I need to follow this thread. My son has the exact same issue. Although, in his case, I have noticed that maybe 50% of the time it does change the meaning ever so slightly. I notice it is more problematic in word problems (math) because accuracy is more important there - it has more of an impact. I'd love to hear suggestions of how to help this. One of his OTS suggested his using the Tubaloo http://www.amazon.com/WhisperPhone-Solo-Grades-K-4-HB-WPS1/dp/B002UJCYI0 while he reads out loud to me. He's been using it for two months and his reading improved nicely (not sure if it were just developmental or due to tubaloo) but he still skips words and substitutes. I also pretty much make him read out loud to me for 15 mintutes a day. He wants/likes to read silently but with all his word skipping and such he'll only reinforce bad habits... I am hoping the repition of him reading out loud with me making him go back each time he skips a word will help. Anyway, really interested to hear suggestions!