[Listen Again] The Relationship Between Phonics and Language Comprehension with Tiffany Hogan

There's so many good things and really exciting also a podcast host of the See , Hear , Speak podcast . So we're so excited to have you here today , Tiffany . Thank you for having me .

And we just want to first start by asking you what is language comprehension and what goes into it ?

The language comprehension portion primarily relates to the ability to understand the language that's created by the printed text . So when you read to yourself , you have the inner voice that you hear . Or if you read aloud , then you're hearing the external voice . But it's comprehending whether you're hearing it internally or external hearing and comprehending that language .

Language comprehension is actually not limited to spoken language . Though signing , then if they're understanding the signs , then that's also a form of language comprehension , because you're comprehending the message from a form that's being created , whether that form is the movement of hands or spoken language .

Now , there's a lot of components that go into language comprehension . It is a complex beast and we know that language comprehension starts developing from birth .

There's even some really cool studies showing that it starts to develop in utero , as fetuses are listening to the language that's in the environment around them and when they are born , there's some cool studies showing that they can pick up on some of the parameters of that language and can even detect some of the familiar voices .

So language is really developing from utero . Now , language is made up of a couple of different components . So I always like to think that , you know , we have the simple view which is taking that complex reading comprehension and boiling it down to two primary components . We do the same thing with language .

We take the complexity of language and we boil it down to three primary components . The do the same thing with language . We take the complexity of language and we boil it down to three primary components . The first one is related to form , so that's the sounds of language and that's called phonology .

And then the next one is the content of language , and that's like words and syntax and morphology . And the last one is the social use of language and that's like what we call pragmatics .

I can talk a little bit more as we get to it about what we found as related directly to language comprehension in service of reading comprehension , but that's an overall view of the complexity of language .

I'm just curious are they used interchangeably , those terms , or do they have actual different meanings ? It can be very confusing .

Then it changed the language listening . But what we did in our study was we looked at different measures of language comprehension versus listening comprehension . Now , language comprehension measures are related more to like , for instance , listening to directions and answering them or being told to , you know , do multi-step kind of things ? Do multi-step kind of things ?

And then listening comprehension , on the other hand , that's really been operationalized as having a child listen to a story and then answer questions . So those are different , slightly different tasks , and so we wanted to see , you know , are these all tapping into the same ability ?

And when we did that with children , what we found is that it tapped into the same ability . So it was all just one kind of reservoir of language knowledge . So I use them interchangeably and I have data to show that . That's okay .

But I do actually prefer language comprehension because it represents a broader view of what's going into that construct as opposed to listening comprehension , which is really that listening to a story and answering questions .

So I'm really glad you asked that and I actually , when I give talks I have a slide on it because I got asked that question so much and I think it's an important one because as a language pathologist you know words matter . So I'm glad we clarified that .

two , looking at the data and the individual differences in children , and what we find is that there is a definite overlap . It's , you know the graphics , you see where they're separated .

It would actually be better representation if they were like two circles or Venn diagrams where they were overlapped , because we do see that they have a large shared variation and that's been known for some time .

But it's almost like you look at the glass half empty , half full , like people have just kind of ignored the half full part where they're overlapping , acknowledging it in the data sets and , you know , representing it on the graphs , but not really talking about it .

But this is a great question to think through and a recent study actually addressed this and I thought , oh , this is great because we've been , you know , seeing this for so long but we haven't really explicitly looked at it .

And so a study that was done by Youngsook Kim and that was just published this year , in 2023 , she did look at the overlap between word reading and listening comprehension and she wanted to see you know what explains that overlap . Like what is that ?

And what she found is that , not surprisingly , executive function explains some of that overlap as a kind of an additional factor , and also something called morphological awareness , which is really an awareness .

We talk a lot about phonological awareness , so phonological awareness and the awareness of sounds , but morphological awareness is the awareness of the individual units of meaning , like recognizing that the S at the end of cats makes it plural , like recognizing that the S at the end of cats makes it plural .

