Reading and Writing

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written language skills

Written Language Skills

Reading is a complex learned ability. Comprehension and production of written language (i.e., reading and writing) depend on many foundational linguistic skills that are either developed before a child even starts to learn to read (e.g., production of most English speech sounds, recognition of when words rhyme, production and comprehension of longer grammatical sentences, ability to tell a coherent story). Many of these linguistic skills continue to develop as children are learning to read. For example, children’s ability to tell increasingly complex narratives continues to develop during childhood at the same time that they’re learning to read.

Learning to read (if done in an evidence-informed manner) further promotes language development because it helps children acquire metalinguistic skills – thinking about language – and gives them practice with using more complex language. For example, most people don’t think specifically about how they’re forming sentences. However, because we use complex vocabulary and grammar more often when we’re writing than when we’re speaking (for good reasons), when teachers teach grammar rules explicitly, children become better at writing. This in turn improves their speaking skills.

During the first few years of school, children are learning to read. Around grade 3, however, they are increasingly reading to learn. Educational content is increasingly delivered through written text (e.g., science, history, literature) with the complexity of these texts gradually increasing over time. Children also continue to work on their writing skills as the expectations continue to increase. They are also expected to demonstrate their knowledge using their writing (e.g., essays, math word problems, lab reports). Thus, children who have trouble learning to read and write are very likely to require additional support to be successful with learning the curriculum.

Children also use their reading and writing skills increasingly in their daily life outside of school. For example, using text messages and emails, reading content of interest in books and on the internet, reading instructions for games, and reading signs and product labels. They are working toward using reading and writing for adult purposes as well such as reading and writing for work (e.g., an electrician reading blue prints and job instructions, a lawyer reading legal documents, a real estate agent preparing a contract, a salesperson writing an email to a customer), reading for enjoyment (e.g., reading about motorcycles or about things to do on their trip to Florida), to learn a new skill (e.g., how to change the oil in their car), and reading for activities of daily life (e.g., reading a contract for a new cell phone plan, completing a census questionnaire).

Written & Spoken Language: The Connection Between Literacy, Language, and Speech

Literacy (reading and writing) is an extension of spoken language – it is founded on good speech and oral language skills such as phonological processing, vocabulary, inferencing, and grammar. Humans are biologically programmed to develop oral language and speech when this innate predisposition is combined with interactions with other people, but not reading – reading must be taught. Very early on, babies begin to make sounds and eventually as toddlers combine them into meaningful words and then combine those words into sentences. Even babies under the age of 6 months can distinguish between different speech sounds they hear (even better than adults). Many children who struggle with learning to read have a history of a spoken language and/or speech sound disorder. Children with language and speech disorders are at a higher risk of reading disorders.

Reading is not an innate skill – it is taught. Reading systems were invented by people to represent spoken language. Therefore, although children with typically developing oral language and speech skills do not need to be taught explicitly how to speak their native language(s) – they acquire it through exposure in their daily life – we do need to explicitly teach children how to read. Reading requires 'print knowledge' - that print has meaning, moves from left to right and top to bottom (in English). Often this begins with teaching young children the alphabet, how to turn a page, how to hold a book upright, and so on.

Reading also requires ‘phonological awareness’ - understanding that we can manipulate the sounds in words (“red” + “y” = “ready”). There are many phonological awareness skills (e.g., rhyme recognition and production, phoneme and syllable blending, phoneme and syllable segmentation, etc.) that children develop during their preschool and early school years up to about grade 2. These skills are crucial to successfully decoding print.

Specific Skills Required for Reading and Writing

When a child is struggling with literacy, it may be in any or all of a number of areas. Some of these skill areas are described briefly here. Keep in mind that if a child also has a speech and/or language disorder (e.g., phonological disorder, developmental language disorder) they will also likely require speech-language therapy in addition to literacy intervention. They are also more likely to require SLP-level intervention for their reading and writing.

connection

specific skills

Note: "sight recognition" of words is not the same as learning "sight words"

Phonological Processing

Phonological processing is the brain’s ability to use speech sounds to recognize, remember, and produce words. It is a foundational processing skill for speaking, reading, and spelling. There are three subskills:

Phonological awareness: The ability to recognize and manipulate individual speech sounds and speech sound patterns (e.g., recognizing when words rhyme, splitting up words into their individual sounds).

