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PhonAware Tx Teresa A. Ukrainetz

1

Phonemic Awareness: What, How, When,

To Whom, and How Much

Nowadays

Teresa A. Ukrainetz, Ph.D., S-‐LP(C) University of Wyoming

Phon Aware Tx 1

The Plan

1.  Phonemic awareness & reading 2.  Some other related concepts 3.  Academic standards for phonemic awareness 4.  Early and later tasks to teach 5.  Teaching acMviMes & materials 6.  Scaffolding & ordering learning 7.  InstrucMon intensity 8.  And a look at phonological memory & retrieval

tx

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For More Ideas and Informa;on

From: Pro-‐Ed Email: Teresa at

[email protected]

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Phonemic Awareness •  Understanding that speech is composed of minimal units

of sound that are separable and manipulable – and ability to conduct those separa;ons and manipula;ons

•  Phoneme = a minimally contrasMve unit of speech dogs = /d/ /aw/ /g/ /z/ clogs = /k/ /l/ /aw/ /g/ /z/

–  /r/ and /l/ are phonemes in English, but not Japanese –  /ph/ and /p/ are only phones in English

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Why Phonemic Awareness Tx? •  Necessary for reading and spelling in alphabeMc wriMng systems

•  Very teachable skill •  Reading disabiliMes explained in part by phonemic awareness deficits –  Developmentally-‐limited explanaMon (Stanovich) –  Affects decoding iniMally, then decoding deficits and lack of reading affect comprehension (Maahew Effect)

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Phonological Awareness THE SOUNDS OF SPEECH

1. Phonemic awareness Plus 2. Onset - rime (/d/-/awg/, /bl/-/awg/) 3.  Syllables (/ba/-/na/-/na/) Plus sort of but not really: 1.  Words (hot-dog, I see mom) ← involves meaning 2.  Environmental sounds (tweet-tweet) ← not speech

BUT NOT THE SOUNDS OF LETTERS

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2

Other Terminology Related to Phon-‐

•  Phones •  Phonemes •  Phonemic awareness •  Phonological awareness •  Phonological processing

•  Phonology •  Phonological producMon •  Phonological disorder

•  PhoneMc spelling •  Phonics •  AlphabeMc principle •  Graphemes •  Orthographic knowledge

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Phonemic Awareness in Reading •  In scienMfically-‐based curricula •  In NICHD (2000) report as 5 big areas of reading: –  Phonemic awareness, phonics, vocabulary, comprehension, fluency

•  In simple view of reading –  In the Decode part of Decode + Comprehend

•  In DIBELS progress tesMng for K-‐1 –  First phoneme matching, phoneme segmenMng

•  In actual teacher pracMces –  Classroom reading curricula and instrucMon

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Increasing Levels of Phonemic Awareness

Ukrainetz, Nuspl, Wilkerson, & Beddes (2011) •  PreK tx study on teaching phonemic awareness •  Data collected in 2005 and 2007 •  No formal instrucMon in the daycares •  Big increase on first phoneme isola8ng: –  2005, n = 15, pre-‐test mn = 1.2 (2.0), 0 ≥ 8/10 –  2007, n = 24, pre-‐test mn = 5.3 (4.2), 12 ≥ 8/10 –  t(37) = 3.528, p = .001, d = 1.19

•  Variable with trend to increase, but stable on leaer names: –  2005, pre-‐test mn = 14.9 (10.5) –  2007, pre-‐test mn = 20.1 (8.7) –  not sig diff, d = 0.50

5330 PhonAwarePlus Tx 9

So What Should SLPs Do? •  Formally our domain as an oral language skill important for reading

•  Used to teach teachers about it but no longer •  SMll our domain for children with language disorders

•  But need to be strategic and efficient in tx, doing only what is needed for as long as needed

For once, we may need to do less rather than more!

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OLD View of Developmental Order 3-‐4 yrs: Sounds & sentences tasks

⇓ 4-‐5 yrs: Rhyme & syllable tasks

⇓ 5-‐6 yrs: First phoneme tasks

⇓ 6-‐7 yrs: All other phoneme tasks in monosyllablic words

⇓ 8 yrs+: All other phoneme tasks in mulMsyllabic words

Phon Aware Tx 11

NEW View of Developmental Order

3-‐4 yrs: First phoneme tasks ⇓

4-‐5 yrs: First phoneme, rhyme, syllable tasks ⇓

5-‐6 yrs: Phoneme segment & blend in monosyllabic words

⇓ 7 yrs+: Other phoneme tasks in monosyllables &

mulMsyllabic words

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So What to Teach?

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Common Core Standards & Decoding •  Reading code skills paramount in NCLB –  Improved early basic reading performance across naMon

•  AaenMon shiled to comprehension and composiMon with Common Core (NaMonal Governors AssociaMon Center for Best PracMces and the Council of Chief State School Officers, 2010)

The Common Core’s emphasis on high-‐level comprehension skills calls for a reversal of NCLB’s focus on decoding and low-‐level literacy skills (Calkins et al., 2012, p. 29)

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COMMON CORE STATE STANDARDS FOR

English Language Arts & Literacy in History/Social Studies, Science, and Technical Subjects

Common Core Language Arts Categories

Reading Standards And the Rest

Reading: Founda8onal Skills Wri8ng

•  Print Concepts •  Phonological Awareness •  Phonics and Word Recogni8on •  Fluency

•  Text Types and Purposes •  Produc8on and Distribu8on of Wri8ng •  Research to Build and Present Knowledge •  Range of Wri8ng

