Speech Language Pathologists and the Remediation of Reading Disabilities

Chrprt, ]2

Speeeh T.anguage Farhologistsand the Remediationof Reading Disabilities

Nimpama Srikanth o Prathibha Karanth

Introduction

r\-fy'uring the ldst 15 to 20 yedrs, resen(hers i$ lhe a,pa or

communication disordeis have evinced an increasins interest ins p,\ ific 'edd ing ,J is.rbiji ties - der elop men tal dy Jeria. C.linicaj insightsand rcceDt developments i.r psycholhguistics have emphasised rheiinguistic .ather than the visual processing aspe€ts of reading. ,Lis-

fenin& speaking, reading and wdting arc interrelated funcriois oflh"\dmecomn uni dtion >ysrem \^e caU tanguaSF. Dyste\ia dppear>on a founddt ion of del .ry in lhe dpvelopmenr of lhe enrire s)<temdevoted to languagd (Richafiso ,'1992,p.92).

Reading proficiency is rooted in tanguage abiliries. Reseafch-eis have investigated aspe.ts of language knowledge as weti asdiscrete language processing abilities in an alrempt to specify thos€abilides that contribute to rcading acquisition. Kan&i (1992) vie!'eddyslexia as a developmental langlage disord€r. It is a ianguageimpairment that trranifesls it5ef in difficulti€s in both spoken andwdtten language dev€lopment. As a rcsdt of this shift in emphasis,speech language pathologists have begun to play a more inrcg]at.ole in the identificatiorl, assessment and remediarion of chiidrenwith reading disabilities.

For years, oral language and reading disabiliries were viewedas two unr€lated problems. Reading was h.eated as a subiecr ro be

sp..Eh Ltuguage Padrolognrs and ihe Renediation of Reding Disabilities 151

learne.l in th€ same martner as hjstory ma6ematics and science_Cradually, views changed and researchers began to explole rhe roleof €ognitive processes in reading. As rcading rheorists began todevelop and rcfine thetr language based rheodes of reading, rheassessme.nt and remediation procedur€s for.hildren v/fth readingdisabilities in.orporated more linguistic factors. Since opeech t?.n-gllage pathologists were already targeting linguislic processes inLheir therapy rvith language disordered childrcn, they began to s:'eihe t i r ,ks behveerr rc iding and or. , l ldng1la9. pro, p<. ine.

F.emediation

In some childre4 linguistic deficits that d;srupt tF,€ir orat tan-gtage also interfere with thef wdten lan$age. In such cases,speech language patirologisls should adopt an intugrated approachto language therapy. Therapy procedures aird materials can be de-veloped lvhich simrltaneously target piocesses crucial to bothwriften and oral language. For exanple, therapy directed ar in-creasing knorvledge of morphological syniactic srxlcturcs can facilitate oral Ianguage as well as reading comprehension. Spcciri.al).,the aim should be to hain children to understand and conshucrmore complex phrases and senLer.ces using boih spoken and printedwords. Speech language pathologis{s also improve reading com-prehension in language disordeied children by facititating rex! levetprocesshg. They can train children io use comprehelsion sh.ategiesinvoiving self questioning, imagery elaboratior or texr sbuctureidenti{ication. These strategies have often been used ro ftrcilitareoral langrage comprehension and appear to be effective in lmproving reading comprehension.

For some language disordered childr€n, thc mosi significanraspect of their-r{iitten language probtem is word lecognirion (Catts& Ka hi, 1986). Herc, speech languag€ pathoiogists could workdirectly on phonoiogical awareness and sound lettel correspon-dence. They have the opporturdty and skill to play an imporrantrole in the developmeni and impiemfftation of phonological awar€nass training progradmes. Iheir training in language, especiallyphonetics and phonology, and experience in training meh in€uisticskills in language therapy prov ide them wi& the mosr appropriarebackground for teaching children to bealvare of thespeechsoundstucture of languagc. In addition, ihey also have direct experience

152 Nintpnflasrikanth a Ptnthil)hn Knrnnth

rJr hdinurS pl onoloSli dr rwdr. ness ;n . ontu1. non q ith dJti. rldHoni lerdp\ lh i5. l in i 'a le. p.r ien.^ wouU p.o\ F \ dtudbtp i , r de\ eropin8and implementin€ phonoloSicat awareness trainingprogram.nes:

Gillon and Dodd (199s) observed en.oumging resutrs ftomstudies using shuctured phonotogical h-aining progrirnmes whichincorporate direct teaching in underctanding the jink between thephonological sturcture of the word and iis wrirten representation.Thcv ddded ihdt l rdi^ ing i r ' phonorogic"t pro. essinS s( i iL hdd dSre. i lar ol le( t on;nrpro\.J18 rpdJrng a,. u, r . \ lhdn only t la iniJrS in. nid.r ic drd semdnti . ski l l , .

nronologtdi pro.cssing -( , i ra ni , .8 programn es in, tddlph.nologn dl anclv\ i \ .Li t t . hr iFr ndme r ro; tedge. segnrenL,r ion.manipulafion, blending of speech sounds and relaringl$is kno,{,1,€dge of spoken language to the written form. Ttris-tlevetops an"r arFac\< of t le sound sblh tu re or sFoten t"nguage rhrougi na.

n. i btenctLns phonemes and creahngr fonscious awareness of how these skiUs are related io reading and spetfing (citlon & Dodd, 1997).

