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Challenging the NICHD Reading Research Agenda.

The report of the National Reading Panel is touted as being based on a medical model of research. Offering a perspective from the field of medicine itself, Dr. Strauss examines the report and finds that it falls short on several of the most basic standards of good medical research.

By Steven L. Strauss, M.D.

THE BEHAVIOR of the National Institute of Child Health and Human Development (NICHD) with regard to the production and dissemination of the report of its National Reading Panel is nothing short of scandalous. In fact, the scandal is of such enormity that it demands a full explanation.

The chief element of the scandal is the falsification of the panel's findings. This is immediately apparent when the panel's full report is compared with the short summary version offered for wide distribution. The full report acknowledges that there is scant evidence to justify the claim that phonics instruction leads to improved reading ability, noting that only some normal first-graders showed some gains. But the summary report falsifies the panel's own findings and asserts that phonics instruction correlates with improved reading ability in a number of areas all the way up to grade 6. Such distortions have been amply documented by Elaine Garan in her important new book and in these pages.1

Of course, it is the summary report that has been distributed to the media and to policy makers. Therefore, it should not be completely surprising to discover that the summary report was prepared, in part, by Widmeyer Baker, a public relations firm. This means that we can, quite accurately, think of the summary report as "PR," which certainly puts it in a different light. But it is more disturbing that the PR firm that contributed to the report is the same one employed by McGraw- Hill, a company with a substantial financial stake in the matter of the role of phonics in reading instruction.

But the scandal does not stop there. According to Garan -- citing panel member Joanne Yatvin's minority report for the NRP -- the sole reviewer of the phonics section of the NRP report was Barbara Foorman, a NICHD- funded researcher. And of the 38 articles included in the NRP's phonics meta-analysis, Foorman was the lead or secondary author of four. In other words, she contributed more than 10% of the articles reviewed by the NRP and was a reviewer of her own work.

The NRP meta-analysis was based on its version of a medical model of research that compares performance criteria before and after treatment. So, for example, just as a clinical researcher might compare pain level or muscle strength before and after treatment with drug X, so too did the studies reviewed by the NRP compare reading "ability" before and after phonics "treatment."

A recent series in the British Medical Journal reviewed the methodology behind an acceptable meta-analysis.2 The authors specifically noted the importance of a thoroughly blind review of the studies, to the point of suggesting that articles be typographically reformatted so that the reviewers cannot identify the journal, authors, funding, or any other feature that could influence the review process. The authors of the British Medical Journal series pointed out that the quality of meta- analyses is significantly improved by such blinded methodology. The relevance of these concerns to Foorman's review is clear.

Foorman's NRP phonics studies are also open to serious criticism on their own terms. In at least two of the studies, Foorman refers to a set of 60 stimulus words that were used to test young readers before and after phonics instruction. Some of the words are labeled "regular," and others are labeled "exceptional." But no explanation is offered of how the stimulus words were assigned to one category or the other. Fundamentally, this oversight means that there is no way to tell for certain what Foorman means by "phonics."

Suppose Foorman's understanding of phonics is not the same as that assumed in the other studies included in the meta-analysis. Even worse, suppose that the various studies used mutually contradictory conceptions of phonics. Then the studies cannot be included together in a meta-analysis. But the NRP report does not indicate that anyone verified that all the phonics studies were studies of apples and not studies of apples and oranges.

This is not a hypothetical matter in the present situation. Foorman's stimulus words are, quite simply, confusing and incoherent from the point of view of phonics. I informally asked a group of teachers to divide Foorman's stimulus words into those that are regular and those that are not. I obtained nothing close to a consensus. Here are Foorman's 60 words. The "exceptional" words are marked with an asterisk.
 nail pure last chrome*
 port bowl* rake knack*
 lord rate dine putt*
 pool cram chef* warm*
 born camp tart wrong*
 cone led leak mint
 whet* botch rack neat
 meek neck knit* sew*
 main chord* fake shall*
 site phase* fate clutch
 known* norm whop* bold
 shun past comb* husk
 fair reel heir* lose*
 dare hose link blow
 lime word* wrist* share

In one of Foorman's NRP studies, first-grade children were tested before and after they received instruction on letter-sound relationships.3 Some children received relatively more "letter-sound instruction," and others received relatively less. The authors of the study claimed that children who received relatively more letter-sound instruction showed significantly greater improvement on reading both regular and exceptional words than those who received relatively less letter-sound instruction.

