Many of the interventions discussed relative to the remediation of oral language also may be contribute to improvements in reading and writing. For example, working on morphological knowledge, which includes morphological awareness and morphological processing, facilitates improvement in decoding and spelling. Working on improving receptive vocabulary facilitates improved reading comprehension. Working on expressive vocabulary results in improved writing. The following paragraphs will address some specific interventions for targeting reading and writing.

Scientifically Based Reading Instruction

In 2000, the National Reading Panel of the US identified five critical components to scientifically based reading instruction: phonemic awareness, phonics, fluency, vocabulary, and comprehension. Speech-language pathologists can have a role in working in each of these aspects of literacy. Collaboration with colleagues, including classroom teachers, resource room teachers, and reading specialists, is critical in order to negotiate roles to ensure that all of the child’s needs are being addressed, and that the professionals are building on each other’s work, rather than duplicating services or providing conflicting information.

Phonemic Awareness

Phonemic awareness refers to the ability to perceive and manipulate the individual sounds in words. Phonemic awareness in not about the letters, it is merely about the sounds. Phonemic awareness and phonics have been found to be related, yet independent enough to constitute separate constructs (Catts et al. 2015). Although teachers and parents usually understand the need to teach phonics, the sound-letter correspondence, phonemic awareness is sometimes overlooked. Phonemic awareness includes identifying the first, middle, or final sound of a CVC word; deleting or adding a sound; blending sounds, such as hearing /k/ /eI/ /k/ and blending it into cake; segmenting sounds, such as hearing pool and segmenting it into /p/ /u/ /l/; and manipulating sounds, for example, changing the /p/ in pool  to /t/ and producing tool. Phonemic awareness interventions have been shown to generalize to non-targeted skills (Suggate, 2016). Phonemic awareness interventions are beneficial to all readers, but especially readers in kindergarten or first grade (Shanahan, 2006). Roughly 15 minutes per day of phonemic awareness instruction during the first semester of kindergarten, for a total of 14-18 hours, has been suggested (Shanahan, 2006). However, some children may need less and others, especially those with deficits, will need more. Phonemic awareness teaching in small groups show benefit over working in large groups, segmenting and blending have the most impact on reading, and making the activities seem like “play” is beneficial (Shanahan, 2006). Phonemic awareness is a strong predictor of reading ability (Melby-Lervag et al., 2012, Powell & Atkinson, 2020).

A broader term that encompasses phonemic awareness is phonological awareness. Phonological awareness refers to knowledge of the sound structure of words, but involves larger “chunks” of sound than phonemic awareness, which refers to the understanding of individual sounds. A speech signal can be hierarchically divided into sentences, words, syllables, onset-rime, and individual speech sounds. Children attend to smaller parts of words as they develop (Anthony & Francis, 2012). Phonological awareness includes identifying and producing rhyming words; breaking words sentences into words, words into syllables, and syllables into onset-rime; and identifying words that begin or end with the same sound. Although development of awareness of sound at these larger units of language develops earlier than awareness of sound at the level of the individual phoneme, the relation of these tasks to reading seems to be due to their association with phonemic awareness (Melby-Lervag et al., 2012).  Intervention at the phoneme level should begin in kindergarten (Rehfeld et al., 2022; Schuele & Boudreau, 2008). Phonemic awareness instruction is effective when delivered by a variety of professionals, including teachers, SLPs, and trained volunteers, but the largest effects are noted when the instruction is delivered by SLPs (Rehfeld et al). This underscores the importance of SLPs playing a leading role in this aspect of instruction in schools. Powell and Atkinson (2020) revealed that phonological awareness is a causal mechanism in decoding words and non-words accurately, but does not play a strong role in decoding words with irregular spellings, which are typically decoded via the lexical pathway.

Phonemic awareness should be taught until the reader can easily segment words completely. It should be taught early in the phonics sequence, and can be taught both separately from and simultaneously with phonics (Shanahan, 2006).

