By Mara Hampton Thesis Chair : Tina K. Veale Ph.D. CCC-SLP

1. Visual Phonics and Phonological Awareness Interventions: Stability of Gains in Language and Literacy By Mara Hampton Thesis Chair : Tina K. Veale Ph.D. CCC-SLP

2. Phonological Awareness Less Complex More Complex

3. Phonological Awareness and Literacy Development • Building block of literacy (National Reading Panel, 2000; Gillon, 2000) • Predictor of future reading success (Wagner, Torgesen, and Rashotte 1994) • Greater improvement in reading abilities with phonological awareness training (Hatcher, Hulme, and Ellis 1994)

4. Phonological Awareness and Language • Hansen (2003) and Megli (2004): • 10-week small group phonological awareness training program • 20-minute intervals, twice a week • Activities included syllable blending & segmenting, rhyme recognition & production, phoneme recognition, etc. • Significant gains in expressive & receptive language skills were demonstrated • Dyke (2008): • Replicated intervention methods used in Hansen (2003) and Megli (2004) studies. • Measured only auditory comprehension • Significant gains in auditory comprehension of typically developing preschoolers

5. See-the-Sound Visual Phonics (Visual Phonics) • Multisensory strategy that represents all of the sounds of English with a hand-shape cue and corresponding written symbol • Hand and symbol cue for each sound • Provides visual, tactile, & kinesthetic information about phonemes • Not a communication system, but rather an instructional tool

6. Visual Phonics and Phonological Awareness • Narr (2008) examined the relationship of phonological awareness and decoding skills in 10 students who were deaf or hard-of- hearing. • Visual Phonics was incorporated during the phonemic awareness and phonic aspects of the reading process. • Participants were able to use phonological information to make rhyme judgments and to decode

7. Visual Phonics and Language Impairment • Dyke (2009) • 25 preschool children with speech and/or language deficits • 2 experimental groups (PA only; PA + VP; 1 control group • 10 week small group phonological awareness intervention • Activities included rhyme production & recognition, syllable segmenting & blending, & beginning sound awareness. • Results: Auditory comprehension, expressive language, language content and language structure improved significantly in both experimental groups, but not in the control group.

8. Visual Phonics and Literacy • Gergits (2010) • 25 preschool children with speech and/or language delay • 2 experimental groups (PA only; PA + VP); 1 control group • 10 week small group phonological awareness intervention • Activities included rhyme production & recognition, syllable segmenting & blending, & beginning sound awareness. • Results: No significant difference between groups in literacy skill acquisition. Trend toward more gains in PA + VP group.

9. Phonological Awareness Supplemented by Visual Phonics

10. Research Questions • After a six month lapse, to what extent do speech-language impaired preschoolers maintain gains in language and literacy from treatment with phonological awareness? • After a six month lapse, to what extent do speech-language impaired preschoolers maintain gains in language and literacy from treatment with phonological awareness supplemented by visual phonics? • After a six month lapse, is there a difference noted between the phonological awareness intervention vs. the phonological awareness intervention supplemented by visual phonics upon language and literacy abilities?

11. Subjects • 10 of the 25 subjects were available • Speech and/or language delay based on results of the Clinical Evaluation of Language Fundamentals-Preschool, 2nd Edition (CELF-P:2) and Goldman Fristoe Test of Articulation, 2nd Edition (GFTA-2) • No significant academic concerns • Normal hearing and visual acuity • Students of two central Illinois at-risk early childhood programs • Experimental groups • Group 1: Phonological awareness intervention (N=2) • Group 2: Phonological awareness intervention in conjunction with visual phonics (N=6). • Control group • Nontreatment group (N=2)

12. Subjects

13. Methodology • Previous studies utilized pretest-posttest control group design. Current study utilized a time series design. • The following language and literacy tests were administered approximately 6 months after completion of the previous study: • Test of Auditory Comprehension of Language, 3rd Edition • Clinical Evaluation of Language Fundamentals – Preschool, 2nd Edition • Phonological Awareness and Literacy Screening –Pre-Kindergarten • Phonological Awareness and Literacy Screening-Kindergarten • Testing conducted by 1 licensed SLP or 1 of 2 supervised undergraduate students in CDS

14. Data Analysis • CELF-P:2 core language scores and TACL-3 quotient scores were used to compare the overall change in language abilities and receptive language of the experimental and control groups. • PALS total percentage correct scores were used to compare the overall change in literacy abilities of the experimental and control groups. • Performance was evaluated using descriptive statistics and inspection of tabled data.

15. CELF-P:2 Core Language Standard Scores Group 1: Pretest to Posttest 1 gain= 7.5 pts; Posttest 1 to Posttest 2 gain=3.0 pts. Pretest to Posttest 2 gain= 10.5 pts Group 2: Pretest to Posttest 1 gain=28.1 pts; Posttest 1 to Posttest 2 drop=14.3 pts. Pretest to Posttest 2 gain=13.8 pts Control Group: Pretest to Posttest 1 gain=4 pts; posttest 1 to posttest 2 gain=12 pts. Pretest to Posttest 2 gain=16 pts.

16. TACL-3 Quotient Scores Group 1: Pretest to Posttest 1 gain= 3.5 pts; Posttest 1 to Posttest 2 drop=1.0 pts. Pretest to Posttest 2 gain= 2.5 pts Group 2: Pretest to Posttest 1 gain=9.5 pts; Posttest 1 to Posttest 2 drop=6.7 pts. Pretest to Posttest 2 gain=2.8 pts Control Group: Pretest to Posttest 1 gain=2 pts; posttest 1 to posttest 2 drop=4.5 pts. Pretest to Posttest 2 gain=2.5 pts.

