ASHA recently adopted the position that speech-language pathologists can and should play a critical and direct role in the development of literacy for children and youth with communication disorders (Ad Hoc Committee on Reading and Written Language Disorders, 1999). SLPs can play many different roles in facilitating reading in children with and without communication disorders. These roles include prevention, identification, assessment, intervention, monitoring, and follow-up. SLPs also can play important roles in curriculum and instruction, advocacy, leadership, and continuing education.
The exact roles SLPs assume will depend on the policies and administrative structures of the work setting (e.g., school, clinic, private practice, hospital). There are three general roles SLPs might assume: planning team member, direct-service provider, or collaborative consultant (indirect-service provider). In some cases, an SLP might assume all of these roles. For example, an SLP might provide direct services for phonological awareness; consult with teachers on the best way to improve reading fluency, spelling, or writing; and be a part of the planning team in designing a language arts curriculum.
My focus here is on reading fluency. Fluency is generally acknowledged to be a critical component of reading, but until recently has often been neglected in classroom instruction and remediation programs. Fluency usually is defined as the ability to read with speed, accuracy, and proper expression. The fluent reader is able to group words into appropriate clause or phrase units and produce these units with correct intonation, stress, and pausing. Fluent readers see clauses and phrases as chunks of text and use these chunks to read and write more quickly.
Fluency = Word Recognition + Comprehension
Although fluency is dependent on adequate word recognition, proficiency in word recognition does not always result in fluent reading. Proficient word recognition may be sufficient to read quickly and accurately, but it is not sufficient to read with proper expression. In order to have proper expression (i.e., know which words to emphasize and when to pause), there must be some sensitivity to grammatical units (syntax) and punctuation cues.
In other words, reading fluency requires some application of language knowledge that is part of the comprehension process. Some recent studies have confirmed the link between comprehension and fluency. These studies have found that fluency improves with increases in students' ability to understand, interpret, and critically analyze texts.
Assessing Word Recognition and Comprehension
The view that fluency reflects the integration of word recognition and comprehension abilities means that fluency problems can arise from inefficiency in either of these skills. To adequately address fluency problems, then, both word recognition and comprehension processes must be assessed.
A comprehensive assessment of word-recognition abilities includes information about phonological awareness, letter identification, sound-letter correspondence knowledge, word-attack skills, and sight-word reading. Assessing comprehension is not as straightforward.
Norm-referenced tests of reading can provide some information about comprehension abilities, but these tests should be supplemented with other measures that provide information about students' ability to identify grammatical units, interpret and analyze texts, construct inferences, and apply background knowledge to construct meaning. There are many reliable sources that provide excellent descriptions and suggestions for the kinds of assessment procedures that should be used to evaluate word recognition and comprehension abilities (see reference list).
An assessment of reading fluency should evaluate accuracy, speed, and expression. There are a few norm-referenced tests of reading fluency. The Test of Reading Fluency (TORF) evaluates oral reading fluency on one-minute timed reading samples. The measure of fluency is the number of words read correctly, which is defined as a word read within three seconds and pronounced correctly.
The Gray Oral Reading Test-3 (GORT-3) is a more widely used measure of fluency. The GORT-3 measures rate, accuracy, and comprehension. Students read passages that increase in length (40–131 words) and difficulty. Scores reflect both rate and accuracy. The GORT-3 also includes an error analysis that differentiates between omissions, insertions, repetitions, mispronunciations, silent pauses longer than five seconds, and attempts longer than 10 seconds. Although the TORF and GORT-3 do not specifically address reading with expression, descriptive impressions and comments about this aspect of fluency could be added to the assessment report.
Informal Reading Inventories (IRIs) also can be used to determine a student's fluency level. IRIs are widely used to diagnose reading problems and understand how a student constructs meaning and uses word-attack strategies. They provide information about students' independent, instructional, and frustration reading levels. IRIs consist of sets of graded word lists and passages that students read both silently and aloud. The typical order of tasks is word recognition, oral reading fluency and comprehension, silent-reading comprehension, and listening comprehension.
Performance on the word-recognition task test is used to determine the level of the first passage that the student reads orally. Increasingly difficult passages are then presented until performance falls below the oral reading accuracy and comprehension criterion levels. The students then read a passage silently at the instructional level established through oral reading. Progressively more difficult passages are read until comprehension falls below the criterion level (80%–90%). The same procedure is followed for the listening comprehension task.
Passages in IRIs are representative of textbooks at different grade levels, so IRIs provide information about how a student functions with classroom-like materials. Different types of IRIs are available, ranging from separate tests to teacher-constructed versions. In order to use IRIs effectively, teachers need to be able to do miscue (error) analyses to identify children's specific reading strengths and weaknesses. It should be clear that IRIs provide useful information about students' actual reading abilities. Further information about IRIs can be found in most textbooks on reading (see sidebar for references).
Because word-recognition proficiency and comprehension abilities are inextricably tied with reading fluency, improving these abilities will directly affect fluency. As with assessment, there are many excellent sources available that describe procedures, programs, and strategies to improve word recognition and comprehension abilities (see references). There is also a body of literature that focuses specifically on improving reading fluency.
There have been two major instructional approaches to facilitating reading fluency. The first approach includes procedures that emphasize repeated oral reading practice or guided repeated oral reading. Some specific techniques include paired reading, assisted reading, and echo reading. In reviewing the studies that investigated the effectiveness of these techniques, the National Reading Panel found that repeated reading and receiving guidance or feedback from peers, parents, or teachers were all effective in improving reading skills. The second approach focused on increasing the amount of independent or recreational reading that children do. This approach was not found to affect the amount of reading or reading achievement.
A more recent meta-analysis of the efficacy of fluency-enhancing techniques by David Chard and colleagues provided some more specific guidelines about the efficacy of instructional approaches.
The key findings are that:
- Repeated reading with teacher models is more effective than audiotape and computer-
generated models, which are more effective than no model.
- Having a model also promotes comprehension.
- Peer tutoring is not as effective as cross-age tutoring. Peers are less likely than older children to provide feedback.
- Progressively increasing the difficulty of the text and providing feedback for missed words is important.
- Varying the amounts of text to facilitate chunking does not improve fluency.
- Re-reading a text seven times is better than three times, which is better than one time.
In summary, reading fluency shows the most improvement when students reread a text many times to many different people, using progressively more difficult text with feedback and correction.
Because rereading is the most effective way to improve fluency, choosing appropriate texts for students to read is crucial. Students would have little interest in reading uninteresting or unengaging texts.
Putting on plays (Readers' Theatre), reading poetry, and learning to tell ghost stories are some ways to promote repeated reading. In Readers' Theatre, for example, students do not rely on props or costumes, just their voices as they face the audience with their scripts in hand.
Role of the SLP
It is no longer sufficient for SLPs to focus solely on early literacy skills and phoneme awareness. SLPs need to embrace a more comprehensive approach to literacy that involves becoming knowledgeable about all aspects of reading, including reading fluency, which has been described as the most neglected reading skill. Teachers are often frustrated when children appear to have all the basic skills and knowledge to read but still struggle.
Understanding why a child is having difficulty reading fluently requires knowledge of the processes involved in word recognition and comprehension as well as
experience unraveling cause-effect relationships. SLPs are well qualified in both of these areas. They also have considerable experience in the language and fluency-based activities that are effective in improving reading fluency. SLPs should not only play a prominent role in assessing and improving reading fluency; they should also take a leadership role in making sure that reading fluency is acknowledged as an important aspect of reading proficiency.