Phonics

Phonics refers to the relationships between letters and sounds. The explicit teaching of phonics has been shown to improve decoding and comprehension in kindergarten and first grade children, but only decoding in older readers. This finding highlights the importance of teaching phonics early. Systematic teaching of phonics, that is, using a phonics program, is more effective than opportunistic teaching of phonics, whereby teachers design mini lessons based on students’ individual needs. Research is needed to determine the most effective phonics program. Both synthetic phonics, the teaching of individual sounds and how to blend them into words, and analytic phonics, teaching larger chunks of words (e.g., “word families”) are beneficial and teachers should teach both. Phonics should be taught in kindergarten through second grades, with additional instruction for readers who are still having difficulty mastering phonics. Phonics instruction that is individual, in small groups, or part of whole class instruction works well. The instruction needs to go beyond recognizing the sounds made by individual letters and groups of letters, and into using this recognition to decode new words. Nonsense words can be used for this purpose, as the use of nonsense words provides additional practice opportunities and can help the assessor determine whether the child is actually decoding using phonics versus using prior knowledge of a given word. When working with children who speak a dialect that differs from their teacher’s dialect, the teacher needs to be cognizant of the dialectal differences and emphasize the students’ learning of how the letter sounds are pronounced in their own dialect, not necessarily the teacher’s dialect (Shanahan, 2006).

Although direct instruction in phonics is critical for reading success, it should be noted that, somewhat surprisingly, phonemic awareness interventions tends to be better for generalizing to non-targeted skills, including comprehension (Catts et al., 2015, Suggate, 2016). Phonics can be taught independently of or simultaneously with phonemic awareness (Shanahan, 2006).

Fluency

In this chapter, we are referring to fluency in the context of this word’s use in the study and instruction of reading, rather than as it is typically used in speech-language pathology in reference to stuttering. Thus, oral reading fluency  refers to reading with accuracy, speed, and expression. Instruction in oral reading fluency improves not only fluency, but also decoding, word recognition, and comprehension (Shanahan, 2006).

Traditional “round robin” reading, whereby children in a class take turns reading aloud while the rest of the class follows along, has been shown to be ineffective and should not be used. Three essential features of fluency instruction have been identified. First, the reading practice should be done orally, rather than silently. Second, reading should included repeated reading of and listening to a given text. Third, students should receive guidance. The listener should be able to provide feedback and assistance (Shanahan, 2006).

Paired reading can be an effective technique for improving oral reading fluency. Two children can be paired with the same text, and take turns reading it. One child begins as the reader, and the other child assumes the role of the guide, then the roles are reversed. It is beneficial to use reading material that is at the child’s instructional level, or at the child’s frustration level if support is provided. Using material at the child’s independent level does not result in as much progress in oral reading fluency as using material at the instructional or frustration level.

Vocabulary

Vocabulary as used here refers to knowledge of word meanings. SLPs have a role in all of the components of scientifically based reading instruction, but vocabulary is one component with which SLPs tend to be most familiar. Explicit vocabulary instruction improves reading comprehension. Traditional dictionary work, such as copying definitions, has not been shown to be beneficial. In contrast, a number of successful vocabulary interventions have been show to be effective. Semantic maps and webs can be useful in demonstrating relations among words and concepts. Direct explanations of word meanings also are effective, and review of newly acquired words is essential (Shanahan, 2006).

Dialogic reading is one type of intervention that facilities vocabulary learning in young children. Dialogic reading involves an adult reading with a child and engaging with the text. The adult can name vocabulary words, define words, recast and expand the child’s utterances, and ask open-ended questions. Noble et al. (2020) described the PEER sequence, which the adult uses to prompt the child to make a comment about the book, evaluates and expands the child’s comment, and repeats the prompt to maximize learning form the expansion. The authors recommend five types of prompts, which comprise the acronym CROWD: completion, recall, open-ended, question, wh- question, and distancing question. Wordless picture books can be effective materials for dialogic reading (Grolig et al., 2020).

Working on morphological skills also can be beneficial for readers with low reading vocabulary. These students should be guided to capitalize on their knowledge of the syntactic, phonological, and orthographic information in morphemes. They may need assistance in applying the semantic information from morphemes (Goodwin, Petscher, & Tock, 2020).

