LEITERS TO THE EDITOR

vidual child psychiatrists, between different centers, as well as between different countries. My conclusions are based on international surveys I undertook; one was about 15 years ago, and the other was very recently. These surveys were published, and the findings suggest that major differences in clinical practice, especially in relation to pediatric psychopharmacology, are due to the following: I. differences in theoretical views, diagnostic schemes, and treatment approaches between various child psychiatrists; 2. lack of sufficient training and experience of some child psychiatrists; 3. ethical, social, cultural, and political resistance and pressures against the use of medications in children and adolescents; and 4. lack of professional resources and certain psychotropic drugs in a number of countries. As a result, many children and adolescents who suffer from psychiatric disorders, and especially those with "disruptive behavior," are either deprived from effective pharmacotherapy or are treated with drugs that are ineffective, unsafe, or untested. Although child psychiatrists may disagree on diagnoses and therapy, we ought to reach a consensus on the needs and methods of evaluating treatment outcome. On a broader scale, a concerted national and international collaborative effort in mass education, professional training, and research should be a priority. To get additional information on child psychiatry practices in the United States and abroad, I have prepared a survey questionnaire. I wonder if our Academy would be interested in actively participating in undertaking such a survey and in analyzing the data. Jovan G. Simeon, M.D. Child Psychiatry Research Royal Ottawa Hospital

Book Review: The Female Fear To the Editor: The book review by William C. Ackerley, M.D. on The Female Fear (J. Am. Acad. Child Adolesc. Psychiatry. 29:991, 1990) brought attention to an important publication (which I might otherwise have overlooked). This book is important to clinicians because most or possibly all child psychiatrists in practice will have to work with patients who have been through the ordeal of rape/sexual molestation. Unfortunately, the review does little to help with the key question: namely, the relationship of the work of the authors of the reviewed book to our patients' rape experiences and clinical problems. In other words, is there evidence that we can generalize from findings and recommendations of the book under review? We read that the book is "based upon 300 interviews conducted with women across the country.... " We need to know how representative this group of women is of the female population of the United States. We certainly would want to know how these interviews were conducted: were they structured, semistructured, or open-ended? We should know what methods of data analysis were employed by the authors, etc. Although the author states that he is better able to understand women's fear of rape and better able to grasp how deep and how horrible are the emotional reactions and scars left by the brutal crime of rape, he has provided little information about this study that would enlighten the reader of this review. Is it not time that the editors of this distinguished Journal set guidelines for book reviewers that include basic

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scientific criteria and discourage emotional biases (as understandable as these may be!)? J. Homann, M.D. Eastern Maine Medical Center Bangor, Maine

IQ and Reading Progress To the Editor: In this article in the Journal, "IQ and Reading Progress: A Test of the Capacity Notion of IQ" (January 1989), authors Share, McGee, and Silva argue, on the basis of their longitudinal data, "the relationship between IQ and reading was too weak to permit useful predictions for individual children on the basis of IQ alone" (p. 100). I direct the readers attention to the following research articles: I. Bruck (1987) reported that childhood IQ followed by family ,. socioeconomic status were the best predictors of educational outcomes during and after secondary school. This was especially the case at the low and high ends of cognitive ability. 2. Huesmann et al. (1984) reported that IQ at age 8 accounted for more than 25% of the variance in academic attainment (reading, spelling, and arithmetic) in males aged 30 years. 3. Tramontana et al. (1988) reviewed 74 longitudinal studies addressing the preschool prediction of later academic achievement. They reported most studies found a significant predictive relationship, with about one-third of the studies finding IQ to be best predictor of later achievement. When IQ was not predictive, subject samples were primarily composed of individuals from lower socioeconomic backgrounds. Therefore, there is ample evidence that IQ has predictive value for academic, occupational, and social attainments in adulthood. Why didn't Share and his colleagues find a strong relationship between IQ and reading? Examination of their correlational analysis indicates that they artificially divided IQ scores into six groups (thereby reducing the range of scores from about 60 to 6), and they artificially dichotomized reading ability into above and below age 9 reading levels (again reducing the possible range). A correlation coefficient is a function of the variability of the measures. Whenever the range of the measurement is reduced, the associated correlation coefficient is also reduced (Roscoe, 1975). It would be of great interest to know the correlation between standard scores from the IQ measure at age 7 and the Burt Reading Test at age 13. The authors also argue that "unless it can be shown to have some predictive value for the nature of treatment or treatment outcome, considerations of IQ should be discarded in discussions of reading difficulties" (p. 1(0). This statement fails to recognize the research of Rutter and Yule (1975), indicating that poor readers with low IQs showed a variety of associated abnormalities on motor, praxic, speech, and other developmental functions. However, poor readers with high IQs showed evidence of only speech and language difficulties. Stanovich (1988) has provided considerable evidence indicating that poor readers with high IQs have specific deficits in phonological processing, whereas poor readers with low IQs show evidence of broadbased developmental delay. Maughan et al. (1985) reported that youngsters with IQs over 82 made significantly more progress in reading over a 4-year period than youngsters with IQs below 82. Within a clinical teaching realm, the procedures used to teach slow learners are not appropriate for the bright youngster with impaired reading. The slow learner requires a broad-based program to improve conceptual, cognitive, social, and language development as well as academic skills. The intelligent child has acquired conceptual, rea-

