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Language Levels and Modalities How to Conduct Comprehensive Assessment and Intervention Hawaii Speech-Language-Hearing Association Nickola Wolf Nelson, PhD, CCC-SLP Professor Emerita, Western Michigan U. nickola.nelson@wmich.edu Speaker


  1. You can find this diagram on the Internet simply by Googling “reading rope.” The citation is: Scarborough, H. S. (2001). Connecting early language and literacy to later reading (dis) abilities: Evidence, theory, and practice. In S. Neuman & D. Dickinson (Eds.), Handbook for research in early literacy (pp. 97- 110). New York: Guilford Press.

  2. Relationships of Disorders of Oral & Written Language • Two dimensions may explain dyslexia and specific language impairment (SLI) – Phonological skills (sound/word level) – Nonphonological skills (sentence/discourse level) (Bishop & Snowling, 2004; Catts, Adlof, Hogan, & Weismer, 2005)

  3. Quadrant Model Sentence/Discourse Ability Good listening comp + sentence formulation when talking Normal Language Average in both Low reading decoding + Dyslexia fluency + spelling + word inflection when writing Sound/Word Ability High sound/word skills Spoken + Written and surface reading Specific Low Reading + Low Oral Language Good Reading Decoding Disorder Comprehension Deficit + Poor Comprehension (Bishop & Snowling, 2004; Catts, Adlof, Hogan, & Weismer, 2005; Catts, Adlof, & Weismer, 2006; Ramus, Marshall, Rosen, & van der Lely, 2013)

  4. Comprehensive planning – What next? Does the What kinds What should What kinds child have of needs? we target? of needs? intervention? • Problem of • Most spoken and/or important • Parent input • Materials written • Most impaired • Student input • Theoretical language? • Most likely to model • Teacher input • Particular make a • Formal testing profile? difference • Comorbid problems?

  5. Connecting Assessment and Intervention • Assessment • Teacher, parent, child interviews • Norm-referenced testing (curriculum relevant levels x modalities) • Curriculum- based language assessment (integrated sound/word and sentence/ discourse) • Intervention • Explicit instruction in the code and structure of words (sound/word level) as needed • Curriculum-based language intervention (integrated sentence/discourse level)

  6. Formal and Informal Assessment Formal Assessment Informal Assessment • Provides rich qualitative • Provides norm-referenced information information • Provides information about • Provides information about this student, but not clear student’s strengths and how performance compares weaknesses compared to to peers peers • May be modified to probe • Must be administered exactly deeper; repeat as standardized • May use same materials for • Must NOT use assessment assessment and intervention materials for intervention • May be curriculum based • May be curriculum relevant

  7. Screening Gathering Teacher, Parent, Student Input Student Language Scale (SLS)

  8. Consider teacher, parent, and student input on the SLS Multiple sources Co-norming Student Rating Scale

  9. Using the SLS for 3 Validated Purposes  Screening for dyslexia and other language/literacy disorders;  Gathering input from teacher, parent, and student perspectives to contribute to planning; and  Promoting home-school communication for students with and without language/literacy concerns.

  10. Gen Ed. Teacher SLS in 3 rd Grade Parent SLS in 3 rd Grade January January

  11. A Little More than One Year Later Gen Ed. Teacher SLS in 4 th Grade Parent SLS in 4 th Grade May May

  12. Teacher’s ratings on the first 8 items-- • Are 2 or more ratings <5? • Are all (but 1) ratings >5?  High sensitivity  High specificity 90% of 68 students with LLD 90% of 203 students with NL identified accurately as identified accurately as not having problems having problems Sensitivity Specificity Teacher 61/68 = .90** 182/203 = .90** Parent 203/239 = .85* 1065/1290 = .83* Student 66/90 = .73 257/419 = .61 Correlation between Items 1-8 and total TILLS for Teachers = .752** Parents = .613**

  13. Consider teacher, parent, and student input on the SLS Multiple sources Co-norming Student Rating Scale Correlation between Items 3-4 and Sound/Word Composite: Teachers = .671** Parents = .595**

  14. Consider teacher, parent, and student input on the SLS Multiple sources Co-norming Student Rating Scale Correlation between Items 1- 2, 5-8 and Sentence/Discourse Composite: Teachers = .720** Parents = .570**

  15. (Nelson, Plante, Helm-Estabrooks, & Hotz, 2016)

  16. What are the language demands of the curriculum? • Integration across language levels • Master reading decoding by Grade 3 • Be a competent speller by Grade 3 • Expectation to process complex language that is discipline specific • Complex sentence structure • Cohesion demands connections across sentence and discourse boundaries

  17. Language Levels X Modalities Model Nelson, N. W., Plante, E., Helm-Estabrooks, N., & Hotz, G. (2015). Test of Integrated Language and Literacy Skills TM (TILLS™). Brookes Publishing Co., Inc.

