Reading and Writing
Reading and Reading Deficits
Reading is a complex ability. It requires both decoding and reading comprehension. Decoding is the ability to read aloud written words and knowing which sounds are represented by the written letters (e.g., red vs reed vs read). Reading comprehension is the ability to read silently and understand what the text means.
Reading is founded on good speech and oral language skills such as vocabulary and grammar. It requires 'print knowledge' - that print has meaning, moves from left to right and top to bottom (in English). It relies on ‘phonological awareness’ - understanding that we can manipulate the sounds in words (“red” + “y” = “ready”).
When a child is struggling with reading, it may be in any or all of these areas - decoding, reading comprehension, oral language and speech, print knowledge, and phonological awareness.
There are different types of reading deficits such as a phonological reading deficit (associated with dyslexia) and reading comprehension deficit. Every student that struggles with reading may have a different profile, which is why individual treatment has been shown to be more effective than groups of three or more children (Hall & Burns, 2018; Slavin et al., 2009; Vaughn et al., 2003). Young struggling readers are more likely to have difficulties with phonological awareness and phonics (preschool, primary, grades 1-2), whereas older children (grade 3 and up) are more likely to have difficulties with reading comprehension and oral language (Suggate et al., 2016).
The American Speech-Language-Hearing Association provides excellent descriptions of reading and writing deficits at the following links:
An S-LP can evaluate a child’s skills to determine whether s/he is exhibiting a reading deficit, describe the nature of these difficulties, and identify deficits in oral language that may be contributing to these difficulties (as is often the case). When done in collaboration with a psychologist who can perform a psychoeducational assessment and establish a diagnosis of dyslexia when appropriate, a comprehensive profile of a child's language strengths and areas of difficulty can be developed.
'Dyslexia' or a 'phonological reading deficit' is only one type of reading disorder. A 'phonological reading deficit' is a language impairment that can be diagnosed by an S-LP. It includes in-depth evaluation of both written and oral language abilities. 'Dyslexia' or a 'specific learning disability in reading' is a learning disability that is diagnosed by a psychologist and involves comprehensive evaluation of many skills including language processing, IQ, attention, and academic performance. Shoreline's clinicians advocate for a collaborative approach to assessment that involves evaluation by both an S-LP and a psychologist.
In order to identify the linguistic area(s) that are underlying a child or adolescent's difficulty with reading, we start services with a comprehensive evaluation which typically includes examination of the following areas (depending in part on the age of the client):
oral language - we first screen for oral language difficulties, and then assess based on the results of the screening
spelling and writing
Assessment typically requires 2 to 3 60-minute appointments. After the administration of evaluation tools and protocols during these appointments, the S-LP will analyze the data and document the results in a written report. This report includes recommendations for treatment and referrals as needs be.
As with management for any communication impairment, there is more than one single approach to treatment. In the case of reading deficits, it is inaccurate to claim that one particular approach is superior to all others in all cases. Selection of a treatment approach should be based on the individual needs of clients and their specific profile of difficulty as well as what approaches have been shown effective in research. For example, there are a number of phonics-based approaches that are effective. Shoreline takes an individualized approach to treatment for reading deficits. We do not ascribe to a single protocol, as each child is unique. After a comprehensive assessment of reading, writing, and oral language skills, our clinicians create an individualized plan tailored to a child's particular needs and based on current research findings.
The American Speech-Language-Hearing Association has developed an overview of some of the many approaches to reading and writing intervention and can be accessed at the link below:
COVE Readers Program
Shoreline's Approach to Reading Intervention
Delivered by an S-LP
At Shoreline, we take an individualized approach to reading intervention based on a child's specific profile of strengths and areas of weakness as established during assessment (Hall & Burns, 2018; Paul & Clarke, 2016). Intervention usually consists of work in the following areas (National Reading Panel, 2000): phonological awareness (Bus & van Ijzendoorn, 1999), systematic phonics (Torgerson, Brooks, & Hall (2006), fluency [Vadasy & Sanders, 2009; Duff & Clarke, 2011), vocabulary, and comprehension. The amount of time spent on any of these areas depends on what the child's specific areas of need are (Hall & Burns, 2018). For example, one child may require more time on phonics skills, whereas another may require more time on comprehension, and other on vocabulary.