In another of Foorman's NRP studies, she and her colleagues found that children who were given phoneme instruction performed significantly more accurately on reading regular words than those who were not given such instruction and that children who were given onset-rime instruction performed significantly more accurately on exceptional words.4

But these conclusions are compelling only to the extent that we understand and accept what Foorman and her colleagues mean by "regular" and "exceptional." Unfortunately, no set of principles for making that distinction is provided. Consider, for example, the word phase, categorized by the authors as exceptional. Why is this word exceptional? It cannot be because of the final, silent e or the preceding "long" vowel, since other words with this characteristic are regular, such as rake, dine, fake, and fate. It cannot be because of the pronunciation of the letter s as a voiced /z/ sound, since hose, also with a voiced /z/, is regular.

The only candidate is the initial digraph ph. But initial ph is unexceptionally pronounced /f/. Its exceptional status must thus be on the basis of some peculiar formal property, perhaps that the two letters together are pronounced as neither of the individual letters would be. But this also cannot be correct, since the digraph sh has exactly this formal characteristic, yet shun and share are judged to be regular.

Similar problems are encountered in the analysis of virtually every other exceptional word listed. To the extent that such problems remain unresolved, there is no reason whatsoever to accept any of the authors' claims. The claims are empty since we simply don't know what they are about. In turn, there is no reason to accept any of the NRP's conclusions that are based on an acceptance of such studies.

Indeed, the NRP report should be challenged to show where in its meta- analysis the panel scrutinized the studies for internal consistency and mutual compatibility. Of course, the panel did nothing of the sort, since, of all the criteria they used to decide which articles to include or exclude, nowhere is the quality of the study mentioned. All that mattered, ultimately, was that the authors claimed to have tested reading before and after phonics instruction. Quality was assumed simply because the study appeared in a peer-reviewed journal.

I am not a statistician, and I do not know whether 38 studies should be considered adequate for performing a meta-analysis of the type and scope carried out by the NRP. But let us suppose that it is. Consider then that these 38 studies were the entire amount that passed through the NRP's inclusion and exclusion filters and that the journals scanned were in fact all those published in English over a period of nearly 30 years. In other words, a global English language database spanning nearly three decades produced little more than one study per year that looked at phonics intervention with a study design deemed acceptable by the NRP.

This in itself is a very interesting finding, for it indicates that the educational research community did not consider such studies to be of very much importance and that the NRP "ignored the preponderance of research" in the field of reading and education, to quote James Cunningham's apt assessment of the NRP report.5 Apparently, the panel members, mostly experimental scientists, felt that they knew better than the researchers in the field of reading itself regarding just what counted as clinically important. A similar attitude again found expression in a recent article in Scientific American, co-authored by Foorman, in which the authors baldly declare that, if only student teachers were given a high-quality linguistics course on phonics, they would not have to be handed scripted lesson plans with formulaic drills on alphabetics.6

THE NRP VERSION of a medical model of research is, in fact, only a caricature of real clinical research in medicine. True, before a drug is approved, its efficacy must be demonstrated. But that is not all there is to clinical research. The researchers must be careful not to overstate their findings. And, furthermore, the drug under study must be shown to be relatively safe, no matter how effective it may be.

Suppose we accept that the phonics intervention studies indeed demonstrated improved "accuracy" or "fluency" of word reading. This is still a far cry from having demonstrated improved comprehension of novel, authentic text -- certainly the gold standard for assessing any reading intervention.

In medicine, it has been clearly demonstrated that lowering blood pressure in hypertensive individuals reduces the risk of heart attack and stroke. Yet, even though some antihypertensive drugs, called calcium channel blockers, demonstrably lower blood pressure, they do not in turn reduce the risk of heart attack. Indeed, some antihypertensive medications pose health risks for individuals with asthma or depression. Others pose health risks for individuals with neuromuscular disease. Despite the potential benefit, the potential risk may be the overriding factor in deciding whether or not to use the drug at all.

A better medical-model analysis of phonics intervention than the one carried out by the NRP would at the very least include questions about potential risks. One might argue that there aren't any conceivable risks associated with phonics intervention, but that would at least acknowledge the full spectrum of issues involved in the assessment of interventions. The NRP report, as far as I can tell, did not even raise the question of potential risk, despite its touting of the "medical model."

But there is no doubt that a number of potential risks really do exist when children are exposed to intensive phonics. They spend less class time reading real books. To many, phonics exercises are boring and laborious, and persistent exposure to them might even turn off potential readers to the joys of reading. Overly "phonicsed" readers pay less attention to meaning. Overly "phonicsed" readers may be more likely to move their lips, which slows them down and thus compromises their construction of meaning. This list could no doubt be extended.

Two years ago, Reid Lyon, the reading research director of NICHD, testified before a congressional committee in support of President Bush's program of high-stakes testing and accountability as a means of raising reading achievement.7 But where is the scientific evidence that high-stakes testing and accountability lead to improved reading ability? And, just as crucially, where is the evidence that they do so without risk? The answers to these questions were utterly and completely missing from Lyon's testimony, which is rather remarkable, considering the appeal to "science" that has justified the NICHD reading research agenda for more than a decade.

