Journal of Learning Disabilities

http://ldx.sagepub.com/ Dyslexia as Disability or Handicap: When Does Vocabulary Matter?

Carsten Elbro J Learn Disabil 2010 43: 469 originally published online 5 May 2010 DOI: 10.1177/0022219409357349 The online version of this article can be found at: http://ldx.sagepub.com/content/43/5/469

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Dyslexia as Disability or Handicap: When Does Vocabulary Matter?

Carsten Elbro1

Journal of Learning Disabilities 478 43(5) 469 Hammill Institute on Disabilities 2010 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0022219409357349 http://journaloflearningdisabilities .sagepub.com

Abstract General cognitive ability is still a factor in current definitions of dyslexia despite two decades of research showing little or no relevance to the nature of dyslexia. This article suggests one reason why this may be so. The suggestion is based on a distinction between dyslexia as a disability (poor ability)as it is viewed and explained by psycholinguistic and neuropsychological researchand dyslexia seen as a handicap (the consequences of a poor ability) in the educational world. While general knowledge and ability may be irrelevant to the nature of dyslexia as a disability, general knowledge and ability does relate to an ensuing handicap. Vocabulary is possibly the most closely linked subcomponent of general knowledge and ability to reading. It was thus hypothesized that when reading ability was controlled individuals with high vocabulary would be more likely than others would to experience a reading handicap as a function of poor reading. Conversely, vocabulary would not relate to the severity of the reading disability per se. These hypotheses were supported by results from a study of 165 adult poor readers. Keywords dyslexia, reading disability, reading handicap, verbal IQ, vocabulary

Introduction
Tradition defines dyslexia as unexpected difficulties in learning to read. According to major organisations of practitioners, dyslexics reading difficulties are unexpectedin relation to other cognitive abilities (International Dyslexia Association, after some discussion, in Lyon, Shaywitz & Shaywitz, 2003, p. 2); the difficulties are not solely accounted for by mental age (ICD10, F81.0. WHO, 2007). In other words, dyslexia is a discrepancy between reading attainment and general intellectual potential. There is a continuing debate about such discrepancy definitions of dyslexia. Although some organisations, such as the European Dyslexia Association, do not refer to intellectual potential, discrepancy definitions are still adhered to by influential organisations such as the International Dyslexia Association. Modern qualifications of the definition of dyslexia specify the reading difficulties to reside in word decoding; a proximal cause is phonological processing difficulties. Modern definitions also underline the neurobiological origins and the moderate heritability (previously called constitutional nature) of dyslexia (Lyon etal., 2003). However, a comparison of reading attainment with other cognitive abilities (e.g., IQ) is still at the heart of influential, international definitions.

The longevity of other cognitive abilities in the definition of dyslexia may seem surprising. After more than two decades of research, there is little evidence that general cognitive abilities matter (an overview is provided by Fletcher, Coulter, Reschly & Vaughn, 2004; Sternberg & Grigorenko, 2002). For example, IQ appears to be not very relevant to dyslexia in at least two important ways. First, general knowledge and cognitive ability (especially nonverbal IQ) are not strong predictors of initial reading development once specific linguistic and orthographic abilities, such as letter knowledge, are controlled (e.g., Catts, Fey, Zhang & Tomblin, 2001; Elbro, Borstrm & Petersen, 1998). In a manner of speaking, research has been able to unpack the important components of general knowledge and abilities in relation to reading: They are budding orthographic knowledge, primarily letter knowledge, phoneme awareness, vocabulary, and more general language abilities. When such predictors are taken into account, traditional
1

University of Copenhagen, Denmark

Corresponding Author: Carsten Elbro, University of Copenhagen, Department of Nordic Studies and Linguistics, 120 Njalsgade, DK-2300 Copenhagen S, Denmark Email: ce@hum.ku.dk

