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A Path to Success: Using a Public Health Model to Create Reading Programs

by Dr. Marion Blank

Michael Shaughnessy, the editor of the New Mexico Journal of Reading, recently interviewed me about my ideas for transforming reading education. It gave me a great opportunity to expand on an idea that I think has tremendous potential for bringing reading success to all. That idea rests on adopting a public health model in our classrooms.

The interview started with the following question:

1) You are proposing that we adopt a major change in our approach to teaching reading. How would you describe the current approach?

Here is my response:

To answer that question, it's helpful to step back and look at the way government sponsored education developed in our nation. Although they were called public schools, they were not for 'everyone.' The education of children from wealthy families was typically carried out in their homes. Public schools were for the "other children." Essentially they were the government's answer to the immigration problem that troubled the country then--just as now. Leaders like Noah Webster felt it was essential that minority languages be eradicated and that the children be "Americanized." A focus on the three R's was seen as the answer. Literacy would be the way to transform the population.

The goals were extraordinarily ambitious; the financing was not. Expenditures were kept to a minimum. Photos taken of the period show unbelievably cramped rooms, children jammed together along rows of desks, and almost no materials on hand. Supplies were so limited that often there was only a single book to a class. To make sure that the material had been read and retained, teachers insisted on the children memorizing the text. Then to see if, in fact, this is what had taken place, they asked questions to test the students' recall. The end result was that memory demands dominated the classroom exchange.

Essentially the system was public education on the cheap. It was a mass system with little or no consideration given to what constitutes effective learning nor to the methods by which it might be achieved.

2) Is it useful to think in terms of that model today? Haven't we moved far from the picture you are drawing of public education a century ago?

Fortunately, there have been many significant changes over the decades that have led to smaller classes, better facilities, a broad range of supplies, new curricula. Those changes, however, have not meant the elimination of features present at the outset. For example, materials are no longer in short supply and so there is no need to stress memory as was done in the past. Still, as research on classroom dialogue consistently shows, the memory-based question-answer format continues to dominate the exchange. It starts in the preschool with questions such as "What color is this?" and it continues on through high school and beyond with questions such as "Who knows when World War II took place?" These sorts of questions are such a hallmark of education that any film showing a classroom scene such as Stand and Deliver will have the teacher tossing one query after another at the students.

The persistence of old practices is really not surprising. As with the QWERTY keyboard, which we've long known is far from the best layout for typing, it is extremely difficult to dislodge a method once it takes hold. This is essentially what has happened in schools.

No area shows this more than reading instruction. For example, in the 1800's, reading was based on the McGuffey reading series which offered "stories" such as "the cat has the rat." The original 1836 version of these books was used by four-fifths of all American school children for over three-quarters of a century. No other books ever had so much influence over so many children over such a long period.

The influence did not stop when the use of the books stopped. The texts that first graders see today look amazingly similar to the ones children saw well over a hundred years ago. Dr. Seuss may have replaced the cat and the rat with The Cat in the Hat but that hardly seems significant.

From the outset, these materials have been associated with high rates of failure. While the rates have varied somewhat from one period to another, across the decades, failure has been an unfortunate constant. Initially the failure was ignored. For decades, the expectation was that a child would learn to read. Any failure to do so was attributed to some weakness in the child--he or she was unmotivated, had limited ability, and so on. The school had no responsibility for ensuring success. Over the decades, however, largely as a result of the learning disabilities movement, that view has shifted. Schools were given the responsibility of ensuring that every child learn to read.

This shift led to a significant organizational change in the educational system. For the bulk of the students, the mass system has remained in effect. But for a small percentage, estimated at between 6 and 10% of the population, an individualized subsystem was created to meet the needs of this long-existing, but newly-identified segment of the population.

While it is not usually discussed in these terms, basically the mass education model was amended to include a medical model. The latter involves a highly individualized approach to the diagnosis and treatment of a disease or disorder. That is why we now have IEP's (Individualized Education Programs) and the whole range of services that go along with that concept. It is possible to raise questions as to whether this is the appropriate model to use. However, there is no question that it is unbelievably costly. To cite but one example, in 2005, Massachusetts spent $7,421 per "regular day" student and $14,643 per "special needs" student.

3) From your description, it seems that the educational system made a reasonable--albeit costly--adjustment to meet the needs of the children. What concerns do you have about this dual model?

