How many parents and professionals have experienced the following scenario? The child in question is reading very fluently (Landi & Ryherd, 2017) but comprehending very little of what s/he is reading. Attempts at remediation follow (oftentimes without the administration of a comprehensive assessment) with a focus on reading texts and answering text-related questions. However, much to everyone’s dismay the problem persists and worsens over time. The child’s mental health suffers as a result since numerous studies show that reading deficits including dyslexia are associated with depression, anxiety, attention, as well as behavioral problems (Arnold et al., 2005; Knivsberg & Andreassen, 2008; Huc-Chabrolle, et al, 2010; Kempe, Gustafson, & Samuelsson, 2011; Boyes, et al, 2016; Livingston et al, 2018). Continue reading Comprehending Reading Comprehension
Those of you familiar with my blog, know that a number of my posts take on a form of extended responses to posts and comments on social media which deal with certain questionable speech pathology trends and ongoing issues (e.g., controversial diagnostic labels, questionable recommendations, non-evidence based practices, etc.). So, today, I’d like to talk about sweeping general recommendations as pertaining to literacy interventions. Continue reading But is this the Best Practice Recommendation?
In my previous posts, I’ve shared my thoughts about picture books being an excellent source of materials for assessment and treatment purposes. They can serve as narrative elicitation aids for children of various ages and intellectual abilities, ranging from pre-K through fourth grade. They are also incredibly effective treatment aids for addressing a variety of speech, language, and literacy goals that extend far beyond narrative production. Continue reading Speech, Language, and Literacy Fun with Karma Wilson’s “Bear” Books
Because the children I assess, often require supplementary reading instruction services, many parents frequently ask me how they can best determine if a reading specialist has the right experience to help their child learn how to read. So today’s blog post describes what type of knowledge reading specialists ought to possess and what type of questions parents (and other professionals) can ask them in order to determine their approaches to treating literacy-related difficulties of struggling learners. Continue reading Dear Reading Specialist, May I Ask You a Few Questions?
SLPs are constantly on the lookout for good quality affordable materials in the area of literacy. However, what many clinicians may not realize is that there are massive amounts of FREE evidence-based literacy-related resources available online for their use. These materials can be easily adapted or implemented as is, by parents, teachers, speech-language pathologists, as well as other literacy-focused professionals (e.g., tutors, etc.).
Below, I have compiled a rather modest list of my preferred resources (including a few articles) for children aged Pre-K-12 grade pertaining to the following literacy-related areas: Continue reading Free Literacy Resources for Parents and Professionals
Picture books are absolutely wonderful for both assessment and treatment purposes! They are terrific as narrative elicitation aids for children of various ages, ranging from pre-K through fourth grade. They are amazing treatment aids for addressing a variety of speech, language, and literacy goals that extend far beyond narrative production. Continue reading Speech, Language, and Literacy Fun with Helen Lester’s Picture Books
Today I want to talk treatment. That thing that we need to plan for as we are doing our assessments. But are we starting our treatments the right way? The answer may surprise you. I often see SLPs phrasing questions regarding treatment the following way: “I have a student diagnosed with ____ (insert disorder here). What is everyone using (program/app/materials) during therapy sessions to address ___ diagnosis?”
Of course, the answer is never that simple. Just because a child has a diagnosis of a social communication disorder, word-finding deficits, or a reading disability does not automatically indicate to the treating clinician, which ‘cookie cutter’ materials and programs are best suited for the child in question. Only a profile of strengths and needs based on a comprehensive language and literacy testing can address this in an adequate and targeted manner.
To illustrate, reading intervention is a much debated and controversial topic nowadays. Everywhere you turn there’s a barrage of advice for clinicians and parents regarding which program/approach to use. Barton, Wilson, OG… the well-intentioned advice just keeps on coming. The problem is that without knowing the child’s specific deficit areas, the application of the above approaches is quite frankly … pointless.
There could be endless variations of how deficits manifest in poor readers. Is it aspects of phonological awareness, phonics, morphology, etc. What combination of deficits is preventing the child from becoming a good reader?
Let’s a take a look at an example, below. It’s the CTOPP-2 results of a 7-6-year-old female with a documented history of extensive reading difficulties and a significant family history of reading disabilities in the family.
Results of the Comprehensive Test of Phonological Processing-2 (CTOPP-2)
|Subtests||Scaled Scores||Percentile Ranks||Description|
|Elision (EL)||7||16||Below Average|
|Blending Words (BW)||13||84||Above Average|
|Phoneme Isolation (PI)||6||9||Below Average|
|Memory for Digits (MD)||8||25||Average|
|Nonword Repetition (NR)||8||25||Average|
|Rapid Digit Naming (RD)||10||50||Average|
|Rapid Letter Naming (RL)||11||63||Average|
|Blending Nonwords (BN)||8||25||Average|
|Segmenting Nonwords (SN)||8||25||Average|
However, the results of her CTOPP-2 testing clearly indicate that phonological awareness, despite two areas of mild weaknesses, is not really a significant problem for this child. So let’s look at the student’s reading fluency results.