Indeed, there are anecdotal reports of serious mental health problems among schoolchildren as a consequence of the new climate of testing and accountability, so much so that a number of prominent child and adolescent psychiatrists and psychologists recently signed a petition demanding a moratorium on high-stakes testing.8 In England, the National Union of Teachers recently voted to boycott the administration of that nation's high-stakes tests partly because evidence is accumulating that such tests pose a mental health risk to young people.

If NICHD were consistent in its declared principles, its representatives would testify before Congress that there is currently no scientific evidence that can justify the use of high-stakes testing and accountability. If it decided to study the matter first, as any scientist would advocate, and to request congressional funds for this purpose, then, in keeping with a medical model of clinical research, it would have to simultaneously request funds to study the potential risks. The decision to go ahead with high-stakes testing and accountability could then be made by weighing the risks against the benefits. The National Institutes of Health makes use of this model of research when it comes to almost everything -- except reading.

Rather than employ an acceptable medical model of clinical evaluation, one that assesses both benefits and risks, the NICHD model is, in fact, a corporate-business model of assessment. The overriding priority of making a profit always outweighs both individual and social risks. That is why society as a whole has had to fight against corporate pollution of the environment, chronic structural unemployment, unsafe working conditions, exploitation of child labor, and so on. To the corporate- business mentality, these matters are risks to be dealt with only if forced to, since treating them threatens the maximization of profit. Likewise, NICHD's strange perception of an inflexible need for phonics and its public support for high-stakes testing and accountability have led the agency to neglect potential risks. Frankly speaking, this is not a medical model of clinical assessment, NICHD's claims notwithstanding.

NICHD's corporate connection is not merely conceptual. In fact, it is the basis for the entire scandal, a scandal in which NICHD's own research report is falsified when prepared for public consumption, a scandal in which the public is further beguiled with misleading allusions to science and a medical model of research that has supposedly allowed us to find out "what works." In a similar fashion, we have been told that nuclear power works, so we'll worry about disposing of the waste later.

NICHD's corporate connection was explicitly revealed by Duane Alexander, NICHD's director, in his presentation before Congress on the occasion of the release of the NRP report.9 Referring to the panel's work, Alexander told the lawmakers that "the significance of these findings for the future literacy of this nation and for the economic prosperity and global competitiveness of our people is enormous." This comment deserves reflection.

The charge of the National Reading Panel was, according to Alexander, to "review the scientific literature reporting the results of research on how children learn to read and the effectiveness of various approaches to teaching reading." The charge did not include the economic goal of improving the literacy skills of U.S. citizens in order to enhance the competitive edge of U.S. corporations in the global economy. Yet anyone who has followed the agenda of corporate America, as articulated by the Business Roundtable, knows that the current congressional urgency regarding literacy is about improving the skills of the U.S. workforce in order to make U.S. labor more productive, so that U.S. corporations will not fall behind their European and Asian competitors.10

Alexander's remarks follow from this agenda and from nothing else, since even ardent advocates of intensive phonics do not thereby automatically become cheerleaders for General Motors in its competition with Volkswagen or Toyota for a greater share of the automobile market. In fact, it is perfectly natural to imagine sincere advocates of intensive phonics who would wish instead to donate our new "scientific" understanding of reading to the rest of the world, so that we, as a generous and privileged people, could help wipe out the scourge of global illiteracy, no matter what effect this has on the competitive edge of "our" corporations.

Likewise, NICHD's claims about reading have no inherent bearing on the issue of high-stakes testing and accountability. One can be a sincere advocate of intensive phonics and still oppose the coercive pedagogical practices that follow from a regimen of high-stakes testing and accountability. But the real charge of NICHD and of the NRP is to promote the agenda of the Business Roundtable, which is among the nation's strongest and most influential advocates of high-stakes testing and accountability as a means of forcing "21st-century literacy skills" on the next generation of workers.

To view the findings of the NRP report as containing scientific information that will position U.S. corporations to better compete with their European and Asian counterparts is, in my opinion, also scandalous, especially when understood against the backdrop of the NRP's much-vaunted medical model. It is as if the productivity of labor depended crucially on a high level of visual acuity, and our scientists had discovered a new technique to improve visual acuity, which we were then going to distribute only to our own citizens and withhold from the rest of the world in order to maintain "our" competitive edge. Or imagine that our scientific laboratories discovered a cure for AIDS, but someone noted that the AIDS problem overseas represented a permanent drain on local economies, so that not providing the cure to these countries would enhance our competitive economic edge. No sane, ethical human being could accept this line of reasoning and withhold the treatment.