And so those are the two factors that really connected word reading and listening comprehension . You can kind of think about that even in the classroom when you think about , you know , understanding a child's language comprehension , understanding their word reading ability , that tells you how well they'll comprehend text .

But on top of that , also having a better sense of their focus of attention , executive functioning and their language awareness is another factor .

So executive function is the actual definition is it's a set of general purpose control processes that regulate your thoughts and behaviors . So it's a more domain , general kind of cognition that involves working memory . So being able to hold something in memory and manipulate it , like we do when we ask children to do phonological awareness tasks , for instance .

That's a type of manipulation A lot of times . A common one you hear about is reversing digits , so asking children to listen to a set of digits like 1 , 2 , 8 , 10 , and then they're asked to reverse them . So they have to hold them in memory and reverse them . Another way to measure executive function is inhibition .

So you're asking children to inhibit a response . So maybe they'll see a series of letters , one at a time , or pictures , and then you ask them to not push a space bar when they see an A , for instance . So they push it every time they see a letter except for A .

So you have to like inhibit that response and then attentional control and that's more of your focus of attention . And a lot of times there's some pretty cool studies looking at this , like card sorting , where you ask kids to start sort cards by color versus by the symbol , which you know .

I call this the UNO task , in some ways right , and so this is a way to get at like attention , like focus of attention . Are you focusing on the color , are you focusing on the symbol ? And that's you know we can do . Stroop tasks are similar , like read the , you know , read the word that spells a color .

Like read the word green and the word green might be spelled in blue . So you have to inhibit one or the other . So these are ways to get at executive function . We think of executive function a lot other . So these are ways to get at executive function . We think of executive function a lot , you know .

I think practically like can the child organize their materials , can they clean their desk out , can they get from one place to another and keep a schedule and be on time ?

But the way we think about it in terms of scientific analyses and measurement is much more at a basic level of , you know , trying to tap into some of those processes that lead to the functional outcomes of executive functioning .

But that first example the 1 , 2 , 8 , 10 , and we would have a child or a person say them in reverse , how is that not memorizing ? Like , how is that executive function and not memorizing ?

So we think a lot about this and I think that you're hitting on something that's so important and that is it's very difficult to separate out constructs , like you know . I would say , how does that relate to the content of numbers or how does that you know ? How can you separate language comprehension from working memory ?

It's very , very difficult to do that and I think there's a lot of debate and it really goes back to this first question of the overlap between language and reading . What we often see in all of these tasks is an overlap with something else .

So , even though that task is called working memory , others might call it something a little different if they focus on the variation between the content , knowledge or the experience of the child . So it's a great question and I think there's not an easy answer to it .

A lot of what we hear makes intuitive sense and what I've learned as a scientist is sometimes your intuition is right and sometimes it's not , and so we have to look at the data and one of the examples is you often hear well , the child has ADHD or some type of executive function difficulty .

Maybe it's not even diagnosed ADHD , so we really can't measure word reading or language comprehension because we won't really get a true measure of it right , because they'll be too distracted .

But actually we have a study coming out on this where we looked at a large sample of children and we measured their executive functioning , we measured their working memory kind of those two kind of components that we talked about , the kind of the inhibition part versus the working memory part of how to manipulate sounds and numbers .

And then we also looked at word reading and we looked at language comprehension and we really wanted to see is this true ?

Like , can you really not get a good , accurate read of language comprehension if a child has difficulty in executive functioning and actually it's not true at all what we find is that there's a normal distribution of those abilities across all of these children , such that you can , you know , we found several children who have ADHD , for instance , who had really good

word reading and good working memory , and vice versa . So just because a child has ADHD doesn't mean they're automatically not going to do well on a language comprehension test .

They are separate constructs that use separate brain processing mechanisms , and so it's important to think that , even though they are related , that Venn diagram does overlap , that there is some unique variation as well . So it's probably just pulling from lots of different areas of the brain at the time .

But I definitely think that it's important to look at all these , you know , just look at the individual differences in children across all of these abilities , because that is what will lead to what I've referred to as a child's cognitive , linguistic fingerprint .