Phonological memory: The ability to hold speech sounds in one’s working memory so they can be manipulated (e.g., after sounding out the word ‘ship’, being able to hold those sounds in the right order long enough to write down the corresponding letters, or, after sounding out the individual letters in a word, holding those sounds in one’s working memory long enough to then blend them together in order to form the word).

Rapid automatic naming: The ability to retrieve the names of common symbols and objects (e.g., quickly recognizing that the symbol ‘s’ is the letter pronounced “ess”).

Unless a child has a condition affecting development of the phonological system (e.g., phonological disorder, dyslexia) the phonological processing skills required for daily speaking and reading acquisition will develop the same way vocabulary and grammar do – through interaction. However, as reading and writing place greater demands on the phonological system, and English is a language in which the connection between speech sounds and letters is not always obvious (e.g., ‘red’ and ‘ready’ both have a short ‘e’ sound but different spellings), even children with typically developing phonological skills benefit from phonological awareness instruction and activities. Engaging in this learning can foster an interest in language, confidence, and metalinguistic skills (thinking about language and awareness of its rules). Children with developmental and learning disorders affecting phonological processing will certainly require explicit support with developing these skills.

Since phonological awareness is a natural, innate human ability (like speech and spoken language) milestones for mastering specific phonological awareness skills (e.g., rhyme production, phoneme substitution) will be different than the ages at which the skill may be taught in school. When it’s taught in school, the purpose is not to develop the cognitive capacity for the skills (the child will already have the ability), but instead to increase the child’s awareness and intentional use of the skill (metalinguistic skill) for learning activities such as reading. It’s similar to running – no one taught us how to run; we simply started to be able to do so at some point when our muscles and motor planning skills were advanced enough. Athletes, however, can learn from coaches about body mechanics and how to run to participate in competitive races.

Print Knowledge

Print knowledge is understanding the purpose and conventions of reading in a particular language. It includes understanding that letters convey meaning, that these letters are combined to create words and sentences, and that these symbols are read from left to right and top to bottom in English. It includes knowing how to hold a book, that turning pages leads to more information in the same story or on the same topic, and that the pictures are related to the letter symbols.

Decoding

Decoding is the ability to look at a sequence of printed letters (e.g., a word or sentence) and then connect those symbols with the sequence of speech sounds they represent (e.g., red vs reed vs read) - this is what is taught with phonics. This is what we’re doing when we ask a child to “sound it out”. Even as adults, when we encounter unfamiliar printed sequences (e.g., ‘hyperlexia’) we can usually figure out how to pronounce it based on our decoding abilities. If a child does not have good decoding skills, they will be unable to decipher unfamiliar words.

Reading Fluency

Reading fluency is the ability to read accurately, quickly, and naturally (e.g., pausing when expected, using expression). Fluency is acquired through mastery of phonics and phonological awareness skills, rapid recognition of irregularly spelled words, and repeated practice.

Reading Comprehension

Reading comprehension is the ability to understand what the text means after it has been decoded. It requires good verbal memory, vocabulary, grammar (syntax and morphology), and verbal reasoning (e.g., inferencing, interpreting non-literal language like metaphors). These are linguistic skills that are foundational for reading comprehension. Even children who have typically developing spoken language may have difficulty with reading comprehension. This is partly because printed language is more complex than spoken language – we use more formal and more advanced vocabulary and grammar. Reading is also often ‘decontextualized’ – it is not related to the here and now and often deals with content never experienced personally. This is one reason why experience and concept knowledge also contribute to reading comprehension.

More complex language: “Old Man Crow turned one eye toward Coyote.”

