An Early Intervention for Dyslexia
Dyslexia is a specific learning disability that is neurological in origin.
But the brain has plasticity - it can be changed.
NIH research has repeatedly demonstrated that lack of phonemic awareness is the root cause of reading failure. Phonemes are the smallest unit of SPOKEN language, not WRITTEN language.
A play based early intervention with a focus on spoken language is vital.
The National Reading Panel - NRP - assessed the effectiveness of different approaches used to teach children to read. There have been other national reports, but the report from the NRP remains the most widely accepted and cited. On two topics—technology and encouraging children to read—there were not enough studies from which to draw conclusions. More research is needed to decide whether technology can be used effectively to improve reading, and how best to encourage children to read in ways that will improve their reading ability. At the Shaping Brains Centre this is one of our focus areas.
The NRP concluded that phonemic awareness helped children of all levels improve their reading, including normally developing readers, children at risk for future reading problems, disabled readers, preschoolers, kindergartners, 1st graders, children in 2nd through 6th grades (most of whom were disabled readers), children across various SES levels, and children learning to read in English as well as other languages.
Lack of phonemic awareness had been found to be a high predictor of a reading disability. Phonemic awareness is often confused with phonics and it is important to have a clear understanding of each and not assume that children will develop phonemic awareness while being taught phonics. It also is useful to distinguish phonemic awareness from another related term, phonological awareness. The systematic teaching of phonemic awareness is critical for individuals diagnosed with dyslexia. Phonemic awareness is something that should be taught before phonics—or at least early in the phonics sequence—so children receive maximum benefit from their phonics instruction. Currently all UK schools teach reading using phonics - however, if the struggling child has been taught using phonics, and is not reading well, it is unlikely that more of the same program (eg in small groups or on 1:1 basis), or a different phonics scheme will help them until they improve their phonemic awareness. This is also the case for adults who cannot yet read. While many organisations are seeking to help functionally illiterate adults to read using a 'phonics' approach the underlying phonemic awareness issues many face are again not addressed. Worryingly, the help offered in may cases seem to repeat the use of the same strategies that likely failed them in the first pace - for example splitting words into 'units' larger than phonemes and asking students to learn whole high frequency words as 'sight words.' Many also seem to only focus on a limited number of graphemes and use decodable readers that only have these graphemes plus some 'sight words', and 'finish' their sessions at this point, with the learner still unable to read a newspaper. Many do not teach spelling at the same time, or even expose learners to the 300+ graphemes used to read and spell in English. Many phonics programs only show around 90, for example the graphemes covered in 'Letters and Sounds'. While this can provide a great start, far more is needed if students are to read with fluency and comprehension, and know how to spell unfamiliar words while writing.
When a 'spelling to reading' and 'speech to print' approach is taken it is arguably far easier to change brain activity, and see increased activation in the left hemispheric regions important for reading. 'The use of an evidence-based phonologic reading intervention facilitates the development of those fast-paced neural systems that underlie skilled reading" (Shaywitz et al. (2002) p. 931).
The evidence relating to levels of phonemic awareness on school entry is overwhelming, whether a student has dyslexia or not. Phonemic awareness has been shown to be a very powerful predictor of later reading achievement. Phonemic awareness] is a better predictor than more global measures such as IQ or general language proficiency. (Griffith and Olson, 1992)
Even before a student learns to read, we can predict with a high level of accuracy whether that student will be a good reader or a poor reader by the end of third grade and beyond (Good, Simmons, and Kame'enui, 2001; Torgesen, 1998, 2004). Prediction is possible with simple tests that measure awareness of speech sounds in words. The importance of phonemic awareness in reading has been shown in studies that reveal the close connection between phonemic awareness and reading achievement (Torgesen & Mathes, 2000): Young children with well-developed phonemic awareness skills tend to be successful readers, while children without these skills usually are not. Instruction in speech-sound awareness reduces and alleviates reading and spelling difficulties (Adams, Foorman, Lundberg, & Beeler, 1998; Gillon, 2004; NICHD, 2000; Rath, 2001). Teaching speech sounds explicitly and directly also accelerates learning of the alphabetic code.
A report from the National Association for the Education of Young Children argues that there is ample time in the preschool day for phonemic awareness activities within a play-based program. For children at risk, in particular, early intervention has been shown to be of critical importance. Cunningham, AE & Chen, Y 2014, Matthew Effects: the rich get richer in literacy, Encyclopedia of Language Development, SAGE Publications Inc, Thousand Oaks, CA; Griffiths, Y & Stuart, M 2013, Reviewing evidence-based practice for pupils with dyslexia and literacy difficulties, Journal of Research in Reading, 36(1), 96-116. )
The US National Reading Panel found that children as young as four years of age benefited from instruction in phonemic awareness and the alphabetic principle when the instruction was presented in an interesting and entertaining, albeit systematic manner. Our own work has indicated that this work can start much earlier. At the Shaping Brains Centre we aim to offer unique research in this area, with students participating in early intervention sessions from the age of 18 months.
