Courtenay Frazier Norbury 1 & Shula Chiat 2

1. Semantic vs. phonological therapy for word recognition: A single case study of intervention with a language impaired child Courtenay Frazier Norbury1 & Shula Chiat2 1Oxford Study of Children’s Communication Impairments, Department of Experimental Psychology, University of Oxford, UK 2Department of Language and Communication Sciences, City University, UK

2. Introduction • Evidence clearly demonstrates that children with speech and language impairments are at increased risk for reading failure • Research has emphasized the role of phonological processing in normal reading development and in reading disorders • The role of semantics in word recognition is unclear or understated, especially in relation to how children with reading difficulties continue to develop sight vocabularies despite impaired phonological ability

3. Experimental Questions • Can a child’s sight vocabulary be increased by incorporating active semantic processing of single words into word recognition tasks? • Can a child with a phonological processing deficit learn to apply phonological knowledge to single word reading? • Could semantic processing support use of weaker phonological skills in word reading? • Which approach would be most effective in improving single word reading?

4. WS male chronological age: 8;6 educated in language unit with 2 days of mainstream integration first referred to Speech and Language Therapy at age 3;0 Non-verbal Abilities Age Equivalent: 9;0 (10;0 for visual recognition) Vocabulary Age Equivalent: 6;8 Receptive Language Age Equivalent: 7;0 Reading Age Equivalent: <6;0 Subject These scores are indicative of a specific language impairment (SLI). However, reading abilities are more impaired than language skills.

5. Auditory Discrimination 1-2 syllable words: 23/24 3-4 syllable words: 5/10 Non-word Repetition Total score: 21/40 3-4 syllable words: 7/20 Rhyme Production Total score: 15/20 Auditory Organization Total score: 16/24 88% of reading errors were real word substitutions, only 9% neologisms (non-words) 47% visual reading errors (sharing 50% of letters with target word) 16% vowel only errors 97% of errors shared onset with target words Phonological Processing and Reading Errors This suggests a predominantly visual approach to reading, with some attempt to use weak phonological decoding

6. Reading List 132 words chosen that WS could not read highly imageable nouns regular spelling in WS vocabulary Divided into 3 treatment groups matched for frequency and complexity Control Tasks Functionally related Graded Non-word Reading Reading related France Primary Reading Test Language related Test for Reception of Grammar Unrelated BAS Number Skills Procedure

7. Intervention

8. Example: Semantic and Phonological Links

9. Results: Total number of target words read correctly • Treated words improved significantly more than foils and no-treatment controls • Words which received exposure only (foils) also improved significantly • Reading of all words at ceiling level post-therapy. No differences between groups detected

10. Results: Control tasks • Significant improvement seen in the functionally related task (Non-word reading) • Improvement also seen in reading related task (France Primary Reading Test). WS more willing to attempt longer passages • As expected, no improvement seen in either the language related or the unrelated tasks during the therapy period • Therefore, improvements seen less likely to be result of general development

11. Discussion • Significant improvement of target words over foils in the semantic only condition suggests that exposure alone is not as effective as active semantic processing • Generalisation is more likely to occur when phonological skills are addressed in relation to reading • Results lend tentative support to connectionist models which suggest that semantic skills may support weaker phonological processing

12. Discussion (continued) • Semantic processing of single words should not be seen as an alternative to phonological processing because of its limited generalization • However, semantic processing may be useful to: • increase sight vocabulary by focusing simple exposure activities • support weak phonological skills • increase opportunities for immediate success with reading