It is no wonder that the NRP report is shrouded in scandal. From the start, its true charge was shielded from the public. That charge -- to increase the literacy skills of the U.S. work force in order to increase the competitive edge of U.S. corporations -- is being sold to the public with such catch phrases as "literacy crisis," "scientifically valid," and "medical model." But the true charge views children as malleable cannon fodder in a global economic war. "More and more we see that competition in the international marketplace is in reality a 'battle of the classrooms,'" says Norman Augustine, former CEO of Lockheed Martin, former head of the Business Roundtable's Education Task Force, and currently an education advisor to President Bush.11

The stakes are truly high in the struggle against this scandal. History can show us what happened -- twice in the 20th century, in fact -- when the battle between U.S. corporations and those of Europe and Asia reached a saturation point in the division of the world's markets. The issue here is nothing less than the fight to prevent the next world war.

1. Elaine M. Garan, "Beyond the Smoke and Mirrors: A Critique of the National Reading Panel Report on Phonics," Phi Delta Kappan, March 2001, pp. 500-506; and idem, Resisting Reading Mandates: How to Triumph with the Truth (Portsmouth, N.H.: Heinemann, 2002).

2. Matthias Egger and Davey Smith, "Meta-analysis: Potential and Promise," British Medical Journal, vol. 315, 1997, pp. 1371-74; Matthias Egger, Davey Smith, and Andrew N. Phillips, "Meta-analysis: Principles and Procedures," British Medical Journal, vol. 315, 1997, pp. 1533-37; and Matthias Egger et al., "Bias in Meta-analysis Detected by a Simple, Graphical Test," British Medical Journal, vol. 315, 1997, pp. 629-34.

3. Barbara R. Foorman et al., "How Letter-Sound Instruction Mediates Progress in First-Grade Reading and Spelling," Journal of Educational Psychology, vol. 83, 1991, pp. 456-69.

4. D. W. Haskell, Barbara R. Foorman, and P. R. Swank, "Effects of Three Orthographic/Phonological Units on First-Grade Reading," Remedial and Special Education, vol. 13, 1992, pp. 40-49.

5. James W. Cunningham, "The National Reading Panel Report," Reading Research Quarterly, vol. 6, 2001, pp. 326-35.

6. Keith Rayner, Barbara R. Foorman, Charles A. Perfetti, David Pesetsky, and Mark S. Seidenberg, "How Should Reading Be Taught?," Scientific American, March 2002, pp. 84-91.

7. G. Reid Lyon, "Measuring Success: Using Assessments and Accountability to Raise Student Achievement," statement before the Subcommittee on Education Reform of the Committee on Education and the Workforce, U.S. House of Representatives, 8 March 2001.

8. Alliance for Childhood, "High Stakes Testing Position Statement," 25 April 2001, available on the Web at

9. Duane Alexander, M.D., director, National Institute of Child Health and Human Development, testimony before the Labor, Health and Human Services, and Education Subcommittee of the Senate Appropriations Committee, U.S. Senate, 13 April 2000.

10. For a review of the business connection to the testing agenda, see Bess Altwerger and Steven L. Strauss, "The Business Behind Testing," Language Arts, vol. 79, 2002, pp. 256-62. Various Business Roundtable documents touching on the subject are available on the Web at, including "Workforce Training and Development," 1993; "Continuing the Commitment: Essential Components of a Successful Education System," 1995; "A Business Leader's Guide to Setting Academic Standards," 1997; Norman Augustine, Ed Lupsberger, and James Orr III, "A Common Agenda for Improving American Education," 1997; "An Introduction to the Business Roundtable," 1998; and "International Economic Crisis: Letter Hand-Delivered to the President, Leadership, and Congress," 1998. See also Edward B. Rust, Jr., Co-Chairman Business Coalition for Excellence in Education, Chair the Business Roundtable Education Task Force, statement before the Subcommittee on Education Reform of the Committee on Education and the Workforce, U.S. House of Representatives, 8 March 2001.

11. Norman R. Augustine, "A Business Leader's Guide to Setting Academic Standards," the Business Roundtable,, 2 July 1997.

STEVEN L. STRAUSS, M.D., formerly on the faculty of the University of Maryland School of Medicine, is a neurologist in private practice in Baltimore and the author of Linguistics, Neurology, and the Politics of Phonics: Silent E Speaks Out (Erlbaum, 2003). An earlier version of this article was presented at the annual meeting of the International Reading Association, San Francisco, May 2002.
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Title Annotation:National Institute of Child Health and Human Development
Author:Strauss, Steven L.
Publication:Phi Delta Kappan
Date:Feb 1, 2003
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