Orton-Gillingham Reading Methodology for Articulation and Literacy Skill Development

1. Orton-Gillingham Reading Methodology for Articulation and Literacy Skill Development

3. Subject The child in this study was a 7.2 year-old male who had received individual speech and language treatment sessions for unintelligible speech, severe expressive language delay, and mild receptive language delay within the Children�s Speech and Language Pathology Department at the Center for Children�s Rehabilitation, West Bloomfield Medical Building, from September 9, 2008 to present. He also participated in a literacy group for two 10-week terms from July 1, 2009 to December 23, 2009.

4. Subject Although progress had been significant for speech, language, and emergent literacy skill development following the 1 1/2 years of individual speech and language treatment and the 6-month group treatment for literacy training, the child�s spontaneous speech was still characterized by a mild articulation delay as measured by the Goldman Fristoe-2 Test of Articulation, a moderately severe delay in verbal expression and a mild delay in auditory comprehension as measured by the Clinical Evaluation of Language Fundamentals-Revised Fourth Edition, and a severe delay in literacy skill development as measured by the Emerging Literacy and Language Assessment prior to initiation of the Orton-Gillingham training.

5. Subject Nonlinguistic development was characterized by a mild delay in fine and gross motor development, diagnosed by neurologist Gary Trock, MD at Beaumont Hospital, Royal Oak, Michigan on April 3, 2008. The child received physical and occupational therapy from April 14, 2008 to October 8, 2008 at the Center for Children�s Rehabilitation to increase muscle strength and endurance.

6. Setting The setting for this study was the Children�s Speech Pathology Department within the Center for Children�s Rehabilitation, West Bloomfield Medical Building. The trainer for the study was an SLP-CCC who administered the treatment and probe procedures for each of the sessions. The trainer had received training in the Orton-Gillingham (OG) Multi-Sensory Reading Methodology in November, 2009.

7. Dependent Variable The dependent variable in this study was the articulation of sounds while blending them into consonant-vowel-consonant (CVC) nonsense words. The criterion established was 90% correct articulation of CVC words on a post-training session probe task or completion of five consecutive training sessions regardless of percent correct. The five-session criterion was used because of concerns about involving the child in an extended study.

8. Dependent Variable Two elements, including 1) accurate articulation of vowel phonemes in the medial position of CVC nonsense words and 2) accurate articulation of consonant phonemes in the initial and final positions of CVC nonsense words, were used to determine correctness of responses. The child�s performance on the probe tasks is depicted in Graph 1, which includes percent of correct responses for each behavior during baseline, treatment, and a final no-treatment phase.

9. Independent Variable The independent variable was the OG three-part drill/vowel intensive and consisted of training and reinforcement elements. Repetition through drill, positive verbal feedback, and a variety of cueing strategies were used during the intervention. Verbal feedback was delivered for correct responses following presentation of the three-part drill/vowel intensive components (visual, auditory, and blending). If a response was incorrect, the trainer used repetition and a variety of cues to elicit the target response. The training procedures were expected to provide generalization of the target responses to the probe tasks.

10. Design A multiple baseline across behaviors design was used to test the effectiveness of the intervention with two functionally similar yet independent behaviors of the same subject in the same setting. The intervention was sequentially applied as the criterion level of performance was met on the preceding target behavior. Treatment was discontinued with a target behavior once criterion was achieved during the session or after five consecutive sessions.

11. Intervention The intervention was the controlled sequential training offered from the OG Multi-Sensory Reading Methodology, including: Three-part drill Visual (Sound cards needed for review until criterion is achieved) SLP: Flash cards (stating sound if needed) Child: States the sound Auditory (Used phoneme/grapheme chart to highlight criterion concepts) SLP: State sound using the chart Child: Repeat, write letter kinesthetically in sand, name letter and sound, underlining from left to right Blending (Cards in CVC format) SLP: Tap cards individually (stating sound if needed) Child: State individual sound and then blend together (20 trials with assistance blending when needed)

12. Intervention Vowel Intensive Child: Place vowel sticks in ABC order SLP: State vowel sound Child: Hold up appropriate vowel, naming vowel and sound SLP: Progress into VC patterns and then into CVC patterns Child: Continue to listen for the correct vowel sound, naming the vowel and sound Probe sessions immediately followed the treatment. During the probe task, the SLP withheld feedback or prompting regarding response accuracy.

13. Nonsense Word ProbeFirst Fourteen Phonemes of the Orton-Gillingham New Alphabet kad pog hij gil kip mil hod chad toch dij gam cig toch pim dok hic gak mag dap mik

14. CVC Real WordsPractice at home15 minutes each day Dad jam had pig lap jot Tim cod

15. Obtaining the Data and Plotting the Results The data obtained consisted of the subject�s performance on probe tasks that involved accurate articulation while blending CVC nonsense words. Data were plotted on x-y graphs, which in turn were used to determine the subject�s performance with the untrained stimuli on the probe tasks. (See Graph 1.)

17. Results The results of this study indicated that articulation while blending CVC nonsense words, formed from the first fourteen sounds of the OG New Alphabet, improved through the OG Reading Methodology. The performance of the subject on the probe measuring accurate articulation of the vowel phonemes in CVC nonsense words reached a 90% level of accuracy and reached criterion. A 30% increase in accuracy, from 60 to 90%, was achieved. The performance of the subject on the probe measuring accurate articulation of the consonant phonemes reached 87%. Although the subject did not reach criterion, a 33% increase, from 54 to 87% accuracy, was achieved during blending of CVC words with target sounds at the beginning and end of the words.

