Banter Speech & Language

Sydney speech pathologists helping adults and children speak for themselves.

phonological awareness

How to find out if your child has a reading problem (and how to choose the right treatment approach)

by Leave a Comment

There’s so much nonsense out there about kids’ reading problems and treatments. Unfortunately, lots of education, technology, and health businesses cash in on parents’ concerns by selling them expensive products and services unsupported by research evidence.

We get lots of calls and emails from anxious parents who are – understandably – worried about their children’s reading progress. Many are totally confused by the conflicting advice, jargon, glossy brochures and other clever marketing tricks used by different organisations to describe reading problems and how to “fix them”.

In this article, we discuss reading problems without the jargon. We also highlight reading treatment approaches that have been proven to work by high quality research.

1. Reading problems. Are they the same thing as “dyslexia”, “specific learning disorders with impairments in reading and/or writing” and “reading disabilities”?

Confusing and overlapping terms for reading problems are a big barrier for many parents looking to get reading help for their kids.

To learn to read, children need to acquire the Big Five evidence-based reading skills: phonemic awareness, phonics, vocabulary, reading comprehension skills and reading fluency. Difficulty acquiring one of more of these skills can cause reading and spelling problems.

Some reading problems – particularly to do with problems decoding written words – are called “dyslexia”. The term “dyslexia” is controversial and fiercely debated internationally for a few (good) reasons. One of the many definitions out there says that children with dyslexia usually have a significant impairment in their acquisition of:

which cannot be explained by:

  • low IQ; or
  • vision problems; or
  • neurological damage (e.g. a brain injury); or
  • (controversially) “poor educational opportunities” (Lyon et al., 2003).

You can read more about the dyslexia debate here.

Some researchers refer to statistically significant reading problems as “reading disabilities” (e.g. Galuschka et al., 2014). This term is also controversial – in part because reading (unlike talking) is “biologically unnatural” – everyone has to learn to do it from scratch, and some people can’t do it because they haven’t been taught properly. The word “disability” can also be very confronting for some worried parents.

“Specific learning disorder with impairment in reading (or writing)” is the (very wordy) language used by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (the DSM-5) the “bible” of mental health professionals in America and in many other countries, including Australia. Meeting the criteria for this disorder can be very important in some situations, e.g. to qualify for funding or special exam allowances (see below).

To side-step all this confusion, we’ll refer to reading problems as….(drum roll): “reading problems”.

2. Are all reading problems the same?

No.

Some are severe. Some are moderate. Some are mild. Some affect mainly one aspect of reading (e.g. comprehension but not decoding, as in hyperlexia). Others affect more than one aspect of reading (e.g. problems with phonological awareness, decoding, reading fluency and reading comprehension).

3. How can you find out if your child has a significant reading problem?

Most parents who contact us know their child is struggling to keep up with peers in reading, e.g. because they have observed the problems directly or have been told by their teachers.

The simplest way to get to the bottom of what’s going on is for your child to undertake a comprehensive and reliable standardised reading test. For example, in our clinic, we administer the York Assessment of Reading for Comprehension – Australian Edition (Snowling, et al., 2012) (the YARC), which has been shown to be reliable and valid for Australian school children (see YARC manual, pages 100-103).

4. You’ve seen someone about it. How severe is the problem?

In the best of worlds, your child’s speech pathologist, educator or educational psychologist would tell you clearly in their written assessment report.

In reality, some formal reports are very hard to read and understand unless you have a background in health, education or statistics. If you don’t understand the report, ask the professional to explain it in Plain English. To make reading reports easier for families, I have posted a Plain English guide to understanding standardised test scores: here.

How do we categorise reading problem severities? Consistent with published reading studies (e.g. Galuschka et al., 2014), we are of the view that a:

  • severe reading problem is where your child’s reading performance is below the ~2.5th percentile (at least two standard deviations below the average). In other words, where at least 97.5% of your child’s peers are better readers. Other rules of thumb are where your child is at least two years below grade/year level, or has at least a two-year gap between his/her actual age (also called chronological age) and reading age.
  • moderate reading problem is where your child’s reading performance is below the 16th percentile (at least one standard deviation below the average). In other words, where at least 84% of your child’s peers are better readers. Other rules of thumb are where your child is at least one year below grade/year level, or has at least a one-year gap between his/her actual age (also called chronological age) and reading age.
  • mild reading problem is where your child’s reading performance is below the 25th percentile. In other words, where at least 75% of your child’s peers are better readers.

5. Does my child need to undergo a battery of expensive IQ and other tests before he or she can get help with reading?

No. No. No.

Read the next sentence carefully:

The best evidence-based treatments for kids with reading problems are exactly the same for:

  • kids with a formal diagnosis of dyslexia or learning disorder; and
  • kids without a formal diagnosis of dyslexia or learning disorder.

(This is something many “dyslexia assessment specialists” don’t tell you.)

In some situations, a formal and expensive diagnosis (e.g. of “dyslexia” or a “Specific learning disorder with impairment in reading”) might get your child special funding or exam allowances (or both). Again, this is controversial because it favours children from families who can afford to pay health and education experts to complete batteries of expensive IQ and other tests.