The sound struchre of speech is nor a salient feature of taa_$ age lor some children. These ctritdran have Iiftte conscious aware_ness ol speech during the preschool years and may enter schoolwith a limited appreciation of rhe fac i that words arecomposed ofsound.segnenti (Cans,1991) young chitdren may not tully appre,clate the segnental nature of speect" much less be able to isjatethe initial sound in a word and manage a rarget sou{d held ;nmemoiy It is importanr to begin at a more etementa.y l€vel jn or_der to help children become aware of the sound segnrents of speechSpecific suggestions for phonenic awareness r.iinilg t a," Ue"r.,provided and the tasks describe.l vary in complexity and in rhecognitive lingr.dstic demands ihey ptac€ on rhe;hild.

Sound fk\ A,,nvitis. I hesF ar. roryounSe., hild ren 1z_lr"rr. nidgc) i heqc tasls focus chi tdr. ' r s drtunhon;n rhe sound: oiworr js.This may involve rcciting nursery rhymes that contaii frequenisouncl repetitions. These may be followed by ones that requite moreparticipation from children. They could be encou raged ro say odyone parl ol . phrase. for Ursrrncc hdppJ ror ,happy biahddy:.Mure shucturpd dct iv i t je\ .ould bc use; t l tJ. i t i iatF phonotoCi.ala\\ drene5s Chi ld ren slrould L,ee\pt i (rr tv raLghuo, rr+ori .e s;rdson lhe l ,a\ is of in i t id l / l in" ' cound\ or rhvmi,rg \FgmFnh.

__!

spee.h LanguaSe P6thologLrr aid ,!ie Rem€diation of R€.ding Dnabitlies iEg

. Al.tdit1lj D6trimiwr;r7. At an early tevet, it includes ide.nrj4-ing alrd attending to sounds in rhe w orld around _ marching en;i_ronmental sourds to pictures and lar€r identi4,ing diff€renaes beiween words. Link should be established between r-he teiter soundjheard and the wlitf.en form.

,SetnwtuLlot!. Chlldrenneed to devetop rhe abiliry io s€gmentwords into cound s€gments in order to lerrir ro spel. S€g;enta_iion is imDortant for mor€ comptex words. Researah has revealedahat childrer performed b€tter on syuable segmentatiotl iasl(' thanon phoneme segmentation.

Phonemes are more absbaci than syitabtes. The n€rging oisourlds makes it very difficult to segmenr auditoraNy one ph;n;meirom anotl]er Sylables are more discreiei ihe energy pelk or vo_cali., nrcleus of the syllable pro'ides an audibte cte rhai inay beused in segmentation. Segmentation activities car-! be nrAodtceciby having children identify th.3 energy peaks or sylabtes tu words.hshuchons can start ivith compound words tike ,basebatl, and'cowboy' in which each sytlable is a commor r .ord. Chitdlen willhave to be taught to tap for each syllable and pronoun e each syllable. After this, shi{t to words like ,baby, and ,umbrena, wherechildren have to identify the syllables in those .rvords. Fouowingtnis, phoneue segmentation can be inrroduced_ Because of the atishactness of ihe phonemer explicit and lengthy training js requircd.Ar, o 'din ;ro L.h kodicz( to80), l rdining(;n bpSin byt,etpmg.hi t_arpn \egn-nt Lnihdt phoneme, in l \ords. I le furLher noted lhaichildren should be presented with isotaied phonem€s and rheirkey words. In a progamme caled Alpha Time (Weiman & Fried_ma& 1989) ch;idren were iniroducad ro tatter peopte, i.e., whosenames begtu with a different 6ound, for example, no;sy nose,. Inteaching the sounds of the language in the context ot phonemesegmeniatuon, inskuction should begin wifh confinuant soundssuch as'fricatives and nasals' ({ot exatapte/sl, /z/, /t/ arcf catives and /m/, /n/ arenasals) as opposed to noncontinuantssuch as'stops andglig€s' (torinstarrce, / p/ , /b/, /t/ , / d/ arc stapsand /I/ is a glide). Continuants can atso be pronounced in isoia_f iol l dnd h:ghl ighicd bv rFngtheni.s o. uvcrdrr i .utar io,r a d ih!sm,r.le ed!1er for childrcn to segmenr

Bltul.nt Actun*' Denalid that childran bt€n.t rogerlt€. a seriesofspeech sounds to forin a word. Btendi,.lg js an imp;rran! skilt in

aI54 Nintpnin Sakanth . Plntltibltd Kdrattlh

Iearning to decode a printed word phonetically. In decodn& chil-dren not only havo to identi8, ihe phonemes rcpresented by theiefters or the letter sequences, but aiso have to blend t11e phonamestogether to identify the word. Children should be presented withisolated sllables from multisyllabic words and taught to blendthem rogether. Ii is important to begin with compound words like'railway, toothbrush' before moving to i{ords like'paper'. h teachiltg phoneme segmentation and biending, it is often us€fui to provide ch dren with visual .tues (Elkonirr 1973).