Reading Literature and Informa8onal Text

Speaking and Listening

•  Key Ideas and Details •  CraI and Structure •  Integra8on of Knowledge and Ideas •  Range of Reading and Level of Text •  Complexity

•  Comprehension and Collabora8on •  Presenta8on of Knowledge and Ideas

Language

•  Conven8ons of Standard English •  Knowledge of Language •  Vocabulary Acquisi8on and Use

Ukrainetz Contextualized Tx & Common Core 15

Common Core Kindergarten Standards

Demonstrate understanding of spoken words, syllables, and sounds (phonemes) 1.  Recognize and produce rhyming words 2.  Count, pronounce, blend, and segment syllables in spoken

words 3.  Blend and segment onsets and rimes of single-‐syllable

spoken words 4.  Isolate and pronounce the iniMal, medial vowel, and final

sounds in three-‐phoneme (CVC) words ( not including final /l/, /r/, or /x/)

5.  Add or subsMtute individual phonemes in simple, one-‐syllable words to make new words


First Grade Standards Demonstrate understanding of spoken words, syllables, and sounds (phonemes)

1.  DisMnguish long from short vowel sounds in spoken single-‐syllable words

2.  Orally produce single-‐syllable words by blending sounds, including consonant blends

3.  Isolate and pronounce iniMal, medial vowel, and final sounds in spoken single-‐syllable words

4.  Segment spoken single-‐syllable words into their complete sequence of individual sounds

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Standards & Research Evidence •  Phoneme isolaMon, segmenMng, and blending for simple

words needed for reading and spelling •  First grade standards make sense •  Lack of second grade fancy task standards make sense •  BUT kindergarten standards include opMonal skills, adding

unnecessary complexity and work

Don’t interpret the CCSS [Common Core] as a mandate to shoehorn more stuff into an already overcrowded curriculum (Calkins et al., 2012, p. 182)



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Past PracMces •  Teach phonological awareness –  Syllables and rhyme are obvious and easy –  Entry into speech sound awareness

•  Start with these large speech units –  For preschoolers –  K-‐1 tx progression –  IniMate minimal speech unit aler mastery of larger unit

•  Phoneme achievements –  Preschoolers culminate with first sound introducMon –  K could master first sound tasks –  1st could master simple segmenMng

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Revising the RecommendaMons – Start and Stay with Phonemes

•  Larger speech units not an easier entry –  Rhyme and syllable not needed for early reading/spelling –  Nor for entry into phonemes –  Some first phoneme tasks very easy –  Syllable to phoneme segmenMng confusing

•  Right from the get-‐go –  Start with phonemes for K and preschoolers –  Use rhyme incidentally to highlight sounds of words

•  Phoneme achievements –  Pre-‐K can master first sounds (many w/o explicit instrucMon) –  K can master simple segmenMng

So that should save ;me! Phon Aware Tx 20

Tasks to Teach

1.  IsolaMng first, middle, final phonemes 2.  Matching first, middle, final phonemes 3.  SegmenMng simple words into phonemes 4.  Blending simple words from phonemes

Just teaching these should save ;me.

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And Even Phoneme Order Not Strict 1.  Visible and conMnuant consonants

/m/, /b/, /f/, /s/… 2.  Not visible but salient consonants:

/g/, /n/, /sh/, /dz/… 3.  Word iniMal consonant clusters and tense vowels:

/sp/, /sm/, /sk/, /i/, /u/… 4.  Everything else

/r/, /l/, /w/, /j/ /sl/,/gr/, /tw/ /a/, /aw/, /E/ V-‐/sk/, V-‐/nk/, V-‐/gz/

Guide to task order OR to support and expecta;ons


Making Tasks Harder or Easier

•  Tasks can be made harder by increasing cogniMve and memory demands

•  e.g., phoneme matching – Match from two words – Match from four words – With or without pictures – With known or unknown vocabulary

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What About These Fancy Tasks? 1.  DeleMng and subsMtuMng (change the /g/ in blog to /t/ ) 2.  MulMsyllabic words (extraordinary, inspira;onal) 3.  DeleMng and subsMtuMng communicaMvely (Pig LaMn)

Maybe benefits, but not as phonemic awareness per se •  Phonemic awareness contributes liale to reading ability

beyond 3rd grade level •  Advanced phonemic awareness tasks involve cogniMve

operaMons, memory, and spelling •  Reading and spelling experiences improve phonemic

awareness



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A Reciprocal RelaMonship

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Reading and Spelling

Phonemic Awareness

Fancy Phonemic Awareness Tasks for Reading and Spelling

•  Long words NOT read or spelled leaer by leaer –  Syllabic, morphemic chunks, and MGRs

•  And listening hard can make your spelling worse! •  buVer, been, words •  /u/ as in moo, through, do, lieu, new, blue, tune

•  What about all that work holding exclama;on in mind while sounding it out and moving blocks around? More on that to come…


To Whom?

Basically preschl and K But beyond that…

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Who Should Get Phonemic Awareness Tx?

•  Children on our IEPed caseload (Tier III) –  First phoneme awareness for preschool –  Basic phonemic awareness for K-‐2, depending... –  Fancy phonemic awareness for 3+, depending...

•  Basic phonemic awareness part of Tier I and II reading instrucMon –  Check on explicitness and quality –  Possibly parMcipate in Tier II remediaMon You can be an extra pair of hands, but don’t you have something else you should be doing?