But a simple (much cheaper) standardised reading assessment like the YARC will tell you if your child has a significant reading problem and needs help to learn how to read.

6. Where should professionals look for the best evidence about reading treatment approaches that work?

As with any question about evidence-based treatments for our clients, we look first to the results of randomised controlled trials (RCTs) published in peer reviewed, quality journals. RCTs reduce the risk of bias and are the most rigorous way of determining whether a treatment actually works (Sibbald & Roland, 1998). RCTs about reading treatments are particularly important because of the very opinionated squabbles that break out between different reading “experts” over the best approach to reading instruction. You can read more about RCTs and why they are considered the “gold standard” of good research here.

Interested readers can also access the full texts of several landmark reports published about effective reading instruction by following the links at the bottom of our article about what works in reading instruction, including the US National Reading Panel report of 2000.

7. So what kinds of reading treatments work?

In 2014, a so-called “Meta-Analysis” of the then-published RCTs of reading treatments was published (see citation below). Here are some of the key findings made by the authors:

  • Phonics instruction is the “only approach whose effectiveness on reading and spelling performance in children and adolescents with reading disabilities is statistically confirmed“. This finding is consistent with earlier meta-analyses published in 2001 and 2012 (McArthur et al., 2012; Ehri et al., 2001).
  • Systematic instruction of letter-sound correspondence and decoding strategies, and the application of these skills in reading and writing activities, is the most effective method for improving literacy skills of children and adolescents with reading disabilities.
  • Phonics instruction has been shown by RCTs to work in English-speaking countries, but also in studies conducted in Spain, Finland and Italy.
  • Reading fluency training alone is not an effective way to enhance the reading or spelling ability of children and adolescents with reading disabilities.
  • Phonemic awareness training has been shown to be effective for preschool children at risk for reading disabilities (e.g.  Ehri et al., 2001; Bus et al., 1999). However, as a standalone treatment, it does not appear to have a significant effect on school children’s reading or spelling performance.
  • Phonics instruction combines elements of reading fluency and phonemic awareness training; and has the potential to increase the reading and spelling performance of children and adolescents with reading disabilities.
  • Using Irlen tinted lenses and overlays does not improve literacy: positive results reported in some lower quality studies are mainly due to placebo effects. (You can read independent research about why Irlen tinted lenses and overlays are not recommended here.)
  • Auditory training focused on sub-skills underpinning reading does not significantly improve children’s reading and spelling skills.

Bottom line

High quality, peer-reviewed research evidence demonstrates that even severe reading and spelling difficulties can be ameliorated with appropriate treatment. At this stage, the best treatment approach available for children and teenagers with significant reading problems is phonics instruction. In our clinic, we’ve applied these findings to inform our approach to helping children with reading problems to read.

Related articles:

Principal source: Galuschka, K., Ise, E., Krickm K., & Schulte-Korne, G. (2014). Effectiveness of Treatment Approaches for Children and Adolescents with Reading Disabilities: A Meta-Analysis of Randomised Controlled Trials, PLOS One, 9(2), open access (full text) available here. Note the correction.

Image: http://tinyurl.com/m7qzuog

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

Kick-start your child’s reading with speech sound knowledge (phonological awareness)

by Leave a Comment

To learn to read properly, phonological awareness is:

  • one of the Big Five skills kids need to know; and
  • one of the three so-called “cognitive foundations” of literacy,

(Hulme & Snowling, 2013).

Compared to other necessary skills – like phonics and reading comprehension – it’s also harder to explain.

A. So what is phonological awareness?

  • “Phonological”, here, means relating to the study of speech sounds in language.
  • “Phonological awareness” is knowledge of speech-sound-based skills including:
    • perceiving speech sounds (e.g. the first sound in “cat” is /k/; the last sound in “cat” is /t/; the middle sound in “cat”” is /ae/);
    • identifying rhymes, e.g. (“cat” and “hat” rhyme because the so-called “rime” /aet/ sounds the same, even though the start (onset) is different);
    • identifying and manipulating syllables (or beats) in words (e.g. cat, jum-per, he-li-cop-ter; saying “butterfly” without the last syllable, gives you “butter”);
    • blending sounds into words (e.g. /k/ + /ae/ + /t/ together say “cat”);
    • segmenting words into speech sounds (e.g. “cat” is made up of three speech sounds: /k/, /ae/ and /t/); and
    • manipulating sounds (e.g. “If you say “cat” (/kaet/), without the /k/, you are left with “at” (/aet/). If you say moon without the /n/, you say “moo”; if you say “slip” without the /l/, you say “sip”).
  • “Phonological awareness” is sometimes (imprecisely) called phonemic awareness*.

B. Why does phonological awareness matter so much?

  • Phonological awareness skills are strong predictors of later reading ability (e.g. Adams, 1990; Lonigan, 2004, National Reading Panel, 2000; Melby-Lervag et al., 2012).
  • The more sensitive a child is to component sounds in words (e.g. syllables, rhymes, individual sounds), the better reader he/she is capable of becoming – regardless of intelligence, memory, receptive vocabulary and social class (e.g. Adams, 1990; Lewis et al., 2006).
  • Phoneme awareness is strongly correlated with individual differences in word reading ability, even controlling for short-term memory differences (Hulme & Snowling, 2013).