Less complex language we may use if we were telling the story: “Old Man Crow looked at Coyote.”

“Coyote: A Trickster Tale from the American Southwest” by Gerald McDermott

Encoding

Encoding is the reverse of decoding – it is the spelling of words. Encoding requires the ability to choose the right letters to match the sounds and morphemes in the word we wish to spell. Spelling is harder than reading – it is more active and requires more explicit application of spelling rules.

Writing Composition

Writing composition is the writing of sentences and paragraphs. It is a very complex skill. We use complex vocabulary and grammar more often in our writing than our conversation. Also, imperfect expression such as revising what we’re saying as we’re saying it (“He was go—first he went to the mall and then was going to the lake.”) and using run-on sentences is acceptable but not when we’re writing. This is because it would very difficult to read such writing. Writing composition also requires us to apply writing conventions such as capitalization and punctuation to help our reader.

Vocabulary

In order to understand the words written on the page, children must know what the words mean. For example, if they’re reading a passage on pandas but have never encountered the word China or bamboo before, much of the passage wouldn’t make sense. Reading helps us to expand our vocabularies because it exposes us to vocabulary that we don’t encounter in daily life (as a Nova Scotian, when was the last time you encountered a panda?). We use strategies to learn the words such as asking an adult, looking up the meaning in a dictionary, or using the context to infer the meaning at least partially. For example, in the sentence, “Pandas eat bamboo leaves,” you might infer that bamboo is a plant because leaves grow on plants.

Morphological Awareness

Morphological awareness is the understanding of how words are structured and formed, including recognizing and manipulating the smallest units of meaning (morphemes) like affixes (suffixes, prefixes) and root and base words. Morphology is important for reading and writing for many reasons such as the following:

Understanding the meaning of specific affixes and root/base words helps us infer the meaning of new words. For example, we can infer the meaning of ‘unforgettable’ if we know the meaning of ‘forget’, ‘un’ (not, or opposite of), and ‘able’ (capability to do something).

Applying phonics rules to reading and writing. For example, if a child wants to read the word ‘hoping’ correctly (e.g., “He is hoping that he will win the race.”) rather than perhaps misreading it as ‘hopping’ (e.g., “The rabbit is hopping away.”) they need to understand the doubling and drop the ‘e’ spelling rules that affect the spelling of the base words ‘hope’ and ‘hop’.

In English, when suffixes are added, we may not be able to figure out how to spell the word based on sounding out the word alone. For example, if a child wants to spell ‘walked’ correctly rather than misspelling is as ‘walkt’ they have to recognize that the verb tense suffix ‘ed’ has three different pronunciations depending on which sound precedes it (e.g., in ‘walked’ the -ed is pronounced /t/, in ‘hugged’ the -ed is pronounced /d/, and in ‘wanted’ the -ed is pronounced /ɛd/) but that regardless of how it’s pronounced, it is spelled -ed.

Syntax

Syntax refers to the rules of a language that govern word order in sentences. For example, in the passive sentence, “The cowboy was chased by the bull,” you understand that it is the cowboy that is trying to escape. In comparison, in the sentence, “The cowboy chased the bull,” it is the bull trying to flee. Understanding syntax helps us with writing composition and reading. It also helps with reading fluency by helping us know when to pause in a sentence. For example, consider the sentence, “Her straining arms shook / under the weight of the rock / as she tried to lift it out of the hole.” The slash marks indicate where you might take a pause. To know when to pause, the word ‘straining’ needs to be recognized as an adjective rather than a verb (her straining arms). The -ing suffix may make one think it’s a verb at first glance (and struggling readers often do). However, because of the word’s position in relation to the noun ‘arms’ (before instead of after ‘arms’ and without the auxiliary verb ‘are’ as in ‘her arms are straining’), we know that it’s actually a type of word called a participle – a verb that is being used as an adjective. If it’s misinterpreted as a verb (as in ‘she is straining her arms’), the reader might put a pause after straining instead of the true verb ‘shook’ – “Her straining / arms shook….” In addition to slowing down reading, in many cases it can result in the youth misunderstanding what is written.

