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Two years ago, Dr. Bruce McCandliss, a psychologist at the Sackler Institute of Developmental Psychobiology of Weill Cornell Medical College, introduced a reading program he co-developed into some of New York City's public elementary schools. The program, known as Reading Works, uses computer-based reading lessons, and as students have learned from the curriculum, scientists have used brain scans and other methods to monitor how their brains are changing.

Now, two years later, results from the program are coming in from children across many parts of New York City, and the preliminary data are impressive. Children involved in the program, which encompasses 20 forty-minute sessions over a period of several months, are now reading at an ability level, on average, 1.2 grades higher. And scientists now have a better idea of how children learn to read and what keeps some from becoming proficient at it.

Reading Works is aimed at poor readers those students who, when given an initial test by Dr. McCandliss, scored at or below the 40th percentile. We have children ranging from the 40th percentile all the way down to the first percentile, says Dr. McCandliss. We're actually spread pretty evenly among those considered to be poor readers. Government agencies often use the 21st percentile as a rough border in determining dyslexia. Children who score below the 21st percentile, but possess average to high IQ's, are considered dyslexic. Others, with low IQ's and scores below the 40th percentile, are considered to be poor readers, but not dyslexic. Dr. McCandliss' study includes both groups, but is also designed so comparisons can be made between the two.

The Screening Process

After obtaining consent from parents, and assent from the child, a large group of children take part in an initial reading test, and from these results, eligible students are invited back for additional rounds of testing. An oral vocabulary test is used to determine English proficiency and ensure reading problems are the result of a disability and not a language barrier.

Each eligible child (along with his/her parents) also meets individually with scientists and participates in a mock MRI imaging session. This gives children a chance to become comfortable with the machine and helps us find out if they feel ready for a real MRI, explains Dr. McCandliss. To make it fun, we show DVD's and let them play games inside the MRI. At the beginning and end of a protocol, each child has a real brain scan while he/she does simple tasks with words, and scientists monitor brain activity. Brain scans are also given to a group of average readers who serve as a control group.

How the Brain Functions

What we're looking at is this, says Dr. McCandliss, pointing towards an MRI image of a human brain. These two regions in the posterior portion of the left hemisphere. The regions, which stand out as a brighter hue in the MRI, are areas considered crucial in reading. One region is the superior temporal gyrus (located slightly above and behind the left ear) that is associated with phonological processes or thinking about the sound of written words. The other, known as the visual word form area, or VWFA, is located in the mid-fusiform gyrus (behind the left ear, near the hairline), and is associated with a reader's ability to recognize words by sight.

Typically, the VWFA develops slowly, and in children, there is actually little difference in the VWFA between impaired and non-impaired readers. The problem lies in the phonological region. It should jump into action when children internally sound out a word. But, in poor readers, it doesn't, and when words can't be sounded out, they don't become familiar and make their way into the VWFA.

With little activity in their phonological region, children might be able to handle one part of a word (e.g., the ha in hat), but as they try to put parts into a whole, they forget the first ones or become confused, and the process falls apart. Interestingly, in poor readers, the frontal regions of the brain the ones that control effort actually show high levels of activity. Meaning, the brains of poor readers try, but (without intervention) are not entirely organized for proficient reading.

How the Study Works

After the screening process, students accepted into the study are divided into two groups, and each group receives its own protocol. Students in the Reading Works group have computer-based lessons that focus on breaking down words and building on sounds they have used previously. Here, if a student successfully completes a lesson, he/she attempts a higher level in the next session. Should he or she experience difficulty, the level will be repeated. An adult tutor (typically, an undergraduate student) watches over each student's lesson, and offers guidance and encouragement.

The second group is called Guided Reading, which could be thought of as a comparison group, or a way for scientists to compare the effectiveness of Reading Works. With Guided Reading, each child is still assigned a tutor at random, but the focus is simply on reading and understanding books. Each time a student and tutor meet, they review what the child read last, and then choose a new book that is previewed, read, and discussed.

Both programs will have a significant impact on the students involved, says Dr. McCandliss, even though the methods of getting them there are very different. To find what is most effective, the components of each program can be measured and compared.

One New York City public school has already integrated Reading Works into its regular curriculum for struggling readers, and Dr. McCandliss hopes more will do so. A system that would allow schools to download curriculum free of charge is now being explored.

It's important we do this, Dr. McCandliss concludes, pointing to his laptop screen which is now alive with a mixture of MRI images and reading lessons. Without reading, what kind of future would these children have?

Factual Background

Dr. Bruce McCandliss is Assistant Professor of Psychology in Psychiatry at the Sackler Institute for Developmental Psychobiology of Weill Cornell Medical College. During postdoctoral work at the University of Pittsburgh, he began to develop Reading Works with Isabel Beck, a psychologist and educator at the University of Pittsburgh. Reading Works software is copyrighted by the University of Pittsburgh and is based on previous work by Dr. Isabel Beck.

The Sackler Reading Study initially began in 2002 as a pilot study at two NYC public schools, one in Spanish Harlem and the other in Chelsea. The current protocol grew from the pilot study and was introduced into other NYC schools in March 2003. To date, about 70 children have taken part in the current protocol. It is one of the few partnerships between an academic university and the NYC public school system.

Dr. McCandliss' next study, on the brain mechanics of how children learn, will also involve NYC public school students and is scheduled to begin fall 2004.

The Sackler Institute of Developmental Psychobiology, a research group within the Department of Psychiatry of Weill Cornell Medical College, is dedicated to advancing understanding of brain mechanisms involved in the development of cognitive and emotional skills.