Speak, Read, Write, Thrive: The Power of Combining Language and Literacy in Therapy

In speech-language pathology, integrating language and literacy targets in therapy services has become increasingly recognized as a critical factor for expediting therapy outcomes and providing the most efficacious, evidence-based services. Language and literacy are intricately connected processes that mutually influence each other, making a comprehensive, integrated approach essential for clients who face both speech and reading challenges. Below, I explore the reasons for this integration, backed by research and clinical practice, and highlight its impact on therapy effectiveness.

Understanding the Interconnection: Language and Literacy

Language and literacy are not isolated skills; rather, they are deeply intertwined processes. Oral language development lays the foundation for literacy, and literacy supports further language growth, particularly in vocabulary, syntax, and comprehension. According to Scarborough’s Reading Rope model (2001), successful reading involves the integration of word recognition (decoding) and language comprehension (listening comprehension). Deficits in one or both areas can impact overall reading proficiency, particularly in children with language impairments.

For children with language-based learning disabilities, research indicates that explicit instruction in both language and literacy skills is essential to fostering significant progress (Snowling & Hulme, 2012). This is particularly true for students with significant reading impairment where deficits in phonological awareness, rapid automatic naming, and orthographic processing often overlap with language difficulties. By addressing these areas holistically, speech-language pathologists (SLPs) can create more efficient and effective interventions that target multiple skills simultaneously, enhancing therapy outcomes.

Expediting Therapy Outcomes: The Benefits of Integration

1. Efficiency Through Targeted Instruction
   Integrating language and literacy goals in therapy allows clinicians to work on multiple skills concurrently, which accelerates progress. For example, phonological awareness activities that improve a child’s ability to recognize and manipulate sounds in words not only target speech sound disorders but also enhance reading decoding skills (Moats & Tolman, 2019). Similarly, addressing oral narrative skills can improve both expressive language and reading comprehension, allowing therapy to have broader impacts on academic performance. Furthermore, literacy-focused interventions are shown to improve both oral language and literacy outcomes, particularly when phonological awareness and reading comprehension are targeted (Tambyraja, & Schmitt, 2020).
2. Generalization of Skills
   When language and literacy skills are taught together, clients are more likely to generalize those skills across contexts. Literacy tasks such as reading and writing naturally integrate oral language demands, and practicing these skills in a therapeutic context can improve a client’s ability to apply them in academic and social environments. Generalization is critical because it reflects functional communication improvements, a primary goal of speech therapy. SLPs who implement language and literacy together can support clients in applying their skills in real-world tasks, such as reading a textbook or writing an essay.
3. Alignment with Evidence-Based Practice
   Research strongly supports the integration of literacy into speech therapy for children with language disorders, particularly in light of the overlap between language impairments and reading difficulties. A study by Catts, Adlof, Hogan, and Ellis Weismer (2005) revealed that approximately 50% of children with language impairments in kindergarten go on to develop reading difficulties. Given this significant overlap, evidence suggests that interventions addressing both domains are likely to be more effective than addressing each in isolation. SLPs can rely on evidence-based frameworks such as the Simple View of Reading (Gough & Tunmer, 1986), which posits that reading comprehension is the product of both decoding and listening comprehension, to guide their integrated approach. Similarly, The Literacy Network, developed by Dr. Jan Wasowicz (2021) builds upon the well-known Scarborough’s Reading Rope, by integrating both reading and writing processes. The key focus of this framework is the interconnectedness of language skills, emphasizing that both decoding (reading) and encoding (spelling) should be taught together from an early stage. It highlights four quadrants of literacy skills: language comprehension, language expression, written word recognition (decoding), and written word production (encoding). Rather than isolating foundational skills from higher-level thinking skills, Wasowicz’s model suggests that these should be taught in an integrated manner. This approach helps students strengthen both reading and writing skills simultaneously, supporting a more fluid development of literacy (Wasowicz, 2021).
4. Fostering Long-Term Success
   Early and explicit intervention in both language and literacy can have long-term benefits, particularly for at-risk populations. Preventive approaches that target emergent literacy in preschoolers and early elementary-aged children have been shown to reduce the likelihood of reading failure (Justice & Pullen, 2003). In addition, fostering strong language and literacy skills supports academic success beyond the early years, as students with well-developed language abilities are better equipped to tackle the demands of secondary and higher education. Finally, federal legislation mandates that SLPs must address literacy as part of their scope of practice, particularly in school-based services, to promote students’ academic success (Tambyraja, & Schmitt, 2020).

Practical Considerations for SLPs

SLPs can successfully integrate language and literacy targets by:

• Embedding Literacy into Contextualized Speech-Language Therapy: Incorporating reading and writing tasks into therapy sessions. For example, children with language disorders can work on comprehension and expressive language through narrative interventions and picture books or text discussions. (Gillam et al., 2012)
• Collaborating with Educators: Partnering with classroom teachers to ensure that literacy targets in therapy align with the child’s school curriculum. This collaboration ensures consistency in skill application across settings.
• Using Evidence-Based Interventions: Appropriately implementing EBP approaches to decoding, reading comprehension, spelling, and writing such as KAT, RAVE-O, SPELL-Links, Think SRSD, etc., with fidelity, to support language and literacy simultaneously.

Conclusion

Integrating language and literacy targets in speech therapy is not only a best practice but a necessity to provide the most efficacious, evidence-based services. By addressing both language and literacy in tandem, SLPs can expedite therapy outcomes, facilitate the generalization of skills, and ultimately support long-term academic and social success for their students. The evidence overwhelmingly supports a holistic approach, with research and clinical practice affirming that focusing on these interconnected skills can drive meaningful and lasting progress.

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References

1. Catts, H. W., Adlof, S. M., Hogan, T. P., & Ellis Weismer, S. (2005). Are specific language impairment and dyslexia distinct disorders? Journal of Speech, Language, and Hearing Research, 48(6), 1378–1396.
2. Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: Results of an early efficacy study. Language, Speech, and Hearing Services in Schools, 43(3), 276–291.
3. Gough, P. B., & Tunmer, W. E. (1986). Decoding, reading, and reading disability. Remedial and Special Education, 7(1), 6–10.
4. Justice, L. M., & Pullen, P. C. (2003). Promising interventions for promoting emergent literacy skills: Three evidence-based approaches. Topics in Early Childhood Special Education, 23(3), 99-113.
5. Moats, L. C., & Tolman, C. A. (2019). Speech to Print: Language Essentials for Teachers (3rd ed.). Paul H. Brookes Publishing.
6. Scarborough, H. S. (2001). Connecting early language and literacy to later reading (dis)abilities: Evidence, theory, and practice. In S. B. Neuman & D. K. Dickinson (Eds.), Handbook of Early Literacy Research (pp. 97–110). Guilford Press.
7. Snowling, M. J., & Hulme, C. (2012). Interventions for children’s language and literacy difficulties. International Journal of Language & Communication Disorders, 47(1), 27-34.
8. Tambyraja, S. R., & Schmitt, M. B. (2020). Embedding evidence-based practices to address literacy in school-based speech-language therapy. Topics in Language Disorders, 40(4), 341-356.
9. Wasowicz, J. (2021). The Language Literacy Network: A New Twist on the Reading Rope to Advance Literacy Outcomes. Learning By Design.