C. Do all kids learn phonological awareness skills easily?

No.

For example:

  • children with developmental language disorders and/or speech sound disorders (speech-language disorders) tend to develop phonological awareness skills more slowly than typically developing kids (e.g. Goulandris & Snowling, 2004), increasing the risk they will have later reading difficulties (e.g. Rescorla, 2002; Catts et al., 2002).
  • children who exhibit atypical speech error patterns tend to have poor phonological awareness and are at an increased risk of reading and/or spelling problems (e.g. Gillon, 2000, McNeill & Gillon, 2014).
  • there is lots of evidence of a large initial gap in phonological skills between children with developmental language and/or speech sound disorders and their typically developing peers (e.g. Puranik et al., 2010). This gap leads to ongoing reading difficulties for many children with speech-language disorders (e.g. Leitoa & Fletcher, 2004), which has knock-on effects to other academic areas (e.g. Beitchman et al., 1996).
  • as many as 47% of children with speech-language disorders may show persistent reading and spelling difficulties well into their teenage years (Stoeckel et al., 2013).
  • children diagnosed with dyslexia show a large deficit on phonological awareness tasks compared to typically developing peers (Melby-Lervag et al., 2012).

D. How do you measure it?

In Australia, we have a number of standardised phonological awareness tests to assess a child’s phonological awareness development against their peers. In our clinic, for example, we use the Sutherland Phonological Awareness Test-Revised (Neilson, 2003). Another popular assessment is the Queensland University Inventory of Literacy (Dodd et al., 1996). The Clinical Evaluation of Language Functioning-4 also has a helpful criterion-based test with cut-off scores by age.

E. Can phonological awareness skills be taught?

Yes.

More than 20 years of research has demonstrated that phonological training programs that provide early, systematic teaching can prevent reading difficulties for most children (e.g. Ehri et al., 2001, Foorman et al., 1998).

There is promising (although still limited) evidence that younger students with speech-language disorders can learn phonological awareness skills (Al Otaiba et al., 2009). However, for older children (aged 7.5 and older) with speech-language disorders, it can be a long road (e.g. Pokorni et al., 2004). For this reason, early and intense intervention for children at risk of speech-language-readings disorders is recommended (e.g. Torgesen, 2000).

F. Which phonological awareness skills should be prioritised?

Children at risk benefit most from early intervention targeting phonological skills at the phoneme (sound) level. Training should focus, in particular, on:

  • sound identification;
  • sound-letter links (e.g. Muter al el., 2004); and
  • phoneme (sound) blending, segmenting and manipulation skills,

(Warwick et al., 1993; Gillon, 2000, 2002, 2005; Ukrainetz et al., 2011; McNeil et al., 2009; Gillon & Macfarlane, 2017.)

G. How should phonological awareness skills be taught?

Phonological awareness training – especially for kids at risk of reading problems – should:

  • start early;
  • be taught explicitly and directly – particularly the links between sounds and letters;
  • include specific feedback from the teacher/speech pathologist ;
  • give the child lots of opportunity to reflect on their attempts;
  • have specific targets, with outcomes measured;
  • involve families; and
  • be culturally sensitive, especially for indigenous children (Gillon & Macfarlane, 2017).

Bottom line

There is widespread agreement that phonological skills are the foundation for learning to read and write. Early mastery of phonological skills is vital for a child’s reading development. Some children – especially kids with speech-language disorders – need extra help to acquire phonological awareness skills. For children at risk of reading problems, phonological awareness training should be started early, directly taught, and focus at the sound level.

Principal sources:
  1. Gillon, G. &  Macfarlane, A. H. (2017). A culturally responsive framework for enhancing phonological awareness development in children with speech and language impairment. Speech, Language and Hearing, published online, 23 January 2017.
  2. Hulme, C. & Snowling, M. J. (2013). Learning to read: what we know and what we need to understand better. Child Development Perspectives, 7(1), 1-5.
  3. Al Otaiba, S., Puranik, C.S., Ziolkowski, R. A., Montgomery, T.M. (2009). Effectiveness of Early Phonological Awareness Interventions for Students with Speech or Language Impairments. Journal of Special Education, 43(2), 107-128.

Free Resource: For an example of an evidence-based Phonological Awareness Training Program for 5-7 year olds, including manual and materials, click here.

* More technically, phonological awareness is knowledge about the sound structure of the language and the ability to manipulate the sounds making up that structure (Rayner, Foorman, Perfetti, Pesetsky, and Seidenberg, 2001).

Related articles:

Image: http://tinyurl.com/hddr66y

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

Is your child struggling to read? Here’s what works

by Leave a Comment

On reflection, I’m incredibly lucky.

Both my parents were teachers. Growing up, my house was full of chatter, stories and books. My early state school education in regional Victoria was long on “old school” phonics and short on fads.

I learned to read without much trouble. I discovered many of the things I’m still passionate about in life – dinosaurs, planets, social justice, travel, speech and language, consumer rights, history, current affairs, philosophy, and bad science fiction – because I could read. Reading lets me learn new skills, explore the world, entertain myself and my kids, connect with friends and colleagues, and of course, earn my living as a speech pathologist and lawyer.

