The varieties of pathways to dysfluent reading: Comparing subtypes of children with dyslexia at letter, word, and connected text levels of reading

The majority of work on the double-deficit hypothesis (DDH) of dyslexia has been done at the letter and word levels of reading. Key research questions addressed in this study are (a) do readers with different subtypes of dyslexia display differences in fluency at particular reading levels (e.g., letter, word, and connected text)? and (b) do children with dyslexia identified by either low-achievement or ability-achievement discrepancy criteria show similar differences when classified by the DDH? To address these questions, the authors assessed a sample of 158 children with severe reading impairments in second and third grades on an extensive battery and classified them into three reader subtypes using the DDH. The results demonstrated that the three DDH subtypes exhibited differences in fluency at different levels of reading (letter, word, and connected text), underscoring the separate reading profiles of these subtypes and the different possible routes to dysfluency in reading disabilities. Furthermore, the results suggest that the different patterns among DDH subtypes are primarily driven by the ability-achievement discrepancy group. The implications of these findings are discussed for intervention, reading theory, and a more refined understanding of heterogeneity.