Early Intervention and Prevention
of Reading and Writing Disabilities
in Preschool and Kindergarten
Children
Judith Rutberg-Self, Ph.D.
It is possible to diagnose and
prevent reading (and writing)
disabilities
Before children can read!!!
Early Intervention is Critical
The Case for Early Intervention
To the extent that we allow
children to fall seriously behind
at any point during early
elementary school, we are
moving to a “remedial” rather
than a “preventive” model of
intervention. Once children fall
behind…it may require very
intensive interventions…
because of the large amount
of reading practice that is lost
by children each month and
year that they remain poor
readers.”
Joseph Torgesen, Ph.D., Florida State University
Why Early Intervention is Not Widely Used in
the Public Schools
• Current guidelines use a" discrepancy
formula” to qualify students for special
education services under the
designation of specific learning
disability.
• Severe discrepancy between ability
(as measured by IQ) and
achievement (as measured by
current academic achievement
testing)
• If there is not a significant difference
between predicted scores based on
IQ, then the child is performing at the
“expected level” and does not meet
criteria for services.
Why the Discrepancy Formula is Wrong:
The “Wait to Fail Model”
• Every state uses a different
discrepancy formula –
different criteria, different
assessments
• There is no evidence of
intrinsic differences
between reading-disabled
children with achievement
discrepancy and reading
disabled children without
achievement discrepancy.
Both groups make gains
with treatment.
Comparison of Reading Disabled
Children With and Without IQAchievement Discrepancy
9
Why the Discrepancy Formula is Wrong:
The “Wait to Fail Model”
• Using a discrepancy model interferes
with the early identification of learning
disabilities. Poor academic
performance cannot be reliably
measured until grade 3, creating a
“wait to fail” model. Children need to
get bad enough to qualify for services.
Often, these students never catch up.
• Current federal guidelines exclude
services to children due to environment,
inadequate teaching, cultural, and
economic disadvantage, the very
children who need services!
Demise of the Severe Discrepancy
Formula
• The Congress has passed a bill that will
end the federal law requiring a
discrepancy formula in May, 2005, after
more than 25 years!!!
• New models will need to be set up:
– Early Intervention
– Three-Tiered Model
– Response to Intervention
Children Do Not “Outgrow”
Learning Difficulties
• If a child is not learning at the
pace of other children, it is
generally not a “readiness”
issue!
• “Giving it time”, and “waiting a
little longer” results in the child
falling further behind and
damaging her self-esteem.
• Early diagnosis and targeted
science-driven intervention is
critical!
Myths about reading and writing
Myth # 1
Most children will mature and
grow out of their learning
difficulties.
Reality # 1
• No! Research supports a
nature/nurture model. It is better
to intervene than to wait.
• There are critical
developmental periods in which
learning to read is easier.
• Children do not “mature” out of
dyslexia and dysgraphia.
• Current research does not
support retention for academic
deficits.
Research on Grade Retention
from National Association of School
Psychologists
• Initial achievement gains may occur
during the year the student is
retained, but is not sustained.
• Retention is associated with
significant increases in behavior
problems and poor self esteem.
• Highest rates among poor, minority,
or inner-city youth.
• May have positive impact when
students are not simply held back,
but receive specific remediation
Myth # 2
Dyslexia can be cured by
phonics training.
Reality # 2: No
• Some children have
deficits in PHONOLOGICAL
AWARENESS, and unless
that is remediated so they
can hear the individual
phonemes or speech
sounds in spoken words,
they will not apply phonics
productively.
Reality # 2: No
• Some children have
deficits in ORTHOGRAPHIC
AWARENESS, and unless
that is remediated so they
can represent written
words efficiently in shortterm memory, they will not
apply phonics properly.
Reality # 2: No
• Some children have
deficits in RAPID
AUTOMATIZED NAMING,
and unless they can
access words from their
“mental dictionary”
fluently, they will not
become automatic
decoders and readers.
Myth # 3
• Some children are auditory
learners and some children are
visual learners (aptitudetreatment model).
• Visual learners do best with a
“sight word approach”, and
auditory learners do best with
“phonics”.