Children and adults who struggle to read miss out on many of the opportunities good readers take for granted. Helping people to learn to read is important work – far too important to waste time, energy and money on false ideas and programs that don’t work.

In this article, we summarise some of the key evidence-based principles to help children (and adults) to read. We also include links to peer-reviewed evidence, leading researchers’ websites, and some evidence-based literacy programs and resources.

12 principles I apply

A. Learning to read is a right, not a privilege 

1. Reading is a human right, and affects your health, work opportunities and life-participation.

  • The General Assembly of the United Nations is convinced that: “[L]iteracy is crucial to the acquisition of every child, youth and adult, of essential life skills that enable them to address the challenges they may face in life, and represents an essential step in basic education, which is an indispensable means for effective participation in the societies and economies of the 21st century.” (GA Resolution 56/116.)
  • Low literacy may impair health, affecting the patient-doctor communication dynamics, and leading to substandard medical care. It is associated with poor understanding of written or spoken medical advice, adverse health outcomes, and negative effects on the health of the population (e.g. AHRQ Report, see below).
  • Early reading difficulties are related to children’s ability to develop positive social skills (e.g. Bennett et al., 2003).
  • Academic problems, like poor reading, often foster behavioural problems, which frequently result in disciplinary practices that remove the student from school (Christle et al., 2005).
  • Low levels of literacy affect educational attainment and labour force participation (ABS, 2009).

2. Learning to read opens doors; poor reading ability closes them. Literacy creates opportunities for lifelong learning and training, a good job, housing stability and improved health across your life (Gakidou et al., 2010). (Not being able to read has big negative effects on school achievement, job opportunities, mental health and participation in society.) Arguably, reading is more important than ever, with most jobs in the West now requiring literacy (e.g. Murnane, 2004), and with access to the Internet, social media platforms and even texting friends requiring a degree of literacy to participate socially (e.g. Durkin et al., 2011).

B. Reading instruction should be based on independent, peer-reviewed evidence (not ideology), and should take the client’s socio-economic background and oral language skills into account

3. Reading is “biologically unnatural“. Humans have only been reading since about 3000BC (Fischer, 2001). Unlike speaking, you have to learn to do it (e.g. Gough & Hillinger, 1980). That’s why literacy is still not universal (e.g. Gough, 1996). While it’s true some kids find reading easy to learn, others need a lot of help.

4. Reading instruction should be based on the “Five Big Ideas” (aka the “Big Five”). Independent, peer-reviewed scientific research evidence reviews (cited below) say that, to learn to read, you need to be taught these “Big Five”:

  • Phonemic awareness (also known as phonological awareness): knowledge about the sound structure of the language and the ability to manipulate the sound making up that structure (Rayner, Foorman, Perfetti, Pesetsky, and Seidenberg, 2001).
  • Phonics: see below.
  • Vocabulary: it’s been estimated that, to cope with the curriculum, a Year 2 child needs to understand 300-400 words; a Year 3-4 child needs to understand 3,000-4,000 words; and a Year 5 student needs 10,000! (Hempenstall, 2005).
  • Comprehension skills.
  • Reading fluency.

5. As one of the Big Five, direct synthetic phonics instruction is essential. In the USA, Australia and the UK, independent evidence reviews affirmed the need for systematic, direct and explicit phonics instruction so that children master the essential alphabetic code-breaking skills required for foundational reading proficiency. (The importance of teaching teachers to do this was recognised by the New South Wales Board of Studies in 2015 – New South Wales Board of Studies, Teaching and Educational Standards. (2015).)

The best phonics to teach children is “synthetic phonics“. Synthetic doesn’t mean “fake”, here; it means “synthesising” (or blending) the sounds (phonemes) together to read words. You can read an excellent explanation of “synthetic phonics” by some of my favourite literacy researchers here.

6. It’s a myth that you can’t use phonics to read English words. In fact, according to Hanna et al., (1996):

  • 50% of English words are directly decodable with synthetic phonics;
  • 36% have only one “breach” of the sound-letter link (usually a vowel);
  • 10% can be spelt properly if morphology and word histories/roots are taken into account; and
  • only 4% are truly irregular.

7. Oral language skills (talking and understanding) and reading skills are linked; oral language and reading skills are mutually beneficial. Improvements in spoken language skills improve reading skills, and vice versa. Oral language and reading skills piggy back on each other during the school years (Snow, 2016). If one is impaired or delayed, the other suffers. For example, children with speech-language language disorders (diagnosed or not) are at a high risk of having reading problems.

Similarly, children with reading problems may have problems learning new words and higher level language skills, which then affect their oral language development. (This, by the way, is why I screen oral language and phonological awareness in addition to decoding and reading comprehension when assessing a school-aged child with reading problems.)

8. Kids learn to read on an uneven playing field. Socio-economically disadvantaged children are at greater risk of language and reading difficulties than children from higher socio-economic backgrounds. Even though oral language development is biologically natural, it’s vulnerable to environmental factors. For example, the foundations of early language development (and the emergence of emotional security) both depend on a high dose of quality carer engagement. By the age of 4 years, on average, children of high income, professional parents may have heard 30 million more words than some children from a socio-economically disadvantaged background (e.g. Hart & Risely, 1995).