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470 measures of IQ do not contribute to the individual variance in reading development (an overview is provided by Elbro & Scarborough, 2004). The traditional discrepancy definition of dyslexia has been seriously undermined by this disclosure of the proximal potentials for reading development. As the reasons for poor reading development are rapidly being discovered, the number of surprisingly poor readers will decrease equally rapidlyand dyslexia will disappear by definitionwhile the reading difficulties remain. Second, research has shown that the reading and language profiles are identical among children with high and children with low cognitive abilities (as measured by IQ). Nothing is gained in terms of differential diagnosis by the inclusion of IQ (Shaywitz, Fletcher, Holahan, & Shaywitz, 1992; Siegel, 1988, 1989; Stanovich, 1991). Dyslexics with a discrepancy between IQ and reading are quite similar to nondiscrepant, garden variety poor readers with respect to their reading profilespoor decoding and nonword namingand with respect to the associated cognitive difficulties (i.e., poor phoneme awareness, slow rapid naming, poor phonological learning and memory). This has been reported consistently for reading in both English and more regular orthographies (e.g., Landerl, 2003; Metz, Marx, Weber, & Schneider, 2003). In older children and adults, on the other hand, moderate to strong correlations have been found between reading ability and general cognitive abilities (especially vocabulary and verbal IQ; Sattler, 2001). However, the highest correlations are with reading comprehension and not with decoding, which is the compromised skill in dyslexia. Furthermore, the correlation becomes stronger with age because early reading ability predicts the growth in general verbal abilities even more strongly than verbal abilities themselves (Cunningham & Stanovich, 1997; Stanovich & Cunningham, 1993). Why is it, then, that the comparisons with general abilities survive? The suggestion in this article is that recent research has mostly focused on dyslexia as a disability (poor ability), whereas practitioners definitions are also concerned with handicaps (consequences of poor abilities) because practitioners take practical consequences of reading difficulties into account. Important goals (among others) of research into dyslexia are to clarify the characteristics, the causes, and the treatment of dyslexia. In this work, the nature and size of the handicapping consequences of dyslexia are not the primary focus, and dyslexia is viewed as a disability (poor ability). On the other hand, practitioners such as school psychologists, remedial teachers, and their organisations not only are concerned with poor reading but need to consider also the broader consequences of this disability (i.e., the ensuing handicaps).

Journal of Learning Disabilities 43(5)

Causes
Genetic, environmental Disability e.g., poor reading

Consequences
Handicap e.g., educational challenge

Requirements Individual aims and external demands

Figure 1. A reading handicap depends on both disability and individual reading requirements

Disability or Handicap?
In general terms, a disability is a low or compromised physical or mental level of functioning. It may be poor

walking (following an injury, for example), poor speech, or poor reading. A handicap is the negative consequence of an impairment. It may be a problem with access to certain buildings and facilities caused by poor walking, it may be difficulties in conversations caused by poor speech, or it may be difficulties in an education caused by poor reading ability. It is easy to see that the terms disability and handicap depend on each other. Disabilities without handicapping consequences are not really worth public attention. For example, under the U.S. Constitution, a disability is not any kind of poor ability but only one with handicapping consequences: A disability is a physical or mental impairment that substantially limits one or more of the major life activities of such individual ( 12102(2) US Government, 2008). Conversely, handicaps are often, but not always, caused by disabilities. It may be a handicap to be taller than average on transatlantic flights. The mutual dependence means that the two concepts are easily confused. And it is possibly closer to common use to think of disability and handicap as different orientations on a causeconsequence scale: Disabilities are related toward the causes end of the scale, whereas handicaps are related toward the consequences end of the scale (see Figure 1). The distinction between disability and handicap has a major implication. Handicaps are highly relative. They depend not only on the size of the disability but on individual and societal requirements for the corresponding ability. In a society with no written texts, a reading disability is not a handicap. On the other hand, for an individual with a wish to take an advanced academic degree in a highly literate society, even a small reading disability could be a major handicap. Differences between both societies and individuals matter for the size of the handicap. The relationship between a disability and a handicap can be expressed in the following pseudo-formula: H = D R, where H is the resulting handicap, D is the disability degree, and R represents the requirements for the corresponding ability. The three variables may attain values between zero and one. If the requirements are zero, there can be no handicap (as in the illiterate society) regardless of the disability.