So every child is truly unique because all these streams are coming forward to result in their functional ability in the classroom . It's all impacted by all these different language cognitive abilities . And then that doesn't even bring into the fact that they also have certain personality traits , like you know , likability or sociability and all those different .

There's that's a literature I don't know enough about , but there are , you know , really good metrics of these kinds of traits that also impact the functional outcomes for these children .

So I think the thing that I am curious about is , as a teacher , I know that we want to enhance students language comprehension , and it's actually really reassuring talking with you and it kind of is reassuring that they're separate constructs because that means we can work to strengthen each one , right ? Is that ? Yes , okay , absolutely so .

As a teacher , then , what could we do if we wanted to focus on that language comprehension one , and maybe we'll take another side street down the road and talk about other ones . But if we wanted to enhance students' language comprehension , what could we do ?

So that's like the baton you're holding and you're getting the child to read words , and then you pass the baton on later , let's say the later elementary grades , and you start shifting . And those teachers in the later grades , like third , fourth and fifth , they're focusing more on language comprehension and comprehension activities .

So what we found is that it's better if we cannot treat it like a relay race but treat it like parallel races that are going on , so that you're , you know , activating both along the continuum .

And so what that means is that we would have more time for language comprehension in the early grades and we would also carve out time for reading words , advanced word reading , in the later grades , so that you would have these two streams .

So when you talk about what teachers can do to stimulate language comprehension , I think of this in two separate kind of buckets . The first thing to do is think through the system that's in place and think about your ELA block . Think about you know what's your focus of attention as a teacher across the grades . That's one way to think about it .

So it's the system level approach to making sure that you're including reading comprehension . And the next way to think about it is what are you actually doing like day to day in the classroom to stimulate ?

So when I talk about this parallel race , I'm really talking more about the structures that we have in place in our system , in the ELA block and also in our multiple tiers of support systems . So in the MTSS or response intervention , you know , you know tiers .

What we often see is there's one tier right , so you have like really strong tier one instruction and then you do some screening and then you see who's struggling and you provide some small group instruction and you continue to monitor with progress monitoring and then if a child's continuing to struggle , you send them for maybe a special education evaluation .

But what happens is within our system , that focus changes over time , like I mentioned , like a relay race , like it's like . In the beginning you're really focused on word reading . Later you start to focus on comprehension . What we found clearly in multiple longitudinal studies with children is that we do have two separate strands that need to be stimulated across .

And so I've been thinking , even through with my educational partners , like perhaps we need two different sets of MTSS processes , one for word reading and one for language across the grades , because we want to make sure that one we're not missing kids who are struggling with language in the early grades and that we're also not missing kids later who have word reading

problems . So that's kind of a structural way to really think through language comprehension Now at a detailed way . One thing we have to really be thinking through is are we testing language comprehension , are we teaching language comprehension ? And this was first noted by Jean Chal in the 60s .

She said you know , we're not really teaching language comprehension , we're just testing it . And what she meant is that the curricula back then and I'll also argue it does it quite a bit today is you say well , I'm focusing on comprehension when I ask the child questions about the text , but that's just testing comprehension .

That is qualitatively different than teaching comprehension . When we think about teaching comprehension , we think about the individual malleable components that we can work on , and there's been several consistent in the literature . One is vocabulary . That's a big one , you know . It's like we kids learn vocabulary words .

There's a great literature about how to do it and some of the key factors in teaching vocabulary is to make child-friendly definitions , not like in the old days when we were told to look it up in the dictionary . We know that doesn't work very well . So one thing is just focusing on that .

One of the reasons the dictionary definition doesn't work is because , you know , oftentimes the dictionary definition is even more complicated than the word itself .

So if you're teaching a new word , write it , say it , you know , spell it , all those different things . So we know vocabulary is critically important to language comprehension and impacts reading comprehension as well . And then the other part we know is important is grammar .

So grammatical knowledge in you know grammar , split up into two components , or syntax , which is like word order and the sentence structure .