J. Am . Acad. Child Adolesc. Psychiatry, 30:4, July 1991

LEITERS TO THE EDITOR

soning, and verbal skills but is not able to decode individual words (Thomson, 1984). In conclusion, a large number of longitudinal studies have reported that childhood IQ has significant predictive value for academic, occupational, and social attainments in adulthood. The research has also shown that poor readers with low IQs are significantly different on a variety of developmental measures when compared with poor readers with high IQs, including rate of reading progress. Last, the kind of procedures used to teach slow learners are not appropriate for the intelligent youngster who has impaired reading skills. Anne Cornwall, Ph.D. IWK Children's Hospital Halifax, Nova Scotia, Canada REFERENCES

Bruck, M. (1987), The adult outcomes of children with learning disabilities. Annals of Dyslexia, 37:252-263. Huesmann, L. R., Eron, L. D., Lefkowitz, M. M. & Walder, L. O. (1984), Stability of aggression over time and generations. Devel· opmental Psychology, 20: 1120-1134. Maughan, B., Gray, G. & Rutter, M. (1985), Reading retardation and antisocial behavior. A follow-up into employment. J. Child Psychol. Psychiatry, 26:741-758. Roscoe, J. T. (1975), Fundamental Research Statistics for the Behavioral Sciences, 2nd Ed. New York: Holt, Rinehart, & Winston, Inc. Rutter, M. & Yule, W. (1975), The concept of specific reading retardation. J. Child Psychol. Psychiatry, 16:181-197. Share, D. L., McGee, R. & Silva, P. A. (1989), IQ and reading progress: a test of the capacity notion of IQ. J. Am. Acad. Child Psychiatry, 28:97-100. Stanovich, K. E. (1988), Explaining the differences between the dyslexic and the garden-variety poor reader: the phonological core variable-difference model. Journal of Learning Disabilities, 21 :590604. Thomson, M. (1984), Developmental Dyslexia. London: Arnold. Tramontana, M. G., Hopper, S. R. & Selzer, S. C. (1988), Research on the preschool prediction of later academic achievement: a review. Developmental Review, 8:89-146.

The Authors Reply:

In our 1989 paper, we set out to test the "milk and jug" notion that IQ sets a limit on the absolute level of achievement and/or the rate of progress of which a child is capable. Accordingly, we examined the attainment levels (reading ages) achieved at age 13 by children classified according to preschool IQ. The data revealed that most lowIQ children were not impaired in reading; some were even above average. We also looked at the relationship the other way around by asking who were the "illiterates" (reading ages below the traditional cutoff of 9 years). Again, most of this group had IQs in the normal range. In this context, we also noted that IQ was not entirely unrelated to literacy level because, in a supplementary analysis, IQ accounted for a small but significant amount of variance in literacy level, that is, in predicting whether a child would be literate or illiterate. On the basis of these findings, we concluded that, contrary to the "milk and jug" view, IQ does not set a limit on levels of attainment. Later analyses also found that IQ does not limit rate of progress either. Cornwall suggests that we failed to find a strong predictive relationship between IQ and reading in our correlational analysis because we artificially divided IQ scores into six groups, thereby restricting range and consequently attenuating the size of the correlation. This assertion, however, is not correct. We correlated the full continuum of original, individual IQ scores (not grouped scores) with literacy level. The simple correlational analysis between continuous IQ and J. Am. Acad. Child Adolesc. Psychiatry, 30:4, July 1991