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Phonemic Awareness Tx Need

•  Basic phonemic awareness (isolaMng, segmenMng, blending)

•  Indicators: – Low on first phoneme isolaMng or matching in late preschool or early K

– Low on phoneme segmenMng in late K – Spelling is pre-‐phoneMc or missing phonemes:

m mom ab cat sa sun

pas place fat fast

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How to Teach?

Approaches, procedures, acMviMes, materials

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Overview of Phonemic Awareness InstrucMon

1. A culminaMon of a verMcal hierarchy of environmental sound, word, syllable, rhyme, and phoneme acMviMes

2.   Hierarchical ver8cally-‐ordered discrete single-‐skill phoneme tasks

3.   Cycled horizontally-‐ordered and integrated mix of contextualized and discrete phoneme tasks

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Phonemic Awareness in Daily Life

•  Sound play – Rhymes – Preschool joke talk – Pig LaMn

•  Talk about text – Let’s read a story – Let’s write a story

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Remember the Reciprocal RelaMonship

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Reading and Spelling

Phonemic Awareness

Phonemic Awareness AcMviMes 1.  Name play –  No materials needed

2.  Contrived drill-‐games –  Matching, Fishing, Guess-‐the-‐Word –  ArMc cards, phonology cards, plasMc food, puzzles

3.  Shared books –  Aphabet –  AlliteraMve –  Rhyming

4.  Message WriMng –  WriMng to dictaMon, child wriMng –  White board, paper, or computer

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Drill-‐Games

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Going Fishing

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Animal Puzzles and Food Bag

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Alphabet & AlliteraMve Books

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Focus on the Sounds Not the Leaers

•  Big BEAR buys a bike •  Liale BEAR buys a bike

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Rhyming Books Phon Aware Tx 40

Mini Rhyme Stories

•  Use rhyme as a tool not as a tx objecMve

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Talking about Speech Sounds during

Book Sharing •  There was a boy named Fred. He didn’t want to go to bed.

•  What are the rhyming words? •  What is the first sound of Fred and bed? •  Let’s count the sounds in Fred and bed, get your fingers ready. Which is longer?

•  I’m going to say the sounds of another word that rhymes with Fred and shed. /r-‐E-‐d/

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8

Emergent WriMng

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Talking about Speech Sounds while Message WriMng

•  Let’s write Happy Birthday Mom. •  What is the first sound in happy? I will write that.

•  Let’s say all the sounds in happy. Fingers ready? /h-‐ae-‐p-‐i/ 4 sounds, I will write the leaers.

•  There should be 4 leaers for 4 sounds, but wriMng is funny someMmes, 4 sounds, 5 leaers!

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CriMcal Tx Features: RISE

•  Repeated OpportuniMes •  Intensity of scheduling •  SystemaMc support •  Explicit Skill Focus

✚ The Learner Factor of AaenMon & Engagement

SPPA5330 Foundations of Language Tx 45

How Much R-‐I-‐S-‐E? Regular à Supportive à Intervention Contexts

R Few ⇒ Some ⇒ Many

I Class ⇒ Group ⇒ Individual; Occasional ⇒ Regular ⇒

Frequent; Short ⇒ Middling ⇒ Long

S Little ⇒ Some ⇒ Lots

E Implicit ⇒ Explicit ⇒ Meta

✚ Passive & minimal ⇒ Motivated attentive ⇒ Self-directed &

sustained engagement SPPA5330 Foundations of Language Tx 46

RISE with Phonemic Awareness

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Repeated Opportunities

Isolate + segment two words / pg for 5 pgs = 20 opps

Intensity Grps of 2-3 ch, 30 min/wk for 8-10 weeks

Systematic Support

Structural scaffolds: Rhyme to highlight form > content; letters to represent phonemes; simple single skill games Interactive scaffolds: Wait for answer, stress a sound, give hand cues, model, expand part to full segmentation

Explicit Skill Focus

Focus on phonemic awareness over letters or vocabulary

Two EffecMve Approaches to Phonemic Awareness InstrucMon

1.  Skill Mastery – Hierarchical verMcally-‐ordered discrete single-‐skill phoneme tasks AKA Skill mastery, Clinician-‐directed

2.  Integrated MulMple Skill – Cycled horizontally-‐ordered mix of contextualized and discrete phoneme tasks AKA Whole-‐part, Hybrid, Contextualized Skill

Both occurring along with print and spelling experiences and instrucMon



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Guide to Task Order OR to Task Support 1.  Visible and conMnuant consonants

/m/, /b/, /f/, /s/… 2.  Not visible but salient consonants:

/g/, /n/, /sh/, /dz/… 3.  Word iniMal consonant clusters and tense vowels:

/sp/, /sm/, /sk/, /i/, /u/… 4.  Everything else

/r/, /l/, /w/, /j/ /sl/,/gr/, /tw/ /a/, /aw/, /E/ V-‐/sk/, V-‐/nk/, V-‐/gz/

•  All in simple word shapes: CVC à CV, CVCV, CCVC à VC, CVCC •  SomeMmes in challenging words: Teresa, Veronica, Nadia


Tx Reminders •  Repeat, emphasize, or extend isolated consonants •  Isolated stop consonants impossible, but minimize

following vowel to short schwa •  Have fun with long names but don’t expect accuracy

•  AGAIN, SOUNDS OF SPEECH NOT SOUNDS OF LETTERS despite –  purpose being to read and write not to speak and listen

–  and teaching in a print context –  or teaching along with sound-‐leaer instrucMon

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Single Skill VerMcal Tx Sequence

