Intervention Using Metalinguistics to Improve Comprehension and Literacy

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Intervention Using Metalinguistics to Improve
Comprehension and Literacy

• Martha Coen-Cummings, Ph.D. CCC-SLP
• ASHA 2008 Conference

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Consider.

• Language is not an isolated sphere of activity
  but our fundamental human instrument for dealing
  with the world.
• E.D. Hirsch, Jr.

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Language to Literacy Model
COMPREHENSION
DECODING SPELLING
PHONICS
PHONOLOGICAL AWARENESS
ORAL LANGUAGE
AUDITORY PROCESSING/ SPEECH PERCEPTION
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APD from the viewpoint of an SLP and/or classroom
teacher

• Auditory processing skills and speech perception
  are foundational skills for the emergence of
  phonemic awareness and in the broader sense
  phonological awareness important argument for
  anyone working with kindergarten through 6th
  graders www.nationalreadingpanel.org/Press/press_r
  el_4_13_.htm
• Language processing skills are the foundational
  skills related to following directions,
  comprehension of academic content (whether
  presented verbally or in text)
• Both these skills are important building blocks
  to literacy important for anyone working with
  children

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In a childs world, its important to have solid
auditory processing and phonological awareness
skills because

• From preschool 2nd grade, children are
  learning to read
• From grade 3 and above, children are reading to
  learn

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Equally important in the early elementary school
years

• A child must learn to listen in order to LISTEN
  TO LEARN!
• Geffner Ross-Swain, Auditory Processing
  Disorders Assessment, Management and Treatment,
  2007, pg.154

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• auditory processing skills and speech perception
  are foundational skills for the emergence of
  phonemic awareness and in the broader sense,
  phonological awareness.
• These skills are important building blocks to
  literacy.

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For the sake of todays conference, we shall use
the following processing definitions for
reference purposes
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Auditory Processing definition (ASHA, 2005, p2)

• a deficit in the perceptual processing of
  auditory stimuli and the neurobiological activity
  underlying that processing
• The evaluation is often a bottom-up approach,
  analyzing the childs ability to transfer the
  acoustic signal via the peripheral hearing
  system, CANS and ending in the upper cortex
  (ASHA, 2005 Chermak, 1998 Chermak Musiek,
  1997)
• Treatment however often takes a top-down
  approach, in which metacognitive and
  metalinguistic strategies are explicitly taught
  to minimize the impact of the processing deficit
  on the listeners life (Bellis, 2003 Chermak,
  1998 Ferre, 2006)

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Research has outlined the problems with
separating auditory processing into distinct
clinical entities

• Lubert (1981) stated that the impairment in the
  ability to detect acoustic features of the
  auditory signal was the primary difficulty
  preventing children from performing higher level
  language tasks.
• Leonard (1998) felt a message had to be
  acoustically and phonetically received and
  retained before meaningful interpretation and
  analysis could occur.
• Multiple authors and resources over time have
  indicated that auditory processing encompasses a
  variety of auditory and language abilities, and
  is not a simple discrete skill that is easily
  isolated and defined (Gail Richard, chapter 8
  Language Processing vs. Auditory Processing in
  Geffner Ross-Swain, 2007)

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Language Processing definition

• Begins at a very concrete level such as noun and
  verb labels, but progresses into experiential
  concrete then into abstract conceptual language.
  Early levels attach meaning to the acoustic
  signal but then refine itself to nuances of
  suprasegmentals of speech (e.g. prosody,
  inflection, timing, etc) Thus, linguistic
  knowledge interpretation of words spoken, but
  meaning changes based upon HOW the verbalization
  was spoken according to acoustic overlays
  (sarcasm, etc.)
• Gail Richard, ch. 8 in Geffner Swains APD
  book, 2007

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Auditory processing and Spelling Skills(When
the Brain Cant Hear, Teri Bellis

• Spelling relies heavily on how we hear sounds,
  and thus in early grades invented spelling is
  encouraged, like in this emerging phonics-based
  spelling example

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(Developmentally appropriate errors)

• My favrit pursun in the wurd is my mom. She koks
  for me and I luv the peesa with peprone on it. I
  luv my bruter, but he ets my peesa and I hit him.
  I haf to go to im owt win I hit my bruter. I
  dont like time owt.

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Invented Spelling samples can provide great
clinical insight into how a child hears the
sounds of speech.

• A CHILDS INABILITY TO PERFORM INVENTED SPELLING
  AT A YOUNG AGE MAY BE AN EARLY RED FLAG OF AN
  AUDITORY PROCESSING DISORDER.
• Look for auditory decoding errors reflected in
  spelling, especially for b, d, g, p, t, k.

