High Quality Services?
What do high quality services look like for kids who struggle to read?
This is a question that comes up time and again from friends, clients, teachers, and trainees.
My go to answer that drives everyone mad is, “It depends.”
High quality services should be tailored to meet the unique needs and circumstances of the child sitting in front of you in order for that child to make meaningful progress.
Those words are taken directly from federal law.
How that’s translated into classrooms and clinics varies widely.
Each child deserves access to literacy. Full stop.
In classrooms, teachers should be directly and explicitly teaching phonics in primary grades to ALL kids. All classrooms kindergarten through twelfth grade should be actively engaging students in content through direct instruction. Students should not be tasked with the job of teaching themselves through reading complex text. Students should be taught content through read aloud and thoughtful engagement with text and information through multimedia.
The instruction of phonics should include reading REAL words in isolation and spelling REAL words that follow rules and patterns. These rules and patterns should be explicitly taught, and students should be given ample time to practice these skills in isolation and in context.
I emphasize the word real because in recent history, benchmark assessments have begun to utilize nonsense word probes to assess decoding skills. In turn, teachers have begun teaching to that assessment. Teaching nonsense words has layers of negative ramifications. People are going to disagree with me here, and I’m ok with that. In my experience, the two biggest issues are: a missed opportunity to develop vocabulary, and the input of illegal patterns that don’t occur in the English language. To be clear, I think these assessments are excellent tools to measure underlying decoding skills. I do not think these words should be used, taught, or practiced as part of daily instruction. If you’ve ever worked with English Language Learners or kids with ASD, you know these nonsense words are truly problematic.
I realize many folks have opinions regarding the lack of importance of spelling instruction. I know, with absolute certainty, that all students benefit from explicit instruction in spelling AND that it accelerates reading gains. I am constantly referring to Dr. Sylvia Richardson’s motto, Teach a child to read a word, and he may never learn to spell it. Teach a child to spell a word, and he will learn to read it.
If you’ve never taught spelling in an incremental, sequential, and cumulative way, you might not have experienced its power. Whole group spelling lessons are transformative and provide daily opportunities to introduce new vocabulary and practice grammar and mechanics through sentence dictation. These activities should be part of any private clinic experience claiming to provide science of reading based interventions.
Phonological awareness skills, particularly phonics, segmenting sounds, and blending sounds, should be included in interventions for students with weak foundational skills. These activities are ideally not programmatically based, but rather prescriptively tailored to support the errors seen in reading and spelling.
Many students will need direct and explicit instruction to read and spell high-frequency non-phonetic sight words like said, thought, was, etc. These interventions should focus on tracing and saying the letter names, and then reading the word. For highly verbal students, a mnemonic saying might be helpful. For highly visual students, marking the part of the word that doesn’t play fair might be helpful. These words should be taught slowly. Often four at a time is the maximum for a student who struggles with rote memorization tasks.
Some students do not need comprehension or vocabulary interventions. When examining a student’s psycho-educational evaluation, those with high listening comprehension scores, high vocabulary scores, and high oral language scores do not require goals for comprehension on the IEP. These children who struggle to read, are likely on this particular struggle bus because of a decoding deficit. See the interventions listed above.
Students with weak vocabulary, poor background knowledge, and low listening comprehension, and/or low oral language scores will need thoughtfully tailored interventions to improve these deficits. Fun fact, handing a child a packet of passages with questions at the end is not a thoughtfully tailored intervention.
These students require direct and explicit instruction in how to visualize content. This most often looks like a therapist or teacher pre-teaching necessary vocabulary, multiple exposures to particular content, and instruction in monitoring thinking while reading. Aspects of high-quality programs like Lindamood-Bell’s Visualizing and Verbalizing™️ could be employed to support students with these weaknesses.
Students should be asked to retell content using their own words, generate main idea, and use the retell to support higher-order thinking questions. In my own practice, many students need to go sentence by sentence for quite some time before moving to more text. It’s stunning what they can’t recall after reading even a simple sentence or two. They aren’t seeing the mind-movie. This has to be taught.
Students who struggle with executive function will likely struggle with comprehension and written expression. These students need interventions tailored to support their weak organizational skills. They will likely require explicit instruction in note-taking, organizing their thoughts, and planning for long-term assignments.
Learning to read is a complex task, progress towards remediation is slow-going. The progress of a child with dyslexia is often consistently inconsistent. It’s crazy-making.
I counsel parents that it will likely be a year before we see any lasting, meaningful changes. Most of my clients are with me for 2-5 years twice weekly. I typically reassess every 50 sessions. Anything more frequent will only be maddening since data will likely ebb and flow. Also, if I stop to reassess, that’s time I’m not running intervention. Classrooms lose so many precious hours to data collection that could be better spent on actual meaningful instructional time.
Progress monitoring should include word level reading, word level spelling, a writing sample, phonological awareness monitoring, and a connected text on the child’s level scored for accuracy and followed up with retell and comprehension questions. In schools, these assessments should be repeated three times per year.
Remember that words per minute is a precarious predictor. My clients who are trained to stop and ask questions or reread confusing passages will “fail” a fluency probe but may have stellar comprehension. Students with depressed processing speeds will likely always be slower readers, but that doesn’t mean they lack comprehension capabilities.
Our schools have a long way to go to meet the needs of all readers. Schools are filled with well-meaning teachers truly doing their best. Continued advocacy and support for trainings and mentorship in schools is my great hope. Training isn’t enough. Teachers need support within mentorship communities to grow these complex skills. A certificate in xyz isn’t going to make the magic happen. Teachers need support within their unique community of learners to best hone their skills to meet the needs of these specific microcosms.
High quality private therapists should be able to speak knowledgeably about each of these elements as they relate to your child. A certificate or lack thereof is not a way to choose a therapist. I highly encourage parents to ask for references and find a therapist who has a strong, longstanding reputation in the community. If she’s full, ask her for suggestions for other folks to try. You can also ask if she’s ever heard of Ms. So-and-So. Many of us will do sleuthing for you to determine if the person you’re hiring is up for the job.
A webinar series for parents is coming in early 2024. If there’s a topic you’re yearning to learn more about, drop a comment below. #untileverychildcanread