And then there's morphology , which is those individual components of words , and in English , because our sentence , we don't do a lot of the moving around of words like they do in Spanish , for instance , having the adjective before . So we actually call our grammar morphosyntax , we kind of put it together .

But children having a good and more comprehensive morphosyntax is helpful . And then we have some other three other skills that we categorize as higher level language skills . They're not going to be surprising to you , they're ones you've heard about Story grammar . So understanding the structure of stories like that .

There's a character and setting and these are higher level . We call these higher level language because vocabulary and morphosyntax that should develop on its own with children through exposure . Higher level language some children do struggle with that . We can talk about what that looks like .

But higher level language skills are ones that are just don't come automatically to children . They really benefit from instruction . I mean , I remember being in graduate school you know I'll date myself . You know I was like in the late 20s in graduate school learning about story grammar . It never occurred to me , I didn't think about it .

I was a good comprehender of stories but I didn't really think about story grammar and that's a good example . Like you don't have to think about this , but if you do , it does show to improve children's comprehension . There's also comprehension monitoring .

That's just being aware of the fact , like we do sometimes when we're going to bed , like I do , and you want to read one last chapter of a book and then you realize I don't think I really even remember that chapter at all . It's just having the awareness of that and a lot of children don't ? They just push on . Yeah , so having that awareness .

And then the last higher level component we think about is inferencing , so just really highlighting the gaps in stories and helping children to have better inferencing skills . Those are five of the malleable factors that are involved in most language comprehension curricula and have the most scientific evidence .

But what we have to think about with language comprehension is we have to be systematic and explicit in our instruction of language comprehension and it has to have a curriculum that builds upon itself . So when you think about all our discussion about word reading and teaching systematic , explicit phonics , we have to have that same level .

I always say everything we do for word reading and know is good for word reading we have to do for language . So testing it consistently , comprehension or , I'm sorry , curriculum-based measures , screening , you know , systematic , explicit instruction that builds upon the skills .

That has to happen for language as well , and that's not the case typically now in the classroom because again , it's kind of that shift that occurs over time and we need to have that systematic approach and we've done work in language comprehension .

We have , you know , run randomized control trials on language comprehension and you can make improvements for children and I think that's important . So one last thing I'll say is I want to tie language comprehension to knowledge . So we hear a lot about world knowledge and how important knowledge is , absolutely .

But we also have to think about how do we get knowledge into children's brains , like , how does it happen ? It happens through language . So when I say that I'm focused on language comprehension , just by saying that I'm also talking about knowledge , because it's really hard to focus on language when you have nothing to talk about .

So we got to have the content there . Content is so important . So you know , when you know a lot of discussion around word reading and knowledge , that's pretty synonymous with what I'm saying about word reading and language comprehension . I'm focused on how to get that knowledge into the child's brain .

But you mentioned testing and I think if I were a teacher listening right now , I think I'd be wondering what does this look like Like ? I know the testing that happens at maybe the state level isn't the most helpful to me in my classroom , with immediate results .

You know , oftentimes those don't come back for months and months and the students are not even my students by the time the test results come back . So what you mentioned frequent assessment , what does that look like ? So you mentioned frequent assessment . What does that look like ?

I will say that there is a free , open access measure called the cubed that was funded by the federal government for the last decade . It's a fantastic resource . I always say you know what ? I've really avoided saying things are free because actually nothing in this world is free . I'm gonna I always now call it prepaid by your tax dollars , because it was paid .

Nothing's free , so it is free to you , but you did prepay it , and so those measures are really hard to create because , you know , with word reading , it is a restricted set , right .

So we have a restricted set of sounds and letters that we're teaching and even though you can use that restricted set to create all types of words and non-words and it's , you know , infinite , in that way , when you're teaching the decoding aspect , you really can teach in more discreet . Now , language truly is infinite and it changes .

So we add new words to the dictionary every year , right , and even grammar changes , like you know , of course , when I was growing up , it was like you know two fish , now it's like two fishes . What's that's a thing now you know like it evolves over time and and so it really is intractable . So it's , it's just , it's not finite .