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Elbro If the requirements are high, even a small disability will have handicapping consequences. The general point is that there are additional, individual sources of variation in handicaps as compared with disabilities. Even for people in similar social situations, there are still important differences, namely, those related to their individual demands for reading abilities. One such source of differences may be general knowledge or abilities such as those that are picked up by vocabulary tests or IQ measures. For example, a person with a particularly rich vocabulary is probably likely to set higher goals than are other people. These goals may simply be a wish to be able to spell all the many words in his or her vocabulary, or it may be a more general wish to engage in further education in academic fields where language abilities are important. Given such high aims, even a small disability in reading will become noticeable as a major handicap. Consequently, it may be that general knowledge and abilities are relevant to dyslexia seen as a handicap although general ability is not all that relevant to poor reading seen as a disability. If general abilities are indeed important for dyslexia as a handicap, one would predict that general abilities would matter to the assessment of reading where individual aims and conditions matter, whereas general abilities would not be as important for reading disabilities when standard, nonindividual requirements are applied. More specifically, general knowledge and abilities would be predicted to correlate positively with the probability of a reading handicap after controlling for reading ability, whereas no correlation would be expected between general abilities and a reading disability given standard reading requirements. A study tested this prediction. It investigated the relationships between actual reading and spelling abilities on one hand and perceived and diagnosed reading disabilities and handicaps on the other. Because vocabulary is one of the stronger predictors of initial success in reading and possibly the most closely linked subcomponent of traditional IQ measures to reading, it was chosen as one measure of general knowledge and ability. Clearly, vocabulary taps knowledge rather than ability. However, vocabulary has been found to be the single subscale that correlates more highly with a full-scale IQ test, such as the Wechsler Intelligence Scale for Children, than any other subscale (e.g., Dunn, 1981; Hodapp & Gerken, 1999). Thus, the choice of vocabulary as a measure of general ability provided a rather strong test of the independence of general ability and dyslexia. The specific hypothesis was that the relevance of vocabulary for experienced and diagnosed reading problems is variable and will depend on the nature of the problems: Vocabulary scores correlate positively with reading handicaps when reading and spelling abilities are controlled. For

471 example, it was expected that young adults and adults with high vocabulary scores would be more susceptible than others would to perceived reading handicaps in their chosen education simply because of their higher demands for reading abilities. Hence, after control for reading and spelling abilities, high-vocabulary participants would more readily respond with a yes than others would to a question like the following: Did your reading and spelling difficulties affect your education? Conversely, it was hypothesised that vocabulary would not matter for perceived reading disabilities, that is, with respect to reading functions with requirements that are the similar between individuals. For example, vocabulary would not matter to responses to a question such as Did you have difficulties learning to read and write at school? or Do you find that TV subtitles are difficult to read? Of particular interest was the relationship between vocabulary and the diagnosis of reading difficulties as reflected in referral to special education in schooland in adulthood later. Normally, schools are expected to help students achieve some standard level of reading proficiency (perhaps even a national average, although it is unclear how everyone can be above average). On the other hand, many educators and international organizations (e.g., UNESCO, 2004, p. 13) would advocate for individually set goals, which implies that students with or without reading difficulties are helped to reach their potential. In the former case, general verbal knowledge and abilities are of questionable relevance to the provision of remedial teaching in reading. In the latter case, however, verbal knowledge and abilities would be important for the evaluation of the discrepancy between potential and actual achievement in reading. In adulthood, the adult must usually take the first step toward participation in remedial teaching. This means that the adults perceived shortcomings in reading and their consequences play a central role. Therefore, it was expected that adults view their reading difficulties as handicaps and that their potential and personal expectations come into play. In that case, better vocabularies will increase the sensitivity to reading difficulties. As a behavioral consequence, adults with high vocabulary scores would also be more likely to enter courses for poor readers than would adults with lower vocabulary scoresonce their reading abilities were taken into account. This specific hypothesis was also tested in the current study.

