A differential diagnosis of three types of severe reading disability cases is presented. The brain damaged-ego disturbed child suffers a defect in the central nervous system which makes it extremely difficult to develop such basic skills as perception, concept formation, and language. The specific brain injury cases, classed as organic remedial, have a language impairment caused by an actual lesion to the occipital-parietal area of the brain. The classification functional remedial is used for those children without definite brain damage whole capacity to read is impaired by a distrubed pattern of neurologic organization. The brain damaged-ego disturbed child is almost always hyperactive and hyperdistractible and has difficulty in making generalizations and manipulating verbal concepts. The organic and functional remedial children can function with normal behavior until they encounter a situation dealing specifically with interpreting reading material, at which time they may withdraw or act out frustrations aggressively. The verbal IQ is significantly higher than the performance IQ in the ego distrubed child, while the reverse is true for the organic and functional remedials. References are included. (CM)