e a d i n g problems wi t h a n e u r o l o g i c a l i m p l i c a t i o n ; (2) the Gerstmann syndrome; and (3) the s t u d i e s which d i r e c t l y p e r t a i n to the f o u r symptoms of the Gerstmann syndrome as found i n c h i l d r e n with l e a r n i n g d i s a b i l i t i e s . HISTORICAL BACKGROUND E a r l y accounts of c h i l d r e n with r e a d i n g d i s a b i l i t i e s were p u b l i s h e d by o p h t h a l m o l o g i s t s . Reading f a i l u r e , a t t r i b u t e d 17 t o f a u l t y v i s i o n , b r o u g h t t h e s e c h i l d r e n t o t h e i r a t t e n t i o n . U n a b l e t o p r o v i d e an o p h t h a l m i c d i a g n o s i s f o r t h e r e t a r d a t i o n i n r e a d i n g f o u n d i n some o f t h e i r p a t i e n t s , o p h t h a l m o l o g i s t s t u r n e d t o t h e m e d i c a l l i t e r a t u r e f o r an e x p l a n a t i o n . The s i m i -l a r i t y be tween m e d i c a l l y r e p o r t e d d e s c r i p t i o n s o f a d u l t s who had l o s t t h e a b i l i t y t o r e a d due t o i l l n e s s o r b r a i n damage, and t h e c h a r a c t e r i s t i c s o f t h e s e c h i l d r e n who were d e l a y e d i n a c q u i r i n g t h i s s k i l l , s u g g e s t e d a p a t h o l o g i c a l b a s i s u n d e r l y i n g t h e cause o f r e a d i n g f a i l u r e . Thus " t h e r e grew up t h e c o n c e p -t i o n o f a s p e c i f i c t y p e o f i n h e r i t e d a p h a s i a w h i c h was f i r s t t e rmed ' c o n g e n i t a l w o r d - b l i n d n e s s ' . " " ' ' W o r d - B l i n d n e s s . The f i r s t w r i t e r t o p ropound a n e u r o -2 l o g i c a l e x p l a n a t i o n o f a r e a d i n g d i s a b i l i t y was M o r g a n . I n 1896 , Morgan r e p o r t e d on a f o u r t e e n y e a r o l d boy who was " b r i g h t and i n t e l l i g e n t , q u i c k a t games, and i n no way i n f e r i o r 3 t o o t h e r s o f h i s age" b u t who r e v e r s e d l e t t e r s i n w o r d s , had t r o u b l e w i t h a r i t h m e t i c and e x p e r i e n c e d t h e g r e a t e s t d i f f i c u l t y l e a r n i n g t o r e a d . Morgan commented: He seems t o have no power o f p r e s e r v i n g and s t o r i n g up t h e v i s u a l i m p r e s s i o n p r o d u c e d by w o r d s , - hence t h e w o r d s , though s e e n , have no M a c d o n a l d C r i t c h l e y , Deve lopmenta1 D y s l e x i a (London : W i l l i a m Heinemann M e d i c a l Books", 196 4) , p . 8 . 2 P r i n g l e W. M o r g a n , . " A Case o f C o n g e n i t a l W o r d - B l i n d n e s s , " B r i t i s h M e d i c a l J o u r n a l , . 2 :1378 , 1896 . 3 I b i d . 18 s i g n i f i c a n c e f o r him. H i s v i s u a l memory f o r words i s d e f e c t i v e o r a b s e n t ; which i s e q u i v a l e n t t o say-i n g t h a t h i s i s what Kussmaul has termed "word-b l i n d . 1 ^ H i n s h e l w o o d , who had p r e v i o u s l y p u b l i s h e d a c c o u n t s of a d u l t s who were " w o r d - b l i n d , ' ^ was i n t e r e s t e d i n what Morgan had proposed as an u n d e r l y i n g cause o f r e a d i n g f a i l u r e i n 7 c h i l d r e n . I n 1900 Hinshelwood p u b l i s h e d h i s f i r s t a c count of two b o y s , age t e n and e l e v e n , who were u n a b l e t o r e a d due t o , as he b e l i e v e d , a c o n g e n i t a l d e f i c i e n c y f o r the v i s u a l 8 memory f o r words. He s t a t e d t h a t such cases were p r o b a b l y not so r a r e , but. went u n r e c o g n i z e d . He w r o t e : I t i s the m a t t e r o f h i g h e s t i m p o r t a n c e t o r e c o g n i z e ; t h e cause and t r u e n a t u r e o f t h i s d i f f i -c u l t y i n l e a r n i n g t o r e a d w h i c h i s e x p e r i e n c e d by th e s e c h i l d r e n , o t h e r w i s e they may be h a r s h l y t r e a t e d as i m b e c i l e s o r i n c o r r i g i b l e s and e i t h e r n e g l e c t e d o r f l o g g e d f o r a d e f e c t f o r which t h e y a r e no w i s e r e s p o n s i b l e . 9 I b i d . James H i n s h e l w o o d , "Word-Blindness and V i s u a l Memory," L a n c e t , 2:1564-1570, 1895. James H i n s h e l w o o d , "A Case of D y s l e x i a : A P e c u l i a r Form o f W o r d - B l i n d n e s s , " L a n c e t , 2:1451-1454, 1896. 7 James Hi n s h e l w o o d , "The V i s u a l Memory f o r Words and F i g u r e s , " The B r i t i s h M e d i c a l J o u r n a l , 2:1543-1544, 1896. James Hi n s h e l w o o d , " C o n g e n i t a l W o r d - B l i n d n e s s , " L a n c e t , 1:1506-1508, 1900. 9 I b i d . 19 He was p a r t i c u l a r l y c o n c e r n e d about t h e s e c h i l d r e n and c o n t i n u e d t o p u b l i s h a c c o u n t s d e s c r i b i n g t h e i r d i f f i c u l t i e s and s u g g e s t i n g t e a c h i n g methods t o overcome t h e i r h a n d i c a p . I t was l a r g e l y t h r o u g h t h e e a r l y w r i t i n g s o f H i n s h e l w o o d t h a t o t h e r m e d i c a l men became aware o f s i m i l a r p r o b l e m s i n t h e 11 12 c h i l d r e n t h e y e x a m i n e d . R e p o r t s by S t e p h e n s o n and F i s h e r 13 14 15 i n G r e a t B r i t a i n , and by C l a r i r b o r n e and McCready ' i n t h e U n i t e d S t a t e s appeared i n t h e l i t e r a t u r e . They g e n e r a l l y a g r e e d t h a t t h e p r o b l e m stemmed f rom a h e r e d i t a r y d e f e c t o f t h e l anguage c e n t e r o f t h e b r a i n . 16 S t r e p h o s y m b o l i a . O r t o n , w h i l e c o n d u c t i n g a p s y c h o l o g i c a l s t u d y on. e i g h t y - f o u r s c h o o l c h i l d r e n who had been s e l e c t e d by James H i n s h e l w o o d , "The T r e a t m e n t o f W o r d - B l i n d n e s s , . A c q u i r e d and C o n g e n i t a l , " The B r i t i s h M e d i c a l J o u r n a l , 2 : 1 0 3 3 -1035 , 1 9 1 2 . " ^ S i d n e y S t e p h e n s o n , " C o n g e n i t a l W o r d - B l i n d n e s s , " L a n c e t , 2 : 8 2 7 - 8 2 8 , 1904 . 12 J . H e r b e r t F i s h e r , " C o n g e n i t a l W o r d - B l i n d n e s s ( i n a b i l -i t y t o l e a r n t o r e a d ) , " T r a n s a c t i o n s o f t h e O p h t h a l m o l o g i c a l S o c i e t y , U . K . , 30 : 2 1 6 - 2 2 5 , 1910 . 13 J . H e r b e r t C l a i r b o r n e , "Types o f - C o n g e n i t a l Symbol A m b l y o p i a , " J o u r n a l o f t h e A m e r i c a n M e d i c a l A s s o c i a t i o n , 47 : 1813-1816 , 1906 . 14 B o s w o r t h E . M c C r e a d y , " B i o l o g i c a l V a r i a t i o n s i n t h e H i g h e r C e r e b r a l C e n t e r s C a u s i n g R e t a r d a t i o n , " A r c h i v e s o f  P e d i a t r i c s , 2 7 : 5 0 6 - 5 1 3 , 1910 . 15 . B o s w o r t h E . M c C r e a d y , " D e f e c t s i n t h e Zone o f Language (Word-Deafness and W o r d - B l i n d n e s s ) and T h e i r I n f l u e n c e i n E d u c a t i o n and B e h a v i o r , " A m e r i c a n J o u r n a l o f P s y c h i a t r y , 8 3 : 2 6 7 - 2 7 7 , 1 9 2 6 . ~ ~ -1 c Samuel T . O r t o n , " ' W o r d - B l i n d n e s s ' i n S c h o o l C h i l d r e n , " A r c h i v e s o f N e u r o l o g y and P s y c h i a t r y , 1 4 : 5 8 1 - 6 1 5 , 1925 . 20 t h e i r teachers as r e t a r d e d or d e f e c t i v e i n t h e i r s c h o o l work, found f i f t e e n c h i l d r e n i n the group who were r e t a r d e d o n l y i n r e a d i n g a b i l i t y . Upon a more d e t a i l e d study he observed t h a t these c h i l d r e n r e v e r s e d l e t t e r s and words w h i l e r e a d i n g or w r i t i n g . Orton, r e c o g n i z i n g the resemblance between these cases and those r e p o r t e d by Hinshelwood as " c o n g e n i t a l l y word b l i n d , " d i d not t h i n k they were " d e f e c t i v e s . " Rather, he f e l t they r e p r e s e n t e d an i s o l a t e d d i s a b i l i t y , which c o u l d range from severe to m i l d and which, p r o v i d e d they r e c e i v e d the proper t r a i n i n g , c o u l d be helped. He d i s a g r e e d w i t h the use of the term " c o n g e n i t a l word-blindness" and c o i n e d ^ the word "strephosymbolia" (meaning t w i s t e d symbol) to d e s c r i b e such a r e a d i n g d i s a b i l i t y . Orton's Theory of C e r e b r a l Dominance. Orton b e l i e v e d t h a t the problem these c h i l d r e n experienced i n l e a r n i n g to read was due to a p h y s i o l o g i c a l v a r i a n t r a t h e r than a g e n e r a l mental d e f e c t or a s p e c i a l b r a i n d e f e c t . He s a i d , ". . .1 b e l i e v e t h i s d i s o r d e r i s h e r e d i t a r y r a t h e r than c o n g e n i t a l , and I much p r e f e r to c a l l i t developmental than e i t h e r congen 17 i t a l or h e r e d i t a r y . " O r t o n 1 s theory of c e r e b r a l dominance was based on the e l a b o r a t i o n of three c o r t i c a l l e v e l s w i t h i n the b r a i n . The Samuel T. Orton, " V i s u a l Functions i n Strephosymboli A r c h i v e s Of Ophthalmology, 30:707^-717, 1943. 21 f i r s t l e v e l he d e s c r i b e d as t h e p e r c e p t i v e o r t h e a r r i v a l p l a t -f o r m f o r I n c o m i n g s e n s o r y s e n s a t i o n s . The s e c o n d l e v e l , w h i c h s u r r o u n d e d t h e a r r i v a l p l a t f o r m , he c a l l e d t h e r e c o g n i t i o n a r e a . A t t h i s l e v e l , awareness o f t h e meaning f o r c o n c r e t e o b j e c t s o c c u r r e d . These two l e v e l s were s e r v e d by b o t h hem-i s p h e r e s . A t t h e t h i r d , o r a s s o c i a t i v e l e v e l , one h e m i s p h e r e became d o m i n a n t and assumed t h e r e s p o n s i b i l i t y o f i n t e g r a t i n g a l l t h e s e n s o r y i n p u t s f rom t h e l o w e r two l e v e l s . T h i s t h i r d l e v e l was g o v e r n e d by a c o n s i d e r a b l e a r e a o f t h e t e m p e r o -18 p a r i e t a l r e g i o n o f t h e c o r t e x . When a c h i l d e n t e r e d s c h o o l he had d e v e l o p e d t h e second l e v e l o f v i s u a l i m p r e s s i o n s and t h e t h i r d l e v e l . o f a u d i t o r y a s s o c i a t i o n . As r e a d i n g i n s t r u c t i o n was b e g u n , t h e t h i r d v i s u a l l e v e l had t o be d e v e l o p e d and i n t e g r a t e d w i t h t h e t h i r d a u d i t o r y l e v e l . O r t o n s t a t e d : The v i s u a l l y a c q u i r e d m a t e r i a l must f o r m a q u i c k and s e c u r e a s s o c i a t i o n w i t h t h e word meaning w h i c h has p r e v i o u s l y been i m p l a n t e d by t h e a u d i t o r y p a t h i n o r d e r t h a t t h e meaning o f t h e p r i n t e d word may be u n d e r s t o o d . A f a i l u r e o f t h i s prompt l i n k i n g r e s u l t s i n s t r e p h o -s y m b o l i a . 1 9 18 Samuel T . O r t o n , "The T h r e e L e v e l s o f C o r t i c a l E l a b o r -a t i o n i n R e l a t i o n t o C e r t a i n P s y c h i a t r i c Symptoms , " A m e r i c a n  J o u r n a l o f P s y c h i a t r y , 8 5 : 6 4 7 - 6 5 9 , 1929 . 19 Samuel T . O r t o n , "The N e u r o l o g i c B a s i s o f E l e m e n t a r y E d u c a t i o n , " : A r c h i v e s o f N e u r o l o g y and P s y c h i a t r y , 2 1 : 6 4 1 - 6 47 , 1929 . 9 22 O r t o n r e a s o n e d t h a t c e r e b r a l dominance f o r l a n g u a g e was n e c e s s a r y t o e l i d e t h e r e v e r s e d image i n t h e no n - d o m i n a n t h e m i s p h e r e . I f dominance f o r t h e a s s o c i a t i v e c e n t e r had n o t be e n e s t a b l i s h e d when a c h i l d f i r s t l e a r n e d t o r e a d , t h e n b o t h h e m i s p h e r e s w o u l d r e c o r d t h e v i s u a l i m p r e s s i o n , b u t as m i r r o r e d c o p i e s . C o n f u s i o n o f memory p a t t e r n s w o u l d o c c u r . A u d i t o r y sounds w o u l d n o t n e c e s s a r i l y p r o d u c e t h e c o r r e c t s e q u e n c i n g o f l e t t e r s and t h e p r i n t e d image w o u l d n o t a r o u s e t h e c o r r e c t a u d i t o r y memory o f t h e word t o w h i c h t h e meaning was a t t a c h e d . T h e r e w o u l d a l s o be a t e n d e n c y t o . a s i n s t r a d d i r e c t i o n i n r e a d i n g and w r i t i n g w o r d s . ^ The e s t a b l i s h i n g o f one h e m i s p h e r e as t h e d o m i n a n t l a n -guage c e n t e r he b e l i e v e d t o be an i n h e r i t e d c h a r a c t e r i s t i c . The m a s t e r h e m i s p h e r e was u s u a l l y i n d i c a t e d by t h e m a s t e r hand, a l t h o u g h c u l t u r a l i n f l u e n c e s m i g h t o v e r r i d e t h e n a t u r a l t e n d e n c y t o u s e one hand i n p r e f e r e n c e t o t h e o t h e r . Thus m i x e d domin-a n c e was n o t a c a u s a l f a c t o r i n s t r e p h o s y m b o l i a , b u t p r o v i d e d e v i d e n c e t h a t t h e c h i l d was n o t a l l r i g h t s i d e d o r l e f t s i d e d 21 as f a r as t h e b r a i n was c o n c e r n e d . When q u e s t i o n e d on t h e r e l a t i o n o f m i x e d dominance t o r e a d i n g O r t o n r e p l i e d : 20 T. . , I b i d . 21 Samuel T. O r t o n , " V i s u a l F u n c t i o n s i n S t r e p h o s y m b o l i a , " A r c h i v e s o f O p h t h a l m o l o g y , 30:707-717, 1943. 23 One p r o b a b l y makes a m i s t a k e i n a t t e m p t i n g t o a s s o c i a t e t o o c l o s e l y c o n d i t i o n s l i k e r e a d i n g d i s a b i l i t y w i t h handedness p a t t e r n . The g r e a t m a j o r i t y o f my p a t i e n t s w i t h r e a d i n g d i s a b i l i t y a r e r i g h t h a n d e d . Many o f them a r e a l s o r i g h t eyed and r i g h t f o o t e d ; i n o t h e r w o r d s , many o f them have d i s t i n c t l y u n i l a t e r a l motor p a t t e r n s , b u t t h i s does n o t p r e c l u d e t h e p o s s i b i l i t y o f a c o n f u s i o n o f dominance and one sees t h e same symptoms as i n t h o s e who do have c o n f u s i o n i n t h e m o t o r p a t t e r n s . 2 2 I t w o u l d seem t h a t much o f t h e r e s e a r c h ba sed on O r t o n ' s t h e o r y has p l a c e d a g r e a t e r emphas i s t h a n he d i d on..lhandedness p a t t e r n s i n t r y i n g t o d e t e r m i n e t h e cause o f a r e a d i n g d i s -a b i l i t y and i n e s t a b l i s h i n g a c r i t e r i o n o f a n e u r o l o g i c a l c o n -d i t i o n w h i c h c o u l d a f f e c t r e a d i n g . L a t e r a l Dominance and R e a d i n g A b i l i t y . S t u d i e s r e l a t i n g 23 l a t e r a l i t y w i t h r e a d i n g a b i l i t y a r e e x t e n s i v e . Eames, 24 25 E t t l m g e r and J a c k s o n , and H a r r i s have f o u n d a s l i g h t l y h i g h e r i n c i d e n c e o f l a t e r a l dominance a n o m a l i e s among p o o r 2 6 r e a d e r s , b u t o t h e r s have n o t f o u n d hand p a t t e r n s t o d i f f e r e n -22 Samuel T . O r t o n , D i s c u s s i o n o f a p a p e r , " M i m e t i c S m i l e d n e s s as R e l a t e d t o Handednes s : An I n d i c a t o r o f B a s i c Modes o f Human A d a p t i o n , " by D r . J . G . L y n n , A r c h i v e s o f  N e u r o l o g y and P s y c h i a t r y , 47 :106 4 , 1942 . 23 Thomas H . Eames, "The A n a t o m i c a l B a s i s o f L a t e r a l D o m i n a n c e , " A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y , 4 : 5 2 4 - 5 2 8 , 1 9 3 4 , 24 G . E t t l m g e r and C . V . J a c k s o n , " O r g a n i c F a c t o r s m D e v e l o p m e n t a l D y s l e x i a , " P r o c e e d i n g s o f t h e R o y a l S o c i e t y o f M e d i c i n e , 4 8 : 9 9 8 - 1 0 0 , 1955 . 25 A l b e r t J . H a r r i s , " L a t e r a l Dominance , D i r e c t i o n a l C o n f u s i o n and R e a d i n g D i s a b i l i t y , " J o u r n a l o f P s y c h o l o g y , 4 4 : 2 8 3 - 2 9 4 , 1957 . " 2 6 L i l l i a n S . W o l f e , " D i r e c t i o n a l F a c t o r s i n S p e c i f i c R e a d i n g D i s a b i l i t y : I L a t e r a l i t y o f F u n c t i o n , " J o u r n a l o f G e n e t i c P s y c h o l o g y , 5 8 : 4 5 - 5 6 , 1941 ; A r t h u r I . G a t e s and Guy L . 24 t i a t e good and p o o r r e a d e r s . A l a r g e s c a l e , l o n g i t u d i n a l 27 s t u d y by D o u g l a s and o t h e r s f a i l e d t o show a r e l a t i o n s h i p be tween d i s t u r b e d hand-eye p r e f e r e n c e s and s c h o o l a c h i e v e m e n t . 2 8 W e i n t r a u b , i n a r e v i e w o f r e s e a r c h on l a t e r a l i t y and r e a d i n g , c o n c l u d e d t h e i s s u e was s t i l l c o n f u s e d , p a r t l y due t o I t h e i n s t r u m e n t u sed f o r t e s t i n g l a t e r a l i t y , and p a r t l y due t o t h e s e l e c t i o n o f s u b j e c t s . U n s e l e c t e d p o p u l a t i o n s o f s c h o o l c h i l d r e n have shown l i t t l e , i f a n y , r e l a t i o n s h i p between l a t e r a l i t y and r e a d i n g a b i l i t y ; whereas s e l e c t e d p o p u l a t i o n s o f c l i n i c a l c a se s have shown a r e l a t i o n s h i p . A l t h o u g h hand p r e f e r e n c e becomes b e t t e r e s t a b l i s h e d w i t h a g e , t h e n e u r o l o g i c a l i m p l i c a t i o n s o f l a t e r a l i t y p a t t e r n s r e m a i n u n c l e a r . 29 C e r e b r a l Dominance and Handedness . . S i l v e r and H a g i n , who f o u n d no g r e a t e r i n c i d e n c e o f r i g h t , l e f t o r m i x e d d o m i n -ance i n r e t a r d e d r e a d e r s t h a n i n n o r m a l r e a d e r s , d i d f i n d a B o n d , " R e l a t i o n o f Handednes s , E y e - S i g h t i n g and A c u i t y Domin-ance t o R e a d i n g , " J o u r n a l o f E d u c a t i o n a l Psychology,. 27:450-456, 1936; P a u l A . W i t t y and D a v i d K o p e l , " S i n i s t r a l and M i x e d M a n u a l - O c u l a r B e h a v i o r i n R e a d i n g D i s a b i l i t y , " J o u r n a l o f  E d u c a t i o n a l P s y c h o l o g y , 27:119-134, 1936. 27 J . W . B . D o u g l a s , J . M . Ross and J . E . ' C o o p e r , "The R e l a -t i o n s h i p Between H a n d e d n e s s , A t t a i n m e n t and A d j u s t m e n t i n a N a t i o n a l Sample o f S c h o o l C h i l d r e n , " E d u c a t i o n a l R e s e a r c h , 9:223-231, 1967. 2 8 Samuel W e i n t r a u b , " E y e - h a n d P r e f e r e n c e and R e a d i n g , " R e a d i n g T e a c h e r , 21:3694, 1968. 29 A r c h i e A . S i l v e r and Rosa H a g i n , " S p e c i f i c R e a d i n g D i s a b i l i t y : D e l i n e a t i o n o f t h e Syndrome and R e l a t i o n t o C e r e b r a l D o m i n a n c e , " C o m p r e h e n s i v e P s y c h i a t r y , 1:126-134, 1960. 25 s i g n i f i c a n t d i f f e r e n c e between r e t a r d e d and n o r m a l r e a d e r s on S c h i l d e r ' s e x t e n s i o n t e s t . S e v e n t y p e r c e n t o f t h e r e a d i n g d i s a b i l i t y g roup showed l e f t hand e l e v a t i o n i n d i c a t i n g t h e y were r i g h t b r a i n d o m i n a n t . They s u g g e s t e d t h e r e s u l t s o f t h e i r s t u d y i n d i c a t e d t h a t t h e r i g h t h e m i s p h e r e o f t h e b r a i n does n o t e s t a b l i s h c l e a r - c u t d o m i n a n c e . I n e x p l a i n i n g t h e i r t e s t t h e y w r o t e : I n n o r m a l r e a d e r s t h e e l e v a t e d hand u s u a l l y c o r r e s p o n d s t o t h a t u sed f o r w r i t i n g ; i n c h i l d r e n w i t h s e v e r e r e a d i n g d i s a b i l i t y t h e e x t e n d e d arm may be o p p o s i t e f rom t h a t u s e d f o r w r i t i n g o r n e i t h e r arm may be e l e v a t e d . We s u g g e s t t h a t t h e e l e v a t e d e x t r e m i t y i s t h e one w h i c h has t h e g r e a t e r m u s c l e tone and hence i s an e x p r e s s i o n o f c e r e b r a l dominance f o r l a n g u a g e . The a b n o r m a l r e s p o n s e s s u g g e s t s t o us t h a t a c l e a r - c u t c e r e b r a l p a t t e r n f o r l anguage has n o t been e s t a b l i s h e d . 3 0 I n a f o l l o w - u p s t u d y , u s i n g t h e same e x t e n s i o n t e s t , t h e y found c l e a r - c u t c e r e b r a l dominance i n t h e r e t a r d e d r e a d e r was s t i l l 31 n o t e s t a b l i s h e d by a d u l t h o o d . 32 R o b e r t s , r e p o r t i n g on t h e i n c i d e n c e o f a p h a s i a f o l l o w -i n g an o p e r a t i o n on t h e l e f t h e m i s p h e r e , f o u n d 72 p e r c e n t 30 A r c h i e A . S i l v e r and Rosa H a g i n , " S t r a t e g i e s o f I n t e r v e n t i o n i n t h e Spec t rum o f D e f e c t s i n S p e c i f i c R e a d i n g D i s a b i l i t y , " B u l l e t i n " o f t h e O r t o n S o c i e t y , 1 7 : 3 9 - 4 6 , 1967 . 31 S i l v e r and H a g i n , " S p e c i f i c R e a d i n g D i s a b i l i t y : F o l l o w -up S t u d i e s , " A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y , 3 4 : 9 5 - 1 0 2 , 1964. 32 Lamar R o b e r t s , "Handedness and C e r e b r a l D o m i n a n c e , " T r a n s a c t i o n s o f t h e A m e r i c a n N e u r o l o g i c a l A s s o c i a t i o n , 8 0 : 1 4 3 -148 , 1955 . " 26 l e f t - h a n d e d and 73 p e r c e n t r i g h t - h a n d e d p a t i e n t s w i t h a d i s -t u r b a n c e i n l a n g u a g e f u n c t i o n . When t h e o p e r a t i o n was p e r f o r m e d on t h e r i g h t h e m i s p h e r e o n l y 0.5 p e r c e n t r i g h t - h a n d e d and 6 p e r c e n t l e f t - h a n d e d p a t i e n t s were so a f f l i c t e d . From h i s d a t a i t w o u l d seem a c o n s t a n t r e l a t i o n s h i p between hand p r e f e r e n c e and dominance f o r s p e e c h i n t h e o p p o s i t e h e m i s p h e r e does n o t e x i s t . A l s o i t w o u l d a p p e a r f r o m t h e s e r e s u l t s t h a t t h e l e f t h e m i s p h e r e assumes dominance f o r l a n g u a g e i n a m a j o r p o r t i o n o f t h e p o p u l a t i o n . R e v e r s a l s • R e v e r s a l s i n r e a d i n g and w r i t i n g h a v e . b e e n s t u d i e d i n i s o l a t i o n and i n r e l a t i o n t o h a n d e d n e s s and l a t e r -33 a l i t y . Many i n v e s t i g a t o r s h a v e f o u n d t h a t y o u n g e r c h i l d r e n make more r e v e r s a l e r r o r s t h a n o l d e r c h i l d r e n . However, a l t h o u g h o l d e r c h i l d r e n make f e w e r r e v e r s a l s o f who l e words, l e t t e r and 34 t r a n s p o s i t i o n e r r o r s p e r s i s t . S t u d i e s o f r e v e r s a l e r r o r s H e l e n Kennedy, " R e v e r s a l s , R e v e r s a l s , R e v e r s a l s , " J o u r n a l o f E x p e r i m e n t a l E d u c a t i o n , 23:161-170, 1954; G e r t r u d e H i l d r e t h , " R e v e r s a l s i n R e a d i n g ' a n d W r i t i n g , " J o u r n a l o f  E d u c a t i o n a l P s y c h o l o g y , 25:1-20, 1943; C l i f f o r d Woody and A l b e r t P h i l l i p s , "The E f f e c t s on Handedness on R e v e r s a l s i n R e a d i n g , " J o u r n a l o f E d u c a t i o n a l R e s e a r c h , 27:651-662, 1934. 34 L o m e T e e g a r t e n , " T e s t s f o r t h e T e n d e n c y t o R e v e r s a l i n . R e a d i n g , " J o u r n a l o f E d u c a t i o n a l R e s e a r c h , 27:81-97, 1933; L i l l i a n S. W o l f e , . " A n ~ E x p e r i m e n t a l S t u d y o f R e v e r s a l s i n R e a d i n g , " A m e r i c a n J o u r n a l o f P s y c h o l o g y , - 5 2 : 5 3 3 - 5 6 1 , 1939; P a u l W i t t y and D a v i d K o p e l , " F a c t o r s A s s o c i a t e d w i t h t h e E t i o l o g y o f R e a d i n g D i s a b i l i t y , " J o u r n a l o f E d u c a t i o n a l R e s e a r c h , 29:449-459, 1963; A r t h u r I . G a t e s and Guy L . Bond, " R e l a t i o n o f H a n d e d n e s s , E y e - S i g h t i n g and A c u i t y Dominance t o R e a d i n g , " J o u r n a l o f E d u c a t i o n a l P s y c h o l o g y , 27:450-456, 1936. 