• Children should be taught
according to their learning
style.
Reality # 3
• There is no scientific evidence
to support the theory of
learning styles.
• It is likely that children who
exhibit a particular learning
preference may in reality have
deficits in the non-preferred
area.
• Both aural (phonological) and
visual (orthographic) processes
are involved in word
recognition.
Myth # 4
• Dyslexic children see letters
and words backward and
reversals are a strong sign
of dyslexia.
Reality # 4
• There is no evidence that
dyslexic children actually see
letters backwards. Reversals are
irrelevant to the diagnosis of
dyslexia (Shaywitz)
• Dyslexic children have trouble
in naming, but not in copying
letters.
• Backward writing and letter
reversals are common in the
early stages of writing
development.
Myth # 5
• Left-handedness,
difficulties with spatial
(including right-left)
orientation, trouble tying
shoelaces, and clumsiness
are associated with
dyslexia.
Reality # 5
• No research findings
support the association of
clumsiness and
coordination problems with
dyslexia. The vast majority
of dyslexic individuals
(about 88 percent) share a
common phonologic
weakness. (Shaywitz)
Myth # 6
• Reading disabilities are the
most common form of
learning disability.
Reality # 6
• Reading disabilities may be
identified sooner, but writing
disabilities are more
persistent.
• Writing disabilities are
extremely prevalent in the
population of children with
learning disabilities.
What is Dyslexia
• Dyslexia is a specific
language-based disorder
of constitutional origin
characterized by
difficulties in single word
decoding, usually
reflecting insufficient
phonological processing.”
Reid Lyon, National Institute of Child
Health and Human Development,
1995
What is Dyslexia?
First signs in kindergarten: Unusual
difficulty in learning to name
letters and attach phonemes to
letters. (OrthographicPhonological Mapping
Relationships)
1st grade signs: Unusual difficulty
learning to read single words
out of sentence context (sight
words and/or phonological
decoding).
Dyslexia is manifest by variable
difficulty with different forms of
language, often including, in
addition to problems with
reading, a conspicuous problem
with acquiring proficiency with
writing and spelling.
Wong
Early Warning Signs of Reading
Disabilities
Early Warning Signs of Reading
Disabilities
Delay in Speaking
• May not begin speaking
single words until 15 months
and phrases until after their
second birthday.
• May have family history of
late talking.
• Some dyslexic children do
not exhibit speech delays.
Early Warning Signs of Reading
Disabilities
Difficulties in Pronunciation
• Sometimes referred to as “baby
talk”.
• By age 5-6, a child should have
little problem saying most words
correctly.
• Typical mispronunciations
involve leaving off beginning
sounds (“pisquetti”), or inverting
sounds (“aminal”).
Early Warning Signs of Reading
Disabilities
Difficulties With Rhyming
• Dyslexic children may show
insensitivity to rhyme.
• Dyslexic children may confuse
words that sound alike.
• It is not a matter of
intelligence, but of insensitivity
to the sound structure of
language.
Early Warning Signs of Reading
Disabilities
Word Retrieval Difficulties
• May use incorrect phoneme –
word is close in sound but
different in meaning
(tornado/volcano).
• May talk around a word
• May use filler words like “stuff”,
“things” instead of actual name
of object.
• Expressive language problem,
not thinking problem.
Early Warning Signs of Reading
Disabilities
Difficulty Naming Alphabet Letters
• This is the most robust early
predictor of dyslexia.
• Many children know the names
of most of upper and lower
case alphabet letters by the
entry of kindergarten.
• After a full year of kindergarten
instruction, children should
know most of the letter-sound
relationships.
Early Warning Signs of Writing Disabilities
• Difficulties in Gross and Fine
Motor Coordination Contribute
to Writing Disabilities
– Dyspraxia- difficulty getting the
muscles to work together to
cooperate in the right way to
accomplish a motor action.
– “I know what to do, I can explain
it, but it’s just that my muscles
won’t do it.”
– These students hold their pencil in
an awkward way, or tightly, which
helps them control their muscles
better but can also make writing
very slow.