Because of that , when you're creating measures of language , you have to take into account this change . But you also have to start to equate on things like knowledge , for instance , and that's so hard .

So when , when you want to give curriculum-based measures of word reading right , you would have your set of words that you're teaching , the skills you're teaching , and you would measure did the child learn this ? Did they learn silent E ? Did they learn blends , digraphs ?

What you're teaching , you would actually determine did they learn it , and that would fuel your instruction . When you're doing language measures , you want to do similar types of measures . But let's take vocabulary , for instance . I've worked on curriculum-based measures of vocabulary . So let's say you do that .

First off , when you say , how do you do this , you want to say you know ? Hey , child , I taught you this word and now I want to see if you know what it is . I taught you the word justice . I used this child-friendly definition . I did everything right . And then you say , hey , I use this child-friendly definition , I did everything right .

And then you say , hey , what's justice ? And then they give you a definition and let me tell you that's hard to score because , kids , you might be like , well , he's kind of right , I don't . So then you have to give , like , either partial credit , really hard , or you give maybe dynamic , like , maybe they say something and you want to query more .

You're like , well , I'll give you two points if you say it right the first time , but if I have to ask you more , I'll give you one point . It's tricky to give . So there's a lot of great science around creating these measures , but in the meantime , one of the best ones is the cubed .

It was 10 years of development and they're short stories that were equated on knowledge and a million other things equated on story grammar , equated on number of words , equated on things like how many times was the main character mentioned in the story .

And this is because , if you're going to give language comprehension measures across time three times a year , you want to make sure that the first one you gave wasn't the easiest one , because then later , when you give the next one and you know the child's improving and then they do worse . You're like why did they do worse ?

Well , they did worse because the next measure was harder . You're like why did they do worse ? Well , they did worse because the next measure was harder . So trying to equate the measure is really really tricky . So that's an area of research that's ongoing .

I do have a Google document that I created for this exact question that leads educators , and maybe we can link it in resources where you can go to this free , open access document that lists off all the screening measures currently available for language , because there's screening measures and then there's progress monitoring measures and then there's outcome measures , and

it's a really tricky nut to crack in that way . So if you're looking for things , there are some things available , but they're not as readily available as others . The other thing that we need to do very clearly is we need to integrate it into the curriculum right . So we need measures that are like .

We need a curriculum that also has measures that go right along with the curriculum . That's the ideal situation .

But my big issue now is like at least changing the mindset that we need this , because I used to not talk about this as much because I was waiting for measures . I would think to myself I don't want to bring this up because there's no resources to direct anyone to . But I kind of got over that because I felt like you know what ?

We just need awareness first , and then the measures will come and the curriculum will come . And we do have some great curricula around knowledge and language now . So that thing , that nut , has been cracked a bit and we're continuing to do even better and better on that . But I know the measures will come as well . I want to say one last thing about this .

That makes it even trickier . So here's the situation . This that makes it even trickier . So here's the situation . Reading , comprehension measures in the early grades test word reading , not comprehension . This has been shown over and over and over and over .

And it's so tricky because I work with school partners and they'll say to me we do test comprehension in first grade , we totally test it . Here's the measure .

And I'm like , oh no , because what we've shown in our longitudinal studies is that when we look at what accounts for the variation in word reading , we do see the simple view playing out , of course , the two components .

But what we find is in the early grades the majority of the impact of comprehension is on word reading and if you and then later it changes , it's less word reading and more comprehension If you kind of look at the ground truth of what you're giving the tests of .

Okay , so first off , to give a reading comprehension test to a first or second grader , you have to have words they can read . And words they can read are not representing complexity in language . So you ask them to read a passage and if you they can read the words , the language itself is so easy that they can guess it , even if their language isn't great .

Now , in the later grades , we actually see a shift . It's kind of interesting , you see that even children who might not be able to read words that well , as long as they have a certain threshold of word reading and they can start to access the text .

Then , even though the language is complex , they can use their language skill to understand it and fill in the gap .