Method Measures
The participants reading and spelling abilities, phoneme awareness, and vocabulary were measured in four individual,

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472 computer-administered tests. Information about the participants reading background and self-evaluation as readers was collected in written questionnaires with multiple-choice responses. Word decoding. Word decoding was measured in a pseudo-homophone task. This task was selected for two reasons. First, it taps the ability to recognise words by phonological recoding, which is the core difficulty in dyslexic reading (e.g., Elbro, 1998; Elbro, Nielsen, & Petersen, 1994; Rack, Snowling, & Olson, 1992). Second, it can be administered in group settings, which is not possible with oral reading tasks. In this task, the participant is asked to select the nonword out of four nonwords that may sound like a real word (e.g., tro, tuf, tys, sof, where tuf is the expected answer because it sounds like the word tough). The participant is allowed 5 minutes to attempt as many of the 38 items as possible. The original version of this test correlates strongly with oral reading of pronounceable nonwords (r= .82; Elbro etal., 1994). An alternate, computeradministered version of this test was developed and employed for this study. Reliability was .90 (Chronbachs alpha) in this sample. Spelling to dictation. A short text was presented aurally in two- to four-word segments (phrases) at a time for participants to write down. There were 20 items (segments), and the score was the number of correct segments. Reliability was .94 (Chronbachs alpha) in this sample. Phoneme awareness. Phoneme awareness was assessed in a Spoonerism task. This task was selected because previous studies have found that production of Spoonerisms is one of the spoken language tasks that most clearly distinguish adult dyslexics, even compensated dyslexics, from normal readers (e.g., Paulesu et al., 2001). Participants are presented with two words, which are both spoken and pictured, and they are asked to select the picture out of four that depicts the words when the initial sounds are swapped (e.g., rye Moses becomes my roses). The task has 23 items and a reliability of .84 (Chronbachs alpha) in this sample. Receptive vocabulary. Receptive vocabulary was assessed in a task where participants hear a spoken word and are required to point (with the computer mouse) to the corresponding picture out of a selection of four (similar to the British Picture Vocabulary Scales and the Peabody Picture Vocabulary Test). There are 40 items. The reliability was .84 in this sample. Questionnaire data. Participants were asked 15, mainly yes-or-no, questions about their reading and writing disabilities and handicaps (listed in the appendix). These questions varied in terms of how much individual aims and expectations influenced the requirements for reading abilities. Four questions were about reading as handicap. They were concerned with individual consequences of reading difficulties, both in terms of self-perceived handicaps (e.g., Did your

Journal of Learning Disabilities 43(5) reading and spelling difficulties affect your education after you left school?) and in terms of possible behavioural consequences (e.g., whether the participant had received remedial teaching as an adult). Because reading courses for poor adult readers are free of charge in Denmark, it was assumed that adults sign up for remedial teaching because they experience reading difficulties as a handicap. Another 11 questions were more about reading as a disabilitybecause variations in individual expectations were less important. One question was school oriented: Did you have difficulties learning to read and write at school? A related question was simply whether the participant had received remedial teaching in school. As noted in the introduction, it was expected that schools would refer students to remedial teaching irrespectively of their general verbal potential. The other nine questions were about difficulties with everyday reading and writing tasks. For example, one question was, Do you think that TV subtitles are difficult to read? In Denmark, films or other program in foreign languages are never dubbedwith the exception of programs for young children (who cannot read). This means that all adults have to read subtitles when they watch TV with speakers of foreign languageswhich are in the majority in TV-transmitted films. Naturally, the vocabulary depends on what is said, but the maximum length and speed of the subtitles remain fairly constant given the limitations of the medium and the concern for the variation in adult reading abilities. Consequently, the requirements for reading ability posed by TV subtitles are fairly constant and well known to Danish adults. It is a nonindividual norm against which they can measure their reading abilities. The nine questions were deliberately directed toward particular types of texts rather than toward the participants themselves. In addition to these 15 questions, participants were asked a number of questions concerning general information such as gender, age, level of education, and current education. The various types of questions were presented in the same random order to all participants.

