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Immunizations and treatments in early reading

Posted by Freddy Hiebert on 4 August 2010

Elfrieda H. Hiebert, TextProject & University of California, Berkeley

More than once over the past several months, I have heard at conferences or read in papers or reports that we now know what to do to bring young children to successful literacy. Within the recent report, Time to act (Carnegie Council on Advancing Adolescent Literacy, 2010), the statement is made: “these results [early reading interventions] demonstrate that with a concerted effort we can indeed improve the literacy achievement of all our nation’s children.” (p. 8). Early reading interventions such as those reviewed by Torgesen (2000) are identified as the source of this shift. In reviewing five intervention studies, Torgesen concluded that three-quarters of the students in the lowest 20 percentile could be moved to effective word reading above the 30th percentile. These early interventions, according to one school of thought, could serve as an inoculation to ensure that students had the skills that they needed for subsequent literacy tasks in school and beyond (Coyne, Kame’enui, Simmons, and Harn, 2004). Now the statement is made that these early immunization 1 efforts, while successful, are not sufficient as Time to Act (Carnegie Council on Advancing Adolescent Literacy, 2010): “early improvements in literacy alone are not enough to guarantee excellent adolescent literacy achievement.” (p. 8).

Why policy-makers and scholars are surprised that the immunization was not enough could be the focus of an entire volume. The complexities of literacy in the digital age and the needs and strengths of adolescents call for literacy experiences for adolescents that are unique from those of young children. Had policy-makers and particular groups of scholars been willing to consider complex answers to profound problems in literacy, rather than to mandate simplistic responses, we might be well on our way to providing more adolescents with more of the relevant and engaging literacy experiences they need and want.

There are many reasons why many adolescents have low levels of literacy and/or are disengaged or disinterested in it. Many of these reasons have been iterated in the various reports on adolescent literacy (e.g., Biancarosa & Snow, 2006; Heller & Greenleaf, 2007). I offer an additional explanation—not as a sole explanation but as a strong contributing factor: problems with the immunization that was promoted in documents such as those of Coyne et al. (2004) and Torgesen (2000).

Before I describe some of the problems with the immunization, let me describe the primary stance of these interventions. All of the five intervention studies that Torgesen (2000) reviewed emphasized phonological awareness and decoding. There was a substantial amount of word learning outside the context of books and, when books were used, most fell into the category that I have described as “extreme decodables” (see, Hiebert, June 17, 2010). Extreme decodables are characterized by numerous infrequent words, many of which may have consistent grapheme-phoneme correspondences but often have unfamiliar, if not archaic, meanings for young children (e.g., vex, wrench). For young children, the texts that are created when these words are combined are often incomprehensible (e.g., He has a fan and a rat and a rag).

The perspective that there is a specific treatment that can be an immunization is itself problematic. But the immunization metaphor allows for several hypotheses about what may have gone awry.

  • First, the treatment might have been the wrong one. In medicine, it is entirely possible to treat young children for one illness (e.g., the flu) when, in reality, they have another illness (e.g., meningitis). In reading, children may be given a treatment of extreme decodables where characters such as Sip and Tip sit, tap, tip, and sip and where exercises and assessments are as likely to involve nonsense words as they are real words. For children who have never held books in their hands before, these words and experiences may be sufficiently alien that they fail to understand the function or the content. The extreme decodables may serve a function at some point. But what these students may really have needed initially was involvement with books that had stories that made sense and/or communicated information about the world around them.
  • There may have been a reaction to the immunization. It is not unusual for children to have a reaction to an immunization. Reactions can be fairly common when too much of a serum is given and an allergic reaction occurs. Similarly, too much of a particular literacy intervention (especially if given at the wrong time and to students with particular propensities) could result in precisely the opposite effect than the intended one. Children who are given extreme decodables day after day and year after year may learn to decode (and, yes, as the reports indicate, most children are able to decode by the end of second grade (see, e.g., Wise, Olson, & Ring, 1999)). They may, however, choose not to read or view reading as a very pleasurable or informative experience.