27 i n d i c a t e t h e s e t e n d e n c i e s a r e g r e a t e r among p o o r e r r e a d e r s t h a n among n o r m a l reader's. . L e f t - h a n d e d o r m i x e d l a t e r a l i t y c h a r a c t e r i s t i c s o f c h i l d r e n have n o t shown a p o s i t i v e r e l a -t i o n s h i p t o i n c r e a s e d r e v e r s a l e r r o r s o v e r r i g h t - h a n d e d 35 c h i l d r e n . R e v e r s a l t e n d e n c i e s have b e e n f o u n d 3 6 p o o r v i s u a l p e r c e p t i o n . V a r i o u s s t u d i e s t h e p o o r e r r e a d e r c a n d i s c r i m i n a t e v i s u a l t o be u n r e l a t e d t o have v e r i f i e d t h a t f o r m s as w e l l as t h e b e t t e r r e a d e r . I n t h e s e s t u d i e s , t h e o v e r a l l l o w e r p e r -f o r m a n c e o f t h e p o o r e r r e a d e r c o u l d n o t be a t t r i b u t e d t o a p e r c e p t u a l d e f i c i t . S c h i l d e r has s t a t e d : I n t h e c o n g e n i t a l r e a d i n g d i s a b i l i t y , t h e d i f f i c u l t y c o n c e r n s t h e i n n e r s t r u c t u r e o f t h e word and i t s s o u n d . I t i s an a g n o s t i c t r o u b l e , n o t s o much c o n c e r n i n g t h e m e r e l y o p t i c s p h e r e , b u t a s p h e r e w h i c h i s n e a r e r t h e i n t e l l e c t u a l l i f e t h a n t h e o p t i c p e r c e p t i o n . 3 7 35 . G e r t r u d e H i l d r e t h , " R e v e r s a l s m R e a d i n g and W r i t i n g , " J o u r n a l o f E d u c a t i o n a l P s y c h o l o g y , .25:1-20, 1934;. P a u l A. W i t t y and D a v i d K o p e l , " F a c t o r s A s s o c i a t e d w i t h t h e E t i o l o g y o f R e a d i n g D i s a b i l i t y , " J o u r n a l o f E d u c a t i o n a l R e s e a r c h , 29: 4499459, 1936. 3 6 L u c y F i l d e s , "A P s y c h o l o g i c a l I n q u i r y i n t o t h e N a t u r e o f t h e C o n d i t i o n Known as C o n g e n i t a l W o r d - B l i n d n e s s , " B r a i n , 44:286-307, 1921; L i l l i a n S. W o l f e , "An E x p e r i m e n t a l S t u d y o f R e v e r s a l s i n R e a d i n g , " A m e r i c a n J o u r n a l o f P s y c h o l o g y , 52: 533-561, 1939; P a u l S c h i l d e r , " C o n g e n i t a l A l e x i a and i t s R e l a t i o n t o O p t i c P e r c e p t i o n , " J o u r n a l o f G e n e t i c P s y c h o l o g y , 65:67-88, 1944; J.G. L y l e and J u d i t h Goyen, " V i s u a l R e c o g n i -t i o n , D e v e l o p m e n t a l L a g , and S t r e p h o s y m b o l i a i n R e a d i n g R e t a r d a t i o n , " J o u r n a l o f A b n o r m a l P s y c h o l o g y , 73:25-29, 1968. 37 P a u l S c h i l d e r , " C o n g e n i t a l A l e x i a and i t s R e l a t i o n t o O p t i c P e r c e p t i o n , " J o u r n a l o f G e n e t i c P s y c h o l o g y , 65:67-88, 1944. 28 V i s i o n and R e a d i n g A b i l i t y . A l t h o u g h some r e a d i n g s p r o -blems may be t r a c e d t o p o o r eye s i g h t , o p h t h a l m o l o g i s t s do n o t f e e l t h i s i s a f a c t o r i n t h e c a se o f a r e a d i n g d i s a b i l i t y . I n a r e v i e w a r t i c l e , N i c h o l l s d i s c u s s e d t h e c o n f l i c t i n g d a t a r e l a t e d t o v i s u a l d e f e c t s and r e a d i n g a b i l i t y , b u t ba sed on h i s own work w i t h c h i l d r e n he s t a t e d , " D e f e c t s i n t h e o c u l a r mechanism must be c o n s i d e r e d o n l y as an added o r c o n t r i b u t o r y 3 8 d i f f i c u l t y . I f e e l c e r t a i n t h e y do n o t i n i t i a t e d y s l e x i a . " H e l v e s t o n s e n t a q u e s t i o n n a i r e t o e i g h t e e n o p h t h a l m o -l o g i s t s and a s k e d them t o g r a d e t h e s i g n i f i c a n c e o f eye f u n c -t i o n w i t h r e g a r d t o t h e r o l e each p l a y e d i n d y s l e x i a . The r e s u l t s f rom t h e q u e s t i o n n a i r e showed o n l y two o f f i f t e e n eye f u n c t i o n s t e s t e d by t h e o p h t h a l m o l o g i s t s were c o n s i d e r e d t o be even p o s s i b l y s i g n i f i c a n t . The two eye f u n c t i o n s t h o u g h t t o be r e l a t e d t o a r e a d i n g d i s a b i l i t y were b i n o c u l a r eye c o n t r o l b e h a v i o r and p h o r i a s ( the p o s i t i o n o f t h e eye b a l l i n r e l a t i o n 39 t o t h e d i r e c t i o n o f i t s v i s u a l a x i s ) . Koos t e s t e d p r i m a r y c h i l d r e n f o r a c o n t r o l l i n g eye i n b i n o c u l a r v i s i o n . No s i g n i f i c a n t r e l a t i o n s h i p be tween t h e l a c k o f a c o n t r o l l i n g eye and l o w e r r e a d i n g a b i l i t y emerged J o h n V . V . N i c h o l l s , " C o n g e n i t a l D y s l e x i a : A P r o b l e m i n E t i o l o g y , " C a n a d i a n M e d i c a l A s s o c i a t i o n J o u r n a l , 8 2 : 5 7 5 -578 , 1960 . 3 9 Eugene H e l v e s t o n , " D y s l e x i a , " The S i g h t - S a v i n g R e v i e w , 3 8 : 2 0 3 - 2 0 8 , 1968 . L 29 when t h e r e s u l t s f o r t h e t o t a l g r o u p were a n a l y s e d . A t t h e g r a d e two l e v e l a p o s i t i v e d i f f e r e n c e e x i s t e d between t h e p r e s e n c e o f a c o n t r o l l i n g eye and r e a d i n g s c o r e s , b u t n o t a t 40 t h e g r a d e one o r g r a d e t h r e e l e v e l . E l e c t r o e n c e p h a l o g r a p h (E .E . G . ) and Reading" A b i l i t y . The e x a c t r e l a t i o n s h i p between E . E . G . r e c o r d i n g s and a r e a d i n g 41 d i s a b i l i t y i s n o t known. Hughes e t a l . s t u d i e d 125 p a t i e n t s o v e r e i g h t y e a r s o f age . S e v e n t y - f i v e p e r c e n t o f t h e s e c h i l -d r e n , w i t h a s p e c i f i c r e a d i n g d i s a b i l i t y , had a b n o r m a l E . E . G . ' s w h i l e a l l o f t h e c h i l d r e n showed u n s t a b l e c o r t i c a l rhythms and f r e q u e n c i e s f a l l i n g i n t h e a l p h a r ange were s i g n i f i c a n t l y 42 a b s e n t . K e n n a r d e t a l . f o u n d s i m i l a r r e s u l t s . S e v e n t y - o n e p e r c e n t o f t h e r e a d i n g d i s a b i l i t y g roup and 77 p e r c e n t o f t h e n o r m a l r e a d e r s w i t h b e h a v i o r p r o b l e m s had a b n o r m a l E . E . G . r e -c o r d i n g s , b u t no s p e c i f i c p a t t e r n o f a b n o r m a l i t y d i f f e r e n t i a t e d p o o r r e a d e r s f rom good r e a d e r s . B o t h s t u d i e s compared l a t e r -a l i t y p a t t e r n s w i t h E . E . G . changes b u t no r e l a t i o n s h i p was f o u n d . E u g e n i a M . K o o s , " M a n i f e s t a t i o n s o f C e r e b r a l Dominance and P r i m a r y R e t a r d a t i o n i n P r i m a r y Grade C h i l d r e n , " J o u r n a l o f G e n e t i c P s y c h o l o g y , 104:155-165, 1964. ~ ^ 41 J . Hughes , R. L e a n d e r , and G . K e t c h u m , " E l e c t r o e n ^ -c e p h a l o g r a p h i c S t u d y o f S p e c i f i c R e a d i n g D i s a b i l i t y , " E . E . G . and C l i n i c a l N e u r o p h y s i o l o g y , 1:377-378, 1949. 42 M a r g a r e t A . K e n n a r d , R a l p h R a b i n o v i t c h , and D o n a l d W e s l e r , "The A b n o r m a l E l e c t r o e n c e p h a l o g r a m as R e l a t e d t o R e a d i n g D i s a b i l i t y i n C h i l d r e n w i t h D i s o r d e r s o f B e h a v i o r , " C a n a d i a n M e d i c a l A s s o c i a t i o n J o u r n a l , 67:330-333, 1952. 30 Out o f 100 r e a d i n g d i s a b i l i t y c h i l d r e n examined by 43 P a r k , 36 p e r c e n t had a b n o r m a l E . E . G . r e c o r d s . He g rouped t h e s e c h i l d r e n on t h e b a s i s o f t h e i r E . E . G " . r e c o r d and was a b l e t o r e l a t e f o u r d i f f e r e n t t y p e s o f E . E . G . waves t o f o u r d i f f e r e n t r e a d i n g d i s a b i l i t y g r o u p s . The r e m a i n i n g 64 p e r c e n t o f t h e r e a d i n g d i s a b i l i t y g r o u p , w i t h n o r m a l E . E . G . r e c o r d s , he f o u n d were t h e b e s t r e a d e r s . I n a d d i t i o n t h e s e c h i l d r e n had average I . Q . ' s and showed no e v i d e n c e o f o r g a n -i c i t y w i t h i n t h e v i s u a l s y s t e m . A l t e r n a t e P r o p o s a l U n d e r l y i n g a R e a d i n g D i s a b i l i t y I n t r y i n g t o d e t e r m i n e t h e u n d e r l y i n g cause o f a r e a d i n g d i s a b i l i t y , r e s e a r c h s t u d i e s o f l a t e r a l d o m i n a n c e , c e r e b r a l d o m i n a n c e , v i s u a l d e f e c t s , and a b n o r m a l E . E . G . r e c o r d s , so f a r , have n o t p r o v i d e d c o n c l u s i v e e v i d e n c e f o r i d e n t i f y i n g c h i l d r e n w i t h a r e a d i n g d i s a b i l i t y on t h e b a s i s o f any o f t h e s e f a c t o r s . A n o t h e r b a s i s f o r d i a g n o s i n g and d e t e r m i n i n g t h e u n d e r l y i n g cause o f a r e a d i n g d i s a b i l i t y , i s t h e a p p l i c a t i o n o f knowledge g a i n e d f r o m m e d i c a l r e p o r t s on a d u l t s who have l o s t c e r t a i n a b i l i t i e s a f t e r damage t o a l o c a l i z e d a r e a o f t h e b r a i n has o c c u r r e d . The p o s s i b i l i t y t h a t one l o c a l i z i n g c l u s t e r o f symptoms, known as t h e Ger s tmann syndrome and f o u n d i n a d u l t s who have l o s t s p e c i f i c a b i l i t i e s , m i g h t be r e l a t e d t o t h e George E . P a r k , " O p h t h a l m o l o g i c a l A s p e c t s o f L e a r n i n g D i s o r d e r s , " J o u r n a l o f L e a r n i n g D i s a b i l i t i e s , 2 : 1 8 9 - 1 9 8 , 1969 . d e l a y i n t h e a c q u i s i t i o n o f t h e s e a b i l i t i e s by c h i l d r e n p r o v i -ded t h e b a s i s f o r t h i s s t u d y . The f o l l o w i n g s e c t i o n p r e s e n t s t h e s t u d i e s w h i c h r e l a t e t o t h i s a s p e c t o f t h e i n v e s t i g a t i o n . THE GERSTMANN SYNDROME I n 1924 , J o s e f Ger s tmann r e p o r t e d f o u r c h a r a c t e r i s t i c symptoms f o u n d i n a d u l t s as " . . . a r e s u l t o f a l e s i o n i n t h e p a r i e t o - o c c i p i t a l r e g i o n o f t h e b r a i n , namely i n t h a t p a r t w h i c h c o r r e s p o n d s t o t h e a n g u l a r g y r u s i n i t s t r a n s i t i o n t o t h e s e c o n d o c c i p i t a l c o n v o l u t i o n " on t h e d o m i n a n t s i d e o f t h e b r a i n D e s c r i p t i o n . The m a j o r symptom was a l o s s i n t h e p a t i e n t ' s a b i l i t y t o d i f f e r e n t i a t e h i s f i n g e r s , h i s ; own as w e l l as t h o s e o f a n o t h e r p e r s o n , t o name them c o r r e c t l y , t o i n d i c a t e s p e c i f i c f i n g e r s on command, o r t o i m i t a t e g i v e n f i n g e r p o s -t u r e s o f t h e e x a m i n e r . T h i s d e f i c i t , t e rmed f i n g e r a g n o s i a (not k n o w i n g t h e f i n g e r s ) , was more e v i d e n t i n r e l a t i o n t o t h e m i d d l e t h r e e f i n g e r s and was c o n s i d e r e d p r i m a r y t o t h e syndrome Ger s tmann f o u n d , i n a d d i t i o n t o f i n g e r a g n o s i a , a d i s -o r i e n t a t i o n f o r r i g h t and l e f t i n r e g a r d t o t h e p e r s o n ' s own s e l f as w e l l as t o o t h e r s ; a g r a p h i a , a d i s t u r b a n c e i n w r i t i n g ; and a c a l c u l i a , an i s o l a t e d d i s a b i l i t y f o r c a l c u l a t i o n . Of t h e s e l a t t e r two symptoms, a g r a p h i a a p p e a r e d as a d i f f i c u l t y i n J o s e f G e r s t m a n n , "Syndrome o f F i n g e r A g n o s i a , D i s -o r i e n t a t i o n f o r R i g h t and L e f t , A g r a p h i a and A c a l c u l i a , " A r c h i v e s o f N e u r o l o g y and P s y c h i a t r y , 4 4 : 3 9 8 - 4 0 8 , 1940 . 32 forming the l e t t e r s or words and was more pronounced when the p a t i e n t expressed h i s own thoughts i n w r i t i n g than when he was p e r m i t t e d t o copy. A c a l c u l i a , d i f f i c u l t y i n c a l c u l a t i n g , was a d i s o r i e n t a t i o n r e g a r d i n g the sequence and the decimal v a l u e s of d i g i t s w i t h i n a number. The syndrome l o c a l i z e d the l e s i o n i n the dominant hemisphere. The more e x t e n s i v e the f o c a l l e s i o n , the more other p a t h o l o g i c a l m a n i f e s t a t i o n s r e s u l t e d . A p r a x i a , and impaired r e a d i n g a b i l i t y and impaired c o l o r p e r c e p t i o n might a l s o be found i n c o n j u n c t i o n w i t h the syndrome. 45 46 C o n f l i c t i n g Evidence. N i e l s e n and Benton have questioned the a c t u a l l o c a l i z i n g aspect of the syndrome as w e l l as the s i g n i f i c a n c e of the f o u r symptoms i n e s t a b l i s h i n g a separate syndrome. T h e i r r e p o r t s i n d i c a t e t h a t the presence of these f o u r symptoms does not always i m p l i c a t e the p a r i e t a l r e g i o n o f the dominant hemisphere nor does the absence of these symptoms exclude the p a r i e t a l r e g i o n of the b r a i n . Thompson, i n h i s book Reading D i s a b i l i t y , commenting on the Gerstmann syndrome s t a t e d : From the l i t e r a t u r e , i n c l u d i n g f u r t h e r c o n t r i -b u t i o n s of Gerstmann, and from the w r i t e r ' s c l i n i c a l e x p e r i e n c e , i t appears t h a t the f o u r J.M. N i e l s e n , "Gerstmann Syndrome: F i n g e r Agnosia, Agraphia, Confusion of Right and L e f t , and A c a l c u l i a , " A r c h i v e s of Neurology, and Psychology , 39:536-5.60, 1938. 46 A r t h u r L. Benton, "The F i c t i o n of the 'Gerstmann Syndrome'," J o u r n a l of Neurology, Neurosurgery, and P s y c h i a t r y , 24:176-181, 1961. 33 symptoms a r e n o t an a l l o r none p r o p o s i t i o n . F i n g e r a g n o s i a does n o t mean c o m p l e t e o b l i t e r -a t i o n o f f i n g e r r e c o g n i t i o n , a g r a p h i a does n o t mean c o m p l e t e i n a b i l i t y t o w r i t e , and d y s c a l -c u l i a does n o t mean i n a b i l i t y t o add two and t w o . I n f a c t , at. l e a s t one. f u n c t i o n i n t h e q u a r t e t o f symptoms may show l i t t l e i f any i m p a i r m e n t . 4 7 RELATED STUDIES V e r y few s t u d i e s have been c a r r i e d o u t on c h i l d r e n i n w h i c h a l l f o u r o f t h e Gers tmann symptoms have been r e c o r d e d . A g r e a t number o f s t u d i e s , a l t h o u g h s t i l l l i m i t e d i n number, have i n v e s t i g a t e d one o r two o f t h e symptoms i n i s o l a t i o n o r i n c o m b i n a t i o n . One o f t h e f i r s t a s s o c i a t i o n s made between t h e Ger s tmann syndrome and a l e a r n i n g d i s a b i l i t y was i n t h e a r e a o f a r i t h m e t i c . D y s c a l c u l i a . G u t t m a n n , i n 1936 , r e p o r t e d on c h i l d r e n who were c o n s i d e r e d b a c k w a r d i n a r i t h m e t i c . He r e f e r r e d t o t h e Ger s tmann syndrome , p a r t i c u l a r l y as i t r e l a t e d t o t h e p a r i e t a l l o b e o f t h e b r a i n , and f e l t t h e r e was v a l u e i n t r a n s -f e r r i n g knowledge g a i n e d f rom p a t h o l o g i c a l s t u d i e s t o c o n d i t i o n s o f backwardnes s o r d e v e l o p m e n t a l d e l a y s i n c h i l d r e n . He w r o t e t h a t i n many c a s e s c h i l d r e n c o u l d p e r f o r m m e n t a l a r i t h m e t i c c o r r e c t l y , b u t made e r r o r s i n v o l v i n g d i r e c t i o n a l c o n f u s i o n when c a l c u l a t i o n s had t o be done on p a p e r . He t h o u g h t s u c h a L l o y d J . Thompson, R e a d i n g D i s a b i 1 1 t y ( S p r i n g f i e l d , I l l i n o i s : C h a r l e s C . Thomas"^ 1966) , p . 49 . 34 d i s o r d e r was due t o a d i f f i c u l t y i n w r i t i n g t h e numbers w h i c h was r e l a t e d t o a r e t a r d a t i o n i n a c q u i r i n g a knowledge o f 48 r i g h t . a n d l e f t . I n 1938 S t r a u s s and Werner s t u d i e d a r i t h m e t i c a b i l i t y i n r e l a t i o n t o f i n g e r a g n o s i a . They t e s t e d two g r o u p s ( f o u r -t e e n boys i n each group) who were s i m i l a r as t o c h r o n o l o g i c a l age , m e n t a l a g e , and i n t e l l i g e n c e , b u t who d i f f e r e d i n a r i t h -m e t i c a b i l i t y . Two g roups were f o r m e d : an a r i t h m e t i c a b i l i t y g r o u p i n w h i c h a r i t h m e t i c age was g r e a t e r t h a n r e a d i n g a g e , and an a r i t h m e t i c d i s a b i l i t y g roup i n w h i c h r e a d i n g age was g r e a t e r t h a n a r i t h m e t i c age . The a r i t h m e t i c a b i l i t y g r o u p made few or- no e r r o r s on t h e f i n g e r t e s t , whereas t h e a r i t h m e -t i c d i s a b i l i t y g r o u p made e r r o r s r a n g i n g f rom 22 - 66 o u t o f a p o s s i b l e 1 3 0 . They c o n c l u d e d t h e r e was a r e l a t i o n s h i p between a d e f i c i e n c y i n t h e f i n g e r schema and d i f f i c u l t i e s w i t h number 4 . - 49 ' o p e r a t i o n s . B e n t o n r e p l i c a t e d S t r a u s s and W e r n e r ' s s t u d y t o v e r i f y t h e i r f i n d i n g s o f a s i g n i f i c a n t a s s o c i a t i o n be tween f i n g e r a g n o s i a and a c a l c u l i a . He compared t h e r e s u l t s o f t w e n t y - t w o n o r m a l c h i l d r e n ( f i f t e e n boys and s e v e n g i r l s ) and t w e n t y -E r i c G u t t m a n n , " C o n g e n i t a l A r i t h m e t i c D i s a b i l i t y and A c a l c u l i a , " B r i t i s h J o u r n a l o f M e d i c a l P s y c h o l o g y , 1 6 : 1 6 - 3 5 , 1936 . 49 A l f r e d S t r a u s s and H e i n z W e r n e r , " D e f i c i e n c y i n t h e F i n g e r Schema i n R e l a t i o n t o A r i t h m e t i c D i s a b i l i t y ( F i n g e r A g n o s i a and A c a l c u l i a ) , " A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y , 8 : 7 1 9 - 7 2 4 , 1938 . 35 t h r e e s u b n o r m a l b o y s . The r e s u l t s o f h i s s t u d y d i d n o t show any c o n s i s t e n t r e l a t i o n s h i p be tween t h e number o f f i n g e r e r r o r s and l o w e r a r i t h m e t i c a b i l i t y i n e i t h e r g r o u p . He c o n -c l u d e d t h e r e was no s u p p o r t f o r S t r a u s s and W e r n e r ' s h y p o t h e s i s . More r e c e n t l y , C r i t c h l e y has m e n t i o n e d i n h i s monograph on d y s l e x i a t h a t a c h a r a c t e r i s t i c , b u t l e s s w e l l - k n o w n , d e f e c t o f c h i l d r e n w i t h a r e a d i n g d i s a b i l i t y i s t h e i r i n a b i l i t y t o w r i t e l a r g e numbers c o r r e c t l y . T h e i r e r r o r s i n v o l v e an e x c e s s o r d i r t h o f z e r o s , i n c o r r e c t p l a c e m e n t o f commas, and o c c a s i o n a l r e v e r s a l s o f t h e number s e q u e n c e . He adds t h a t c o n f u s i o n i n w r i t i n g numbers may o r may n o t a f f e c t c a l c u l a t i n g a b i l i t y . I n some i n s t a n c e s , ' c h i l d r e n w i t h a r e a d i n g d i s a b i l i t y may p e r f o r m e x c e p t i o n a l l y w e l l i n c o m p u t a t i o n , w h i l e o t h e r s may have d i f f i -51 c u l t y w i t h a l l a s p e c t s o f a r i t h m e t i c . D y s g r a p h i a . I t was l a r g e l y O r t o n ' s work w h i c h drew a t t e n t i o n t o t h e r e l a t i o n s h i p between s p e l l i n g a b i l i t y and r e a d i n g a b i l i t y . A l t h o u g h p o o r s p e l l i n g a b i l i t y c o u l d e x i s t as an i s o l a t e d d e f e c t , a " s e l e c t i v e d i s a b i l i t y i n s p e l l i n g 52 u s u a l l y accompanie s t h e r e a d i n g d i s a b i l i t y . " I n c h i l d r e n A r t h u r L . B e n t o n , James H u t c h e o n and E l s i e Seymour, " A r i t h m e t i c A b i l i t y , F i n g e r - L o c a l i z a t i o n C a p a c i t y and Rights-L e f t D i s c r i m i n a t i o n s i n N o r m a l and D e f e c t i v e C h i l d r e n , " A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y , 21:756-766, 1951. 51 ^ M a c d o n a l d C r i t c h l e y , D e v e l o p m e n t a l D y s l e x i a (London : W i l l i a m Heinemann M e d i c a l B o o k s , 1964) , p p . 3.6-38. 52 Samuel T . O r t o n , " S p e c i a l D i s a b i l i t y i n S p e l l i n g , " B u l l e t i n o f t h e N e u r o l o g1 c a1 I n s t i t u t e o f New Y o r k , 1:159-192, 1931. ~ ~ ~ 36 w i t h a s e v e r e s p e l l i n g d i s a b i l i t y t h e e r r o r s made c o n s i s t e d o f s t a t i c and k i n e t i c r e v e r s a l s , e l i s i o n o f v o w e l s and c o n -f u s i o n o f c o n s o n a n t s w h i c h were s i m i l a r i n f o r m o r s o u n d . V o w e l s and t h e many sounds o f " a " were a l s o f e r t i l e s o u r c e s o f e r r o r . O r t o n t h o u g h t t h e s e e r r o r s were p r o b a b l y due t o an i n c o n s i s t e n t r e c a l l o f v i s u a l , a u d i t o r y , and k i n e s t h e t i c 53 engrams . I n 1946 , Hermann and V o l d b y d e s c r i b e d t y p i c a l w r i t i n g e r r o r s made by 250 w o r d - b l i n d c h i l d r e n i n Denmark. They r e -p o r t e d a s i m i l a r i t y be tween t h e w r i t i n g e r r o r s o f w o r d - b l i n d c h i l d r e n and t h e a g r a p h i a o f a d u l t s w h i c h was f o u n d as a f e a -t u r e o f t h e Gers tmann syndrome . The e r r o r s w h i c h a p p e a r e d most f r e q u e n t l y were a c o n f u s i o n o f l e t t e r s h a p e s , d i s f i g u r e -ment o f l e t t e r s and many c o r r e c t i o n s , c o n t a m i n a t i o n o f one l e t t e r w i t h a n o t h e r , m i r r o r - w r i t i n g , t h e i n s e r t i o n o f b l o c k l e t t e r s i n t o s c r i p t , and s t a t i c and k i n e t i c r e v e r s a l s . They s t a t e d : I n c o n s t i t u t i o n a l d y s l e x i a we f i n d . . . s e v e r e g r a m m a t i c a l d i s t u r b a n c e s a r e accompanied by a more o r l e s s compromised m o r p h o l o g y o f t h e h a n d w r i t i n g . I f s p e l l i n g d i f f i c u l t i e s a r e b u t s m a l l , t h e d i s f i g u r e m e n t o f l e t t e r s w i l l s t a n d back o r maybe n o t o c c u r a t a l l ; we have t h e i m p r e s s i o n , h o w e v e r , t h a t i t e x i s t s more f r e q u e n t l y t h a n i s g e n e r a l l y a c c o u n t e d f o r i n t h e l i t e r a t u r e .'=>4 53 3 J I b i d . 54 K . Hermann and H . V o l d b y , "The M o r p h o l o g y o f Hand^ w r i t i n g i n C o n g e n i t a l W o r d - B l i n d n e s s , " A c t a P s y c h i a t r i a and  N e u r o l o g i a , 2 1 : 3 4 9 - 3 6 3 , 1946 . 37 A n o t h e r a s p e c t o f w r i t t e n l anguage has been s t u d i e d by M y k l e b u s t . H i s P i c t u r e S t o r y Language T e s t was d e v e l o p e d t o measure a c h i l d ' s f a c i l i t y w i t h t h e w r i t t e n w o r d . U s i n g s t a n d a r d s b a s e d on s t o r i e s w r i t t e n by c h i l d r e n f rom t h e ages o f s e v e n t o s e v e n t e e n , i t a s s e s s e d l anguage g r o w t h and d e v e l o p -ment i n t h r e e a r e a s : p r o d u c t i v i t y , s y n t a x , and l e v e l o f a b s t r a c t t h i n k i n g . R e s u l t s f o r n o r m a l c h i l d r e n showed maximum g r o w t h o c c u r s i n a l l t h r e e a r e a s f rom t h e age o f s e v e n t o t h i r t e e n y e a r s . Between t h e ages o f t h i r t e e n and s e v e n t e e n t h e r e was a l e v e l l i n g o f f i n g r o w t h f o r t o t a l words and t o t a l s e n t e n c e s , b u t c o n t i n u e d g r o w t h , a l t h o u g h l e s s d r a m a t i c t h a n a t t h e y o u n g e r l e v e l s , i n words p e r s e n t e n c e , s y n t a x , and a b s t r a c t t h o u g h t . C h i l d r e n w i t h r e a d i n g d i s a b i l i t i e s d e v i a t e d f rom t h e norm m a i n l y i n t h e a r e a o f p r o d u c t i v i t y . A b s t r a c t t h o u g h t and s y n t a x , a l t h o u g h d e f i c i e n t i n some i n s t a n c e s , d i d n o t p r o -v i d e as r e l i a b l e a p r e d i c t o r o f a r e a d i n g d i s a b i l i t y as t h e measure o f t o t a l o u t p u t i n w r i t t e n e x p r e s s i o n . He w r o t e : . . . we a r e c o n c e r n e d o n l y w i t h t h e p o s t u -l a t i o n t h a t a c q u i r i n g t h e t h r e e v e r b a l f o r m s , t h e s p o k e n , r e a d , and w r i t t e n , assumed i n t e g r i t y f o r l e a r n i n g t h r o u g h c e r t a i n m o d a l i t i e s , n o t o n l y i n terms o f each m o d a l i t y s e p a r a t e l y b u t a l s o i n b e i n g a b l e t o c o n v e r t t h a t w h i c h i s l e a r n e d t h r o u g h one o f t h e s e i n t o e q u i v a l e n t s l e a r n e d t h r o u g h o t h e r c h a n n e l s . I t i s s u c h t r a n s m o d a l l e a r n i n g w h i c h o f t e n i s d e f i c i e n t i n c h i l d r e n w i t h l e a r n i n g d i s a b i l i t i e s . 