Sotttrd Monipblatiln Tatk:. Require children to lea1.n to deiete(say 'cowboy' v/iihorlt'cow'), ac{d ('al with 'f' at ile beginnnlg) orsubstitute the sound segments in words. Such activities should beinh-oduced only a{ter .hildren have acquir€d proficiency in seg-mentation and blending.

The review of literature on the remediarion oI readins disability re!eah a B iJe r.rngp ot renedirll", hniques ltretlue.r'on Ihatkeeps recuring is what could be the osl effeclive approach toremediation- This question becomes more reievant in the Indiancontext where a vast majol iiy of children come from non-English-<perking b.r . kground.. .r t iendIJ)g Lngt i-h m.diums( hools. Airudi(Sdkanth, 199s) rvas undertaken to evaiuate the efficacy of a reme-dial programme in gnglish in a small group of dyslexic childien. Itwas based on the Aston Teaching Programme. Hower,,ea a fewmodificaiions $'ere incorpolated in vierr' of the difficuliies encoun,tercd by these children nr witten and oral language tasks. The AstonTeaching Programme was chosen as it is a flexible, detailed, usefulsource of teaching ma tedal. It takes into account bodr the strengthsand weaknesses of the child, uses a combined aDproach of audi-lor) and visu.r l modi l i f i^s ald adopis a.ystemll . .pproa.h roenable a chiid to lean. Each task is bfoken into its comDonent irarlsand remedial ion tdk.5 inlo account eaLh ! tdse that a:hi ld n ouldpass t l rough on hL" way lo wri f lan tdn$dgtpror ic iFncy.

Three subjects rvere selected (in the age group o{ 7-12yearc)who were plovisionally diagiosed as'developmental dyslexia'. Apretherapy evaluation was carried out using th(} Indian version(Loomba, 1995) o{ ihe Test of Early Reading Skills (Ra-- & Poiter,1973). This tesi provictes an assessnent of a wide rarge of readingskilis, ftom initial percephral discrimination skills to moie com-plex structural anaiysis of words. lt cove$ almost a[ spher€s ofrcddrng. Ihc lc\ l in. lud' . ' t }e fouowing \Fl : f ion,:

sp.{n iargeage parhotogsts &d thc Rem.atiaiid otReaitig Disnbiiitis 155

t. Alphaberldenrification invotves idenrification of uppe, case-

lette$ (26 *em4 and tcw€, case ]ettem (26 irems).. l-'tilTll:llr.y.,\e^crtrarr !.upp"r c,se rerrers r20 ;ren\)ano torver case lett€.s (2b iteris).

3. Visual Discrimination

.T l1:i !l i: 1'o -,..dr.n,,81r-a. su, n,s v crotr.,j sroJ.,orrourhgure5.

rn Parl2. (he tr .K remdL\ Lhe \aiF, t ru; inc r t jmul i . r , . ,e. ter5

" r:,o_r_:)"ff?re. 8h. b.,i) Jnd

"vo,.i. {for i.s,cn.e. .objq. r \uo orJ U,s, r inr i rr , i ion. in- id\k is to;o-nHfy 4h.Jhtrrrc- two words said are simita| or ditferent (30 items)_5. Phoneme-Craphemecorrespondence.

fdr l I (A) fhe inihdl pt ,one,n. j r hoEen , ' rd rot)os inc iL.; \F ^ordscragiv.nan.ts. id r to, ,r . I hcchi jo rhenharroi jerr_i4 the word LeBi^i,;rg h rrfi the !.iDr*. uncolldnL.(I t ) \uhdJ, :ds\ for e,roing.onsondntPart 2 The task in the thre€ sulrscctions is to write the co|l€_spond;ns sr.rpheDre ol th" w^rd. spot .n aloud, at rhe besin.rxng or urF s ord, dr dre nrrdrng or Lhe u ord ano r}le bienL.o. Jrru(rurdt Ar idty\ i \ jnrolve\ jcr ten.e complet ion choolursdppropridte plurals. tenje mdrker, dnd df i i \c,

Z Oat Reading inctudes differcnr tevels of reading paragraphswhich are given ro cbild,en. Ch aren ar! astea"qiresa'oJ onth€ parLic u la r pdraqraDh.

& I

rl1l8,In, tuJ. ,.: io; rJ3ins rhe chirJ io do borh sponran._orr- and.opy wrir ing.

For each chit4 rhe scores obrained were compared wirh &€ nor_maiive data on Indian children provicled by Loomba (1995).