For children with dyslexia or a phonologically based reading deficit, effective intervention should include training in letter sounds, phonological awareness, and linking letters and sounds through writing and reading from texts at the appropriate level to reinforce emergent skills (Snowling & Hulme, 2011, 2012). In contrast, children with poor reading comprehension skills require a different 'diet' attuned to their needs and can benefit from training in oral language skills, particularly vocabulary training (Snowling & Hulme, 2011).
Phonological awareness is the understanding that all words are made up of individual sounds and the ability to manipulate those sounds, for example by rhyming or switching a sound to make a new word. It is a basic skill necessary for learning to read and is the first component of an effective reading intervention (National Reading Panel, 2000). Some children develop this skill naturally, while others need help to learn. There is large support in the research on the importance of phonological awareness training (e.g., Bus & Van Ijzendoorn, 1999; National Reading Panel, 2000). However, it has also been shown that training phonological awareness alone is not sufficient and effective reading interventions need to include more components (National Reading Panel, 2000).
Systematic Phonics Instruction
The second component of effective reading intervention is systematic phonics instruction (National Reading Panel, 2000). Phonics instruction focuses on letter knowledge and the relationship between the written letter and the sound it makes (also called the 'alphabetic principle'), and how this can be applied to the tasks of reading and spelling (Ehri et al., 2001). The instruction of phonics has been proven to be more effective when it is taught in an explicit, organized, and sequenced way, called ,systematic phonics, (National Reading Panel, 2000; Torgerson, Brooks, & Hall, 2006).
The third component of an effective reading intervention is targeted at increasing reading fluency. Fluent readers are able to read accurately and smoothly, recognizing words automatically and without many decoding struggles. In treatment, this is achieved through repeated reading of the same texts (e.g., Vadasy & Sanders, 2009), which has been found effective as part of a broader reading intervention (Duff & Clarke, 2011).
Vocabulary instruction is the fourth component of reading instruction as a strong vocabulary is necessary for understanding language and learning from text. There is evidence that vocabulary instruction is helpful (Clarke et al., 2010; Ellerman et al., 2009) but the approach and type of instruction will vary depending on the individual.
The fifth component of intervention is targeting reading comprehension. For some struggling readers, this component will be the most important. How reading comprehension is targeted will vary based on the individual and different approaches have been examined in research (see discussion in Clarke et al., 2010), such as: working with mental imagery or inferencing, strengthening vocabulary, narrative skills, comprehension monitoring, visual or graphic illustrations of ideas, story-structure training, question answering and asking, summarization, and multiple-strategy teaching. At Shoreline, we tailor the reading comprehension intervention based on the individual’s language profile and current needs for learning in school. Reading comprehension intervention has been shown to be effective long-term and with promise to transfer to areas not specifically targeted (Suggate, 2016).
To maximize potential for improvement, we work with children one-on-one rather than in groups (Hall & Burns, 2018; Slavin et al., 2009; Vaughn et al., 2003). This approach ensures that programming is completely individualized and designed to target the client's specific profile of need with maximal opportunities to practice skills within a treatment session.
Evidence-based practice means that we use the best available research findings to guide our approach to intervention but also that we use years of clinical expertise and take into account the needs and preferences of every client and their families. We have based the COVE Readers program on the latest research in reading intervention as well as several large meta-analytic studies and combined our findings with many years of clinical experience. This has created a strong program with the possibilities to individualize and tailor in order to meet the needs of any client.
Based on research and experience, we know that early intervention is important (e.g., Clarke et al., 2017; Hall & Burns, 2018). Getting the right support in the early grades is vital for academic success. However, it is also important to note that older student benefit from intervention as well (see Hall & Burns, 2018), and it is never too late to offer tailored support.