Participants
A total of 165 adults and young adults took part in the study. The participants were randomly selected among students in four kinds of education: there were participants from two sorts of reading courses and from two types of education that traditionally attract a relatively high percentage of poor readers. The two sorts of reading courses were for adults with poor reading (e.g., dyslexia): one was remedial teaching of reading and writing in Danish for adults (n= 67), the other was preparatory education for adults with poor reading (n = 16). The two types of education were vocational training (n= 47), and general education for adults preparing

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Table 1. Descriptive Statistics of the Four Measures of Reading and Language Abilities (n= 165) Measure Word decoding (pseudo-homophones) (max= 38) Spelling to dictation (max= 20) Phoneme awareness (spoonerisms) (max= 23) Receptive vocabulary (max= 40) M (SD) 15.0 (8.1) 15.3 (5.7) 13.6 (5.5) 23.3 (5.8)

473

MinMax 036 020 023 636

for a school-leaving exam (n = 35). Classes were selected from nine urban areas in Denmark so as to be geographically and linguistically representative. None could be characterized as inner-city classes because of the relatively high social homogeneity in Denmark. The participants were all those who spoke Danish as their first language selected from a larger sample of 212 adults. A few participants failed to reply to some of the questions. Hence, some analyses are based on a slightly lower number of participants, in which cases the number is given. The sample comprised 79 women and 86 men. The average age of the selected sample was 29 years (range 1660 years). The majority of the participants had taken a school-leaving exam after 9 or 10 years in school (n= 120 of 163); only 18 had left school after fewer than 9 years without a school-leaving exam. The majority had no further education or vocational training (n = 89 of 161), a substantial group (n= 45) had completed vocational training, and only few (n = 16) had completed any further education.

The number of yes responses from each participant was added into a sum score that reflected the general level of the perceived difficulties with everyday reading and spelling. This individual difficulty index (ranging from 09) was then treated as the dependent variable in a multiple regression analysis with the same independent variables as in the analyses of the responses to individual questions.

Results
The mean scores on the four measures of reading, spelling, vocabulary, and phoneme awareness are displayed in Table 1. The mean score of 15.0 in the word-decoding task is comparable to the 10th percentile (14.3) reported from adults with no history of reading difficulties at school (Elbro, 1998). On the other hand, the mean score in this study is much higher than the mean of 8.8 among adults in special education (Arnbak & Elbro, 1999). Hence, this sample included adults with variable but generally poor reading (and spelling) abilities. The correlations between the ability measures are shown in Table 2. As would be expected, reading and spelling were highly correlated, whereas the oral language measures correlated weakly or modestly with the reading and spelling measures. Hence, colinearity between reading and spelling was a potential problem in the multivariate analyses reported below but the weak correlations between vocabulary and reading and spelling were not a major problem. The distribution of the responses to the questionnaire is shown in Table 3 (leftmost column) together with the results of the regression analyses (one per row). The perceived difficulties with nine everyday reading and/or spelling tasks were summed for each participant as described in the analyses section above. The proportion of the adults who rated each of the reading and/or spelling tasks as difficult ranged from 32% who found computer use difficult to 70% who found spelling words to be difficult. Of the participants, 33% found it difficult to read TV subtitles. The responses about reading difficulties with the nine everyday tasks were quite homogeneous, Chronbachs alpha was .88, and all corrected item-total correlations were .46 or higher. This homogeneity attested to the reliability of the individual questions and made it reasonable to add the yes responses from each participant

Procedure and Data Analysis

Participants were given the tasks in the same order questionnaire followed by the four tests in the following order: word decoding, phoneme awareness, vocabulary, and spelling. The participants worked individually in four-group settings under the supervision of trained experimenters. The experimenters would read the questionnaire to participants who might need help with reading. The individual responses were not disclosed to the rest of the group. The relationships between measured abilities and selfreported reading disabilities and handicaps were subjected to regression analyses. The yes/no responses to each of the questions about reading disabilities and handicaps were entered as the dependent variable in separate logistic regression analyses. The independent variables were the four measures of reading, spelling, phoneme awareness, and vocabulary. The scores on these four measures were standardised before the analyses to make the coefficients readily interpretable and comparable. The independent variables were entered in a forward, stepwise manner. To obtain a robust measure of difficulties with everyday reading and spelling tasks, responses to the nine questions about such difficulties were collapsed and analyzed together.