Reid Lyon has suggested that the 20 million children suffering from reading failure in the US at the time could be reduced by approximately two-thirds through effective phonemic awareness training. There is no reason to think this would not apply in the UK.
Diane McGuinness is an outspoken critic of whole language instruction but also of phonics as traditionally taught - the "print to speech" method ie 'what sound does this letter make ?'. Instead she strongly advocates the approach to early reading instruction known as linguistic phonics - the "speech to print" approach. This has a clear focus on phonemic awareness and explicit instruction in the mapping of phonemes to graphemes - the alphabetic code. McGuinness stirred up controversy many years ago for her views on dyslexia and teaching letter names. She argues that dyslexia is a socially created problem that results from a complex spelling code and ineffective teaching methods. Claims made in her book 'Language Development and Learning to Read: The Scientific Study of How Language Development Affects Reading Skill' support this idea, for example using data from non-English speaking countries that have a transparent alphabetical writing system. Such countries report no or low illiteracy rates (with reference made to OECD reports) and the condition of "dyslexia" is entirely unknown, due to there being no need for decoding in reading acquisition in such writing systems. In her 2004 book she states "There is no question that the high functional illiteracy rate in English-speaking countries is largely a product of our formidable spelling code and the way it is (or is not) taught." (p. 41)
The McGuiness 'prototype' is as follows:
Research informs us that we should follow these principles when teaching reading: The Prototype
• Teach a ‘sound-to-print’ orientation. Sounds, not letters, are the basis for the code.
• Teach phonemes (individual sounds) only – no other unit.
• Begin with the Basic Code (a one-to-one correspondence between the 40–44 sounds and their most common spelling).
• Teach children to identify and sequence sounds in real words by segmenting and blending, using letters.
•Teach children how to write each letter. Integrate writing into every lesson.
• Link writing (spelling) and reading to ensure children learn that the alphabet is a code and that codes are reversible: encoding/decoding.
• Lessons should move on to include the advanced spelling code (the 136 remaining common spellings). All sounds in English have more than one spelling. Teachers must avoid any technique, strategy, or tool that will mislead children, and this means:
• No letter names. Letter names are a source of ‘noise’ which block an automatic connection between sounds and their spellings. ‘Catch-up’ readers in particular, rely on a strategy of mixing sounds and letter names when they try to decode.
• No sight words. Remember, no one can learn to read by memorising whole words by sight (see Introduction), and research consistently shows that whole-word memorisation has a highly negative impact on learning to read. Even the Exception words (see p19) can be partly decoded phonetically.
• No guessing. There is no need to guess in a sound-based methodology. Guessing creates a climate of insecurity. Beginning readers and flawed readers need a climate of security to access the code successfully.
Diane McGuinness, p.121 and p323 Early Reading Instruction, MIT Press 2004 T
According to the NHS up to 1 in 10 students have some degree of dyslexia, which is a life long problem. This appears to contradict the hypothesis that dyslexic brains can be 're-wired' . D.C., Eden and her team of researchers are using brain scans to figure out exactly what makes dyslexic brains different. They also want to know what can be done to rewire the brain, coaxing it to do what it wasn't "designed" to do. Their work appears to support the claims from McGuinness.
The idea that most struggling students are instructional casualties is presented by other reading scientists.
"When we look at the kids who are having a tough time learning to read and we went through the statistics, thirty-eight percent nationally, disaggregate that, seventy percent kids from poverty and so forth hit the wall. Ninety-five percent of those kids are instructional casualties. About five to six percent of those kids have what we call dyslexia or learning disabilities in reading. Ninety-five percent of the kids hitting the wall in learning to read are what we call NBT: Never Been Taught.'
G. Reid Lyon, Past- Chief of the Child Development and Behavior Branch of the National Institute of Child Health & Human Development
'What’s been shown is [that] if you give children highly effective, evidence-based intervention you can bring down the number of struggling readers to five to seven percent.'
Sally Shaywitz, Pediatric Neuroscience, Yale University, Author of Overcoming Dyslexia.
Offering pre-school aged children explicit teaching in phonemic awareness, the opportunity to use a 'speech to print' approach to map phonemes to graphemes within play based activities, sharing these learning journeys by filming the children, allowing for planned visits and on-site training to raise awareness, can only be a good thing! A longitudinal research project tracking the literacy progress of these children throughout primary school can help to answer many questions about literacy difficulties, and specifically about dyslexia. Will children be more likely to achieve the literacy levels required by the end of primary school, regardless of how taught at school? Can we protect children from the negative effects of ineffective teaching strategies? How early can we start teaching children to 'talk on paper'.
Can we 'immunise children against illiteracy'?
Can we rewire dyslexic brains, before children even start school?