What Do We Know About Reading and Students with E/BD?

Reading Levels of Students with E/BD

Only a few studies have documented the reading achievement of students with E/BD. Most of these studies have described reading levels, based on standardized measures, for purposes of comparison with achievement in other subjects or to other groups of students.

The achievement patterns of psychiatric samples, such as students hospitalized for serious behavior disorders, have been studied by Forness and his colleagues, who found moderate levels of reading difficulties. In one study, students were on the average only moderately below grade level on a standardized test of reading achievement despite considerable variability within the sample (Forness, Frankel, Caldon, & Carter, 1980). In a second study, only one-third of a sample of 92 psychiatric inpatients had deficits of more than 1 year in reading when adjusted for IQ (Forness, Bennett, & Tose, 1983). In addition, they displayed a homogeneous pattern of underachievement in reading, spelling, and math, rather than specific deficits in one area. Students in both samples ranged from elementary to middle school (ages 6–14).

Descriptive achievement data have also been obtained on students with E/BD who are in the public schools (Kauffman, Cullinan, & Epstein, 1987). Due to the large age range (7–19), the students were subdivided into younger, middle, and older groups. Almost three-fourths of the sample, regardless of the age group, were functioning 1 to 2 or more years below grade level on reading comprehension.

Another way in which reading achievement has been explored is by studying the intellectual and achievement characteristics of students with E/BD. A review of 25 studies published from 1966 to 1985 in this area (Mastropieri, Jenkins, & Scruggs, 1985) revealed the following:

• Underachievement in reading was noted when actual achievement was compared to intellectual ability levels.
• Support was found for the notion that students with BD are underachieving in all areas of academic functioning with no content-specific deficits, except in some studies that documented more serious problems with math.
• While other variables have been studied in relation to achievement including attitude toward school subjects, locus of control, impulsivity, and responses to test-taking situations, no causal links between these variables and reading levels were evident.

In summary, the reading levels of students with E/BD as a group may be characterized as typically below grade level and moderately deficient. This finding holds across all grade levels. However, as with any categorization or subgroup, there is considerable variability among students with E/BD, with some individuals being excellent readers. Most studies suggest that students with E/BD also exhibit patterns of underachievement when ability levels are taken into consideration.

Comparisons of Students with E/BD and Students with LD

In direct comparisons of the reading levels of students with E/BD with those of students with LD, students with E/BD generally score higher (i.e., are found to be somewhat less deficient) in reading than their counterparts with LD. Four out of five studies with students ranging from ages 6 to 12 documented differences that ranged from slightly higher to significantly higher when statistical comparisons were made (Epstein & Cullinan, 1983; Fuller & Goh, 1981; Harris, King, Reifler, & Rosenberg, 1984; Mastropieri et al., 1985; Scruggs & Mastropieri, 1986). The measures of reading were primarily word recognition and reading comprehension; one study assessed reading rate and found that students with E/BD read at a much higher rate (measured in words per minute) than their LD counterparts (Epstein & Cullinan, 1983).

One study compared the behavioral and academic profiles of students from a special campus for students with LD with those of students from a special campus for students with E/BD and found minimal differences between the two groups (Harris et al., 1984). Students with E/BD had higher total scores on a measure of clinical problems, but students with LD also had inflated scores, well above the average range. As a group, the students with LD were more delayed in reading skills, although not significantly so. Such findings led the authors to conclude that "special services for behavior disorder are needed for the LD group and instruction for specific learning problems are required for the ED group" .

Another group of researchers assessed comorbidity, or the presence of LD in children and adolescents admitted to a psychiatric hospital for E/BD (Fessler, Rosenberg, & Rosenberg, 1991). They found that that almost 40% were identified as having LD and almost 18% were identified as having learning problems; the majority of both groups were deficient in all reading areas assessed. Perhaps the statistic of most concern is that fewer than half these students (44%) had received special education services of any type prior to being admitted to the hospital. These statistics would argue for better identification of students with E/BD and for recognizing the coexistence of E/BD with LD.

In sum, the reading achievement of students with E/BD has been documented as highly variable and moderately deficient, probably a little higher when compared with peers with LD. Measures used in these studies represent estimations of reading levels; no diagnostic testing of specific reading skills with this population has been reported. However, research has also investigated the relationship between the reading problems and externalizing behavior disorders.

Relationship between Reading Problems and Externalizing Behavior Disorders

Externalizing behavior disorders are prevalent among children and youth with E/BD. Externalizing behaviors are a broad categorization of problem behaviors that are typically defined as including behaviors of an acting-out nature; lying, fighting, cheating, stealing, oppositional behavior, and rule breaking make up one cluster of behaviors often referred to as antisocial behavior or conduct disorder. Problems with attention, impulsivity, and hyperactivity make up another cluster, usually referred to as attention deficit hyperactivity disorder. These two clusters of behavior often overlap; that is, children and youth may both have attentional/hyperactivity problems and exhibit antisocial behavior. Each cluster will be discussed in the following summary of studies as it relates to research on reading problems.

