In the past three decades a revolution has altered the way society approaches people with disabilities. Social changes resulted in a significant increase in fundamental and applied research that seeks to improve the lives of people with disabilities by facilitating better understanding of the mechanisms, manifestations, prevention, and treatment of functional impairment. Specific Reading Disability (SRD) has benefited from this revolution. This review focuses on the evolution of SRD, new information in its neurobiology and management, and the challenges that remain. Evidence from a wide spectrum of research provides strong support for the role of phonology in Specific Reading Disability. Despite the mounting evidence, the case is far from completely established. Adults with compensated SRD read but still demonstrate disordered phonology (Felton et al. [1990] Brain Language 39:485-497). Whether poor phonology is causal or a covariant remains to be demonstrated. Of children with poor phonology, it is not known how many are poor readers. While phonology is associated with SRD, other studies have questioned the uniqueness of SRD. Challenges have been made to the method of classification, the uniqueness of phonological dysfunction as a mechanism in SRD and the response to treatment. In the final analysis all poor readers may have a common core of dysphonology, independent of whether their reading is discrepant from their IQ.