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Spelling sample from a 2nd grade girl with
left-hemisphere, speech-sound-based APD or
Auditory Decoding Deficit...same text as
presented earlier.

• My vavd besn ina wud is my mum. She kig fr me anI
  luv the bese wit brone ont. I luv my bute bu het
  my pese anI item. I af tigo tenod hin I et my
  bute. I dun-lit tenod.

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APD and Reading

• An excellent reference to peruse regarding the
  current debate of sensory bases of reading and
  language disorders can be found at
• www.essex.ac.uk/psychology/symposium2001

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Speech-Specific Hypothesis cont.

• This asserts that the processing deficits are
  specific to speech, arising from the difficulty
  of identifying the phonological categories of
  similar phonemes rather than from deficits in
  either the temporal order judgment or the brief
  acoustic changes of formant transitions (Mody et
  al., 1997, p 220)

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Variability between and within studieswhat does
it mean?

• Little agreement in the literature (as
  exemplified by the Essex symposium abstracts)
  which hypothesis is correct, and therefore
  recommendations for treatment are limited and
  varied at best.
• As D.V. M Bishop (University of Oxford, UK)
  summarizes, It seems that no sooner does one
  research group publish a finding demonstrating
  perceptual deficits than another publishes a
  failure to replicate.

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Is it Temporal Processing?

• The temporal deficit hypothesis suggests that
  persons with developmental dyslexia have sensory
  impairments, which involve the processing of
  rapidly changing acoustic information such as
  that encountered in formant transitions.
• This deficit is thought to affect the development
  of reading by disrupting the normal acquisition
  of phonological representations critical for
  sound-grapheme associations

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Principal Auditory Components of Temporal
Processing

• Temporal integration duration and intensity of
  the stimuli
• The perception of temporal order (TOJ) rapidly
  presented linguistic and nonlingustic stimuli
• Short-term memory - necessary to recall elements
  in sequence (Jutras Gagne et al., 2003)
• Temporal resolution interval between two
  consecutive stimuli, may include gap detection,
  masking level difference, detection of amplitude
  modulation, detection of temporal
  asynchronization (Moncrieff, 04)

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Developmental Dyslexia

• Developmental dyslexics, individuals with an
  unexplained difficulty in reading, have been
  shown to have deficits in phonological processing
  the awareness of the sound structure of words
  and more fundamental deficits in rapid auditory
  processing.

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Definition of Dyslexia The International
Dyslexia Association, (2002)

• Dyslexia is a language based learning disability.
  It accounts for approximately 85 of all people
  with a learning disability. Dyslexia refers to a
  cluster of symptoms resulting in people having
  difficulties with specific language skills,
  particularly reading. Students with dyslexia may
  experience difficulties in other language skills
  such as spelling, writing and speaking.

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Auditory and Visual Processing (Multisensory)

• Children with dyslexia often exhibit weaknesses
  in auditory and/or visual processing. They may
  have weak phonemic awareness, meaning they are
  unaware of the role sounds play in words. They
  have difficulty rhyming words, blending sounds to
  make words, or segmenting words into sounds.

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• Knowledge of letter-sound associations, which
  include letter sound recognition, letter sound
  recall, and the ability to print a given letter
  sound, has been identified by Duncan and Seymour
  (2000) as the best indicator, in the early school
  years, of later literacy.
• Additionally, reading fluency is related to
  applying the recognition of auditory cues to the
  grammatical markers contained in the text being
  read.

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• In spite of the neurobiological and genetic
  influences on dyslexia, there is a biological
  basis for the disorder. Neuroimaging data
  indicate that brain processes related to sound
  structure of language are disrupted in dyslexia.
• Disruptions in both phonological and auditory
  processing in dyslexia are linked to
  abnormalities in neural processing.
• (Donna Geffner, ASHA 2004 presentation)

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• Shaywitz et al., (1998) using fMRI found
  decreased activity in temporoparietal
  regions-superior temporal gyrus and angular
  gyrus, during phonological processing of both
  letter and pseudo rhyme.

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Neurology

• An fMRI study by Bernal Altman (2003) included
  17 abnormally delayed speech children and 35
  age-matched children without delayed speech.
• The preliminary results indicated that children
  with unusually delayed speech tended to have
  higher levels of right brain lobe activity than
  children without delayed speech, who tended to
  use the left side of their brains when they
  listen.