17. PALS AVERAGE PERCENTAGE OF CORRECTNESS Group 1: Pretest to Posttest 1 gain= 17.1 pts; Posttest 1 to Posttest 2 gain=7.1 pts. Pretest to Posttest 2 gain= 24.4 pts Group 2: Pretest to Posttest 1 gain=25.2 pts; Posttest 1 to Posttest 2 drop=27.5 pts. Pretest to Posttest 2 gain=52.7 pts Control Group: Pretest to Posttest 1 gain=8.4 pts; posttest 1 to posttest 2 gain=32.6pts. Pretest to Posttest 2 gain=41 pts.

18. Summary of Results • Subjects made substantial gains in language abilities following 10 weeks of PA or PA + VP intervention. Six months later, language gains attained at PT1 were not retained. • Subjects made greater gains in early literacy skills following 10 weeks of PA + VP intervention only. Subjects in this group continued to make greater gains over the next 6 months, as well. Subjects in the other groups made gains; however, they were not as large.

19. Clinical Implications • Children with speech-language deficits did not retain language gains realized following 10 weeks of PA or PA + VP intervention. • 10 week intervention not adequate amount of time for lasting language changes. • Children in VP + PA group relied on hand shape cues, but did not develop an internal representation of the sounds. • Children with speech-language deficits improved early literacy skills after 10 weeks of PA + VP intervention, and continued to see gains 6 months later. Children who received PA intervention without VP did not make as large gains. • VP may have more impact on early literacy skills than language skills. • Changes may be realized over time rather than immediately.

20. Clinical Implications • Speech-language pathologists should play an active role in phonological awareness intervention. • Consider the timing, duration, and intensity of intervention.

21. Strengths and Limitations • A control group was incorporated to determine if changes in core language, receptive language, and early literacy skill development could be attributed to the interventions. • Only a small number of participants from the previous study were available for testing, potentially compromising the reliability of these results. • Amount of PA intervention incorporated into subjects’ preschool curricula was not controlled and may have influenced measurements.

22. Future Research • Further exploration of the use of VP to develop language and literacy skills in a speech- language impaired population. • Longer intervention time periods • Study subject with language impairment without speech involvement • Extend intervention into the classroom and/or home

23. References • Bird, J., Bishop, D.V.M, & Freeman, N.H. (1995). Phonological awareness and literacy development in children with expressive phonological impairments. Journal of Speech and Hearing Research, 38, 446-462. • Dyke, J. (2008). Phonological awareness intervention with preschool children: Changes in receptive language abilities. Unpublished honor's thesis; Eastern Illinois University; Charleston , Illinois. • Dyke, J. (2010). The application of visual phonics and phonological awareness interventions to address language impairment in preschool children. Unpublished master’s thesis; Eastern Illinois University; Charleston, Illinois. • Gergits, E. (2010). Using visual phonics and phonological awareness interventions for language impaired preschoolers. Unpublished master’s thesis; Eastern Illinois University; Charleston, Illinois. • Gillon, G. (2000). The efficacy of phonological awareness intervention for children with spoken language impairment. Language, Speech, and Hearing Services in Schools, 31, 126-141. • Hansen, D. (2003). Changes in language abilities of preschool children following phonological awareness training. Unpublished master’s thesis; Western Illinois University; Macomb, Illinois. • Hatcher, P.J., Hulme, C., & Ellis, A.W. (1994). Ameliorating early reading failure by integrating the teaching of reading and phonological skills: The phonological linkage hypothesis. Child Development, 65, 41-57.

24. References • Megli, M. (2004). Phonological awareness training: Augmenting speech and language. Unpublished master’s thesis; Western Illinois University; Macomb, Illinois. • Montgomery, J. (2008). Dave krupke: What exactly is visual phonics? Communication Disorders Quarterly, 29, 177-182. doi:10.1177/1525740108318413 • Narr, R. F. (2008) Phonological awareness and decoding in deaf/ hard-of-hearing students who use visual phonics. Journal of Deaf Studies and Deaf Education, 10, 1-12. • National Institute of Child Health and Development (2000). Report of the National Reading Panel. Teaching children to read: An evidence-based assessment of the scientific research literature on reading and its implications for reading instruction (NIH Publication No. 00-4769). Washington, DC: U.S. Government Printing Office. • Raitano,N.A., Pennington, B. F.,Tunick, B. F.,Boada,R., & Shriberg, L. D. (2004). Pre-literacy skills of subgroups of children with speech sound disorders. Journal of Child Psychology and Psychiatry, 45, 821–835. • Rvachew, S., Ohberg, A., Grawburg, M., & Heyding, J. (2003). Phonological awareness and phonemic perception in 4-year-old children with delayed expressive phonology skills. American Journal of Speech-Language Pathology, 12, 463–471. Doi:10.1044/1058-0360(2003/092)

25. References • Schuele, C.M., & Boudreau, D. (2008). Phonological awareness intervention: Beyond the basics. Language, Speech, and Hearing Services in Schools, 39, 3-20. • Snow, C., Burns, M., & Griffin, P. (1998). Preventing Reading Difficulties in Young Children. Washington, D.C.: National Academy Press. • Stark, R., Bernstein, L., Condion, R., Bender, M., Tallal, P., & Catts, H. (1984). Four year follow-up study of language impaired children. Annals of dyslexia, 34, 49-68. • van Kleeck, A., Gillam, R.B., & McFadden, T.U. (1998). A study of classroom-based phonological awareness training for preschoolers with speech and/or language disorders. American Journal of Speech-Language Pathology, 7, 65-76. • Wagner, R.K., Torgesen, J.K., & Rashotte, C.A. (1994). Development of reading-related phonological processing abilities: New Evidence of Bidirectional Causality from a latent variable longitudinal study. Developmental Psychology, 30, 73-87.

26. Questions