LANGUAGE LEARNING DISORDERS

Understanding language difficulties and current evidence-based teaching practice

University of Queensland Speech Pathology Presentation

2008

Christine Barrett and Samantha Short(4th year Speech Pathology)

ACKNOWLEDGEMENTS

Dr Lorraine Hammond

Dr Michael O’Keeffe

Professor Gail T. Gillon

See References and Resources for list of research evidence…

DEFINITIONS

Learning Disorder (LD)•Unexpected difficulty relative to age and other abilities to learn in school (Listening, reading, mathematics, social skills)

Language Learning Disorder (LLD)•Learning difficulty that primarily affects language-based skills such as reading, writing, spelling

Dyslexia•Specific language-based disorder characterised by difficulties in single word decoding, usually reflecting difficulties in phonological processing abilities

(Paul, 2005)

DEFINITIONS

LD

LLD

DYSLEXIA

(Paul, 2005)

STATISTICS

•70 to 80% of children learn how to transform printed symbols into a phonetic code without much difficulty (Shaywitz, 2003)

And the remaining 20-30%???

STATISTICS

•Around 20 to 30% of children need a specific reading instruction (Mather, 1992)

•Up to 1/3 of the world’s population remains illiterate (Roselli, 1993)

•20-30% of Australian children have difficulty learning to read (Westwood, 2001)

•Even when good classroom instruction is delivered in preschool and kindergarten, approx 20% of children fail to acquire adequate phonological awareness skills (Schuele & Boudreau, 2008).

BASICS OF READING

There are two major components in the reading process:

Decoding - results in word identification

Comprehension - results in deriving meaning

(Shaywitz, 2003)

PA DEVELOPMENT BENCHMARKS

Source: Schuele & Boudreau (2008)

THINGS YOU MAY NOTICE IN THE CHILD WITH LLD/DYSLEXIA…

• Insensitivity to rhyme• Trouble learning letters/ sounds of alphabet• Failure to understand that words come apart• Inability to match letters to sounds • No word attack strategies for unfamiliar words• Miss chunks of words (eg get first & last bits but miss middle)• Phonetic errors - look similar, sound very different (eg gorse & goose)

•Educated guessing of a word (when reading) from the first letter/sound/syllable•Family history•Good at verbal activities and not so good at written activities•Avoidance of reading• Terror about reading aloud

THINGS YOU MAY NOTICE IN THE CHILD WITH LLD/DYSLEXIA…

(O’Keeffe)

AREAS FOR ASSESSMENT OF A CHILD WITH SUSPECTED LLD/DYSLEXIA

•Cognition•Speech and language/PA skills•Memory•Visual perceptual skills•Fine motor skills•Case history (family history and child history)

(O’Keeffe)

AETIOLOGY

The truth is… we don’t

know!(yet!)

SUSPECT THEORIES ???

•Magnocellular Theory

•Scotopic Sensitivity Syndrome

•Cerebellar Developmental Delay

•There is no doubt that the core problem in dyslexia is phonologic (i.e. related to sound awareness and manipulation)

What we do know comes from studies using fMRI…

Brain Basics

(Hammond, 2002)

WHAT WE DO KNOW•fMRI imaging has identified 3 reading pathways in the brain’s left hemisphere

•Dorsal parietal-temporal system - word analysis – beginner reader area e.g. ‘dog’ reading by linking sounds to letters

•Ventral occipito-temporal system - word form - an automatic pathway used by skilled readers once they have a stable neural representation of the word (spelling, presentation and meaning activated on sight of word)e.g. ‘d-o-g’ – furry animal, pet, barks

•Left inferior frontal gyrus - articulation and word analysis – strategy used by skilled readers allowing them to slowly analyse unknown word(Shaywitz, 2003)

Parietal-temporal (Dorsal) region

WORD ANALYSIS

Occipito-temporal (Ventral) region WORD FORM

BA - Inferior frontal gyrus

ARTICULATION / WORD ANALYSIS

Three Regions

of Interest

Good readers use these three areas to decode wordsTherefore reading is easier and more fluent

Poor readers rely more on the front and right side of the brain to decode words as a compensatory mechanism. This system is functional but is not automatic.Reading is less efficient and therefore less fluent.

(Hammond, 2002)

WHAT WE DO KNOW

WHAT WE DO KNOW•fMRI examination shows neural differences in the structure of the brains of people with dyslexia (reading problems) when compared to people who do not have dyslexia.

•The complexity of the brain and its development presents numerous opportunities for faulty wiring to be present.

•Different degrees of dyslexia occur with variations in faulty wiring.

•Impaired phonological processing leads to a “hazy” mental representation of a word which interferes with the formation of a stable neural model of the word.