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Neuroimaging of Rapid Auditory Stimuli

• Event related potentials suggest that neural
  processing of rapid auditory stimuli is disrupted
  in dyslexics. During fMRI, rapid and slow
  temporal changes characteristic of speech
  nonlinguistic syllables, were presented.
• Dyslexic adults showed a disruption in the neural
  response to rapid auditory stimuli.
• Temple et al., 2001

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• Brain imaging scans of the children who
  participated in training showed that critical
  areas of the brain used for reading were
  activated for the first time and began to
  function more normally. Additional regions of the
  brain were activated in what researchers believe
  the dyslexics use as a compensatory strategy as
  they learn to read more fluently.
• Training that can aid decoding skills, reading
  fluency and comprehension will be discussed next.
  

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ALL CHILDREN NEED PHONOLOGICAL AWARENESS SKILLS
TO BE SUCCESSFUL READERS AND SPELLERS, AND WILL
BENEFIT FROM CURRICULA THAT TEACH PHONOLOGICAL
AWARENESS.
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The role of auditory processing metalinguistic
skills in learning how to read and spell

• The ability to segment words into syllable and
  phonemes requires auditory processing and speech
  perception skills to be intact.
• Auditory processing of sound and speech
  perception are FOUNDATIONAL skills for the
  emergence of phonemic awareness.

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Non-speech acoustical must be taught in
association with grammatical markers!

• Increase comprehension of conversation and text
  by using books on audiotape/CD. Point out the
  correspondence between grammatical markers to the
  speakers inflection and pauses commasbreath,
  period pause, questionsraise pitch,
  exclamationintensity/stress

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Metalinguistic Overlays

• Non-speech acoustical cues that can change
  meaning of a message presented auditorily in
  conversation, or through sentences being read
• Prosody inflectional cues can indicate
  questions vs.exclamation points vs. periods at
  the end of a sentence, etc. APPLYING these cues
  by the reader provides greater fluency to the
  text being read, and often greater comprehension.
• Rhythm can completey change word meaning REcord
  (object) vs. reCORD (verb)
• Stress can impact KEY word understanding
• intonation can indicate sincerity or sarcasm
• Segmenting can change word meaning They saw the
  CARGO on the boat vs. They saw the car go on the
  boat!

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Auditory Training for Metalinguistic cues

• Detection of SILENCE/PAUSE
• Discrimination of pitch patterns,
  intensity/temporal cues associated with sentences
  heard or text read
• Vigilance (noting when stimuli change)

03/10/07
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Temporal Gap Detection

• Ask the child to detect brief gaps inserted
  within brief bursts of white noise which are
  progressively shortened approaching criterion of
  1 - 5 msec of gap detection.
• Use audiometer or even a childs electronic
  keyboard for stimulus presentation
• can use tape recorded samples or present live,
  realizing the poor temporal validity

03/10/07
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SOUND DISCRIMINATION (whether 2 stimuli are
same/different)

• Frequency Differences
• Discern pitch differences of approx. 5 - 10 Hz
• can use available programs (Earobics Step 1
  Farmer Fardell, Away We Go (Scientific Learning
  Corp Spaceship)
• OR audiotape tone sequence of 2 notes presented
  in series of 3, from your audiometer or even
  piano and use in therapy

09/16/98
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DISCRIMINATION (cont.)

• Tone Glide Discrimination
• NORM identification of durations of only 1 - 2
  msecs
• Determine the upward or downward direction of a
  fundamental frequency sweep for tone bursts of a
  few msecs.
• Initially, the clinician can simply whistle
  sweeps, but as accuracy improves, will need more
  valid stimuli from audiologist

09/16/98
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DISCRIMINATION (continued)

• Temporal tone order discrimination
• tones with durations of approx. 25 msec,
  presented with audiometer or keyboard
• listener task is to discriminate tone order
• e.g. High - low - low
• child can use colored poker chips to represent
  the High vs. low tones, which removes verbal
  components from the task

09/16/98
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Video exampleHigh/Low tone presentation

• 2nd level of pitch pattern discrimination

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Live presentationAudience Training of pitch
pattern application

• Pitch rising question mark or exclamation mark
• Pitch lowering period/statement

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Live audience training

• Book on audio-tape/CD listening for pause in the
  text being read to child, and indicating by a
  hand/finger raise when pause is recognized.WHILE
  text is seen

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Continue auditory accuracy of pause
identification step 2

• NOW, xerox several pages from the book being read
  on tape, but white-out all grammatical markers.
• Have the child listen for ONE metalinguistic
  overlay at a time (e.g. pause to indicate
  sentence end, while looking for a capitol letter
  to follow CHILD PLACES PERIOD ON XEROXED PAGE
  WITH COLORED PEN/MARKER.
• Lastly, turn off tape/CD, and compare childs
  grammatical markings to those of the actual text.

