VOL. 63, NO. 2 BOOK REVIEWS 357

The author naively states that studies of the chromosome are being carried out on the as­sumption that some unusual genetic compli­cation may be found, but he gives no refer­ences. (Are there any geneticists doing chromosome studies for a "reading de­fect"?)

Obviously there are educators, physicians and psychologists who do not accept a "de­velopmental lag" as the predominant cause of reading disorders, and the author ac­knowledges this fact. But he does not ade­quately describe their objections. An impor­tant observation of many educators is that children with reading problems often do not show many of the other deficiencies that Orton associated with "developmental dyslexia" (many have only the reading problem). Even some of the author's own case reports are not convincing examples of developmental lag but rather suggest other causative factors.

This book quite rightly exmphasizes the importance of the reading problem. "Among school children in this country (6 to 17 years of age), over 10 per cent of those not mentally retarded are more than 2 years re­tarded in reading according to their mental age ability." However, a reading problem at a young age has not prevented significant achievement for some gifted individuals (for example, Woodrow Wilson, Thomas A. Edison, August Rodin, Paul Ehrlich and Gamil Nasser). An interesting suggestion of the author is that Lee Harvey Oswald had developmental dyslexia. He presents ev­idence for this contention and then "won­ders what the outcome might have been if the handicap had been recognized when he started his schooling and appropriate re­medial reading had been utilized at that time."

The author offers many suggestions for attacking the widespread problem of dys­lexia at various levels. He urges that schools identify developmental dyslexia as early as possible and that reading instruction begin at the age of four or five years. Some edu­

cators would not approve of this latter suggestion because not all children are "ready" to read by the age of four or five (irrespective of whether or not they have reading problems at a later age).

This book is valuable for its detailed de­scription of the developmental-lag theory of reading disability.

Alex E. Krill

T H E DISABLED READER: EDUCATION OF THE DYSLEXIC CHILD. Edited by John Money. Baltimore, The Johns Hopkins Press, 1966. Clothbound, 421 pages, 21 figures (including 3 that are in color), 17 tables. Price: $8.50. This book is a collection of independent

writings discussing principles of the reading process, teaching beginning readers and the diagnosis and treatment of reading prob­lems. It was assembled by combining origi­nal chapters from 13 contributors with four chapters reprinted from already published material. The contributors include psycholo­gists, educators, a linguist and a psychi­atrist.

Most modern teaching programs for be­ginning readers attempt to solve that trou­blesome truth about the English language: the inconsistent relationship between its phonology and its orthography. (For in­stance, ough can appear as plough, ought, rough, though, cough, or through and, as G. B. Shaw pointed out, ghoti should be pro­nounced just like fish : gh as in rough ; o as in women; and ti as in nation.) One pro­gram uses an artificial alphabet with consis­tent sound-symbol relationships (The Initial Teaching Alphabet). Eventually the child transfers to the regular alphabet. Another method superimposes consistency on ex­isting letters by assigning a given color to a letter or a compound of letters if the pho­netic or sound value is the same. A third method uses a "linguistics" approach. Ini­tially only letter combinations with regular or consistent relationships between sounds

358 AMERICAN JOURNAL OF OPHTHALMOLOGY FEBRUARY, 1967

and printed symbols are taught. Inconsis­tencies of the English language are intro­duced after the consistencies are learned gradually and systematically. Each method has its disadvantages.

Obviously there are a variety of ap­proaches to teaching the beginning reader. But an important point made by Isenberg is "pending the accumulation of definitive evi­dence based upon control studies, we can only conclude that the excellence of the teacher and a class size small enough for in-dividualization of instruction are far more important than the choice of method."

An interesting chapter on the epidemiol­ogy of reading retardation defined the "problem." Apparently in 1956, 11% of United States citizens had not reached a fourth-grade reading level. The number of sixth-grade students reading two or more grades below expected "grade level" varies widely from suburb to city and also with the type of school, a survey from a large metro­politan complex (unnamed) showed. It re­ported that 28% of sixth-grade school children in the city, 15% in the commuter-county areas, 3% in surrounding suburbs, and 0 children in an independent school had reading skills more than two years below the sixth-grade norm.

Several methods and principles are dis­cussed in teaching the retarded reader. It is emphasized that no one approach is "the best" and that a multiplicity of sensory stimulation utilizing visual, auditory, and kinesthetic techniques may have to be used with the emphasis depending on the child. One of the newer methods discussed, the Progressive Choice Reading method, com­bines aspects of programmed instruction with a "linguistic" approach. Programs using this method have been developed for adolescent and adult culturally deprived poor readers and educable mentally handi­capped readers.

Strong preventive as well as corrective programs for retarded readers in the class­room are urged but this is usually impossi­ble at the present time because of a tre­

mendous shortage of adequately trained teachers of reading skills. A section with selected case reports illustrates in detail the diagnostic evaluation of severe reading problems. There is no discussion on current fashions in perceptual training and visual-motor co-ordination for retarded readers because the author claims these methods have not yet been proved to have any direct effect on the learning of reading.

The book is helpful in understanding edu­cational problems of either the beginning or the disabled reader. It is of particular value in explaining approaches to teaching both groups.

Alex E. Krill

T H E OCULAR FUNDUS. By Arno Nover. (Translated by Frederick C. Biodi.) Phil­adelphia, Lea & Febiger, 1966. Cloth-bound, 154 pages, 36 black and white il­lustrations, 92 color reproductions, index. Price: $15.00. This small volume offers a surprisingly

adequate and up-to-date account of the most commonly encountered fundus lesions. It should prove particularly helpful to the gen­eral physician, as the color reproductions are numerous and beautiful. Also the juxta­position of text and illustrations is judi­ciously chosen to facilitate correlation.

The book is in two parts, a general and a special. The general part is subdivided into two chapters, that is, a brief historical ac­count of the invention of the ophthal­moscope, and a sufficiently detailed descrip­tion of the methods most commonly used for examination of the ocular media, direct and indirect ophthalmoscopy, and simple de­termination of refractive errors, to aid less experienced observers, such as students and general practitioners.

The special part begins with a superbly illustrated description of the normal fundus, its variations and congenital deviations from the norm. Ocular participation in systemic diseases, local diseases of inflammatory and