LITERACY is essential in our society. Yet, at least 4 million school children are failing to acquire proficiency in reading. These children not only fall behind in school work but also suffer profound emotional and social repercussions. The pediatrician can play a role in reducing this sizable loss of individual potential through detecting, evaluating, and referring the retarded reader.More than 20,000 articles and books are devoted to reading retardation.1-7 While a vast array of information has been accumulated, noticeable gaps in interdisciplinary communication have prevented full use of what is known.In clinical medicine signs (objective findings) are distinguished from symptoms (subjective complaints). Viewed in this framework retarded reading is a sign which can be identified with reasonable accuracy through standardized tests. Most authorities agree that reading retardation exists when a child's skill in reading falls two or more years below his mental age level, measured respectively by individually administered reading and intelligence tests. As¬ sociated symptoms, however, are not present in the usual form because the complaints about the reading problem ordinarily are made by teachers and parents rather than the patient, the child.During the onset of a reading problem, the child may experience anxiety or its somatic deriva¬ tives when confronted with the printed word, but later he may deny concern about his reading handicap. While most investigations are aimed at these signs and symptoms, it is clear that the underlying pathological processes must be identified. This paper will review present knowledge about reading disabilities and highlight the com¬ plex nature of the reading process. We will fol¬ low Fabian's 8 convenient groupings : ( 1 ) organ centered studies, (2) individual centered studies, (3) family centered studies, and (4) school centered studies.Organ Centered Studies These studies are grouped according to body systems: visual, auditory, central nervous sys¬ tem, and endocrine.Visual and Auditory Systems.-Although reading takes place in the brain, not in the eyes or ears, defects of vision and hearing should be ruled out in all children with reading problems.Studies of visual factors disclose that while sensory impairment per se is not of primary etiological importance in the vast majority of cases,9·10 children with reading retardation do show defective integration of visual perceptions, eg, difficulty in analyzing words, confused direc¬ tional orientation of the printed word, and reversal of letters.The phonetic method of teaching reading by associating sounds with visual symbols is widely accepted. An intact auditory apparatus is