One challenge that educators face is the selection of vocabulary words to teach. One commonly used approach is the three-tiered approach (Beck, McKeown, & Kucan, 2013). Tier 1 is comprised of words used frequently in oral language. These words typically are learned naturally at a young age via repeated exposure. Tier 2 words are found across a variety of domains and are widely used in written language, but less commonly used in oral communication. Tier 3 consists of words that are specific to a topic or domain, and are rarely used outside that domain. Beck and colleagues suggest focusing on Tier 2 words for explicit instruction.

In contrast to the tiered approach, Hiebert (2020) recommends the selection of a “core vocabulary” based on the frequency of words in school texts. This provides a naturalistic context for teaching the vocabulary. Instruction then focuses on making semantic and morphological connections among the words and understanding multiple meanings of words. Extensive reading, conversations, and minilessions can be used to teach the core vocabulary.

Reading comprehension

The ultimate goal of reading is reading comprehension. As adult readers, we do not read a text merely to accomplish the decoding, we read to understand and interpret. Reading comprehension involves the active construction of meaning, rather than mere passive recall. The aforementioned elements of scientifically-based reading instruction contribute to reading comprehension. In addition to mastery of these skills, reading comprehension strategies can be taught to further improve understanding of written texts. These strategies differ from skills in that strategies are used consciously, reflectively, and purposefully. The National Reading Panel examined more than 200 studies of the use of reading comprehension strategies, and found sufficient evidence to support the following seven reading comprehension strategies: question asking, monitoring, summarization, question answering, story mapping, comparative grouping, and graphic organizers (Shanahan, 2006).

Reading comprehension strategies can be taught in combination. Shanahan (2006) recommends the use of the reciprocal teaching approach for teaching combinations of reading comprehension strategies. In this approach, the teacher begins by explaining the strategy, describing how and when to use it,  explaining why it is helpful, and demonstrating its use. Next, the student completes the activity, with support from the teacher, which can include re-explaining the strategy. The student then completes multiple tasks using the strategy, with fading support from the teacher. Last, the student is expected to use the strategy independently.

Reading comprehension should be addressed in a variety of genres. The CCSS (National Governors Association, 2010) have standards for reading comprehension of narrative, expository, and argument/opinion texts. Comprehension of each of these genres should be incorporated into intervention.

Morphological Awareness

Morphological awareness was not included in the National Reading Panel’s list; however, evidence suggests that targeting morphological awareness is beneficial for reading and writing. Morphology includes both phonological and semantic information, and contributes indirectly to oral reading fluency via its relation to phonemic awareness, and to silent reading fluency via its relation to vocabulary (Giazitzidou et al., 2022; Kargiotidis et al., 2022). In word reading, children apply morphological decoding, as evidenced by decoding two-morpheme words faster and more accurately than single-morpheme words, even when the words are matched for word length, word frequency, and ending spelling. They engage in morphological analysis by using knowledge of morphemes to facilitate understanding of words. Thus, morphology contributes to both reading fluency and reading comprehension (Levasque et al., 2021).

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Intervention for Writing

Writing interventions that focus on foundational writing skills, including spelling, have positive outcomes in writing (McMaster et al., 2018). For children with dyslexia, spelling interventions that include phonics, morphology, and orthography are particularly successful in improving spelling. Improving spelling using these types of interventions can help decrease the potential for cognitive overload caused by difficulty with spelling, which can adversely impact the other aspects of writing when there are fewer cognitive resources to allocate to them (Galuschka et al., 2020). A focus on alternations, or different letters or letter combinations that can be used to represent a sound, can be beneficial for working on spelling in combination with a focus on the alphabetic principle (Berninger et al., 2002). Computer software programs targeting spelling can be helpful in facilitating improvements, but alone are not sufficient to significantly improve spelling; individual treatment is necessary for significant progress to occur (Galuschka et al., 2020).