  18. Assessing the Sound/Word Level Assessing Phonological language skills Use Nonwords or pseudo-words Use Real words

  19. Common Core State Standards Grade 2. Phonics and Word Grade 3. Phonics and Word Recognition Recognition • • CCSS.ELA-Literacy.RF.3.3 CCSS.ELA-Literacy.RF.2.3 • Know and apply grade-level phonics and Know and apply grade-level phonics word analysis skills in decoding words. and word analysis skills in decoding – Identify and know the meaning of the most words. common prefixes and derivational suffixes. – Distinguish long and short vowels – Decode words with common Latin suffixes. – when reading regularly spelled one- Decode multisyllable words. – syllable words. Read grade-appropriate irregularly spelled words. – Know spelling-sound correspondences for additional common vowel teams. Grade 5. Phonics and Word Recognition Fluency – Decode regularly spelled two-syllable • CCSS.ELA-LITERACY.RF.5.3 words with long vowels. Know and apply grade-level phonics and – Decode words with common prefixes word analysis skills in decoding words. and suffixes. • CCSS.ELA-LITERACY.RF.5.3.A – Identify words with inconsistent but Use combined knowledge of all letter- sound correspondences, syllabication common spelling-sound patterns, and morphology (e.g., roots and correspondences. affixes) to read accurately unfamiliar – Recognize and read grade-appropriate multisyllabic words in context and out of irregularly spelled words. context.

  20. Sound/Word Level – Formal assessment 2. Phonemic Awareness (PA) “If the word is bip, and we take away the first sound, the word becomes [hesitate] … ip.” “If the word is stig, and we take away the first sound, the word becomes… tig.”

  21. Sound/Word Level – Formal assessment using nonwords 4. Nonword Repetition (NWRep) 5. Nonword Spelling (NWSpell) Does the student represent phonology of the spoken word? • show awareness of morphology? • 10. Nonword Reading (NWRead) Does the student represent phonology using the spoken word? • show awareness of morphology? •

  22. Sound/Word Level – Formal assessment using real words 11. Reading Fluency (RF) The Principal’s Daughter Example We have a principal. - Age 8-10 The principal has a daughter. - Mark any words not Her name is Sara. read fluently She wants to be a clown. - No… She came Monday. - Sounding out ... - Hesitation She had on makeup. - Omission .. - Repetition She looked scary. - Change … Some children cried. … She took off her wig. The children were happy. They knew Sara.

  23. Sound/Word Level – Formal assessment using real words 12. Written Expression (WE) The Little Dog Example to illustrate There was a dog. sentence combining. He was little. Narrative discourse • He was brown. Syntactic abilities • He was white. Word-level abilities • A car almost hit him. It was in front of our school. He was scared. He was okay.

  24. Word Level – Formal assessment using real words Discourse: 4/20 = 20% SS 2 Sentence: 4/4 = 1.00 SS 7 Word: 18/23 = 78% SS 3

  25. Discourse Score: 18/20 content units = 90% WE-Disc SS = 10 Sentence Score: 18 content/7 T-units =2.57 WE-Sent SS = 11 Word Score: 74/88 wds without error = 84% 18 WE-Word SS = 0

  26. 14. Digit Span Forward 15. Digit Span Backward 14. Digit Span Forward (DSF) Say, “I am going to say some numbers. Listen to the numbers, and when I finish, you say them back to me exactly the same way.” 15. Digit Span Backward (DSB) “This time, when I read the numbers to you, I want you to listen carefully and say them back to me in backward order.”

