• Hearing loss across the spectrum (mild/moderate/severe/profound, unilateral, and/or fluctuating due to repeated otitis media with effusion).

• Poor cognitive skills including rapid automatic naming, short-term memory, working memory or executive functioning.

• Diagnoses including childhood apraxia of speech (CAS), attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD; higher rates of SCRD).

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Once a child has been identified as ‘at risk’ for reading difficulties (as per factors above) or been noted as struggling with grade-expected reading or writing, a full literacy assessment should be completed. Although schools in Ontario provide benchmark evaluations of students’ reading and writing skills, teachers and school staff do not have the time resources to complete full literacy assessments on all struggling children. Remember that 20% of children have dyslexia - in a school of 500 children, that is approximately 100 children! In Ontario, a speech-language pathologist working in private practice can complete a comprehensive literacy assessment. It is recommended to check your health insurance benefits under “Speech Language Pathology” or “Speech Therapy” as many plans have coverage for all or part of this assessment.

 

Research shows that the following should be included in a comprehensive literacy assessment:

• Phonological awareness skills including blending, segmenting and letter-sound correspondences. This helps to determine whether a child may need direct teaching on these skills but also how quickly we expect a child to move through explicit reading and writing instruction.

• Single-word reading of both real and nonsense words. Single word reading removes any context that a child can be using to read words and taxes their phonological knowledge (knowledge of rules for sounding out words). In addition, nonsense words force a child to use phonological knowledge rather than visual memory. For example, some children can read the word “big” because they have seen it so many times and remember it as a whole, but the nonsense word “dix” requires a child to use decoding skills or ‘sounding it out’.

• Single-word spelling of real words.

• Oral reading on passages to look at accuracy, fluency (rate), prosody (phrasing and expression when reading aloud), and reading comprehension.

• Oral use and understanding of vocabulary.

• Listening comprehension of sentences and/or passages.

 

There are expensive standardized tests available for many of these areas, however, research has also encouraged the use of informal reading inventories (IRIs) and curriculum-based measures (CBMs) as they are often available at schools. Many possible literacy assessment tools are listed in research articles, including one by Literacyhow here.  My arsenal of literacy assessment includes:

• Comprehensive Test of Phonological Processing - 5th edition (CTOPP-5) for phonological processing. I typically complete the Elison, Blending and Rapid Naming subtests.

• Gallistel-Ellis (GE) Test of Coding for single-word reading and spelling. I love this assessment because it is organized by different rules of reading (e.g., short vowels, silent ‘e’, phonetically irregular words).

• Gray Oral Reading Test - 5th edition (GORT-5) for oral reading of passages to look at accuracy, fluency and reading comprehension. 

• Informal rating scale developed by National Assessment for Educational Progress for prosody. The rating scale and its explanation are available here.

• A variety of sub-tests from language assessments based on client needs for oral language assessment (e.g., Word Classes and/or Expressive Vocabulary from Clinical Evaluation of Language Foundations - 5th edition [CELF-5]; Receptive and/or Expressive One-Word Picture Vocabulary Tests).

 

Following the research I have done for this blog series along with reflection on my own practice, I am going to work to incorporate communication with a student’s teacher earlier in the assessment/intervention process. Teachers have such valuable information about a child’s reading, writing and language skills as well as other observations about attention, focus and academic performance.

 

So to wrap up, we have now reviewed both background information about literacy, warning signs for later reading difficulties, as well as  areas to include in a comprehensive literacy assessment. Up next, tips and strategies for literacy intervention!

 

Research:

Anthony, J. L., Greenblatt Aghara, R., Dunkelberger, M. J., Anthony, T. I., Williams, M. W. & Zhang, Z. (2011). What Factors Place Children With Speech

     Sound Disorders at Risk for Reading Problems? American Journal of Speech-Language Pathology, 20, 146-160.

Catts, H. W., Fey, M. E., Zhang, X. & Tomblin, J. B. (2001). Estimating the Risk of Future Reading Difficulties in Kindergarten Children: A Research-

     Based Model and Its Clinical Implementation. Language, Speech, and Hearing in Schools, 32, 38-50.

Colebrander, D., Ricketts, J. & Breadmore, H. L. (2018), Early Identification of Dyslexia: Understanding the Issues. Language, Speech, and Hearing

     in Schools, 49, 817-828.

Shaywitz, S. (1996). Dyslexia. Scientific America. 

Spear-Swerling, L. (2015). Common Types of Reading Problems and How to Help Children Who Have Them.. The Reading Teacher, 69(5), 513- 

     522.

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