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Literacy

Reading Disorders

IDEA and NCLB 2004 described the essential components of reading instruction to be phonemic awareness, phonics, vocabulary development, fluency including oral reading and reading comprehension.  Difficulties can occur in the production, comprehension, and awareness within any language component at the sound, syllable, word, sentence, and discourse levels. 

There is a lot of discrepancy between disciplines on who is responsible for assessing and treating reading disorders.  Mostly b/c of lack of education on the topic.  There are "Reading Teachers".  In fact, my mother was one of the first certified Reading Teachers in NYC.  So in Grad School, when given the difficult assignment of differentiating SLP's training in reading and Reading Teachers by Dr. Valenti, immediately we all cried as usual, but when finished and able to find the answer, satisfaction run throughout.  Unfortunately, as with a lot of the disorders we treat, this one is very high up there in knowing if it is under our umbrella.  However, we should only assess and treat what we feel comfortable treating.  If we have no experience - we teach ourselves.  Though some, from reading online groups, appear not to do that process and just say "we never learned it".  I never learned any treatment in Grad School.  I was prompted and I looked them up myself, taught myself and was corrected if I was wrong - Though corrected by myself.  Our Supervision style was unique and amazing thanks to Dr. Geller to say the least.  It wasn't just a Supervision style - it was a lifestyle change called "Reflection". 

I've said this before, and I'll continue to say it.  We (as SLP's) were all taught differently.  We were taught different theories, different skill sets, different treatments, and when we become clinicians it's then up to us to continue to do what is correct in maintaining educating ourselves (not only for credit) but when teaching ourselves how to assess or treat for instance - look up research and know how to read the literature.  Base it on experience whether it be our own or consensus of others.  And always consider whether it's ethical. 

At the bottom you can find and download a free ebook provided from Nat'l Center from Learning Disabilities about Dyslexia that is very helpful


Reading; Defined

Phonemic Awareness

Phonemic awareness is the ability to identify phonemes as the units comprising syllables and words, and usually appears in children at age 6 or 7 (Bankson & Bernthal, 2007).  Phonemic awareness is the acknowledgement that spoken words contain smaller sound elements (the units comprising syllables and words).  It requires metalinguistic skills and a child’s ability to separate a word from its meaning.  Children who are learning to read must be able to understand that written words are composed of graphemes, which is necessary in learning to decode.  Difficulties in decoding can impair word recognition, which in turn influences reading fluency and comprehension.  Phonemic awareness requires both cognitive and language skills (Catts & Kamhi, 2005).

Rhyme, Alliteration, and Syllable Awareness have been viewed as developmental early indicators of phonological awareness.  It is also the foundation for learning the alphabetic principle which is an essential part of reading.  Bankson & Bernthal (2007) state “children must coordinate knowledge about print form with that of phonological structure”.   A child who experiences slight hearing loss or possibly undetected hearing loss during these developmental years may not fully acquire or maintain the phonological system which can later impact decoding skills.   That is why it is necessary to get an audiological evaluation before pursuing reading therapy.  Pre-school children with phonological impairments are more likely to encounter problems with phonological awareness and literacy. 

We are trained to distinguish between a speech and language disorder and a language difference.  A child may have a regional or social dialect that an SLP would be able to differentiate from a speech disorder.  Labov (2003) defines dialect as “a phonological or grammatical feature that varies with a readers language background”.  Differences in dialect are likely to influence the child’s learning of sound/symbol relationships (Adger et., al, 2007).  By identifying these differences, the SLP can therefore reduce disproportionality rates associated with misidentification and the misclassification of students with language differences. 


Phonics

Phonics a grapheme-phoneme correspondence defined as a student’s ability to internalize and automate alphabetical symbols as representative of phonemes (Gravani & Meyer, 2007). Phonics improves word recognition, spelling and reading comprehension.  Reading instruction in the primary grades focuses on teaching children to decode words. Longitudinal studies have shown that phonological skills are the fundamentals for decoding.  Assisting children in developing accurate representations of the relationship between phonemes and graphemes facilitates reading achievement (Catts & Kamhi, 2005).  Children with dyslexia have difficulty with sound-symbol correspondence, which impedes the development of phonemic awareness and phonics (Catts & Kamhi 2005).  Teaching them the corresponding sounds and their letter names in isolation, syllable, word, and phrase level.  early on will likely reduce increased reading difficulties. 


Vocabulary Devlopment

Vocabulary development refers to a process by which one learns new words, therefore increasing their lexicon.  Increasing data demonstrates that limited vocabulary causes difficulty in reading comprehension.  As cited in Gravani & Meyer (2007), Hart and Risley (2003) found that the vocabulary use of a child was a predictive measure of later language skills and was strongly associated with reading comprehension. SLP’s can enrich a child’s vocabulary development through a multisensory approach using kinesthetic, tactile, auditory, visual, olfactory, and gustatory by exposing them to life experiences they may not have experienced otherwise.  SLP’s can enrich a child’s vocabulary for a child who may have minimal experiences or to further enhance a child’s vocabulary that is already enriched (Gravani & Meyer, 2007).  Ex.  Children who cannot orally identify words on a page are difficult to distinguish between language or comprehension difficulties when in fact they are having word finding difficulties.  When some of these children have been probed further, they are able to point to the word on the page, demonstrating that they do in fact possess the word; they cannot retrieve the sound pattern of the word.  SLP’s are trained to perform item analysis to investigate the reasons for errors on assessments rather than simply counting it as a mistake.  The SLP asks “why” the child made a mistake in order to avoid misdiagnosis.  The SLP can modify standard test taking procedures (e.g. ask the child to point to the word) to assist in proficiently assessing and evaluating the data in reading.


