1. LANGUAGE LEARNING DISORDERS
Understanding language difficulties and
current evidence-based teaching practice
University of Queensland
Speech Pathology Presentation
2008
Christine Barrett and Samantha Short
(4th year Speech Pathology)

2. ACKNOWLEDGEMENTS
Dr Lorraine Hammond
Dr Michael O’Keeffe
Professor Gail T. Gillon
See References and Resources for list
of research evidence…

3. DEFINITIONS
Learning Disorder (LD)
•Unexpected difficulty relative to age and other
abilities to learn in school (Listening, reading,
mathematics, social skills)
Language Learning Disorder (LLD)
•Learning difficulty that primarily affects
language-based skills such as reading, writing,
spelling
Dyslexia
•Specific language-based disorder characterised
by difficulties in single word decoding, usually
reflecting difficulties in phonological processing
abilities
(Paul, 2005)

4. DEFINITIONS
LD
LLD
DYSLEXIA
(Paul, 2005)

5. STATISTICS
•70 to 80% of children learn how to
transform printed symbols into a phonetic
code without much difficulty (Shaywitz,
2003)
And the remaining 20-30%???

6. STATISTICS
•Around 20 to 30% of children need a
specific reading instruction (Mather, 1992)
•Up to 1/3 of the world’s population remains
illiterate (Roselli, 1993)
•20-30% of Australian children have difficulty
learning to read (Westwood, 2001)
•Even when good classroom instruction is
delivered in preschool and kindergarten,
approx 20% of children fail to acquire
adequate phonological awareness skills
(Schuele & Boudreau, 2008).

7. BASICS OF READING
There are two major components in
the reading process:
Decoding - results in word identification
Comprehension - results in deriving
meaning
(Shaywitz, 2003)

8. PA DEVELOPMENT BENCHMARKS
Source: Schuele & Boudreau (2008)

9. THINGS YOU MAY NOTICE IN THE CHILD
WITH LLD/DYSLEXIA…
• Insensitivity to rhyme
• Trouble learning letters/ sounds of
alphabet
• Failure to understand that words come
apart
• Inability to match letters to sounds
• No word attack strategies for unfamiliar
words
• Miss chunks of words (eg get first & last
bits but miss middle)
• Phonetic errors - look similar, sound
very different (eg gorse & goose)

10. THINGS YOU MAY NOTICE IN THE CHILD
WITH LLD/DYSLEXIA…
•Educated guessing of a word
(when reading) from the first
letter/sound/syllable
•Family history
•Good at verbal activities and
not so good at written activities
•Avoidance of reading
• Terror about reading aloud
(O’Keeffe)

11. AREAS FOR ASSESSMENT OF A CHILD WITH
SUSPECTED LLD/DYSLEXIA
•Cognition
•Speech and language/PA skills
•Memory
•Visual perceptual skills
•Fine motor skills
•Case history (family history and
child history)
(O’Keeffe)

12. AETIOLOGY
The truth is…
we don’t
know!
(yet!)

13. SUSPECT THEORIES ???
•Magnocellular Theory
•Scotopic Sensitivity Syndrome
•Cerebellar Developmental Delay
•There is no doubt that the core
problem in dyslexia is phonologic
(i.e. related to sound awareness and
manipulation)

14. What we do know comes
from studies using fMRI…

15. Brain
Basics
(Hammond, 2002)

16. WHAT WE DO KNOW
•fMRI imaging has identified 3 reading pathways
in the brain’s left hemisphere
•Dorsal parietal-temporal system - word
analysis – beginner reader area e.g.
‘dog’ reading by linking sounds to letters
•Ventral occipito-temporal system - word form
- an automatic pathway used by skilled readers
once they have a stable neural representation
of the word (spelling, presentation and
meaning activated on sight of word)
e.g. ‘d-o-g’ – furry animal, pet, barks
•Left inferior frontal gyrus - articulation and
word analysis – strategy used by skilled
readers allowing them to slowly analyse
(Shaywitz, 2003) unknown word

17. BA - Inferior frontal gyrus
Parietal-temporal
ARTICULATION / WORD (Dorsal) region
ANALYSIS
WORD ANALYSIS
Three Regions Occipito-temporal (Ventral)
region WORD FORM
of Interest

18. WHAT WE DO KNOW
Good readers use these three areas to
decode words
Therefore reading is easier and more
fluent
Poor readers rely more on the front
and right side of the brain to decode
words as a compensatory mechanism.
This system is functional but is not
automatic.
Reading is less efficient and therefore less
fluent.
(Hammond, 2002)

19. WHAT WE DO KNOW
•fMRI examination shows neural differences
in the structure of the brains of people with
dyslexia (reading problems) when compared
to people who do not have dyslexia.
•The complexity of the brain and its
development presents numerous
opportunities for faulty wiring to be present.
•Different degrees of dyslexia occur with
variations in faulty wiring.
•Impaired phonological processing leads to a
“hazy” mental representation of a word
which interferes with the formation of a
stable neural model of the word.
(Shaywitz, 2003)

