Reading and Writing
Reading is a complex ability. It requires both decoding and reading comprehension.
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 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 formal language: “Old Man Crow turned one eye toward Coyote.”
Less formal 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
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, but not reading. Very early on, babies begin to make sounds and eventually combine them into meaningful words, and then combine those words into sentences. Babies under the age of 6 months can distinguish between different speech sounds they hear! 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 deficits.
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.
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.
Note: "sight recognition" of words is not the same as learning "sight words"
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:
A speech-language pathologist can evaluate a child’s skills to determine whether they are exhibiting a reading deficit, describe the nature of these difficulties, and identify deficits 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.
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.
Shoreline advocates for a comprehensive approach to assessment of literacy skills that includes evaluation by an educational 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., a specific learning disability in reading and/or writing), this will be evaluated and diagnosed by a psychologist.
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.
Treatment and Tutoring
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 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: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942549§ion=Treatment
Our reading programming is informed by the work of the Barksdale Reading Institute and the University of Florida Literacy Institute (UFLI). Our handwriting programming is informed by Handwriting Without Tears.
Shoreline offers three streams for reading support:
Intervention with a speech-language pathologist: This is typically recommended for children with more complex needs such as moderate to severe reading difficulties and/or co-occurring speech sound and/or spoken language delays/disorders.
Tutoring with our literacy tutor: This is often recommended for children and youths with milder or less complex difficulties.
Speech-language pathologist and tutor: this option may be recommended for children and youths who require frequent and repeated practice and who have a slower rate of progress due to the severity of their reading difficulties. In this stream, the speech-language pathologist is primarily responsible for advancing goals. Every two or three sessions would be with the speech-language pathologist, and then other sessions are conducted by the tutor to continue the practice. This option is more economical for families in which their children require this level of frequent, repeated practice with a skilled partner.
Which stream is most appropriate will be based on the recommendation of the testing psychologist or speech-language pathologist in collaboration with the child's guardian(s).
Our tutor is able to work with children in both English and French. Our speech-language pathologists and occupational therapists are able to provide services in English. It is anticipated that we will be able to also offer speech-language pathology services for literacy in French in late 2023/early 2024.
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 - Decoding
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 our approach to reading intervention 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.
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"
Local Tutoring Programs
After assessment, sometimes your SLP may recommend a tutor rather than SLP intervention. This recommendation is based on what the best option is for the child and their family. Tutoring programs should include customized to the individual student's strengths and areas of need. They should include each of these five components: phonological awareness, systematic phonics, reading fluency, vocabulary, and comprehension.
Below are some local tutoring programs. Inclusion on their list does not imply endorsement.
Based in Cape Breton with the option for online learning sessions
Tutors have a Bachelor of Education
Locations in Halifax and Bedford
Scottish Rite Charitable Foundation
Tutors use the Orton-Gillingham approach
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//0022-06220.127.116.113
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.
Children who are having difficulty learning to write may have problems with the mechanics or fine motor skills needed to write (physically producing the letter), learning the symbols or letters (e.g., ‘b’ vs ‘d’), how to spell, and/or composition - how to express their thoughts in writing (e.g., retrieving the right word and its spelling and combining the words into sentences into paragraphs). When children have trouble learning to write, they may just require additional instruction (e.g., with a tutor) or they may have dysgraphia.
Both occupational therapists and speech-language pathologists may be involved in supporting children with dysgraphia. Occupational therapists work with children on the fine motor and hand-eye coordination skills needed for writing. Speech-language pathologists work with children on the linguistic aspects of dysgraphia (symbols, spelling, composition). There is certainly some overlap in this area. For example, if an occupational therapist is working with a child on their fine motor skills for writing, they will also be working on letter learning (symbol knowledge). Your OT/SLP will let you know which is the most appropriate professional to work with based on your child’s specific needs.