18. Results The percentage of CVC nonsense words that were blended with all three of the phonemes produced accurately increased significantly. The initial baseline measure of 20% accuracy increased to 76% during the treatment program and dropped to 66% during the no-treatment phase at the end of the study. Analysis of mis-articulations revealed that the subject�s errors were characterized by poor sound-symbol association for two of the three vowels: the short /o/ and short /i/. The subject�s errors with articulation of these vowels were characterized by distortions or short /a/ substitutions. The subject also inconsistently confused the /b/ and the /d/ phonemes in the initial and final positions of the CVC words. The other consonant sound-symbol errors were inconsistent in nature and were not characteristic of the subject�s articulation during conversation. (See Graph 2.)

20. Limitations of the Study The OG Multi-Sensory three-part drill/vowel intensive for teaching accurate sound blending is effective. However, it is difficult to know which of the training components or combination of components might have been responsible for the changes. The trainer did adhere to the training procedures as they were defined in the OG Reading Methodology. The generalization from training to probe trials was substantial, although the gains were not fully maintained during the no-treatment phase.

21. Table 1. (Part 1) Summary of Orton-Gillingham Reading Methodology for Articulation and Literacy Skill Development Feature Type of Design Goal of Study Subject Setting Description Multiple baseline across behaviors Determine if a behaviorally-based treatment can affect or modulate the blending and speech skills of a child with language impairments Seven-year-old male receiving services for delayed speech, language, and literacy skill development Children�s Speech and Language Pathology Department, Center for Children�s Rehabilitation, West Bloomfield Medical Building, Beaumont Hospital

22. Table 1. (Part 2) Summary of Orton-Gillingham Reading Methodology for Articulation and Literacy Skill Development Feature Dependent Variable Independent Variable Results and Outcomes Description Articulation while blending sounds into CVC nonsense words Orton-Gillingham Multi-Sensory Reading Methodology (three-part drill/vowel intensive) The performance by the subject reached a 90% level of accuracy on the first probe behavior and an 87% level of accuracy on the second probe behavior over the 10 treatment sessions that were implemented from November 25, 2009 to February 24, 2010.

23. Discussion Over the last several decades, considerable evidence has emerged in support of the language basis of reading difficulties. Research has clearly demonstrated that a phonological processing deficit underlies both the articulation and word-reading difficulties exhibited by many children. In fact, a phonological processing deficit is now viewed as the primary causal factor of dyslexia. This single subject, multiple baseline study suggests that the Orton-Gillingham Reading Methodology is an effective treatment program to improve both articulation and word-reading in a child with speech and language impairment.

24. References Bell, Nanci (1986). Visualizing and Verbalizing: For Language Comprehension and Thinking. San Luis Obispo, California: Gander Educational Publishing. Bowen, Carolyn C. (1983). Angling for Words: A Study Book for Language Training. Novato, California: Academic Therapy Publications. Brown-Chidsy, R. (2007). No More �Waiting to Fail�: How Response to Intervention Works and Why it is Needed. Educational Leadership, 65(2), 40-46. Connor, C. M., Morrison, F. J., & Slominski, L. (2006). Preschool Instruction and Children's Literacy Skill Growth. Journal of Educational Psychology, 98(4), 665-689.

25. References Connor, C. M., Son, S. H., Hindman, A., & Morrison, F. J. (2005). Teacher Qualifications, Classroom Practices, and Family Characteristics: Complex Effects on First Graders' Language and Early Reading. Journal of School Psychology, 43, 343-375. Craig, H. K. & Washington, J. A. (in press). Language Variation and Literacy Learning. In K. Appel, B. Ehren, E. Silliman, and C. A. Stone (Eds.), Handbook of Language and Literacy Development and Disorders. New York: Guilford Press. Justice, L. M. (Ed) (2006). Clinical Approaches to Emergent Literacy Intervention. San Diego, CA: Plural Publishing.

26. References Justice, L. M. (2006). Evidence-Based Practice, Response-to-Intervention, and Prevention of Reading Difficulties. Language, Speech, and Hearing Services in Schools, 37, 1-14. Justice, L. M., Kaderavek, J., Bowles, R., & Grimm, K. (2005). Phonological Awareness, Language Impairment, and Parent-Child Shared Reading: A Feasibility Study. Topics in Early Childhood Special Education, 25, 143-156. Pence, K., & Justice, L. M. (2007). Language Development: Theory to Practice. Upper Saddle River, NJ: Merrill Prentice Hall. �Report of the National Reading Panel: Teaching Children to Read,� http://www.nichd.nih.gov

27. References Shaywitz, Sally M.D. (2003). Overcoming Dyslexia. New York: Alfred A. Knopf. Traub, Nina, & Bloom, Francis (1990). Recipe for Reading (3rd ed.). Cambridge: Educator�s Publishing Service. Vaughn, S., Wanzek, J., & Fletcher, J. M. (2007). Multiple Tiers of Intervention: A Framework for Prevention and Identification of Students with Reading/ Learning Disabilities. In B. M. Taylor & J. E. Ysseldyke (Eds.), Effective Instruction for Struggling Readers, K-6 (pp. 173-195). New York: Teacher�s College Press. Wanzek, J., & Haager, D. (2003). Teaching Word Recognition with Blending and Analogizing. Teaching Exceptional Children, 36(1), 32-38.