5 5 He lmer K . M y k l e b u s t , Deve lopment and D i s o r d e r s o f  W r i t t e n L a n g u a g e , v o l . I (New Y o r k : Grune and S t r a t t o n , 1 9 6 5 ) , p . 5 . 38 F i n g e r A g n o s i a . Two t e s t s f o r c h i l d r e n have been d e v -e l o p e d t o measure t h e i r knowledge o f t h e f i n g e r s . K i n s b o u r n e and W a r r i n g t o n f i r s t d e v e l o p e d t h e i r t e s t o f f i n g e r d i f f e r e n -t i a t i o n f o r a d u l t s . L a t e r , t h e y m o d i f i e d i t and s t a n d a r d i z e d i t on n i n e t y c h i l d r e n between t h e ages o f f o u r - a n d - a - h a l f and s e v e n - a n d - a - h a l f . The t h r e e p a r t s o f t h e t e s t were d e s i g n e d t o d e t e r m i n e " f i n g e r s e n s e , " t h a t i s , an awareness o f t h e s p a t i a l a r r angement o f t h e f i n g e r s on t h e hand and t o each o t h e r . I t was t h i s " f i n g e r s e n s e " w h i c h t h e y f e l t was / los t " , by-57 p a t i e n t s who d e v e l o p e d t h e Gers tmann syndrome. I n s t a n d a r d i z i n g t h e i r t e s t on c h i l d r e n , t h e y f o u n d t h e number o f c o r r e c t r e s p o n s e s i n c r e a s e d w i t h a g e . C h i l d r e n be tween t h e ages o f f i v e and s i x a c h i e v e d o n l y 50 p e r c e n t s u c c e s s , b u t by s e v e n - a n d - a - h a l f y e a r s t h e s e c h i l d r e n a c h i e v e d o v e r 90 p e r c e n t s u c c e s s on t h e t e s t . They r e m a r k e d : The c u r v e s a r e s u c h as w o u l d be e x p e c t e d were t h e y r e p r e s e n t a t i v e o f an a s p e c t o f m a t u r a t i o n s u b j e c t t o n o r m a l v a r i a t i o n . 5 8 B e n t o n ' s t e s t f o r f i n g e r l o c a l i z a t i o n , w h i c h measures t h e a b i l i t y t o i d e n t i f y t h e f i n g e r s t o u c h e d , showed t h e same °^M. K i n s b o u r n e and E l i z a b e t h K . W a r r i n g t o n , " A S t u d y o f F i n g e r A g n o s i a , " B r a i n , 8 5 : 4 7 - 6 6 , 1962 . 57 M . K i n s b o u r n e and E l i z a b e t h K . W a r r i n g t o n , "The Dev-e l o p m e n t o f F i n g e r . D i f f e r e n t i a t i o n , " Q u a r t e r l y J o u r n a l o f E x p e r i m e n t a 1 P s y c h o l o g y , 1 5 : 1 3 2 - 1 3 7 , 1963 . I b i d . improvement i n c o r r e c t responses with age. On h i s b a t t e r y of t e s t s , s i x year o l d c h i l d r e n performed c o r r e c t l y a t a 70 per cent l e v e l , whereas nine year o l d c h i l d r e n scored c o r r e c t l y a t 59 the 89 per cent l e v e l . F i n g e r Agnosia and S p e l l i n g . Kinsbourne and Warrington t e s t e d a group of a d u l t p a t i e n t s with b r a i n damage f o r the presence or absence of f i n g e r agnosia. A w r i t t e n s p e l l i n g t e s t i n d i c a t e d t h a t - t h e f i n g e r agnosia group made s p e l l i n g e r r o r s of l e t t e r o r d e r w h i l e the group, i n which f i n g e r agnosia was absent, made e r r o r s of extraneous l e t t e r s . ^ 0 S i m i l a r s p e l l i n g e r r o r s had been found a s s o c i a t e d w i t h f i n g e r agnosia i n an e a r l i e r study. F i n g e r Agnosia and Reading A b i l i t y . Reed t e s t e d two groups of c h i l d r e n , s i x and ten years of age, on Benton's f i n g e r . l o c a l i z a t i o n t e s t . S e l e c t i n g o n l y those c h i l d r e n a t e i t h e r age l e v e l who made more e r r o r s on one hand than on the other, he grouped them a c c o r d i n g t o l a t e r a l i z a t i o n of e r r o r s — i . e . more r i g h t hand e r r o r s or more l e f t hand e r r o r s . Comparing 59 A r t h u r L. Benton, " R i g h t - L e f t D i s c r i m i n a t i o n s and  F i n g e r L o c a l i z a t i o n (New York: Paul B. Hoeber, 1959) , p~. 83. 60 M. Kinsbourne and E l i z a b e t h K. Warrington, "Dis o r d e r s of S p e l l i n g , " J o u r n a l of Neurology, Neurosurgery and P s y c h i a t r y , 27:224-228, 1964. ' " ~ ~~ 61 M. Kinsbourne and E l i z a b e t h K. Warrington, "A Study of F i n g e r Agnosia," B r a i n , 85:47-66, 1962. 40 f i n g e r l o c a l i z a t i o n e r r o r s w i t h r e a d i n g a b i l i t y , he f o u n d a t t e n y e a r s o f age c h i l d r e n who made more e r r o r s on t h e r i g h t h a n d , i m p l i c a t i n g t h e l e f t h e m i s p h e r e i n r e l a t i o n t o l anguage f u n c t i o n , were a l s o p o o r e r i n r e a d i n g a b i l i t y . A t s i x y e a r s o f age more e r r o r s on t h e l e f t h a n d , i m p l i c a t i n g t h e r i g h t , h e m i s p h e r e i n r e l a t i o n t o s p a t i a l o r i e n t a t i o n , d i d n o t d i f f e r -e n t i a t e be tween good and p o o r r e a d e r s . A f u r t h e r a n a l y s i s be tween t h e number o f f i n g e r e r r o r s and r e a d i n g a b i l i t y showed no r e l a t i o n s h i p . He c o n c l u d e d h i s r e s u l t s p r o v i d e d some v a l -i d i t y f o r t h e r e l a t i o n s h i p between f i n g e r a g n o s i a and r e a d i n g a b i l i t y . The c h i l d r e n i n h i s s t u d y were n o t b r a i n damaged and he s u g g e s t e d t h e d i f f e r e n c e i n l anguage p r o f i c i e n c y may p a r -6 2 t i a l l y r e s u l t f rom v a r i a t i o n s i n c e r e b r a l i n t e g r i t y . F i n g e r A g n o s i a and R i g h t - L e f t O r i e n t a t i o n . Of a g roup o f c h i l d r e n t e s t e d f o r a r e a d i n g d i s a b i l i t y , S i l v e r and H a g i n r e t e s t e d 59 p e r c e n t as a d u l t s t e n t o t w e l v e y e a r s l a t e r . They a d m i n i s t e r e d t h e same b a t t e r y o f t e s t s two o f w h i c h were f o r r i g h t - l e f t o r i e n t a t i o n and f i n g e r ' ' t g n o s i s . As c h i l d r e n 89 p e r c e n t o f t h e r e a d i n g d i s a b i l i t y g r o u p showed r i g h t - l e f t c o n f u s i o n as compared t o t h e c o n t r o l g roup . . R e t e s t e d as a d u l t s no d i f f e r e n c e be tween t h e g roups was f o u n d i n t h e i r a b i l i t y t o d i s t i n g u i s h r i g h t . a n d l e f t . On t h e f i n g e r t e s t , one James C . R e e d , " L a t e r a l i z e d F i n g e r A g n o s i a and R e a d i n g A c h i e v e m e n t a t Ages S i x and T e n , " C h i I d D e v e l o p m e n t , 3 8 : 2 1 3 - 2 2 0 , 1967 . ^ 41 g r o u p o f r e a d i n g d i s a b i l i t y a d u l t s h a d i m p r o v e d and were n o t s i g n i f i c a n t l y d i f f e r e n t f r o m t h e c o n t r o l s . A s e c o n d g r o u p o f a d u l t s , c l a s s i f i e d as o r g a n i c r e a d i n g p r o b l e m s , s t i l l made a g r e a t many e r r o r s on t h e f i n g e r t e s t . S i l v e r and H a g i n c o n -c l u d e d t h a t t h e a b i l i t y t o d i s c r i m i n a t e b etween r i g h t and l e f t i m p r o v e d f r o m c h i l d h o o d t o a d u l t h o o d , b u t t h a t i n t h e c a s e o f r e a d i n g d i s a b i l i t i e s o f an o r g a n i c n a t u r e d i f f i c u l t y 6 3 w i t h t h e f i n g e r g n o s i s t e s t p e r s i s t e d i n t o a d u l t h o o d . R i g h t - L e f t O r i e n t a t i o n . B e n t o n o b s e r v e d t h a t c h i l d r e n g a i n a knowledge o f r i g h t and l e f t f i r s t on t h e m s e l v e s and t h e n i n r e l a t i o n t o s o m e o n e . f a c i n g them. H i s s t a n d a r d i z e d t e s t f o r a knowledge o f r i g h t and l e f t on " s e l f " showed t h e number o f c o r r e c t r e s p o n s e s i n c r e a s e d w i t h a g e . S c o r e s o f 6 5 p e r c e n t c o r r e c t a t s i x y e a r s , and 92 p e r c e n t c o r r e c t a t n i n e y e a r s were o b t a i n e d . B e n t o n commented t h a t a l t h o u g h a knowledge o f r i g h t and l e f t on o n e s e l f d e v e l o p e d f i r s t , mas-t e r y o f t h i s was n o t a s u f f i c i e n t c o n d i t i o n f o r c o r r e c t 64 l a t e r a l o r i e n t a t i o n w i t h r e s p e c t t o o t h e r p e o p l e . D u r i n g h i s t e s t i n g o f c h i l d r e n f o r t h e i r k n owledge o f r i g h t and l e f t , B e n t o n d i s c o v e r e d a g r o u p who a l w a y s r e v e r s e d a command by s y s t e m a t i c a l l y u s i n g t h e i r l e f t hand when a 6 3 A r c h i e A. S i l v e r and Rosa A. H a g i n , " S p e c i f i c R e a d i n g D i s a b i l i t y : F o l l o w - u p S t u d i e s , " A m e r i c a n J o u r n a l o f O r t h o p s y -c h i a t r y . , 34:95-102, 1954. 64 . A r t h u r L . B e n t o n , R i g h t - L e f t D i s c r i m i n a t i o n s and F i n g e r L o c a l i z a t i o n (New Y o r k : P a u l B. Ho e b e r , 1959, pp.28-31. 42 command was g i v e n f o r t h e r i g h t , y e t o t h e r w i s e c o m p l e t i n g t h e command c o r r e c t l y . P u r s u i n g t h i s d i s c o v e r y , B e n t o n and K e m b l e t e s t e d t w e n t y d i s a b l e d r e a d e r s a n d t w e n t y a v e r a g e r e a d e r s o n t h e i r k n o w l e d g e o f r i g h t and l e f t . T h e y f o u n d one a v e r a g e r e a d e r and f o u r r e a d i n g d i s a b i l i t y c h i l d r e n who made s y s t e m a t i c r e v e r s a l s . A l t h o u g h t h e r e a d i n g d i s a b i l i t y g r o u p p e r f o r m e d l e s s w e l l t h a n t h e c o n t r o l s on a l l t h r e e p a r t s o f t h e t e s t , none o f t h e d i f f e r e n c e s was s i g n i f i c a n t . B e n t o n and K e m b l e c o n c l u d e d t h a t c h i l d r e n w i t h a r e a d i n g d i s a b i l i t y h a v e a s t r o n g e r t e n d e n c y t o show r e v e r s a l s i n o r i e n t a t i o n , b u t t h a t s u c h a p e r f o r m a n c e i n d i c a t e d a d e f i c i t i n s y m b o l i c f u n c t i o n r a t h e r t h a n a d i s t u r b a n c e i n t h e b o d y s c h e m a . ^ R i c e t e s t e d 200 p r i m a r y c h i l d r e n whose mean i n t e l l i -g e n c e q u o t i e n t r a n g e d f r o m 115-120, f o r t h e i r k n o w l e d g e o f r i g h t and l e f t . He f o u n d , w i t h i n g r a d e s a n d w i t h i n t h e t o t a l g r o u p , t h a t y o u n g e r c h i l d r e n made more s y s t e m a t i c r e v e r s a l s t h a n o l d e r c h i l d r e n . By G r a d e t h r e e , o n l y 2 p e r c e n t c o n -t i n u e d t o make s y s t e m a t i c r e v e r s a l s . C o - v a r i a n c e a n a l y s e s b e t w e e n r e v e r s a l s a n d n o n - r e v e r s a l s w i t h v i s u a l r e t e n t i o n , r e a d i n g , a r i t h m e t i c , a n d a u d i t o r y a b i l i t y w e r e n o t s i g n i f i c a n t . A r t h u r L . B e n t o n and J o a n D . K e m b l e , " R i g h t - L e f t O r i e n t a t i o n a n d R e a d i n g D i s a b i l i t y , " P s y c h i a t r i a e t N e u r o l o g i a , 139:49-60, 1960. 6 6 James A . R i c e , " R i g h t - L e f t D i s c r i m i n a t i o n : S y s t e m a t i c R e v e r s a l i n B r i g h t C h i l d r e n , " J o u r n a l o f L e a r n i n g D i s a b i l i t i e s , 1:654-659, 1968. 43 T o t a l Gers tmann Syndrome. Hermann and N o r r i e , o f t h e W o r d - B l i n d I n s t i t u t e i n Copenhagen , Denmark were t h e f i r s t t o s u g g e s t t h e Gers tmann syndrome m i g h t u n d e r l i e a r e a d i n g d i s -a b i l i t y . T h e i r s t u d y compared w o r d - b l i n d c h i l d r e n w i t h n o r m a l c h i l d r e n f rom e l e m e n t a r y and s e c o n d a r y s c h o o l s i n Copenhagen . R i g h t - l e f t d i s o r i e n t a t i o n was f o u n d i n 44 p e r c e n t o f t h e w o r d - b l i n d c h i l d r e n as compared t o 19 p e r c e n t and 7 p e r c e n t o f t h e c h i l d r e n f rom t h e e l e m e n t a r y and s e c o n d a r y s c h o o l s r e s p e c t i v e l y . T h i r t y - s i x p e r c e n t o f t h e w o r d - b l i n d , b u t o n l y 16 p e r c e n t o f t h e e l e m e n t a r y and 3 p e r c e n t o f t h e s e c o n d a r y s c h o o l c h i l d r e n were u n c e r t a i n on t e s t s f o r f i n g e r a g n o s i a . A c o m p a r i s o n o f t h e symptoms c o m p r i s i n g t h e Gers tmann syndrome and t h o s e f o u n d i n t h e w o r d - b l i n d c h i l d r e n i n d i c a t e d 6 7 a s t r o n g a s s o c i a t i o n between t h e two c o n d i t i o n s . K i n s b o u r n e and W a r r i n g t o n s t u d i e d seven c h i l d r e n who t e s t e d p o s i t i v e l y f o r f i n g e r a g n o s i a . S i x s c o r e d w e l l b e l o w t h e i r c h r o n o l o g i c a l age i n r e a d i n g , s p e l l i n g , and a r i t h m e t i c a b i l i t y ; one s c o r e d a b o v e . When t e s t e d f o r t h e f o u r symptoms o f t h e Gers tmann syndrome a l l s even showed d e f i c i t s i n s p e l l i n g ( d y s g r a p h i a ) , a d d i t i o n and s u b t r a c t i o n ( d y s c a l c u l i a ) , and i n a knowledge o f r i g h t and l e f t on o t h e r s . O n l y f o u r o f t h e seven were d e f i c i e n t i n a knowledge o f r i g h t and l e f t on them-s e l v e s , and i n w r i t i n g a b i l i t y . K i n s b o u r n e and W a r r i n g t o n 6 7 Knud Hermann and E d i t h N o r r i e , " I s C o n g e n i t a l Word-B l i n d n e s s a H e r e d i t a r y Type o f G e r s t m a n n ' s S y n d r o m e , " P s y c h i a t r i a and N e u r o l o g i a , 1 3 6 : 5 9 - 7 3 , 1958 . 44 r e l a t e d t h e i r f i n d i n g s t o a d e v e l o p m e n t a l b a s i s , b u t m e d i c a l e x a m i n a t i o n s had r e v e a l e d t h a t s i x o f t h e s e v e n c h i l d r e n had s u f f e r e d c e r e b r a l damage t h r o u g h i l l n e s s , e p i l e p s y , o r a t 6 8 t h e t i m e o f b i r t h . P r e v i o u s r e s e a r c h h as i n d i c a t e d t h a t a p o s s i b l e r e l a -t i o n s h i p b etween a r e a d i n g d i s a b i l i t y and t h e f o u r symptoms o f t h e Ge r s t m a n n syndrome may e x i s t . A l s o , k i n e t i c and s t a t i c r e v e r s a l e r r o r s i n s p e l l i n g have b e e n a s s o c i a t e d w i t h a r e a d i n g d i s a b i l i t y and w i t h t h e d y s g r a p h i a o f t h e Ger s t m a n n syndrome. , The i n t e r r e l a t i o n s h i p o f a r e a d i n g p r o b l e m c o u p l e d w i t h r e v e r s a l e r r o r s i n s p e l l i n g h as n o t b e e n t e s t e d i n c o n j u n c t i o n w i t h a l l f o u r symptoms o f t h e Ger s t m a n n syndrome. I n a d d i t i o n , a l l o f t h e s e symptoms have n o t b e e n e s t a b l i s h e d as t o t h e i r f r e -q u e n c y o f o c c u r r e n c e i n a sample o f n o r m a l s c h o o l c h i l d r e n w h i c h i n c l u d e s b o t h good and p o o r r e a d e r s , and b o t h good and p o o r s p e l l e r s . I n t h i s s t u d y , t h e r e l a t i o n s h i p between r e a d i n g a b i l i t y , s p e l l i n g a b i l i t y , and t h e f o u r symptoms o f t h e Gerstmann syndrome was e x a m i n e d i n an a t t e m p t a t c l a r i f i c a t i o n o f t h e above f a c t o r s . SUMMARY V a r i o u s n e u r o l o g i c a l c o n d i t i o n s have been p r o p o s e d as u n d e r l y i n g a " r e a d i n g d i s a b i l i t y " i n w h i c h r e v e r s a l e r r o r s i n 6 8 M. K i n s b o u r n e and E l i z a b e t h K. W a r r i n g t o n , "The D e v e l o p m e n t a l Gerstmann Syndrome," A r c h i v e s o f N e u r o l o g y , 8:490-501, 1963. ^ ^ ~ 45 s p e l l i n g were a prominent f e a t u r e . Hinshelwood thought the d i s a b i l i t y due to " c o n g e n i t a l word-blindness." Orton sugges-ted a l a c k of c e r e b r a l dominance c o n t r i b u t e d to the d i s a b i l i t y . More r e c e n t l y , Hermann has r e l a t e d such c o n d i t i o n to a type of " h e r e d i t a r y Gerstmann syndrome.". Orton's theory of c e r e b r a l dominance has r e c e i v e d the g r e a t e s t a t t e n t i o n from r e s e a r c h e r s . However, l a t e r a l i t y p a t t e r n s , l e f t - h a n d e d n e s s , poor v i s i o n , and abnormal E.E.G. r e c o r d i n g s have not shown a c o n s i s t e n t r e l a t i o n s h i p with a r e a d i n g problem. R e v e r s a l e r r o r s i n s p e l l i n g have shown a c o r r e l a t i o n with a r e a d i n g problem. T h i s type of s p e l l i n g e r r o r has been found more f r e q u e n t l y among poorer readers than among b e t t e r r e a d e r s . Although younger c h i l d r e n make a g r e a t e r number of these e r r o r s than o l d e r c h i l d r e n , t r a n s p o s i t i o n e r r o r s p e r s i s t among o l d e r c h i l d r e n . The presence of r e v e r s a l e r r o r s i n s p e l l i n g does not appear to be r e l a t e d to p e r c e p t u a l d i f f i c u l -t i e s , mixed l a t e r a l i t y , l e f t - h a n d e d n e s s , or poor v i s i o n . The f o u r symptoms of the Gerstmann syndrome: d i s o r i e n -t a t i o n f o r f i g h t and l e f t , f i n g e r agnosia, d y s c a l c u l i a and d ysgraphia have p r o v i d e d some evidence, e i t h e r i n d i v i d u a l l y or as a group, f o r an a s s o c i a t i o n w i t h a r e a d i n g problem and with r e v e r s a l e r r o r s i n s p e l l i n g . CHAPTER I I I DEVELOPMENT AND ADMINISTRATION OF THE INSTRUMENTS The p u r p o s e o f t h i s c h a p t e r i s t o d e s c r i b e (1) t h e c o n s t r u c t i o n , a d m i n i s t r a t i o n , and s c o r i n g o f t h e s p e l l i n g t e s t , (2) t h e g r o u p i n g and s e l e c t i o n o f c h i l d r e n t o be t e s t e d f o r t h e Ger s tmann syndrome , and (3) t h e s e l e c t i o n , a d m i n i s -t r a t i o n , and s c o r i n g o f t h e f o u r t e s t s f o r t h e Gers tmann syndrome . THE SPELLING TEST S t a t i c and k i n e t i c r e v e r s a l e r r o r s i n s p e l l i n g w h i c h p e r s i s t p a s t 'grade t h r e e a r e c o n s i d e r e d i n d i c a t i v e o f a r e a d i n g d i s a b i l i t y . " ' " However , c h i l d r e n who a r e good r e a d e r s 2 can a l s o make s u c h m i s t a k e s , b u t do so l e s s f r e q u e n t l y . A t e s t c o n t a i n i n g words w h i c h w o u l d p o s s i b l y e l i c i t s t a t i c and k i n e t i c r e v e r s a l e r r o r s , was c o n s t r u c t e d t o d e t e r m i n e t h e e x t e n t t o w h i c h s u c h e r r o r s w o u l d be made by b o t h good and p o o r r e a d e r s . C . K o l s o n and G . K a l u g e r , C l i n i c a l A s p e c t s o f R e m e d i a l  R e a d i n g ( S p r i n g f i e l d , I l l i n o i s : C h a r l e s C . Thomas, 1 9 6 3 ) , p . 30 . 2 Knud Hermann, R e a d i n g D i s a b i l i t y (Copenhagen, Denmark: E j n a r M u n k s g a a r d A . S . , 1 9 5 9 ) , p . 7 5 . C o n s t r u c t i o n o f t h e S p e l l i n g T e s t Two h u n d r e d words were i n i t i a l l y s e l e c t e d f r o m D o l c h ' s 3 L i s t o f 2,000 Commonest Words f o r . S p e l l i n g . The c h o i c e o f t h e s e words was b a s e d on t h e i r p o t e n t i a l f o r r e v e r s a l e r r o r s i n l e t t e r s e q u e n c e o r o r i e n t a t i o n , and on t h e i r s p e l l i n g d i f f i c u l t y f o r G r a d e f i v e s t u d e n t s . Words were j u d g e d t o be p o s s i b l e s o u r c e s o f r e v e r s a l e r r o r i f t h e y c o n t a i n e d (1) v o w e l d i g r a p h s ( p r a i s e , b e l i e v e ) , (2) d i p h t h o n g s ( v o i c e ) , ( 3 ) v o w e l s a p p e a r i n g t o g e t h e r , b u t b o t h s o u n d i n g ( u s u a l , g i a n t ) , (4) v o w e l - c o n s o n a n t c o m b i n a t i o n s ( h o r s e , s e v e r a l ) , (5) a v o w e l p r e c e d e d o r f o l l o w e d by an " r " ( g i r l , t r u t h ) , (6) t w o t o r more c o n s o n a n t s t o g e t h e r ( s c h o o l , h u n d r e d ) , (7) l e t t e r s whose o r i e n t a t i o n c o u l d be r e v e r s e d (month-mouth, b r i d g e - d r i b g e ) . The two h u n d r e d words c h o s e n a c c o r d i n g t o t h e f o r e g o i n g c r i t e r i a were r a n d o m l y d i v i d e d i n t o two g r o u p s o f one h u n d r e d words e a c h . From e a c h g r o u p o f a h u n d r e d , f i f t y words were s e l e c t e d and p a i r e d , as much as p o s s i b l e , on t h e s i m i l a r i t y o f l e t t e r c o m b i n a t i o n s ( i . e . l e a t h e r - f e a t h e r , v a c a t i o n - s t a t i o n , f a i r y - s t a i r s ) . Two t e s t s "A" and "B" were c o n s t r u c t e d . E a c h t e s t c o n t a i n e d t w e n t y - f i v e word p a i r s . The r e m a i n i n g , unmatched f i f t y w o r d s , f r o m e a c h g r o u p o f one h u n d r e d w e r e d i s c a r d e d . Edward W. D o l c h , B e t t e r S p e l l i n g (Champaign, I l l i n o i s : The G a r r a r P r e s s , 1 9 4 2 ) , pp. 257-270. 