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Comprehensive Assessment and Treatment of Literacy Disorders In Comprehensive Assessment and Treatment of Literacy Disorders in Speech-Language Pathology Created by Tatyana Elleseff MA CCC-SLP Smart Speech Therapy LLC For Individual Use Only. Do not resell, copy, or share downloads. Do not remove copyright. WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Overview This presentation 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. WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Learning Objectives At the end of this presentation learners will be able to: Identify formal literacy assessment instruments sensitive to detection of dyslexia and other literacy deficits in children 3.6-18.0 years of age Describe informal literacy assessment procedures to supplement formal testing List components of effective literacy instruction for struggling learners Explain how to effectively incorporate components of reading instruction into speech language therapy sessions WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Hierarchy of Language Development Receptive Language Comprehension of words, phrases, sentences, stories Expressive Language Speaking single words, phrases, sentences, engaging in conversations, producing stories Reading Words, sentences, short stories, chapter books, etc. General topics Domain specific topics (science, social studies, etc.) Spelling Writing Words, sentences, short stories, essays Language develops along a continuum with listening comprehension and oral expression being the foundational framework for development of later more complex abilities such as reading, spelling, and writing Thus effective language interventions for struggling learners involve working on reading, writing, and spelling (literacy) in conjunction with listening comprehension and oral expression WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Why Should SLPs Address Literacy? ASHA Literacy Gateway: “(SLPs) have the specialized knowledge and experience needed to identify communication problems and to provide the help that children need to build critical language and literacy skills” As per, Snowling & Hulme, 2012: “Aside from children who ‘can listen and speak well’, yet have difficulty learning to read (dyslexia), the main risk factor for reading disorders is problematic language development” (pg. 27) Language and phonological skills are the foundations of literacy development SLPs play a critical role in the identification of children who are likely to go on to have literacy difficulties and are well positioned to intervene Aspects of oral language ability beyond phonology provide the foundation for reading comprehension (Bowyer-Crane, et al, 2007; Oakhill, Cain, & Bryant, 2003; Muter, Hulme, Snowling, & Stevenson, 2004) Reading comprehension relies on the interaction of decoding + linguistic comprehension Variations in linguistic comprehension depend upon a range of factors including vocabulary and grammatical abilities and resources such as attention (Bowyer-Crane, et al, 2007) WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Definition of Dyslexia As per International Dyslexia Association (IDA) “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.” IDA definition affirms the fact that dyslexia is a linguistically based disability WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Select Dyslexia Myths Myth 1: Dyslexia can be diagnosed based on a single test! DYSLEXIA CANNOT BE CONFIRMED BY THE ADMINISTRATION OF ONE SPECIFIC TEST. A comprehensive battery of tests (from a single or multiple adequately trained professionals) needs to actually be administered in order to confirm the presence of reading based disabilities Myth 2: A doctor can diagnose dyslexia! Physicians do not have adequate training to diagnose learning disabilities, the same way they cannot diagnose speech and language problems. Both lie squarely outside of their scope of practice! A doctor can listen to parental concerns and suggest an appropriate plan of action (recommend relevant professionals to assess deficit areas) but they couldn’t possibly diagnose dyslexia which is made on the basis of multiple assessments. Myth 3: Speech Language Pathologists cannot perform dyslexia testing! Speech language pathologists trained in identification of reading and writing disorders are fully qualified to perform significant portions of dyslexia battery. WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Dyslexia and the Brain Developmental dyslexia is frequently associated with atypical brain structure and function within regions of the left hemisphere reading network. Reading is supported by a network of regions in the left hemisphere (Price,2012), including the occipito-temporal, temporo-parietal, and inferior frontal cortices. The occipito-temporal cortex holds the “visual word form area.” (IDA) Both the temporo-parietal and inferiorfrontal cortices play a role in phonological and semantic processing of words, with inferior-frontal cortex also involved in the formation of speech sounds. Children with dyslexia demonstrate reduced cortical thickness within previously identified reading areas including bilateral occipitotemporal and occipitoparietal regions as well as increased gyrification in left occipitotemporal and right superior frontal cortices (Williams et al, 2017) WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Dyslexia and IQ Tanaka et al, 2011 found that fMRIs of children with dyslexia with low IQs had the same patterns of brain circuitry abnormalities as those of the children with dyslexia with normal IQs Both groups had less activity in the two left hemisphere brain regions that are often less active in dyslexics. Children's reading disability is not related to their IQ alone but to identifiable patterns of abnormal brain function Regardless of IQ, poor readers have similar kinds of reading difficulties in relation to phonological processing Children with lower than average IQ should receive the same reading help that is offered to normal IQ children with dyslexia, as they too will benefit from the targeted reading interventions WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Dyslexia Controversy There’s significant controversy over the use of the label “dyslexia” In their book: “The Dyslexia Debate” Julian G. Elliott and Elena L. Grigorenko argue that the label is a cultural meme that remains unscientific and conceptually problematic The end of dyslexia? (article on the topic HERE) While the term “dyslexia” does not automatically explain what type of specific reading-related deficits the child is experiencing or what prevents him/her from reading effectively, it does alert professionals to the fact that a reading disability EXISTS For the purpose of this presentation rather than utilizing the term “dyslexia”, a more broad term “literacy deficits” will be used to refer to children who experience difficulty with reading, writing, and spelling WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Genetics of Literacy Disorders Children with immediate and/or extended family members with diagnoses such as “dyslexia”, “reading disability”, “learning disability” or special education placements during school years are significantly more at risk of developing literacy based deficits than children with no history of above family problems Dyslexia and learning disabilities are due to multifactorial inheritance - combination of genes from both parents interacts with environmental factors Linked to specific gene FOXP2 (involved in fine motor control) Dyslexia (Scerri & Schulte-Korne, 2010) Learning disability (Bishop, 2009) Speech Sound Disorders (SSD) share genetic contribution with dyslexia and later developing reading difficulties (Stein at al, 2004) WWW.SMARTSPEECHTHERAPY.COM Copyright © 2013 Smart Speech Therapy LLC Page ‹#› Idiopathic Causation A number of children with no recognizable family history of learning disabilities, may be at risk
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