But is this the Best Practice Recommendation?

Those of you familiar with my blog, know that a number of my posts take on a form of extended responses to posts and comments on social media which deal with certain questionable speech pathology trends and ongoing issues (e.g., controversial diagnostic labels, questionable recommendations, non-evidence based practices, etc.). So, today, I’d like to talk about sweeping general recommendations as pertaining to literacy interventions.

Nowadays, more and more SLPs are becoming involved in the assessment and treatment of literacy.  And that is not only truly wonderful and commendable but is certainly well supported by ASHA, our national organization. In this process, many professionals are trying to obtain additional education and training on this subject and this is where it becomes more complicated. Whenever professionals post questions on their own or parental behalf regarding best practices in literacy interventions, invariably a flood of well-meaning advice will follow. Numerous recommendations will be made to either obtain or seek out Orton-Gillingham/Wilson/Lindamood Bell/Barton trainings/specialists in order to work with children on reading.

However, believe it or not, the truth is that while some of these trainings are advantageous if given by reputable providers, most are unnecessary. Furthermore, when used with children in isolation, the above approaches actually possess pretty significant limitations.

Before I explain why let’s take a look at the components of reading instruction necessary for the creation of successful readers. In order for children to become successful readers, they require instruction in the following aspects of literacy: phonological and phonemic awareness, phonics, vocabulary, and semantic awareness, morphological awareness, orthographic knowledge, as well as reading fluency and reading comprehension. Furthermore, while synthetic phonics is HUGELY important for reading success, it is only the first of many steps, necessary to becoming a proficient reader.

So what are the best practices with respect to literacy interventions? Well, it’s quite simple really. How can you possibly know how to intervene if you have not determined the extent of the child’s deficits in the areas of language and literacy?

How can one possibly recommend a random intervention, without knowing if it’s even applicable to the student in question?

Here’s a basic example for illustration purposes. Several years ago I was asked to perform an initial evaluation on an 11-year-old student who was displaying very severe difficulties in learning to read. This child had been receiving Wilson instruction in the school setting for several years, with very limited gains. A review of his records had revealed that this instruction was initiated without any form of a reading assessment and that his language abilities have also not been previously assessed either.

Unfortunately, this was quite apparent when I observed his reading instruction session with a focus on decoding disyllabic words (Wilson Student Reader 3).  At that time, the student was reported to have been “stuck” at that level for a period of almost one year.  During the observation, it became very quickly apparent why. The student continued to present with very significant decoding difficulties and was only partially successful with his task secondary to memorization strategies (he had worked with that workbook for such a long time that he had managed to memorize many of the words).

When I performed a comprehensive assessment of the student’s language and literacy abilities, it quickly became apparent why the student was struggling so significantly with reading. He had deficits in many foundational areas of language and literacy including phonemic awareness, vocabulary, morphology, orthographic knowledge, narrative abilities, etc. Hence, I knew that unless these deficits were systematically and explicitly addressed in conjunction with providing the student with a reading instruction focused on his areas of needs, the student would continue to struggle with reading, and no amount of Wilson intervention would be helpful.

Furthermore, it is important to note that none of the reading interventions (e,g., Wilson, Barton, Seeing Stars, etc.) when provided in isolation, without meaningful supplementation, can adequately meet any student’s reading needs. To illustrate, the Institute of Education Sciences examined available data and concluded that the Wilson Reading Program was found to have positive effects on sound-letter correspondence but “no discernable effects on fluency or comprehension.” As a result, Wilson instruction may be useful for establishing initial sound-letter mastery, but then additional instruction is still required to address students’ abilities in the areas of phonemic awareness, morphological knowledge, reading fluency and comprehension.

Hence, user beware! Whenever you hear a well-meaning recommendation, “The child/student requires ______ instruction“, keep these 3 things in mind:

1. A comprehensive language and literacy assessment is ALWAYS required prior to the initiation of any intervention in order to catalog areas of deficits and establish initial treatment targets
2. NOT one instructional reading approach to date, when used in isolation, will remediate all of the student’s reading-related deficits
3. It is not the instructional approach but the knowledge and skills of the professional which are ultimately responsible for teaching the child to be a good speaker, reader, speller and writer

For more  FREE EBP information pertaining to assessment and treatment of literacy (including instructional videos and books), visit SLPs for Evidence-Based Practice group on Facebook.