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Journal of Learning Disabilities 43(5)

Table 2. Correlational Coefficients Between the Four Measures of Reading and Language Abilities (n= 165) Measure Word decoding Spelling Phoneme awareness Receptive vocabulary
All correlations are significant (p< .001).

Word Decoding

Spelling

Phoneme Awareness

.62 .55 .41 .25 .25

.40

Table 3. Self-Reported Reading Disabilities and Handicaps and Their Relationship With Reading, Spelling, and Vocabulary Scores Self-Report Reading disabilities Difficulty learning to read and write in school (yes/no= 101/63) Received remedial teaching in school (yes/no= 87/78) Difficulties with everyday reading and writing as adult (scale 09)a Reading handicaps General effects on schooling (yes/no= 93/68) General effects on education (yes/no= 65/93) Considers himself or herself dyslexic (yes/no= 81/84) Received remedial teaching as adult (yes/no= 65/100) 1. Word Decoding 1.01 (14.4***) 1.83 (38.8***) 0.47 (6.4***) 0.87 (11.0***) 1.22 (24.4***) 1.01 (11.0***) 1.55 (30.0***) Present Abilities 2. Spelling 0.97 (5.3*) 0.29 (3.9***) 1.10 (8.0**) 1.57 (14.0***) 3.Vocabulary 0.42 (4.1**) 0.56 (8.3**) 0.79 (11.3***) 0.73 (12.5***)

Each row displays the b coefficients from a stepwise logistic regression analysis (with Waldorf statistic and significance level in parentheses).Variables entered the equation in the order shown (from left to right). a Results from multiple linear regression: standardized coefficients (and t-values with significance level). *p< .05. **p< .01. ***p< .001.

to form an individual score (from 09, average = 4.1, SD = 3.1). The sum score was interpreted as a general measure of perceived difficulties with everyday reading and spelling. The sum score was subjected to a linear hierarchical regression analysis with stepwise selection of the independent variables: reading, spelling, vocabulary, and phoneme awareness. The regression analyses indicate that phoneme awareness did not contribute independent variance to any of the questionnaire responses in any analysis when reading and spelling were entered first. In most analyses, reading was the strongest correlate and, hence, entered first. In some analyses, spelling ability was the stronger correlate and entered first. The reading and spelling coefficients were always negative, as would be expected, indicating that good reading correlated negatively with reported reading disabilities and handicaps. Vocabulary always entered the regressions last because it mostly became significant after controlling for reading and spelling. As predicted, vocabulary was positively associated with perceived reading handicaps; that is, adults with larger vocabularies were more likely to experience reading handicaps after reading and spelling abilities were controlled.

The coefficients displayed in Table 3 indicate how much the probability of a yes response changed with a 1standard deviation change in ability. For example, a 1.01 coefficient means that an increase in, for example, word decoding of 1 standard deviation reduces the probability of a yes response by exp(1.01)a factor of 2.7. As hypothesized, vocabulary did not contribute independent variance to the responses about reading disabilities (Table 3, first three rows). Initial problems with learning to read and write in school did not relate to vocabulary when reading and spelling abilities were accounted for. Similarly, remedial teaching was provided relatively independently of vocabulary abilities. Hence, the analysis suggests that referral to special education in school is based on a disability criterionsimply how far a student is lagging behind his or her peers. Likewise, only reading and spelling contributed independent variance to perceived difficulties with the nine everyday reading and spelling tasks. The adjusted r2 was .41 for reading alone and .46 for the final model with both reading and spelling. Vocabulary was not significant, partial r= .08. Conversely, vocabulary contributed to the adults selfreported reading and spelling handicaps. A high vocabulary score corresponded to an increased probability that reading

