Written Language Disorders SPEECH-LANGUAGE PATHOLOGISTS AS UNIQUELY QUALIFIED PROFESSIONALS Oklahoma Speech-Language Hearing Association (OSHA) October 2018 Nicole Power, M.S., M.Ed., CCC-SLP Advanced Organizer What you will learn today ¡ Research and information about written language disorders ¡ How SLPs are uniquely qualified to support struggling readers What you will not learn today ¡ The” right way” to approach this ¡ “The” answer Written Language Disorders Wait….what do you mean ‘Written Language Disorder’? Written Language Disorders What is a written language disorder? ASHA says, “A disorder of written language involves a significant impairment in fluent word recognition (i.e., reading decoding and sight word recognition), reading comprehension, written spelling, or written expression (i.e., written composition; Ehri, 2000; Gough & Tunmer, 1986; Kamhi & Catts, 2012; Tunmer & Chapman, 2007, 2012). A word recognition disorder is also known as dyslexia. Source: https://www.asha.org/Practice-Portal/Clinical-Topics/Written-Language-Disorders/ There is not a universal definition of dyslexia “Although researchers have studied dyslexia for over a century, there is still much debate about how dyslexia differs from other reading difficulties and how to support students labeled dyslexic. Nevertheless, dyslexia policy and practice are steeped in authoritative discourse that speaks of a definitive definition, unique characteristics, and prescribed intervention programs that are not well supported by research.” Worthy, J., Svrcek, N., Daly-Lesch, A., S. Tily (2018). “We know for a fact”: Dyslexia interventionists and the power of authoritative Discourse. Journal of Literacy Research, p1-24 Lombardino, L. & Guager, L. (2015). Dyslexia: Why is this diagnosis so challenging? Sig 1 Perspectives ASHA. Popular Definitions- 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.” The IDA also defines dyslexia as “…a language-based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and pronouncing words.” https://dyslexiaida.org/definition-of-dyslexia/ https://dyslexiaida.org/dyslexia-basics/ Reid, L., Shaywitz, S., Shaywitz, B. (2003). Defining Comorbidity, Teachers’ Knowledge of Language and Reading. Annals of Dyslexia. 53, page 1. Who’s right? No universally accepted definition of reading disorders at this time. Parents suspect dyslexia and go to Professional A and are told the child doesn’t have dyslexia, but does have written language issues or specific learning disability. So parents then go to Professional B who says the child does have dyslexia. This is why parents talk among themselves and label Professional A as someone who doesn’t have a clue and Professional B as the one with all the answers. The reality is that both professionals may be equally competent in assessing the child, but are utilizing different definitions, theoretical frameworks, or discipline specific labels. Elliott, J., Grigorenko, E (2014). The dyslexia debate. Cambridge University Press. Does anyone agree on anything? Does anyone agree on anything? Yes ¡ In general, most professionals agree that a child with Intellectual Disabilities (ID) would not qualify as specific learning disorder, written language disorder, or dyslexia as the primary diagnosis. ¡ Professionals also agree that children with other primary diagnoses would still benefit from the same explicit, systematic, literacy instruction as those with primary diagnosis of dyslexia, written language disorder, SLD, etc. ¡ In general, most professionals look for listening comprehension skills to be significantly higher than the decoding skills and for substantial difficulties with phonological awareness tasks. Yes! Although there is disagreement about what terminology to use, there is consensus about symptoms that need further attention ¡ Family history of reading difficulties ¡ Difficulty learning the alphabet song, letters and sounds ¡ Difficulty rhyming ¡ Trouble learning left to right ¡ Trouble identifying individual sounds in words ¡ Poor spelling ¡ Knows a word one day and not the next ¡ Writing on the lines is difficult ¡ Knows phonics rules but can’t apply them effectively ¡ Misreads or omits small words like a, the, of ¡ Substitutes a word for another word with similar meaning when reading More things we know Written language disorders/reading disabilities are often hereditary Children with speech-language