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Videotape example of reading application of pitch
changes
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Vigilance (sustained attention)

• Listener required to sustain attention to a
  continuous stream of auditory stimuli (such as
  environmental sounds, syllables, or words) and
  respond (e.g. raising hand or tapping table) when
  a particular target stimulus is heard (e.g.
  Earobics Step 2 Hippo Hoops)
• Failure to detect inattention
• False positives impulsivity

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Metalinguistics moves into Language Therapy

• Discourse Cohesion Devices
• Schema Theory and Use
• Content Schemata
• Formal Schemata
• Schema Induction

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Language Therapy(CAPD New Perspectives
inManagement Chermak Musiek, 1997, p.192 - 199

• Discourse Cohesion Devices
• Referents (pronouns, pro-verbs, comparatives)
• Pronouns Susan heard a noise. She was
  scared by it.
• Pro-verbs The hurricane hit land. When it
  did, the whole town was under water.
• Comparatives Luke loves to play football
  similarly, Kyle love to skateboard.
• Substitution The class designed a fuel pump. The
  parents were not surprised by their childrens
  ingenuity.

03/05
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Discourse Cohesion Devices cont.

• Ellipsis Kerianne loves listening to Ray
  Charles. Her mom does too.
• Conjunctions
• ADDITIVE (and)
• CAUSAL (therefore)
• TEMPORAL (before, after, during)

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Cont. with language strategies

• Schema Theory and Use (a set of expectations
  stored in memory that preserves the relations
  among concepts/knowledge about a situation,
  event, or situation) Children show this ability
  as young as 2 to 3 years (Nippold, 1988)
• Content Schemata (scripts for events related to
  content) The punter kicked the ball vs. the
  golfer kicked the ball.

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• Formal Schemata (linguistic markers that
  organize, integrate and predict relationships
  across propositions, but they do not specify
  meaning) Include conjunctions and correlative
  pairs (not only/but also, neither/nor)
• Schema Induction Induction learning involves an
  indirect approach to instruction, which
  emphasizes the role of DISCOVERY for
  learning.example.

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Metalinguistic Strategies

• Vocabulary Building
• semantic priming
• increased language base
• auditory closure analogue
• Construction of Meaning
• situational cues At McDonalds, I grabbed a
  burger vs. The police officer grabbed a
  burglar
• ambiguous sentences that change due to STRESS
  CUESexamples follow

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Sentence meaning changes due to words emphasized
by increased loudness and prolonging duration

• My MOM will pick me up in front of the school at
  330
• My mom will pick me up IN FRONT of the school at
  330
• My mom will pick me up in front of the SCHOOL at
  330
• My mom will pick me up in front of the school at
  330

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AUDIENCE PARTICIPATION TO IDENTIFY KEY WORD BASED
ON AUDITORY CUES

• Tomorrow my brother will get an award at his cub
  scout meeting.
• Today we need to go to the psychologist to get
  tests run.
• On Tuesday, lets meet at P.F. Changs off exit 12.

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Auditory Memory Enhancement

• Teach strategies such as chunking or verbal
  rehearsal (e.g. Earobics 1 or 2 for word
  (Sam)/phoneme series (Noah) Karloons Balloons
  or Calling All Engines, I Spy programs for word
  lists/following directions when covering text on
  screen and modifying initially, Thinkin-Things I
  for auditory ONLY information)
• Teach Imagery techniques draw key points to
  stories Post-It notes of correct of main
  points, then open set retell story based on
  pictures. Finally draw in your mind.

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More memory enhancement activities to improve
visualization techniques

• Use colorform-type pictures and stickers to
  increase memory for a list/series of items
• Add one sticker
• Next person, adds another sticker, and
  points/verbalizes the items in the order placed
  while LOOKING at the board
• Next, that same person covers the board with a
  piece of construction paper (no visual cues) and
  repeats the sequence of the items placed, but
  pointing to the general location of where that
  item would be under the construction paper.
• This continues for each persons turn until they
  are unable to name the list. It is not unusual
  for kids 10 years and up to be able to recall up
  to 16 items in a row, using this technique, and
  this give them a tremendous amount of confidence.
• Discussing how we typically recall numbers of
  lists (chunking in 3 or 4, like phone numbers) is
  a good start to this activity.

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Metacognitive Strategies

• Assess childs metacognitive knowledge through
  their understanding of task demands
• appropriate allocation of attention
• identifying important parts of the message
• self-monitoring
• self-questioning
• cognitive problem-solving

09/16/98