Carson et al. (2013) Phon Aware Tx 51

Week Skill Activities

1 Rhyme Bingo, odd-one-out

2 Initial phoneme Bingo, matching, odd-one-out

3 Final phoneme Bingo, matching, odd-one-out

4 & 5 Phoneme

blending

Drawing, singing, bingo; mainly 2-3 phoneme words; 4-

phoneme and consonant clusters to extend students

6 & 7 Phoneme

segmenting

Drawing, singing, bingo; mainly 2-3 phoneme words; 4-

phoneme and consonant clusters to extend students

8 & 9 Phoneme

manipulation

Letter cards and white board for manipulating letters and

sounds in words to create new words

10 Review Reviewed prior 9 wks with focus on phoneme segmenting

and blending

MulMple Skill

Horizontal Tx Cycle

Session Activities Skills/Tasks

1 a. Open Skill Qn

b. Naming

c. Book

d. One Game

d. Close Skill Qn

a. What and why from one child

b. Naming has one primary skill task

c. Book has four skill tasks

d. Game has one primary skill task

d. Specific answer from each child

2 a. Open Skill Qn

b. Naming

c. 2-3 Games

d. Close Skill Qn

See Session 1; Games each address

different skill tasks

3 a. Open Skill Qn

b. Naming

c. Writing

d. 1-2 Games

e. Close Skill Qn

See Session 1; Writing has four skill

tasks

Phon Aware Tx 52

Ukrainetz et al. (2009)

VerMcal vs Horizontal Task Order Ver8cal: /b/à/b-‐a/à/b-‐a-‐d/ •  Single subskill or task

focus •  Contrived, controlled

tasks •  Ordered in difficulty •  Mastery of each task

before the next •  Minimal instructor

support during task

Horizontal /b/+/b-‐a/+/b-‐a-‐d/ •  MulMple subskill or task

foci •  Purposeful, complex tasks •  Varied difficulty •  Varied performance

across tasks •  InteracMve scaffolding

matched to need

Phon Aware Tx 53

Why Horizontal?

•  VerMcal discrete skill is convenMonal approach that is simpler to execute and collect data in structured, contrived games

•  Horizontal requires a skilled clinician to dynamically scaffold child in purposeful and complex acMviMes

Why bother?

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Why I Like Horizontal •  AlternaMve to verMcal •  Less advance planning •  Learned more like in daily life •  Taught like other language skills •  Allows child self-‐regulated learning •  Allows SLP to respond to need in the moment •  Allows variaMon in level within a group •  Links to use in books and message wriMng •  More interesMng for everyone

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Scaffolding Phonemic Awareness •  Dynamic interacMve individualized instrucMonal

moves –  Support acMve learning –  Lead to greater independence –  Iin acMvity beyond current independent performance

•  Horizontal ordering –  Integral part –  From imitaMon to independence

•  VerMcal ordering –  Light scaffolding possible –  Heavy to moderate indicates need to back up

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Scaffolding Phoneme IsolaMon

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Heavy Isolate and exaggerate phoneme in isolation and in the word, point to mouth and tell children to look, say the correct response, elicit response from child.

What is the first sound in milk, /m/m/m/m/m/ milk? Watch my mouth, /m/m/m/m/ilk. The first sound is /m/. You say /m/.

Moderate Isolate phoneme and exaggerate, point to mouth and tell children to look, exaggerate phoneme in word (use two or more depending on need).

What is the first sound in milk? /m/m/m/m/ milk? (point to mouth).

Arriving at Independence for IsolaMon

Phon Aware Tx 58

Light Emphasize beginning phoneme in the word.

What is the first sound in milk?

None Ask the question What is the first sound in milk?

Scaffolding Beyond The First Aaempt

Phon Aware Tx 59

High Scaffolding: SLP: Okay Amanda, here’s another one for you. What’s the first sound, Amanda, look at me. What’s the first sound in dare? A: Don’t you dare! SLP: What’s the first sound in dare? A: /g-g-g/ SLP: Look at my mouth -- /d-d/ A: D SLP: D is the letter. The sound is /d/ A: /d/ SLP: Good job! /d/ is the first sound in dare

Scaffolding SegmenMng

Phon Aware Tx 60

Heavy Isolate and raise finger for each phoneme in the word. The child copies and counts. Confirm correct number, repeat segmented sounds.

The word is red. Get your fists ready to count the sounds. /r/ (raise one finger) Say the sounds with me. /E/ (raise second finger). Yes, /r/ /E/ /d/. How many sounds? Count my fingers. Right three sounds. /r/ /E/ /d/

Moderate Get mouth ready for first phoneme, but pause for children to say it, raise finger, then mouth sound but pause for the other phonemes. Have child tell how many phonemes.

The word is red. Get your fists ready. You say the sounds this time (mouth /r/ and raise finger). /E/ (raise finger), /d/ (raise finger)? Yes, /r/ /E/ /d/. How many sounds?


11

Arriving at Independent SegmenMng

Phon Aware Tx 61

Light Get the mouth ready to say each phoneme. Raise finger for each phoneme. Say aloud only the middle sounds.

The word is red. Get your fists ready. (mouth the sound /r/), /e/, (raise fingers), (mouth /d/). Yes, /r/ /e/ /d/. How many sounds?

None Ask the question. Say the sounds in red.

Scaffolding SegmenMng a Simple Word

Phon Aware Tx 62

Light Scaffolding, Simple Word: SLP: How many sounds are in the word the? Show me the sounds. Tap my fingers and show me. J: /th-e/ SLP: Yes! /th-e/, /th-e/. Two sounds.