Early Warning Signs of Writing Disabilities:
Difficulty writing the letters of the
alphabet from memory:
• Handwriting automaticity at an
early age (writing alphabet
letters quickly from memory) is a
strong predictor of the quality
of composition in older,
normally developing writers.
• If letter production is automatic,
then the child is able to attend
to higher level composing
processes, such as deciding
what to write about, what to
say, and how to say it.
In order to assess and treat
reading and writing disabilities, it is
necessary to understand the
underlying sub-processes.
Process Assessment
• Process assessment has
been a method used for
treatment of learning
disabilities for several
decades.
• However, the “processes”
that were addressed in the
past were not scientifically
proven for the treatment of
learning disabilities.
Process Assessment
• Examples of past nonscientifically sound
processes to treat learning
disabilities and dyslexia
– Visual-Perceptual training
– Doman-Delicato (crawling
therapy
– Vision Training/Colored
lenses
Process Assessment
• Scientifically valid process
assessment treats the
underlying processes
directly related to reading
and writing!
Understanding the Functional Reading
and Writing System
Virginia Berninger, Ph.D. Director, U.E. Learning
Disabilities Center
• The functional reading and
writing system draws upon
different processes which must
be orchestrated together.
• The working brain is like an
orchestra; each instrument is a
separable component, but the
playing of all instruments must be
synthesized to play music.
(Michael Posner, 1988)
Functional Reading and Writing
System
• Phonological system is the aural
processing system (hearing)
and is the first system to
become functional.
• It is followed by the
orthographic processing system
(visual system).
• Handwriting relies on the
orthographic-motor
component and the ability to
recognize, retrieve, and form
letters automatically.
Functional Reading and Writing System
Phonemic Awareness
• Phonological or phonemic
awareness refers to the ability
to consciously isolate and
manipulate the phonemic
elements (smallest units of
sound) within words.
• Reading involves converting
written letters into their sounds
and appreciating that the
words are composed of smaller
segments or phonemes.
Functional Reading and Writing System
Phonologic Awareness
• Every language has a
basic set of elementary
sounds called phonemes.
Spoken words are formed
by combining these sounds
into meaningful
sequences. (Sattler, 2002)
• “Cat” has single letter
phonemes that can be
segmented into “cuh-ah-t”
Functional Reading and Writing System
Phonological Awareness
• Phonological awareness
also includes the abilities to
segment words into
syllables, delete and
substitute phonemes,
recognize rhyme, and
appreciate puns.
Functional Reading and Writing System
Phonological Awareness is Developmental
1. Preschool children learn to
rhyme (perceive the similarity
of sound patterns at ends of
words).
•
Mother Goose, Dr. Seuss books
2. Next, kindergarten children
perceive and can segment
syllables in words (mon-key).
3. Finally, by the end of
kindergarten, children can
perceive and segment
phonemes in monosyllabic
words (c-a-t).
Functional Reading and Writing System
Orthographic Awareness
• Orthographic Awareness
involves the ability to process
letters and letter units – “built-in
spellchecker”.
• Orthographic ability is a visual,
letter-specific process and is
separate from being able to
recognize and remember other
non-letter symbols.
Functional Reading and Writing System
Orthographic Awareness is Developmental
• Preschool- recognize and
produce letter-like symbols.
• K-1st grade – recognize
and produce the letters of
their own written
language.
Functional Reading and Writing System
Orthographic Coding
• Orthographic Coding is the ability to
represent (image) a written word in
memory, including the entire word as
well as discrete segments of a word.
• Before children can pronounce
written words, they acquire
representations of written words in
memory and have some knowledge
of acceptable letter sequences found
in written English (e.g. “u” follows “q”).
Functional Reading and Writing System
Orthographic Coding is Developmental
• Preschool children can
recognize whole words (their
names, “Cheerios”).
• Kindergarten children can
remember if a single letter is in a
word.
• The ability to recall letter cluster
groups in words at third grade
predicted reading and writing
skills (Berninger).
Functional Reading and Writing System
Rapid Automatized Naming (RAN)
• RAN, or rapid naming, is the
ability to retrieve the names for
objects, colors, digits, or letters
efficiently from long-term
memory.