If you’re thinking – "I don’t remember learning this explicitly and I certainly have never heard the word participle before" – you may very well be right. We won’t get into the benefits of explicit instruction in morphology and syntax here for learning readers who don’t need extra help. We do know, however, that for learners who need extra help (e.g., those with reading disorders), this type of explicit instruction at a level appropriate for their age and knowledge is extremely helpful. The goal is not for them to become linguists (unless they wish to) – but to develop the metalinguistic skills they will need to become skilled readers and writers so they can achieve their goals for their education, future occupation, and independence as an adult.

Image from "The Grammar Project" (Fogharty Foundation and Ochre Education)

Treatment

Shoreline's approach

Shoreline’s Approach to Structured Literacy Intervention

History

Our approach to literacy intervention and tutoring arose out of the unmet needs of our clients and conversations with their devoted guardians. Because reading and writing are a man-made extension of our innate human abilities with speech and spoken language, persons with speech and language disorders also often have difficulties with written language (reading and writing). Many of our clients whom we were seeing for speech and/or language treatment were also receiving additional support at school or with tutors for acquisition of reading and spelling skills. For some of our clients, the local options available weren’t the right fit for their needs, particularly when they also had additional processing demands such as from speech and language disorders, anxiety disorders, ADHD, or dysgraphia (difficulty with handwriting). This is why our literacy programming is designed based on principles of evidence-informed literacy intervention, rather than using a single program. Also, most literacy programs are designed for use by educators rather than clinicians who approach interventions from a different lens.

OT was added to respond to the needs of clients who also required support with graphomotor skills for handwriting (e.g., fine motor, visual motor integration, visual perception), executive functioning (e.g., organization of thought, working memory, attention, inhibition), and emotional regulation (e.g., frustration tolerance, demand avoidance, anxiety).

As our clients responded well to our approach for SLP-level literacy intervention, sometimes they had siblings who also needed support but not at the level of an SLP. Their parents asked for tutoring-level supports that would still be informed by our overall approach to literacy support. Currently, our literacy tutors are either certified Nova Scotian teachers or those with relevant educational background (e.g., psychology, linguistics, French language) plus training by our SLPs.

Finally, we added math tutoring to our offerings since children who have difficulty learning to read also require support with learning math skills. This is because math requires the ability to read instructions (e.g., textbooks, homework assignments) and word problems.

Overarching Principles

To maintain flexibility and the ability to individualize intervention, we made the decision to not adopt a single intervention program. Rather, we approach our literacy interventions using a structured literacy approach using guiding principles which are described below.

Informed

Our approach to literacy intervention is informed by the in-depth training achieved by SLPs and OTs who both hold a master’s degree in their respective professions and bachelor’s degrees in related fields (SLP – psychology, linguistics, neuroscience; OT – kinesiology, biology, psychology), the education and practical skills of our tutors who are certified teachers, and the education or our tutors who hold undergraduate degrees in related fields such as linguistics and psychology.

Choosing which skills to target and in which order and which protocols to use is based on the available research literature. In doing so, we apply these principles to our programming:

Comprehensive: Quality reading support should include instruction or treatment (depending on which stream the child is in) in phonological processing, alphabetic knowledge and phonics, reading fluency, vocabulary, morphology, syntax, and reading comprehension. The balance of focus on each of these areas at any given time depends on the developing and individualized needs of each client.

Structured and systematic: Skills should progress in a certain order so that more complex skills are built upon less complex skills in a way that is systematic and structured. We teach skills to mastery (consistently accurate and effortless) before moving on to move difficult goals.

Explicit: Instruction and treatment should be explicit and help the student develop metalinguistic skills and strategies.

