I received a phone call today from a mother of a middle school age boy.  I have receive phone calls like this or I have the conversations with parents and it is always the same thing.....I don't know what to do but I know I need to do something.

As a parent there is nothing I wouldn't do for my children.  I would move mountains to help them be as successful in life and overcome any obstacle.  So I get how these parents must feel because the story is the same.  They have pursued a variety of different therapies and tutors.  Things seem to work for a short period of time or initially but the long term gains simply aren't there and as the child moves through school it becomes more and more obvious that the child continues to struggle.

It is these stories and families that continue to push me to learn as much as possible to help children.  Because of the huge need I have pursued every opportunity possible to gain the skills to teach children to read no matter what the obstacle is that is interfering with them mastering that critical skill.  There is not one method that is the cure all or the best.  A multi sensory structured language educations (MSLE) approach is PROVEN to be the most effective method for children with Dyslexia and related reading disabilities.  The problem for some is there are too many choices and it can be difficult to determine which method best meets the need of that specific child.  

Research indicates that the MSLE programs are very comparable as far as content taught.  There is variability in how taught but to be considered a MSLE approach there is a specific criteria the program must meet.  So why do we continue to see children who are receiving this type of intervention but are not making the expected progress?  Often it is because the program chosen is not the best fit for that child's profile of strengths and weaknesses.  Research proves that the most influential factor in promoting success for the child is the level of training of the person providing the intervention. 

It is critical that we train ourselves and others in the best methods available and learning one method sometimes isn't enough.  There is always one child that will not fit neatly into a specific profile that results in instant and sustainable progress.  Those children are the ones that continue to push me to look for more tools to put in my tool box.  So, help us spread the word about Dyslexia and promote trainings in our area.  This is how we will change the lives of many children who are needlessly struggling.  There are lots of options available we just need to make them available.

Reading demands.......
In the course of one's education there are very few years dedicated to teaching a child to read because the reading demands increase dramatically after 2nd grade.  This is why early intervention is critical.  Below is a brief look at some of the ways the reading and writing demands shift after 2nd grade.  For children who are not fluent readers these new expectations can be very overwhelming.  However, hope is not lost.  There are ways to continue to address and remediate the underlying deficits while teaching the child strategies and giving them tools to stay afloat academically.  

The nature of the expectations for reading and writing change as a child progresses through school.   After the second grade there is a shift in curriculum away from learning to read toward reading to learn.  After the third grade, a child should have the ability to read and comprehend a variety of genre and styles of print.  A child should be able to recognize and benefit from varying organizational structures used in curriculum material, use word knowledge for comprehending increasingly complex material, learning new words through reading, and extract the main idea from details and summarize information.

In addition to the increased reading demands, there is also a significant increase in the demands for writing.  After the third grade a student should be able to use a variety of genres and styles when writing.  The student should be able to organize information for clarity and cohesion as well as move seamlessly between oral and written discourse.  After third grade students begin to use writing for learning, i.e. note taking, summarizing, and outlining.   Written language also becomes a significant, additional source of learning.

For children in high school these demands are even greater because the mode in which instruction is provided relies heavily on a lecture note-taking relationship.  For high school children with a language-based learning disability, they are often at a great disadvantage especially if their deficits lie in auditory comprehension and written expression.  A child must have good auditory comprehension skills in order to attend, process, and identify the important information presented orally.  The secondary demand is to then translate that information into a written format through taking notes.  Deficits in these areas make it difficult for the child to access information efficiently and accurately.  Over time other areas of language will begin to suffer.

I have spent the last 48 hours traveling to and from Wichita Kansas to participate in a conference hosted by Fundamental Learning Center.  It was a long trip but the company was great and the conference was awesome.  The best part was the opportunity to collaborate with professionals who are equally as passionate about educating these children.  Sadly these professionals are experiencing the same frustrations and road blocks that I am running into.  There is comfort in numbers and knowing that these challenges are not unique to me nor are they the result of something I am or am not doing brings a level of comfort.  However when I really think about it the 'sameness' of these experiences frustrates me.  How can we all be meeting the same brick walls.  We are say the same thing, the are working towards the same goal, and yet too many children continue to stubble needlessly.  This is not a new movement....providing the right kind of education for children with Dyslexia but there seems to be so much more that needs to be done.  One lady I was speaking to during lunch said, "you know the phrase, it's a drop in the bucket?  This sometimes feels like I am being asked to drain the ocean with only a teaspoon to use."  I have thought of this one comment as we traveled back home and wondered how could we trade the teaspoon for a bucket?  How could we combine all of our individual teaspoons so we have a greater impact?