48 P r e l i m i n a r y t e s t i n g was c a r r i e d o u t by t h e c l a s s r o o m t e a c h e r s i n two d i f f e r e n t e l e m e n t a r y s c h o o l s . I n s t r u c t i o n s f o r a d m i n i s t e r i n g t h e s p e l l i n g t e s t were i n c l u d e d w i t h e a c h t e s t . A l l t h e f i f t h g r a d e c h i l d r e n i n one s c h o o l (N = 101) were g i v e n t e s t "A" and a l l t h e f i f t h g r a d e c h i l d r e n i n t h e s e c o n d s c h o o l (N = 73) were g i v e n t e s t "B". The two t e s t s were s c o r e d f o r e r r o r s i n l e t t e r s e q u e n c e , i n l e t t e r o r i e n -t a t i o n , and f o r g e n e r a l m i s s p e l l i n g s . T o t a l e r r o r s o f e a c h t y p e were r e c o r d e d f o r e a c h word m a k i n g up b o t h t e s t "A" and t e s t "B". Words w h i c h were t o o d i f f i c u l t , t o o e a s y , o r w h i c h d i d n o t c a u s e a r e v e r s a l e r r o r were d i s c a r d e d . O n l y t h e words w h i c h h a d r e v e a l e d a t e n d e n c y f o r r e v e r s a l s i n s e q u e n c e o r o r i e n t a t i o n and w h i c h f i f t y p e r c e n t o r more o f t h e s t u d e n t s s p e l l e d c o r r e c t l y were u s e d i n t h e f i n a l t e s t . The words were a r r a n g e d on t h e t e s t s o t h a t a s p l i t -h a l f c o r r e l a t i o n o f r e l i a b i l i t y c o u l d be c a l c u l a t e d . The f i r s t h a l f o f t h e t e s t c o n t a i n e d one o f t h e word p a i r s ; t h e s e c o n d h a l f o f t h e t e s t c o n t a i n e d i t s c o u n t e r p a r t . The words were o r d e r e d w i t h t h e more d i f f i c u l t words b e i n g p l a c e d t o w a r d s t h e m i d d l e o f e a c h h a l f and s o t h a t t h e word p a i r s were n o t d i r e c t l y o p p o s i t e e a c h o t h e r . The f i n a l t e s t i n s t r u m e n t was a d m i n i s t e r e d t o f i f t y -s e v e n f i f t h g r a d e c h i l d r e n i n a d i f f e r e n t e l e m e n t a r y s c h o o l f r o m t h e ones u s e d f o r t h e i n i t i a l t e s t s . The same i n s t r u c -t i o n s f o r a d m i n i s t e r i n g t h e t e s t were i n c l u d e d and f o l l o w e d 49 by t h e c l a s s r o o m t e a c h e r . T o t a l e r r o r s ( r e v e r s a l s and g e n e r a l m i s s p e l l i n g s ) were r e c o r d e d f o r e a c h h a l f o f t h e t e s t . Re-l i a b i l i t y , u s i n g a s p l i t - h a l f c o r r e l a t i o n , was 0.78. When t h e Spearman-Brown f o r m u l a was a p p l i e d t o t h e f i n a l t e s t t h e r e l i a b i l i t y o f t h e w h o l e t e s t i n s t r u m e n t was 0.876. The f i n a l t e s t i n s t r u m e n t i s shown i n A p p e n d i x A. A d m i n i s t r a t i o n o f t h e S p e l l i n g T e s t The s p e l l i n g t e s t was a d m i n i s t e r e d t o a l l f i f t h g r a d e s t u d e n t s i n f i v e e l e m e n t a r y s c h o o l s i n Richmond S c h o o l D i s t r i c t d u r i n g t h e l a s t week i n J a n u a r y , 1969. I t was a d m i n i s t e r e d by t h e same e x a m i n e r t o e a c h c l a s s b etween t h e h o u r s o f n i n e and t e n - t h i r t y i n t h e m o r n i n g . The t o t a l t i m e p e r c l a s s , i n c l u d i n g i n s t r u c t i o n s , s e t t i n g up o f t h e p a p e r s p r e p a r a t o r y t o t h e t e s t , a d m i n i s t e r i n g t h e t e s t , and c o l l e c t i n g t h e p a p e r s was a p p r o x i -m a t e l y t w e n t y m i n u t e s . The t o t a l number o f c h i l d r e n t e s t e d a t t h i s t i m e was 468. The c h i l d r e n were i n f o r m e d t h a t t h e y were t o have a. s p e l l i n g t e s t and t h e i n s t r u c t i o n s f o r t h e t e s t were g i v e n . When t h e c h i l d r e n were r e a d y t h e words were d i c t a t e d a t a u n i -f o r m p a c e . A p p r o x i m a t e l y f i v e s e c o n d s e l a p s e d b etween t h e t i m e a word was g i v e n and t h e number s i g n a l l i n g t h e n e x t word. The words were p r o n o u n c e d s l o w l y and d i s t i n c t l y . Such words as ' F e b r u a r y , " u s u a l " "poem" 'q-uiet 1, and" s e v e r a l " , were s a i d w i t h e q u a l s t r e s s p l a c e d on a l l t h e s y l l a b l e s so t h a t s p e l l i n g e r r o r s i n w h i c h t h e o r d e r o f t h e l e t t e r s were c h a n g e d c o u l d be 50 c o n s i d e r e d k i n e t i c r e v e r s a l e r r o r s . The. one s y l l a b l e words were p r o n o u n c e d so t h a t t h e sounds r e p r e s e n t i n g t h e l e t t e r sequence r e c e i v e d e q u a l s t r e s s . . C a r e was t a k e n t o a v o i d d i s -t o r t i o n o f a word s u c h as " p e r a l " f o r " p e a r l . " S c o r i n g o f t h e S p e l l i n g T e s t S p e l l i n g e r r o r s o f a s t a t i c n a t u r e were marked u s i n g t h e f o l l o w i n g c r i t e r i a . A s t a t i c r e v e r s a l e r r o r was c o u n t e d as s u c h i f a l e t t e r ' s o r i e n t a t i o n was r e v e r s e d . S t a t i c r e v e r -s a l e r r o r s o c c u r r e d w i t h o n l y two l e t t e r s , " n " and " b " . The most common o f t h e s e e r r o r s was f o u n d i n t h e s p e l l i n g o f " m o n t h " as " m o u t h " . The same e r r o r a p p e a r e d l e s s f r e q u e n t l y i n t h e s p e l l i n g o f " f r o n t " as " f r o u t " . However , i f " m o n t h " was s p e l l e d " m o u n t h " t h i s s p e l l i n g was marked as a m i s s p e l l i n g and n o t as a s t a t i c r e v e r s a l e r r o r . O n l y two c h i l d r e n i n t h e t o t a l sample w r o t e a " d " f o r a " b " . Whenever t h e i n c o r r e c t o r i e n t a t i o n o f a " b " o c c u r r e d i n a w o r d , i t was marked as a s t a t i c r e v e r s a l e r r o r . S p e l l i n g e r r o r s o f a k i n e t i c n a t u r e were m a r k e d , u s i n g t h e f o l l o w i n g c r i t e r i a . A k i n e t i c r e v e r s a l e r r o r was marked as such ' i f any i n c o r r e c t s e q u e n c i n g o f t h e c o r r e c t l e t t e r s o c c u r r e d i n t h e s p e l l i n g o f a w o r d . F o r e x a m p l e , t h e s p e l l i n g s " F e b u r a r y , " " F e b r a u r y " , " p e p o l e " , " p e o p e l " , " p e o l p e " , " u s a u l " , " u a s u l " , were marked as k i n e t i c r e v e r s a l e r r o r s . Any o t h e r i n c o r r e c t s p e l l i n g s f o r t h e s e words were marked as m i s s p e l l i n g s . 51 A d e v i a t i o n f rom t h e above m a r k i n g o f k i n e t i c r e v e r s a l s i n w h i c h t h e c o r r e c t l e t t e r s had t o o c c u r b u t i n t h e wrong o r d e r , was i n m a r k i n g words i n w h i c h an " r " was i n c o r r e c t l y p l a c e d . F o r e x a m p l e , t h e s p e l l i n g " g e r l " was marked as a m i s s p e l l i n g b u t t h e s p e l l i n g " g r e l " was marked as a k i n e t i c r e v e r s a l e r r o r . The same s t a n d a r d was a p p l i e d t o s i m i l a r words s u c h as " b u r s t " . The s p e l l i n g " b r i s t " and " b r e s t " were marked as r e v e r s a l e r r o r s , b u t t h e s p e l l i n g s " b i r s t " and " b e r s t " were marked as m i s s p e l l i n g s . Words w h i c h were n o t a t t e m p t e d o r w h i c h were m i s s p e l l e d i n a manner o t h e r t h a n t h a t w h i c h c o u l d be c l a s s i f i e d as a r e v e r s a l e r r o r were marked as m i s s p e l l i n g s . The t o t a l number o f r e v e r s a l e r r o r s was r e c o r d e d f o r each c h i l d . GROUPING AND SELECTION OF CHILDREN TO BE TESTED FOR THE GERSTMANN SYNDROME F o l l o w i n g t h e a d m i n i s t r a t i o n o f t h e s p e l l i n g t e s t , t h e a g e , and t h e S t a n f o r d A c h i e v e m e n t T e s t s c o r e s f o r r e a d i n g and f o r a r i t h m e t i c a b i l i t y were c o l l e c t e d f rom t h e i n d i v i d u a l p r o g r e s s r e c o r d c a r d s and r e c o r d e d f o r each c h i l d . G r o u p i n g o f t h e C h i l d r e n As t h e S t a n f o r d A c h i e v e m e n t T e s t had been a d m i n i s t e r e d a t t h e end o f g r a d e f o u r , a s c o r e o f 4 .0 o r b e l o w was t h e 52 c r i t e r i o n u sed f o r a c h i l d r e a d i n g one o r more y e a r s b e l o w g r a d e p l a c e m e n t . On t h e b a s i s o f t h e s p e l l i n g t e s t and t h e r e a d i n g s c o r e s , t h e c h i l d r e n were d i v i d e d i n t o t h e f o l l o w i n g g r o u p s : Group R e v e r s a l E r r o r s S t a n f o r d A c h i e v e m e n t Number i n S p e l l i n g S c o r e i n R e a d i n g 1 1 o r more 4 .0 o r b e l o w 7 4 2 1 o r more 4 . 1 o r above 170 3 0 4 .0 o r b e l o w 7 4 0 4 . 1 o r above 92 From t h e o r i g i n a l sample o f 468 c h i l d r e n t e s t e d , 125 were o m i t t e d f rom t h e sample a t t h i s t i m e as t h e i r p r o g r e s s r e c o r d c a r d s l a c k e d s u f f i c i e n t d a t a . S e l e c t i o n o f C h i l d r e n t o be T e s t e d f o r t h e Ger s tmann Syndrome The c h i l d r e n t o be t e s t e d f o r t h e f o u r symptoms o f t h e Ger s tmann syndrome were s e l e c t e d i n t h e f o l l o w i n g manner . I n Group 1 s i x t e e n o f t h e 74 c h i l d r e n made s i x o r more r e v e r s a l e r r o r s i n s p e l l i n g , and i n Group 2 , n i n e t e e n o f t h e 170 c h i l -d r e n made s i x o r more r e v e r s a l e r r o r s . Of t h e s e c h i l d r e n , who made s i x o r more r e v e r s a l e r r o r s i n s p e l l i n g , f i f t e e n were s e l e c t e d a t random f rom b o t h Group 1 and Group 2 . From t h e r e m a i n i n g c h i l d r e n i n Groups 1 and 2 , who made f i v e o r f ewer r e v e r s a l e r r o r s i n s p e l l i n g , f i f t e e n were s e l e c t e d a t random f rom b o t h Group 1 and Group 2 . Thus g r o u p s 1 and 2 each 53 c o n s i s t e d o f t h i r t y c h i l d r e n , f i f t e e n who made f i v e o r f e w e r r e v e r s a l e r r o r s and f i f t e e n who made s i x o r more r e v e r s a l e r r o r s . T h i r t y c h i l d r e n were s e l e c t e d a t random f r o m Group 4, and a l l s e v e n c h i l d r e n i n Group 3 were i n c l u d e d i n t h e i n d i v i -d u a l t e s t i n g . I n t o t a l , 97 c h i l d r e n were t e s t e d f o r t h e f o u r symptoms o f t h e G e r s t m a n n syndrome. TESTING FOR THE GERSTMANN SYNDROME S e l e c t i o n o f T e s t s F o u r t e s t s r e q u i r e d t o d e t e r m i n e t h e p r e s e n c e o f t h e Gerstmann syndrome i n c l u d e : one f o r d i s o r i e n t a t i o n f o r r i g h t and l e f t , one f o r f i n g e r a g n o s i a , one f o r d y s g r a p h i a , and one f o r d y s c a l c u l i a . The f o u r t e s t s u s e d t o measure w h e t h e r t h e s e symptoms were p r e s e n t o r a b s e n t a r e d e s c r i b e d b e l o w . D i s o r i e n t a t i o n f o r r i g h t and l e f t . P r e v i o u s r e s e a r c h and t h e l i m i t a t i o n o f t i m e f o r t e s t i n g s u g g e s t e d t h a t e i g h t commands w o u l d be s u f f i c i e n t t o t e s t a c h i l d ' s knowledge o f r i g h t and l e f t . Of t h e e i g h t commands u s e d , s i x t e s t e d a c h i l d ' s a w a r e n e s s o f r i g h t and l e f t on h i m s e l f . Two o f t h e s e commands d i d n o t r e q u i r e c r o s s i n g t h e body m i d - l i n e , two commands r e q u i r e d a d i r e c t i o n a l movement, and two commands r e q u i r e d c r o s s i n g t h e body m i d - l i n e . The r e m a i n i n g two com-mands t e s t e d t h e s u b j e c t ' s k nowledge o f r i g h t and l e f t on a n o t h e r p e r s o n f a c i n g h im. One o f t h e s e commands r e q u i r e d o n l y t h e i d e n t i f i c a t i o n o f r i g h t and l e f t on t h e o t h e r p e r s o n . 54 The c h i l d c o u l d use w h i c h e v e r hand he chose t o make t h e r e s -p o n s e . The s e c o n d command, a d o u b l e c r o s s e d o n e , r e q u i r e d t h e s u b j e c t t o i d e n t i f y r i g h t o r l e f t on t h e o t h e r p e r s o n i n d i r e c t r e l a t i o n s h i p t o h i m s e l f . The commands and t h e o r d e r i n w h i c h t h e y were g i v e n a r e shown i n A p p e n d i x C . F i n g e r A g n o s i a . A t e s t f o r f i n g e r a g n o s i a was c h o s e n w h i c h most c l o s e l y p a r a l l e l e d t h i s symptom as f o u n d i n t h e Ger s tmann syndrome . K i n s b o u r n e and W a r r i n g t o n have s t a t e d t h a t i n t h e Ger s tmann syndrome t h e p a t i e n t s u f f e r s f rom a l o s s o f " f i n g e r s e n s e " . T h e i r t e s t , w h i c h was d e s i g n e d t o measure 4 t h i s d e f i c i t , was s e l e c t e d . The t e s t was s u i t a b l e t o use w i t h g r a d e f i v e c h i l d r e n as t h e t h r e e p a r t s o f t h e t e s t a r e p a s s e d by 90 p e r c e n t o f t h e c h i l d r e n by t h e age o f s e v e n - a n d - a - h a l f . A l s o , no v e r b a l i d e n t i f i c a t i o n o f t h e f i n g e r s by name was r e q u i r e d . The s u b -j e c t m e r e l y r e p o r t e d t h e number o f f i n g e r s b e i n g t o u c h e d , t h e number o f f i n g e r s i n between t h o s e b e i n g t o u c h e d , o r i d e n t i -f i e d t h e b l o c k w h i c h he c o u l d see as t h e same as t h e one he h e l d i n h i s h a n d , w h i c h he c o u l d n o t s e e . A p i c t u r e o f t h e t e s t i s shown i n A p p e n d i x B . D y s g r a p h i a . M y k l e b u s t ' s P i c t u r e S t o r y Language T e s t was s e l e c t e d t o measure l anguage f a c i l i t y . H i s t e s t p r o v i d e d M . K i n s b o u r n e and E l i z a b e t h K . W a r r i n g t o n / "The Deve lopment o f F i n g e r D i f f e r e n t i a t i o n , " Q u a r t e r l y J o u r n a l o f  E x p e r i m e n t a l ' P s y c h o l o g y / 1 5 : 1 3 2 - 1 3 7 , 1 9 6 3 . 55 a numerical score for three areas of language a b i l i t y ; pro-duction, syntax, and abstract thought. Stanine conversion 5 tables permitted a c l a s s i f x c a t i o n of each child ' s raw score. In the development of his t e s t , Myklebust found that children with a reading d i s a b i l i t y scored low i n production ( i . e . they wrote much shorter stories than t h e i r peers). Neither syntax scores nor more concrete ideas i n t h e i r s t o r i e s were as r e l i a b l e a predictor of a c h i l d with a reading d i s a -b i l i t y as was limited output. Low productivity i n the written work of children could be interpreted as being a d i f f i c u l t y i n expressing ideas i n writing which i s a milder form of the symptom agraphia as defined by Ganong. Using t h i s c r i t e r i o n , a stanine score of 3.0 or below for productivity was used as the measure of a language d i s a b i l i t y . Myklebust calculated the r e l i a b i l i t y of his test using odd-even c o e f f i c i e n t s for words per sentence and for syntax. Overall r e l i a b i l i t y for words per sentence was 0.82 and for syntax 0.88. When r e l i a b i l i t y was analysed by age, the lowest c o e f f i c i e n t s occurred at the eleven to thirteen year age l e v e l s . For words per sentence, the c o e f f i c i e n t s were 0.38 Helmer R. Myklebust, Development and Disorders of  Written Language, v o l . I (New York: Grune & Stratton, 1965), pp. 269-272. 6 William F. Ganong, Review of Medic a1 Phys iology (Los Alto s , C a l i f o r n i a : Lange Medical Publications, 1969), p. 213. f o r e l e v e n y e a r o l d s , and 0 .54 f o r t h i r t e e n y e a r o l d s . S y n t a x c o e f f i c i e n t s were 0 .56 f o r e l e v e n y e a r o l d s and 0 .52 f o r t h i r -t e e n y e a r o l d s i n d i c a t i n g g r e a t e r v a r i a t i o n s i n a b i l i t y a t t h e s e ages t h a n a t o t h e r ages t e s t e d . D y s c a l c u l i a . An a r i t h m e t i c d i s a b i l i t y , as a symptom o f t h e Ger s tmann syndrome , can be an i n a b i l i t y t o c a l c u l a t e o r an i n a b i l i t y t o w r i t e numbers u s i n g t h e c o r r e c t p l a c e v a l u e . A s h o r t a r i t h m e t i c t e s t was c o n s t r u c t e d w h i c h w o u l d t e s t f o r b o t h o f t h e s e symptoms. The f i r s t p a r t o f t h e t e s t c o n t a i n e d e i g h t numbers w r i t t e n t o d i c t a t i o n . . The numbers t o be w r i t t e n r a n g e d i n p l a c e v a l u e f rom t h e hundreds up t o t h e m i l l i o n s . The s e c o n d p a r t o f t h e t e s t c o n t a i n e d two a d d i t i o n , two s u b -t r a c t i o n , and t h r e e m u l t i p l i c a t i o n q u e s t i o n s w h i c h t h e m a j o r i t y o f g r a d e f i v e c h i l d r e n c o u l d p e r f o r m c o r r e c t l y . The s e l e c t i o n o f , t h e s e t h r e e a r e a s o f a r i t h m e t i c a b i l i t y was b a s e d on t h e a s s u m p t i o n t h a t by g r a d e f i v e t h e c h i l d r e n w o u l d be v e r y f a m i l i a r w i t h each p r o c e s s . E r r o r s w h i c h o c c u r r e d w o u l d t h e n r e f l e c t a b a s i c weakness i n c o m p u t a t i o n a b i l i t y . The a r i t h -m e t i c t e s t appear s i n A p p e n d i x D. A d m i n i s t r a t i o n o f t h e T e s t s The n i n e t y - s e v e n c h i l d r e n s e l e c t e d t o be t e s t e d f o r t h e f o u r symptoms o f t h e Ger s tmann syndrome , were t e s t e d d u r i n g t h e l a s t two weeks o f A p r i l , 1969 . 57 D y s c a l c u l i a and D y s g r a p h i a . The a r i t h m e t i c and l anguage t e s t s were a d m i n i s t e r e d t o s m a l l g r o u p s o f s e v e n t o t w e l v e c h i l d r e n . The room used f o r t e s t i n g was l a r g e enough t o accomodate t w e l v e c h i l d r e n c o m f o r t a b l y and was n o t r e q u i r e d by t h e s c h o o l f o r o t h e r a c t i v i t i e s a t t h a t t i m e . The a r i t h -m e t i c t e s t was a d m i n i s t e r e d f i r s t , f o l l o w e d by t h e l anguage t e s t . The c h i l d r e n were a l l o w e d s u f f i c i e n t t i m e so t h a t a l l c o u l d f i n i s h each t e s t . When t h e y had f i n i s h e d t h e l anguage s e c t i o n t h e y r e t u r n e d t o t h e i r c l a s s r o o m . The t i m e f o r b o t h t e s t s v a r i e d f rom t h i r t y t o f o r t y - f i v e m i n u t e s p e r g r o u p . Admi n i s t r a t i o n ' o f t h e a r i t h m e t i c t e s t . The c h i l d r e n were i n f o r m e d t h a t t h e t e s t was i n two p a r t s . The f i r s t p a r t o f t h e t e s t c o n t a i n e d b l a n k l i n e s on w h i c h t h e y w o u l d w r i t e numbers f rom d i c t a t i o n . The p a p e r s were d i s t r i b u t e d and t h e c h i l d r e n i n s t r u c t e d t o l i s t e n c a r e f u l l y as t h e numbers w o u l d be g i v e n o n l y o n c e . When t h e c h i l d r e n u n d e r s t o o d how t h e y were t o p r o c e e d , t h e numbers were d i c t a t e d c l e a r l y and s l o w l y . The speed o f d i c t a t i o n was c o n t r o l l e d by d i c t a t i n g t h e n e x t number when a l l t h e c h i l d r e n had c o m p l e t e d w r i t i n g t h e p r e v i o u s number . A cue t h a t t h e n e x t number w o u l d be g i v e n was t h e number o f t h e q u e s t i o n . When t h e f i r s t p a r t was c o n c l u d e d , t h e c h i l d r e n were i n s t r u c t e d t o c o n t i n u e on t h e i r own and c o m p l e t e t h e c o m p u t a t i o n a l q u e s t i o n s on t h e s e c o n d p a r t . 58 A d m i n i s t r a t i o n of the P i c t u r e Story Language T e s t . F o l l o w i n g the completion of the a r i t h m e t i c t e s t , the c h i l d r e n were shown a 19 x 14 i n c h enlargement of the p i c t u r e used by Myklebust, shown i n Appendix E. The p i c t u r e was c a r r i e d around to each c h i l d i n the group so t h a t he c o u l d view the p i c t u r e c l o s e l y and study i t b e f o r e being t o l d t h a t he was to w r i t e a s t o r y about i t , The c h i l d r e n were t o l d t h a t they were to w r i t e t h e i r s t o r i e s on the back of t h e i r a r i t h m e t i c paper, t h a t i t was t o be the b e s t s t o r y they c o u l d w r i t e , and t h a t i f they wished a c l o s e r look a t the p i c t u r e w h i l e they were w r i t i n g they were to r a i s e t h e i r hand and the p i c t u r e would be brought over t o them f o r a c l o s e r look. To such q u e s t i o n s as whether they should g i v e t h e i r s t o r y a t i t l e , i f i t c o u l d be imaginary, or what l e n g t h i t should be, a standard answer, "Whatever you t h i n k makes your s t o r y the b e s t s t o r y you can w r i t e w i l l be a c c e p t a b l e " was g i v e n . R'ight-Left O r i e n t a t i o n and f i n g e r agnosia. Each i n d i -v i d u a l was t e s t e d , i n t u r n , f o r r i g h t - l e f t o r i e n t a t i o n and f o r f i n g e r a g nosia. The i n d i v i d u a l t e s t i n g was conducted i n a s m a l l , unused room i n each s c h o o l . The room was equipped with a l a r g e desk or t a b l e and two c h a i r s . The examiner s a t behind the desk and the c h i l d t o be t e s t e d s a t o p p o s i t e her. Each c h i l d ' s responses were recorded on an i n d i v i d u a l r e c o r d sheet. The s e r i e s of commands f o r a knowledge of r i g h t and l e f t , and the touches and order of p r e s e n t a t i o n of 59 t h e b l o c k s f o r t h e f i n g e r t e s t were i d e n t i c a l f o r each c h i l d and f o l l o w e d t h e sequence shown i n A p p e n d i x C . I f a c h i l d c o r r e c t e d an i n c o r r e c t r e s p o n s e w i t h i n f i v e seconds t h i s was n o t e d . H e s i t a t i o n s were a l s o r e c o r d e d . T e s t i n g f o r a D i s o r i e n t a t i o n f o r r i g h t and l e f t . E a c h c h i l d was i n f o r m e d t h a t e i g h t d i f f e r e n t commands w o u l d be g i v e n i n t h e t e s t . He-was i n s t r u c t e d t o l i s t e n c a r e f u l l y and t h e n do e x a c t l y as d i r e c t e d a f t e r each command had been g i v e n . When t h e c h i l d i n d i c a t e d he u n d e r s t o o d t h e i n s t r u c t i o n s , t h e e i g h t commands were g i v e n q u i c k l y , a l l o w i n g o n l y s u f f i c i e n t t i m e f o r t h e c h i l d t o r e s p o n d . T e s t i n g f o r f i n g e r a g n o s i a . K i n s b o u r n e and W a r r i n g t o n c o n d u c t e d t h e i r f i n g e r t e s t by h a v i n g t h e c h i l d r e n c l o s e t h e i r eyes w h i l e t h e i r f i n g e r s were b e i n g t o u c h e d . P r e l i m i n a r y t e s t i n g had shown a t e n d e n c y f o r t h e c h i l d r e n t o peek when t h e y were u n s u r e i f t h e y were o n l y r e q u e s t e d t o c l o s e t h e i r e y e s . To overcome t h i s , a s m a l l box 1 2 - 1 / 2 i n c h e s w i d e , 8 -1 /2 i n c h e s h i g h and 8 i n c h e s d e e p , c o v e r e d i n brown p a p e r w i t h a s m a l l r e c t a n g u l a r h o l e 3 -1 /2 x 2 -1 /4 i n c h e s c u t i n t h e base a t t h e f r o n t o f t h e b o x , was u s e d f o r t h e f i n g e r t e s t . The back o f t h e b o x , f a c i n g t h e e x a m i n e r , was o p e n . A s i m i l a r 7 method f o r t e s t i n g f i n g e r l o c a l i z a t i o n was u sed by B e n t o n . A r t h u r L . B e n t o n , R i g h t - L e f t D i s c r i m i n a t i o n s and  F i n g e r L o c a l i z a t i o n (New Y o r k : P a u l B . H o e b e r , 1 9 5 9 ) , p . 2 1 . 60 B e f o r e s e c t i o n s A and B o f t h e t e s t were a d m i n i s t e r e d , t h e method i n w h i c h t h e c h i l d ' s f i n g e r s w o u l d be t o u c h e d was e x p l a i n e d . The c h i l d p l a c e d h i s hand on t h e t a b l e , pa lm down, and w i t h t h e f i n g e r s s p r e a d a p a r t ; Two d e m o n s t r a t i o n t o u c h e s , w h i c h t h e c h i l d c o u l d s e e , were made by t h e e x a m i n e r . When t h e c h i l d had answered c o r r e c t l y , i n d i c a t i n g he u n d e r -s t o o d how he was t o r e s p o n d , he was t h e n i n s t r u c t e d t o p l a c e h i s hand i n s i d e t h e b o x . The r i g h t hand was t e s t e d f i r s t i n a l l c a s e s , f o l l o w e d by t h e l e f t . The e x a m i n e r made f o u r t o u c h e s on each h a n d . Touch was m a i n t a i n e d u n t i l t h e c h i l d had r e s p o n d e d . Responses were r e c o r d e d on t h e i n d i v i d u a l r e c o r d s h e e t . B e f o r e p a r t C o f t h e t e s t was a d m i n i s t e r e d , t h e c h i l d was shown t h e b l o c k s . One s e t o f b l o c k s was p l a c e d on t o p o f t h e box and t h e c h i l d was a l l o w e d t i m e to . l o o k a t them c l o s e l y and t o examine t h e i r s h a p e . The d u p l i c a t e s e t , k e p t i n s i d e t h e b o x , was a l s o shown t o t h e c h i l d . He was i n f o r m e d t h a t h i s f i n g e r s w o u l d be formed a r o u n d a b l o c k i n s i d e t h e b o x . He w o u l d n o t be p e r m i t t e d t o move h i s f i n g e r s o v e r t h e s h a p e , b u t c o u l d h o l d t h e b l o c k i n h i s hand as l o n g as he w i s h e d . When he c o u l d i d e n t i f y t h e b l o c k he h e l d , he was t o p o i n t t o t h e i d e n t i c a l b l o c k on t o p o f t h e b o x . W h e n . t h e c h i l d i n d i -c a t e d he u n d e r s t o o d how t h i s p a r t o f t h e t e s t was t o . b e c a r r i e d o u t , h e - p l a c e d f i r s t h i s r i g h t and t h e n h i s l e f t hand i n s i d e t h e b o x . The b l o c k s were p l a c e d , i n t u r n , i n h i s hand and h i s r e s p o n s e s were r e c o r d e d as f o r T e s t A and B . 