EriefProfie arui l{istory ofrhe Chiidren Selected

^ An |h" !hf* sLt je".s h.d \ :s i ted Ine Alt tndic Inst j tute of5pee. n anJ Fledru.B. Myrore, forcc,nrptaintsor poor pprtormaj ice .ln d, adcmr(, h.r( . t ' requent orro,, m ,pe ing, .ontu; ion over U.e

poor readirS rnrt w, idJ,8 c( i t ts. dinicut iy.n.arvrng out, rd\- rdom inshu t io rc. io . op\ urg trom Lhe boarj , , r'a'rvLng oul ordt mshr!tions "nd slow Ln furishilg wort. Ut thernree\uutF.tsa{ ie,hrpd, ngi ish med{um s( hootsdnd th.re had b^enno rnJnSe ur rhp mediupl ot inslr u, rron (see ldbtp r2 t . , .

156 Ni/"pn"n Snknath . Pturtiibha Knronth

Trble 12-l B.icf holilc {,f rhc Childrs

Englisn Nril Avengeinr€IiE€nce

Nil AveraSeintelli€a.eOnce Ave.ageintelltS&.e

Prctherapy evaluation leveated tiat the three childrer did fat1,/ie onrudihrr),lnd virudl ta\ksof iderrifc.)rjon, rr.altarri <li.crmiuation, but faced difficulties with rhe phoneme grapheme con€_spondence tasks and written and orat knguage rasks. Detajls of theDasehre asscssment ar€ prcsented in Table 12.2.

1:16l€ 12.2 Prcrhcrnpy Enluiion Dctaits

t ethetuW E"alutton1G-/

-i7.E-----i;-

S.,

1. Alphabet Iddtification

3. visual Discrimimtion

4. Auditory Discriminati@s. Phoneme cEplene Conespondence

26/26 (+)24/261+)

26/26 (+)26/26 {+)

15/16 (+)15/17 (+)19/30\ )

23/30l-)i5l30 (,)

26/26 (+J 26/26 \+j26/26 \+) 26/26l+)

26/26 (' 26/26 (\25/26\) 26/?6 (+)

16/16 (+) 1s/16l+)17/17 (+) \1/17 (-)30/30 (+) 30/30 c)

1s/3o \-) 2e/30 (-)'t4/34

\-) 25/3D | )

e/18 ( ) 18/18 (+) 16118(-)8/15 ( ) 13115 (_) r13115{ )a/2ol J 1e/20{-) 20/n\+)1/10 ( ) 1 /10{- ) 4/ ro t )

No les : / ' ) i nn !d rp " " r , - pp rop r i d e {o , . . d - . ompJPd ro n r nd t rpd , , ,( - ) . I n . l n - r+ Lp ow JFF s , om\ ds tonpJ ,ea ro n t { ndhv dd ,4 .

sp@h r;nguge Palhotogists an.i rte Remediarion or !{qdir8 Dielitrri6 157

Baseline Assessr:rent irr pleading and Writing

CASE A In readjng, ihe chiid preturre<t being read ro, substituredsoundr stipped lines whne readin& guessed white read_.jng simitar wods, reversed tetters aa<i corutused vowek.In w-rfting, rhe child omitt€d t€iters, word

"ndi";;.regularised irregular {,ords, confused "r*"h

a;jmixed capiiat and smati lenefs.

a"A -f 6 L: .edd;ng, i te . hi td .n;<pronoun, eJ ,ro,ds, . rbcjn,T: d 'or:<. .edd &uou8h plr- . ru. i : ! r . . ]c1 s! . . -pdwhrte red ding simjtar words.Ii *..itin& the chdci omirLed lefte,:s, yrord ending6, addedrek". : . .ortused vo\ ets regrra,;er l : rogutJr rrro.

. ,eversed leder) dnd id, od {:liJi irurry Lr Lre ,,ie Lf .or. reci gramnatical skuctures.a i ' f ( h rcrdin8. ihe.hi ld or ispronounced {ord<, sdL\r j_

i ! ] : : \or:r r-dL1 $rodgh p,J|) frudHonl;nd $.es,edwhde reading sindar words.

In wr*ing, rhe chitd omitted letrerc, v.ord endings, ad{tedietrers,

:onfused voweis, r€gnlarised in_eg"d, *.ra",rev€rsed tettels and was unabte to fnrniriate gram_

. matically correct senten.es.

KeepiJrS in view Lle lndi, idu.r, errc. paLre.n\ dnd fic jredlo' o!n.urrres, thc goats s,erc dFte"jr ined dcrordingt) h/or l i !acdone in specfic areas which werei

1. -Audiiory visual chanRet deficiis: ?he €mphas;s was on audi-tory memory and seqlen nr& auditory an.i eisuat dis.ri:ni-n4Bon..rhyme percepi i^n.aud;{o^ _vL,r.dl n,socidtron,scdnriIIDo!, orrespondence, \y;labi6( aiion cn.t u ord rdmfie{ L^...Dl to.ieq.re..ing, di.c.imirrddon d,ld .nemory. J1e remrirl_:ig subgoats proved a cha engng rask_

: Playing the $me ofsinon ,iys,..s.,r \v€ni to r l re n, iker /shop d id bou8htaFptcs(ner .h ' ldadd3 orb8e, nango, et )

" lrFasmE renta.e l€ngth. $jjd reFeaLs 1.n.,I see a do8 ...ts€e a btdck dos.