Multimodal / multisensory: Students may benefit from engaging with the materials in different modalities. For example, work on both encoding (phoneme to grapheme; spelling) and decoding (grapheme to phoneme; reading) at the same time is helpful (and working on encoding helps improve decoding), incorporating movement (e.g., writing the words, descrambling tiles, tapping syllables and phonemes), and visuals (e.g., foam squares to represent phonemes and then placing letter tiles on them to demonstrate correspondence).

Evidence-informed protocols: Some protocols are effective while others are less effective or even ineffective. For example, repeated reading (e.g., reading the same paragraph 5x in a row) is much more effective than non-repeated continuous reading in targeting reading fluency, and round-robin style reading (students in a group take turns reading different parts in a passage with students listening to their peer read) is ineffective for struggling readers.

Interprofessional

Students come in with diverse needs. Based on the needs of the student, they may work with one or several team members including occupational therapy, speech-language pathology, or literacy tutoring. Occupational therapists support students who have concurrent needs with executive functioning and handwriting. Speech-language pathologists work with students with more complex needs (e.g., concurrent speech and language difficulties and/or more persistent reading deficits). Literacy tutors work with students who are accessing additional one-on-one instruction for the first time or who have less severe reading difficulties.

Individualized

Although small group learning formats used by other services are an excellent evidence-informed choice for reading support, our students need one-on-one supports. This eliminates the distraction of other students (e.g., students with ADHD), increases practice opportunities, and allows 100% individualization to the student’s needs. Occasionally, if there is a sibling pair who have similar needs, they can be supported together in a small group.

Although there are many excellent, high-quality reading ‘programs’ available, not all programs work for all students. Even the best programs delivered with fidelity will fail certain students (just like not all medical conditions respond to all medical treatments). Taking an individualized approach allows flexibility in meeting the individual needs of students.

Shoreline offers several different streams based on the level of need of clients. These are described in the section on streams below.

Intervention

As with management for any area of difficulty, there is more than one single approach to treatment. In the case of reading deficits, it is inaccurate to claim that one particular program 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 as 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 program, as each child is unique. For example, Orton Gillingham is a high quality approach to reading instruction (systematic, explicit phonics instruction using multisensory learning), but there are MANY programs that are then based on the OG approach (e.g., Wilson Reading System, Barton Reading and Spelling System, Lindamood Bell, just to name a few). After a comprehensive assessment of reading, writing, and oral language skills (if needed), our clinicians create an individualized plan tailored to a child's particular needs and based on current research findings.

Shoreline has several streams for literacy support. Some students will work with an SLP, others a tutor, and some with both. This is either determined at intake in consultation with an intake clinician (SLP) based on the history of the child and testing already completed (e.g., by a psychologist or other SLP) or after assessment by one of Shoreline’s SLPs. Below is a rough guideline of which students would be appropriate for which stream within Shoreline’s approach.

SLP:

more complex needs (e.g., multiple co-occurring needs including ADHD, intellectual delay, autistic, anxiety disorder, speech sound disorder, language disorder) or very persistent reading difficulties
have already engaged in quality reading tutoring in the past (at Shoreline or elsewhere) with little progress
significant concurrent speech and/or language disorder
significant phonological processing difficulties
counselling needs (e.g., significant learned helplessness or low frustration tolerance)
specific needs for behavioural and emotional supports (e.g., pathological demand avoidance profile, significant anxiety, express frustration by hurting themselves)

Tutor:

haven’t engaged in reading supports in the past
may or may not have diagnosis of reading specific learning disorder from a psychologist
reading disorder has been ruled out / do not meet criterion for reading disorder (“low normal”) but they would benefit from additional one-on-one instruction
specifically recommended by psychologist who has already determined the most appropriate level of support
less complex needs overall

SLP and Tutor:

The SLP sets goals and leads programming and the tutor provides additional skilled practice. These clients need the SLP stream but would benefit from additional practice with a skilled partner (tutor) because they require intensive practice and progress moves slowly. Rather than seeing the SLP twice a week, they see the SLP once and then the tutor continues the same practice at a second session.
The SLP targets higher-level language-related goals and the tutor targets specific phonics goals. These clients have many goals and seeing the SLP to target all is not feasible. The SLP would target goals related to language (if they also have a language disorder), phonological processing, and reading comprehension, while the tutor focuses on phonics instruction and practice. The SLP and tutor collaborate on goal setting.