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475 considered a reading disability, there appears to be no need for a discrepancy definition (with vocabulary knowledge or associated verbal abilities) or the use of regression formulae in practice. This conclusion is consistent with decades of research indicating that IQ may be irrelevant to the definition of dyslexia (e.g., Fletcher et al., 2004; Siegel, 1989; Stanovich, 1991). The results also indicate that vocabulary did not matter for referral to remedial teaching. This result is consistent with the participants reported problems in learning to read. It probably reflects the common practice that focuses on reading difficulties in the primary grades and provides remedial teaching to children with decoding problems. Remedial teaching is rarely provided for students with specific problems in reading comprehension without decoding problems (Cain & Oakhill, 2004; Leach, Scarborough, & Rescorla, 2003). Apparently, schools did not provide remedial teaching to help students with reading difficulties to reach their potential but rather to reach a general ability level (e.g., a national standard). In contrast, it was found that a good vocabulary increased the risk of a perceived reading handicap when actual reading ability was controlled. For example, larger vocabularies were associated with a higher risk of a perceived reading handicap in school and subsequent education. Similarly, adults with bigger vocabularies were more likely than others were to attend reading courses. This finding was consistent with the finding that adults with big vocabularies were much more likely than other adults were to consider themselves dyslexic. Hence, when children and adults set individually variable demands for reading ability, vocabulary does matter. In those cases, when dyslexia is considered an individually perceived handicap, a discrepancy definition seems to be called for. Dyslexia as an individual reading handicap is likely to reflect a discrepantly low reading ability in relation to vocabularyand probably also in relation to other cognitive abilities. These findings also suggest that adults perceptions of themselves as dyslexic depend on more than their initial reading difficulties. It is likely that persistent experiences of reading difficulties in both education and social life reinforce the perception of a reading handicap. In any case, the handicapping consequences are a part of the concept of dyslexia in adults who consider themselves to be dyslexic. Seen in this light, it is understandable that some dyslexia organizations define dyslexia as a handicap. It may seem surprising that vocabulary size was a positive predictor of reported reading difficulties after controlling for reading ability. The initial development of word decoding may be only weakly correlated with vocabulary (and verbal IQ). However, there is good evidence that vocabulary becomes an important correlate at

40

Do reading difficulties affect your education? Yes No

30 Vocabulary

20

10

0 0 10 20 30 Word Decoding 40

Figure 2. Bigger vocabularies make adults more sensitive to poor reading in their education (N= 165)

difficulties had affected the schooling and education of an adult (Table 3, middle section). A high vocabulary score also corresponded to an increased likelihood that an adult considered him or herself to be dyslexic and that he or she had taken the consequence and enrolled in remedial teaching as an adult. Hence, the participants own perception of being dyslexic or not follows the handicap definitionjust like their participation in remedial teaching as adults does. Figure 2 depicts the association between reading ability, vocabulary, and a self-reported reading handicap in education. The dotted triangle contains almost all the participants who had been affected by their poor reading during their education. The nonrandom distribution of the affected adults was supported by the regression analysis (Table 3, fifth row). This distribution illustrates the idea that a perceived reading handicap in education depends on both poor reading and (good) vocabulary.

Discussion
Overall, the results support the hypothesis: Vocabulary does not influence reading disabilities, but it does influence perceived reading handicaps. When the demands for reading abilities are fixed, as in initial reading instruction in most schools, vocabulary size is irrelevant to the measure of reading disabilities. Adults with a history of difficulties in initial learning to read in school are not characterised by a particularly large or small vocabulary once their reading and spelling abilities are taken into account. Similarly, their self-reported shortcomings on a variety of everyday reading and spelling tasks depends on reading and spelling abilities, not on vocabulary size. Hence, as long as dyslexia is

