Dyslexia Guild Conference 2013 - Keynote Speaker Dr Courtenay Frazier

D R C O U R T E N A Y F R A Z I E R N O R B U R Y

R O Y A L H O L L O W A Y , U N I V E R S I T Y O F L O N D O N

THE RELATIONSHIP BETWEEN LANGUAGE AND LITERACY

LITERACY IS PARASITIC ON LANGUAGE SKILLS

• at-risk studies:

precursors to dyslexia

• poor comprehenders

have language

impairments

• literacy in atypical

populations

• intervention focusing

on language

supports later literacy

THE NATURE OF READING

Both skills are necessary. Neither skill is sufficient

COMPREHENSION DECODING

READING

SIMPLE VIEW OF READING

comprehension:

oral language skills

(vocabulary, grammar,

discourse)

decoding:

phonological processing

-

+

- +

skilled poor

comprehender

dyslexia generally poor

reader

(language disorder)

Bishop & Snowling (2004). Psychological Bulletin

Plaut et al., (1996)

semantics

phonology orthography

spoken

words

printed

words

word

meanings

Phonological

skills

Verbal STM

Phonological

awareness

Nonword

repetition

Phonological

Learning

Name

retrieval

Based on Snowling & Hulme (1994)

A T R I S K S T U D I E S

PRE-CURSORS OF DYSLEXIA

DIRECTION OF CAUSATION?

• phonological skills

• reading skills

• need to demonstrate that phonological deficits are

evident prior to reading instruction

reading skills

phonological skills

AT-RISK STUDIES

• considerable evidence that dyslexia is

influenced by genetic factors

• thus, children of adult dyslexics are at

greatly increased risk of becoming dyslexic

• can assess phonological skills in early

childhood, before reading instruction occurs

AT-RISK STUDIES

• Scarborough (1990)

• Snowling, Gallagher, & Frith (2003)

• Nash, Hulme, Gooch & Snowling (2013)

test children at high-risk and

low-risk on phonology, language

and related measures

prior to school entry

follow these children up at ~8yrs:

high-risk: dyslexic

high-risk: not dyslexic

low-risk: not dyslexic

HIGHLY CONSISTENT FINDINGS…

• high-risk children who go on to develop dyslexia have significant and persisting deficits in all phonological tasks • speech perception

• verbal short-term memory • RAN

• phonological awareness

• non-word repetition

• object naming • letter knowledge

• high-risk children who do not develop dyslexia

also have difficulties with phonologically based tasks and non-word decoding • these tend to be milder

BUT

• those that go on to develop dyslexia also

have pervasive impairments in oral

language development:

• vocabulary knowledge, grammar

• those with unimpaired literacy do not differ

from controls on broader measures of

language ability

SUMMARY: AT-RISK STUDIES

• children at-risk of dyslexia have phonological

deficits prior to the onset of reading instruction

• children who go on to have dyslexia also have

broader range language deficits in pre-school years

• children with oral language and phonological

weaknesses at school entry need support to

develop these skills

POOR COMPREHENDERS

EXAMPLE FROM NARA-II

Kim stopped on her way to school. In

the middle of the traffic lay two children. Their bicycles had crashed

into each other. Kim ran quickly to

help. She saw that no-one was hurt.

The children pointed to a television camera. ‘We are taking part in a road

safety lesson’ they said. 1. Where was Kim going?

2. Why did Kim stop?

3. What had happened to the bikes?

4. How do you think Kim felt?

5. What did Kim do?

6. Were the children hurt?

7. What were the children really doing?

8. How did Kim find out what was happening?

POOR COMPREHENDERS

• 10% of normal

population

• unnoticed in the classroom

• Nation & Snowling, 1997 • 17 poor comprehenders

and 17 controls • Matched on age,

nonword single word reading and nonverbal ability

60

70

80

90

100

110

120

Comprehension Accuracy

Normal Readers Poor Comprehenders

Nation & Snowling, 1997

Plaut et al., (1996)

semantics

phonology orthography

spoken

words

printed

words

word

meanings

Synonym judgement (mean the same?)