Because of this , when we think about word reading and when we think about the simple view of reading and the reading rope , when we give comprehension measures , they have to be language comprehension measures , not reading comprehension , because language comprehension is going to get at the complexity for the child's age , not their reading level , and I think this is a

tricky concept personally to explain and to think about . But I really want to hit it home because there's even been studies showing that in the early grades if you ask children comprehension questions before you read the passage , they'll like they're like , have a 75% chance of getting them right .

Like that would just frustrate them and I know they're not going to do well , why would I do that ?

So , working on language through books and oh , I also want to talk about books for a moment , if you indulge me a bit , because it really relates . It really relates to this . It's exactly what you said , melissa , about the books and reading it .

The other thing that we've seen is that when you have books that you're using to teach phonics skills , like decodables or practice books , those different things that should not be your comprehension books either . So when we do comprehension , we actually divorce the kind of simple view we say like reading .

When you're doing comprehension and you're using books , you actually use books that are , you know , one to two grade levels above their word reading and don't require them to read because they need the language that's in those books , but they don't need to be tied to having to read them .

So you either have , you know , a set of coding , yeah , exactly , so you either have two separate books , sets of books that you need to tackle . Or you know , there's magical cases where there's some decodable books that tackle good content and that's great too .

But you need to not be tied to the books , because I will tell you in talking to teachers it's such a great question They'll be like , well , how do I do this ? Because the books , you know , don't tackle this language complexity and I'll say well , those books are for word reading instruction and there's books for language instruction .

See that in your ELA block you might spend , you know , in the early grades , more percentage of time on word reading , but you wouldn't want to , and maybe later on , more percentage of time on comprehension , but you wouldn't want to exclude them .

And that's what really happens , because you know it's , you get busy and also , honestly , if there's no curriculum to support it , it's not going to happen in a systematic , explicit way . You have to have the curricula in place . You can't just say , oh yeah , have fun with language .

I mean , I'm a speech language pathologist and I can't think of language activities on the fly , especially for a whole entire classroom , like that's magical . You need some materials to help with that . Glad you said that .

Are we saying the same thing here ?

So you have a short passage , you know you , either if it's language comprehension or listening comprehension , you would read it out loud to them . They do not see any print , you just read it to them and they answer questions . If it's reading comprehension , you could even use the same passage , depending on what your focus is . You could give them the passage .

They read it to themselves . There's different rules , like do you take it away after they read it ? Do you leave it there ? That's just a nuance . But then they answer questions . So one involves word reading and one doesn't .

I just watch them grow up and document their skills in the later grades , starting around 10th grade and all the way through adulthood . If you have good reading and language comprehension , you're using the exact same brain processes that's been shown and they overlap dramatically , like basically they're the same thing .

So once you're later and you've melded those two skills , you have automatic word recognition . It won't matter if I say it out loud to you or if I let you read it , it's going to be the exact same score . But that doesn't happen until later , and that also happens if you're neurotypical . That will happen Now .

If you're neurodivergent and you have a difficulty in one area or the other , then you might have a preference .

I think I've seen through like middle school , right , it kind of like Peter . It kind of evens out in middle school . Can you like elaborate on what about that ? Older age kind of brings it up to speed .

It's like why would you ever need to have language comprehension without reading comprehension ? Right , it's only there to help you read . Now , I would argue that could be said for the case of word reading , and we say that all the time , like you want to read words so that you can understand text . Language comprehension is , I would argue , dual purpose .

So it is , of course , in the service of reading comprehension , but it also serves you every day , because even right now , your listeners are using language comprehension . Unless they're reading a transcript , they're using language comprehension abilities and every day when we interact socially , we use language comprehension . So it's a little different than word reading .

That way , we really want to think about the fact that it's , of course , in the service of reading comprehension , it becomes one , but it's also so useful in everyday language . So what I'm even thinking of like television , television podcasts , of course is a big one . Now , of course .

