Embracing Expertise Series

Significant disparities in early reading proficiency prevail in the United States, as more than half of all fourth grade students are reading below grade level. Among them are children with developmental dyslexia, characterized by the inability to read and comprehend text. Learning to read is a complex, multi-faceted process that relies on several speech and language-related skills, and deficits in any of these sub-skills are known to negatively impact a child’s ability to learn to read. Poor literacy skills can have lifelong negative impacts on academic, social, and vocational outcomes. The American Speech-Language-Hearing Association (ASHA) has long acknowledged that speech-language pathologists play a critical and direct role in the identification and remediation of children with reading and written language difficulties, which is common for children with speech and language impairments. Despite ASHA’s position that SLPs can play a critical role in the identification and remediation of literacy deficits in children and adolescents, survey research has demonstrated that SLPs report a lack of training and confidence on how to support literacy skills in children. In this course, we address this crucial clinical gap by providing a guide for SLPs aiming to bolster their clinical knowledge of literacy development in children. We will review foundational processes of reading development, discuss components of speech and language with an SLP’s scope of practice that are key predictors of literacy outcomes, and provide intervention guidance to support literacy development in children at highest risk for literacy deficits.

The intricate process of learning to read relies on acquiring several speech and language-related sub-skills, which starts well before the onset of formal reading instruction. Speech-language pathologists have an important opportunity to facilitate the development of crucial building blocks for literacy from preschool age, through targeting key predictors of long-term reading outcomes such as phonological awareness. This presentation will provide an overview of the speech and language-related sub-skills that serve as fundamental early building blocks for literacy development, and discuss the role of a speech-language pathologist in supporting children’s readiness for learning to read in early childhood. This course will then review emergent literacy skills and early literacy milestones. We will specify important opportunities speech-language pathologists have to target and monitor children’s emergent language and literacy skills within their direct scope of practice.

Children with speech and language impairments are at significant risk for co-occurring literacy deficits that last well into the formal schooling years and beyond. These deficits may include children with dyslexia, who exhibit a significant difficulty decoding written text for meaning, and children with poor language comprehension which may make it difficult for children to comprehend complex linguistic structure associated with literary contexts. Speech-language pathologists have extensive expertise in subcomponents of linguistic structure that support literacy development through phonological skills and comprehension through semantics, morphological, and syntactic knowledge. In this presentation, we will briefly review more advanced literacy skills beyond phonological awareness, phonics, and other early literacy skills that are necessary to succeed academically in older elementary and secondary grades. We will discuss specific ways speech-language pathologists can provide support for these later literacy skills through appropriate assessment and intervention techniques.

Co-occurring language and reading difficulties are highly prevalent. After all, reading involves accessing and comprehending language in written form, such that language skills are tightly interwoven with the ability to read and comprehend text. This presentation will review the key components of language that are crucial for learning to read and comprehend text. Thereafter, we will discuss the highly elevated risk for reading difficulties among children with language disorders. In this discussion, we will review and clarify terminology used to describe children with language disorders, including the classification of developmental language disorder (DLD). This course will then provide specific recommendations for how speech-language pathologists can concurrently support language and literacy development among children with language disorders within their direct scope of practice.

Children with speech sound disorders are at risk for co-occurring literacy deficits that can have long-term impacts on their academic success. As such, speech-language pathologists play a critical and direct role in the identification and remediation of literacy deficits for children with speech sound disorders. Substantial evidence in the literature shows that children with speech sound disorders are at risk for co-occurring literacy deficits which may impact a variety of pre-literacy or literacy skills including poor phonological awareness, word reading, morphological awareness, and orthographic knowledge. The risk for literacy deficits in children with speech sound disorders substantially increases for children who have a co-occurring language impairment, for children whose speech errors persist after literacy instruction has begun, or when children exhibit production of atypical phonological errors. The risk for literacy deficits in children with speech sound disorders is unsurprising given the phonological nature of both speaking and reading and the amount of overlap in the phonological skills needed to support both. In this course, we review the theoretical underpinnings for the overlap in speech sound disorders and literacy deficits and provide guidance for integrating literacy support into speech therapy for children with speech sound disorders.