Different children have very different levels of exposure to language and books when the turn up for their first day at school. Unsurprisingly, this has knock-on effects for readiness to learn to read (see the discussion about the Matthew Effect below).

C. Evidence-based reading instruction for young struggling school-aged children is urgent: the critical 3-year window to teach children to read well

9. The 3-year learning-to-read “window”. In the first three years at school, the focus is on helping children learn to read. This is when good evidence-based reading instruction is most important. Your child’s access to good reading instruction in this period is important for all children, and vital for children from low-socioeconomic backgrounds and children struggling to read.

10. The “fourth grade slump”. Starting in the fourth year of school, the focus of the curriculum switches away from learning to read. Instead, children are expected to “read to learn”. For good readers, this is no problem. For poor readers, this is where the real trouble begins:

  • By the fourth year of school (year 3), a child’s performance relative to his/her peers becomes fairly fixed (Spira et al., 2005);
  • your child’s reading level by the start of the third grade is a good predictor of:
    • later academic achievement; and
    • later mental and social health; and
  • the “Matthew Effect” kicks into high gear.

11. The Matthew Effect. With reading (as with money), the rich get richer, and the poor get poorer. Good readers read more, learn more word meanings and then improve their reading skills. Children who are poor readers read less, and don’t learn new words as quickly, which further slows their growth in reading ability (Stanovich, 1986). As school progresses, the gap between good and poor readers grows and grows and grows.

That’s not to say that older kids and adults can’t learn to read. It’s just that it’s harder. As with language difficulties generally, the earlier you get help, the better. But it’s never too late!

D. Too many children and adults can’t read properly

12. Literacy levels are a big problem in Australia:

  • In 2011, a quarter of Australian Year 4 children are below the expected standard in reading; and 7% performed “extremely poorly” (ACER, 2012).
  • In 2009, 43.7% of adults were at or below Level 2 in their reading skills on a 5 point scale (ABS, 2009).
  • In 2011, the Industry Skills Council of Australia  found that millions of Australians have insufficient language, literacy and numeracy (“LLN”) skills to benefit from training or to participate effectively at work (ISCA, 2011).

The human, social and economic costs of low literacy are enormous.

E. So what gets in the way?

A controversial question!  Here are some candidates:

  • Professional divides: An unhelpful divide exists between the knowledge bases and expertise of teachers, speech pathologists and education psychologists. Teachers are educators, whereas psychologists and speech pathologists are health professionals. Reading failure is of course both an education and health problem. But the lack of coordination between different professionals doesn’t help clients with reading problems or their families. When I work with a school-aged child, my first port of call is the parents. My second port of call (with parents’ consent) is to teachers and any health professionals who’ve worked or are working with the child. The more we can coordinate our care and approach, prioritising the client’s interests and goals, the better things tend to go.
  • Ideological squabbling. If you’ve got a day or two to waste surfing the Internet and getting confused at all the navel gazing and self-interest, Google “Reading Wars”. In short, the “war” was fought between supporters of:
    • a phonics- and phonemic awareness-based approach to reading instruction, focused on letter-sound links and blending sounds to read words; and
    • so-called Whole-Language theories, based on post-modern theories of child development, teaching children to read words from “cues”, like context and pictures in predictable texts.

Although it was hoped that the independent reviews in the USA, UK and Australia (cited below) resolved the “reading wars” in favour of phonics and the rest of the Big Five, there are still programs influenced by Whole Language philosophies used today, including the much-maligned “Reading Recovery” program (which you can read about here). In any case, the key casualties of the war were and continue to be children failing to learn to read.

  • Inadequate training in the Big Five (and the “Peter Effect”). You can only give what you have; and you can only teach what you know. If you haven’t been taught properly how to teach reading using evidence-based teaching methods, you will have great difficulty teaching school children to read – especially struggling students. Unfortunately, some teachers, speech pathologists and psychologists haven’t been trained in how to teach reading using the evidence, especially if their University lecturers subscribed to the Whole Language ideology. Any education or health professional engaged in helping people to read should have training in how to teach the Big Five.
  • Commercial programs unsupported by independent evidence, glossy products and fads. Unfortunately, there is a big market for children and adults with poor literacy in Australia and elsewhere. Lots of reading programs seek to “exploit” this market, and some of them have no evidence to support their effectiveness. Of course, it’s hard for parents (and even some teachers) to know which ones are evidence-based. Fortunately, there are independent research groups that publish evidence summaries to assist. In our clinic, for example, we only use evidence-based programs based on the Big Five.

Whatever the reasons, we should all strive to read and apply the best quality, independent evidence to better support school-aged children, young adults, and adults with reading problems.

Related articles:

Principal source: Snow, P.C. (2016). Elizabeth Usher Memorial Lecture: Language is literacy is language – Positioning speech-language pathology in education policy, practice, paradigms and polemics. International Journal of Speech-Language Pathology, 18:3, 216-228. (This article should be mandatory reading for any teacher, speech pathologist or education psychologist working in literacy.)