So the way that converges is once your word reading skills are intact enough to be automatic , then that's when you start to see the convergence happen , because it won't matter , because as we listen , that's truly automatic , because speech is dynamic , it's transient , I say it , it's gone , the only way my speech lives is in your memory , whereas visual , when you're

looking at a word , that is completely automatic . You know static , right , it's right there , it doesn't change and you can see it over and over . So it's capturing speech . Right , you can hold it tight where speech is just in and out .

But when you're good at reading words , it doesn't matter Like , you read the words and you understand it , or you , you know , hear it and you understand it . It's really the word reading that plays into the way that those two converge .

And actually what we find is that children who struggle to read words , children who have dyslexia or subclinical or any kind of struggle with word reading , oftentimes they may rely more on their listening comprehension , because reading words is a struggle , like if they're given a passage and they're trying to read it , it's like they don't have any cognitive energy left

, like , no , there's nothing left for them to comprehend , right , and I know you've talked about that , I think , on the podcast a bit . So you know it's like you have that and then they might prefer for you to tell them Right , they're just like don't , I don't want to read it , I just want you to tell me . Now the flip side also happens .

You have children who have difficulty with language comprehension for whatever reason , whether they have developmental language disorder or they have difficulty processing , processing limitations , all kinds of factors . They may prefer to read it Like they may . You may say , you know they may be listening and be like I'd rather see it .

I want time to process and see it For them . That's something they want . So I do think that you know , for neurotypicals it's usually interchangeable , but even so , I think people do have a preference . So I do this , I do this example . That's listening comprehension .

When I give talks and I've just learned to put it up on the screen because it drives my audience nuts , I tell them like okay , just you can close your eyes , but if you really want to see it , just remember this is listening comprehension . You're not really reading it because it literally I get so much feedback . I'd really like to see that example .

I want to be able to read that example , even though it's a listening comprehension example , because we do tend to prefer mostly to see it unless we have struggles with comfort .

I was like I want to read that . I don't want I . I heard it already , but now I want to read it .

We didn't write the word at all , we just said it . Let's say it's elevator , I mean that's not a great one , probably because most kids know , but let's say they don't Elevator , elevator , elevator . Here's an elevator . You go on it , give them all the definition , whatever , you can even show them a picture of it , but you don't write it out ever .

Just no writing . Then we had a condition where we actually wrote the same kids , different words , and it was like counterbalance . We do all the research manipulations you do , and so then we'd have yeah , we'd have like we'd say elevator , all the same thing , and we wrote it out . And what was fascinating and this is a , this is a phenomenon .

Now that's been , that's been done , you know , studied over and over , and there's converging evidence called orthographic facilitation . Children learn the spoken word better when they've seen the written first . So not even . It's just not even like writing it . It's just not even like them right now . Nope , just seeing it , just seeing it .

And so we've studied why that might be the case .

There's some theoretical evidence or some other evidence it's you know , really , what we think is happening theoretically , and also , you know , looking at some of the early brain work , is that you're activating multiple parts of the brain , for one thing , and also you have a better sense of the letter , the sounds , because you have letter , sound correspondence , and so

you can visualize it . And I think about this as the name tag phenomenon . Have you ever been at a conference or met someone and they say their name and you hear it , but don't you really just want to look at their name tag to make sure you heard the right thing ?

So that's important too . So multiple modalities is really important for teaching vocabulary , but also it ties into this reading comprehension phenomenon versus language or listening comprehension .

And also we published our paper on children with dyslexia because there was also this view of like you don't want to include the written word for children with dyslexia because they struggle to read . But actually what we showed is that including the written word for them was also helpful .

Even though they struggled to read , they still benefited from having the written representation of the word . So this is pretty new work , lori . So I didn't know about it .

I was thinking if I don't have a strong sense of or I'm you know , I'm a child with dyslexia , I don't have a strong sense of elevator doesn't start with an L , it starts with an E . I'm going , ah , right , I'm making the ah .

So I'm thinking if I were a kid and I was visualizing that as somebody was saying it , I would be visualizing it wrong and then I'd have to go back and undo that incorrect rather than just seeing it correct for the first time .

