Disorders of Reading and Writing (2024)

Below are descriptions of reading, writing, and spelling disorders. Although these descriptions are listed separately, individuals can experience combined deficits in more than one area. For example, deficits in word recognition and reading comprehension often co-occur as readers must not only recognize words but also make inferences about implicit situations in the text (Castles et al., 2018). Spelling impairment and difficulties expressing ideas in written form can affect both reading and writing; difficulty or progress in either spelling or word reading can influence performance in the other area. The terms “poor readers” or “garden variety readers” are sometimes used to describe readers with generalized difficulties in reading comprehension. Similarly, a person can have difficulty with the writing process as well as with generating the written product.

Deficits in reading, writing, and spelling can affect one or more language domains (see below). For a detailed description of the language domains as they relate to spoken and written language, see Language In Brief.

Labels for reading disorders include dyslexia, reading disability, reading disorder, specific reading disorder, and specific reading comprehension deficit. Writing disorder labels also vary, with some being dysgraphia, writing disability, writing disorder, and specific writing disorder.

Areas to consider in assessing and treating written language disorders as well as differentially diagnosing within and across spoken and written language disorders are also included below. For more comprehensive lists, see the Assessment and Treatment sections of the Written Language Disorders Practice Portal page.

Reading: Word Recognition

Word recognition deficit is sometimes referred to as dyslexia. It is characterized by difficulty with reading despite instruction and without coexisting intellectual, sensory, or neurological difficulties. A person with word recognition deficits typically has relatively intact language comprehension but may have difficulties with

Focus of Assessment/Treatment

Alphabet/letter knowledge
Phonological awareness (rhyming, segmenting and blending, awareness of sounds and syllables in words)
Morphological awareness (inflections, derivations, and compounds)
Sound–symbol correspondence
Sight word knowledge
Reading decoding
Reading fluency
Spelling
Vocabulary

Reading Comprehension

Reading comprehension deficit is sometimes referred to as specific comprehension deficit or hyperlexia. Hyperlexia can be differentiated from precocious reading, in that individuals with hyperlexia have significant problems in listening and reading comprehension.

A person with reading comprehension deficits may have difficulties with

adequate or advanced word recognition skills;
reading fluency; and
social, cognitive, or linguistic skills.

Focus of Assessment/Treatment

Print awareness
Knowledge of basic story structure and story components
Vocabulary knowledge, including
- multiple-meaning words,
- synonyms, and
- antonyms
Morphological awareness (inflections, derivations, and compounds)
Understanding meaning from context
Figurative language and ambiguities in text, including
- multiple-meaning words and
- ambiguous sentence structures
Paraphrasing and summarizing
Making inferences
Knowledge of different text structures and genres
Use of strategies to facilitate comprehension, including
- skimming,
- rereading, and
- taking notes
Using strategies to self-monitor comprehension
May need to address spoken language difficulties

Dysgraphia

Dysgraphia may refer to either difficulty with language or spelling-based aspects of written expression. Dysgraphia can occur alone or can co-occur with dyslexia and/or other learning disabilities.

The cognitive–linguistic aspects of dysgraphia are involved in the writing process and the writing product.

Writing Process Deficit

Writing process deficits are problems with the cognitive–linguistic aspects of writing and may be described under the umbrella term dysgraphia.

Focus of Assessment/Treatment

Using pictures to tell stories
Writing for different purposes, including writing to

entertain,
persuade, and
inform

Writing for different audiences
Planning, including

brainstorming,
use of story maps, and
webbing

Drafting, including

referring to story maps,
making webs, and
writing planning notes

Using digital technologies (e.g., Internet) to gather information for writing
Revising and editing content
Spelling

Writing Product Deficits

Writing product deficits are sometimes described under the umbrella term dysgraphia. For more information, please visit the International Dyslexia Association’s page on Understanding Dysgraphia.

Dysgraphia, as it relates to the writing product, involves

difficulty organizing and adequately expressing thoughts in writing,
difficulty constructing grammatically correct sentences of varying types and difficulty using writing conventions (e.g., capitalization and punctuation),
limited written fluency,
syntactic formulation problems (complexity and correctness impacted),
word choice limitations (in variety and appropriateness), and
numerous words spelled incorrectly.

Focus of Assessment/Treatment

Pretend writing
Writing letters of the alphabet
Printing first and last name
Labeling pictures
Producing text via handwriting and/or keyboarding
Copying text
Writing from dictation
Writing a variety of grammatically correct sentence types
Judging correctness of grammar and morphology and correcting errors
Writing cohesively, including

providing detail,
linking ideas, and
elaborating

Using conventions of writing correctly, including

capitalization and
punctuation

Knowledge of different text structures and genres

Spelling

Deficits in spelling are sometimes called dysorthography. Such deficits involve difficulty with encoding phonological information. Spelling difficulties can affect both reading and writing and are an area of weakness for most individuals with dyslexia. Spelling deficits include

difficulty representing the phonological structure of regularly spelled words,
difficulty remembering and reproducing the patterns of irregularly spelled words,
lack of morphemic awareness in spelling, and
difficulty spelling and inflecting words correctly in sentences.

Focus of Assessment/Treatment

Using letter–sound knowledge to spell words as they sound
Understanding the phonological, morphological, and orthographic aspects of regular and irregular spellings
Correcting spelling errors

Spoken and Written Language

Deficits in spoken and written language can affect reading, writing, and spelling. Such deficits may be referred to as oral and written language learning disability.

These deficits involve marked difficulty with oral language and involve problems of similar severity that cross multiple systems. Deficits in spoken and writing language may result in difficulty with

pronouncing complex words,
reading fluency,
word recognition/decoding,
spelling, and
language comprehension.

Focus of Assessment/Treatment

Treatment should address areas of difficulty in reading, writing, and spelling as indicated. Treatment should match the degree to which sound/word structure knowledge and sentence/discourse level knowledge are impaired across spoken and written modalities—listening, speaking, reading, and writing.

Language Domains Primarily Affected

Domain	Area of Domain	Phonology	Morpho-syntax	Semantics	Pragmatics
Reading
	Word recognition	X		X
	Reading comprehension		X	X	X
Writing
	Writing process			X	X
	Writing product	X	X	X	X
Spelling		X	X	X	X
Spoken and written language		X	X	X	X

References

Castles, A., Rastle, K., & Nation, K. (2018). Ending the reading wars: Reading acquisition from novice to expert. Psychological Science in the Public Interest, 19(1), 5–51. https://doi.org/10.1177%2F1529100618772271

Chung, P. J., Patel, D. R., & Nizami, I. (2020). Disorder of written expression and dysgraphia: Definition, diagnosis, and management. Translational Pediatrics, 9(Suppl 1), S46–S54. https://doi.org/10.21037/tp.2019.11.01