Remediating the core deficits of developmental reading disability: a double-deficit perspective.

The double-deficit hypothesis (Wolf, 1997; Wolf & Bowers, 1999, this issue) contends that deficits in phonological awareness and deficits in visual naming speed represent two independent causal impediments to reading acquisition for children with developmental reading disabilities (RD). One hundred and sixty-six children with severe RD from 7 to 13 years of age were classified into three deficit subgroups according to a double-deficit framework. A total of 140 children with RD, 84% of the sample, were classified; 54% demonstrated a double deficit (DD), 22% a phonological deficit only (PHON), and 24% a visual-naming speed deficit only (VNS). Diagnostic test profiles highlighted the joint contributions of the two core deficits in depressing written language acquisition. The children in the DD group were more globally impaired than those in the other subgroups, and the VNS group children were the highest achieving and most selectively impaired readers. Following 35 hours of word identification training, sizable gains and significant generalization of training effects were achieved by all subgroups. A metacognitive phonics program resulted in greater generalized effects across the domain of real English words, and a phonological training program produced superior outcomes within the phonological processing domain. The greatest non-word reading gains were achieved by children with only phonological deficits.