He read every word correctly. He could not tell me a thing about it.

Charlie was in third grade, and he hated reading class.

He could tell you exactly why, too, which not every eight-year-old can. It was not the reading. The reading was the easy part. It was the twenty minutes afterward, when the questions started and everybody found out again what he could not do.

Charlie and his teachers and his classmates all knew that he was a very fluent reader. The problem started with the questions. If it was a simple question, like the name of a character in the book or an action they were doing, such as running or talking, he could answer that. Once they wanted to know why, or how, or when, Charlie could not answer, because he could not recall even reading any of that.

You probably know how that feels. A dense textbook, or a stack of insurance papers. You read every word, you got to the bottom, and you came away with nothing. The difference is that for you it happens rarely. For Charlie it happened every day.

What he heard, week after week, was that he needed to pay attention while he read.

Charlie was sure he was paying attention. He was sure he was following the instructions of his teachers, reading every word from the top of the page to the bottom of the page, but nobody had ever told him that you could read well and still not understand what you read. That led Charlie to work out that reading was actually two different chores. He needed to learn how to read the words and how to understand what they said. He wondered why his teacher had not already taught him that.

Charlie's teacher did want to teach him, so she had an idea for working out why he was struggling. She had him read a story himself, and then she asked him questions about it. Then she read a story out loud to him, and asked him questions about that one.

Hearing it made no difference at all. He could not tell her about that story either.

Five minutes, no form, no meeting, no budget, and that small test tells you which of two very different children you have.

If a child suddenly understands the story when he hears it, the trouble is in the first chore, getting the words off the page. All of him was going into that, with nothing left over by the time the meaning came around. That is the smooth-sounding reader I wrote to you about this summer, working far harder than he looks.

If he still cannot tell you much when somebody reads it to him, reading is not the disability. Reading is only where it became visible. What is hard for him is understanding language itself, and that was true long before anybody handed him a book.

Charlie was the second kind, and there are more of him than you would think. Among seven and eight year olds, ten to fifteen percent read the words correctly and still do not understand what they have read. For older children it settles at around eight percent. Even that is two children in an average classroom. Two, in every room, every year, and what they have in common is that they all sound fine out loud.

Here is what still bothers me, and it has bothered me for thirty years. I almost never met one of these children who had been given that five-minute test before a formal evaluation was already underway. By the time somebody thought to simply read to a child and ask him a question, he had been told to pay attention for about two years, and he had usually started to believe them.

The name for Charlie's trouble is receptive language, which just means what is coming in, as opposed to what he can send back out. It has two halves. What the individual words mean, and what they mean in combination, once grammar and context get involved.

You can test the second half on yourself. It takes one second.

Picture a happy boy.

Now picture an exceedingly happy boy.

Whatever you just did, that is the move Charlie cannot make. You can picture happy. Nobody can picture exceedingly, because exceedingly is not a thing. It is an instruction to take the picture you have and turn it up. A child has to know that the word is reaching forward to change the word after it, and he has to be able to change the picture to match. If either half is missing, the word lands as decoration and he sails straight past it.

Now look again at what Charlie could give his teacher. A name. Somebody running, or talking. A character you can see, an action you can watch, both of them arriving with a picture attached. What he could not give back was why, and how, and when, and what anybody felt about any of it. Not one of those has a picture of its own. That is not a coincidence.

If you're wondering where reading comprehension problems come from, there is a research article that looked at this with 400,000 children in first, second, and third grade. They looked at the ones who read accurately and understood poorly, and they found that over 99% of those also had a vocabulary problem. This is important when trying to remediate the problem.

If you have been told for years that your child is bright and simply not applying himself, this is one of the things that sentence can turn out to mean.

Here is the part parents find hardest. Charlie did not know he had missed anything, and he was not lying when he said he had read it. Nobody had taught him the second chore.

So here is what to watch for, keeping in mind that most of it stays hidden until third or fourth grade.

• A child who reads aloud well, even beautifully, and remembers almost nothing afterward.
• A child who can tell you what a character did, and not how he felt about it or why he did it.
• A child who knows every word in the sentence and still cannot tell you what the sentence means.
• A child who is fine at math computation and sinks on word problems. Word problems are receptive language wearing a math costume.
• A child whose reading grades fall off a cliff in third or fourth grade, which is when school quietly stops teaching children to read and starts expecting them to read in order to learn everything else.

If you recognize your child in that, here is what I would tell you if you were sitting across from me.

Read to him, above the level he can manage on his own, and ask him questions as you go. Everyday talk only holds so many words, and books are where the rest of them live. Let him know that the point is to pick up more words without having to struggle for them, and that you are doing it together now so that he can do it by himself later.

Teach him to stop at the end of a paragraph and say it back to you in his own words. It is slow and it is worth it. It shows him what understanding is supposed to feel like, and it shows you the exact place where it stops.

If the pattern holds, ask your school in writing for a speech and language evaluation, and use the words receptive language when you ask. A reading test looks at whether he can get the words off the page. He can. That is not the question you are asking.

I wrote a short novel about a boy similar to Charlie. He is eight, he reads every word on the page correctly, and the story keeps getting away from him. It is called When Stories Don't Make Sense. Children in this spot almost never get to read about somebody like themselves, and sometimes a story explains it better than an adult can.

Charlie worked out what was wrong by himself, and he said it out loud to a room of adults. Reading and understanding are two different things. Charlie figured it out, but it took Charlie to help them understand it too.

If you work in a school and one specific child came to mind while you were reading this, please forward it to that child's parent. They have been told for years what their child cannot do. Nobody has told them why.

Warmly,

Dr. Pat

Patricia McGuire, MD, FAAP

Developmental-Behavioral Pediatrician

P.S. If you work in a school, or you are about to hand this to somebody who does, I made a single page for the staff room. One boy at five different ages, what the classroom sees each time, and what it usually turns out to be. It is free and there is nothing to join. Give me the one-pager.