754 Nitupa,to Sriknnth a Prathibha Kan tll

6 Therap' r l sdvr d . "ntpn.o 6nd qL-sr iorD , tcasted bas€don tle tsrence, e.s.;I h pn, ro t l ,e shop dnd bouahi bJhFi c" and.d8d.€nd rhen". \quEbotu bd"ed on rhe5e, ,tence,

. Wr5p, ' r ph," . " ' to a . t , i ld dd t l .o . h, td h" ,io r€peat rhe ph.ase io another.hild.

o (h 'dM hr !e to,Foor a scquel .eot rerd,cd

€ $uni l mah h,ng t q( : d . ( rag rhp. F, rd to suj -h inosound. f tFrapi I mdr p, a ser 'c of rosd5dad rh" . l , i ld srops B hFn h issound and t$ar o{the iherapist march.

o (hnd,"n h" !e !o.on,cnrrah, on L ie pc,oor ,of lips and ro.g,!e and warch themelves in themirro{ to disrhguish souds.

. Reading out words witll rhe sane inftial or final,oLnd dd rhen dr"w rhe.hild,s drrstio^ to iL

. Rpading out wo,d, in b tu. h onp ot rhp h o.d-has a dilferst inftial o. final soxnd.

o ciying &e .hild a tjst of rtrvminq words anddire.hnS him/her to circle p..e of Ue *o.as

" Using nu.sery ihymes to help chitdrdapDeciateihe.oncept of rhyme

c Crcup aral work, €.&,Tell me a .olou ihar rhymes wfth bed.Idmtily a word that fiymes with.hajrfom thewords: sear/fairlchoP.

o At a basic level rea.hing the .hitd what .osn_tutes a word-a grclp of ieners with space

. Readihga 6entencedd pointinS ro each word.

. L.bellinC the objecrs around rhe room wirh

o Using woodo leners ro mar.h rhe terier ,{i&

. Playing J spy'gane wirh obje.rs rn Ltr rherapyroom using ir il6l lener sou nds only.

€ Using riddles wfth sight words_td rcund, !can bounce, You .ar piay wilh de I begin wth'B'-Wlat ah 17

. Cluldlen look for words m maqaTines besnning wrth cerrain lefters.

RhyftiqS

sp€ech langlag€ Pantoiogists ed &€ Remediario. of Readhg Disabititics 159

o FindinC objecis/picrare in th! therap). ioon/books b€Siming wittr a parricutar sound.

Syliabifi.ation o Le$nlg rhe child listen ro words of varying]€ngths dd idenriting/nakh'i€ rhen w hthe appropriatu ser of syllables.

o SelectinC polysyllabic words froN rir .hild,ssight vo.abulary aad wiiting ihem on ltashcards. civing the.hild a cafd rhat.onsritulesrhe rftr syltabte of the wor4 rh€n gi\ihg rhechild more cads ro sele.r rlre one rhar conpieresr i r F d o r d . e . g . o r a F i

s Helping fte.hild split up long words inro sepa-.ate syllables on paper first. RehindinS the.hild that each syilabte.ontaiN a lowet. Cir_cling syllabls in.olo.'red a€tt pens hetps.

Word Fanilies o Making lists of words wirh CVC conbinatione.9., nar, Pai, cat.

o civhg the child rhe first rwo lefters of the wordfanily, e.9., !a and encounSing lhe chitd iohake as nany words as po$ible wfth ihis wordtamily.

2. Specific spelling rules and cues: The fo{us was on specificdrpac including reglllar pl'rrah, \ ompte\ pturdt\ (1"r/-/.,.r ).mr gL 'e' ru le (/a.e -/d.i, 8), doublp rute \hop-hopp,"3), sorr a ndhard 'c (when 'c ' is rol lowed b\ 'p. t y i t makes ss 5ound,with exceptions which were explained to the children), so{tand hard'g' (when'g/ is followed by ? r, 1,ft makes i soundwith exceptions), silent lene$ (l is sitent belore k in the wordzrrlk, I is sileni before n in the word palTr) ard the use of mne-monic devtues. Simultaneous oral spelling and sylabte divi_sions were used to approach a new wo.d. Rote leandnA wasnol enLouraSed. This aspect rpquired 'orbrdnt re! rs ion. \ormore than one mle was introd[ced per week.

3. Training in comprellension skitls: These skils included ]js-tening comprehensio& thinking, discussior quesrionjngandstory related descriptive tasks, for exampte, giving the chitda series of sentences/ whi€h could be true/fatse and rhe childhad 10 listen and idenii{y fte error Reading orr untitled storiasio the child and the child had to give a title. S€.tuencing simpteduee to foul step.ards to form a storu

164 lJirupntu1 Snkarth . Prnthibltn Knnnth

4. Oral expression: included vocabulary expansion, senten e for,matlon/ sentence .ompletion, naffation, questioning and en-gaging in general conversation.