61 S c o r i n g ' o f t h e T e s t s The c r i t e r i o n u s e d i n d e t e r m i n i n g w h e t h e r a symptom o f t h e Ger s tmann syndrome was p r e s e n t o r a b s e n t f o r each o f t h e f o u r t e s t s was as f o l l o w s . F i n g e r a g n o s i a . The e x a m i n e r f o l l o w e d t h e c r i t e r i o n 8 e s t a b l i s h e d by K i n s b o u r n e and W a r r i n g t o n . S i x c o r r e c t r e s -ponses o u t o f t h e e i g h t were r e q u i r e d f o r a pa s s on each p a r t o f t h e f i n g e r t e s t . A p o s i t i v e o r n e g a t i v e c o n d i t i o n o f f i n g e r a g n o s i a was a s s i g n e d f o r each o f t h e s e t e s t s , and r e -c o r d e d on t h e f i n a l i n d i v i d u a l r e c o r d s h e e t shown i n A p p e n d i x F . D i s o r i e n t a t i o n f o r r i g h t . a n d l e f t . The r e s u l t s o f t h e e i g h t commands were r e c o r d e d i n two p a r t s . A b s e n c e o f t h i s symptom on p a r t one r e q u i r e d f o u r c o r r e c t r e s p o n s e s o u t o f . t h e s i x commands w h i c h r e l a t e d t o a knowledge o f r i g h t and l e f t on t h e m s e l v e s . Two h e s i t a t i o n s were p e r m i t t e d i n c o n j u n c -t i o n w i t h a c o r r e c t r e s p o n s e , b u t more t h a n two h e s i t a t i o n s , even t h o u g h t h e c o r r e c t r e s p o n s e had; been g i v e n were c o u n t e d as a f a i l u r e . ^ P a r t t w o , w h i c h t e s t e d f o r a knowledge o f r i g h t and l e f t on a n o t h e r p e r s o n , r e q u i r e d b o t h commands t o be e x e c u t e d c o r r e c t l y . One h e s i t a t i o n was p e r m i t t e d a l o n g w i t h a c o r r e c t r e s p o n s e . R e s u l t s were t a b u l a t e d and r e c o r d e d as p o s i t i v e o r n e g a t i v e c o n d i t i o n s o f t h i s symptom on t h e f i n a l i n d i v i d u a l r e c o r d s h e e t . K i n s b o u r n e and W a r r i n g t o n , l o c . c i t . B e n t o n , o p . c i t . , p . 8 3 . 62 D y s g r a p h i a . M y k l e b u s t ' s method was f o l l o w e d i n s c o r i n g t o t a l w o r d s , t o t a l s e n t e n c e s , t o t a l words p e r s e n t e n c e , s y n t a x , ro and a b s t r a c t - c o n c r e t e l e v e l . ' The raw s c o r e s f o r each a r e a o f l anguage a b i l i t y were c o n v e r t e d t o s t a n i n e s . A s t a n i n e o f t h r e e o r b e l o w f o r t o t a l words p r o v i d e d t h e p o s i t i v e c r i t e r i o n f o r d y s g r a p h i a . D y s c a l c u l i a . Absence o f t h i s symptom on P a r t A o f t h e a r i t h m e t i c t e s t r e q u i r e d f i v e o r more numbers t o be w r i t t e n c o r r e c t l y . An e x c e s s o r i n s u f f i c i e n t number o f z e r o s , commas i n c o r r e c t l y p l a c e d , o r t h e number sequence r e v e r s e d were marked as e r r o r s . F o u r o r more c o r r e c t answers were r e q u i r e d on t h e c a l c u l a t i o n p a r t o f t h e t e s t . L e s s t h a n f o u r c o r r e c t a n s w e r s , w h i c h was v e r i f i e d by a s c o r e o f 4 .0 o r b e l o w on t h e S t a n f o r d A c h i e v e m e n t T e s t f o r a r i t h m e t i c a b i l i t y , p r o v i d e d t h e c r i t e r i o n t h a t d y s c a l c u l i a f o r c a l c u l a t i n g a b i l i t y was p r e s e n t . R e s u l t s were r e c o r d e d as p o s i t i v e o r n e g a t i v e f o r each p a r t o f t h e t e s t . T r e a t m e n t o f ' t h e ' D a t a Two methods o f a n a l y s i s were u sed t o i n t e r p r e t t h e d a t a . The r e s u l t s were r e p o r t e d as p e r c e n t a g e s when t h e c h i l d r e n i n t h e t o t a l s a m p l e . c o u l d be g r o u p e d by number i n t o v a r i o u s c a t e g o r i e s on t h e b a s i s o f r e a d i n g and s p e l l i n g M y k l e b u s t , op_. c i t . , p p . 9 5 - 1 4 6 . 63 a b i l i t y . The r e s u l t s were r e p o r t e d as c h i - s q u a r e v a l u e s when t h e i n t e r r e l a t i o n s h i p between two o r more n o m i n a l v a r i a b l e s was d e s i r e d and t h e d a t a were i n t h e form o f f r e q u e n c i e s i n d i s c r e t e c a t e g o r i e s . The a s s u m p t i o n , u n d e r t h e n u l l h y p o t h e s i s , was t h a t t h e s e v a r i a b l e s were i n d e p e n d e n t . A s i g n i f i c a n t c h i -s q u a r e v a l u e w o u l d t h e n i n d i c a t e t h a t t h e v a r i a b l e s were n o t i n d e p e n d e n t , b u t were i n t e r d e p e n d e n t o r r e l a t e d and t h e n u l l h y p o t h e s i s r e j e c t e d . ^ ' " ' R e s u l t s were c o n s i d e r e d s i g n i f i c a n t a t t h e .05 l e v e l . A d e s c r i p t i v e p r e s e n t a t i o n was u sed t o i n t e r p r e t t h e d a t a when t h e e x p e c t e d f r e q u e n c y i n each c e l l d i d n o t s a t i s f y t h e u n d e r l y i n g c o n d i t i o n s o f t h e c h i - s q u a r e t e s t . SUMMARY A s p e l l i n g t e s t was c o n s t r u c t e d o f words l i k e l y t o . cause s t a t i c and k i n e t i c r e v e r s a l e r r o r s by g r a d e f i v e s t u d e n t s . The s p e l l i n g t e s t was a d m i n i s t e r e d t o 468 c h i l d r e n i n f i v e e l e m e n t a r y s c h o o l s i n Richmond S c h o o l D i s t r i c t d u r i n g t h e l a s t week i n J a n u a r y , 1969 . S t a n f o r d A c h i e v e m e n t T e s t r e a d i n g and a r i t h m e t i c s c o r e s were c o l l e c t e d f rom t h e p r o g r e s s r e c o r d c a r d s f o r each c h i l d . A t t h i s t i m e 125 c h i l d r e n were o m i t t e d f rom t h e sample as t h e i r p r o g r e s s r e c o r d c a r d s l a c k e d s u f f i c i e n t d a t a . 11''' ^ - R i c h a r d P . Runyon and A u d r e y H a b e r , F u n d a m e n t a l s o f B e h a v i o r a l S t a t i s t i c s ( R e a d i n g , M a s s a c h u s e t t s ! A d d i s o n -W e s l e y P u b l i s h i n g Company, 1 9 6 7 ) , p p . 2 0 6 - 2 1 2 . 64 From t h e r e m a i n i n g 343 c h i l d r e n who were d i v i d e d i n t o f o u r g r o u p s b a s e d on r e a d i n g and s p e l l i n g a b i l i t y , 97 were s e l e c t e d t o be t e s t e d f o r t h e f o u r symptoms o f t h e G e r s t m a n n syndrome.' E a c h c h i l d was t e s t e d f o r a k n owledge o f r i g h t and l e f t , f i n g e r s e n s e , l a n g u a g e a b i l i t y , and a r i t h m e t i c a b i l i t y d u r i n g the. l a s t two weeks o f A p r i l , 1969. The r e s u l t s o f t h e s e t e s t s were r e c o r d e d as p o s i t i v e o r n e g a t i v e c o n d i t i o n s f o r e a c h symptom i n t h e G e r s t m a n n syndrome. The d a t a were^then p r e p a r e d f o r a n a l y s i s t o d e t e r m i n e t h e e x t e n t t o w h i c h a r e l a t i o n s h i p e x i s t e d between r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g a b i l i t y , and t h e p r e s e n c e o f t h e f o u r G e r s t m a n n symptoms. The r e s u l t s were r e p o r t e d e i t h e r as a p e r c e n t a g e , t o show t h e r e l a t i o n s h i p between t h e p r e s e n c e o f r e v e r s a l e r r o r s i n s p e l l i n g and r e a d i n g a b i l i t y , o r as a c h i - s q u a r e v a l u e , t o a s c e r t a i n t h e r e l a t i o n s h i p b etween g r o u p membership and t h e p r e s e n c e o f t h e f o u r symptoms o f t h e G e r s t m a n n syndrome. 1 CHAPTER I V PRESENTATION AND INTERPRETATION OF THE DATA T h i s c h a p t e r w i l l p r e s e n t and i n t e r p r e t t h e d a t a c o l -l e c t e d d u r i n g t h e c o u r s e o f t h e s t u d y . The d a t a w i l l be p r e s e n t e d i n t h r e e p a r t s . P a r t A w i l l p r e s e n t and i n t e r p r e t t h e d a t a on t h e 343 g r a d e f i v e s t u d e n t s t e s t e d f o r s p e l l i n g a b i l i t y . The r e l a t i o n s h i p o f r e a d i n g and s p e l l i n g a b i l i t y o f t h e t o t a l sample w i l l be d i s c u s s e d . P a r t B w i l l p r e s e n t and i n t e r p r e t t h e d a t a on 97 c h i l d r e n who were t e s t e d f o r t h e f o u r symptoms o f t h e Ger s tmann syndrome . The p r e s e n c e o f each o f t h e f o u r Ger s tmann symptoms i n r e l a t i o n t o (1) g r o u p m e m b e r s h i p , (2) r e a d i n g a b i l i t y , (3) s p e l l i n g a b i l i t y , (4) number o f r e -v e r s a l e r r o r s , and (5) sex and c h r o n o l o g i c a l age w i l l be d i s c u s s e d . The c l u s t e r i n g o f symptoms among t h e . g r o u p s w i l l a l s o be e x a m i n e d . P a r t C w i l l be a d i s c u s s i o n and i n t e r p r e t a t i o n o f t h e d a t a . PART A RELATIONSHIP OF READING AND REVERSALS IN SPELLING A s p e l l i n g t e s t was a d m i n i s t e r e d t o 343 g r a d e f i v e c h i l -d r e n . The t e s t was marked f o r s t a t i c and k i n e t i c r e v e r s a l e r r o r s and t h e number o f t h e s e e r r o r s made by each c h i l d t o t a l l e d . The number o f r e v e r s a l e r r o r s i n s p e l l i n g was r e c o r d e d i n r e -l a t i o n t o r e a d i n g a b i l i t y and on t h i s b a s i s t h e c h i l d r e n were 66 d i v i d e d i n t o f o u r g r o u p s . T a b l e I shows t h e number and t h e p e r c e n t o f t h e t o t a l sample o f 343 c h i l d r e n who were a s s i g n e d t o one o f f o u r g roups i n a c c o r d a n c e w i t h t h e i r r e a d i n g and s p e l l i n g a b i l i t y . T a b l e I D i v i s i o n o f C h i l d r e n i n t h e T o t a l Sample on t h e B a s i s o f S p e l l i n g and R e a d i n g A b i l i t y G r o u p * Number o f C h i l d r e n P e r c e n t 1 74 21 2 170 50 3 7 2 4 92 27 T o t a l 343 100 Group 1 - R e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l 4 .0 Group 2 - R e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l £ - 4 . 1 Group 3 - No r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l 4 .0 Group 4 - No r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l ^ 4 . 1 As s een i n T a b l e I , 71 p e r c e n t o f t h e c h i l d r e n i n t h e t o t a l sample made one o r more r e v e r s a l e r r o r s i n i n . s p e l l i n g . F i f t y p e r c e n t o f t h e s a m p l e , who made r e v e r s a l e r r o r s i n s p e l l i n g , were r e a d i n g c l o s e t o g r a d e p l a c e m e n t o r a b o v e , w h i l e 21 p e r c e n t r e a d one o r more y e a r s b e l o w g r a d e p l a c e m e n t . Of t h e r e m a i n i n g 29 p e r c e n t , who made no r e v e r s a l e r r o r s i n s p e l l i n g , 27 p e r c e n t o f t h e sample were r e a d i n g c l o s e t o g rade 67 p l a c e m e n t o r a b o v e , w h i l e o n l y 2 p e r c e n t r e a d one o r more y e a r s b e l o w g r a d e p l a c e m e n t . Two f u r t h e r c o m p a r i s o n s were made f rom t h e d a t a shown i n T a b l e I . When t h e t o t a l sample was examined on t h e b a s i s o f r e a d i n g a b i l i t y , i t was f o u n d t h a t 91 p e r . c e n t o f t h e c h i l d r e n r e a d i n g b e l o w g r a d e l e v e l (Groups 1 and 3) made r e v e r -s a l e r r o r s i n s p e l l i n g , w h i l e o n l y 65 p e r c e n t o f t h e c h i l d r e n r e a d i n g a t . o r above g r a d e l e v e l (Groups 2 and 4) made r e v e r s a l e r r o r s i n s p e l l i n g . When t h e t o t a l sample was examined on t h e b a s i s o f r e v e r s a l e r r o r s i n s p e l l i n g , i t was f o u n d t h a t 30 p e r c e n t o f t h e c h i l d r e n who made r e v e r s a l e r r o r s i n s p e l l i n g (Groups 1 and 2) r e a d b e l o w g r a d e l e v e l , whereas o n l y 7 p e r c e n t o f t h e c h i l d r e n m a k i n g no r e v e r s a l e r r o r s i n s p e l l i n g (Groups 3 and 4) r e a d b e l o w g r a d e l e v e l . T a b l e I I shows t h e d i v i s i o n o f t h e s e g rade f i v e c h i l d r e n w i t h i n each o f t h e f o u r g r o u p s b a s e d on t h e number o f r e v e r s a l e r r o r s i n s p e l l i n g i n r e l a t i o n t o r e a d i n g a b i l i t y . From T a b l e I I i t can be s een t h a t as r e a d i n g s c o r e s i n c r e a s e d t h e number o f r e v e r s a l e r r o r s i n s p e l l i n g d e c r e a s e d . The range o f r e v e r s a l e r r o r s (1-15) f o r t h e c h i l d r e n i n Group 2 r e a d i n g a t a l e v e l c l o s e t o g r a d e p l a c e m e n t i s t h e same as f o r t h e c h i l d r e n i n Group 1 r e a d i n g one o r more y e a r s b e l o w g r a d e p l a c e m e n t . However , as r e a d i n g a b i l i t y exceeded g r a d e p l a c e m e n t by one o r more y e a r s t h e r ange i n r e v e r s a l e r r o r s became s m a l l e r . 68 T a b l e I I R e v e r s a l E r r o r s i n S p e l l i n g i n R e l a t i o n t o R e a d i n g A b i l i t y Number o f R e v e r s a l E r r o r s Number o f C h i l d r e n 11 - 15 3 * 1 * * - -6 - 10 1 3 * 1 7 * * 1* * -1 - 5 58 * 1 3 2 * * * 1 6 * * 3 * * 0 7 * * * 4 9 * * * * 3 7 * * * * g * * * * R e a d i n g Grade L e v e l 2 . 1 - 4 . 0 4 . 1 - 6 . 0 6 . 1 - 8 . 0 8 . 1 - 1 0 . 0 * Group 1; * * Group 2 ; * * * Group 3 ; * . * . * * Group 4, A l s o , as seen i n T a b l e I I , as r e a d i n g s c o r e s i n c r e a s e d t h e number o f c h i l d r e n i n r e l a t i o n t o t o t a l g r o u p membership m a k i n g o v e r f i v e r e v e r s a l e r r o r s i n s p e l l i n g a t each r e a d i n g l e v e l d e c r e a s e d . Of t h e c h i l d r e n r e a d i n g one o r more y e a r s b e l o w g r a d e p l a c e m e n t , t h r e e made between e l e v e n and f i f t e e n r e v e r s a l e r r o r s . O f - t h e c h i l d r e n r e a d i n g i n a r a n g e c l o s e . t o g r a d e p l a c e m e n t , o n l y one made o v e r t e n r e v e r s a l e r r o r s i n s p e l l i n g . A t t h e r e a d i n g • l e v e l s one o r more y e a r s above g rade p l a c e m e n t , o n l y one c h i l d r e a d i n g a t a g r a d e l e v e l o f 6 . 1 -8 .0 made be tween s i x and t e n r e v e r s a l e r r o r s and none o f t h e 69 c h i l d r e n r e a d i n g a t the h i g h e s t l e v e l made over f i v e r e v e r s a l e r r o r s i n s p e l l i n g . From the data i n Table I I the percentage of c h i l d r e n a t each r e a d i n g l e v e l making r e v e r s a l e r r o r s i n s p e l l i n g was c a l -c u l a t e d and the r e s u l t s are presented i n F i g u r e 1 . As w i l l be seen i n F i g u r e 1 , the percentage of grade f i v e c h i l d r e n i n each rea d i n g l e v e l making r e v e r s a l e r r o r s i n s p e l l i n g a l s o decreased as the re a d i n g l e v e l above grade p l a c e -ment i n c r e a s e d . Of the c h i l d r e n r e a d i n g a t a l e v e l one or more years below grade placement, 91 per cent made r e v e r s a l e r r o r s i n s p e l l i n g . When r e a d i n g a b i l i t y i s i n the range c l o s e . t o grade placement, 75 p e r . c e n t of the c h i l d r e n r e a d i n g at t h i s l e v e l made r e v e r s a l e r r o r s i n s p e l l i n g . As re a d i n g a b i l i t y i n c r e a s e d t o a l e v e l one or more years above grade placement, 32 per cent of the c h i l d r e n r e a d i n g a t a 6 . 1 - 8 . 0 grade l e v e l made r e v e r s a l e r r o r s i n s p e l l i n g as d i d 33 per cent of the c h i l d r e n r e a d i n g a t an 8 . 1 - 1 0 . 0 grade l e v e l . The f i n d i n g s of t h i s study, based on the t o t a l sample of 3 43 grade f i v e s t u d e n t s , show 21 per cent of the c h i l d r e n who read below grade placement made r e v e r s a l e r r o r s i n s p e l l i n g . Two per cent o f the c h i l d r e n who read below grade placement made no r e v e r s a l e r r o r s i n s p e l l i n g . Of the remaining 77 per cent of the c h i l d r e n who read c l o s e t o or above grade placement, o n l y 35 per cent do not make r e v e r s a l e r r o r s i n s p e l l i n g . The g r e a t e s t percentage of c h i l d r e n making r e v e r s a l e r r o r s i n s p e l l i n g was found i n the group r e a d i n g one or more —I 1 —I 1 2 . 1 - 4 . 0 4 . 1 - 6 . 0 6 . 1 - 8 . 0 8 . 1 - 1 0 . 0 R e a d i n g A c h i e v e m e n t L e v e l FIGURE 1 P e r c e n t a g e o f C h i l d r e n i n Each R e a d i n g A c h i e v e m e n t L e v e l - M a k i n g R e v e r s a l E r r o r s i n S p e l l i n g 71 y e a r s b e l o w g r a d e p l a c e m e n t . However , r e v e r s a l e r r o r s were made by 65 p e r c e n t o f t h e c h i l d r e n r e a d i n g c l o s e t o o r above g r a d e p l a c e m e n t . I t w o u l d seem t h a t a m a j o r i t y o f c h i l d r e n a t t h e f i f t h g r a d e l e v e l do make r e v e r s a l e r r o r s i n s p e l l i n g . However , as r e a d i n g a b i l i t y i n c r e a s e d above g r a d e p l a c e m e n t , t h e number o f r e v e r s a l e r r o r s and t h e p e r c e n t a g e o f c h i l d r e n m a k i n g s u c h e r r o r s d e c r e a s e d , s u g g e s t i n g t h a t some r e l a t i o n s h i p may e x i s t be tween r e v e r s a l e r r o r s i n s p e l l i n g and r e a d i n g r e -t a r d a t i o n . PART B INDIVIDUAL GERSTMANN SYMPTOMS I N RELATION TO GROUP MEMBERSHIP, READING A B I L I T Y , SPELLING A B I L I T Y , NUMBER OP REVERSAL ERRORS, ADDITIONAL V A R I A B L E S , AND CLUSTERING OF SYMPTOMS BY GROUP Of t h e 343 f i f t h - g r a d e c h i l d r e n , d i v i d e d i n t o f o u r g r o u p s on t h e b a s i s o f s p e l l i n g and r e a d i n g a b i l i t y , t h i r t y were s e l -e c t e d a t random f rom each o f Groups 1, 2 , and 4 . As Group 3 c o n t a i n e d o n l y s e v e n c h i l d r e n , a l l s even c h i l d r e n were i n c l u d e d i n t h e i n d i v i d u a l t e s t i n g . I n t o t a l , 97 c h i l d r e n were t e s t e d f o r t h e f o u r Ger s tmann symptoms. T a b l e I I I shows t h e number and t h e p e r c e n t a g e o f c h i l d r e n i n each g r o u p t e s t i n g p o s i t i v e l y f o r each symptom o f t h e Ger s tmann syndrome . 72 TABLE I I I C h i l d r e n i n E a c h Group T e s t i n g P o s i t i v e l y f o r E a c h Ger s tmann Symptom by Number and by P e r c e n t „ - N o . o f D i s o r i e n - ^ , . G r o u p * C f t i l d r e n t a t i o n f o r F i n g e r D y s c a i c u i i a D y s g r a p h r a p e r g r o u p R i g h t - • L e f t A g n o s i a O r d e r C a l c . N o . a "5 N o . Q. "5 N o . % N o . % N o . a "6 1 30 24 80 13 43 19 63 20 67 15 50 2 30 23 77 5 17 9 30 7 23 6 20 3 7 6 86 1 14 2 29 5 71 2 29 4 30 10 33 6 20 2 7 1 3 1 3 * Group 1 - R e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l . $ 4 . 0 Group 2 - R e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l > 4 . 1 Group 3 - No r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l < 4 .0 Group 4 - No r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l > 4 . 1 As can be seen i n T a b l e I I I d i f f e r e n c e s e x i s t e d between g roups f o r t h e p r e s e n c e o f each o f t h e f o u r symptoms o f t h e Gers tmann syndrome . The p e r c e n t a g e o f c h i l d r e n i n Groups 1-4, r e s p e c t i v e l y , t e s t i n g p o s i t i v e l y f o r a d i s o r i e n t a t i o n f o r r i g h t and l e f t was 80 p e r c e n t , 77 p e r c e n t , 86 p e r c e n t , and 33 p e r c e n t . The p e r c e n t a g e o f c h i l d r e n i n Groups 1 - 4 r e s p e c t i v e l y , t e s t i n g p o s i t i v e l y f o r f i n g e r a g n o s i a was 43 p e r c e n t , 17 p e r c e n t , 14 p e r . c e n t , and 20 p e r c e n t . The p e r c e n t a g e o f c h i l d r e n i n Groups 1-4, r e s p e c t i v e l y , t e s t i n g p o s i t i v e l y f o r d y s c a l c u l i a was f o r " o r d e r " 63 p e r c e n t , 30 p e r c e n t , 29 p e r c e n t , and 7 p e r 73 cent, and for "ca l c u l a t i o n " 67 per cent, 23 per cent, 71 per cent, and 3 per cent. The percentage of children i n Groups 1-4, respectively, testing p o s i t i v e l y for dysgraphia was 50 per cent, 20.per cent, 29 per cent, and 3 per cent. By inspection of the data, Group 1 showed the greatest percentage of children testing p o s i t i v e l y for finger agnosia, d y s c a l c u l i a (order), and dysgraphia. Groups 1 and 3 showed the greatest percentage of children testing p o s i t i v e l y for a di s o r i e n t a t i o n for r i g h t and l e f t , and dy s c a l c u l i a ( c a l c u l a t i o n ) . Table IV Difference Between Groups 1 and 4, 1 and 2 and 2 and 4 for the Presence of Each Gerstmann Symptom Chi-square Symptom Groups Groups Groups . 1 and 4 1 and 2 . 2.and.4 D i s o r i e n t a t i o n f o r R i g h t and L e f t 11 .46* .00 9 .68* F i n g e r A g n o s i a 2 .78* 3 .88* .00 D y s c a l c u l i a ( o r d e r ) 18 .74* 5 .42* 4 .00* D y s c a l c u l i a ( c a l c u l a t i o n ) 23 .72* 9 .68* 3 .60* D y s g r a p h i a 14 .38* 3 .68* 2 .58* S i g n i f i c a n t at the .05 l e v e l (one-tail t e s t ) . 74 As seen i n Table IV s i g n i f i c a n t differences between groups were found. The chi-square values obtained when Groups 1 and 4 were compared were s i g n i f i c a n t for each symptom. These results would indicate that the number of children i n Group 1 testing p o s i t i v e l y for each Gerstmann symptom was related to group membership. The analysis between Groups 1 and 2 showed the presence of a l l the Gerstmann symptoms except a di s o r i e n -t a t i o n for r i g h t and l e f t to be s i g n i f i c a n t l y related to membership i n Group 1 as compared to Group 2. The analysis between Group 2 and 4 showed only a d i s o r i e n t a t i o n for r i g h t and l e f t and d y s c a l c u l i a , both order and c a l c u l a t i o n to be s i g n i f i c a n t l y related to membership i n Group 2 as compared to Group 4. These results would indicate that the number of children i n each group testing p o s i t i v e l y for each symptom of the Gerstmann syndrome was dependent on group membership. Two sub-groups were formed by combining Groups 1 and 2 (reversal errors i n spelling) and Groups 3 and 4 (no reversal errors i n spelling) with no regard to reading a b i l i t y . The n u l l hypothesis that the number of children testing p o s i t i v e l y for each of the Gerstmann symptoms was independent of rever-s a l errors i n s p e l l i n g , was tested. Chi-square values were calculated for between groups differences and a. correction for continuity was applied for one degree of freedom. The results are presented i n Table V. Marginal t o t a l s for the data shown i n Table V are presented i n Appendix G. 75 T a b l e V D i f f e r e n c e Between R e v e r s a l and N o n - R e v e r s a l Groups f o r t h e P r e s e n c e o f Each Gers tmann Symptom Symptom C h i - s q u a r e D i s o r i e n t a t i o n f o r R i g h t and L e f t 1 0 . 7 9 * F i n g e r A g n o s i a .92 D y s c a l c u l i a ( o r d e r ) 1 1 . 7 1 * D y s c a l c u l i a ( c a l c u l a t i o n ) 7 . 2 3 * D y s g r a p h i a 7 . 6 1 * S i g n i f i c a n t a t t h e .05 l e v e l ( o n e - t a i l t e s t ) As seen i n T a b l e V , a s i g n i f i c a n t d i f f e r e n c e between t h e two g roups m a k i n g r e v e r s a l e r r o r s i n s p e l l i n g and t h e two g roups m a k i n g no r e v e r s a l e r r o r s i n s p e l l i n g was f o u n d f o r a d i s -o r i e n t a t i o n f o r r i g h t and l e f t , f o r d y s c a l c u l i a , b o t h o r d e r and c a l c u l a t i o n , and f o r d y s g r a p h i a . No d i f f e r e n c e i n . t h e number o f c h i l d r e n t e s t i n g p o s i t i v e l y f o r f i n g e r a g n o s i a was f o u n d between c h i l d r e n m a k i n g r e v e r s a l e r r o r s i n s p e l l i n g and t h o s e n o t m a k i n g r e v e r s a l e r r o r s i n s p e l l i n g . F u r t h e r a n a l y s i s o f t h e d a t a shown i n T a b l e I I I , page 72 was made on t h e b a s i s o f r e a d i n g a b i l i t y . Two g roups were formed by c o m b i n i n g Groups 1 and 3 ( r e a d i n g l e v e l b e l o w g r a d e 76 p l a c e m e n t ) and Groups 2 and 4 ( r e a d i n g l e v e l c l o s e t o o r above g rade p l a c e m e n t ) w i t h no r e g a r d f o r r e v e r s a l e r r o r s i n s p e l l i n g . The n u l l h y p o t h e s i s , t h a t t h e number o f c h i l d r e n t e s t i n g p o s i -t i v e l y f o r each Gers tmann symptom was i n d e p e n d e n t o f r e a d i n g a b i l i t y , was t e s t e d . G h i - s q u a r e v a l u e s were c a l c u l a t e d and a c o r r e c t i o n f o r c o n t i n u i t y a p p l i e d f o r one degree o f f r e e d o m . The r e s u l t s a r e shown i n T a b l e V I . M a r g i n a l t o t a l s f o r t h e d a t a shown i n T a b l e V I a r e p r e s e n t e d i n A p p e n d i x G . T a b l e V I D i f f e r e n c e Between P o o r and B e t t e r Reader s F o r t h e P r e s e n c e o f Each Gers tmann Symptom Symptom C h i - s q u a r e D i s o r i e n t a t i o n f o r R i g h t and L e f t F i n g e r A g n o s i a D y s c a l c u l i a ( o r d e r ) D y s c a l c u l i a ( c a l c u l a t i o n ) D y s g r a p h i a S i g n i f i c a n t a t t h e .05 l e v e l ( o n e - t a i l t e s t ) As seen i n T a b l e V I a s i g n i f i c a n t d i f f e r e n c e between t h e p o o r e r r e a d e r s (Groups 1 and 3) and t h e b e t t e r r e a d e r s (Groups 2 and 4) was f o u n d f o r t h e number o f c h i l d r e n t e s t i n g p o s i -5 . 