histories are more likely to have reading problems Reading is language-based Symptoms of reading struggles can be identified as early as Pre-K and diagnosis of dyslexia/written language disorders is generally acceptable at the end of K/beginning of 1st Myths make things muddy Seeing/writing letters backwards is a hallmark sign Can’t be diagnosed until a child is at least 9yrs old Children with dyslexia are gifted Dyslexia is a medical diagnosis so can’t be done in schools It’s a vision problem and helped with colored overlays Myth-busters Myth #1 Children see/write letters backwards ¡ Dyslexia is not a vision problem, or a problem with the eyes ¡ Writing reversals is a typical developmental stage lasting until about the end of 2nd grade Myth #2 Children can’t be diagnosed until 9yrs ¡ This myth stems from the use of an outdated discrepancy method. Allison D. Brooks, Virginia W. Berninger & Robert D. Abbott (2011) Letter Naming and Letter Writing Reversals in Children With Dyslexia: Momentary Inefficiency in the Phonological and Orthographic Loops of Working Memory, Developmental Neuropsychology, 36:7, 847-868, Ryder D, Norwich B. What's in a name? Perspectives of dyslexia assessors working with students in the UK higher education sector. Dyslexia. 2018;24:109–127. Myth-busters Myth #3 Children with dyslexia are gifted ¡ All children have strengths and weaknesses. Children with dyslexia are not more or less gifted than any other child. Myth #4 Dyslexia is a medical diagnosis ¡ Doctors are not trained to administer language, literacy, cognitive, or achievement assessments that may be used in dyslexia assessments ¡ Many professionals are qualified to diagnose dyslexia – including SLPs! ¡ “OSERS reiterates that there is nothing in the IDEA or our implementing regulations that would prohibit IEP Teams from referencing or using dyslexia, dyscalculia, or dysgraphia in a child’s IEP. “ Office of Special Education and Rehabilitative Services (OSERS) Letter to Colleagues October 23, 2015. Myth-busters Myth #5 It’s a vision problem ¡ “Most experts believe that dyslexia is a language- based disorder. Vision problems can interfere with the process of learning; however, vision problems are not the cause of primary dyslexia or learning disabilities. Scientific evidence does not support the efficacy of eye exercises, behavioral vision therapy, or special tinted filters or lenses…” AAP, AAPOS, AACO, AAO. Joint Statement: Learning disabilities, dyslexia, and vision. American Academy of Ophthalmology. July 2014. Are we talking about the same thing? When a professional or parent says a child has reading problems, what do they mean exactly? What symptoms are they talking about? When there is a diagnosis of dyslexia, written language disorder, specific learning disability, read the report. Make sure it is clear what criteria they based the diagnosis on for highest level of understanding between professionals and families. The same concept must be applied when a child is struggling with literacy, tested, and not found eligible or given a diagnosis. What was the criteria that the child did not meet? When we are explicit in our conversations about what we mean, then we can be more sure that we are being understood correctly when we are trying to help a child. Reading What’s an SLP got to do with it? SLPs have everything to do with it Scarborough, H. S. (2001). Connecting early language and literacy to later reading (disabilities: Evidence, theory, and practice. In S. Neuman & D. Dickinson (Eds.), Handbook for research in early literacy (pp. 97–110). New York, NY: Guilford Press. Reading is language based The relationship of language to literacy has been demonstrated over decades of research. Children with language disorders that were resolved by age 5 ½ were more likely to have average reading and writing. Language issues persisting past this age were more likely to have poor literacy outcomes. This means SLPs are first-line triage personnel! An SLP may be the first person to identify language or literacy issues in young children, treat them, and educate the parents about possible future needs. Snowling, M., Duff, F.., Nash, H., & C. Hulme (Dec 2016). Language profiles and literacy outcomes of children with resolving, emerging, or persisting language impairments. The Journal of Child Psychology and Psychiatry, 57(12), p. 1360-1369. “I’m not the reading