Scaffolding SegmenMng a Hard Word

Phon Aware Tx 63

Light Scaffolding, Complex Word: SLP: What’s the next word? J: Titanic SLP: Titanic! That has a lot of sounds in it. What do you think the first sound is? J: /T-i-tan-i-c/ (sticks out five fingers as he says sounds). SLP: Good! You counted most of the sounds. J: There’s five sounds. SLP: Okay, that was good for such a long word.

Scaffolding Tips for Young Children

•  In the zone – Enough help for success with effort; vary effort vs success

– Recognize parMal and increasing correctness •  Blending – Closed choices with rhyming/pictures/objects •  SegmentaMon

– Mouth and finger assists segmentaMon – Present the correct model but accept approximaMons

– For preschoolers, aim is idea of phoneme segmentaMon and embedded isolaMon opps


IniMaMng Speech Sound Awareness

•  Listening pracMce, but on phonemes •  Becoming aware of mouth and ear •  Isolated phoneme pracMce, but Med to word context

•  Choral and individual, for a few minutes •  First sound in my name, Teresa, /t-‐t-‐t-‐t-‐t/ (point to my mouth) everyone say this together…

•  Use salient phoneme contrasts – /p/ vs /s/ vs /n/


How Much?

For 3 months? 2 years? 15 min a week? 60 min a week?

Phon Aware Tx 66


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How Much – The Teaching Episode & Tx Dosage

•  To determine intensity, think about drug dosages •  AcMve treatment element in its minimal unit –  Teaching episode = IniMaMon+Response+EvaluaMon

•  A dosage framework (Warren, Yoder, & Fey, 2007) –  Dose: 1 session –  Form: Nature of acMviMes in session –  Strength: Number of episodes in 1 dose –  Frequency: Number of doses per week –  DuraMon: Number of weeks of does –  Total intensity: DuraMon x Frequency x Strength

Phon Aware Tx 67

Beyond the Basic IRE Episode •  IRE plus –  Clinician model without response –  Peer response heard as model –  Choral response belonging to whom?

•  MulMple task episodes –  Let’s see if sun and slow match. What is the first sound in sun? [match + isolate]

–  Let’s say the all the sounds in sun. You start, the first sound is-‐-‐ [segment + isolate]

– What am I holding in this bag? /P-‐i-‐ch/. Peach. Your turn. You say the sounds in the next word and I will guess. [blend + isolate]

Phon Aware Tx 68

Intensity Evidence to 2001 •  Large number of controlled studies have obtained significant and large gains

•  Intensity has varied considerably: –  Session lengths of 15 to 90 minutes –  Frequencies of 1 to 5 Mmes weekly –  DuraMons of 4 to 32 weeks –  Individual, group, and whole class arrangements –  Learners from 4 to 8 years, of a range of abiliMes

•  No report of number of teaching episodes •  Rarely treatment fidelity or child aaendance info

Phon Aware Tx 69

Ehri et al. (2001) Meta-‐Analysis •  Part of NRP (2000) •  Evidence for phonemic awareness treatment effects

•  52 studies with 96 treatment-‐control comparisons reviewed –  Mixed pre-‐phonemic and phonemic

•  Results: –  Small group beaer than individual or whole class –  Typical learners had larger gains than weaker learners –  1-‐2 tasks beaer than 3+ phonemic/pre-‐phonemic tasks –  5 to 18 hours best, with no difference in this span

Phon Aware Tx 70

Intensity – How Much Tx? Depends on How

•  The long way: 6 months if full phonological spectrum, whole K class 15-‐min daily instrucMon (24 hrs): –  Brady et al. (1994), moderate gains on segmenMng: d = 0.57

•  The short way: 7 weeks if phoneme-‐level only, small K groups, 3-‐4x/wk 20-‐30 min instrucMon (12 hrs): –  Ball & Blachman (1988): Say-‐it-‐and-‐move it blank/leaer Mles; SegmenMng: vs no-‐tx & leaer tx, d = 1.85, d = 1.67.

– Ukrainetz et al. (2000): Sound talk embedded in rhyming books and shared wriMng acMviMes; SegmenMng: d = 1.37


Tx Intensity for Children with Language Impairment

•  7 controlled group studies at phoneme level (incl. rhyme) for 4-‐7 yr olds – Warrick et al. (1993), van Kleeck et al. (1998), Gillon (2000, 2005), Segers & Voerhoeven (2004), Denne et al (205), Hesketh et al. (2000)

•  4 included other speech/language objs •  Individual or small group, 3-‐20 hrs •  Best results for 12-‐20 hours, large segmen8ng effect (>d = 1)

Phon Aware Tx 72


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Does the Old Evidence SMll Apply? •  Studies unMl recently contrasted phonological awareness tx to regular classroom instrucMon with

•  BUT now... – One of the 5 pillars of reading (NRP, 2000) –  Part of K-‐1 standardized reading dx (DIBELS) – Olen taught in RTI and in classroom –  Primarily at the phoneme level in K

•  So how much is enough for tx with classroom phonemic awareness instruc8on?

Phon Aware Tx 73

A Study of Intensity

Ukrainetz, Ross, & Harm (2009) •  41 5-‐6 year old kindergartners, including 22 English learners, with low leaer and first sound knowledge on DIBELS

•  11 hours of phonemic awareness treatment: – Concentrated (CP, 3x/wk, Oct -‐ Dec) – Dispersed (DP, 1x/wk, Oct to March) – Vocabulary control (CON, 1x/wk to March)

Phon Aware Tx 74

Ukrainetz, Ross, & Harm (2009) What is the effect on phonemic awareness and nonsense word reading of supplementary phonemic awareness instruc;on concentrated in the fall compared to dispersed through the year for at-‐risk Ks?

