How to Assess and Treat Reading Difficulties

Reading difficulties in children may be more common than you think. Studies show that 7% of school-aged children have difficulties with reading and spelling. That is almost 1 in 15! [1] 

You may also have heard of the term Dyslexia – the difficulty learning to read. Educational psychologists provide a clinical diagnosis of Dyslexia. They assess areas of cognition, visual processing, and memory. While psychologists make the formal diagnoses for dyslexia, speech pathology can help! Speech pathology assessments investigate gaps and areas of breakdown that cause reading difficulties.

So what happens in a speech pathology literacy assessment? A literacy assessment is more than a spelling test or counting how many reading errors a child makes. A literacy assessment can take up to 3 hours. This is due to the many layers of reading and language skills speech pathologists need to cover. An easy way to understand the layers is to look at the ‘Reading Rope’.

Each thread that gets twisted and woven into the rope is crucial and fundamental to reading. These threads represent the skills that a child has to master. For example, the word recognition skills a child needs are decoding, sight word recognition, and phonological awareness. Other skills relate to language, which include vocabulary, inferencing, and prediction. Other threads relate to cognitive skills like attention, focus and memory. Gaps in any of these components will weaken the ‘Reading Rope’. This may manifest into difficulties with reading comprehension, reading fluency, or accuracy!

Let us break down what happens in a literacy assessment! The first part of the assessment looks at a child’s word recognition skills:

Decoding. Can your child use letter sound knowledge to figure out words that are new to them? Decoding means word-level reading. If your child is in year 1, they may recognise 2 letters that can combine to make a new sound. For example, ‘sh’, ‘ai’ and ‘oo’. These letter combinations are ‘digraphs’. Children use their letter sound knowledge to figure out how words are pronounced. This is one of the foundational threads to reading, and is covered in a literacy assessment.

[2]Phonological awareness. This skill is not about reading letters themselves. Phonological awareness is an irreplaceable skill that precedes learning to read and write. Your child may have learned that words have syllables (e.g. ‘kangaroo’ is made up of ‘kan-ga-roo’). Words are also made up of many smaller sounds (e.g. ‘cup’ is broken down further into ‘c-u-p’). This awareness is a skill your child needs to master before they can learn to read and write.[3]

Sight recognition. There are a lot of words a child will learn to recognise as a whole instead of decoding each time they read. We call these words sight words or ‘camera words’. Common words include ‘the’, ‘was’ and ‘before’. Children who have below-average sight word recognition skills can over rely on their decoding skills to read. This often means reading is very effortful and slow.[4] A speech pathologist will assess your child’s ability to recognise sight words at an age-appropriate level.

The second part of a literacy assessment covers language comprehension skills. Children will have difficulties reading and understanding a story if they do not understand a spoken story! Language skills play a big part in strengthening the ‘Reading Rope’ and building robust reading skills.

Vocabulary knowledge. A reading text may contain words they do not hear in daily conversations. These tend to be higher level vocabulary words such as ‘ominously’, ‘telescope’, ‘frequency’. Children may feel stuck when they come across these unfamiliar words. Low vocabulary skills will also imnpact how much meaning children can derive from stories and textbooks.[5]

Background knowledge. We are constantly making connections in our brain when we read – ‘What do I already know about this topic? Have I had a similar experience?’. A child’s knowledge of facts and their ability to make meaningful connections to real life is so important. Their experiences impact how well they understand a text.

Language structures. Complex sentences often contain multiple parts (e.g. conjunctions). They also have different verb tenses (e.g. present, past), plural forms (e.g. ‘mice’, ‘geese’) and so on. A child with reading difficulties may also struggle with complex spoken sentences.

Literacy knowledge. Knowledge of print and different genres of text is also an important thread to the ‘reading rope’. Children learn that print is read from left to right and words are arranged in lines with gaps between them. They also notice print on a range of flyers, packaging, signs and billboards.

Verbal reasoning. A child with reading difficulties may be able to understand a text at face value, but miss the information that is ‘between the lines’. Verbal reasoning is a higher-level language skill that allows children to make inferences. These are ‘smart guesses’ based on the clues provided in the text. Their knowledge of idioms (e.g. once in a blue moon) and metaphors will also help them interpret the text.

After assessing all of these components, speech pathologists can pinpoint the weaker threads in the Reading Rope. We then provide targeted treatment. There is no one-size-fits-all therapy program. Each child’s knowledge gaps are different, with vastly different learning styles! We provide tailored therapy support in each of these areas for your child.

Speech pathology is also different from a tutoring service. We assess and diagnose the literacy skills that have not been properly developed. Speech pathologists understand where the skill gaps are. We know why they are impacting current literacy ability and why progress has been slow. Literacy intervention is about understanding which threads are loose or missing in their rope. After a time of therapy, children may continue to need some level of support. At this point, we will refer them to tutoring for generalised literacy support.

If you notice your child has difficulties with any of the reading areas described in the reading rope, here’s what to do. Start by using these 7 tips to help your child feel more confident reading at home! Speech pathologists are trained in identifying underlying causes of reading difficulties. We use evidence-based methods to make effective changes in your child’s ability to read.

Read more about what reading difficulties look like, when to seek help and how speech pathologists support children here. 

References: 

1. Yang, L., Li, C., Li, X., Zhai, M., An, Q., Zhang, Y., Zhao, J., & Weng, X. (2022). Prevalence of developmental dyslexia in primary school children: A systematic review and meta-analysis. Brain Sciences, 12(2), 240. https://doi.org/10.3390/brainsci12020240
2. Linda Larsen, Saskia Kohnen, Lyndsey Nickels & Genevieve McArthur (2015) The Letter-Sound Test (LeST): a reliable and valid comprehensive measure of grapheme–phoneme knowledge, Australian Journal of Learning Difficulties, 20:2, 129-142, DOI: 10.1080/19404158.2015.1037323
3. Pfost, M., Blatter, K., Artelt, C., Stanat, P., & Schneider, W. (2019). Effects of training phonological awareness on children’s reading skills. Journal of Applied Developmental Psychology, 65, 101067. https://doi.org/10.1016/j.appdev.2019.101067 
4. Steacy, L.M., Fuchs, D., Gilbert, J.K. et al. Sight word acquisition in first grade students at risk for reading disabilities: an item-level exploration of the number of exposures required for mastery. Ann. of Dyslexia 70, 259–274 (2020). https://doi.org/10.1007/s11881-020-00198-7
5. Kilpatrick, D. A. (2015). Essentials of assessing, preventing, and overcoming reading difficulties. John Wiley & Sons.