There is an old saying about "If it ain't broke, don't fix it." If the system were working, it would not be necessary to think about changing it. But the system IS broken--seriously broken. The teaching of reading is the central goal of schooling and it is failing miserably in meeting that goal.

The model assumes that reading failure is confined to the learning disabled population. And indeed most people share that belief. Were that the case, then a medical model applied to a small segment of children might be legitimate. But reading failure extends far, far beyond that population. Unbelievable as it may seem, approximately 40 % of perfectly bright, healthy children are failing in reading. For example, in a report on the past decade titled Reading: The Nation"s Report Card, the National Assessment for Educational Progress found 37 percent to 40 percent of fourth graders to be reading "below basic levels."

Reading failure rates of the magnitude being reported are not signs of problems in the children. They are signs of problems in the teaching system. Chester Finn, President of the Thomas B. Fordham Foundation, was right on target when he said that America should "view the educational inadequacies of millions of its daughters and sons not in terms of organic problems inherent in the children but rather as the fallout from unsound, inept or ill-conceived instruction by adults."

4) Given your interests, it seems that you believe that a public health model can somehow be used to overcome the problems that our schools are facing.

Exactly. We can get an idea of what we might gain by looking at a public health service that we--in the developed world at least--- have had the good fortune to live with all our lives. The service I am referring to is the water supply system to a large city.

From the production side, the creation of a safe and abundant water supply requires an amazing integration of sophisticated complex information from a wide variety of fields involving medicine, engineering, biology, demographics, monitoring systems and more. At the same time, the demands on the end user are also amazing--but they are amazing in their simplicity.

All that users need do is turn on a tap. Of course, there are a few other things that would be wise for them to master--they should know how to adjust the handles to get warm water or cold water, they should notice if the color looks strange, if the taste is not right, if the pressure is low. But for the most part, they can take the system for granted. The professionals have done their job in a way that makes life safe, easy, and effective for vast numbers of people.

If we apply these ideas to the educational realm we can make the following statements:

  • both public education and public health represent mass systems, but each has a very different infrastructure
  • public education has long relied on unsophisticated content that yields high rates of failure
  • public health has developed exquisitely sophisticated services that yield high rates of success.
  • the key to change in school success is to provide children with programs where behind the scenes work by experts presents the children with user-friendly systems that yield steady success.

5) Can you give us some examples showing how the contents of current systems lack the sophistication you believe is essential?

For a start, the failure rate speaks for itself. Unless you maintain that forty percent of the population lacks the skills to become literate, then current programs are clearly not working, But we can be far more specific. If we take the time to examine current systems of instruction, their weaknesses become apparent.

Consider, for example, phonics which, from the time of the McGuffey readers, has been the dominant mode of instruction in our country. While there is a range of phonics programs, all rely on teaching children to "sound out " unfamiliar words by assigning a sound to each letter. This technique has been so deeply ingrained in us that it seems the natural thing to do. Even parents who have never had an education course immediately say to a child who is confronting a troublesome word, "Well, let's sound it out. What sound does this letter make?"

I recently was supervising a new teacher. She had asked her student to write the word "famous." After putting down the letter "f," he was stymied. Her response, which seemed to be almost instinctive, was to say, "Well, sound it out." That ultimately did not work but that is not the point of this anecdote. What is instructive for our purposes is that after the session, I asked her to follow her own advice and to write "famous" by using the sounding out rules the child had been taught. Her end product was "faimus."

Defenders of the system say that it is fine if the child were to have made this sort of "errors." Indeed it is not even deemed to be an error but rather a pattern that is appropriate to a particular "stage" of spelling. Over time, we are assured that the child's spelling will evolve to what is the accepted convention. Parents who have been given this advice know this is not what happens. Referring to their children's spelling as a "disaster zone," they are distraught at the persistence of incorrect patterns.

But let's go back to the teacher's suggestion which, as often happens, did not help the child in any way. It seems reasonable to ask why advice that does not work continues to be offered. The answer is to be found in a powerful force that stealthily and steadily works to block the change that we so vitally need. Somehow, the adults do not register that fact that the instructions they offer serve to mire children in failure. They seem to have blinders on that allow them to believe that the ineffective advice they offer is actually useful--despite the endless examples to the contrary.

While the teachers are unaware of the wrong responses they elicit, the children who are on the firing line are painfully aware of them. All you need do to hear a slew of deeply negative emotions is ask children with reading difficulties what they think about "sounding out.". What you are likely to hear is "oh no, not that torture again."

