Reading skills progress in a stage-like manner. There is no evidence that reading, unlike language, develops without direct instruction. Failing to develop preceding skills has a dramatic impact on development of more sophisticated cognitive skills. For example, children who have poor phonemic sensitivity struggle to develop phonetic decoding; poor word recognition and word decoding skills have a negative impact on reading comprehension. Primary care physicians need to be aware of reading problems and frequent comorbid conditions. Recognition of risk factors can help physicians direct children early to badly needed resources, which, at the least, decreases the risk for and minimize the impact of one additional challenge for these children.