•  41 Ks: low leaer & first sound knowledge on DIBELS, incl 22 ELL •  11 hours of phonemic awareness tx:

1.  Concentrated (CP, 3x/wk, Oct -‐ Dec) 2.  Dispersed (DP, 1x/wk, Oct to March) 3.  Vocabulary control (CON, 1x/wk to March)

•  Effects in December of more tx •  Effects in April of different distribuMon of tx


Dose Form

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Order Horizontal

Tasks First isolate, last isolate, blend, segment

Activities Name, picture, object, book, & writing activities (fingers for segmenting)

Dose Strength

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Grouping 3 children

Session length 30 minutes

Episodes (IRE+)

≥ 5 per task per child = 20 + listening to 1/2 the 40 peer models /.. Session dose = 40 episodes

Dose Frequency & DuraMon

Phon Aware Tx 78

Frequency 1 or 3

Duration 8 or 24 weeks

Total time 12 hours of tx

Total intensity 960 teaching episodes


14

Effect of Intensity on Phonemic Awareness

Phon Aware Tx 79

Mild

0

5

10

15

20

25

30

35

40

Sept Dec MarchTime Points

Mea

n/40

CPDPCON

Moderate

0

5

10

15

20

25

30

35

40

Sept Dec MarchTime Points

Results for Ukr&al. Intensity Tx Study •  Over a school yr, for SLP tx and classrm instrucMon

•  Most improved into the normal range •  A few sMll below expectaMons; rec’d for sped dx

•  English learners = naMve English speakers •  Short intense tx = long weekly tx •  At-‐risk Ks, esp mild deficits, improve a lot with only classroom instrucMon and incidental self-‐regulatory gains from tx for another area

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RecommendaMons for Phonemic Awareness Intensity

•  Total intensity –  5-‐18 hours for typical ch –  12-‐20 hours for ch w/ lang imp

•  Most of this in the regular classroom •  AddiMonal tx? –  8 sessions of 20 episodes per child? –  5 episodes per child in tx sessions on other goals over 24 sessions?

–  An addiMonal boost for our kids, but not a lot

Spend the ;me you save on increasing intensity for other language skills

Phon Aware Tx 81

Phonemic Awareness in Summary 1.  Tier I and II -- teachers handling phonemic awareness 2.  Tier III -- SLPs, but strategically and efficiently 3.  Teach at the phoneme level 4.  Teach isolating, blending, and easy segmenting 5.  Do not teach students to listen really hard 6.  Use both drill-game and purposeful print activities 7.  Use RISE in all tx activities 8.  Use vertical or horizontal ordering 9.  Match scaffolding to child need and task difficulty

* A little quality tx will go a long way for this teachable skill *

Phon Aware Tx 82

What About the Rest of the Story of Phonological Processing Tx?

Deficits underlying most reading disabiliMes (aka dyslexia) 1.  Phonemic awareness 2.  Phonological working memory 3.  Phonological code retrieval (wordfinding)

What about #4, Phonological ProducMon?

Phon Aware Tx 83

Saying the Words – The ProducMon Part of Phonological Processing

•  Not a significant part of phonological processing deficits –  For ch with sig speech sound disorders, 1/3 show

comprehension deficits and 3/4 producMon deficits (Shriberg & Kwiatkowski, 1994)

–  BUT low co-‐morbidity (<2%) for Ks ided with language impairment (Shriberg et al., 1999)

•  If only phonological disorder, not a significant predictor of later reading problems –  BUT LI and RD show mild difficulMes with mulMsyllabic

pronunciaMon (Goffman, 2004; Munson et al., 2005) –  And oral & limb motor coordinaMon (Zelaznik & Goffman,

2010) Phon Aware Tx 84


15

Phonological Processing Tx Need •  Word-‐reading problems •  Persistent trouble on phonemic awareness compared to peers

•  Low on auditory memory and rapid automaMzed naming (CTOPP)

•  Spelling may show convenMonal spelling but lost in mulMsyllabic words decious delicious camatily calamity

•  Watch the student spell: Spelling process shows forge|ng and repeated tries even if answer correct

Phon Aware Tx 85

A Fancy Task Program

Lindamood Phoneme Sequencing Program (LiPS, Lindamood & Lindamood, 1998):

•  Structured hierarchical procedure with step-‐by-‐step tasks and prompts

•  Blocks and leaer-‐blocks represent phonemes in nonsense & real words

•  IniMated with arMculatory phoneMcs instrucMon on disMncMve features (stop, fricaMve, alveolar)

•  Invented vocabulary to describe arMculators (Mp tapper, lip popper, skinny air)

•  Olen extended Mme of 1+ years •  Phonemic awareness, leaer-‐sound correspondence,

auditory memory, word retrieval, convenMonal spelling

Phon Aware Tx 86

But Maybe It is Intense Quality Tx More than LiPS?

