Text is language: What SLPs need to know about dyslexia Heather Gillum, PhD, CCC-SLP Speech-Language Pathologist Structured Literacy Teacher

Session objectives 1. Define dyslexia and its relationship with oral language 2. Describe the SLP’s role in reading disorders in general and for dyslexia in particular 3. Discuss best practices for dyslexia intervention

Domains of speech and language FORM Phonology Grammar/Morphology Syntax CONTENT Semantics USE Pragmatics

Language disorder Impaired comprehension and/or use of spoken, written and/or other symbol systems not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability May manifest as deficits in vocabulary (word knowledge and use) sentence structure (ability to put words and word endings together correctly to form sentences) impairments in discourse (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation).

Text is language made visible

Oral language supports literacy OBVIOUS WAYS Word recognition (decoding) and understanding are early steps in acquiring literacy Knowledge of grammar and syntax are important for comprehension as well as written expression Comprehension monitoring and correction of breakdowns are critical for reading success LESS OBVIOUS WAYS Ability to segment a word into sounds is prerequisite for acquiring sound-symbol association Emerging readers subvocalize and run reading through the expressive language system-errors there will impact comprehension Knowledge of sentence structure allows for prediction of what parts of speech and probable words are likely to be coming next, supporting reading fluency

literacy supports oral language OBVIOUS WAYS “Literate language” incorporates words and phrasing not common in conversation Vocabulary exposure Broadening of world knowledge LESS OBVIOUS WAYS Visual reinforcement of sentence schema may increase usage of more complex sentences Growing knowledge base can be used in conversation to gain further world knowledge and vocabulary

Language is the foundation for the house of literacy

Literacy and identification of language issues The increased linguistic demands of literacy reveal weaknesses that have an academic impact

LANGUAGE-BASED LEARNING DIFFERENCES Reading comprehension difficulties Written expression difficulties Reading decoding difficulties (usually dyslexic in nature)

Dyslexia “Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.” International Dyslexia Association, adopted 2002

Dyslexia is not… Due to laziness; trying harder/reading more will not help Reading backwards; it is not primarily a visual disorder Indicative of low IQ/intellectual disoability Curable; underlying neurobiological differences are likely to continue to make reading more difficult, even after successful intervneiton

Dyslexia is common Impacts 20% of the population (1 in 5) Impacts 80-90% of those with learning disabilities Most common neuro-cognitive disorder

The role of the slp in literacy “It is the position of the American Speech-Language-Hearing Association (ASHA) that speech-language pathologists (SLPs) play a critical and direct role in the development of literacy for children and adolescents with communication disorders…SLPs' knowledge of normal and disordered language acquisition, and their clinical experience in developing individualized programs for children and adolescents, prepare them to assume a variety of roles related to the development of reading and writing.” American Speech-Language Hearing Association Position Statement: Roles and Responsibilities of Speech- Language Pathologists With Respect to Reading and Writing in Children and Adolescents (2001)

Specialization in the slp field Phonology/Articulation Language Neurogenic disorders Gerontology Stuttering Voice Craniofacial and velopharyngeal disorders ELL/Cultural differences Aural rehabilitation Swallowing

KEY LANGUAGE SKILLS FOR READING Phonological awareness Ability to isolate and manipulate sounds in words as a prerequisite for letter-sound mastery Vocabulary Grammar and syntax Higher-order language comprehension Figurative language Discerning author’s purpose and motivation of characters Inference

Multifacted intervention for comorbid dyslexia and language disorder Destabilized phonological awareness, sound-symbol association, vocabulary, grammar/syntax, text structure Must address each skill intentionally, but can do so simultaneously

Comorbid dyslexia and language disorder: areas for intervention Phonological awareness Sound-symbol association Morphology Sentence structure Comprehension at concrete and abstract levels Carry-over into written expression (spelling, word usage, grammar, syntax, paragraph structure)

Training opportunities/Certification Orton-Gillingham Wilson Center for Effective Reading Instruction

Interventions: Building the language base Use item analysis from testing as well as language sampling to identify specific targets for treatment (vocabulary, grammar, syntax) Use evidence-based practices to address these needs, such as conversational recasting and modeling

Interventions: Building the language base Address vocabulary through morpheme analysis and word webs Create card decks of words related to preferred topics that cover parts of speech (subjects, verbs, places, things, etc.) for hands-on practice building sentences Use written language for explicit practice of these skills *

phonological awareness: a key language weakness in dyslexia Pre-alphabetic stage interventions to build segmentation, blending, and rhyming skills Barton Reading and Spelling System Intensive Phonological Awareness Program (Schuele)

dyslexia intervention—the gold standard Orton-Gillingham approach Multisensory Involves rote practice of sounds in words and letter-sound association Includes aspects of decoding, comprehending, and spelling, but the focus is a systematic progression through the rules for decoding, beginning with CVC words and addressing rules for vowels, blends, and morphemes

INTERVENTIONS: reading decoding and comprehension Orton-Gillingham approaches: Wilson Reading Program SPIRE Reading Intervention System Additional support for comprehension: Visualizing and Verbalizing (Lindamood Bell)

Sequence of a typical wilson session Pre-alphabetic or alphabetic drills Syllable or word decoding Phrase/Sentence reading Passage reading Sound drills in reverse Spelling words Writing sentences

Embedding language intervention Syllable or word decoding Embedded morpheme study/related words Word webs Use single words or multiple words in spoken sentences

Embedding language intervention Phrase/Sentence reading Load sentences with targeted grammatical and syntactic targets Pull out targets and write out similar sentences using a model

Embedding language intervention Phrase/Sentence reading Load sentences with targeted grammatical and syntactic targets Pull out targets and write out similar sentences using a model

Embedding language intervention Passage reading Follow up with both concrete and abstract questions that address specific goals Written responses to reading followed by proofreading

Classroom implications

Classroom supports Check-ins for understanding of assignments Provide graphic organizers to support reading comprehension and organization of information for writing Provide ample background information prior to beginning novel studies, etc. Use images such as word webs and sentence diagramming to illustrate relationships among words, grammar, and syntax Allow choice of assignments when possible (book report projects, etc.) Establish a system for handling unfinished work

ACCOMMODATOINS Be prepared to reiterate instruction, saying the same thing in another way to bolster understanding as needed Allow answers to be provided as lists or by highlighting answers in a passage rather than requiring written paragraphs (grading for content only whenever possible) Audiobooks are good, but once students are decoding on grade level they may prefer written text because it is easier to slow down or re-read as needed Allow oral reading of questions, verbal responses, and extra time for tests

RESOURCES Books for Teachers and Parents: Overcoming Dyslexia by Shaywitz and Shaywitz I Read It, but I Don’t Get It by Cris Tovani www.understood.com Structured Literacy Certification: Center for Early Reading Instruction Study modules on Reading Rockets

Discussion and wrap-up