Reading Fluency: “LG’s reading fluency during this task was judged to be significantly affected by excessive speed, inappropriate pausing, word misreadings, choppy prosody, as well as inefficient word attack skills. While she was able to limitedly utilize the phonetic spelling of unfamiliar words (e.g., __) provided to her in parenthesis next to the word (which she initially misread as ‘__’), she exhibited limited use of metalinguistic strategies (e.g., pre-scanning sentences to aid text comprehension, self-correcting to ensure that the read words made sense in the context of the sentence, etc.), when reading the provided passage. To illustrate, during the reading of the text, LG was observed to frequently (at least 3 times) lose her place and skip entire lines of text without any attempts at self-correction. At times she was observed to read the same word a number of different ways (e.g., read ‘soup’ as ‘soup’ then as ‘soap’, ‘roots’ as ‘roofs’ then as ‘roots’, etc.) without attempting to self-correct. LG’s oral reading rate was also observed to be impaired for her age/grade levels. Her prosody was significantly adversely affected due to lack of adequate pausing for punctuation marks (e.g., periods, commas, etc.). Instead, she paused during text reading only when he could not decode select words in the text. Though, LG was able to read 70 words per minute, which was judged to be grossly commensurate with grade-level, out of these 70 words she skipped 2 entire lines of text, invented an entire line of text, as well as made 4 decoding errors and 6 inappropriate pauses.”
So now we know that despite quite decent phonological awareness abilities, this student presents with quite poor sound-letter correspondence skills and will definitely benefit from explicit phonics instruction addressing the above deficit areas. But that is only the beginning! By looking at the analysis of specific misreadings we next need to determine what other literacy areas need to be addressed. For the sake of brevity, I can specify that further analysis of this child reading abilities revealed that reading comprehension, orthographic knowledge, as well as morphological awareness were definitely areas that also required targeted remediation. The assessment also revealed that the child presented with poor spelling and writing abilities, which also needed to be addressed in the context of therapy.
Now, what if I also told you that this child had already been receiving private, Orton-Gillingham reading instruction for a period of 2 years, 1x per week, at the time the above assessment took place? Would you change your mind about the program in question?
Well, the answer is again not so simple! OG is a fine program, but as you can see from the above example it has definite limitations and is not an exclusive fit for this child, or for any child for that matter. Furthermore, a solidly-trained in literacy clinician DOES NOT need to rely on just one program to address literacy deficits. They simply need solid knowledge of typical and atypical language and literacy development/milestones and know how to create a targeted treatment hierarchy in order to deliver effective intervention services. But for that, they need to first, thoughtfully, construct assessment-based treatment goals by carefully taking into the consideration the child’s strengths and needs.
So let’s stop asking which approach/program we should use and start asking about the child’s profile of strengths and needs in order to create accurate language and literacy goals based on solid evidence and scientifically-guided treatment practices.
Helpful Resources Pertaining to Reading:
- Earle, G. A., Sayeski, K. L (2017) Systematic Instruction in Phoneme-Grapheme Correspondence for Students With Reading Disabilities. Intervention in School and Clinic. Vol. 52(5) 262–269
- The Florida Center for Reading Research (FCRR)
- Hasbrouck, J. & Tindal, G. A. (2006). Oral reading fluency norms: A valuable assessment tool for reading teachers. The Reading Teacher. 59(7), 636-644.
- O’Connor, R (2017) Reading Fluency and Students With Reading Disabilities: How Fast Is Fast Enough to Promote Reading Comprehension? Journal of Learning Disabilities
- Tolman, C (2005) Working Smarter, Not Harder: What Teachers of Reading Need to Know and Be Able to Teach IDA Perspectives pp. 15-23.
- Toste et al (2016) Reading Big Words: Instructional Practices to Promote Multisyllabic Word Reading Fluency Intervention in School and Clinic pp. 1–9
- Zipoli, R (2017) Unraveling-Difficult-Sentences: Strategies to Support Reading Comprehension. Intervention in School and Clinic, Vol. 52(4) 218–227. Intervention in School and Clinic, Vol. 52(4) 218–227
September is quickly approaching and school-based speech language pathologists (SLPs) are preparing to go back to work. Many of them are looking to update their arsenal of speech and language materials for the upcoming academic school year.