Fluency (Fluent Reading)

Fluency is a critical component of reading that has long been overlooked.  Fluency is defined as the ability to decode text accurately, quickly, and with proper expression.  Kamhi (2007) states, “The fluent reader is able to group words into appropriate clause or phrase units and produce these units with correct intonation, stress, and pausing.  They see clauses and phrases as chunks of text and use these chunks to read and write more quickly” (p. 1).  Fluency is contingent upon proficient word recognition and comprehension.  Proficiency in word recognition allows the reader to read quickly and accurately.  Proper expression is contingent upon awareness to syntax and punctuation cues.  Some studies have found that fluency improves with increased comprehension skills.  (Kamhi, 2007).  Word recognition encompasses knowledge of phonemic awareness, phonics, sound letter correspondence, word attack skills, and sight – word readings (Valenti, 2008).  The SLP has specialized knowledge in all of these areas.   The SLP can identify a child who is At Risk in any of those underlying deficits which may be causing difficulty in reading fluency.  Ex.  If a child is At Risk for a phonological processing disorder, the SLP can identify and treat this underlying problem which will then increase fluency in reading and/or reduce the probability of reading fluency difficulties from occurring. 

Comprehension

As cited in Gravani & Meyer (2007) & Adler & VanDoren (1972) describe reading comprehension in four levels: 

  1. Understanding the literal meaning of words and sentences
  2. Inspectional reading or systematic skimming (obtaining as much information as possible within a limited amount of time).
  3. Analytic reading (being able to think about the reading; cognitive reflection)
  4. Comparative reading (generating a critical interpretation of the text based on solid intellectual judgments).
Reading comprehension extends beyond identifying a single word.  Comprehension involves all aspects of language (Catts & Kamhi 2005).  Gravani & Meyer (2007) explain “Words seen on the page make a connection with language-based information already stored in the brain.  This language material includes sufficiently developed skills in metalinguistics, vocabulary, syntax, pragmatics, and memory, plus world knowledge, book reading experience, letter knowledge and identification, and an understanding of narratives and the organization of expository text” (p. 345). Catts & Kamhi 2005 state “There is good evidence showing that linguistic comprehension places constraints on reading comprehension” (p. 43).  SLP’s have the specialized knowledge to identify language comprehension difficulties.  The SLP can treat the language comprehension difficulty in hopes of reducing reading comprehension difficulties.  A child with pragmatic difficulties (i.e. Aspergers) may not be able to relate and use their experiences to connect with a character in a story (Gravani & Meyer, 2007).  The SLP is knowledgeable in pragmatics and the symptoms of Aspergers.  They are able to identify and treat the pragmatic symptoms for Aspergers specifically to the child’s needs in order to help them relate to and understand the characters and their feelings in the story.  By treating the underlying cause of difficulty with pragmatics, reading comprehension will increase. 


Download for free, the Dyslexia EBook from Nat'l Center for Learning Disabilities

dyslexiaebook.pdf
File Size: 12304 kb
File Type: pdf
Download File


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  • Home
  • Speech Therapy Materials Store
    • Free SLP Downloads
  • The Speech & Swallow Clinic of South Florida
    • Speech and Language Services & Payment Options
    • Client History Forms
    • About Us >
      • Contact Us
      • Sponsorship & Collaboration
  • Dysphagia
    • The Normal Swallowing Process
    • Brain & Cranial Nerves
    • Guidelines for Safe Swallowing
    • Imaging Examinations
    • Dysphagia Diagnosis
    • Hydration
    • Dysphagia Diets
    • Oral Care/Oral Hygiene
    • Predictors of Aspiration Pneumonia (AP)
    • Dysphagia Treatment Strategies >
      • Tube Feeding
  • Language
    • Developmental Milestones
    • Early Language Learning
    • Enhance Your Child's Communication
  • Aphasia
    • Symptoms of a Stroke
    • Language After Stroke
    • Aphasia Treatment
  • Autism
    • Therapy
    • Sensorimotor
    • Stimulation
  • Feeding
    • Oral Motor
    • GI Disorders in Pediatric Feeding
    • Drooling
  • Articulation vs Phonological
    • Speech Sound Development
    • Articulation Therapy Materials
  • Literacy
    • Reading
    • Processing Disorders
    • Literacy Treatment
    • Phonemic Awareness Treatment
  • Voice
    • Voice Tips
    • Voice Therapy
    • Voice Modifications
  • Motor Speech Disorders/Dysarthrias
    • Classifications of the Dysarthrias
  • Stuttering
    • Normal Fluency Development
    • Enhance Fluency at Home
    • Deal with Stuttering Effectively
  • Speech & Language Therapy Treatment Materials
    • Speech Therapy Material Links >
      • Communication Boards
      • Speech Therapy APPS
  • Patient Advance Directives
  • Resources
  • Blog/News
  • Contact Us
  • Speech Store