In the case of the treatment in California, a better metaphor than a reaction to an immunization is that students have been given an over-dose of a medication or the immunization. According to the state of California’s (California State Board of Education, 2006) textbook adoption guidelines, a treatment of extreme decodables is mandated for kindergarten, first grade, and second grade. Even though the report of the National Reading Panel (NICHD, 2000) stated that such treatments did not have evidence beyond first grade, the California mandates call for a set of two texts for each of the 44 phonemes for students who are not proficient readers in grades four through eight. California’s standing as the 48th state on the National Assessment of Educational Progress (National Center for Education Statistics, 2009) cannot be attributed only to this policy. However, these mandates have not increased the percentage of students who are reading more proficiently.

  • There is even the possibility that a treatment can cause a new disease. A treatment of aspirin has been known to contribute to Reyes syndrome. Certain medications can be the cause of meningitis. The new disease in the case of American students who have been treated by an overabundance of phonological and code-based instruction may be that a disinterest in reading. Evidence for the disinterest of American middle graders in reading is compelling. In international comparisons with students from comparable countries, U.S. students ranked 32nd of 35 nations on reading for their own interest outside of school (Mullis, Martin, & Kennedy, 2003). In a reanalysis of these data with a revised index of attitudes toward reading, U.S. students came in 35th (Twist, Gnaldi, Schagen, & Morrison, 2004).

Might it be that the immunization effort of the past decade in early reading education has contributed to problems that are far more serious than word recognition ever was? Might it even be that students’ word recognition is, in fact, quite good and that it is their background knowledge and engagement in reading that is the real problem? Answers to such questions are urgently needed. A new school year is about to begin where Response to Intervention (RtI) efforts will be applied with a vengeance. To date, I have seen nothing within the RtI literature that indicates that the immunization regimen is being challenged.


Biancarosa, G. & Snow, C. (2006). Reading next: A vision for action and research in middle and high school literacy: A report to Carnegie Corporation of New York (2nd ed.). Washington, DC: Alliance for Excellent Education.

California State Board of Education (2006). Reading/Language Arts Framework for California’s Public Schools: Kindergarten through Grade Twelve. Sacramento, CA: California Department of Education.

Carnegie Council on Advancing Adolescent Literacy (2010). Time to act: An agenda for advancing adolescent literacy for college and career success. New York: Carnegie Corporation of NY.

Coyne, M.D., Kame’enui, E.J., Simmons, D.C., & Harn, B.A. (2004). Beginning reading intervention as inoculation or insulin: First-grade reading performance of strong responders to kindergarten intervention. Journal of Learning Disabilities, 37 (2), 90-104.

Heller, R., & Greenleaf, C.L. (2007, June). Literacy instruction in the content areas: Getting to the core of middle and high school improvement. Washington, DC: Alliance for Excellent Education.

Hiebert, E.H. (June 17, 2010). What exactly is a decodable text? www.textproject.org/franklyfreddy/what-exactly-is-a-decodable-text

Mullis, I. V. S., Martin, M. O., Gonzalez, E. J., & Kennedy, A. M. (2003). PIRLS 2001 international report: IEA’s study of reading literacy achievement in primary schools. Chestnut Hill, MA: Boston College.

National Center for Education Statistics (2009). The Nation’s Report Card: Reading 2009 (NCES 2010–458). Washington, DC: Institute of Education Sciences, U.S. Department of Education.

National Institute of Child Health and Human Development (NICHD). (2000). Report of the National Reading Panel. Teaching children to read: An evidence-based assessment of the scientific research literature on reading and its implications for reading instruction (NIH Publication No. 00-4769). Washington, DC: U.S. Government Printing Office.

Torgesen, J. K. (2000). Individual differences in response to early interventions in reading: The lingering problem of treatment resisters. Learning Disabilities Research & Practice, 15, 55–64.

Twist, L., Gnaldi, M., Schagen, I., & Morrison, J. (2004). Good readers but at a cost? Attitudes to reading in England. Journal of Research in Reading, 27, 387–400.

Wise, B.W., Ring, J., & Olson, R.K. (1999). Training phonological awareness with and without explicit attention to articulation. Journal of Experimental Child Psychology, 72, 271-304.

1 After consulting with medical personnel and reading the literature to distinguish among terms such as inoculations, vaccinations, and immunization, I have chosen to use the word immunization. The intent of vaccinations or inoculations is to produce or boost immunity to a specific disease. Inoculation is the procedure of placing something that will grow or reproduce into the body. Vaccination was originally used to refer specifically to the injection of the smallpox vaccine.