• Measures of rapid naming
require speed and processing
of visual as well as phonological
information.
• Poor performance on rapid
naming tasks is related to
difficulty in reading fluency.
Functional Reading and Writing System
Rapid Automatized Naming (RAN)
• The “Double Deficit”: Children
with deficits in both RAN and
phonological awareness
appear to have more
difficulties learning to read
than individuals with deficits in
either rapid naming or
phonological awareness
alone.
Functional Reading and Writing System
Handwriting Automatization and Accuracy
• Handwriting is “language
by hand”.
• Writing is unique among
the language systems;
language by eye
(reading), language by
mouth (speaking), and
language by ear (hearing);
because it draws upon the
fine-motor system.
Functional Reading and Writing System
Handwriting Automatization and Accuracy
• Mastery of handwriting is
often ignored among
preschool and
kindergarten students.
• Formal instruction in
handwriting is not always
taught.
• Some students require
more explicit instruction in
letter formation than other
students.
Functional Reading and Writing System
Handwriting Automatization and Accuracy
• Fine-motor measures such
as finger-tapping, finger
repetition, finger
succession, and finger
localization, were shown to
be related to writing
(Rutberg and Berninger).
• Students with reading
difficulties had difficulty
with finger recognition
(Fletcher, et. al)
Functional Reading and Writing System
Handwriting Automatization and Accuracy
• The ability to write the
alphabet is a measure of a
child’s ability to automatically
retrieve from long-term
memory and produce with
hand an ordered set of
written symbols.
• This task has been found to be
the best predictor of writing
skills in elementary school
children. (Berninger)
Functional Reading and Writing System
Handwriting Automatization and Accuracy
• EXLICIT INSTRUCTION IN
HANDWRITING, AND
REMEDIATING HANDWRITING
DIFFICULTIES EARLY IS CRITICAL!
• Unless children are able to
automatically retrieve alphabet
letters from memory, writing
does not become fluent.
• Children are not able to attend
to the higher order thinking
processes (spelling and idea
generation) unless the lower
level process of handwriting is
automatized.
Preschool and Kindergarten
Assessment of the Functional
Reading and Writing System
Kindergarten Screening Battery
PAL Test Battery for Reading and Writing
for students K-6
• Developed by Virginia
Berninger, University of
Washington.
• Includes screening
measures for children
grades K-2.
• The subtests of the PAL-RW
target the
neurodevelopmental
processes most relevant to
learning to read and write.
PAL-RW Kindergarten Screening
Battery for Reading and Writing
ORTHOGRAPHIC /MOTOR SCREENING
• Alphabet Writing (speed and
automaticity of writing alphabet
letters in order from memory)(3
minutes)
• Score is letters formed correctly
within first 15 seconds, and time to
write entire alphabet
• Letters must be recognizable out of
context
PAL-RW Kindergarten Screening
Battery for Reading and Writing
ORTHOGRAPHIC SCREENING
• Orthographic Coding (3
minutes)
–
–
Child views a word for 1
second
Child decides if a second
word exactly matches the
first, or is different
• Letter Naming (WIAT-II)
Example of Orthographic Coding
well
wall
different
differant
PAL-RW Kindergarten Screening
Battery for Reading and Writing
RAN
• RAN – letters (2 minutes)
PHONOLOGICAL (5 minutes)
• Rhyming
• Syllables
PAL Rapid Automatized Naming
PAL Rhyming Task (grades K-1)
CTOPP (Ages 5-6)
CTOPP (ages 5-6)
The Pre-School Screening Test
(PREST 2001, PsychCorp)
• Ages 3:6-4:5
• Developed as preschool
screening instrument
• Training Video
• Designed to be used by
teachers rather than
psychologists
• Divided into two parts. Part one
is screener, Part 2 is for children
who come out in “at risk” range
on part 1
PREST
• Administration time 15
minutes for each part
• Tests included part 1
(related to reading and
writing):
–
–
–
–
Rapid Naming (pictures)
Digit Naming
Sentence Repetition
Copying Letter Shapes
PREST
• Tests in part II
– Phonological discrimination
– Digit Span (index of verbal
memory)
– Rhyming
– Sound Order
Other Standardized Assessments
for Kindergarten Students
• Comprehensive Test of
Phonological Processing
(CTOPP)
• Woodcock-Johnson-III
– Sound Awareness
(phonological)
– Letter/Word Identification
(naming alphabet Letters)
Other Standardized Assessments
for Kindergarten Students
WIAT-II (Co-normed with the PAL)
BASIC READING COMPOSITE
• Assesses pre-reading (phonological
awareness) and decoding Skills.