•  Reading: LiPS & Embedded Phonics for 10-‐12yr SLD : indiv 100 min/day for 8 wks -‐-‐> For both txs, rdg accuracy & compreh average range, rate improved, 40% no longer SPED (Torgesen et al., 2001)

•  Language: Computerized or SLP tx for 6-‐9yr SLI: indiv 100 min/day for 8 wks -‐-‐> For all txs, big changes in standardized language measures incl phonemic awareness & auditory temporal proc (Gillam et al., 2008)

Phon Aware Tx 87

Phonological Memory IntervenMon •  Advanced phonemic awareness segmentaMon, subsMtuMon, and deleMon “work-‐outs”

•  As a way in to less-‐accessible components of phonological processing? –  With or w/o color-‐coded Mles and leaers –  Require sustained aaenMon, memory, retrieval and problem-‐solving

•  What about Pig LaMn? •  Memory and rapid naming drills? •  Specialized computer training solware?

Phon Aware Tx 88

Pig LaMn •  Take first consonant or consonant cluster of English word,

move it to end of word and add suffix ay [eɪ] pig → igpay banana → ananabay truck → ucktray happy → appyhay

•  For words that begin with vowel sounds or silent leaer, "way" or “yay” or “ay” added at word end egg → eggway inbox → inboxway

•  Iway antway ootway iecpay oastay ithway amjay

Phon Aware Tx 89

Emerging PosiMve Evidence for Memory Tx

Maridaki-‐Kassotaki (2002) –  Randomly assigned 120 6-‐9 yr Greek ch to tx & no-‐tx control –  Tx: Non-‐word repeMMon exercises for 15-‐min, 4 days/wk, 7 mos

–  Results: Significantly beaer non-‐word rep and reading

Garcia-‐Madruga et al. (2013) –  Randomly assigned 31 Spanish 8-‐9yr to tx & control –  Tx: Drills on aan focus, aan switching, using prior knowledge, semanMc updaMng in working mem, & inhibiMon

–  Results: Sig beaer IQ scores, reading compreh, and working memory

Phon Aware Tx 90


16

CogMed Dual n-‐back Training •  n-‐back task: Listen to or look at stream of leaers or numbers and decide if item matches one that occurred a designated number of items earlier –  2-‐back: 1-‐4-‐5-‐7-‐5-‐2-‐7-‐2-‐7-‐3-‐6-‐8-‐6 – Dual version, parMcipants look at and listen to different sequences simultaneously

•  Tx involves moving incrementally from 1-‐back to 2-‐back and so on

•  Claims to improve memory and intelligence •  See www.soakyourhead.com

Phon Aware Tx 91

Promising But… •  Controlled studies à improvements in aaenMon, working

memory, and reading (Gillam & Gillam, 2010; Holmes et al., 2009, 2010) –  BUT with no-‐tx comparisons, DK tx features responsible (e.g., greater monitoring and encouragement)

–  DK if same outcomes for other language txs with mental rehearsal and manipulaMon

–  DK if changes maintain and generalize to academics •  Or what is changing (Holmes et al., with 8-‐11 yr olds) –  Changes in capacity or control of aaenMon & strategy use? – Majority ch reported concentraMng harder to improve perf –  Strategies incl. closing eyes, rehearsing items, and tracing visual paaerns with eyes

Phon Aware Tx 92

Other Routes To Improving Memory?

•  Other ways to improve daily life performance (Boudreau & Constanza, 2011): many factors impinge on verbal working memory, including student’s language skills, knowledge base, and learning skills –  You remember beVer if you come to the task with founda;onal understanding and awareness of task purpose

•  Berninger et al. (2008): for 4th to 6th graders with reading disability, –  Explicit orthographic and morphological training improved pseudo word reading and real word spelling,

–  But hands-‐on, engaging problem-‐solving science instrucMon improved phonological working memory

Phon Aware Tx 93

Phonological Code Retrieval •  Accurately and quickly accessing the phonological code

represenMng the meanings of known words –  AKA word retrieval, word-‐finding, rapid naming –  In spoken language expression and in fluent reading

•  Rapid naming has a central phonological retrieval component, but also taps aaenMonal, perceptual, memory, lexical, and arMculatory elements

•  Combo of difficulMes in phonological awareness and phonological code retrieval (rapid naming) a “double deficit” source of severe reading difficulMes (Wolf & Bowers, 1999)

Phon Aware Tx 94

Phonological Retrieval Txs

1.  Improving word depth and elaboraMon in tradiMonal semanMcs treatment

2.  Using phonological and semanMc cues to aid word retrieval

3.  Teaching children how to cue and organize themselves 4.  Rapid naming drills for leaers, digits, objects

Phon Aware Tx 95

Effects of Tx on Retrieval •  Improves accuracy and latency of word retrieval in

confrontaMon naming tasks (McGregor & Leonard, 1995) –  BUT liale generalizaMon to untrained words (e.g., Bragard et al., 2012)

–  And none to communicaMve and reading tasks •  Rapid leaer naming txs show immediate increase in leaer

naming speed and reading fluency –  BUT improvements are temporary or require addiMonal orthographic training (Kirby et al., 2010)

•  Rapid naming performance can improve somewhat as a result of reading intervenMon (Torgesen et al., 2010)

Phon Aware Tx 96


17

In Sum – Phonological Memory & Retrieval Tx 1.  Memory performance can improve with

training –  Promising but many quesMons –  Qns re: criMcal tx elements, what is being improved, and whether improvements maintained and applied to academic tasks

2.  Retrieval performance strongly resistant to tx –  With semanMc elaboraMon, cueing tx, or rapid naming tx –  Recommended: Improve language and reading skills, which then improves retrieval

Phon Aware Tx 97

Phonemic Awareness References Ball, E.W., & Blachman, B.A. (1988). Phoneme segment tx. Annals Dyslexia, 38,

