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

2. 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

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

5. 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).

6. Text is language made visible

7. 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

8. 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

9. Language is the foundation for the house of literacy

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

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

12. 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

13. 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

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

15. 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)

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

17. 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

18. 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

19. 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)

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

21. 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

22. 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 *

23. 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)

24. 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

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

26. 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

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

28. 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

29. 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

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

31. Classroom implications

32. 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

33. 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

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

35. Discussion and wrap-up