written language disorders evidence map for pertinent scientific evidence, expert opinion, and client/caregiver perspectives.
The scope of this Practice Portal page is limited to written language disorders (i.e., disorders of reading and writing) in preschool and school-age children (3–21 years old). It can be understood best in relation to the companion Practice Portal on
spoken language disorders.
A disorder of written language involves a significant impairment in fluent word recognition (i.e., reading decoding and sight word recognition), reading
comprehension, written spelling, or written expression (i.e., written composition; Ehri, 2000; Gough & Tunmer, 1986; Kamhi & Catts, 2012; Tunmer & Chapman, 2007, 2012). A word recognition disorder is also known as dyslexia.
Written language disorders, as with spoken language disorders, can involve any of the five language domains (i.e., phonology, morphology, syntax, semantics, and pragmatics). Problems can occur in the awareness, comprehension, and production of language at the sound, syllable, word, sentence, and
discourse levels, as indicated in the table below (Nelson, 2014b; Nelson, Plante, Helm-Estabrooks, & Hotz, 2015). See ASHA's resource,
disorders of reading and writing.
|Sound-, Syllable-, And Word-level Difficulties
||Sentence- And Discourse-level Difficulties
- Difficulty with phonological and morphological structure of words
- Difficulty forming stable associations with the orthographic representations of words in print
- Impaired reading decoding and written spelling skills
- Difficulty recognizing discourse components
- Difficulty using syntax and cohesive devices to represent relationships among ideas
- Impaired reading comprehension and formulation of academic discourse (narrative and expository) and social communication
The relationship between language disorders and learning disabilities is intricate, as indicated in the definition of specific learning disability below:
“The term ‘specific learning disability' means a disorder in one of more of the psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfect ability to listen, speak, read, write, spell, or do mathematical
Language disorders are typically diagnosed before learning disabilities and often affect the child's academic performance. Once academic struggles with reading and writing arise, a learning disability label may be used, even though the underlying issue is a language disorder (Sun & Wallach, 2014).
A written language disorder may occur in the presence of other conditions, such as the following:
- spoken language disorder
- attention-deficit hyperactivity disorder (ADHD)
- emotional disability
- intellectual disability (ID)
- deaf or hard-of-hearing (DHH)
- autism spectrum disorder (ASD)
The relationship between spoken and written language is well established (e.g., Hulme & Snowling, 2013; Kamhi & Catts, 2012). This relationship is underscored in the “simple view of reading” which “presumes that, once the printed word is decoded, the reader applies to the text
exactly the same mechanisms which he or she would [apply to] its spoken equivalent” (Gough & Tunmer, 1986, p. 9). More specifically, the integration of word recognition, vocabulary, and oral language comprehension are important for the development of adequate reading comprehension skills
(Tunmer & Chapman, 2012).
Children need strong knowledge of both the spoken and the written word in order to be successful readers and writers. Children with spoken language problems frequently have difficulty learning to read and write, and children with reading and writing problems often have difficulty with spoken language
(Kamhi & Catts, 2012). For more details, see the Practice Portal page on
spoken language disorders; see also
language in brief and
disorders of reading and writing.
Reading is the process by which an individual constructs meaning by transforming printed symbols in the form of letters or visual characters into recognizable words. Components of reading are outlined in the following definitions:
- Reading decoding—the ability to transform orthographic patterns of alphabetic letters into phonological patterns of a corresponding spoken word
- Word recognition—the ability to identify words when reading, either through word decoding or sight word identification, which may be called the “direct route” (i.e., automatic recognition of word as a whole without using strategies to
- Reading fluency—the ability to recognize and read words accurately, smoothly, and quickly, usually in context
- Reading fluency is affected by reading automaticity—the ability to read a list of words accurately in a specified amount of time.
- Reading fluency combines rapid decoding and sight word identification.
- Reading comprehension—the ability to understand the meaning of written text
- Comprehension is an integrated skill that includes having vocabulary knowledge, using cues (e.g., relational terms) to “unpack” complex syntax, and making sense of the different discourse structures (e.g., stories or expository text).
- Comprehension also requires application of executive functions (e.g., the ability to use prior knowledge and make inferences and predictions; the ability to monitor one's comprehension).
For information about research supporting the five key components of reading instruction (i.e., phonemic awareness, phonics, fluency, vocabulary, and text comprehension), see the
National Reading Panel report (National Institute of Child Health and Human Development, 2000).
Writing is the process of communicating using printed symbols in the form of letters or visual characters, which make up words. Words are formulated into sentences; these sentences are organized into larger paragraphs and often into different discourse genres (narrative, expository, persuasive, poetic,
Writing includes the following:
- Writing process—the ability to plan (i.e., “pre-writing”), organize, draft, reflect on, revise, and edit written text; the ability to address specific audience needs and convey the purpose of the text (e.g., persuasion). This process is iterative.
- Written product—the end product of the writing process; it can be examined at the word level (e.g., word choice and spelling), sentence level (e.g., grammar and complexity), and text level (e.g., discourse structure, use of cohesive devices and coherence). The written product can
also be described in terms of writing conventions (e.g., capitalization and punctuation), communication functions (e.g., to inform, to persuade), organizational structure (e.g., chronological, sequential, compare and contrast), and effectiveness in meeting the
information needs of the audience (Nelson, 2014a; Puranik, Lombardino, & Altmann, 2007; Scott & Windsor, 2000).
Spelling, also known as encoding, requires the ability to segment words into phonemes and map those phonemes onto graphemes (letters or letter combinations) in an acceptable sequence in written form. Words may be spelled “regularly,” which means that each grapheme is associated with a corresponding
phoneme (e.g., cat), or “irregularly,” such that not all graphemes in a word are represented by one phoneme (e.g., right). However, irregularly spelled words may have predictable features based on their morphological makeup.
Spelling depends on semantic awareness; knowledge of phonological, orthographic, and morphological representations of words and their parts; and the ability to create mental models of their interrelationships (e.g., Apel & Masterson, 2001; Berninger, Nagy, Richards, & Raskind, 2008; Bourassa & Treiman,
2001; Ehri, 2000; Masterson & Apel, 2007).
There is a bidirectional relationship between spelling and word reading such that difficulty or progress in one area can influence performance in the other area.
Reading and writing are highly interrelated, and it is difficult to isolate any aspect of reading development that does not have a writing counterpart. For example, syntactic patterns that children read in texts also emerge in their writing (Scott, 1999), and children become fluent orthographic readers at
about the same time that their spelling reflects similar orthographic sophistication (Ehri, 2000).
The interrelationship between reading and writing is also evident in the school setting. For example, kindergarten children are asked to “read” what they “write,” and secondary students “read to find out what to write and write to demonstrate that they understand what they read” (Scott, 1999, p. 224).