Vo.abulary ExpaNiotl Playing word buildin8 games wherch rhetherapist p,ov'des one wod and the chitdhas to give a nunber ofFtared words. play-mg games ot expressive retroning:'Tell mesonething rhar is tong/soft/green u1.otour etc,,.

Senience Compietion The child has to conplere seniences apprc-priately:I s i i o n a _ .Th-opposj tcut !e l l r r_

5. W.jtten expression: The emphasis was onvocabulary expan-sion, sentence formatioD and elaboration of parrs of speech.

Vo.abulary Expansion Teadring the child ro use ihe dicrionary. Marknrg wo.ds thar rt€.Lild would eipecr io read in afarD srory playnrg simple..oss,word puzzt$.

Sentence Fomaticn Print several sentences on co-loured ca.ds and c{t rhem into

. lwo haiv€s. The child has to.om_plere ihe second hatf of the sen-aence wher given rhe 6rst half.

Elaboration on Part5 of Spee.h Teaching rhe chitd parrs of speech - nouns, ve.tJs, adjeciives, etc.Tea.inng roots of wods, sutrixes/preftes so ihat rhe child knowswhere to look for a .tqe in an un,

6. .Useof contextclues inreadiirg: implenmfaiionof word decod-ing strategies to read difficult polysyllabic words, encou.ag€duse of segmentation and phonic knowledge and focused onpunctuation.

sp€h tanguaSe Paihoi%istsald the RerEdiatio\ ofRading Diebfitis 161

7. Visuomotor perccptual aspects: Focwed on body awarenessand motor control (for insta*.e, tauch the left eft with the ightna"d), body a.,vareness and lateraliry, di€ctional awareness,foltowing complex sequentiai co mands (for exa/J.ple,uitetlrc frst lettet af lpar ndn? in the lsst sq.nre), \tis..r.al and audi-tory sequential memory and visual search aciivities. Thesea, tivitie' $erp more r.rdily accepled by lhe child'en. sirrceftey did not involve too much of written work.

8. Goals were incorporated to enable the chil&€n to approachlanguage in a systematic manner Renredial programmes wer€so designed as to u6e the sbongmodalities to ihe maximumand shengthen the i{eaker modalities. There rvas a r€gularinteraction beh{een speech language pathologists and schoolteacherc, wift instructio s to the teachers to obserye tie chil-dren and ass€ss the progress made by them.

Some general principles wer€ incorporal€d and follow€d inthe dierapy sessions (from the Aston Teaching Progamme):

1. One-ihtud oI each session was devoted to revision of lhe pre-viour day's worl,.

2. The new maie al was presented frequently and in a number

(a) ln order for learning to be optimai the Iollowing stag€swere followed: recognitior! recall, ielearning and recall.

(&) The leamed material was presented in a variety of situa-tions to enable the child io generalise his knowledge.

3. The remedial activities were novel aDd changed ftequentiyso that the chiidren were not bored or demotivated.

4. In view of the dysiexics' inlerent difficulty with ihe wittenword, a number of strategi€s were inEoduced:(,r) Systematic organisation of word families.(b) Ditrerent strategies {or spening.(c) Use of mnemonic devices to help reading of pho'netically

irregular words.5. Child r€n were constardy reinforced through bonus pcints and

small rewards. Reinforcements acted as a shong notivation

6. Children werc activeiy involved in the leamiog process ratierthan passively assimiiating the information.

162 Nihtpi'ii Stikahth . Prnlhjbhn k'rtutth

7. Children were continually engaged in a meaningtut rask.iui-ing the session.

8 Imnediate feedback was given ro the children on iheir re_sponsos to help them evaluate the adequacy of thek iesponses.

" Theiapy was administered for a pedod of 6 Inon|]..s, T 7/2hours d week and <ub\equen{,v poaLtherdpeuu. d)se\rment xa!dcne. Chi ldrFn re.orded tmproveDrent in phonpme gr.rpheme(o.-respondence, tasks of discdmination (Case A showed improvementin auditory .{iscrimination while Case C.improve.l in vislal dis-crimination), memory, sequencing and language rasks. Howevex"rhere were individual variations. Derails of postrtrerapy evatua-tion are pres€nted in Table 12.3.