Both antisocial behavior disorders and severe reading problems persist over time, and both lead to poor adjustment in adolescence and adulthood. The presence of reading difficulties among delinquent populations and others with antisocial or conduct problems has been well documented over the years (e.g., Berger, Yule, & Rutter, 1975; Frick et al., 1991; Hinshaw, 1992; Maguin, Loeber, & Le Mahieu, 1993; McGee, Williams, Share, Anderson, & Silva, 1986), leading researchers and developmental specialists to question whether a causal relationship exists. McMichael (1979) posed this question in the title to her article, "The Hen or the Egg? Which Comes First—Antisocial Emotional Disorders or Reading Disability?"

Researchers in various countries have studied the relationship between externalizing behaviors and severe reading difficulties for 30 years. They conducted a series of epidemiological, longitudinal studies in England (Berger et al., 1975; Rutter & Yule, 1970), New Zealand (McGee et al., 1986), Canada (Stott, 1981), Scotland (McMichael, 1979), and Australia (Jorm, Share, Matthews, & MacLean, 1986). By assessing large numbers of children on behavioral and academic measures early in their school careers, in some cases before any formal instruction took place, and then again years later, researchers were able to ascertain relationships between severe behavior problems and reading problems. More specifically, researchers were able to ascertain whether one preceded the other.

Several findings emerged from these studies that shed some light on the question of "which came first?" and other related issues. First, the New Zealand researchers found that it is helpful to break down externalizing disorders into the two subcategories of attention problems/hyperactivity and antisocial/conduct disorder. The cluster of attention/hyperactivity problems was found to be more closely associated than conduct disorder with reading problems, an association also found by Frick et al. (1991) in a study conducted with boys ages 7 to 12 in the United States. However, in a comprehensive review of literature addressing the relationship between externalizing behavior problems and academic underachievement, Hinshaw (1992) argues that the relationship among the variables may be age related. He makes the case that in younger children, inattention and hyperactivity are stronger correlates of academic underachievement than is aggression, and in older children antisocial behavior and delinquency are more clearly associated with underachievement.

The most salient and important finding from the studies is that externalizing problems, especially inattention and hyperactivity, either predate or coexist with reading problems; there is no evidence to suggest causation in either direction. McMichael (1979) summarizes thus:

The children who manifested antisocial behavior and reading difficulties at the age of six to seven appeared to have entered school with a constellation of earlier problems connected with delayed linguistic, perceptual, and cognitive development, low self-esteem, and antisocial behavior. The antisocial behavior had not arisen from loss of self-esteem through reading failure so much as accompanied low self-esteem into school.

Hinshaw (1992), in his literature review, confirms that causal relationships have not been established in either direction. He proposes that variables such as the following may be underlying factors contributing to the complex relationship between behavior problems and underachievement in reading:

Socioeconomic status: Socioeconomic status alone does not explain the overlap between externalizing disorders and underachievement; family interaction variables such as parental attitudes toward literacy or listening to the child's reading appear to mediate the relationship between SES and reading attainment.

Familial variables: Research in this area has been hampered by the dearth of studies and by the methodological issue of ascertaining whether family variables are antecedents or consequences of child problems. However, one well-crafted longitudinal study revealed that (a) early adverse family climate did predict specific reading deficits at age 8 even when language deficits and behavior problems were controlled, and (b) maternal depression/anxiety during the child's formative years was also highly predictive of later reading difficulties (Richman, Stevenson, & Graham, 1982).

Subaverage intelligence: Lower intelligence may be a predisposing factor toward both reading difficulties and aggressive or antisocial behavior. However, it is a complex and multifaceted construct and is not the clear causal agent for both.

Language deficits: Recent conceptions of reading failure recognize the role of language deficits, specifically phonologic and linguistic processing difficulties. Additionally, mild to moderate language problems are associated with a number of behavior problems, especially attention deficit hyperactivity disorder. Research to date indicates that early language problems may in fact mediate problems in reading and problems in behavior; however, additional longitudinal research is needed to specify the nature of the association.

Neurodevelopmental delays: Although a few researchers have proposed that neurodevelopmental delays (manifested in delayed maturation of basic perceptual and motor functions) are a causal factor in language deficits, the topic remains controversial. Hinshaw (1992) suggests that neurodevelopmental delay "is a fuzzy construct, badly in need of sharpening", and its role in the association between behavior problems and achievement problems needs further examination.

In summary, many of the studies reviewed by Hinshaw serve to confirm the complex relationships among these variables in the development of both behavioral difficulties and achievement difficulties. According to Hinshaw (1992), attempting to untangle these associations and isolate single factors "is likely to be quite difficult or even misguided".

Based on this research, it may be concluded that although externalizing behavior disorders and reading problems do coexist and have been the subject of much study, there is no evidence for causation in either direction. However, because of the strong and persistent relationship, and given the negative prognosis for each, educators should continue to search for ways to ameliorate both types of problems. One implication of the research is that educators should perhaps intensify efforts to identify attention/hyperactivity problems as early as possible in order to prevent development of both reading problems and related behavior problems in later years.

Conclusion

Overall, three findings from the literature on students with E/BD and reading seem clear:

• Students with E/BD have an established pattern of underachievement in reading.
• Students who demonstrate comorbidity between E/BD and either LD or attention deficit disorder are particularly at risk for reading problems.
• While strong linkages exist between reading difficulties and externalizing behavior, a causal link is not evident.