Effective metacognition powerfully supports actioning of complex tasks. The complexity of English orthography makes mastery of reading accuracy (word identification) an extremely complex task. At-risk readers thus are likely to benefit greatly from effective metacognition of reading accuracy. Optimal reading-accuracy instruction involves development of conceptual, procedural and conditional knowledges, evidenced in concept and skills development, strategy usage and metacognitive actioning. It is considered likely that metacognition of reading accuracy and metacognition of cognitive processing both support reading-accuracy mastery in children with reading disability. Student metacognition (baseline and learned) and the role of instructional scaffolding as metacognitive supports are considered integral aspects of skill mastery and generalisation. Needs for research on metacognition in reading-accuracy development are discussed.