A child who shows significant language delays or difficulties may be considered at risk. Children who have had early onset learning issues, i.e. chronic ear infections, may be at risk. Children who struggle with rhyming, are slow to learn the connection between letters and sounds, unable to recall the right word, slow to add new vocabulary words, unable to follow multi-step directions are at risk. In order to have reading success, these prerequisites must be in place. If children who are struggling with reading get effective phonological training in kindergarten and first grade, they will have significantly fewer problems learning to read at grade levels than do children who are not identified or helped until third grade.