T.ble r2-3 lbfth.npy Ev.luaiio! Dctaits

1. Atlhab€t ldentifcation

Pari B3. Visral Discrimnrahd

4. Auditory DiKrimimlid5. PlDnene-crapheme Con6pdden e

26/26 \+)26/26 (+)

26/26 (+) 26/26 (+) 26/2-6 (+)26/26l+) 26/26 (+) %/%l+)

26/26 \+) %/26 \+)26/26l+) 26/26l+J

16/16I+j 16/ \6 \+)15/17l-) 15/17 (-)30/30 (+) 30/30 (+)

30/30 (+) 30/30{+)30/30 (+) 30/30 (+)

17/ t8l+) 17 /18 (+J15/ t5 (+) 12/ 15 ( )20/24?) re/20 (-)e/\01+) e/1o i+)

16/16 (+)15/17 {+)30/30 (+)

30/30 i+)23130 (+)

18/18{+)13/1s (+)1e/20 (+)e/10 (+)

f,iot€: (+): Indicares a8c .lptupnate scores 6 comlared ro noqarjve data(-): lndicates t elow a8e sores as .ompared io nomtive dara_

Cas€ A showed considerable improvement in auditofy diecdmination and phoneme-grapheme correspondence. Bu t the child

Sp€nLdguaaepaiirojogjsts&rdrh€Rehenjatronorlkarlin8Disabiiiries 163

fd(ed di f fnulr j w;rh btendc. In stru, ru r , t " na,ysi . , th".hi td haddlJt : : u,w. in, omph\ prnra t . pasr rens+ ano arr i ies r nn h coutd bedthibuted to the hvet ot dirficuliy or rie tesr rienrs. .r he.hitd wdemore tluent in reading and accurate in na

l":,,:."::,.,f ::",,o:,,1 *.,*s, ;;,i;'::'""*"J"r';"J,i:'ofl:il.'fi l'.;;t{il,['i::T:i"::;.jil"ft x:,"?:.1:1,1-,pc, l ncw word_, Ihe,eaa\aninc"ea.Rta\ dreressot \ord r . rmiles anc the cii rd r on,ersed edsily in Lnqli5h.

.", ";fr "?*"""* ili'jiff "trT?Jt ji jl,ilt ;fl : xxil-ued to have prcblems with te*-se fiarke.s and locat"., ofroot *oras.in reading, rhe child u6ed sylabificarion and de_ai"g J^r"g*;to tackle new words. Therc was very liRte ilneous wriring. rhe cr.rild "".0 "o""*,"" oXli","ffiiffi:i:isord\ Dui wds nor d r ca," c onver, ing Lr tngi i ,h.

," ,, "' i;,:,.'i'.'J:l"l'il:,1 l:":ff,f:i::: :f irresu,a, d,ren-ne.*-g,ipr,.ne.oi ;esp***",* il: ;lj:"":il:::,?.lfj1lr]l'iv

wirlr. :eqrn\ U.rs or telrers m words. spontamour $ rit_ug wd< uncdri \ fdcror) dL,e ro pooi vo.abutaq i t ; t t , . rn,oett inprasKs. rhere w^ no carrvove, ot shdicgies taughr to ract ie n"vl14 ord, rhe chi td tresiratea ro conv". .e; i r- , rgt ;* .

,Cate< B and C.howed mdrted i ln pro! ern en I rn lal ts invot!_rrg pnoneme-grapheme correspondence, se(

11,,::':1 l:.:*- *,:',",,-;-",'"", r'ifX:ff #ililf;11 il" l]l*l

^r*o._Tmpro\ed.ppri(.dfion orspa x1s-ib.dtEI'cs wa\ seen Ul (ase. A and B. Cdse A rared

""it ;n tingrrge

:^T:::111:1"','..*rincn rnsrish. bur rcquireo o funl g,iunilng In sequenrrng dnd.ound corresponden.e Ld)G.. . . t

addibo lo remedial trainin8. -eve,al far lor\ R.rre tounclro affeci tmprovement:

I English languagespoken at home.1. ln l luen,e

"nd hclp ot d supporr ive fani ly.r . r<egxtdr i tu o[d rhi ld aftend;nB iherap].

Proficiency in reading goes hanrl in hand wi(en iansuase. Henc€. a rcm..", r*"",,,-" J'iff::T;:# ;naspp! ts .onsht le \ d .omplete progrdmme.

164 NintpdwSnkaflth a Prnthibhn Ka/anth

Conclusions

A( shred earJier, rcsearch dpmonshdres rhar ldng age im-pdired chi ldren are.orten det ic iFnr in phonotogical anainei. a,ramcr.rorp tdre proDtenr\ L'l te,r rn'ng {o re.rd. 'n order to preveni orl imrt t le e\reni of edrt \ a, adem ic diJh.ulHes e\perienced by tan_gudge impaired., hi ldren speA h rd,rgr ldge pdthotogists sho; ld m,corporare spee(h sound awdrene5\ trditinR in tieir individuat orgroup therapy sessions with rhese chitd.enl

Civen thesign;ficdni Fft"( | of pfionotogicdtawarenesson read.' ' in8 de\eJopment dnd a.ademi, performance. some speech I . iJ,_gudge palhologisLs hd! e d. (orded hjgh pr ioriry lo tla|rling speech-ound dh dre ess. They should work in.onjunct ion wirn. bsirooml.i.her\ Io de5iBn inleruenrion p.ogrdmme< for rarSeted , hitdrent he pr imayesponsibi l iw of ,pee, h tangr,ge pdrhotogi<ts woutdDe ro pro\rde specrtrc ul ]ormation dboul the \ound.hxrFdre ofspeech and work along wirh teachers io set tte most appropriategoals and activities fo. chitdren in their classrooms.

