Impact of Literacy Intervention on Achievement Outcomes of Children With Developmental Language Disorders: A Systematic Review Jaumeiko J. Coleman and Rebecca A. Venediktov National Center for Evidence-Based Practice in Communication Disorders American Speech-Language-Hearing Association, Rockville, MD Gary A. Troia Department of Counseling, Educational Psychology, and Special Education Michigan State University, East Lansing, MI Beverly P. Wang National Center for Evidence-Based Practice in Communication Disorders American Speech-Language-Hearing Association, Rockville, MD ASHA’s National Center for Evidence-Based Practice in Communication Disorders • July 2013 ABSTRACT The American Speech-Language-Hearing Purpose: In this systematic review, the Association’s National Center for Evidence- authors examined the impact of literacy Based Practice (N-CEP) was charged with intervention on achievement outcomes of developing an evidence-based systematic school-age children with developmental review (EBSR) of studies reporting on the language disorders. impact of written language (i.e., reading and writing) interventions on achievement Method: Databases containing peer- outcomes of school-aged children with reviewed academic studies were searched developmental language disorder (DLD). for randomized and nonrandomized The relatively recent adoption of the controlled trials that reported efficacy and Common Core State Standards by the bulk comparative efficacy findings in English. of the United States and its territories Methodological quality and strength of underscores the importance of this topic evidence were also evaluated. (Common Core State Standards Initiative, 2012). The standards were created to Results: Nine reading intervention studies promote quality and consistency in were accepted; no writing intervention education for all students so as to adequately studies were identified that met the inclusion prepare them for college and the workforce. criteria for this systematic review. Findings The standards stem from the domains of were grouped by reading intervention mathematics and English language arts and category (e.g., synthetic phonics) and literacy in history/social studies, science, outcome (e.g., spelling). Efficacy was noted and technical subjects. A primary for all reading intervention categories for a consideration in the development of the variety of outcomes, with synthetic phonics English language arts standards was the efficacy findings being the most prevalent, need to prepare students to (a) independently followed by analytic phonics and the whole- and proficiently use listening and speaking word method. Comparative efficacy findings to obtain, assess, and present increasingly were limited and mixed. Strength of complex information evidence ratings were strongest for synthetic (www.corestandards.org); (b) read and phonics, followed by analytic phonics. comprehend texts that increase in Conclusions: Consistent with previous complexity; and (c) write logical arguments, research, synthetic phonics interventions informational/explanatory texts, and resulted in improvements across narratives as students progress through achievement outcome categories. In future school (Common Core State Standards studies, researchers should provide both Initiative, 2012). School-aged children with statistical and clinical significance data to difficulty in any of these language domains facilitate comprehensive interpretation of are at risk for poor performance in many study findings via meta-analysis. Also, the areas of life—school, the workforce, and efficacy and comparative efficacy of writing independent functioning in aspects of intervention should be researched in this everyday living, such as engaging in self- population. care activities and managing finances (e.g., Conti-Ramsden & Durkin, 2008, 2012; Keywords: school age, developmental Graham & Hebert, 2010; Johnson, language disorder, literacy intervention, Beitchman, & Brownlie, 2010; Maughan, achievement outcomes 1995). Given the complexity surrounding the acquisition of written language skills and ASHA’s National Center for Evidence-Based Practice in Communication Disorders • July 2013 1 the accompanying profound importance of conclusion is that these children struggle these skills, the impact of various with words at the phoneme level (van interventions to habilitate DLD must be Kleeck, Gillam, & Hoffman, 2006). Given examined. that conclusion, phonics instruction—which emphasizes the acquisition of letter–sound At the inception of this EBSR, a search correspondence as well as how those letter- of the current literature base was conducted sound combinations are used in spelling and for systematic research syntheses and reading (NICHD, 2000)—appears to be a guidelines that focus on achievement natural selection for improving reading, outcomes associated with written language especially for struggling readers. Within the interventions that have been used with realm of phonics, practitioners can select school-age participants who have DLD. between several types of phonics methods. Several systematic reviews, meta-analyses, For example, synthetic phonics, which and guidelines have been published on the focuses on word decoding at the phonemic efficacy of certain therapy protocols level, and analytic phonics, which addresses designed to address deficits in reading reading at the onset–rime level, may be and/or writing (see, e.g., Duff & Clarke, selected on the basis of a clinician’s beliefs 2010; Gersten et al., 2008; Graham & Perin, about the client’s method as well as current 2007; National Institute of Child Health and skill level. As an alternative, some Human Development [NICHD], 2000; U.S. researches have suggested using a whole- Department of Education, 2010; Wanzek, word method. Although children with Wexler, Vaughn, & Ciullo, 2010). Reading language-based disorders who have reading interventions tended to be based on phonics difficulty may present with phonological and/or whole-word methods, whereas and orthographical processing impairments, writing interventions typically addressed the the former tends to be the core deficit, and, development of skills associated with as such, some researchers have suggested improving the writing process and/or that the relatively unimpaired route (i.e., use product. of a whole-word method) should be used for A variety of reading interventions have reading instruction (Foorman, Breier, & been implemented across disorder Fletcher, 2003). In fact, rapid word categories; many of these interventions are recognition is thought to be a function of based on different theories of reading skilled readers’ ability to recognize a whole development progression (see, e.g., Chall, word as quickly as they can name a single 1983) and the reading process (see, e.g., letter (Ehri & Snowling, 2004). It has been Adams, 1990). These theories have led to surmised that because whole words the implementation of phonics, the whole- correspond more consistently with spoken word method, or a hybrid of the two, all of words, they are easier to access than single which form the basis for the bulk of reading letters or entire sentences (Ehri & Snowling, interventions previously researched. 2004). Findings from a systematic review on Phonological processing deficits—such as the impact of phonics in teaching reading impaired phonological awareness, and spelling revealed a positive effect of phonological memory, or phonological systematic synthetic or analytic phonics learning; nonword repetition; and rapid instruction on reading accuracy when automatic naming—are thought to be the compared with a whole-language or whole- primary causes of specific reading disability word method (Torgerson, Brooks, & Hall, (Lyon, 1995; Lyon, Shaywitz, & Shaywitz, 2006). Nonstatistically significant findings 2003). As such, a logical and substantiated ASHA’s National Center for Evidence-Based Practice in Communication Disorders • July 2013 2 corresponding with negligible effect sizes better understand the effect of written (in favor of systematic phonics instruction) language interventions on the academic were noted for all other outcomes (e.g., achievement of school-aged children with reading comprehension, spelling). No DLD and to determine whether particular significant differences were noted between written language interventions may be more the outcomes of synthetic phonics or less advantageous for children with DLD. instruction versus analytic phonics Prior to initiating this EBSR, we considered instruction. the following two issues pertaining to DLD that affect the characterization of the A substantial amount of writing participant population for this EBSR: intervention efficacy research has been completed on other populations of school- 1. Several definitional concerns exist that aged children—in particular, children with complicate attempts to identify, from learning disabilities, a population that study to study, those participants who includes children with language-based might fall into the DLD category. learning difficulties. For example, 2. These definitional issues result in considerable improvements in writing different implications for researchers, achievement have been noted across studies who focus on etiology and disorder of children with learning disabilities (LD). classification, and clinicians, who Emphasis on handwriting and writing concentrate on language intervention mechanics (e.g., spelling, capitalization, and needs in order to achieve targeted