Further reading

Reading as a human right that affects your health:

US AHRQ’s Evidence Report No. 87, Literacy and Health Outcomes (summary) 

Evidence for what works, including evidence supporting the Big Five:

Rose, J. (2006). The [UK] Independent Review of the Teaching of Early Reading (aka “The Rose Report”)

Evidence that too many children and adults in Australia are poor readers:

Thomson, Sue; Hillman, Kylie; Wernert, Nicole; Schmid, Marina; Buckley, Sarah; Munene, Ann (2012). Monitoring Australian year 4 student achievement internationally: TIMSS and PIRLS 2011. Melbourne: Australian Council for Educational Research (ACER).
Australian Bureau of Statistics (2009). Adult Literacy.

Industry Skills Council of Australia (2011). No More Excuses.

The role of speech pathologists in the development of literacy:

Speech Pathology Australia. (2011). Position Statement: Literacy.

On the shoulders of experts: evidence-based literacy researchers, organisations and blogs I follow: 

If you are interested in the science of reading and evidence-based reading programs and resources, here are some of the key experts, organisations and literacy/language blogs I follow closely (in no particular order):

Toe By Toe

Image: http://tinyurl.com/z3rgm3u

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

“Does Dyslexia Exist?”

by Leave a Comment

For a surefire way to ignite a global debate, simply ask this question in public.

That’s what Professor Julian “Joe” Elliott and Simon Gibbs did when they published a paper with this title in 2008 claiming that “dyslexia” is a scientifically flawed, arbitrary and potentially discriminatory diagnosis.  In 2014, Professor Elliott published a book called the “Dyslexia Debate” with Elena L. Grigorenko which expanded on these claims.

Both publications and a related TV show attracted significant attention from reading experts in the UK and around the world, as well as from families with children diagnosed with dyslexia, and dyslexia support groups and charities.  They set off a media storm, too.  For a small taste of it, check out the this screaming headline from a UK tabloid, including the comments!

Why the controversy?

Learning disorders are emotionally and politically charged topics because they involve real people with real problems as well as significant economic costs – to families and to taxpayers.

A diagnosis of dyslexia can mean the world to children and their families who may have been struggling for years to cope with the effects of reading problems.  In some places, a diagnosis can unlock funding, school places and special resources and allowances that can help children improve their reading outcomes and participation.  As a parent, I want my children to have every opportunity for success and happiness in life.  Why would I expect any other parent or carer to feel differently about their children?

On the other side of the debate are those such as Professor Elliot who argue that the diagnosis is just a ‘medical’ label for an easily detected problem – reading difficulty – and that too much money is invested on unnecessary cognitive processing and other tests – money that could be better spent delivering reading programs to children at risk.  They say it’s not fair that some children with reading problems get access to special resources, while others don’t – especially when some children’s families can’t afford to pay for the (often expensive) assessments to obtain a diagnosis from an educational psychologist or other professional.

I understand both perspectives.

Straight from the horse’s mouth

Last week, I attended a seminar presented by Professor Elliott and hosted by SPELD at the University of Sydney.  I was expecting fireworks and was a little disappointed by how polite and reasonable everyone was, including the speaker.

Professor Elliott made some persuasive points based on his review of the evidence (which he also outlined in his 2008 article):

1. IQ and other intelligence tests do not help diagnose reading disorders (including dyslexia) (Stanovich & Stanovich, 2004).  People with reading disorders exist across the intellectual spectrum.  Some are very bright.  Others aren’t.  It’s a myth that all poor readers are unintelligent.  It’s also a myth that all poor readers and “dyslexics” are gifted.  In light of the research, there is no reason to test a child’s intelligence to ascertain whether they have a reading disorder or dyslexia.

2. We don’t (yet) have any scientifically reliable way of distinguishing dyslexic readers from other poor decoders.  This is partly because…

3. No consensus exists on what dyslexia is (and isn’t):

  • Some definitions are simply a shopping list of symptoms that sometimes go along with reading decoding problems (e.g. speech and language issues, poor working memory, difficulties ordering or sequencing, clumsiness, a poor sense of rhythm, limited processing speed, poor concentration, inconsistent hand preference, poor verbal fluency, poor phonics, frequent letter reversals (e.g. “b” and “d”), difficulty doing mental calculations, low self-image and anxiety when asked to read aloud).  The problem is that items like these crop up with all sorts of other disorders and conditions, including ADHD and dyspraxia.
  • Other definitions talk about possible causes without going into much detail about what they mean.
  • Some definitions exclude people with other disorders or disabilities (e.g. hearing or vision problems, emotional and behavioural difficulties and severe neurological impairment).
  • Some definitions even exclude people from disadvantaged socio-economic backgrounds or children who have had “poor schooling” – which to me seems unfair and fuels the “class-warfare” theme captured by the tabloid headline above.
  • Some definitions require there to be a gap between the child’s (high or normal) intelligence and (poor) decoding ability – despite the fact this flies clearly in the face of the evidence.
  • Some definitions are so wide they capture all poor readers.

Definition examples:

(a) The British Psychological Society says:

“Dyslexia is evident when accurate and fluent word reading and/or spelling develops very incompletely or with great difficulty.  This focuses on literacy learning at the ‘word’ level and implies that the problem is severe and persistent despite appropriate learning opportunities.”

