Speech Pathology, Literacy and High School
Students:
The Current State of the Literature & Clinical
Practice
Dr. Julie Marinac
Lecturer in Speech Pathology,
SHRS, UQ.
j.marinac@uq.edu.au
Dyslexia through the ages
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1877, 1897 Word blindness (Kerr; Kussmaul)
1896, 1917 Congenital word blindness (Morgan; Hinshelwood)
1925
Strephosymbolia (Orton)
1947
Specific reading disability (Eustis)
1962, 2005 Reading disability (Kirk & Bateman; Cantone & Brady)
1972, 2003 Unexpected reading failure (Symmes & Rapoport; Shaywitz et al.)
1975
Specific reading retardation (Berger, Yule & Rutter)
1985
Poor reading (Olson, Kliegl, Davidson & Foltz)
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Dyslexia, defined and redefined
• “Disorder in children who, despite conventional classroom experience,
fail to attain the language skills of reading, writing and spelling
commensurate with their intelligence abilities
(World Federation of Neurology, 1968).
• “A specific language based disorder of constitutional origin,
characterised by difficulties in single word decoding, usually
reflecting insufficient phonological processing abilities (Orton, 1995).
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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DSMIV-TR (2000) and Dyslexia
• Describes 2 correlates for dyslexia – but not ‘dyslexia’ per se.
• 1) Reading disorder (315.00) – unexpected failure to attain age
appropriate skills in reading and decoding single words and text
• 2) Disorder of Written Expression (315.2) – difficulties
demonstrated in spelling and/or written language skills
• Both of these can co-occur or appear in isolation
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Sub-types of Dyslexia
• Visual or visual-perception (Warnke, 1999)
– Probably only 5-10% of those with dyslexia
• Surface (Castles and Coltheart, 1993)
– Primarily affects reading and spelling of irregular words
• Deep (Stanovich, Siegel & Gottardo, 1997)
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Phonological dyslexia
• May be called ‘Developmental Phonological Dyslexia’
– Reflects expectation the difficulties will emerge during period when
reading, spelling and writing are being learned.
– May not be applicable to students who have moved beyond the
literacy learning period (i.e., secondary school students)
• Phonological Core Dyslexia
– Phonological dyslexia that impedes the acquisition of age
appropriate literacy skills beyond primary school age
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Phonological Core Dyslexia
• May originate in a deficit in phonological processing skills
• Demonstrated by written language skill deficits even in those who
have learned to read
• May include those who are not diagnosed until secondary school, the
‘compensated adolescents and adults’ (as per Birch & Chase, 2004;
Wilson & Lesaux, 2001)
• Compensatory strategies and/or the educational environment
(e.g., total reliance on sight word knowledge, and/or learning in a
sight-word environment)
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Recent Findings in the Literature: Prevalence
• No specific figures for secondary school students
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20% of the school population (Glezerman, 1983, in Grigorenko, 2001);
3-10% of the population (Snowling, 2000).
5-17% of school-aged children in the United States
30% of Yr 8 students and 25% of Yr 12 read at a level below expected
(USA Department of Education, 1998).
• Based on reading disability only – primary factor acknowledged as
phonological processing deficits.
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Recent Findings in the Literature: Causality
• Wide-spread agreement for a neurological basis (Warnke, 1999).
• Very little definitive, empirical agreement as to the precise area of the
brain affected (Temple, 2002).
• WHO- “developmental associated with abnormal neurobiological
development related to brain structure and brain function” (ICD-10).
• Activity deficits in connective tissue between posterior and frontal
regions (Temple, 2002), or
• In interhemispheric connective tissue (corpus callosum) (Shillcock &
McDonald, 2005).
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Recent Findings in the Literature: Causality
• Defined by multiple genes/loci (Grigorenko, 2001)
• May be autosomal dominant and additive (Pennington et al., 1991).
• Positive family history increases risk 5.7 times general population
(Pennington and Lefly, 2001).
• 61% of high-risk familial history 8:0yr. children had reading
difficulties in comparison with 13.8% of those without the familial risk
(Snowling, Gallagher, & Frith, 2003).
Genetic factors may determine structural/physiological
differences in the brain then environmental factors ameliorate
those differences by cognitive ‘usage’ .
(Grigorenko, 2001; Vellutino et al., 2004).
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Recent Findings in the Literature:
• Universal but language structure plays major role in type/level of
difficulties with English being particularly problematical
(Grigorenko, 2001).
• Attention/conduct disorders secondary to dyslexia more frequent
than normal and LD controls, but not depression until 18 years of age.
• Criminality and unemployment risk is 24-25% (non-dyslexic is 4%;
German data) (Esser & Schmidt, 1994)
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Evidence from the Clinic
•Screening – 17.66% of 386 Yr 8 students – PA/PP deficits
•Skills deficits
–Phonological Awareness (discrimination, segmentation and blending)
–Vowel knowledge and discrimination
–Metalinguistic and metalanguage
–Auditory memory and organisation
–Written language planning and production
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Evidence from the Students
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Complete reliance on sight word reading/spelling
Instant recognition of consonants but not vowels
Lack of awareness of vowel spelling variations
Word-by-word reading (scanning issues)
Matthew effects
Lack of need for punctuation
Expressive language not translated into graphemic form
Rejection of academic potentials and ideals
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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BSHS / UQSHRS Experience
3 Tiered Collaborative Service Delivery
Teacher observation (reactive)
Whole school screening (Teaching staff; PATHS CII; proactive)
In-depth assessment by Sp Path (diagnostic decisions)
Within class intervention (PATHS-PA & Spelling Classroom Program)
Learning Support (PATHS Support Program in small groups)
Speech Pathology (PATHS Support Program and individual therapy)
Teaching staff (academic and curricular responsibility)
Learning support staff (on-site assistance and management)
Speech Pathologist (diagnostic and management responsibility)
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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Where to from here?
• Accept responsibility for assessment and treatment of PCD in
secondary school students
• Accept need for, and utility of, collaborative approach
• Ensure professional development in secondary schools includes literacy
learning failure and PCD
• Research, research and more research
– Identification, assessment, prevalence, incidence, outcomes,
intervention, efficacy, awareness, evidence for practice, etc. –
everything that has been done in the primary school sector needs to
be replicated in the secondary school sector!!!!
Dr. Julie Marinac Speech Pathology Australia Sydney 2007
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