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476 later stages of reading development when differences in language and text comprehension become more important (Gough, Hoover, & Peterson, 1996; Snowling, Bishop, & Stothard, 2000). In this study, vocabulary was significantly positively correlated with both reading and spelling abilities. Hence, on its own, vocabulary is likely to correlate negatively with difficulties in reading. However, the results indicate that when the shared variance with reading and spelling abilities is accounted for, vocabulary may indeed be positively related to experiences of reading difficulties. The study has some clear limitations. First, the results depend on self-reported histories of reading difficulties, remedial teaching, and perceived reading disabilities and handicaps. Clearly, information collected directly from schools and other institutions would have been more reliable. However, information from schools was not available because by law it is destroyed shortly after students leave school. On the other hand, the information about perceived reading difficulties was highly reliable as indicated by high intercorrelations in spite of considerable variability between items. Also, obtaining information of reading disabilities and handicaps from only one source (i.e. the readers themselves) may also contribute positively to the reliability of the comparisons between outcomes (dependent variables). Second, the study included only one measure of general knowledge and abilitynamely, vocabulary. Given that reading is a verbal activity, it is no surprise that reading correlates with measures of verbal knowledge and that the correlations are higher than those with nonverbal IQ (e.g., Stanovich, 1991). However, it is hard to predict whether individual, IQ-related demands for reading abilities would be stronger for nonverbal IQ than for verbal IQ. Third, the variance in reading and spelling abilities was somewhat restricted because of the focus on reading disabilities and handicaps. This restriction on variability may have limited the correlations with the outcome measures so that the importance of vocabulary may be overestimated. However, logistic regression analyses are more sensitive with a fairly even number of cases for the two values of the dependent variable. So adding more good readers for a greater variability in reading would perhaps not have changed the estimates of the predictors much. Finally, the study was only correlational although the theoretical model (in Figure 1) is causational. A full test of the model would require an experimental design in which the demands for reading ability were varied systematically. This study cannot rule out reversed causalitythat is, that young adults actively choose an education so as to minimize their risk for being handicapped by poor reading abilities. Indeed, it is very likely that many young adults

Journal of Learning Disabilities 43(5) take the demands for reading abilities into consideration when they choose further education and/or vocational training. Future studies could simply ask the relevant questions to shed light on this relationship. The results lead to some straightforward implications for research and practice. First, both research and practice should make clear when dyslexia and other reading difficulties are viewed as disabilities and when they are viewed as handicaps. Both views are relevant to both research and practice. When the causes of dyslexia as a disability are concerned, there may be little point in taking other abilities and knowledge into account. This is true for both research and practice and may be true whether the aim is to identify, prevent, or remediate dyslexia. On the other hand, when the handicap of dyslexia is in focus, the situation is considerably more complex because not only vocabulary but possibly also many other factors that determine the demand for reading should be considered. This study has suggested how a general interaction between these other factors and reading disability contributes to the handicap of dyslexia. But the precise mechanisms of these interactions are far from understood. Indeed, it remains to be seen how other general abilities and knowledge (e.g., verbal IQ and various other components of IQ) interact with reading difficulties.

Appendix
The Questionnaire, Extracts Did you have difficulties learning to read and write in school? Did you receive remedial teaching in Danish at school? Evaluation of nine everyday reading tasks: Do you think that TV subtitles are difficult to read? words are difficult to read? words are difficult to spell? SMS messages are difficult to write? it is difficult to write emails? computers are difficult to use? it is difficult to perform an Internet search? texts are difficult to understand? texts are difficult to write? Did your reading and spelling difficulties affect you in school? Did your reading and spelling difficulties affect your education after you left school? Do you consider yourself dyslexic? Have you received remedial teaching in Danish after you left school?
The original questions in Danish are available from the author. For transparency, the questions are listed here in the same order as in Table 3.

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Elbro Acknowledgments
This work was supported by the Danish Ministry for Education. The organization of the data collection was conducted by Dorthe Haven and Birgit Dilling Jandorf from the Danish Dyslexia Information Centre.

477
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Declaration of Conflicting Interests

The author declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Financial Disclosure/Funding
The authors work with this article was supported by The University of Copenhagen.

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About the Author

Carsten Elbro, PhD, is a professor of applied linguistics at University of Copenhagen, Denmark. His current interests include learning disabilities, reading, and reading development.

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