Children who have adequate decoding skils but subtte lan_grdge dFrir i t5 may suffer t rom te\r le\et pro(c$ing del ic i ts r f tarinterfere with their reading comprehension. In theselases, 5peechlanguage pathologists should work along wftJr reading specialiststo design an elfective mten enrion programnre and L,ener meer theneeds of chi ld 'en with Langudge "nd readir ig def i ( ienciFs

. . I hp nature Jnd ̂ \tpnl ot dre role of \PFFC h hng1l jgepat_hoto_grst5 in. remed id tion is deter m inFd bv the . Linical +H i"g in \^ h k h llc)work. In most cases, however, the most important factor infueni_ing t lFir involvFment B ir} readhg disabi l ; ty rs &eir o$ n i I lerest.

, . lcsear,h hdr \how, ' $, trprogiammes that taci t i tate phono.roSrcar awarenass ortpn reduceeartv reading di#icu,h inchildren atr_rsk.lor i:ading disabfity. There is lho an increasing rcco8nition ofthe lhguisri. b.s i5 or rcad ing disa bili v Spee. h languug" pr"hotogistnave narnmg.rnd ctrru(at F\pert ise to implement sui iable inter_\ Fnf io| l progranrmes. I hey \houtd Lake dI .nh-gr.rred \ . ipw or tangudSe iffFdirmenl ano 'ts rclarionship ro d(ddemi. faiture and useLhpj! e\pertise {o remcd) ordla< welj a5 s riflen tan8udgeprobtems.

References

Catir H..(1991). Ia.ilftaring ph@oloSical al,mesr: Role of spe{h languag.latldognb. La,!E!,3a stedr anA Healitlg Setui.es Sctnols, t2,196.2li.

-

i lspe.ci\ lnnguage Path.logisrs ad rhe Reediafion of Readrg Disalitiiies 1f,5

Catts, Il.,.& Kanhi, A- (1986). l1]e hrEdsric Lasis of r.a.ii.g disqdds impii.atios to. drc sp€{h luguaSe Dathologists L4,g!,8., Sp.(h nnd tjehrA S?lu@s n Sthaols,17,329 341.

F l , 6 : . . D . o r ' L q s D . i i , q , d r . . o o i j , , r \ r . . , , , c p t o . r r o € , . , , , \ \ " . - , . sf o l p f . p + - h . ' h g u b p p " , i o l A i . t . r 3 r . 3 r . . 1 \ . n d J : \ , $ . . 4 i - , ,SrJDal\ 22, ta6 2OJ

L ido | C. . & &dd. B Laor ' . fh , a rF , r . . o r r ,4 s , ^ , o roro8 , .a l . - a - r . , .oi l la i ! l i l s n -o1- . , r n8 , ,ev , rFodr

" "1 '1 , \ . t r , " . t ,g ,p . . , , t , .n t , . "

nrt q.,,td.,r qJroo/i 26 58 osGillon, c, & Dodd, B. (19r). Enhan.nrS r\. ptotulogi.ai pruessnrS sli!1s ir

.1ildrer wirh s!{ific rca{tin8 .isabi11q. t-!t.p.rn l.;,unt;J D6ud6 of annt,1uti.ntiaa, 32 67-9L

Kanhi, A. (1992). Respose to insbri.al p€rsPedive, A .ieeelopnoiaL tdg{agetespqtiae. Iatnr'| aJ t2d"t t3 D isabitxns, 25 (r), 4a-s2.

Lewkownz, N (1980). Plor,eni. awanncss rraining: l!}at to r€a.l and trow iot a.\i\. Itutldl .IEdnQn.jnl PsydtalagiJ, n,6a6 7A0.

Loonba, M. 09s5). D6.'?roz naatysis af etythtiat lrgt"ssjar aJ Erglnlt /nditlgiLills i, trdin, rridrer. Unpub1Gt€d Masrer's disMrario+ U v€..q, ofVy-*,Mysore.

R1.,.C., & Pottd, T.c (1973). tjlt'o,ndt Mrtitl.a dl$nosis: A pn.tiel Sudr t'or tip./d!1oo,r l"n./rl NeN Jo*y: prenrice Hatl Inc.Ri.hddson, s.o. (1992). fi8rati@t ospt.ts E dlnerin. paper

lr$dt€d ar rhe tilsrahuaL confmnre on ?ds!!.dv€s on Dystexia, Mlrft€sboro In D I. saryer,lingu8e abilitier ieadjng acauisihon amt dcveloph€ntat dysl€xja: A discsion d hyporlndal ard obsirved retarionships. /o,n!4t,/tuailiry Disbilities,25 (2),32 9s.

srildil, N. (:1995). ncddidrbn offtndi'g tlisrbitit! i11 .hitt!ftn.V^plblishell Masr.i,sd$sertaiion, Urnveisiry of Mysde, Mysore

Weinan, !., & lrie.lman, R. (1989). Aiprn rrr.. Elnford, NI: Ncw Dimmsions in