There is an old saying about "out of the mouths of babes." It suggests that we might do well to be more attentive to the children's words and try to see what they are experiencing.

Unfortunately, sounding out is not the extent of the problem. Even if a child is willing to sound out any word, he or she won't be able to. The vast majority of English words cannot be decoded by applying a sound to each letter. Try it with words such as bear, home, knife and see what happens. To enable children to read all the words they'll come across, they are asked to memorize rules--rules such as the "silent e" rule and the "double vowel" rule. The number of rules is impressive--almost 600 just to handle the words up to third grade reading. (Once again, we see the extent to which the classroom relies on imposing memory demands on children.)

Now let's compare what we are asking children to do in this area of reading alone versus the demands made on people in turning on a tap. The contrast could not be more striking. Essentially the current system is based on relying on children to continuously extend themselves to do the extraordinary. That is not and can never be the basis for an effective education system.

6) In your book The Reading Remedy, you state that the failure rate is not attributable solely to the fact that current techniques are inadequate. You also state that there are critical areas of skill that are totally omitted from the teaching. Can you describe one of the skills you are referring to?

We've long known that reading is language--although it is in a different medium from spoken language. However, we haven't recognized fully the implications of that idea. For example, in spoken language there is an unquestioned acceptance of the role physical skills (i.e., auditory-vocal) play. There is no comparable acceptance of the role that physical skills play in written language.

Consider, for example, the physical skill of visual analysis that is required for reading. You can get a sense of its importance if you look at the following sets of words: kindle- kindly, sliver-silver, grid-gird, present-percent, value valve, slave-salve, stain-satin, quite-quiet, adult-audit, two-tow; start-stare. Even though the words in each pair are highly similar, it is instantly "obvious" to good readers that they are totally different. Poor readers have a markedly different response. They simply cannot see that such tiny distinctions can be all that important.

We have known for years from researchers such as Allan Paivio that visual recognition skills in experienced readers are unbelievably powerful. For example, good readers are actually faster in identifying whole words than single letters. They are also faster in reading the name of an object that in naming the object itself.

Yet visual skills are never systematically taught to young children. Given their importance, you might be wondering why these basic skills have been ignored. The answer is, once again, to be found in our educational history. Back in the early 1900's when reading problems were garnering attention, there was a pioneering figure--- Dr. Samuel Orton. He maintained that visual problems (including reversals such as seeing "b" for "d," or "saw" for "was") were central to severe reading problems. Gradually, his idea was discounted as people realized that many children, not simply those with problems, showed those difficulties. The idea took hold that visual immaturities were a normal part of reading development--valid notion. But that was not all. Since they were judged a normal part of behavior, it was assumed that the children will "pick them up" on their own--an invalid notion. Nevertheless, that idea was accepted and a critical skill required for reading was cast aside, thereby laying some of the stones on the path to reading failure. It's as if we were designing a water supply system where we felt it was perfectly acceptable to focus on getting the water to flow and to give no attention whatsoever to the issue of bacterial count.

7) It is amazing to think that we are overlooking such basic information that children need. Could you try and show how you might use the public health model to enable children to develop these skills in an easy, user-friendly manner?

This question really demands a two-part answer involving both exclusion and inclusion; that is, we have to (a) exclude, or eliminate, practices in the current systems that unknowingly interfere with learning and (b) include, or introduce, practices that facilitate learning.

Let's start with the issue of exclusion. Though they haven't received much, a whole range of activities that we give to children that actually work against their developing appropriate left-to-right sequencing.

To cite but one example: consider the silent e rule--one of the bedrocks in early reading instruction. It is the one that says with words ending in letter "e" such as home, the "e" is silent but the preceding vowel makes a "long" sound (or as it is sometimes phrased, "it says its name"). But a beginning reader cannot know that the silent "e" rule is operative until he or she gets to the end of a word and sees the final "e." This happens after he or she has gone through the process of sounding out each letter and then, at the end, realizing that the resulting word does not "make sense." At that point, the child has to invoke the rule and scan back in a right-to-left direction to start the word all over again. The intermixing of left-to-right and right-to-left scanning disrupts the acquisition of the automatic left-to-right scanning strategies required for effective reading. The disruption is significant, but with visual skills off the radar screen, it isn't even seen as a blip in the process.

Many of the rules that children are taught to memorize share these conflicts with left-to-right sequencing. It is not appropriate, reasonable, or useful to put the children in a system rife with complexities and inconsistencies and leave it up to them to sort it all out. It is the responsibility of program developers to design systems that eliminate these problems.