(Shaywitz, 2003)

•Neurological evidence exists showing that there are gender differences in brain activation patterns when completing phonological tasks:

•Females – activate the right and left sides of the brain while•Males – only activate the left hemisphere

•Neurobiological proof also shows that same posterior brain disruption seen in children with dyslexia is also seen in adults with dyslexia.

This shows that reading problems do not ‘go away.’

(Shaywitz, 2003)

WHAT WE DO KNOW

INTERVENTION

A good program:

Identifies→Weakness in getting to the sounds of words→Strengths in thinking and reasoning

Provides→Early help for the weakness→Accommodations to help access strengths

•Overall, focuses on both strengths and weaknesses!!!

(Shaywitz, 2003)

INTERVENTION

Basic ingredients of a good program (from what we do know):

•Early intervention•Over-learning•Individualised•Systematic and explicit instructions•Consistency (in teacher/aide)•High intensity•Teacher knowledge and experience

(National Institute of Child Health and Human Development)www.nichd.nih.gov/publications/nrp/smallbook.cfm

•fMRI studies have shown that with early, effective intervention:

•Children can develop into accurate and fluent readers.•Can be trained to use the automatic reading pathway at the back of their brain.

•So intervention with these children is effective and makes lifelong changes to a child’s academic success

(Shaywitz, 2003)

INTERVENTION

INTERVENTION

Specific ingredients of a good speech/language program:

•Oral reading with feedback•Accommodation for student needs•Strengthen student strengths•Specific and explicit instructions in phonics phonemic awareness decoding rote learning vocab expansion reading comprehension strategies written composition training

(National Institute of Child Health and Human Development)www.nichd.nih.gov/publications/nrp/smallbook.cfm

•Teachers are rarely able to provide such appropriately focused and sufficiently intensive instruction within the constraints of their classroom.

•Speech pathologists have the benefit of working intensively with individual children. They can implement specific strategies designed to target individual needs.

SPEECH PATHOLOGY – TEACHER COLLABORATION

(Speech Pathology Australia, National Inquiry into the Teaching of Literacy, 2005)

•A challenge for everyone providing PA intervention is that there is a lot of information on WHAT to teach and not much on HOW to teach it.

•As a starting point, refer to your ‘Beyond the Basics’ handout which includes:

•Example instructional dialogues•Steps for teaching PA skills•Types of modelling strategies•Instructional sequences for PA intervention•Tips for responding to errors•Scaffolding tips

•These basic strategies can be applied to working with anyone with reading difficulties

LANGUAGE DISORDER INTERVENTION

(Scheule & Boudreau, 2008)

•Teach, don’t test: Demonstrate repeatedly the process by which one “solves” phonological awareness tasks.•Plan strategic instruction: Carefully order instructional activities within each step of the instructional sequence (and instructional stimuli within activities)•Scaffold children’s success: Respond strategically to children’s errors and correct responses. Consider also that accurate responses or answers may not always reflect successful learning.

LANGUAGE DISORDER INTERVENTIONSOME TIPS:

(Scheule & Boudreau, 2008)

Source: (Scheule & Boudreau, 2008)

PHONOLOGICAL AWARENESS INTERVENTION HIERARCHY

RECOMMENDED RESOURCES AND REFERENCES

Castles, A. & Coltheart, M. (2004). Is there a causal link from phonological awareness to success in reading? Cognition, 91, 77-111.

Cirrin, F.M., Gillam, R.B. (2008). Language intervention practices for school-age children with spoken language disorders: A systematic review. Language, speech and hearing services in schools. 39, 1, s110-s137.

Gillon, G.T. & McNeill, B.C. (2007). Integrated Phonological Awareness: An intervention program for preschool children with speech-language impairment. Canterbury: University of Canterbury.

O’Shaughnessy, T.E. & Lee Swanson, H. (2000). A Comparison of Reading Interventions for Children with Reading Disabilities. Journal of Learning Disabilities, v33, 3, 257-277.

Schuele, C.M. & Boudreau, D. (2008). Phonological Awareness Intervention: Beyond the basics. Language, speech and hearing services in schools, v39, 3-20.

Shaywitz, S. (2003). Overcoming dyslexia. New York: Random House Inc.

Speech Pathology Australia. (2005). Literacy Teaching Based on Evidence; What roles can SLPs play? Melbourne: Speech Pathology Australia.

SPELD – Specific Learning Disability Association (Queensland)www.speld.org.au

RECOMMENDED RESOURCES AND REFERENCEScont’d

•www.progressivephonics.com

•www.brainconnections.com – Dr Barbara Foreman

•Marcia L Tate – Reading and Language Arts worksheets

•www.texasreading.org

•www.letterland.com

•http://education.qld.gov.au/students/procedure/program/reading-recovery

•www.jollylearning.co.uk

•http://www.elr.com.au

•www.greatbookstoreadaould.co.uk