Treatment is implemented in 'cycles'. Each cycle consists of 20 hours of treatment over approximately 10 weeks (two 60-minute sessions each week). Children who require multiple cycles have the choice of having a break in between cycles or to take them continuously if needed. If a cycle needs to be discontinued before its completion, any professional fees paid for services not yet rendered will be refunded in full.
All treatment sessions are planned and delivered by a speech-language pathologist. Shoreline's lead on reading intervention for children and adolescents is Myrto Brandeker, Ph.D., S-LP. Learn more about Myrto here.
Learn more about the COVE Readers Program.
International Dyslexia Association
National Reading Panel
"Teaching Children to Read: An Evidence-Based Assessment of the Scientific Research Literature on Reading and Its Implications for Reading Instruction"
References on This Page
Bus, A., & van Ijzendoorn, M. H. (1999). Phonological awareness and early reading: A meta=analysis of experimental training studies. Journal of Educational Psychology, 91, 403-414. doi: 10.1037//0022-0618.104.22.1683
Clarke, P. J., Paul, S. A. S., Smith, G., Snowling, M. J., & Hulme, C. (2017). Reading intervention for poor readers at the transition to secondary school. Scientific Studies of Reading, 21, 408-427.
Clarke, P. J., Snowling, M. J., Truelove, E., & Hulme, C. (2010). Ameliorating children’s reading-comprehension difficulties: A randomized controlled trial. Psychological science, 21, 1106-1116.
Duff, F. J., & Clarke, P. J. (2011). Practitioner Review: Reading disorders: What are the effective interventions and how should they be implemented and evaluated?. Journal of Child Psychology and Psychiatry, 52(1), 3-12.
Ehri, L. C., Nunes, S. R., Willows, D. M., Schuster, B. V., Yaghoub-Zadeh, Z., & Shanahan, T. (2001). Phonemic awareness instruction helps children learn to read: Evidence from the National Reading Panel’s meta-analysis. Reading Research Quarterly 36, 250-287.
Hall, M. S., & Burns, M. K. (2018). Meta-analysis of targeted small-group reading interventions. Journal of School Psychology, 66, 54-66.
National Reading Panel (US), National Institute of Child Health, & Human Development (US). (2000). Teaching children to read: An evidence-based assessment of the scientific research literature on reading and its implications for reading instruction. National Institute of Child Health and Human Development, National Institutes of Health.
Paul, S. A. S., & Clarke, P. J. (2016). A systematic review of reading interventions for secondary school students. International Journal of Educational Research, 79, 116-127.
Slavin, R. E., Lake, C., Davis, S., & Madden, N. A. (2011). Effective programs for struggling readers: A best-evidence synthesis. Educational Research Review, 6(1), 1-26.
Snowling, M. J., & Hulme, C. (2011). Evidence‐based interventions for reading and language difficulties: Creating a virtuous circle. British Journal of Educational Psychology, 81(1), 1-23.
Snowling, M. J., & Hulme, C. (2012). Interventions for children's language and literacy difficulties. International Journal of Language & Communication Disorders, 47(1), 27-34.
Suggate, S. P. (2016). A meta-analysis of the long-term effects of phonemic awareness, phonics, fluency, and reading comprehension interventions. Journal of learning disabilities, 49(1), 77-96.
Torgerson, C.J., Brooks, G., & Hall, G. (2006). A systematic review of the research literature on the use of systematic phonics in the teaching of reading and spelling. Department for Education and Skills. London: DfES Research Report 711. Available from https://core.ac.uk/download/pdf/5911476.pdf
Vadasy, P. F., & Sanders, E. A. (2009). Supplemental fluency intervention and determinants of reading outcomes. Scientific Studies of Reading, 13, 383-425.
Vaughn, S., Linan-Thompson, S., Kouzekanani, K., Pedrotty Bryant, D., Dickson, S., & Blozis, S. A. (2003). Reading instruction grouping for students with reading difficulties. Remedial and Special Education, 24(5), 301-315.