boat ship

sob boat

Rhyme judgement (sound the same?)

rope hope

joke soap

SEMANTICS VS PHONOLOGY

200

300

400

500

600

700

800

900

1000

1100

Synonym Task Rhyme Task

RT (mse

c)

Poor Comprehenders Controls

< 1% 2.7%

9.4%

21.3%

Nation & Snowling, 1998

eye

hymn

ocean

chaos neighbour

gnat

choir

suede

eulogy lieutenant

Leicester

league

grotesque

enough

muscle

daughter

words that rely on

semantic support

ORAL LANGUAGE SKILLS

• ‘lower-level’ deficits

• semantic skills

• broader language abilities

• working memory

• ‘higher-level’ discourse processing

• inference making

• comprehension monitoring

• integrating text (across passages and with existing

knowledge)

25 poor comprehenders, 23 controls, matched for

decoding, nonverbal ability and age (8-9 years)

Phonology:

Nonword repetition, phoneme deletion and rhyme oddity

Semantics:

Vocabulary, Similarities

Morphosyntax:

Recalling Sentences, past tense generation, Test for the

Reception of Grammar

High-level language skills:

WISC Comprehension, Test of Language Competence

Nation, Clarke, Marshall & Durand, 2004

25 poor comprehenders, 23 controls, matched for

decoding, nonverbal ability and age (8-9 years)

Phonology:

Nonword repetition, phoneme deletion and rhyme oddity

Semantics:

Vocabulary, Similarities

Morphosyntax:

Recalling Sentences, past tense generation, Test for the

Reception of Grammar

High level language skills:

WISC Comprehension, Test of Language Competence

*

*

*

*

* *

*

Nation, Clarke, Marshall & Durand, 2004

HIGHER-LEVEL CONTEXTUAL PROCESSES: INFERENCING

John had got up early to learn his spellings. He was very tired and decided to take a break. When he opened his eyes again the first thing he noticed was the clock on the chair. It was an hour later and nearly time for school. He picked up his two books and put them in a bag. He started pedalling as fast as he could. However, John ran over some broken bottles and had to walk the rest of the way. By the time he had crossed the bridge and arrived at class, the test was over.

How did John travel to school? What did John do when he decided to take a break? Why did John have to walk some of the way to school? How do you know that John was late for school?

What was John trying to learn? Where was the clock? How many books did John pick up? What did John have to cross on his way to school?

(Oakhill 1984)

OAKHILL (1984)

• skilled readers

(controls) better at

answering both

question types

Higher-level contextual processes:

inferencing

• when text made

available, groups didn’t differ on literal

questions but did on

inference questions

• not due to memory

limitations

• see also Nation et al.

1999

Oakhill (1984)

• Adlof et al. (2010) • prediction of comprehension skill in general

• predictors change over developmental time

• combination of test scores better at anticipating comprehension deficit rather than any one measure

• 2nd grade: recalling sentences, letter identification, maternal education, rapid naming

• 8th grade: recalling sentences, phoneme deletion, maternal education, grammar completion, non-verbal IQ

• Nation et al. (2010) • prospective longitudinal study between ages 5-8

• comparison of poor versus skilled comprehenders at 8

• word reading and decoding accuracy ok at all time points

• subtle but persistent deficits in all aspects of oral language ability at each measurement point

language deficits occur before onset of reading

reading environment also important

LITERACY IN ATYPICAL POPULATIONS

autism

spectrum

disorder

(ASD)

social-emotional reciprocity

nonverbal

communicative behaviours

developing and

maintaining

relationships

Stereotyped

behaviour

Routines, rituals &

rigidity

Highly restricted, fixated interests

unusual sensory

interests

social

communication

and social

interaction

restricted repertoire of

interests and

behaviours

SIMPLE VIEW OF READING

comprehension:

word knowledge

sentence processing

context processing

decoding:

phonological

processing

-

+

-

+

Phonology

• seen as a strength

• articulation

• deficits in non-sense

word repetition

common

• assessment of

phonological

awareness skills

almost non-existent

Comprehension

• generally poor

• good vocabulary,

but ‘lexical quality’

poor

• weaker sentence

processing abilities

• problems with:

• narrative

• inferencing

• figurative expressions

• ambiguity

BUT... most studies of small groups with huge VIQ ranges

Higher level deficits associated with lower level language problems

PROFILES OF READING IN ASD

comprehension:

oral language skills

(vocabulary, grammar,

discourse)

decoding:

phonological processing

-

+

- +

???

Bishop & Snowling (2004). Psychological Bulletin

small number are

‘good’ readers at least 1/3 are

‘poor

comprehenders’

large proportion

may be ‘generally

poor’ readers

NORBURY & NATION (2011). SCIENTIFIC STUDIES OF READING

• individuals with ASD seen at two time points:

• Time 1: mean age 11 years

• Time 2: mean age 15 years

• all still in full-time special educational provision

• all have broadly normal NVIQ

• compared to typically developing boys at Time 2

only

50

60

70

80

90

100

110

words non-words words non-words

ALI

ALN

TD

Time 1 Time 2

The Beaver Story

•Integration of words

appropriate to story

context

•Comprehension of literal

and inferential questions

The Hedgehog Story

•Comprehension

monitoring

•phonological errors

•grammatical errors

•context errors

after Snowling and Frith (1986)

•Integration of words

appropriate to story context

•ALI poor

•Comprehension of literal

and inferential questions

•ALI and ALN struggle

•Comprehension

monitoring

•ALI least likely to spot

errors

•grammatical errors

most difficult

after Snowling and Frith (1986)

WORD READING PROFILES

Re

ad

ing

sta

nd

ard

sc

ore

s

0

20

40

60

80

100

120

140

TD ALN ALI LI

Regular

Irregular

Non-words

Lucas & Norbury (in preparation)

WORD READING PROFILES

Re

ad

ing

sta

nd

ard

sc

ore

s

0

20

40

60

80

100

120

140

TD ALN ALI LI

Regular

Irregular

Non-words

these children

struggle to read

connected text…

Lucas & Norbury (in preparation)

INTERVENTION

semantics

phonology orthography

http://readingformeaning.co.uk/

COMPONENTS OF A GOOD INTERVENTION STUDY

• treatment group and a comparison group

• development, practice effects, regression to the mean

• random allocation of children to each group

• reduce bias

• appropriate assessments for ‘diagnosis’ and ‘outcome’

• standardised and bespoke: related to treatment

• ‘blind’ assessment pre/post therapy

• adequate sample size to show treatment effects

• theoretically motivated/evidence based treatment

COMPONENTS OF A GOOD INTERVENTION STUDY

• see Duff & Clarke (2010) Journal of Child Psychology

& Psychiatry or:

• http://deevybee.blogspot.com/2010_08_01_archive

.html

oral language

programme

text

comprehensio

n programme

combined

programme

total of 160 children: randomly allocated to four groups

aged 8-10 years, no cognitive impairment, discrepant reading -

comprehension

2x 10 week therapy blocks: 3x 30 minute sessions per week

delivered by learning support assistants fully trained by research team

oral language programme text comprehension

programme

•spoken

narrative

•listening

comprehension

•figurative

language

•vocabulary

• written narrative

• reading

comprehension

• inferencing

• metacognitive

strategies

all groups improve relative to no treatment controls

all groups maintain improvement ~11 months after treatment ends

Oral Language group show greatest overall and longest-lasting

gains

language is the

foundation on which

literacy is built

children with

language deficits in

pre-school years are

at hugely increased

risk for reading failure

targeted intervention

improves language

and literacy outcome

complex view of reading

semantics

phonology orthography

grammar discourse

context

THANK YOU!

C O U R T E N A Y . N O R B U R Y @ R H U L . A C . U K