Treating Reading Comprehension Deficits in Children with Language Impairment

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Reading Comprehension Defined

Children with language impairment have a greater risk for developing reading disorders than do their typically developing peers (Boudreau & Hedberg, 1999; Catts, Adlof, Hogan, & Weismer, 2005; Catts, Adlof, & Weismer, 2006; Catts, Fey, Tomblin, & Zhang, 2002). These reading disorders usually manifest as difficulty with decoding and/or comprehension. There is a wealth of information concerning the phonemic awareness and decoding difficulties these children frequently exhibit. Their difficulty with phonological awareness tasks, which can predict difficulty decoding in the beginning stages of reading, is quite well-documented (Catts & Kamhi, 2005; Gillon, 2004). In contrast to decoding difficulties, reading comprehension deficits, for which children with language impairment are also at risk, have received relatively less attention (Boudreau & Hedberg 1999; Catts et al., 2005; Catts et al., 2006).

Reading comprehension is defined as "an active problem solving process in which readers relate the ideas in the text to their own knowledge and experiences which allows the reader to create a mental construct in memory" (National Reading Panel, 2000, p. 23). It is a later-developing reading skill and dependent on the mastery of decoding. In fact, in Chall's six stages (Stages 0 - 5) of reading development, reading comprehension begins to develop in Stage 2 and continues to develop into complex analysis and synthesis of written text through Stage 5 (Chall, 1983). It is a task that requires children to use higher level language skill to make meaning from written text and can be difficult for children with language impairments as well as children with typical language skills (Rand Corporation, 2002). The meaning making aspect of reading comprehension is one of the reasons children with language impairment are at risk for reading comprehension problems. This higher level language task relies heavily on well-developed semantic and syntactic knowledge (Catts & Kamhi, 2005).

Because it is a later-developing skill, reading comprehension can be elusive and not always obvious in the early grades when decoding is the primary focus. Some fourth-grade children, who have had no previous reading difficulty, will experience the phenomenon known as the "fourth grade slump" or late-emerging reading disability (Catts et al., 2005; Catts et al., 2006; Lance, Beverly, Evans, & McCullough, 2003; Leach, Scarborough, & Rescorla, 2003; Rand Corporation, 2002). Leach et al. suggest that approximately 40% of all children with reading disability will have late-emerging problems.

Even though this difficulty may not become apparent until children are older and must read to learn, it does not rule out a language-based cause. In an attempt to better understand the presence of reading problems in children with language impairment, Catts and colleagues (2006) conducted two studies that compared the reading and language test scores of children with reading comprehension deficits and children with word decoding deficits. These authors found that children who had difficulties with reading comprehension scored lower on tests of receptive vocabulary, grammatical comprehension, discourse comprehension, and making inferences than the children with word decoding deficits.

The likelihood that children with language impairment will have reading comprehension problems is sufficient enough to warrant early intervention for literacy (Catts et al., 2006). Oral language stimulation and phonological intervention alone do not appear to be enough (Berninger et al., 2003; Boudreau & Hedberg, 1999). Since reading comprehension ability will have an impact on all aspects of children's academic success, it is imperative that direct and effective instruction is provided early by interventionists (Vaughn & Klingner, 1999), which includes speech-language pathologists (SLPs) (American Speech-Language-Hearing Association, 2001). After the acquisition of word identification, there are several skills children need for reading comprehension and they include some of the following: oral and auditory vocabulary skills, knowledge of syntax, well-developed world knowledge, fluency for reading, and problem-solving ability (Rand Corporation, 2002). As SLPs we target some of those areas, such as semantics and syntax, more than others. As semantic deficits are all too often present in school-age children, the first two methods to be discussed will focus on vocabulary building as the foundation for improved reading comprehension abilities (Lance et al., 2003). These methods provide SLPs with an avenue to target both the semantic deficits of children on their caseload and to meet curricular benchmarks. The other two methods are useful for SLPs who are providing curriculum-based instruction because these methods help teach a broader understanding of written text.

Semantic Mapping

Semantic mapping (Johnson & Pearson, 1984; a.k.a. List-Group-Label; Taba, 1967) is designed to be used with elementary social studies and science texts. In an attempt to help children learn and remember difficult concepts, vocabulary, categorization skills, and organization of verbal concepts. This method is more effective if students have some previous knowledge of the topic under investigation. Tierney, Readence, and Dishner (1995) describe semantic mapping as a three-part strategy: (a) list, (b) group and label new vocabulary words, and (c) follow up.