A fourth-grade student with difficulties in phonological/orthographic associations, automaticity and fluency, and underlying language abilities would most likely have which impairment?

• A. Receptive language
• B. Expressive language
• C. Reading comprehension
• D. Orthography comprehension

Answer: (C)

Decoding and language skills drive reading comprehension. When a child has trouble phonologically mapping sounds to letters and recognizing familiar orthographic patterns, decoding becomes slow and effortful. That extra effort uses up cognitive resources, making it harder to hold and integrate ideas as you read. If underlying language abilities are also weaker, vocabulary and sentence understanding are further limited, cutting into the ability to extract meaning from text. In fourth grade, as texts grow more complex, these combined weaknesses clearly manifest as difficulties with reading comprehension. Receptive or expressive language issues can be part of the picture, but the profile described most directly points to struggles with understanding what is read.