Assessment

A speech-language pathologist can evaluate a child’s skills to determine whether their skills are as expected, describe the nature of these difficulties, and identify support needs in oral language or speech that may be contributing to these difficulties. To identify the linguistic area(s) that may be contributing to a child or adolescent's difficulty with reading, evaluation may include examination of the following areas (depending in part on the age of the client): letter knowledge, reading accuracy, reading fluency, comprehension, phonological knowledge, spelling, and composition.

For children who are having significant difficulty learning to read, Shoreline advocates for a comprehensive approach to assessment of literacy skills that includes evaluation by an educational psychologist. Although an SLP can identify whether a child's literacy skills are as expected based on their literacy instruction and age and can diagnose communication disorders such as speech sound disorders, cluttering, and developmental language disorder, a diagnosis of a reading disability comes from a psychologist.

Psychologists assess a broad range of skills to identify a student's profile of strengths and weakness and what may be impacting their learning. If a child has a suspected learning disorder (e.g., learning disability in reading and/or writing, also often known as dyslexia), this will be evaluated and diagnosed by a psychologist. Such a diagnosis is very helpful for a child to understand and advocate for themselves - many children with different learning needs are unkindly called 'lazy' by other people or may think of themselves as unintelligent (which is untrue - reading disorders have nothing to do with intelligence). Knowing their diagnosis helps them to understand who they are and how humans are diverse, ask for what they need for equitable education, and respond confidently and knowledgeably when someone is unkind. A diagnosis also helps youth to access appropriate accommodations for equitable education as children but also as young adults starting college or university. The diagnosis also helps access financial support such as through the disability tax credit in some cases.

Psychoeducational assessments can be accessed through the IWK, your child's school psychologist, or the private sector. You can find a list of paediatric psychologists who offer psycho-educational assessments here. Magdalena Lysenko of Driftwood Psychology offers this service at Shoreline's office.

Services for literacy support at Shoreline begin with an assessment so we can plan intervention. There are two typical paths:

Review of reports from previous assessment by a psychologist and/or an SLP from another service plus brief (30-45 minutes, $160/h) evaluation with a Shoreline SLP. The purpose is to take baseline data and to plan for intervention.
Comprehensive assessment by a Shoreline SLP (2-3 hours, $225/h). The purpose is to identify a child's specific support needs and strengths, take baseline data, and plan for intervention.

We only accept previous testing reports from appropriately trained and qualified professionals such as psychologists, SLPs, and teachers who have advanced training in standardized testing. These professionals are trained to administer and interpret standardized tests and additional non-standardized protocols. Psychologists and SLPs are trained to diagnose specific profiles within their scopes of practice. SLPs and psychologists have a masters or doctorate degree in their related fields and must maintain their licenses with their provincial regulatory bodies.

We sometimes read 'reports' from tutoring services in which an unqualified person has inappropriately administered standardized tests (e.g., the Gray Oral Reading Test, the Woodcock-Johnson). We unfortunately cannot accept such documentation for the purpose of planning services at Shoreline. When standardized tests are administered by unqualified individuals (e.g., a tutor with a completed or partially completed undergraduate degree or college diploma in a related or non-related field and on-the-job training), their 'findings' are invalid because they do not have the skills and qualifications to use them.

Occupational Therapy

An occupational therapist can evaluate a child's handwriting skills and what may be contributing to any difficulties such as fine motor development and visual-motor integration ('hand-eye coordination'). Occupational therapists are also helpful in supporting children with executive functioning difficulties (e.g., as related to ADHD) that may be impacting their learning to write.

Learn more about supports for handwriting here.

Learn more about supports for ADHD here.

Worksheet from "Handwriting Without Tears"