• Name the letters of the alphabet
• Identify and generate rhyming words
• Identify the beginning and ending
sounds of words
• Match sounds with letters and letter
blends
• Read aloud from a graded word list
Informal Assessment of Preschool
Reading and Writing
from “Designing Early Literacy
Programs- Strategies for At-Risk
Preschool and Kindergarten
Children”
Letter Recognition Assessment
Intervention Activities for Preschool
and Kindergarten Students
Activities to Facilitate Writing
• Handwriting Difficulties Must be
remediated EARLY!
• Handwriting must be explicitly
practiced to make “motor program”
(engram) automatic.
• Practice involves following numbered
arrow cues for forming each letter – so
letter production becomes
automatized and uniform.
• It is difficult to remediate awkward
hand position, even if attended to
early.
Activities to Facilitate Writing
• Have children trace letters of
their name.
• Explicitly teach alphabet letters
rather than providing incidental
instruction.
• Use a multi-sensory approach.
• Focus on letter formation.
(numbered arrows)
• Teach lower-case alphabet
letters before upper case
letters.
Activities to Facilitate Writing
• For children who have
difficulties remembering what
letters look like, keep a copy of
“Talking Letters” on the desk for
referral.
• To help children who have
difficulties remembering letters,
play the “cover-up” game
(covering the letter and having
the child write it from memory).
• Use the PAL Writing Lessons.
PAL Reading
and Writing
Lessons
1. Study the
letter. Follow
the
numbered
arrow cues to
write the
letter.
2. Cover the
letter and
write it from
memory
(orthographic
component).
3. Which letter
do you think is
the best?
Activities to promote phonemic
and phonological awareness
Play rhyming games.
• Around the home, point to
objects and say their names, for
example, “sink”. Then ask your
child to say as many words as
she can that rhyme (wink, pink,
blink). Take turns modeling this
process.
• Some easily rhymed words are
ball, bread, rug, clock and
chair. Let her use some silly or
nonsense, words as: ball-tall,
call, small, dall, jall, nall
Activities to promote phonemic
and phonological awareness
• Say three words such as
“cat”, “dog”, and “sat”
and ask your child which
word sounds different, from
the others (dog). This will
help your child discriminate
between sounds.
Activities to promote phonemic
and phonological awareness
• Play the “take away” game.
Have your child say a word
(“dog”, for example), and then
ask her to say it again without
the beginning “duh” (d) sound
(og). Try a variety of words.
Once your child masters this
task, try having her delete the
ending sound, for example, say
“truck:”, now say it without the
ending “k” sound (“truh”).
Activities to promote phonemic
and phonological awareness
• A much harder task, for
older beginning readers, is
to have them leave out
the middle sound, for
example, say “truck””, now
take away “r”(tuck). In all
of these tasks, make sure
you say the letter
sound,”rrr” NOT the letter
name.
Activities to familiarize a child
about print
• Read regularly to your
child – quantity and
selection are important
• Read nursery rhymes
• Reading should be
interactive with discussion
and open ended questions
at appropriate points in
story
Activities to familiarize a child
about print
• Pair letters with pictures
• Integrate a picture with the
letter (mnemonics) i.e. a lower
case h with house drawn under
the hump of the h; f forms the
stem and leaves of flower
• Teach upper case, lower case,
and sounds separately
• Teach lower case letters first
• Use a multisensory approach
such as sandpaper letters or
finger paints
With Early Intervention, Most
Reading and Writing Disabilities
Can be Prevented.