reading scores was not relevant to the issue being addressed in our paper. These data (predictive validities) have already been reported elsewhere (Silva, 1986). We, of course, agree that there is a significant predictive relationship between IQ and reading achievement but disagree that this relationship is "strong." Cornwall cites several studies assessing correlations between preschool IQ and later achievement. However, most of these, including the majority of the studies reviewed by Tramontana et al. (1988), are not pertinent to the issue of IQ and reading, because they assessed other areas of academic functioning, such as math or social adjustment, or used composite criteria, such as reading plus math. Nonetheless, it should be noted that, contrary to Cornwall's claim, Tramontana et al. 's review of 74 longitudinal studies did not report that one-third of these studies found IQ to be the best predictor of later achievement. To quote Tramontana et aI., "About one-third of the [74] studies examined the predictive validity of IQ ... Overall, most studies found a significant predictive relationship, with many (about one-third of these) finding IQ to be among the best predictors of later achievement," p. 126 (italics added). It is very likely that broad-based tests such as the WISC and Stanford-Binet, which include a diversity of educationally relevant tasks, are indeed the best predictors of general educational achievement. But professional preoccupation with IQ, stemming in part from "milk and jug" conceptions, is liable to obscure those significant advances achieved over the last 15 years in the field of reading research that have enabled us to identify domain-specific factors (such as phonological processing) that are more potent than all-purpose measures, such as IQ (Stanovich, 1988; Wagner and Torgesen, 1987). More importantly, these domain specific factors go much farther than IQ in helping us understand and deal with reading failure (see, for example, Bradley and Bryant, 1983). Domain specific factors, furthermore, do not undermine the assumption of specificity inherent in the notion of specific reading retardation. If low IQ is to blame for school failure, why does dyslexia exist? These children should be struggling in all academic areas. Cornwall is right to raise the broader issue of the utility of IQ in the diagnostic differentiation of poor readers. Rutter and Yule's (1975) seminal work, which we ourselves have replicated, indicated that lowIQ poor readers have a broader range of deficits than high-IQ poor readers (specific reading retarded). But does this simply reflect the selection criterion (low IQ is typically associated with those areas of functioning found to be deficient in low-IQ children) or does the IQbased distinction have implications for differential treatment and prognosis? This is really the heart of the issue. Cornwall suggests that the high-IQ poor reader requires a different teaching approach than the "slow learner" and is likely to make progress more rapidly. This view seems to be common sense, but the research support is, as yet, lacking. The original findings of Rutter and his colleagues on differential rates of progress have not been replicated either by us (Share et aI., 1987) or others (see Stanovich, 1991 for a review). There is also no firm evidence to indicate differential treatment response or differences in the nature of the reading processes/strategies of high- versus low-IQ poor readers (see reviews by Siegel, 1989 and Stanovich, 1991). Indeed, the dearth of studies directly investigating the diagnostic validity of IQ-based classification highlights the stranglehold that traditional "milk and jug" notions about IQ and reading have exercised over thinking about reading failure. This debate, however, has only recently been reopened (see special issues of British Journal of Developmental Psychology, [1985), and Journal of Learning Disabilities, [1989)). It is clear that much work remains to be done. David L. Share, Ph.D. University of Haifa, Israel Rob McGee, Ph.D. Phil A. Silva, Ph.D. University of Otago Dunedin, New Zealand

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IQ and reading progress.

LEITERS TO THE EDITOR vidual child psychiatrists, between different centers, as well as between different countries. My conclusions are based on inte...
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