8 1 * 3 . 4 8 * 1 3 . 6 5 * 2 7 . 5 5 * 1 2 . 4 9 * 77 t i v e l y f o r each Gerstmann symptom. F i n g e r . a g n o s i a , w h i c h p r e -v i o u s l y was n o t found t o be s i g n i f i c a n t l y r e l a t e d t o group membership o r t o r e v e r s a l e r r o r s i n s p e l l i n g , was found i n t h i s a n a l y s i s t o be s i g n i f i c a n t l y r e l a t e d t o r e a d i n g a b i l i t y (.05). A f i n a l a n a l y s i s between groups was made based on the number o f r e v e r s a l e r r o r s made by the c h i l d r e n i n Groups 1 and 2 i n r e l a t i o n t o t h e number o f t h e s e c h i l d r e n t e s t i n g p o s i t i v e l y f o r each Gerstmann symptom. The c h i l d r e n i n each group were d i v i d e d i n t o two sub-groups based on t h e number o f r e v e r s a l e r r o r s i n s p e l l i n g above and below s i x . The number of c h i l d r e n t e s t i n g p o s i t i v e l y f o r each Gerstmann symptom i n r e l a t i o n t o t h e number o f r e v e r s a l e r r o r s made i n s p e l l i n g i s shown i n T a b l e V I I . From T a b l e V I I i t w i l l be seen t h a t t h e number o f c h i l -d r e n t e s t i n g p o s i t i v e l y f o r each symptom of t h e Gerstmann syndrome was not i n f l u e n c e d by t h e number o f r e v e r s a l e r r o r s made i n s p e l l i n g . I n t h e two sub-groups o f Group 1 a s i m i l a r number o f c h i l d r e n t e s t e d p o s i t i v e l y f o r each Gerstmann symp-tom r e g a r d l e s s o f whether t h e y made l e s s t h a n s i x o r s i x o r more r e v e r s a l e r r o r s i n s p e l l i n g . S i m i l a r r e s u l t s were found f o r t h e two sub-groups o f Group 2. I n summary, t h e r e s u l t s p r e s e n t e d i n T a b l e s I I I t o V I I seem t o s u g g e s t a p o s i t i v e r e l a t i o n s h i p between r e a d i n g l e v e l one o r more y e a r s below grade placement, r e v e r s a l e r r o r s i n Table VII Number of C h i l d r e n i n Groups 1 and 2 T e s t i n g P o s i t i v e l y f o r Each Symptom i n the Gerstmann Syndrome i n R e l a t i o n to the Number of Reversal E r r o r s Made i n S p e l l i n g Group* Number of Number of Symptoms Reversal C h i l d r e n per R i g h t - L e f t F i n g e r D y s c a l c u l i a Dysgraphia E r r o r s Sub-group O r i e n t a t i o n Agnosia Order C a l c . 1 < 6 15 11 7 11 10 7 6 15 13 6 8 10 8 2 < 6. 15 13 0 6 3 2 ^ 6 15 10 5 3 4 4 * Group 1 - Reversal e r r o r s i n s p e l l i n g , reading l e v e l ^ 4.0 Group 2 - Reversal e r r o r s i n s p e l l i n g , r eading l e v e l 4.1 00 I 79 s p e l l i n g , and the presence of the Gerstmann syndrome. The large number of children testing p o s i t i v e l y for each Gerstmann symptom i n Group 1, as compared with the numbers testing p o s i t i v e l y for the symptoms i n Groups 2 and 4, was found to be s i g n i f i c a n t for a l l symptoms of the syndrome when Groups 1 and 4 were compared, and for a l l symptoms but a dis o r i e n t a t i o n for r i g h t and l e f t when Groups 1 and 2 were compared. A s i g n i f i c a n t difference between Groups 2 and 4 was found for the number of children i n Group 2 testing p o s i t i v e l y for the symptoms: di s o r i e n t a t i o n for ri g h t and l e f t and dys c a l c u l i a , both order and c a l c u l a t i o n . When the relat i o n s h i p between reversal errors i n s p e l l i n g (disregarding reading a b i l i t y ) and the four symptoms of the Gerstmann syndrome was analysed, a l l symptoms but finger agnosia were found to be s i g n i f i c a n t l y related to s p e l l i n g a b i l i t y . When the relat i o n s h i p between reading levels (disregarding s p e l l i n g a b i l i t y ) was analysed, a l l of the symptoms were found to be s i g n i f i c a n t l y related to reading a b i l i t y . The number of reversal errors i n s p e l l i n g did not appear to be related to the number of Gerstmann symptoms presents. Regardless of whether the children had made less than s i x , or six or more reversal errors i n s p e l l i n g , a sim i l a r number of children i n the two sub-groups of Group 1 and 2 tested p o s i t i v e l y for each of the four Gerstmann symptoms. It would seem that the symptoms of the Gerstmann syndrome were related to group membership. The presence of finger 80 a g n o s i a w o u l d appear t o be r e l a t e d t o g r o u p membership o n l y on t h e b a s i s o f r e a d i n g a b i l i t y . The symptoms: d i s o r i e n t a t i o n f o r r i g h t and l e f t and d y s c a l c u l i a , b o t h o r d e r and c a l c u l a t i o n w o u l d appear t o be r e l a t e d t o g roup membership on t h e b a s i s o f r e v e r s a l e r r o r s i n s p e l l i n g . D y s g r a p h i a w o u l d appear t o be r e l a t e d t o g roup membership when b o t h f a c t o r s , r e a d i n g and s p e l l i n g a b i l i t y a r e c o n s i d e r e d . I n d i v i d u a l Symptoms and A d d i t i o n a l V a r i a b l e s I n a d d i t i o n t o r e a d i n g a b i l i t y and r e v e r s a l e r r o r s i n s p e l l i n g , t h e v a r i a b l e s o f sex and c h r o n o l o g i c a l age were s t u d i e d i n r e l a t i o n t o t h e p r e s e n c e o f t h e Gers tmann syndrome. F o r t h i s a n a l y s i s , d y s c a l c u l i a was r e c o r d e d as p o s i t i v e i f t h e s t i p u l a t e d number o f e r r o r s i n e i t h e r o r d e r o r c a l c u l a t i o n were p r e s e n t . The n u l l h y p o t h e s i s , t h a t t h e p r e s e n c e o f each symptom was i n d e p e n d e n t o f sex and c h r o n o l o g i c a l age , was t e s t e d . T a b l e V I I I p r e s e n t s a summary o f t h e s e f i n d i n g s . The d a t a f o r t h e d i v i s i o n o f each v a r i a b l e i n t o g r o u p s , t h e number o f c h i l -d r e n i n each g r o u p , and t h e m a r g i n a l t o t a l s f o r t h e c h i - s q u a r e v a l u e s i n T a b l e V I I I a r e shown i n A p p e n d i x G . A c o r r e c t i o n f o r c o n t i n u i t y was a p p l i e d f o r one degree o f f reedom i n t h e c a l c u l a t i o n o f t h e c h i - s q u a r e v a l u e s f o r each Gers tmann symptom i n r e l a t i o n t o s e x . As s een i n T a b l e V I I I t h e r e i s l i t t l e r e l a t i o n s h i p b e -tween t h e f o u r Ger s tmann symptoms and e i t h e r sex o r c h r o n o l o g i c a l 81 T a b l e V I I I R e l a t i o n s h i p o f Each Gers tmann Symptom t o Sex and t o C h r o n o l o g i c a l Age Symptoms Sex C h i - s q u a r e C h r o n o l o g i c a l Age C h i - s q u a r e D i s o r i e n t a t i o n f o r R i g h t and L e f t 2 .49 2 .87 F i n g e r A g n o s i a .00 1.96 D y s c a l c u l i a 0 .29 1 8 . 6 2 * D y s g r a p h i a 3 . 5 4 * 2 .45 Degrees o f Freedom 1 2 T e s t o f S i g n i f i c a n c e 1 t a i l 2 t a i l * S i g n i f i c a n t a t t h e .05 l e v e l age . W r i t i n g a b i l i t y was f o u n d t o be s i g n i f i c a n t l y r e l a t e d t o s e x . A g r e a t e r number o f boys t h a n g i r l s t e s t e d p o s i t i v e l y f o r d y s g r a p h i a . A r i t h m e t i c a b i l i t y was f o u n d t o be s i g n i f i c a n t l y r e l a t e d t o c h r o n o l o g i c a l age . The g r e a t e s t number o f c h i l d r e n f a i l i n g t h i s t e s t were i n t h e age g r o u p above t h e mean. The r e m a i n i n g two symptoms, d i s o r i e n t a t i o n f o r r i g h t and l e f t , and f i n g e r a g n o s i a were n o t f o u n d t o be r e l a t e d e i t h e r t o sex o r t o c h r o n o l o g i c a l age . 82 Clustering of Gerstmann Symptoms by Group A l l possible combinations of the four Gerstmann symptoms were coded and the number of children i n each group testing p o s i t i v e l y for each combination recorded. Figure 2 shows the clusters of symptoms and the number of children testing p o s i -t i v e l y f or them by group. As w i l l be seen i n Figure 2, page 83, the clusters of symptoms ranged from a l l four symptoms being present through to none being present. Six children or 6 per cent of the sample tested p o s i t i v e l y for a l l four Gerstmann symptoms. Sixteen children or 16.5 per cent of the sample tested negatively for a l l four Gerstmann symptoms. The remaining seventy-five c h i l -dren or 77.5 per cent of the sample tested p o s i t i v e l y for only one symptom or for combinations of two and three of the Gerstmann symptoms. Only four of a l l the possible combinations of the four Gerstmann symptoms were not found. Of the possible three-symptom clusters there was no grouping of a dis o r i e n t a t i o n for ri g h t and l e f t , finger agnosia, and d y s c a l c u l i a , and none of finger agnosia, d y s c a l c u l i a , and dysgraphia i n any of the four groups. Of a l l the possible two-symptom cl u s t e r s , there was no grouping of finger agnosia with dysgraphia, or of dys c a l c u l i a with dysgraphia i n any of the four groups. The most common cl u s t e r of three symptoms was the com-bination of a di s o r i e n t a t i o n for r i g h t and l e f t , d y s c a l c u l i a , G CD U 13 rH •H ^10 u o u Xi e 5 Group 2 Group 4 Group 3 FIGURE 2 D i f f e r e n t C l u s t e r s by t h e Gerstmann Symptoms as D e m o n s t r a t e d by V a r i o u s Number o f C h i l d r e n i n E a c h Group ZZZZZZZ2 l''iV ' f ' f ltCT D i s o r i e n t a t i o n f o r R i g h t and L e f t F i n g e r A g n o s i a D y s c a l c u l i a D y s g r a p h i a No Symptoms 84 and d y s g r a p h i a . Of t h e e l e v e n c h i l d r e n t e s t i n g p o s i t i v e l y f o r t h e s e t h r e e symptoms, t h e g r e a t e s t number ( e i g h t ) was i n Group 1. The most common c l u s t e r o f two symptoms was t h e c o m b i n a t i o n o f a d i s o r i e n t a t i o n f o r r i g h t and l e f t and d y s -c a l c u l i a . Of t h e s e v e n t e e n c h i l d r e n t e s t i n g p o s i t i v e l y f o r t h e s e two symptoms, t h e g r e a t e s t number (n ine ) was i n Group 2 . The most common s i n g l e symptom was a d i s o r i e n t a t i o n f o r r i g h t and l e f t . Of t h e f i f t e e n c h i l d r e n who t e s t e d p o s i t i v e l y f o r t h i s symptom a l o n e , t h e g r e a t e s t number ( e i g h t ) was i n Group 4 . The v a r i o u s c l u s t e r s o f t h e Gers tmann symptoms shown i n F i g u r e 2 s u g g e s t e d t h a t i t was n o t t h e p r e s e n c e o f any one d i s t i n c t c o m b i n a t i o n o f t h e s e symptoms w h i c h d i f f e r e n t i a t e d between t h e c h i l d r e n i n each g r o u p , b u t r a t h e r t h a t i t was a f u n c t i o n o f t h e o v e r a l l number o f symptoms t h e c h i l d r e n m a n i -f e s t e d w i t h i n each g r o u p . The number o f . c h i l d r e n i n each g r o u p t e s t i n g p o s i t i v e l y f o r a l l f o u r symptoms, f o r a l l c o m b i n a t i o n s o f t h r e e symptoms, f o r a l l c o m b i n a t i o n s o f two symptoms, f o r o n l y one symptom, and f o r none o f t h e symptoms was p l o t t e d and t h e r e s u l t s a r e shown i n F i g u r e 3 . As s een i n F i g u r e 3 (page 8 5 ) , t h e number o f c h i l d r e n t e s t i n g p o s i t i v e l y f o r v a r i o u s c o m b i n a t i o n s o f t h e Gers tmann symptoms i s a f u n c t i o n o f g r o u p m e m b e r s h i p . T w e n t y - s e v e n o f t h i r t y c h i l d r e n i n Group 4 , who were r e a d i n g c l o s e t o o r above g r a d e p l a c e m e n t and made no r e v e r s a l e r r o r s i n s p e l l i n g , t e s t e d p o s i t i v e l y f o r none o r f o r o n l y one o f t h e Gers tmann — i i — ir-Number o f G e r s t m a n n Symptoms FIGURE 3 Number o f C h i l d r e n T e s t i n g P o s i t i v e f o r None, One, C o m b i n a t i o n s o f Two and T h r e e , and A l l F o u r o f t h e G e r s t m a n n Symptoms by Group Group 1 • • Group 3 * G r o u p 2 o ,o Group 4 x 86 symptoms. Twenty-four of t h i r t y children i n Group 2, who were also reading close to or above grade placement but made rever-s a l errors i n s p e l l i n g , tested p o s i t i v e l y for one or for combinations of two Gerstmann symptoms. Twenty-seven of t h i r t y children i n Group 1 who were reading one or more years below grade placement and also made reversal errors i n s p e l l i n g , tested p o s i t i v e l y for combinations of two and three, or for a l l four of the Gerstmann symptoms. The small number of c h i l -dren i n Group 3 make i t d i f f i c u l t to know i f t h i s i s a t r u l y representative group d i s t r i b u t i o n for children reading one or more years below grade placement but making no reversal errors i n s p e l l i n g . However, i t would appear that the children i n Group 3 seem to follow a trend s i m i l a r to those i n Group 2. The percentage of children i n each group testing posi-t i v e l y for clusters of three to four symptoms, one to two symptoms, and for none of the Gerstmann symptoms was determined and the re s u l t s are presented i n Table IX. The percentages shown i n Table IX indicate the presence of various number combinations of Gerstmann symptoms are re-lated to group membership.. Fifty-seven per cent of the children i n Group 1 demonstrated three or four of the Gerstmann symptoms,.40 per cent demonstrated one or two symptoms while 3 per cent demonstrated none. In Group 2, .10 per cent demon-strated three or four of the Gerstmann symptoms and 10 per cent demonstrated none. Eighty per cent of t h i s group tested posi-t i v e l y for one or two symptoms. Group 3 shows 29 per cent 87 T a b l e IX P e r c e n t a g e o f C h i l d r e n W i t h i n E a c h G r o u p * Demon-s t r a t i n g V a r i o u s C l u s t e r s o f t h e Ger s tmann Symptoms Number o f Symptoms Group 1 N o . • % Group 2 N o . % Group 3 N o . % Group 4 N o . .. % 3-4 17 57 3 10 2 29 0 0 1-2 12 40 24 80 5 71 18 60 0 1 3 3 10 0 0 12 40 T o t a l 30 100 30 100 7 100 30 100 * Group 1 - R e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l 4 .0 Group 2 - R e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l 4 . 1 Group 3 - No r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l s 4 .0 Group 4 - No r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g l e v e l £ 4 . 1 t e s t i n g p o s i t i v e l y f o r t h r e e o r f o u r , and 71 p e r c e n t t e s t i n g p o s i t i v e l y f o r one o r two o f t h e symptoms. None o f t h e c h i l -d r e n i n Group 4 d e m o n s t r a t e d t h r e e o r f o u r o f t h e Gers tmann symptoms. A l t h o u g h 60 p e r c e n t o f t h e c h i l d r e n , i n t h i s g r o u p e x h i b i t e d one o r two symptoms, i t w i l l be seen f rom F i g u r e 3 , page 8 5 , t h a t t h e m a j o r i t y o f t h e s e c h i l d r e n t e s t e d p o s i t i v e l y f o r o n l y one symptom. The r e m a i n i n g 40 p e r c e n t o f Group 4 d e m o n s t r a t e d none o f t h e f o u r symptoms. 88 I n summary, t h e r e s u l t s p r e s e n t e d i n T a b l e s V I I I and I X (pp. 8 1 , 87) and i n F i g u r e s 2 and 3 (pp. 8 3 , 85) w o u l d s u g g e s t t h a t t h e p r e s e n c e o f t h e Gers tmann symptoms among g r a d e f i v e c h i l d r e n i s n o t r e l a t e d t o sex o r t o c h r o n o l o g i c a l a g e , b u t i s r e l a t e d t o r e a d i n g and s p e l l i n g a b i l i t y and may be f o u n d , t o v a r y i n g d e g r e e s , among b o t h good and p o o r r e a d e r s . When b o t h p o o r r e a d i n g and p o o r s p e l l i n g a b i l i t y a r e p r e s e n t , a g r e a t e r number o f t h e Gers tmann symptoms a r e f o u n d t h a n when o n l y o n e , e i t h e r p o o r r e a d i n g o r p o o r s p e l l i n g a b i l i t y a r e p r e s e n t . When n e i t h e r r e a d i n g n o r s p e l l i n g a b i l i t y i s p o o r , p o s s i b l y t w o , b u t u s u a l l y one o r none o f t h e Gers tmann symptoms a r e f o u n d . T h i s d i s t r i b u t i o n o f t h e Gers tmann symptoms among g r a d e f i v e c h i l d r e n s u g g e s t s an u n d e r l y i n g common f a c t o r , w h i c h may a f f e c t r e a d i n g and s p e l l i n g a b i l i t y t o v a r y i n g d e g r e e s . PART C DISCUSSION AND INTERPRETATION I n a d u l t s , t h e Ger s tmann syndrome i s u s e d l m e d i c a l l y f o r d i a g n o s t i c p u r p o s e s . I t s p r e s e n c e i m p l i e s a l e s i o n i n t h e i n f e r i o r p a r i e t o - o c c i p i t a l r e g i o n o f t h e c o r t e x , u s u a l l y i n t h e d o m i n a n t h e m i s p h e r e f o r l a n g u a g e . T h i s r e g i o n o f t h e p a r i e t a l l o b e , w h i c h T i e s be tween t h e t h r e e p r i m a r y r e c e i v i n g a r e a s f o r i n c o m i n g v i s u a l , a u d i t o r y , and s o m a t i c s e n s o r y inform m a t i o n , i s d e s i g n a t e d as one o f t h e " a s s o c i a t i o n a r e a s " o f t h e c o r t e x . 89 The f u n c t i o n o f t h e p a r i e t a l " a s s o c i a t i o n a r e a " appear s t o be t w o f o l d . F i r s t , i t seems t o p l a y a r o l e i n t h e i n t e -g r a t i o n o f i n f o r m a t i o n f rom t h e p r i m a r y r e c e i v i n g a r e a s i n l e a r n i n g r e l a t e d t o c o n c e p t f o r m a t i o n and s y m b o l i z a t i o n . S e c o n d , i t appear s t o i n f l u e n c e t h e c o - o r d i n a t i o n o f t h i s i n -f o r m a t i o n t o p r o d u c e t h e r e q u i r e d motor r e s p o n s e . When damage t o t h i s r e g i o n o f t h e c o r t e x o c c u r s , v a r i o u s forms o f t h e a p h a s i a s , a g n o s i a s , and a p r a x i a s a r e o b s e r v e d . How t h e a s s o c i a t i o n o f v i s u a l , a u d i t o r y , and s o m a t i c s e n s o r y i n p u t s and t h e c o r r e s p o n d i n g motor o u t p u t s a r e i n t e -g r a t e d i n t o t h e a l l - e n c o m p a s s i n g a s p e c t s o f l anguage f u n c t i o n i s n o t u n d e r s t o o d . I t i s n o t p o s s i b l e t o i n d i c a t e a g i v e n a r e a o f t h e c o r t e x as b e i n g t h e a r e a f o r " l e a r n i n g " o r t h e a r e a f o r "memory . " R a t h e r , t h e t remendous number o f f i b r o u s i n t e r c o n n e c t i o n s between v a r i o u s a r e a s o f t h e c o r t e x and s u b -c o r t i c a l s t r u c t u r e s s u g g e s t s a h i g h l y complex s y s t e m w h i c h : . . . s e r v e t o b r i n g t o g e t h e r i n t o a p h y s i o -l o g i c a l c o n t i n u u m b o t h s e n s o r y and motor phenomena, so t h a t t h e a s s o c i a t i v e a s se s sment o f i m m e d i a t e s e n s o r y i n p u t s and p a s t e x p e r i e n c e does n o t o c c u r as a n e u r o l o g i c a l l y academic i s s u e , b u t i s c o r r e -l a t e d w i t h a p p r o p r i a t e l y i n t e g r a t e d motor r e s p o n s e s t o i n s u r e t h a t t h e o r g a n i s m behaves i n a s u i t a b l e m a n n e r . 1 The a r e a o f t h e c o r t e x d e s i g n a t e d by t h e Ger s tmann s y n -drome l i e s a d j a c e n t t o t h e o c c i p i t a l l o b e a t t h e p o i n t o f "*"H.J. C a m p b e l l , C o r r e l a t i v e P h y s i o l o g y o f t h e N e r v o u s  Sys tem (New Y o r k : Academic P r e s s , 1 9 6 5 ) , p p . 2 0 4 - 2 0 5 . 90 t r a n s i t i o n from the v i s u a l c o r t e x t o the p a r i e t a l " a s s o c i a t i o n " c o r t e x . In f r o n t of t h i s t r a n s i t i o n area are the a u d i t o r y and somatic r e c e i v i n g c e n t e r s , as w e l l as the motor area of the co r t e x r e s p o n s i b l e f o r the a c t i o n s r e l a t e d t o these incoming s i g n a l s . The o p t i m a l f u n c t i o n i n g of t h i s c o r t i c a l area, l y i n g a t the j u n c t i o n of o c c i p i t a l and p a r i e t a l l o b e s , would appear e s s e n t i a l f o r the i n t e g r a t i o n of i n f o r m a t i o n which c o n t r i b u t e s to man's a b s t r a c t l e a r n i n g a b i l i t y and performance. In a d u l t s , d i s r u p t i o n of t h i s area by a l e s i o n produces the combination of symptoms a s s o c i a t e d w i t h the Gerstmann syndrome.. In c h i l d r e n , d i s r u p t i o n of t h i s area by some f a c t o r or f a c t o r s as y e t unknown, may a f f e c t the ease w i t h which v i s u a l i n f o r m a t i o n i s i n t e g r a t e d w i t h a u d i t o r y and somatic i n f o r m a t i o n t o produce the c o r r e c t motor response and thus a combination of symptoms s i m i l a r t o those of the Gerstmann syndrome are found. The degree of i n t e r r u p t i o n caused by a l e s i o n , or by these unknown f a c t o r s , may produce v a r i a t i o n s i n the presence of each symptoms. J u s t as the presence of the fo u r Gerstmann symptoms i n a d u l t s i s not an a l l or nothing case i n t h a t each symptom may be p r e s e n t t o a g r e a t e r or l e s s e r degree from i n d i v i d u a l t o i n d i v i d u a l a s i m i l a r s i t u a t i o n would appear to be the case w i t h c h i l d r e n . The d i s t r i b u t i o n of symptoms found i n t h i s study would i n d i c a t e j u s t such a v a r i a t i o n i n the degree to which these unknown f a c t o r s h i n d e r the attainment of s k i l l s as measured by s c h o o l performance. The s i g n i f i c a n t r e l a t i o n s h i p between a d i s o r i e n t a t i o n f o r r i g h t and l e f t , d y s c a l c u l i a , and d y s g r a p h i a and group membership, and t o a l e s s e r e x t e n t , t h e s i g n i f i c a n t r e l a t i o n -s h i p o f f i n g e r a g n o s i a t o r e a d i n g a b i l i t y a l o n e , s u g g e s t s a p o s s i b l e c o n c o m i t a n t a s s o c i a t i o n between the Gerstmann syndrome and a " r e a d i n g d i s a b i l i t y " . When r e v e r s a l e r r o r s i n s p e l l i n g a re found c o u p l e d w i t h a r e a d i n g l e v e l one or more y e a r s below grade placement, the g r e a t e s t number o f Gerstmann symptoms ar e a l s o found. When o n l y one, e i t h e r r e v e r s a l e r r o r s i n s p e l l i n g o r a r e a d i n g l e v e l one o r more y e a r s below grade p l a c e ment are found, the number o f accompanying Gerstmann symptoms i s l e s s t h a n when b o t h poor r e a d i n g and poor s p e l l i n g a r e p r e s e n t . When n e i t h e r r e v e r s a l e r r o r s i n s p e l l i n g nor a r e a d i n g l e v e l below grade placement i s found the number o f accompanying Gerstmann symptoms i s e i t h e r s m a l l o r absent. C h i l d r e n r e a d i n g below grade l e v e l , and who make r e v e r -s a l e r r o r s i n s p e l l i n g seem t o e x h i b i t a g r e a t e r number o f the symptoms o f t h e Gerstmann syndrome th a n c h i l d r e n r e a d i n g above grade l e v e l and who make no r e v e r s a l e r r o r s i n s p e l l i n g . I t may be t h a t i n poor r e a d e r s , t h e Gerstmann syndrome may i n d i -c a t e some n e u r o l o g i c a l d i f f i c u l t y f o r s y m b o l i c language. However, o t h e r f a c t o r s ^ such . a s m o t i v a t i o n , t e a c h e r competence, w i t h which t h i s study, i s not concerned ,__may a l s o i n some, way c o n t r i b u t e t o t h e s e d i f f e r e n c e s . 