208-‐225. Boudreau, D., & Costanza-‐Smith, A. (2011). Assessment and tx of working memory

deficits in school-‐age ch: Role of the SLP. LSHSS, 42, 152-‐166. Bragard, A. et al. (2012). Word-‐finding interv for ch with SLI: A mulMple single-‐case

study. LSHSS, 43, 222-‐234. Calkins, L., & al. (2012). Pathways to the Common Core. NH: Heinemann. Carson, K.L. et al. (2013). Classrm phonological aware instrucMon and literacy

outcomes in first year of schl. LSHSS, 44, 147-‐160. Denne, M. et al. (2005). Txg ch w/ exp phonol dis. Internat J Lang & Comm Dis, 40,

493-‐504. Ehri, L.C., et al. (2001). Phonemic aware instruct helps ch learn to read: Evidence frm

NRP’s meta-‐analysis. Rdg Res Q, 36, 250-‐287. Garcia-‐Madruga, J.A. et al. (2013). Rdg compreh and working memory’s exec

processes: Tx study. Rdg Res Q, 48, 155-‐174. Gillam, R.B., & Gillam, S.L. (2012). N-‐Back and CogMed working memory training:

Proceed with cauMon. Perspec;ves Lang Learning & Educ, 19(3), 108-‐116. Gillam, R.B. et al. (2008). Efficacy of Fast ForWord-‐Lang interv in school-‐age ch with

lang imp: A randomized controlled trial. JSLHR, 51, 97-‐119. Gillon, G.T. (2000). Efficacy of phonol aware tx for ch w/ lang impair. LSHSS, 31,

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Gillon, G. (2002). F/u study invesMg benefits of phonol aware tx for ch w/ spoken lang impair. Internat J Lang & Comm Dis, 37, 381-‐400.

Gillon, G.T. (2004). Phonological awareness: From res to prac;ce. NY: Guilford. Gillon, G.T. (2005). FacilitaMng phoneme aware develop in 3-‐&4-‐yr ch w/ spch impair.

LSHSS, 36, 281-‐284. Hesketh, A. et al. (2007). Teaching phoneme aware to pre-‐literate ch w/ spch dis.

Internat J Lang & Comm Dis, 42, 251-‐271. Holmes, J., et al. (2009). AdapMve training leads to sustained enhancement of poor

working memory in ch. Developmental Science, 12(4), F9–F15. Holmes, J., et al., (2010). Working mem deficits can be overcome: Training and

medic on working mem in ch with ADHD. Applied Cogni;ve Psych, 24, 827–836. Maridaki-‐Kossotaki, K. (2002). RelaMon bet phonol memory and rdg ability in Greek-‐

speaking ch: Training of phonol memory. European J Psych of Educ, 17, 63-‐73 McGee, L.M., & Ukrainetz, T.A. (2009). Using scaffolding to teach phonemic aware in

presch & K. Rdg Teacher, 62, 599-‐603. McGregor, K.K. & Leonard, L. (1995). Interv for word-‐finding deficits. In M.E. Fey et

al. (Eds.), Lang interv: Preschl through elementary years (pp. 85-‐106). Brookes. Munson, B. et al. (2005). Influence of vocab size, phonotacMc probability, and

wordlikeness on nonword reps of ch with/without SLI. JSLHR, 48, 1033-‐1047. Segers, E., & Verhoeven, L. (2004). Computer-‐supported phonol aware tx for K ch w/

SLI. LSHSS, 35, 229-‐239. Shriberg, L. D. et al. (1999). Prevalence of spch delay in 6-‐year-‐old ch and

comorbidity with lang impairment. JSLHR, 42, 1461-‐1481. Phon Aware Tx 99

Torgesen, J.K. et al. (2001). Intensive remed instruct for ch with severe RD. J Learning Dis, 34, 33-‐58.

Ukrainetz, T.A. (2006). Scaffolding young students into phonemic awareness. In T.A. Ukrainetz (Ed.), Contextualized Lang Interv (pp. 429-‐467). Pro-‐Ed.

Ukrainetz, T.A. (2008). Phonemic aware instruct for presch: Pre-‐phonemic vs phonemic. EBP Briefs, 2, 47-‐58.

Ukrainetz, T.A. (2009). Phon aware: How much is enough in changing pic of rdg instrucMon? Topics Lang Dis, 29, 344-‐359.

Ukrainetz, T.A. et al. (2000). An invesMg into teaching phonemic aware thru shared rdg & wrtg. Early Childhood Res Q, 15, 331-‐355.

Ukrainetz, T.A. et al. (2009). An invesMg of tx scheduling for phonemic awareness with at-‐risk Ks. LSHSS, 40, 86-‐100.

Ukrainetz, T.A. et al. (2011). Effect of syllable instrucMon on phonemic awareness in preschlers. Early Childhood Res Q, 26, 50-‐60.

van Kleeck, A. et al. (1998). Study of classrm-‐based phonol aware tx for prschlrs w/ spch & lang dis. AJSLP, 7, 65-‐76.

Warren, S.F. et al. (2007). DifferenMal tx intensity res: Missing link to creaMng opMmally effecMve comm interv. MR and DD Res Reviews, 13, 70-‐77.

Warrick, N. et al. (1993). Phon aware lang-‐delay ch. Annals Dyslexia, 43, 153-‐172. Zelaznik, H.N., & Goffman, L. (2010). Generalized motor abiliMes and Mming beh in ch

with SLI. JSLHR, 53, 383-‐393.

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