  27. Assessing the Sentence/Discourse Level (and Vocabulary) Curriculum-related language assessment (Norm- referenced measures can be) Curriculum-based language assessment (Requires use of materials from the student’s actual curriculum)

  28. Common Core State Standards (Grade 2) Informational Text Literature • • CCSS.ELA-Literacy.RI.2.1 CCSS.ELA-Literacy.RL.2.1 Ask and answer such questions Ask and answer such questions as who, what, where, when, as who, what, where, when, why , why , and how to demonstrate and how to demonstrate understanding of key details in a understanding of key details in a text. text. • • CCSS.ELA-Literacy.RI.2.2 CCSS.ELA-Literacy.RL.2.2 Identify the main topic of a Recount stories, including fables multiparagraph text as well as and folktales from diverse the focus of specific paragraphs cultures, and determine their within the text. central message, lesson, or moral. • CCSS.ELA-Literacy.RI.2.3 • Describe the connection CCSS.ELA-Literacy.RL.2.3 between a series of historical Describe how characters in a events, scientific ideas or story respond to major events concepts, or steps in technical and challenges. procedures in a text.

  29. Common Core State Standards (9-12) Informational Text Literature • • CCSS.ELA-LITERACY.RH.11-12.2 CCSS.ELA-LITERACY.RST.9-10.4 Determine the meaning of symbols, Determine the central ideas or key terms, and other domain- information of a primary or specific words and phrases as they are used in a specific scientific or secondary source; provide an technical context relevant to grades accurate summary that makes 9-10 texts and topics . clear the relationships among • CCSS.ELA-LITERACY.RST.9-10.5 the key details and ideas. Analyze the structure of the relationships among concepts in a • CCSS.ELA-LITERACY.RH.11-12.3 text, including relationships among key terms (e.g., force, friction, Evaluate various explanations reaction force, energy ). for actions or events and • CCSS.ELA-LITERACY.RST.9-10.6 determine which explanation Analyze the author's purpose in best accords with textual providing an explanation, describing a procedure, or discussing an evidence, acknowledging experiment in a text, defining the where the text leaves matters question the author seeks to uncertain. address.

  30. Sentence/Discourse Level – Formal assessment 3. Story Retelling (SR) “I’m going to read you a story. Listen carefully. Your job is to tell the story back to me just like I tell it to you.” [score as retained content units] 9. Delayed Story Retelling (DSR) “Remember the story [Tommy the Trickster/The Rubber Raft]? Tell me the story again. Try to remember as much as you can. Start now.”

  31. Sentence/Discourse Level – Formal assessment 6. Listening Comprehension (LC) 7. Reading Comprehension (RC)

  32. Sentence/Discourse Cohesion • Referencing – “…two new territories. Each…” – “President…his…” • Ellipsis (omitting established info) – He did • Lexical substitution (same concept in different words) – “topic the teacher makes her class write about the first day of school every year” … “usual first writing assignment” • Conjunction / transition – if…then, but, when , etc. – however, therefore, consequently Halliday, M.A.K., & Hasan, R. (1976). Cohesion in English . London: Longman.

  33. Sentence/Discourse Level – Formal assessment 8. Following Directions (FD) 13. Social Communication (SC) Rachel [Ron] wants to politely turn down an invitation for a party she thinks will be boring. What do you think Rachel [Ron] would say?

  34. Assessing WE-Discourse and Sentence level 12. Written Expression (WE) Discourse: 4/20 = 20% SS 2 Sentence: 4/4 = 1.00 SS 7 Word: 18/23 = 78% SS 3

  35. 12. Written Expression (WE) She *Took 30 min Discourse: 10/20 = 50 SS=3 Sentence: 10/5 = 2.0 SS=11 Word: 35-1=34/35 = 97 SS=11

  36. Vocabulary – Formal assessment 1. Vocabulary Awareness (VA) Not a single definition bat Requires student to activate semantic awareness owl Categorical • Traits eagle • Part – whole • Switch set • Rule out what applies to all 3 •

  37. Evidence for the Quadrant Model

  38. Scientific evidence for the two dimensions of the quadrant model Factor Reference Final Structure Communality (Semipartial Correlations) Estimate Factor 1 Factor 2 Phonemic Awareness 0.547 0.074 0.550 Non-word Spelling 0.600 0.067 0.642 Non-word Reading 0.734 -0.058 0.786 Reading Fluency 0.406 0.077 0.325 Written Expression Word Score 0.409 0.009 0.267 Story Retelling -0.052 0.500 0.345 Vocabulary Awareness 0.229 0.472 0.629 Listening Comprehension 0.009 0.548 0.476 Reading Comprehension 0.264 0.420 0.589 Following Directions 0.153 0.409 0.412 Social Communications 0.075 0.476 0.428