92 SUMMARY The findings of t h i s study suggest the following con-clusions i n regard to the relat i o n s h i p between reversal errors i n s p e l l i n g , reading a b i l i t y , and the four symptoms of the Gerstmann syndrome at the grade f i v e l e v e l . 1. Of the 343 children tested, 21 per cent made rever-s a l errors i n s p e l l i n g and were reading one or more years below grade placement, 2 per cent made no reversal errors i n sp e l l i n g but were reading one or more years below grade place-ment, 50 per cent made reversal errors i n s p e l l i n g but were reading close to or above grade placement, and 27 per cent made no reversal errors i n s p e l l i n g and were also reading close to or above grade placement. 2. Reversal errors i n s p e l l i n g are not an uncommon error even among the better readers at th i s grade l e v e l . Only 35 per cent of the children reading close to or above grade placement did not make thi s type of s p e l l i n g error. However, some relat i o n s h i p between reversal errors i n s p e l l i n g and reading .a b i l i t y seems to e x i s t . As reading a b i l i t y increased above grade placement, the number of these errors and the percentage of children making such errors decreases. 3. Of the children making reversal errors i n s p e l l i n g 30 per cent were reading one or more years below grade place-ment as compared with 7 per cent of the children reading below grade placement but who made no reversal errors i n s p e l l i n g . 93 4. The number of reversal errors i n s p e l l i n g was not in d i c a t i v e of a "reading d i s a b i l i t y " . The majority of children i n Group 1 made between one and f i v e such errors, as did the majority of children i n Group 2. Also, the c h i l -dren i n Group 2 who were reading close to grade placement showed the same range i n number of reversal errors i n s p e l l i n g as the children i n Group 1 reading one or more years below grade placement. When a comparison was made between the number of reversal errors i n s p e l l i n g and the presence of each of the Gerstmann symptoms, a si m i l a r number of children tested posi-t i v e l y for each symptom regardless of the number of reversal errors made i n s p e l l i n g . 5. The clu s t e r i n g of symptoms by group indicated that the r e l a t i o n s h i p between reading a b i l i t y , reversal errors, i n s p e l l i n g , and the four symptoms of the Gerstmann syndrome was more one of degree than type of d i s a b i l i t y as the majority of children i n the sample tested p o s i t i v e l y for one or more of the four Gerstmann symptoms. Fifty-seven per cent of the children i n Group 1 tested p o s i t i v e l y for three to four of the Gerstmann symptoms as compared to 10 per cent i n Group 2, . 27 per cent i n Group 3, and none i n Group 4. The largest per-centage of children testing p o s i t i v e l y for one or two of the Gerstmann symptoms was found i n Group 2 (80 per cent) and i n Group 3 (71 per cent). The children i n Group 4 tested p o s i -t i v e l y for either one or two symptoms (60 per cent) or for none of the symptoms (40 per cent). 94 6. A s i g n i f i c a n t r e l a t i o n s h i p was f o u n d between r e v e r -s a l e r r o r s i n s p e l l i n g , r e t a r d a t i o n o f one o r more y e a r s i n r e a d i n g a b i l i t y , and a d i s o r i e n t a t i o n f o r r i g h t and l e f t , d y s c a l c u l i a , and d y s g r a p h i a . The p r e s e n c e o f t h e f o u r t h symp-tom i n t h e Ge r s t m a n n syndrome, f i n g e r a g n o s i a , was f o u n d o n l y t o be s i g n i f i c a n t l y a s s o c i a t e d w i t h r e a d i n g r e t a r d a t i o n . 7. A t t h e g r a d e f i v e l e v e l , t h e p r e s e n c e o f two t o f o u r o f t h e G e r s t m a n n symptoms combined w i t h r e v e r s a l e r r o r s i n s p e l l i n g and a r e a d i n g l e v e l one o r more y e a r s b e l o w g r a d e p l a c e m e n t w o u l d a p p e a r t o be s i g n i f i c a n t i n i d e n t i f y i n g a c h i l d w i t h a " r e a d i n g d i s a b i l i t y . " 8. No r e l a t i o n s h i p b etween s e x and t h r e e o f t h e Ger s t m a n n symptoms was f o u n d . O n l y d y s g r a p h i a was s i g n i f i c a n t l y r e l a t e d t o s e x . No r e l a t i o n s h i p between c h r o n o l o g i c a l age and t h r e e o f t h e Ge r s t m a n n symptoms w a s , f o u n d . O n l y d y s g r a p h i a was s i g n i f i c a n t l y r e l a t e d t o age. CHAPTER V SUMMARY, FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS R e s e a r c h s t u d i e s have shown a c o r r e l a t i o n between r e v e r s a l e r r o r s i n s p e l l i n g and a r e a d i n g p r o b l e m . V a r i o u s n e u r o l o g i c a l c o n d i t i o n s have been p r o p o s e d as u n d e r l y i n g a r e a d i n g p r o b l e m i n w h i c h r e v e r s a l e r r o r s i n s p e l l i n g were a p r o m i n e n t f e a t u r e . R e c e n t l y Hermann has r e l a t e d t h i s t y p e o f r e a d i n g p r o b l e m t o a " h e r e d i t a r y Ger s tmann syndrome" . ' ' ' C h i l d r e n who e x p e r i e n c e d i f f i c u l t y i n l e a r n i n g t o r e a d a r e p r e s e n t i n t o d a y ' s e l e m e n t a r y s c h o o l s . The p r o b l e m c o n -f r o n t i n g t h e s c h o o l s i s i n a s s e s s i n g t h o s e h a v i n g a " r e a d i n g d i s a b i l i t y " . D i a g n o s i n g t h i s t y p e o f r e a d i n g p r o b l e m u s u a l l y i n v o l v e s e x t e n s i v e t e s t i n g . A g r o u p o f symptoms w h i c h w o u l d n o t r e q u i r e s p e c i a l i z e d t e s t i n g b u t c o u l d be o b s e r v e d by t h e c l a s s r o o m t e a c h e r d i r e c t l y f r o m t h e c h i l d ' s d a i l y work were c o n s i d e r e d . The p o s s i b i l i t y t h a t t h e Gers tmann syndrome i n c o n j u n c -t i o n w i t h r e v e r s a l e r r o r s i n s p e l l i n g and r e t a r d a t i o n i n r e a d i n g o f one o r more y e a r s m i g h t i d e n t i f y a c h i l d w i t h a " r e a d i n g d i s a b i l i t y " was e x a m i n e d . A s t u d y had n o t been c a r r i e d o u t w i t h a sample o f u n s e l e c t e d s c h o o l c h i l d r e n t o Knud Hermann and E d i t h N o r r i e , " I s C o n g e n i t a l W o r d -B l i n d n e s s a H e r e d i t a r y Type o f G e r s t m a n n ' s S y n d r o m e , " P s y c h i a t r i a and N e u r o l o g i a , 1 3 6 : 5 9 - 7 3 , 1958 . 96 d e t e r m i n e what r e l a t i o n s h i p e x i s t e d between s u c h a c l u s t e r o f symptoms. Grade f i v e s t u d e n t s were c h o s e n as t h e s u b j e c t s f o r t h e s t u d y i n t h a t r e v e r s a l e r r o r s w h i c h p e r s i s t p a s t t h e g r a d e t h r e e l e v e l a r e c o n s i d e r e d s y m p t o m a t i c o f a " r e a d i n g d i s -a b i l i t y " . 2 THE PROBLEM The p u r p o s e o f t h i s s t u d y was t o d e t e r m i n e what r e l a -t i o n s h i p e x i s t e d between r e a d i n g a b i l i t y , r e v e r s a l e r r o r s i n s p e l l i n g , and t h e symptoms o f t h e Gers tmann syndrome i n c h i l -d r e n a t t h e g r a d e f i v e l e v e l s The f o l l o w i n g q u e s t i o n s were r a i s e d : 1. F o r c h i l d r e n a t t h e g r a d e f i v e l e v e l what r e l a t i o n -s h i p e x i s t s be tween r e v e r s a l e r r o r s i n s p e l l i n g ( s t a t i c and k i n e t i c ) and r e a d i n g a b i l i t y ? 1.1 What p e r c e n t a g e o f c h i l d r e n who make t h e s e e r r o r s have a r e a d i n g p r o b l e m ? 1.2 Of t h e c h i l d r e n w i t h a r e a d i n g p r o b l e m what number o f r e v e r s a l e r r o r s w o u l d be i n d i c a t i v e o f a " r e a d i n g d i s a b i l i t y " ? 2 . What r e l a t i o n s h i p e x i s t s be tween r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g a b i l i t y , and t h e Ger s tman syndrome? 2 . 1 How f r e q u e n t l y a r e t h e f o u r symptoms o f t h e 2 . C . K o l s o n and G . K a l u g e r , C l i n i c a l A s p e c t s o f R e m e d i a l  R e a d i n g ( S p r i n g f i e l d , I l l i n o i s : C h a r l e s C . Thomas, 1963) 97 syndrome f o u n d i n r e l a t i o n t o r e v e r s a l e r r o r s i n s p e l l i n g and a r e a d i n g p r o b l e m ? 2.2 What c l u s t e r i n g o f symptoms w o u l d be s i g -n i f i c a n t i n i d e n t i f y i n g a " r e a d i n g d i s a -b i l i t y " a t t h i s g r a d e l e v e l ? 3. To what e x t e n t m i g h t t h e f o u r G e r s t m a n n symptoms be r e l a t e d t o t h e v a r i a b l e s o f s e x and c h r o n o -l o g i c a l age? To p r o v i d e t h e answers t o t h e s e q u e s t i o n s t h e s t u d y was c a r r i e d o u t i n t h e f o l l o w i n g manner. PROCEDURES C o n s t r u c t i o n and A d m i n i s t r a t i o n o f t h e S p e l l i n g T e s t A s p e l l i n g t e s t s u i t e d t o t h e g r a d e f i v e l e v e l was c o n s t r u c t e d . I t c o n t a i n e d f o r t y - f o u r words w h i c h had b e e n s e l e c t e d f r o m D o l c h ' s l i s t o f 2yOx00 Common e s t Words f o r  S p e l l i n g and w h i c h h a d p r o v e d e f f e c t i v e i n e l i c i t i n g k i n e t i c and s t a t i c r e v e r s a l e r r o r s i n s p e l l i n g . A s p l i t - h a l f c o r r e -l a t i o n o f r e l i a b i l i t y f o r t h e t e s t was 0.876. The s p e l l i n g t e s t was a d m i n i s t e r e d by t h e same e x a m i n e r t o 468 g r a d e f i v e s t u d e n t s i n f i v e e l e m e n t a r y s c h o o l s i n Richmond S c h o o l D i s t r i c t d u r i n g t h e l a t t e r h a l f o f J a n u a r y , 1969. The s c h o o l s s e l e c t e d r e p r e s e n t e d a s o c i o - e c o n o m i c l e v e l r a n g i n g f r o m b e l o w a v e r a g e t o above a v e r a g e . A t t h i s 98 time children who were recent immigrants or who had a known physical, emotional or neurological condition were excluded from the sample. Selection of Children to be Tested for the Gerstmann Syndrome Each s p e l l i n g test was scored for s t a t i c and k i n e t i c reversal errors and the children divided into two groups based on t h e i r performance. One group consisted of children who had made one or more reversal errors i n s p e l l i n g ; the second group consisted of children who had not made any rever-s a l errors. A further d i v i s i o n within these two groups was made based on reading a b i l i t y . Reading scores, as measured by the Stanford Achievement  Test administered at the end of grade four, were obtained from the i n d i v i d u a l progress record cards at the time the s p e l l i n g t e s t was administered. A score of 4.0 or below was used as the dividing point for children reading one or more years below grade placement. On thi s basis the children were grouped accordingly: Group 1 - children who had made reversal errors i n s p e l l i n g and were reading at a grade l e v e l of 4.0 or below. Group 2 - children who had made reversal errors i n sp e l l i n g and were reading at a grade l e v e l of 4.1 or above. 99 Group 3 - c h i l d r e n who had made no r e v e r s a l e r r o r s i n s p e l l i n g and were r e a d i n g a t a g r a d e l e v e l o f 4 .0 o r b e l o w . Group 4 - c h i l d r e n who had made no r e v e r s a l e r r o r s i n s p e l l i n g and were r e a d i n g a t a g r a d e l e v e l o f 4 . 1 o r a b o v e . Of t h e 468 c h i l d r e n who were t e s t e d f o r s p e l l i n g a b i l i t y , 125 were o m i t t e d f rom t h e sample as t h e i r p r o g r e s s r e c o r d c a r d s l a c k e d s u f f i c i e n t d a t a . From t h e r e m a i n i n g 343 c h i l d r e n , d i v i d e d i n t o f o u r , g roups b a s e d on r e a d i n g and s p e l l i n g a b i l i t y , t h i r t y were s e l e c t e d a t random f rom Groups 1, 2 , and 4 . As Group 3 c o n t a i n e d o n l y s e v e n c h i l d r e n , a l l s e v e n were i n c l u d e d i n t h e i n d i v i d u a l t e s t i n g . I n t o t a l , 97 c h i l d r e n were t e s t e d f o r t h e f o u r symptoms o f t h e Gers tmann syndrome d u r i n g t h e l a t t e r h a l f o f A p r i l , 1969 . T e s t i n g f o r t h e Ger s tmann Syndrome To d e t e r m i n e t h e p r e s e n c e o r absence o f t h e f o u r symptoms o f t h e Ger s tmann syndrome t h e f o l l o w i n g t e s t s were u s e d : (a) d i s o r i e n t a t i o n f o r r i g h t and l e f t - e i g h t d i r e c t i o n a l com-mands, (b) f i n g e r a g n o s i a - K i n s b o u r n e and W a r r i n g t o n ' s t e s t f o r f i n g e r d i f f e r e n t i a t i o n , .(c) d y s c a l c u l i a - a n . a r i t h m e t i c t e s t w h i c h i n c l u d e d e i g h t l a r g e numbers w r i t t e n . t o d i c t a t i o n and s e v e n c o m p u t a t i o n q u e s t i o n s p l u s , the s c o r e f o r a r i t h m e t i c a b i l i t y as measured by t h e S t a n f o r d A c h i e v e m e n t T e s t , and 100 (d) dysgraphia - Myklebust's Picture Story Language Test. Small groups of children were tested for d y s c a l c u l i a and dysgraphia f i r s t . Following these t e s t s , each c h i l d was then tested i n d i v i d u a l l y for a d i s o r i e n t a t i o n for r i g h t and l e f t and for finger agnosia. The following c r i t e r i a were used to determine the presence or absence of each Gerstmann symptom. Correct per-formance of four of the six commands which tested a knowledge of r i g h t and l e f t on oneself, and both of the commands which tested a knowledge of r i g h t and l e f t on another person facing the subject were required. Two hesitations on the former and one h e s i t a t i o n on the l a t t e r part of the t e s t , following by the correct response, were permitted. Scores below these were recorded as a p o s i t i v e i n d i c a t i o n that a d i s o r i e n t a t i o n for r i g h t and l e f t was present. On the finger agnosia t e s t , correct answers for six of the eight responses on each of the three parts of the test were required. A score of less than six was considered as a p o s i t i v e i n d i c a t i o n that finger agnosia was present. For the arithmetic t e s t , correct answers on f i v e of the eight numbers written to d i c t a t i o n , and on four of the seven computation questions were required. Scores below these were considered as a p o s i t i v e i n d i c a t i o n that d y s c a l c u l i a was present. Confirmation of a computation d i s -a b i l i t y was a score of 4.0 or below on the arithmetic section 101 o f t h e S t a n f o r d A c h i e v e m e n t T e s t . A p o s i t i v e i n d i c a t i o n t h a t d y s g r a p h i a was p r e s e n t was a s t a n i n e s c o r e o f 3 .0 o r b e l o w f o r t o t a l o u t p u t on M y k l e b u s t ' s P i c t u r e S t o r y Language T e s t . T r e a t m e n t o f ; t h e D a t a The d a t a f o r t h e t o t a l sample was a n a l y s e d f o r t h e p e r c e n t a g e o f c h i l d r e n m a k i n g r e v e r s a l e r r o r s i n s p e l l i n g i n r e l a t i o n t o r e a d i n g a b i l i t y and f o r t h e d i s t r i b u t i o n and f r e -quency o f r e v e r s a l e r r o r s i n r e l a t i o n t o r e a d i n g a b i l i t y . The d a t a f o r t h e 97 c h i l d r e n t e s t e d f o r t h e f o u r symptoms o f t h e Ger s tmann syndrome was a n a l y s e d by a c h i - s q u a r e t e s t o f s i g n i f i c a n c e f o r between group d i f f e r e n c e s . The number o f . r e v e r s a l e r r o r s , t h e r e a d i n g and a r i t h m e t i c s c o r e s f rom t h e S t a n f o r d A c h i e v e m e n t T e s t , and t h e p r e s e n c e o r absence o f each o f t h e f o u r symptoms o f t h e Ger s tmann syndrome were t a b u l a t e d f o r each o f t h e 97 c h i l d r e n by g r o u p and t h e d i f f e r -ences b e t w e e n . g r o u p s f o r t h e p r e s e n c e o f t h e f o u r symptoms c a l c u l a t e d . R e s u l t s were c o n s i d e r e d s i g n i f i c a n t a t t h e .05 l e v e l . A d e s c r i p t i v e a n a l y s i s was u sed f o r t h e c l u s t e r i n g o f symptoms o f t h e Gers tmann syndrome by g r o u p . FINDINGS AND CONCLUSIONS The f i n d i n g s o f t h i s s t u d y s u g g e s t t h e f o l l o w i n g c o n c l u s i o n s i n regard^ t o t h e r e l a t i o n s h i p between r e v e r s a l e r r o r s i n s p e l l i n g , r e a d i n g a b i l i t y , and t h e f o u r symptoms 102 of the Gerstmann syndrome at the grade f i v e l e v e l . 1. Of the 343 children tested, 21 per cent made rev-e r s a l errors i n s p e l l i n g and were reading one or more years below grade placement, 2 per cent made no reversal errors i n sp e l l i n g but were reading one or more years below grade placement, 50 per cent made reversal errors i n s p e l l i n g but were reading close to or above grade placement, and 27 per cent made no reversal errors i n s p e l l i n g and were also reading close to or above grade placement. 2. Reversal errors i n s p e l l i n g are not an uncommon error even among the better readers at th i s grade l e v e l . Only 35 per cent of the children reading close to or above grade placement did not make t h i s type of spelling, error. However, a rel a t i o n s h i p between reversal errors i n s p e l l i n g and reading a b i l i t y seems to e x i s t . As reading a b i l i t y i n -creased above grade placement, ,the number of these errors, and the percentage of children making such errors decreased. 3. Of the children making reversal errors i n s p e l l i n g 30 per cent were reading one or more years below grade placement as compared with 7 per cent of the children reading below grade placement but who made no reversal errors i n s p e l l i n g . 4. The number of reversal errors i n s p e l l i n g was not in d i c a t i v e of a "reading d i s a b i l i t y " . The majority of c h i l -103 dren i n Group 1 made between one and f i v e such errors, as did the majority of children i n Group 2. Also, the children i n Group 2 who were reading close to grade placement showed the same range i n number of reversal errors i n s p e l l i n g as the children i n Group 1 reading one.or more years below grade placement. When a comparison was made between the number of reversal errors i n s p e l l i n g and the presence of each of the Gerstmann symptoms, a si m i l a r number of children tested posi-t i v e l y for each symptom regardless of the number of reversal errors made i n s p e l l i n g . 5. The clu s t e r i n g of.symptoms by group indicated that the r e l a t i o n s h i p between reading a b i l i t y , reversal.errors i n sp e l l i n g , and the four symptoms of the Gerstmann syndrome was more one of degree than of type. Fifty-seven percent of the children reading one or more years below grade placement, and who made reversal errors i n s p e l l i n g , tested p o s i t i v e l y for three to four of the Gerstmann symptoms as compared with the majority of children i n the other three groups who tested p o s i t i v e l y for one or two of the Gerstmann symptoms. 6. A s i g n i f i c a n t r e l a t i o n s h i p was found between rever-sal, errors i n s p e l l i n g , retardation of one or more years i n reading a b i l i t y , and a di s o r i e n t a t i o n for. r i g h t and le f t , . -d y s c a l c u l i a , and dysgraphia. The presence of the fourth symptom i n the Gerstmann syndrome, finger agnosia, was found only to be s i g n i f i c a n t l y associated with reading retardation. 104 7. A t t h e g r a d e f i v e l e v e l , t h e p r e s e n c e o f two t o f o u r o f t h e G e r s t m a n n symptoms c o u p l e d w i t h r e v e r s a l e r r o r s i n s p e l l i n g and a r e a d i n g l e v e l one o r more y e a r s b e l o w g r a d e p l a c e m e n t w o u l d a p p e a r t o be s i g n i f i c a n t i n i d e n t i f y i n g a c h i l d w i t h a " r e a d i n g d i s a b i l i t y " . 8. No r e l a t i o n s h i p b etween s e x and t h r e e o f t h e G e r s t m a n n symptoms was f o u n d . O n l y d y s g r a p h i a was s i g n i f i -c a n t l y r e l a t e d t o s e x . No r e l a t i o n s h i p b etween c h r o n o l o g i c a l age and t h r e e o f t h e G e r s t m a n n symptoms was f o u n d . O n l y d y s c a l c u l i a was s i g n i f i c a n t l y r e l a t e d t o age.. The G e r s t m a n n syndrome i m p l i c a t e s t h e p a r i e t o - o c c i p i t a l r e g i o n o f t h e c o r t e x , u s u a l l y i n t h e d o m i n a n t h e m i s p h e r e . The s t r a t e g i c l o c a t i o n o f t h i s c o r t i c a l a r e a , l y i n g between t h e v i s u a l r e c e i v i n g a r e a and t h e a u d i t o r y and s o m a t i c r e -c e i v i n g a r e a s , s u g g e s t s a p o s s i b l e i n t e g r a t i n g r o l e o f . v i s u a l i n p u t s w i t h o t h e r m o d a l i t i e s by t h i s r e g i o n . Some unknown f a c t o r s . r e l a t e d t o t h e o p t i m a l f u n c t i o n i n g o f t h i s c o r t i c a l a r e a i n . c h i l d r e n , as o p p o s e d t o damage by a l e s i o n i n a d u l t s , may i n t e r f e r e w i t h t h e c o o r d i n a t i o n o f i n f o r m a t i o n w h i c h c o n t r i b u t e s t o t h e a b s t r a c t l e a r n i n g o f s y m b o l i c l a n g u a g e . I f t h i s s h o u l d be t h e c a s e , t h e n c h i l d r e n m a n i f e s t i n g t h r e e t o f o u r o f t h e Ger s t m a n n symptoms may e x p e r i e n c e t h e g r e a t e s t d i f f i c u l t y i n l e a r n i n g when i n f o r m a t i o n i s p r e s e n t e d v i s u a l l y . 105 RECOMMENDATIONS The findings of t h i s study would seem to have the f o l -lowing implications for teaching. The concomitant associa-t i o n of reversal errors i n s p e l l i n g , of reading retardation one or more years below grade placement, and of two to four of the Gerstmann symptoms would appear to provide a method for the classroom teacher for i d e n t i f y i n g a c h i l d with a "reading d i s a b i l i t y " . The symptoms, except for finger agnosia, can a l l be observed by the teacher from the child' s d a i l y performance i n the classroom. Depending on the severity of the child's problem, the classroom teacher could either r e f e r the childfdlor further diagnosis or for sp e c i a l help, i f these were available,or make adjustments i n the classroom s i t u a t i o n to meet the needs of the c h i l d . The d i f f i c u l t y i n learning to read which these children experience would seem to be related to a weakness i n esta-b l i s h i n g v i s u a l , auditory, and motor patterns related to sym-b o l i c language. For these children to learn c^ptimall"y>, an approach which makes use of a l l the sensory modalities i n order to a s s i s t i n a secure integration of the v i s u a l symbol with i t s auditory counterpart or with i t s correct motor res-ponse may be more appropriate than r e l y i n g on only one of the sensory channels. Also a greater amount of r e p e t i t i o n and patience may be required on the part of the teacher to assure complete integration of thi s information. 