(b) The International Dyslexia Association – which, incidentally, claims 1 billion people have the condition and up to 20% of the population may have “some symptoms of dyslexia” – defines dyslexia as 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.”

Both these definitions are fairly loose.  What, exactly, is meant by terms like “very incompletely”, “great difficulty”, “despite appropriate learning opportunities”, “neurobiological in origin”, “typically result”, “often unexpected in relation to other cognitive abilities” and “effective classroom instruction”?

4. To date, genetics and brain function research cannot be used to diagnose dyslexia in an individual child.  There is no gene for dyslexia, although a family history of reading difficulties is a risk factor and predictor of potential reading problems.  In contrast to oral language, there is no “reading centre” in the brain.  In evolutionary terms, reading is a very recent phenomena, and universal literacy is only a very recent aim of humanity (see, e.g. Crystal, 2010, and Pinker, 1997).  Expensive brain scans are unlikely to give you as much information about a child’s reading difficulties as an inexpensive standardised reading test.  But we need to encourage continued research into both the genetics and neuro-science of reading disorders.

5. Regardless of whether a poor decoder has a dyslexia diagnosis, the recommended intervention is the same.  The best evidence-based intervention programs for people who have difficulty decoding what they read are the same for poor readers as for people with a diagnosis of dyslexia (see below).  The diagnosis shouldn’t, in theory, make a difference to the treatment of a child with reading problems.  In practice, it can make a difference, e.g. if a diagnosis of dyslexia gives a child access to support or allowances that are not available to struggling readers who do not have a diagnosis (e.g. those children from families who can’t afford to pay for the tests needed for a diagnosis).

Now – obviously – Professor Elliott’s claims represent just one side of the debate.  I want to explore some of the counterclaims made by his detractors in a future post – especially around the psychological importance of a diagnosis for those diagnosed and their families.

Clinical bottom line: what I think (and do) in practice

The debate about dyslexia is fascinating and far from over.  But, as a clinician, client care is more important to me than a socio-political debate about a word.  The key question?

How can we use current evidence about what works to help poor readers learn to read?

As summarised in some of my previous posts, my reading of the evidence tells me that:

  • reliable, valid and relatively inexpensive standardised reading assessments exist to help us identify when a child has or is at risk of a reading disorder;
  • many children with reading disorders also have oral language disorders, which should also be assessed and (if warranted) treated with reading decoding and comprehension problems;
  • early phonological awareness training on letter-sound links, blending sounds into words and segmenting words into sounds can improve later literacy outcomes (e.g. Snowling & Hulme (2005));
  • a highly structured, explicit, phonics-based approach to teaching children to read is successful for many (but not all) poor readers (e.g. Rice & Brooks, 2004; and Hatcher et al., 2006); and
  • to date, ‘bottom up’ processing treatments like working memory and auditory processing programs have not been shown to lead to independently verified improvements in reading outcomes – although work on both types of programs continues, and we must stay on top of developments in both areas.

For these reasons, when working with a client with, or diagnosed as at risk for, a reading disorder – regardless of whether a dyslexia diagnosis has been made – my current practice is to deliver phonics-based training based on the Spalding Method coupled (where appropriate) with explicit phonological awareness training focused on those skills most correlated with reading outcomes.

Related articles:

Principal sources: Professor Joe Elliott, The Dyslexia Debate. Seminar attended by the author on 5 August 2015 at the University of Sydney.

Elliott, J.G., & Gibbs, S. (2008). Does Dyslexia Exist? Journal of Philosophy of Education, 42(3-4), 475-488.

Image: http://bit.ly/1DH7GOL

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

5 resources you can use at home to help your child to read

by Leave a Comment

Sitting on the train the other day, I noticed almost everyone in the carriage was reading. Not novels or magazines. But emails, news feeds, text messages, social media posts and websites. Even the guy singing along with his iPhone was busy scrolling through his library of songs.

In this age of mobile devices and social media, there’s a compelling argument that reading is becoming more important for life participation and success – not less.

So what skills do our kids need to learn in order to read well?

As we’ve previously reported, back in 2000, the US National Reading Panel identified the “Big 5”:

Many children learn these skills without too much difficulty – especially if they go to a school that uses evidence-based literacy instruction methods. For some children, it can be a more difficult road – including for many children with oral language disorders.

In therapy and remedial reading programs, we can target deficits in one or more of these areas. Lots of schools in Australia, for example, run the Making up for Lost Time in Literacy Program – MultiLit – developed by researchers at Macquarie University in Sydney. In therapy, I target the Big 5 using the Spalding Method, supplemented with specific phonological awareness training and reading comprehension strategies.

But, apart from completing reading homework assigned by school and/or speech pathologists, what can parents do to help their children learn to read at home?

Here are 5 of my favourite home-based learning-to-read resources – some high tech, others decidedly “old school”:

1. Reading Doctor: Developed by Australian speech pathologist and literacy expert, Dr Bartek Rajkowski, this collection of PC software and apps is both evidence-based and fun – even for the most reluctant reader. I used this software to help one of my sons learn to decode letters and to blend and segment sounds – essential foundations for his later literacy. In addition to great software, the Reading Doctor website contains a wealth of materials summarising the latest research about reading and how to teach it.

