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Reading difficulty in children: Clinical features and evaluation

S Sutton Hamilton, MD
Section Editors
Marc C Patterson, MD, FRACP
Carolyn Bridgemohan, MD
Deputy Editor
Mary M Torchia, MD


Reading is critical to the academic, economic, and social success of children [1]. However, many children complete schooling without achieving more than basic literacy [2]. Pediatric clinicians are well positioned to identify children at risk for reading difficulties and children who have unexpected difficulties in learning to read. Early identification and timely intervention for such children improve long-term outcome. Clinicians who use standardized, validated screens will identify at-risk children more accurately than those who rely solely on clinical judgment [3].

The clinical features and evaluation of reading difficulty in children will be reviewed here. Normal reading development and the epidemiology, etiology, and treatment of reading difficulty are discussed separately. (See "Reading difficulty in children: Normal reading development and etiology of reading difficulty" and "Reading difficulty in children: Interventions".)

General issues related to learning disabilities also are discussed separately. (See "Definitions of specific learning disability and laws pertaining to learning disabilities in the United States" and "Specific learning disabilities in children: Clinical features" and "Specific learning disabilities in children: Educational management".)


A variety of terms are used to describe reading problems. Different terms may be used in different settings and by different groups (eg, educators, healthcare providers). Definitions for the terms that are used in this topic review are provided below. A detailed discussion of terminology is provided separately. (See "Reading difficulty in children: Normal reading development and etiology of reading difficulty", section on 'Terminology and conceptual framework'.)

Reading difficulty — "Reading difficulty" is defined from a normative perspective (ie, how a child performs in reading compared with peers or educational expectations) [4]. Reading difficulty has a number of causes, one of which is reading disability.

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Literature review current through: Nov 2017. | This topic last updated: Nov 16, 2016.
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