Poor reading comprehension despite fast word decoding in children with hydrocephalus

Children with hydrocephalus decode words better than they understand what t hey read. We tested whether children with hydrocephalus (from myelomeningoc ele or aqueduct stenosis) (1) decode words slowly, (2) use decoding process es similar to those of neurologically intact peers, and (3) comprehend poor ly to the extent that they are slow decoders. We compared speed of word dec oding in 33 children with hydrocephalus and 33 controls matched on a pairwi se basis for age, grade, and word decoding accuracy. The children with hydr ocephalus were as fast as controls in reading words, but, unlike controls, they did not demonstrate an effect of spelling-sound regularity. Further, d ecoding speed did not contribute to reading comprehension beyond word decod ing accuracy. The reading comprehension deficits of good decoders with hydr ocephalus are not related to early-stage processing deficits in word recogn ition speed. Likely origins of comprehension failure in this group are disc ussed. (C) 2001 Academic Press.