2. Why Johnny Can’t Read and What You Can Do About It: First published in 1955, this no-nonsense phonics-based book written by Rudolf Flesch is a gem. In addition to explaining why Flesch thinks phonics is so important – a once-controversial view now vindicated by modern systematic studies into literacy – the book includes a straight forward, step-by-step home program parents can follow to help children to decode and link letters to sounds. You can find it on AbeBooks or Amazon.

3. The Fitzroy Reading Program: A set of 80 phonics-based story books, which gives children ample practice reading and sounding out words. I like the physical books, but the readers are now also available through iTunes.

4. OzPhonics: An iPad-based ‘reading system’ that builds phonological awareness and phonics skills in small steps.

5. The Hairy Letters App: This colourful little app provides children with a great way of practising their letter-sound knowledge.

Bottom line

We hope you find one or more of these resources useful in helping your child to develop his or her early literacy skills.

If your child is having problems learning to read, consult your child’s teacher to see if evidence-based reading programs are available through the school. Additionally, speech pathologists can assess and treat your child for problems with the Big 5 reading skills (including phonological awareness, text fluency and comprehension) and can identify underlying oral language or speech deficits that might be contributing to your child’s difficulties. You should also get your child’s hearing and vision checked.

Related articles:

Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).

Beyond school readiness: 7 signs that your kindergarten, year 1 or year 2 child may have a language delay

by Leave a Comment

There are some fantastic school readiness checklists and speech-language programs out there to help you help your child develop the language skills necessary for his or her first day at big school.  But what signs of language delay should you look out for after your child has started school?

Of course – disclaimer alert! – children don’t develop in exactly the same way according to a pre-programmed formula (if only!). But here are 7 fairly straightforward things you can listen out for that signal there might be an issue worth looking into:

  • Your child doesn’t use correct plurals for common nouns.  He/she says dog for dogs, bus for buses, mans for men, childs for children, and sheeps for sheep. Don’t worry about fish/es – a controversial topic at the best of times!
  • Your child doesn’t have a good handle on the past tense of common irregular verbs, e.g. if he/she says words like “goed” and “holded” and “broked” and “flied” and “falled”.  Although this is a common stage of language development called “overgeneralisation” – the subject of a separate article here – most children have “went”, “held” and “broke”, and “flew” and “fell” down by school.
  • Your child can’t rhyme words, count syllables, identify words that begin with the same sound or link sounds to letters of the alphabet.  This may indicate a problem with phonological awareness, which is strongly related to later reading development.
  • Your child can’t give or follow two-step instructions, e.g. “Put on your shoes after you pack your lunchbox”.  This may indicate your child is not processing sentences with complex syntax or applying rules of thumb, like watching what others do or doing things in the order they’re said.  Of course, it may also indicate your child is ignoring you and testing your patience/limits (something that happens to me with increasing frequency!).
  • Your child can’t sort common words by opposites or category.  For example, knowing black/white, big/small, up/down, over/under, heavy/light are related words; or that chickens, horses, cows, goats, sheep and ducks are all farm animals, while cars, motorbikes, jets, boats and trains are all forms of transport.
  • Your child can’t sit and listen quietly to others.  There are a number of possible explanations for this, including possible attention issues or simply – dare I say it? – old-fashioned naughtiness.  But it may also signal that your child has problems understanding what others are saying, causing frustration to both listener and speaker.
  • Your child can’t re-tell a simple story coherently.  As your child goes up the grades at school, he/she will be required to work with what some academic folk call “text types of the narrative genre”, and what almost everyone else calls “stories”.  This one is easy to check – simply read your child an age-appropriate bedtime story, then ask him/her to tell it back to you.  Does the story make sense?  Did your child cover the start, middle, high point and end?  Did your child identify the main and supporting characters?  Did he/she speak in full, grammatically correct sentences with lots of description and appropriate emotion in his/her voice?

If you spot one or more of these potential issues – DON’T PANIC!  It doesn’t necessarily mean your child has a language delay. If there is an issue, there’s a good chance your child’s teacher has spotted it and is working on it with specialist teachers at the school.  But if you are worried – particularly if your child ticks more than 3 boxes above, or you have a family history of language problems – don’t hesitate to contact a qualified speech-language pathologist who can assess each of the above language skills (and more) with a comprehensive diagnostic assessment.

Image: http://www.flickr.com/photos/britishlibrary/11130516894/
Banter Speech & Language Banter Speech & Language
Banter Speech & Language is an independent firm of speech pathologists for adults and children. We help clients in our local area, including Concord, Rhodes, Strathfield and all other suburbs of Sydney’s Inner West.

Banter Speech & Language is owned and managed by David Kinnane, a Hanen- and LSVT LOUD-certified speech-language pathologist with post-graduate training in the Spalding Method for literacy, the Lidcombe and Camperdown Programs for stuttering, and Voicecraft for voice disorders. David is also a Certified PESL Instructor for accent modification.

David holds a Master of Speech Language Pathology from the University of Sydney, where he was a Dean’s Scholar. David is a Practising Member of Speech Pathology Australia and a Certified Practising Speech Pathologist (CPSP).