20. WHAT WE DO KNOW
•Neurological evidence exists showing that
there are gender differences in brain activation
patterns when completing phonological tasks:
•Females – activate the right and left sides of
the brain while
•Males – only activate the left hemisphere
•Neurobiological proof also shows that same
posterior brain disruption seen in children with
dyslexia is also seen in adults with dyslexia.
This shows that reading problems do not ‘go
away.’
(Shaywitz, 2003)

21. INTERVENTION
A good program:
Identifies
→Weakness in getting to the sounds of words
→Strengths in thinking and reasoning
Provides
→Early help for the weakness
→Accommodations to help access strengths
•Overall, focuses on both strengths and
weaknesses!!!
(Shaywitz, 2003)

22. INTERVENTION
Basic ingredients of a good program
(from what we do know):
•Early intervention
•Over-learning
•Individualised
•Systematic and explicit instructions
•Consistency (in teacher/aide)
•High intensity
•Teacher knowledge and experience
(National Institute of Child Health and Human Development)
www.nichd.nih.gov/publications/nrp/smallbook.cfm

23. INTERVENTION
•fMRI studies have shown that with early,
effective intervention:
•Children can develop into accurate and
fluent readers.
•Can be trained to use the automatic
reading pathway at the back of their
brain.
•So intervention with these children is
effective and makes lifelong changes
to a child’s academic success
(Shaywitz, 2003)

24. INTERVENTION
Specific ingredients of a good
speech/language program:
•Oral reading with feedback
•Accommodation for student needs
•Strengthen student strengths
•Specific and explicit instructions in
phonics
phonemic awareness
decoding
rote learning
vocab expansion
reading comprehension strategies
written composition training
(National Institute of Child Health and Human Development)
www.nichd.nih.gov/publications/nrp/smallbook.cfm

25. SPEECH PATHOLOGY – TEACHER COLLABORATION
•Teachers are rarely able to provide such
appropriately focused and sufficiently
intensive instruction within the constraints
of their classroom.
•Speech pathologists have the benefit of
working intensively with individual
children. They can implement specific
strategies designed to target individual
needs.
(Speech Pathology Australia, National Inquiry into the
Teaching of Literacy, 2005)

26. LANGUAGE DISORDER INTERVENTION
•A challenge for everyone providing PA
intervention is that there is a lot of
information on WHAT to teach and not
much on HOW to teach it.
•As a starting point, refer to your ‘Beyond
the Basics’ handout which includes:
•Example instructional dialogues
•Steps for teaching PA skills
•Types of modelling strategies
•Instructional sequences for PA intervention
•Tips for responding to errors
•Scaffolding tips
•These basic strategies can be applied to
working with anyone with reading difficulties
(Scheule & Boudreau, 2008)

27. LANGUAGE DISORDER INTERVENTION
SOME TIPS:
•Teach, don’t test: Demonstrate repeatedly
the process by which one “solves”
phonological awareness tasks.
•Plan strategic instruction: Carefully order
instructional activities within each step of
the instructional sequence (and instructional
stimuli within activities)
•Scaffold children’s success: Respond
strategically to children’s errors and correct
responses. Consider also that accurate
responses or answers may not always reflect
successful learning.
(Scheule & Boudreau, 2008)

28. PHONOLOGICAL AWARENESS INTERVENTION HIERARCHY
Source: (Scheule & Boudreau, 2008)

29. RECOMMENDED RESOURCES AND REFERENCES
Castles, A. & Coltheart, M. (2004). Is there a causal link from phonological
awareness to success in reading? Cognition, 91, 77-111.
Cirrin, F.M., Gillam, R.B. (2008). Language intervention practices for school-
age children with spoken language disorders: A systematic review.
Language, speech and hearing services in schools. 39, 1, s110-s137.
Gillon, G.T. & McNeill, B.C. (2007). Integrated Phonological Awareness: An
intervention program for preschool children with speech-language
impairment. Canterbury: University of Canterbury.
O’Shaughnessy, T.E. & Lee Swanson, H. (2000). A Comparison of Reading
Interventions for Children with Reading Disabilities. Journal of Learning
Disabilities, v33, 3, 257-277.
Schuele, C.M. & Boudreau, D. (2008). Phonological Awareness Intervention:
Beyond the basics. Language, speech and hearing services in schools, v39,
3-20.
Shaywitz, S. (2003). Overcoming dyslexia. New York: Random House Inc.
Speech Pathology Australia. (2005). Literacy Teaching Based on Evidence;
What roles can SLPs play? Melbourne: Speech Pathology Australia.
SPELD – Specific Learning Disability Association (Queensland)
www.speld.org.au

30. RECOMMENDED RESOURCES AND REFERENCES
cont’d
•www.progressivephonics.com
•www.brainconnections.com – Dr Barbara Foreman
•Marcia L Tate – Reading and Language Arts worksheets
•www.texasreading.org
•www.letterland.com
•http://education.qld.gov.au/students/procedure/program/reading-recovery
•www.jollylearning.co.uk
•http://www.elr.com.au
•www.greatbookstoreadaould.co.uk