A multicomponent approach to writing intervention is beneficial for improving writing quality. An approach combining teaching the alphabetic principle, alternations, levels of language strategies for self-regulation, reflective discussion, keyboarding, and composition practice has been found to be beneficial to at-risk writers (Berninger et al., 2002). Metacognitive strategy-based instruction can help students improve writing skills.Interventions focusing on self-regulated strategy development, which focus on aspects including planning, organizing, and adding details, are also beneficial to. young writers (McMaster, et al., 2020). Cer (2019) implemented a 5-week writing instruction protocol using this type of instruction, and found that students in the metacognitive group demonstrated more improvement in their writing than the group receiving traditional writing instruction. During the first week, the children’s attitudes and beliefs about writing were assessed. They were instructed in declarative knowledge, procedural knowledge, and conditional knowledge. Declarative knowledge instruction included learning about how to consider theme, purpose, structure, and layout should be considered during writing. Next, the students learned about procedural knowledge, or the processes of revising and organizing writing. Finally, they learned about conditional knowledge, or how and when to apply these processes. During the third week, instruction on regulation of cognition was initiated, with instruction on planning, with focusing on ideas and messages prior to beginning to write. The fourth week centered on monitoring: fully understanding the text, deciding if a change is needed, being aware of problems in the text, recognizing linguistic and contextual errors, re-writing ambiguous sections, and adding missing information. During the final week, students evaluated and revised their writing. Peer practice, in which children work with peers and use think-alouds as part of their writing process, with supportive comments and scaffolding from peers and teachers, has found to be an effective metacognitive strategy-based form of instruction (Rodríguez-Málaga et al., 2020).

Some students are apprehensive about writing. Reed et al. (2023) note that writing prompts need to be relevant to students, and provide the following suggestions for selecting writing prompts for middle schoolers. First, prompts need to be interesting and relevant to the students’ personal lives. Second, the prompts should have clear expectations about the task, genre, format, audience, and tone. Third, prompts need to be accessible and fair to students of diverse backgrounds. Their length and complexity must be appropriate for the students’ age, and they should avoid undefined jargon, colloquialisms, cultural references, or rare words that may disadvantage students from some backgrounds. Controversial issues should be avoided, as these could be triggering for some students.

A promising finding by Spencer, Petersen, and collegues, is that oral  language intervention can facilitate improvement in written language (Petersen et al., 2020; Spencer & Petersen, 2018). Story Champs, a program for targeting oral narrative production, has been shown to improve children’s writing even though writing is not explicitly targeted. Similarly, Zuanetti et al. (2021) found that a shared reading intervention for fourth and fifth grade students resulted in improved coherence in narrative writing. This bridge between oral and written language is encouraging. One barrier to targeting written language that has been expressed by SLPs is the time available to address writing, in addition to oral language. If both oral and written language can be addressed by the same intervention method, children will be able to experience increased academic success.

Summary

Reading and writing are essential forms of communication for academic and social success. As such, SLPs need to ensure that students are comprehensively evaluated in these domains, as well as in oral language. If students are having difficulty with reading and writing, oral language should be assessed as well. Although SLPs should not duplicate the services of interprofessional colleagues, they are well-prepared to assess and treat reading and writing, and to collaborate with and provide support to other colleagues who are working with students on reading and writing.

References

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Catts, H. W., Herrera, S., Nielsen, D. C., & Bridges, M. S. (2015). Early prediction of reading comprehension within the simple view framework. Reading and Writing, 28(9), 1407-1425.

Cer, E. (2019). The instruction of writing strategies: The effect of the metacognitive strategy on the writing skills of pupils in secondary education. Sage Open, 9(2), 2158244019842681.

Galuschka, K., Görgen, R., Kalmar, J., Haberstroh, S., Schmalz, X., & Schulte-Körne, G. (2020). Effectiveness of spelling interventions for learners with dyslexia: A meta-analysis and systematic review. Educational Psychologist, 55(1), 1-20.

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Zuanetti, P.A., Novaes, C.B., & Fukuda, M.T. (2021). Intervention based on shared story reading: effect on low and high challenge reading and writing tasks. CoDas,33(3):e20200129 DOI: 10.1590/2317-1782/20202020129. Retrieved from https://www.codas.org.br/article/10.1590/2317-1782/20202020129/pdf/codas-33-3-e20200129-trans1.pdf