I wish I had the answers but I don't.  If any of you have suggestions please feel free to share.  What I do know is there are many people working towards the same goal, educational reform.  We may never reform the entire system but I know with 100% certainty that I have been a catalyst for educational reform in the lives of specific children.  God will continue to reveal to me my role in all of this and I will continue to pray and listen to where he is calling me to go.  I will continue to collaborate with others and rely on their strength when I am feeling discouraged.  Most of all I will close my eyes and picture the face of the many children who have changed my life because they trusted me enough to give me the opportunity to teach them.  

So my message to night is to celebrate the successes that may seem small in comparison to what needs to happen and not get overwhelmed in the challenges that are ahead.  This is what I tell my students when we begin working together.  There are many educators, therapist, parents, and advocates forcing changes.  Change is coming and has happened for many.  What role are you going to play in this movement?

Yesterday I stated that Dyslexia is a language-based reading disability.  There are many who continue to miss this connection.  As I have been preparing to present as a conference this weekend I realize that the connection between language and reading has been there few have simply noticed.  

There are 5 parameters to language and these skills continue to develop beginning at birth and continuing until death. Initially the focus of these language skills is through oral language but once a child begins formal education there is a shift to written language.  Below are the 5 parameters of language.

• Phonology – rules that govern the distribution and sequencing of sounds
  
• Semantics – governs the meaning of words and word combinations
  
• Morphology – conveys subtle meaning and serves specific grammatic and pragmatic functions
  
• Syntax – rule system that governs how words are combined into larger units of meaning
  
• Pragmatics – use of language in context    

Now, Orton-Gillinham based approaches are proven to be more effective means of instruction for children with Dyslexia.  These approaches are referred to as Multisensory Structured Language Education (MSLE) approaches.  To be considered a MSLE approach, the program must include explicit, systematic, and incremental instruction in the following areas.

• Phonology and Phonological Awareness -  Phonology is the study of speech sounds and how they work within their environment.  A phoneme is the smallest unit of sound in a given language that can be recognized as being distinct from other sounds in the language.  Phonological awareness is the understanding of the internal linguistic structure of words.  An important aspect of phonological awareness is phonemic awareness or the ability to segment words into their component sounds.

• Sound-Symbol Association -   This is the knowledge of the various sounds in the English language and their correspondence to the letters and combinations of letters which represent those sounds.  Sound-symbol association must be taught (and mastered) in two directions:  visual to auditory and auditory to visual. Additionally, students must master the blending of sounds and letters into words as well as the segmenting of whole words into the individual sounds. 
• Syllable Instruction -  A syllable is a unit of oral or written language with one vowel sound.  Instruction must include the teaching of the six basic types of syllables in the English language:  closed, vowel-consonant-e, open, consonant-le, r-controlled, and diphthong or vowel pair.  Syllable division rules must be directly taught in relation to the word structure.
  
• Morphology (base words, etc) -  Morphology is the study of how morphemes are combined to form words.  A morpheme is the smallest unit of meaning in the language.  The curriculum must include the study of base words, roots and affixes. 
• Syntax -  Syntax is the set of principles that dictates the sequence and function of words in a sentence in order to convey meaning.  This includes grammar, sentence variation and the mechanics of language. 
• Semantics -  Semantics is that aspect of the language concerned with meaning.  The curriculum (from the beginning) must include instruction in the comprehension of written language. 

This month, October, is Dyslexia Awareness month.  My goal is to not only increase awareness but also share accurate information.  The first, and in my opinion, the most important piece of information is that Dyslexia is a Language-based Learning Disability.

According to the American Speech Language Hearing Association (ASHA), a language-based learning disability is “difficulties with age-appropriate reading, spelling, and/or writing. This disorder is not about how smart a person is.” Most people diagnosed with learning disabilities have average to superior intelligence.

This is very important information for pediatric Speech Language Pathologists.  Often we are the professionals that come in contact with these children first.  These can be children we have treated when they were in preschool and dismissed before entering elementary school or children who have speech and language impairments that persist into elementary school.  As a whole, SLPs need to educate others on the critical relationship between early language skills and later reading development. 

Here is an interesting bit of information.....Specific Language Impairment (SLI) affects around 3%– 10% of children (Tomblin et al., 1997) and is diagnosed when oral language lags behind other areas of development for no apparent reason (L. B. Leonard, 1998).  Similar prevalence levels are reported for developmental dyslexia, which is identified if a child has poor literacy skills despite adequate intelligence and opportunity to learn (Snowling, 2000).  

So SLPs we need to take a more active role in identifying these children sooner and designing and implementing effective treatment approaches.  What do you think?