  39. Interpret TILLS results for 3 validated purposes • Identify language/literacy disorder • Profile patterns of strengths and weaknesses • Track change over time (6 mos. +)

  40. Purpose 1. Identify language/literacy disorder

  41. Identification Core Subtests and Sensitivity/Specificity 6-7 year olds 8-11 year olds 12-18 year olds • Core subtests • Core subtests • Core subtests – Vocab – Vocab – Phoneme Aw Aware Aware – NW Spell – Phoneme – NW Spell – Rdg Comp Aw – NW Read – Reading – NW Rep – WE- Fluency • Sensitivity 84% Discourse – WE-Word • Specificity 84% • Sensitivity 88% • Sensitivity 86% • Specificity 85% • Specificity 90%

  42. TILLS Sensitivity/Specificity

  43. Purpose 2. Profile strengths and weaknesses

  44. Language Levels Sound/Word Composite Score Sentence/Discourse Composite Score Sd/Wd (low) < Sent/Disc  Dyslexia Sd/Wd = Sent/Disc (both low)  LLD, S/LI, LD Sd/Wd > Sent/Disc (low)  Specific Comprehension Deficit

  45. Purpose 3. Track change over time

  46. Interpreting language and literacy profiles

  47. Applying the Quadrant Model Sentence/Discourse Ability Good listening comp + sentence formulation when talking Normal Language Dyslexia Average in both Low reading decoding + fluency + spelling + word inflection when writing Sound/Word Ability High sound/word skills Specific Language Specific and surface reading Low Reading + Low Oral Impairment Comprehension Deficit Language Good Reading Decoding + Poor Comprehension

  48. History of articulation 7;9 Grade 1 difficulties Boy Working on /l/ Getting RtI Tier 2 help for reading delays

  49. 7 year 9 month old boy

  50. 7 year 9 month old boy Core subtests  Sound/word 48  Vocab Aware Sentence/discourse 73  Phoneme Aw  NW Rep Consistent with diagnosis of dyslexia?

  51. 7 year 9 mo old boy Sentence/Discourse Ability School Classification: S/LI-speech Good listening comp Only & sentence formulation High in both? Should there Low reading decoding & fluency & be more? spelling Sound/Word Ability Dyslexia Dx is appropriate High sound/word skills and surface reading? Low in both? Low comprehension in listening and reading?

  52. 7;10 Grade 2 Girl

  53. Teacher and Parent SLS for 7;10, Grade 2 Gen Ed Teacher SLS Parent SLS

  54. Grade 2 girl (age 7;10)

  55. 7;10 Grade 2 Girl Core subtests  Sound/word 50  Vocab Aware Sentence/discourse 71  Phoneme Aw  NW Rep Which quadrant?

  56. 7;10 Grade 2, Girl LD as primary eligibility Sentence/Discourse Ability (rdg). Also gets help in class (co-taught by special ed Good listening comp teacher and other & sentence formulation assignments read to High in both? Low reading her). decoding & fluency & spelling Sound/ Reading decoding and Word Ability fluency goals on IEP. High sound/word skills and surface reading? Should there be goals Low in both? Low comprehension related to oral in listening and reading? language? Written expression and spelling?

  57. Sound-symbol association (alphabetic principle) • Use multi-modality, multi-sensory approach to make sound-symbol association automatic • Sound/letter  speech “Say /p/” – Make page for “My Sounds & Letters Book” – Symbol chip (avoid letter names) – Precise articulation; attention to distinctive features • Sound/speech (visual or aud only)  symbol “Point to /p/” – From array of easily distinguished sounds/letters ee p t m _o_ s a_e • Symbol  sound “What sound does this letter make?” • Sound  letter “Write /p/” • Letter name  “Point to ‘p’” (use with caution)

  58. Identify words with inconsistent but common spelling-sound correspondences.

  59. Misses orthographic cues about Word Pattern Recognition how to pronounce vowels Reading fluency is a big problem (Orthographic Principle) Is student aware of • Consonant  Vowel inflectional and derivational morphemes? – Single consonant  multiple vowels Is student using relatively – Multiple consonants  single vowel better sentence/ discourse • Vowel  Consonant skills to assist with fluency? – Single vowel  multiple consonants Is student monitoring – Multiple vowels  single consonant comprehension – “Does that make sense?” • CVC • Onset  Rime – Common “word families” • Morphology  Orthography – Common “chunks” -ing, -tion, un-, dis- Decode words with common Latin suffixes.