Once the impediments have been overcome, we can move on to the second part of the answer--that is, introducing techniques that stimulate appropriate skill development. In the realm of visual sequencing, this can actually be a lot of fun because it lends itself to matching games that children like.

For example, one technique involves setting up a scrabble type game where children have to match simple sequences that are arrayed in a left-to-right manner. To ensure success and the confidence it evokes, it is critical to start with very easy items involving only two symbols. This may seem excessively easy but it is not. Sequencing demands are so novel that even sequences of two elements can be problematic.

When people first see this activity, they are often surprised that the material involves novel symbols and not the letters children are familiar with. This may seem strange, since the end goal is to have them recognize the sequence of the letters in actual words. There is, however, a good reason for avoiding familiar letters. Those letters can be named and despite the hours put into teaching letter names, naming actually works against developing the visual recognition that effective reading requires.

You've encountered this phenomenon many times but you are not likely to have registered its significance. For example, imagine the times you look up a number in a telephone directory that you need to dial. Until you actually complete the dialing, you're likely to diligently keep repeating the digits (e.g., "three-eight-nine-one-two-eight-seven" "three-eight-nine-one-two-eight-seven" "three-eight-nine-one-two-eight-seven"). Then once the dialing is accomplished, you instantly forget the numbers. The naming of letters results in a similar outcome. The child focuses on labeling the letters and he or she never really gets to "see" the word in the way that is needed for visual recognition. That's why letters that can be named has no payoff if your goal is setting up a system for effective visual word recognition.

At this point, your head may be reeling with the number of factors that need to be taken into account in designing an effective program. But that is precisely the point. In keeping with the ideas of a public health model, the children themselves do not have to deal with any of the difficulties that you have been considering. That is the program designer's task. From the child's perspective, there is a simple matching game that takes about 5 to 10 minutes a session. If the activity is carried out five times a week, generally mastery of the visual sequencing skills needed for reading is attained in about a month. It is quick, it is easy and it lays down the base for a set of skills that will serve the children well for all the years that follow.

6 .The ideas are intriguing, but their success rests on accepting a whole new approach to reading instruction. How do you see that change coming about?

I realize that I am advocating what Thomas Kuhn would term a paradigm shift where we re-think the ideas that have for so long dominated the reading scene. But a reading crisis of the magnitude we are facing cries out for this sort of change.

The first step is awareness. Without it, nothing happens; with it, miracles can happen. We have seen this over and over again. Many of the major social movements of the past century--from rights of minorities, rights of women, rights of the disabled--owe their success to consciousness raising. That experience has also shown us that the changes usually do not start at the top. That is, they do not come from established institutions. That is simply not how institutions work. Instead, it comes from pressure on the institutions by informed citizens.

In the realm of reading, we do have a group who can make this happen. That group contains the millions of parents whose children are failing. They are unbelievably committed to their children and desperate to offer them success. But because the information has not been effectively disseminated, they are unaware that they are part of an epidemic. They believe that the other children are doing well; it is just their child who has somehow inexplicably encountered difficulties. Once they have the information they need, they can become an enormously powerful force in bringing about change.

That is why I wrote The Reading Remedy in a way that makes it accessible to any parent who wants to know how to make their child a successful reader. It is also why I designed the reading program Phonics Plus Five so that parents can have the means to provide easy to use high quality reading instruction for their children.

Am I ruling out teachers and other educational professionals? No, as a group they are enormously devoted and dedicated. At the same time, they are also naturally committed to the systems in which they have been trained. In my view, as consciousness grows, and as pressure builds, they will be responsive to these forces. However, I do not believe that they are likely to be the vanguard for change. If I am mistaken on this, I will be delighted. It will mean that the necessary changes will come even sooner.

Our country is amazing in its inventiveness. Remember, we have been able to put a man on the moon. Once we make the commitment, we surely can develop systems that teach literacy effectively, comprehensively and easily. As with a good public health system, it will require a network of disciplines to cover all the aspects required. That means we need to go beyond our individual fields and draw upon information from psychology, education, neuroscience, linguistics, information technology and more. I think the potential is enormously exciting and the benefit to the children and the nation is unbelievable.

Dr. Marion Blank is a world-renowned authority on how children learn to read with over 40 years experience in the field. She is the creator of the Phonics Plus Five reading & wrting program available for sale on her site. To read more articles by Dr. Blank, please visit her blog and join her newsletter.


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