Speech Pathology, Literacy and High School Students: The Current State of the Literature

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Speech Pathology, Literacy and High School
Students The Current State of the Literature
Clinical Practice

• Dr. Julie Marinac
• Lecturer in Speech Pathology,
• SHRS, UQ.
• j.marinac_at_uq.edu.au

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Dyslexia through the ages

• 1877, 1897 Word blindness (Kerr Kussmaul)
• 1896, 1917 Congenital word blindness (Morgan
  Hinshelwood)
• 1925 Strephosymbolia (Orton)
• 1947 Specific reading disability
  (Eustis)
• 1962, 2005 Reading disability (Kirk Bateman
  Cantone Brady)
• 1972, 2003 Unexpected reading failure (Symmes
  Rapoport Shaywitz et al.)
• 1975 Specific reading retardation
  (Berger, Yule Rutter)
• 1985 Poor reading (Olson, Kliegl,
  Davidson Foltz)

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Dyslexia, defined and redefined

• Disorder in children who, despite conventional
  classroom experience, fail to attain the language
  skills of reading, writing and spelling
  commensurate with their intelligence abilities
• (World Federation of Neurology, 1968).
• A specific language based disorder of
  constitutional origin, characterised by
  difficulties in single word decoding, usually
  reflecting insufficient phonological processing
  abilities (Orton, 1995).

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DSMIV-TR (2000) and Dyslexia

• Describes 2 correlates for dyslexia but not
  dyslexia per se.
• 1) Reading disorder (315.00) unexpected failure
  to attain age appropriate skills in reading and
  decoding single words and text
• 2) Disorder of Written Expression (315.2)
  difficulties demonstrated in spelling and/or
  written language skills
• Both of these can co-occur or appear in isolation

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Sub-types of Dyslexia

• Visual or visual-perception (Warnke, 1999)
• Probably only 5-10 of those with dyslexia
• Surface (Castles and Coltheart, 1993)
• Primarily affects reading and spelling of
  irregular words
• Deep (Stanovich, Siegel Gottardo, 1997)

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Phonological dyslexia

• May be called Developmental Phonological
  Dyslexia
• Reflects expectation the difficulties will emerge
  during period when reading, spelling and writing
  are being learned.
• May not be applicable to students who have moved
  beyond the literacy learning period (i.e.,
  secondary school students)
• Phonological Core Dyslexia
• Phonological dyslexia that impedes the
  acquisition of age appropriate literacy skills
  beyond primary school age

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Phonological Core Dyslexia

• May originate in a deficit in phonological
  processing skills
• Demonstrated by written language skill deficits
  even in those who have learned to read
• May include those who are not diagnosed until
  secondary school, the compensated adolescents
  and adults (as per Birch Chase, 2004 Wilson
  Lesaux, 2001)
• Compensatory strategies and/or the educational
  environment (e.g., total reliance on sight word
  knowledge, and/or learning in a sight-word
  environment)

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Recent Findings in the Literature Prevalence

• No specific figures for secondary school students
• 20 of the school population (Glezerman, 1983, in
  Grigorenko, 2001)
• 3-10 of the population (Snowling, 2000).
• 5-17 of school-aged children in the United
  States
• 30 of Yr 8 students and 25 of Yr 12 read at a
  level below expected (USA Department of
  Education, 1998).
• Based on reading disability only primary factor
  acknowledged as phonological processing deficits.

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Recent Findings in the Literature Causality

• Wide-spread agreement for a neurological basis
  (Warnke, 1999).
• Very little definitive, empirical agreement as to
  the precise area of the brain affected (Temple,
  2002).
• WHO- developmental associated with abnormal
  neurobiological development related to brain
  structure and brain function (ICD-10).
• Activity deficits in connective tissue between
  posterior and frontal regions (Temple, 2002), or
• In interhemispheric connective tissue (corpus
  callosum) (Shillcock McDonald, 2005).

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Recent Findings in the Literature Causality

• Defined by multiple genes/loci (Grigorenko, 2001)
• May be autosomal dominant and additive
  (Pennington et al., 1991).
• Positive family history increases risk 5.7 times
  general population (Pennington and Lefly, 2001).
• 61 of high-risk familial history 80yr. children
  had reading difficulties in comparison with 13.8
  of those without the familial risk (Snowling,
  Gallagher, Frith, 2003).
• Genetic factors may determine structural/physiolog
  ical differences in the brain then environmental
  factors ameliorate those differences by cognitive
  usage .
• (Grigorenko, 2001 Vellutino et al., 2004).

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Recent Findings in the Literature

• Universal but language structure plays major
  role in type/level of difficulties with English
  being particularly problematical
• (Grigorenko, 2001).
• Attention/conduct disorders secondary to dyslexia
  more frequent than normal and LD controls, but
  not depression until 18 years of age.
• Criminality and unemployment risk is 24-25
  (non-dyslexic is 4 German data) (Esser
  Schmidt, 1994)

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Evidence from the Clinic

• Screening 17.66 of 386 Yr 8 students PA/PP
  deficits
• Skills deficits
• Phonological Awareness (discrimination,
  segmentation and blending)
• Vowel knowledge and discrimination
• Metalinguistic and metalanguage
• Auditory memory and organisation
• Written language planning and production

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Evidence from the Students

• Complete reliance on sight word reading/spelling
• Instant recognition of consonants but not vowels
• Lack of awareness of vowel spelling variations
• Word-by-word reading (scanning issues)
• Matthew effects
• Lack of need for punctuation
• Expressive language not translated into graphemic
  form
• Rejection of academic potentials and ideals

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BSHS / UQSHRS Experience

• 3 Tiered Collaborative Service Delivery
• Teacher observation (reactive)
• Whole school screening (Teaching staff PATHS
  CII proactive)
• In-depth assessment by Sp Path (diagnostic
  decisions)
• Within class intervention (PATHS-PA Spelling
  Classroom Program)
• Learning Support (PATHS Support Program in small
  groups)
• Speech Pathology (PATHS Support Program and
  individual therapy)
• Teaching staff (academic and curricular
  responsibility)
• Learning support staff (on-site assistance and
  management)
• Speech Pathologist (diagnostic and management
  responsibility)

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Where to from here?

• Accept responsibility for assessment and
  treatment of PCD in secondary school students
• Accept need for, and utility of, collaborative
  approach
• Ensure professional development in secondary
  schools includes literacy learning failure and
  PCD
• Research, research and more research
• Identification, assessment, prevalence,
  incidence, outcomes, intervention, efficacy,
  awareness, evidence for practice, etc.
  everything that has been done in the primary
  school sector needs to be replicated in the
  secondary school sector!!!!