  60. Sound blending/ orthographic patterns oo 1 fa_e b o fee t e foo 1

  61. Distinguish long and short vowels when reading regularly spelled one-syllable words.

  62. Word Families (analogical processes) • Misses cues about orthographic regularities in reading and spelling • Limited use of analogical reading strategies Read grade- appropriate irregularly spelled words.

  63. Sources for Word Structure Approaches • Barrie-Blackley, S. (2011). The Structure of Written English & Orton-Gillingham for SLPs [online course] http://support.lexercise.com/entries/20510387- lexercise-professional-education-courses • DuBard, E. (1974). Teaching aphasics and other language deficient children: Theory and application of the association method . Hattiesburg, MS: University Press of Mississippi. • Lindamood, P., & Lindamood, P. (1998). Lindamood phonemic sequencing program for reading, spelling, and speech (LiPS; formerly called Auditory Discrimination in Depth ). Austin, TX: ProEd. • Monsees, E. K. (1972). Structured language for children with special language learning problems . Washington, DC: Children’s Hospital National Medical Center. • McGinnis, M. (1963). Aphasic children . Washington, DC: A. G. Bell Association. • Ritchey, K. D., & Goeke, J. L. (2006). Orton-Gillingham and Orton-Gillingham— Based Reading Instruction: A Review of the Literature . The Journal of Special Education, 40 , 171-183 . • Wasowicz, J., Apel, K., Masterson, J. J., & Whitney, A. (2004). Spell-Links to Reading & Writing: A Word Study Curriculum . Evanston, IL: Learning by Design.

  64. 10;5 Grade 5 Identified as having a learning disability Reading goals on IEP Boy ADHD No history of spoken language problems Is there evidence of any?

  65. 10 year 5 month old boy

  66. 10 year 5 month old boy Core subtests  Sound/word 91  Vocab Aware Sentence/discourse 66  NW Spell  NW Read Consistent with diagnosis of dyslexia?  WE-Discourse

  67. 10;5 Grade 5 boy School Classification: Sentence/Discourse Ability LD-Reading Impairment Only + ADHD Good listening comp NOT best fit for & sentence dyslexia, but formulation? High in both? words in context Low reading decoding & fluency & are low spelling? Sound/Word Ability Needs: Listening comp High sound/word Reading comp skills and surface reading? Vocabulary Low in both Low comprehension (semantic in listening and relations) reading? Social comm *Stories may be relative strength

  68. Using Curriculum-Based Language Assessment to Evaluate School-Age Students

  69. Curriculum-based language assessment and intervention “Use of curriculum contexts and content for measuring a student’s language intervention needs and progress” (Nelson, 1989) • Answers the question: – Does the student have the language skills to learn the (reading/math/social studies) curriculum?

  70. Ethnographic Interviews • Student • Teacher • Parents

  71. “The goal in interviewing is to have participants talk about things of interest to them and to cover matters of importance to [you] in a way that allows participants to use their own concepts and terms.” (Stainback & Stainback, 1988, p. 52) Anecdotes about specific Lists and labels about events strengths and needs • When was the last time you felt • What’s the easiest/best “bored”? thing about school? • “When the teacher explained • What’s the hardest/ the math lesson, and I didn’t know what to do.” worst thing?

  72. “If you could change just one thing, what would that be?”

  73. Interviewing Dan • M Are you bored with the assignments that are given? • M Like, the types of things • M Are those boring? • M What makes it boring? • D Sometimes it’s boring. • D Well, sometimes she gives out something> • D I don’t know. • M (Well, um) Let’s think about today when you were in school. • M Can you think of a time when you were bored today? • D Yeah. • M Okay, tell me about it. • D We were doing math. • D And I had no idea what to do. • D So I was bored, I guess.

  74. Curriculum-based language assessment & intervention: 4 Questions Question Target Procedures 1. What language Identify language skills and Expected Response skills are required? strategies effective students [ER] use 2. What does the Observe student’s current Observed Response student currently independent attempt [OR] do? 3. What might the Use dynamic assessment to Mismatch between student learn to do ER  OR establish instructional differently? procedures and targets 4. How should Design scaffolding to help Bridge from curricular task be student make connections; OR  ER scaffolded and modify task only if necessary changed?

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