106 A d j u s t m e n t s i n t h e l e a r n i n g p r o c e s s f o r t h e s e c h i l d r e n c o u l d be made i n v a r i o u s w a y s . The use o f o r a l r a t h e r t h a n w r i t t e n t e s t s and o r a l r a t h e r t h a n w r i t t e n answers f o r many o f t h e e x e r c i s e s a s s i g n e d may p r o v i d e t h e s e c h i l d r e n w i t h a g r e a t e r chance o f s u c c e s s i n t h e i r s c h o o l a c h i e v e m e n t . The use o f t a c t i l e and k i n e s t h e t i c t e a c h i n g methods may p r o v i d e r e i n f o r c e m e n t o f t h e weaker a u d i t o r y , v i s u a l , and motor a r e a s i n l e a r n i n g . The use o f a u d i o - v i s u a l m a t e r i a l may. p r o v i d e a d d i t i o n a l v i c a r i o u s l e a r n i n g e x p e r i e n c e s f o r them w h i c h t h e o t h e r c h i l d r e n i n t h e c l a s s w o u l d n o r m a l l y a c q u i r e t h r o u g h r e a d i n g . S u g g e s t i o n s f o r f u r t h e r r e s e a r c h d e v e l o p i n g f rom t h i s s t u d y w h i c h c o u l d be c o n s i d e r e d a r e : 1. R e p l i c a t i o n o f t h e s t u d y u s i n g a l a r g e r , o r i g i n a l sample so t h a t an e q u a l number o f c h i l d r e n c o u l d be s e l e c t e d a t random f o r each o f t h e f o u r g r o u p s . 2 . R e p l i c a t i o n o f t h e s t u d y i n a n o t h e r r e g i o n o f Canada o r i n a d i f f e r e n t s o c i o - e c o n o m i c a r e a . 3 . A s i m i l a r s t u d y m i g h t be c o n d u c t e d w i t h a d i f f e r e n t age g r o u p o f c h i l d r e n o r w i t h a r ange i n ages t o see what r e l a t i o n s h i p e x i s t s be tween t h e f o u r symptoms o f t h e Gers tmann syndrome and r e a d i n g and s p e l l i n g a b i l i t y as c h i l d r e n m a t u r e . 4 . A s t u d y c o u l d be c o n d u c t e d i n w h i c h a g r o u p o f c h i l d r e n , s e l e c t e d a t random, were f i r s t . t e s t e d f o r t h e f o u r , symptoms o f t h e Ger s tmann syndrome and t h e s e r e s u l t s c o r -r e l a t e d w i t h t h e i r r e a d i n g and s p e l l i n g a b i l i t y . 5. A l o n g i t u d i n a l s t u d y on g r a d e one c h i l d r e n who f a i l i n r e a d i n g w o u l d p r o v i d e e v i d e n c e f o r what r e l a t i o n s h e x i s t s b etween t h e p r e s e n c e o f t h e G e r s t m a n n symptoms, r e a d i n g a b i l i t y , and s c h o o l p r o g r e s s . B I B L I O G R A P H Y 109 A . P e r i o d i c a l s B e l l , L . I . M e t r o p o l i t a n V a n c o u v e r : An O v e r v i e w f o r S o c i a l  P l a n n e r s . B r i t i s h C o l u m b i a : Community C h e s t and C o u n c i l s o f t h e G r e a t e r V a n c o u v e r A r e a , 1966 . B e n t o n , A r t h u r L . "The F i c t i o n o f t h e 'Ger s tmann S y n d r o m e ' , " J o u r n a l o f N e u r o l o g y , N e u r o s u r g e r y , and P s y c h i a t r y , 2 4 : 1 7 6 - 1 8 1 , 1 9 6 1 . B e n t o n , A r t h u r L . and K e m b l e , J o a n D. " R i g h t - L e f t O r i e n t a t i o n and R e a d i n g D i s a b i l i t y , " P s y c h i a t r i a e t N e u r o l o g i a , 1 3 9 : 4 9 - 6 0 , 1960 . C l a i r b o r n e , H e r b e r t J . "Types o f C o n g e n i t a l Symbol A m b l y o p i a , " J o u r n a l o f t h e A m e r i c a n M e d i c a l A s s o c i a t i o n , 4 7 : 1 8 1 3 -1816 , 1906 . " " ' D o u g l a s , J . W . B . , R o s s , J . M . , and C o o p e r , J . E ^ "The R e l a t i o n s h i p Between Handednes s , A t t a i n m e n t and A d j u s t m e n t i n a N a t i o n a l Sample o f S c h o o l C h i l d r e n , " E d u c a t i o n a l  R e s e a r c h , 9 : 2 2 3 - 2 3 1 , 1967 . Eames, Thomas H . "The A n a t o m i c a l B a s i s o f L a t e r a l D o m i n a n c e , " A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y , 4 : 5 2 4 - 5 2 8 , 1934 . E t t l i n g e r , G . , and J a c k s o n , C . V . " O r g a n i c F a c t o r s i n D e v e l o p -m e n t a l D y s l e x i a , " P r o c e e d i n g s o f t h e R o y a l S o c i e t y o f  M e d i c i n e , 4 8 : 9 9 8 - 1 0 0 0 , 1 9 5 5 . " ~ '* " '. ~ F i l d e s , L u c y . " A P s y c h o l o g i c a l I n q u i r y i n t o t h e N a t u r e o f t h e C o n d i t i o n Known as C o n g e n i t a l W o r d - B l i n d n e s s , " B r a i n , 4 4 : 2 8 6 - 3 0 7 , 1 9 2 1 . F i s h e r , H e r b e r t J . " C o n g e n i t a l W o r d - B l i n d n e s s ( I n a b i l i t y t o l e a r n t o r e a d ) , " T r a n s a c t i o n s o f t h e OphthaImoTog ica1  S o c i e t y , U . K . , 3 0 : 2 1 6 - 2 2 5 , 1910 . G a t e s , A r t h u r I . and B o n d , Guy L . " R e l a t i o n o f Handednes s , E y e - s i g h t i n g , and A c u i t y Dominance t o R e a d i n g , " J o u r n a l  o f E d u c a t i o n a l P s y c h o l o g y , 2 7 : 4 5 0 - 4 5 6 , 1936 . G e r s t m a n n , J o s e f . "Syndrome o f F i n g e r A g n o s i a , D i s o r i e n t a t i o n f o r R i g h t and L e f t , A g r a p h i a , and A c a l c u l i a , " A r c h i v e s  o f N e u r o l o g y and P s y c h i a t r y , 3 9 : 3 9 8 - 4 0 8 , 1940 . G u t t m a n n , E r i c . " C o n g e n i t a l A r i t h m e t i c D i s a b i l i t y and A c a l -c u l i a , " B r i t i s h J o u r n a l o f M e d i c a l P s y c h o l o g y , 1 6 : 1 6 -3 5 , 1936 . ~ ' 110 H a r r i s , A l b e r t J . " L a t e r a l Dominance, D i r e c t i o n a l C o n f u s i o n , and R e a d i n g D i s a b i l i t y , " J o u r n a l o f P s y c h o l o g y , 44: 283-294, 1957. H e l v e s t o n , Eugene. " D y s l e x i a , " The S i g h t - S a v i n g Review, 38:203-208, 1968. Hermann, Knud and N o r r i e , E d i t h . " I s C o n g e n i t a l W o r d - B l i n d n e s s a H e r e d i t a r y Type o f Gerstmann's Syndrome," P s y c h i a t r i a  and N e u r o l o g i a , 136:59-73, 1958. ..' ' Hermann, K. and V o l d b y , H. "The M o r p h o l o g y o f H a n d w r i t i n g i n . C o n g e n i t a l W o r d - B l i n d n e s s , " A c t a P s y c h i a . t r i a and  N e u r o l o g i a , 21:349-363, 1946. H i l d r e t h , G e r t r u d e . " R e v e r s a l s i n R e a d i n g and W r i t i n g , " J o u r n a l o f E d u c a t i o n a l P s y c h o l o g y , 25:1-20, 1943. H i n s h e l w o o d , James. " W o r d - B l i n d n e s s and V i s u a l Memory," L a n c e t , 2:1564-1570, 1895. H i n s h e l w o o d , James. "A Case o f D y s l e x i a : A P e c u l i a r Form o f W o r d - B l i n d n e s s , " L a n c e t , 2:1451-1454, 1896. H i n s h e l w o o d , James. "The V i s u a l Memory f o r Words and F i g u r e s , " B r i t i s h M e d i c a l J o u r n a l , 2:1543-1544, 1896. H i n s h e l w o o d , James. " C o n g e n i t a l W o r d - B l i n d n e s s , " L a n c e t , 1:1506-1508, 1900. H i n s h e l w o o d , James. "The T r e a t m e n t o f W o r d - B l i n d n e s s , A c q u i r e d and C o n g e n i t a l , " B r i t i s h M e d i c a l J o u r n a l , 2:1033-1035, 1912. Hughes, J . , L e a n d e r , R., and Ketchum, G. " E l e c t r o e n c e p h a l o -g r a p h i c S t u d y o f S p e c i f i c R e a d i n g D i s a b i l i t y , " E:E.G. and C l i n i c a l N e u r o p h y s i o l o g y , 1:377-378,' 1949 . K a s s , C o r i n e . "Some P s y c h o l o g i c a l C o r r e l a t e s o f S e v e r e R e a d i n g D i s a b i l i t y ( D y s l e x i a ) , " i n S e l e c t e d S t u d i e s on  t h e I l l i n o i s T e s t o f P s y c h o l i r i g u i s t i c A b i l i t y . U r b a n a , I l l i n o i s : I n s t i t u t e f o r R e s e a r c h on E x c e p t i o n a l C h i l d r e n , U n i v e r s i t y o f I l l i n o i s , 1963. K e n n a r d , M a r g a r e t A., R a b i n o v i t c h , R a l p h , and W e s l e r , D o n a l d . "The A b n o r m a l E l e c t r o e n c e p h a l o g r a m as R e l a t e d t o R e a d i n g D i s a b i l i t y i n C h i l d r e n w i t h D i s o r d e r s o f B e h a v i o r , " C a n a d i a n M e d i c a l A s s o c i a t i o n J o u r n a l , 67: 330-333, 1952. Kennedy, H e l e n . " R e v e r s a l s , R e v e r s a l s , R e v e r s a l s , " J o u r n a l o f E x p e r i m e n t a 1 E d u c a t i o n , 23:161-170, 1954. I l l K i n s b o u r n e , M., and W a r r i n g t o n , E l i z a b e t h K. "A S t u d y o f F i n g e r A g n o s i a , " B r a i n , 85:47-66, 1962. K i n s b o u r n e , M., and W a r r i n g t o n , E l i z a b e t h K. "The Developmen-t a l G e r s t m a n n Syndrome," A r c h i v e s o f N e u r o l o g y , , 8 : 4 9 0 -501, 1963. " J 'J' K i n s b o u r n e , M., and W a r r i n g t o n , E l i z a b e t h K. "The D e v e l o p m e n t o f F i n g e r D i f f e r e n t i a t i o n , " Q u a r t e r l y J o u r n a l o f  E x p e r i m e n t a l P s y c h o l o g y , , 1 5 : 1 3 2 - 1 3 7 , 1963. K oos, E u g e n i a . " M a n i f e s t a t i o n s o f C e r e b r a l Dominance and P r i m a r y R e t a r d a t i o n i n P r i m a r y G r a d e C h i l d r e n . " J o u r n a l  o f G e n e t i c P s y c h o l o g y , 104:155-165, 1964. L y l e , J.G. and Goyen, J u d i t h . " V i s u a l R e c o g n i t i o n , D e v e l o p -m e n t a l L a g , and S t r e p h o s y m b o l i a i n R e a d i n g R e t a r d a t i o n , " J o u r n a l o f A b n o r m a l P s y c h o l o g y , 73:25-29, 1968. M c Cready, B o s w o r t h E . " B i o l o g i c a l V a r i a t i o n s i n t h e H i g h e r C e r e b r a l C e n t e r s C a u s i n g R e t a r d a t i o n , " A r c h i v e s o f  P e d i a t r i c s , 27:506-513, 1910. M c C r e a d y , B o s w o r t h E . " D e f e c t s i n t h e Zone o f Language (Word-Deafness and W o r d - B l i n d n e s s ) and T h e i r I n f l u e n c e i n E d u c a t i o n and B e h a v i o r , " A m e r i c a n J o u r n a 1 o f P s y c h i a t r y , 83:267-277, 1926. Morgan, P r i n g l e W. "A C a s e o f C o n g e n i t a l W o r d - B l i n d n e s s , " B r i t i s h M e d i c a l J o u r n a l , 2:1378, 1896. N i c h o l l s , J o h n V.V. " C o n g e n i t a l D y s l e x i a : A P r o b l e m i n E t i o l o g y , " C a n a d i a n M e d i c a l A s s o c i a t i o n J o u r n a l , 82: 575-578, 1960. N i e l s e n , J.M. "Gerstmann Syndrome: F i n g e r A g n o s i a , A g r a p h i a , C o n f u s i o n o f R i g h t and L e f t , and A c a l c u l i a , " A r c h i v e s  o f N e u r o l o g y and P s y c h i a t r y , 39:536-560, 1938. O r t o n , Samuel T. " ' W o r d - B l i n d n e s s ' i n S c h o o l C h i l d r e n , " A r c h i v e s o f N e u r o l o g y and P s y c h i a t r y , 14:581-615, 1925. O r t o n , Samuel T. "An Impediment t o L e a r n i n g t o Read - A N e u r o l o g i c a l E x p l a n a t i o n o f t h e R e a d i n g D i s a b i l i t y , " S c h o o l and S o c i e t y , 28:286-290, 1928. O r t o n , Samuel T. "The N e u r o l o g i c B a s i s o f E l e m e n t a r y E d u c a -t i o n , " A r c h i v e s o f N e u r o l o g y and P s y c h i a t r y , 21:641-647, 1929. 112 O r t o n , Samuel T. "The T h r e e L e v e l s o f C o r t i c a l E l a b o r a t i o n i n R e l a t i o n t o C e r t a i n P s y c h i a t r i c Symptoms," A m e r i c a n J o u r n a l o f P s y c h i a t r y , 85:647-659, 1929. O r t o n , Samuel T. " S p e c i a l D i s a b i l i t y i n S p e l l i n g , " B u l l e t i n of. t h e N e u r o l o g i c a l I n s t i t u t e o f New Y o r k , 1:159-192, O r t o n , Samuel T. i n d i s c u s s i o n o f a p a p e r by D r . J.G. L y n n , . " M i m e t i c S m i l e d n e s s as R e l a t e d t o H a n d e d n e s s : An I n d i c a t o r o f B a s i c Modes o f Human A d a p t i o n , " A r c h i v e s  o f N e u r o l o g y and P s y c h i a t r y , 47:1064, 19 42. O r t o n , Samuel T. " V i s u a l F u n c t i o n s i n S t r e p h o s y m b o l i a , " A r c h i v e s o f O p h t h a l m o l o g y , 30:707-717, 1943. P a r k , G e o r g e E . " O p h t h a l m o l o g i c a l A s p e c t s o f L e a r n i n g D i s -o r d e r s , " J o u r n a l o f L e a r n i n g D i s a b i l i t i e s , 2:189-19 8, 1969. : ' . R a b i n o v i t c h , R a l p h D. " R e a d i n g P r o b l e m s i n C h i l d r e n : D e f i n i -t i o n and C l a s s i f i c a t i o n , " i n D y s l e x i a : . . D i a g n o s i s and  T r e a t m e n t o f R e a d i n g D i s o r d e r s , e d . A r t h u r K. Keeney and V i r g i n i a T. Keeney. S t . L o u i s : The C.V. Mosby Company, 1968. Reed, James C. " L a t e r a l ! z e d F i n g e r A g n o s i a and R e a d i n g A c h i e v e m e n t a t Ages S i x and T e n , " C h i l d D e v e l o p m e n t , 38:213-220, 1967. R i c e , James A. " R i g h t - L e f t D i s c r i m i n a t i o n : S y s t e m a t i c R e v e r s a l i n B r i g h t C h i l d r e n , " J o u r n a l o f L e a r n i n g  D i s a b i l i t i e s , 1:654-659, 1968. R o b e r t s , Lamar. "Handedness and C e r e b r a l Dominance," T r a n s a c t i o n s o f t h e A m e r i c a n N e u r o l o g i c a 1 A s s o c i a t i o n , 80:143-148, 1955. S c h i l d e r , N P a u l . " C o n g e n i t a l A l e x i a and i t s R e l a t i o n t o O p t i c P e r c e p t i o n , " J o u r n a l o f G e n e t i c P s y c h o l o g y , 65:67-88, 1944. S i l v e r , A r c h i e A. and H a g i n , R o s a . " S p e c i f i c R e a d i n g D i s -a b i l i t y : D e l i n e a t i o n o f t h e Syndrome and R e l a t i o n s h i p t o C e r e b r a l Dominance," C o m p r e h e n s i v e P s y c h i a t r y , 1:126-134, 1960. S i l v e r , A r c h i e A. and H a g i n , R o s a . " S p e c i f i c R e a d i n g D i s -a b i l i t y : F o l l o w - u p S t u d i e s , " A m e r i c a n J o u r n a l o f O r t h o p s y c h i a t r y , 34:95-102, 1964. 113 S i l v e r , A r c h i e A. , and H a g i n , R o s a . " S t r a t e g i e s o f I n t e r v e n t i o n i n t h e S p e c t r u m o f D e f e c t s i n S p e c i f i c R e a d i n g D i s -a b i l i t y ,"' B u l T j e t i j l O f 'Otton 'SotiiJe±Y_, 17:39-46, 1967. S t e p h e n s o n , S i d n e y . " C o n g e n i t a l W o r d - B l i n d n e s s , " L a n c e t , 2:827-828, 1904. S t r a u s s , A l f r e d , and Werner, H e i n z . " D e f i c i e n c y i n t h e F i n g e r Schema i n R e l a t i o n t o A r i t h m e t i c D i s a b i l i t y ( F i n g e r A g n o s i a and A c a l c u l i a ) , " A m e r i c a n J o u r n a l o f O r t h o -p s y c h i a t r y , 8:719-724, 1938. " ' ..' T e e g a r t e n , L o m e . " T e s t s f o r t h e T e n d e n c y t o R e v e r s a l i n R e a d i n g , " J o u r n a l o f E d u c a t i o n a l R e s e a r c h , 27:81-97, 19 33.;- ; ' . ' " ' • • W e i n t r a u g , Samuel. "Eye-hand P r e f e r e n c e and. Reading/'!' R e a d i n g T e a c h e r , 21: 369 4 ,"'1968 . W i t t y , P a u l A., and K o p e l , D a v i d . " S i n i s t r a l and M i x e d M a n u a l -O c u l a r B e h a v i o r i n R e a d i n g D i s a b i l i t y , " J o u r n a l o f  E d u c a t i o n a l P s y c h o l o g y , 27:119-134, 1936. W i t t y , P a u l , and Kopel,, D a v i d . " F a c t o r s A s s o c i a t e d w i t h t h e E t i o l o g y o f R e a d i n g D i s a b i l i t y , " J o u r n a l o f E d u c a t i o n a l  R e s e a r c h , 29:449-459, 1936. W o l f e , L i l l i a n S. "An E x p e r i m e n t a l S t u d y o f R e v e r s a l s i n R e a d i n g , " A m e r i c a n J o u r n a l o f P s y c h o l o g y , 52:533-561, 1939. ~ W o l f e , L i l l i a n S. " D i r e c t i o n a l F a c t o r s i n S p e c i f i c R e a d i n g D i s a b i l i t y : I L a t e r a l i t y o f F u n c t i o n , " J o u r n a l o f  G e n e t i c P s y c h o l o g y , 58:45-56, 1941. Woody, C l i f f o r d , and P h i l l i p s , A l b e r t . "The E f f e c t s on Handed-n e s s on R e v e r s a l s i n R e a d i n g , " J o u r n a l o f E d u c a t i o n a l R e s e a r c h , 27:651-662, 1943. B. Books B e n t o n , A r t h u r L . R i g h t - L e f t D i s c r i m i n a t i o n s and F i n g e r L o c a l i z a t i o n . New Y o r k : P a u l B. Ho e b e r , 1959'. C a m p b e l l , H.J. C o r r e l a t i v e P h y s i o l o g y o f t h e N e r v o u s S y s t e m . New Y o r k : A c a d e m i c P r e s s , 1965. C r i t c h l e y , M a c d o n a l d . D e v e l o p m e n t a l D y s l e x i a . L o ndon: W i l l i a m Heinemann M e d i c a l B o o k s , 1964. 114 D o l c h , Edward W. B e t t e r S p e l l i n g . C h a m p a i g n , I l l i n o i s : The The G a r r a r P r e s s , '1942 . * " " Ganong, W i l l i a m F. Review o f M e d i c a l P h y s i o l o g y . L o s A l t o s , C a l i f o r n i a : Lange M e d i c a l P u b l i c a t i o n s , 1969.; Hermann, Knud. R e a d i n g D i s a b i l i t y . Copenhagen, Denmark: E j n a r M u n k s g a a r d A.S., 1 9 5 97 K o l s o n , C . and K a l u g e r , G. C l i n i c a l A s p e c t s o f R e m e d i a l R e a d i n g . S p r i n g f i e l d , I l l i n o i s : C h a r l e s C. Thomas, 1963. Money, J o h n ( e d . ) . The D i s a b l e d R e a d e r . B a l t i m o r e : The J o h n H o p k i n s P r e s s , 1966. Money, J o h n ( e d . ) . R e a d i n g D i s a b i l i t y : P r o g r e s s and R e s e a r c h  Needs i n D y s l e x i a . B a l t i m o r e : The J o h n H o p k i n s P r e s s , 1962 . * ' " M y k l e b u s t , Helmer R. D e v e l o p m e n t and D i s o r d e r s o f W r i t t e n L a n g u a g e, v o l . 1. New Y o r k : Grune and S t r a ' t t o n , 1963. S t a n f o r d A c h i e v e m e n t T e s t , Form W, I n t e r m e d i a t e B a t t e r y . New Y o r k : H a r c o u r t , Brace" and -'World "inc., 1964. Thompson, L l o y d J . R e a d i n g D i s a b i l i t y . S p r i n g f i e l d , I l l i n o i s : C h a r l e s C. Thomas, 1966. A P P E N D I C E S 116 APPENDIX A THE SPELLING.TEST . INSTRUCTIONS TO CLASS: Today you are to have a s p e l l i n g t e s t , but the words are a l l ones which you should know how t o s p e l l . I am i n t e r e s t e d i n f i n d i n g out how w e l l you l i s t e n . The words w i l l be s a i d o n l y once and w i l l not be used i n a sentence. I w i l l not r e -peat any of the words, so you must l i s t e n c a r e f u l l y and then immediately w r i t e down the word you hear me say. I f you miss a word, leave a blank b e s i d e i t s number and be ready t o w r i t e the next word. The number f o r each word w i l l be g i v e n f i r s t . There are f o r t y - f o u r words i n a l l . Number your papers from one to f o r t y - f o u r and w r i t e your name at the top® SPELLING. TEST: 1. horse 12. February 23. perfume 34. c h i e f 2. goes 13. mountain 24. s e v e r a l 35. coach 3. p r a i s e 14. b i r d 25. people 36. t h i r s t y 4. q u i e t 15. t r u l y 26. f r o n t 37. g i a n t 5. t h i r d 16. c u r t a i n 27. p e a r l 38. scare 6. Thursday 17. n o i s e 28. v o i c e 39. b u r s t 7. s c a r f 18. scream 29. c a p t a i n 40. f i r s t 8, piano 19. month 30. s t r u c k 41. f r i e n d 9. b i r t h 20. poem 31. g i r l 42. b r a i n 10. aboard 21. u s u a l 32. f o u n t a i n 43. does 11. b e l i e v e 22. serve 33. l i b r a r y 44. house DIRECTIONS FOR ADMINISTERING THE TEST: Say the number and then the word, pronouncing the word as c l e a r l y and d i s t i n c t l y as p o s s i b l e ; count t o f i v e s l o w l y by 100, 200, 300, 400, 500; then g i v e the next number, f o l l o w e d immediately by the word. Continue i n t h i s manner throughout the t e s t . 117 APPENDIX B F i n g e r D i f f e r e n t i a t i o n T e s t F I G U R E i Finger differentiation test. ( S o u r c e : K i n s b o u r n e and W a r r i n g t o n , Q u a r t e r l y J o u r n a l o f P s y c h i a t r y , p p . 133-134 . 1 1 8 "IH-bctween" test. The finger block test. Blocks arc i in. X r$ in . x 1 in . wi th cut-outs !, in . I in. x I in. 119 APPENDIX C T e s t f o r R i g h t - L e f t O r i e n t a t i o n and F i n g e r A g n o s i a Name S c h o o l T e a c h e r RIGHT-LEFT ORIENTATION c o r r i n c o r . h es 1. t o u c h y o u r r i g h t e a r w i t h y o u r r i g h t hand 2. s t a n d up and t u r n t o t h e l e f t 3. s i t down and p o i n t t o my r i g h t s h o u l d e r ' 4. t o u c h y o u r l e f t knee w i t h y o u r r i g h t hand 5. u s e . y o u r l e f t hand and p o i n t t o my r i g h t e a r ' '  6. t o u c h y o u r r i g h t s h o u l d e r w i t h your, l e f t hand 7. bend down as i f t o " t i e "your r i g h t shoe ' 8. t o u c h y o u r l e f t e l b o w w i t h y o u r l e f t hand \ FINGER AGNOSIA: T e s t A. Two s i m u l t a n e o u s t o u c h e s on one o r two o f t h e m i d d l e f i n g e r s . R e s p o n s e - number-of f i n g e r s t o u c h e d . R i g h t Hand L e f t Hand 1. 2 - m i d d l e f i n g e r ' 1. m i d d l e and s e c o n d ' 2. m i d d l e and f o u r t h 2. 2 - m i d d l e f i n g e r ' 3. 2 - m i d d l e f i n g e r 3. 2 - m i d d l e f i n g e r 4. m i d d l e and s e c o n d 4. m i d d l e and f o u r t h T e s t B. Two s i m u l t a n e o u s t o u c h e s on two f i n g e r s . R e s p o n s e - number o f f i n g e r s i n b e t w e e n . R i g h t Hand L e f t Hand 1. s e c o n d and f o u r t h 1. t h i r d and f o u r t h 2. t h i r d and f o u r t h 2. s e c o n d and f o u r t h 120 s e c o n d and f i f t h 3. t h i r d and thumb t h i r d and thumb 4. s e c o n d and f i f t h T e s t C. I d e n t i f i c a t i o n o f t h e shape o f t h e b l o c k h e l d i n t h e hand. R e s p o n s e - p o i n t t o t h e b l o c k w h i c h i s t h e same as t h e one h e l d . R i g h t Hand L e f t Hand p—n i . cfZb _ _ 1 — * — i _ 1 2. _ L^ZD _ 3 - _ pi-r-t-, -J 4. P—H 121 APPENDIX D ARITHMETIC TEST P a r t A: Numbers w r i t t e n to d i c t a t i o n . (1,010) 1. 2. (2,000,002) (50,050) (300,300) 5. 6. 7. (100,001) (10,000,100) (4,040) (20,007) P a r t B Add 1. 14+28+60+37 184 3529 742 4976 453 S u b t r a c t 784 - 269 = 110741 • 3972 M u l t i p l y . 1. 47 x 60 = 2. 23 x58 3. 450 x907 APPENDIX E R e p r i n t o f Picture'" - u s e d i n M y k l e b u s P i c t u r e S t o r y Language T e s t APPENDIX F RECORD SHEET Group Name ' . Age SPELLING TEST: R e v e r s a l E r r o r s READING ABILITY.: S t a n f o r d Achievement Grade ARITHMETIC ABILITY: S t a n f o r d Achievement Grade GERSTMANN SYNDROME: 1. R i g h t - L e f t O r i e n t a t i o n (a) s e l f (b) others 2. F i n g e r Agnosia (a) (b) (c) 3. D y s c a l c u l i a (a) order (b) c a l c u l a t i o n 4. Dysgraphia PICTURE STORY LANGUAGE TEST - STANINES T o t a l words ' T o t a l sentences T o t a l words per sentence . Syntax A b s t r a c t - C o n c r e t e L e v e l APPENDIX G M a r g i n a l T o t a l s f o r C h i - •Square C a l c u l a t i o n s Shown i n T a b l e s IV, V, V I , and 1 V I I I Column D i s o r i e n t a t i o n F i n g e r D y s c a l c u l i a D y s c a l c u l i a M a r g i n a l f o r R i g h t -L e f t A g n o s i a O r d e r C a l c u l a t i o n D y s g r a p h i a P a s s F a i l P a s s F a i l Pass- F a i l P a s s F a i l P a s s F a i l T a b l e IV Group 1 30 6 24 17 13 11 19 10 20 15 15 Group 2 30 7 23 25 5 21 9 23 7 24 6 Group 3 7 1 6 6 1 5 2 2 5 5 2 Group 4 30 - 20 10 .-. 24 6 ,- 28 ?2- 29 1 29 1-Row M a r g i n a l s 97 34 63 72 25 65 32 64 33 73 24 T a b l e V Combined G r o u p s 1 & 2 60 13 47 42 18 32 28 33 27 39 21 Combined Groups 3 & 4 37 . 21 / 16 30 7 " 33 " 4 31 6 34 3 Row M a r g i n a l s 97 34 63 72 25 65 32 64 33 73 24 T a b l e VI Combined G r o u p s 1 & 3 37 7 30 23 14 16 21 12 25 20 17 Combined Groups 2 & 4 60 27 33 .4.9. 11 49 11 52 8 - 53 7 Row M a r g i n a l s 97 34 63 72 25 65 32 64 33 .73 24 APPENDIX G ( c o n t i n u e d ) Column D i s o r i e n t a t i o n F i n g e r M a r g i n a l f o r R i g h t - L e f t A g n o s i a D y s c a l c u l i a D y s g r a p h i a P a s s F a i l P a s s F a i l - P a s s F a i l P a s s F a i l -T a b l e V I I I Sex Boys 59 16 43 44 15 28 31 40 19 G i r l s 38 17 21 28 10- 21 17 33 .5 Row M a r g i n a l s 97 33 64 72 25 49 48 73 24 C h r o n o l o g i c a l Age 10.00-10.90 39 12 27 29 10 £22 17 28 11 10.10-11.20 28 13 15 23 5 21 7 24 4 11.30-12.10 30 8 22 - 20 10 - fi6 - 24 21 9 Row M a r g i n a l s 97 33 64 72 25 49 48 73 24 ui 

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            data-media="{[{embed.selectedMedia}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
https://iiif.library.ubc.ca/presentation/dsp.831.1-0104115/manifest

Comment

Related Items