With that in mind, I wanted to update my readers regarding all the new products I have recently created with a focus on assessment and treatment in speech language pathology.
My most recent product Assessment of Adolescents with Language and Literacy Impairments in Speech Language Pathology is a 130-slide pdf download which discusses how to effectively select assessment materials in order to conduct comprehensive evaluations of adolescents with suspected language and literacy disorders. It contains embedded links to ALL the books and research articles used in the development of this product.
Effective Reading Instruction Strategies for Intellectually Impaired Students is a 50-slide downloadable presentation in pdf format which describes how speech-language pathologists (SLPs) trained in assessment and intervention of literacy disorders (reading, spelling, and writing) can teach phonological awareness, phonics, as well as reading fluency skills to children with mild-moderate intellectual disabilities. It reviews the research on reading interventions conducted with children with intellectual disabilities, lists components of effective reading instruction as well as explains how to incorporate components of reading instruction into language therapy sessions.
Dysgraphia Checklist for School-Aged Children helps to identify the students’ specific written language deficits who may require further assessment and treatment services to improve their written abilities.
Processing Disorders: Controversial Aspects of Diagnosis and Treatment is a 28-slide downloadable pdf presentation which provides an introduction to processing disorders. It describes the diversity of ‘APD’ symptoms as well as explains the current controversies pertaining to the validity of the ‘APD’ diagnosis. It also discusses how the label “processing difficulties” often masks true language and learning deficits in students which require appropriate language and literacy assessment and targeted intervention services.
Checklist for Identification of Speech Language Disorders in Bilingual and Multicultural Children was created to assist Speech Language Pathologists (SLPs) and Teachers in the decision-making process of how to appropriately identify bilingual and multicultural children who present with speech-language delay/deficits (vs. a language difference), for the purpose of initiating a formal speech-language-literacy evaluation. The goal is to ensure that educational professionals are appropriately identifying bilingual children for assessment and service provision due to legitimate speech language deficits/concerns, and are not over-identifying students because they speak multiple languages or because they come from low socioeconomic backgrounds.
Comprehensive Assessment and Treatment of Literacy Disorders in Speech-Language Pathology is a 125 slide presentation which describes how speech-language pathologists can effectively assess and treat children with literacy disorders, (reading, spelling, and writing deficits including dyslexia) from preschool through adolescence. It explains the impact of language disorders on literacy development, lists formal and informal assessment instruments and procedures, as well as describes the importance of assessing higher order language skills for literacy purposes. It reviews components of effective reading instruction including phonological awareness, orthographic knowledge, vocabulary awareness, morphological awareness, as well as reading fluency and comprehension. Finally, it provides recommendations on how components of effective reading instruction can be cohesively integrated into speech-language therapy sessions in order to improve literacy abilities of children with language disorders and learning disabilities.
Improving Critical Thinking Skills via Picture Books in Children with Language Disorders is a partial 30-slide presentation which discusses effective instructional strategies for teaching language disordered children critical thinking skills via the use of picture books utilizing both the Original (1956) and Revised (2001) Bloom’s Taxonomy: Cognitive Domain which encompasses the (R) categories of remembering, understanding, applying, analyzing, evaluating and creating.
From Wordless Picture Books to Reading Instruction: Effective Strategies for SLPs Working with Intellectually Impaired Students is a full 92 slide presentation which discusses how to address the development of critical thinking skills through a variety of picture books utilizing the framework outlined in Bloom’s Taxonomy: Cognitive Domain which encompasses the categories of knowledge, comprehension, application, analysis, synthesis, and evaluation in children with intellectual impairments. It shares a number of similarities with the above product as it also reviews components of effective reading instruction for children with language and intellectual disabilities as well as provides recommendations on how to integrate reading instruction effectively into speech-language therapy sessions.
Best Practices in Bilingual Literacy Assessments and Interventions is a 105 slide presentation which focuses on how bilingual speech-language pathologists (SLPs) can effectively assess and intervene with simultaneously bilingual and multicultural children (with stronger academic English language skills) diagnosed with linguistically-based literacy impairments. Topics include components of effective literacy assessments for simultaneously bilingual children (with stronger English abilities), best instructional literacy practices, translanguaging support strategies, critical questions relevant to the provision of effective interventions, as well as use of accommodations, modifications and compensatory strategies for improvement of bilingual students’ performance in social and academic settings.
Comprehensive Literacy Checklist For School-Aged Children was created to assist Speech Language Pathologists (SLPs) in the decision-making process of how to identify deficit areas and select assessment instruments to prioritize a literacy assessment for school aged children. The goal is to eliminate administration of unnecessary or irrelevant tests and focus on the administration of instruments directly targeting the specific areas of difficulty that the student presents with.