I'm sure you guys can too , because as a language person there's such cool studies Like I'm going to tell you about one really cool study that was done in 1998 by Uta Frith and her colleagues . So what she did is she looked at children as they became literate . So they were . And then she looked at this special village .

I think it was in Portugal , so I'll have to look back . I can link this article as well , but she you know , the problem with looking at literacy and illiteracy is a lot of times in the US it's tied up with socioeconomic status and some hardships that people have been through right and other factors .

So in this village it was , I think the firstborn child was never allowed to learn to read , but the other children were , and so what they did is they looked to see what the differences were in speech processing once children learned to read versus not .

So they would take the child that didn't learn to read and then they would take the children that did and they would do these sound processing tasks and what they found is that children , when they learn to read , they start to specify their sounds more specifically than a person who doesn't learn to read . So you actually I love her quote from that .

She says that orthography is like a virus that enters your brain and it changes all of your processing . All of your speech processing is changed , because once you intimately tie those together we know that now happens in the visual word form area it changes the way you represent speech . So in this orthographic facilitation you're kind of taking advantage of that .

You're like showing them the letters and sounds and it's more specific , it's specifying their sound representation , which I think is super cool and fun as thinking about sounds and how letters and sounds and how it changes you . And then another study I will say is like looking at , for instance , the word surprise .

So the word surprise , you actually don't say the first R in it . You know when you're speaking you say surprise , surprise . But when you're speaking slowly and you're a literate person , you say surprise , surprise because you're like , you know how it's written right , and we see this consistently .

As children become literate , they start to change the way they say some words , even possibly to the incorrect way . Well , nothing's really incorrect , but you know , it's just they're tying from a different representation like a dialect , it's just . Yeah , I mean , it's just that we , you know , speech is fast and quick and we often reduce our vowels and stuff .

So it's kind of fascinating to see how , you know , we're , reading words changes your language too . You know , melissa . You know reading words changes your language too .

I feel like they needed to read the books before we went . But no shame , no shame they . They were like why would you , why would you ever say , hermione , I'm like , cause I was doing it in my head and just attending to what I thought it was , and then it was like you had never heard that , never heard this word , totally .

So then people will be like have you read that article by blah blah blah ? And I'm like maybe Can I see it written .

She just flew by that developmental language disorder . Can you talk just a little ?

So what we know is if we think first , I'm going to talk about dyslexia , because it's something we know much more about . We've had so many discussions about it . We have decoding dyslexia movements , screening for dyslexia laws . There's so much focus on dyslexia , which is great , fantastic .

So dyslexia , as we know , is the brain-based difference that occurs when you have difficulty learning how to read words , and we know that's a brain-based difficulty . It's a neurodivergence . A child is born with dyslexia .

They have difficulty with connecting letters and sounds and they may have other difficulties or maybe no other difficulties , like you definitely know about kids who there was no other difficulty and then they went to school and all of a sudden they have dyslexia , because that's when they're confronted with pairing letters and sounds .

So that's dyslexia , which we know is the lower end of the distribution of word reading . So there's a range of word reading abilities and at the lowest end , that's where we see children with dyslexia . Now , with that background in mind , let's think about listening comprehension that we've been talking about .

So listening comprehension is also a set of skills that's separate of word reading . That involves using and understanding language , involved with vocabulary and syntax and all these other areas that we discussed .

So what we also know is that there's individual differences in language comprehension , and at the low end of that ability level is children who have developmental language disorder , and when I give talks , I've been really fascinated by this because I have a unique view as someone who studies both , which is actually pretty rare just because of the silos of the way we

work as academics and as educators , so having a unique view of studying both , what we find is that , when I do the facts about dyslexia , they're very similar to the facts about developmental language disorder , with one key difference , and that is the area of struggle .

So we know that children with developmental language disorder they're born with a brain difference that makes it difficult for them to understand and use language that they hear in their ambient environment , so it's very difficult for them . It takes them longer to learn vocabulary words . It takes them longer to learn syntax .

What's really tricky about these kids , though , is that they , from lots of longitudinal studies we show that they follow the same trajectory of language learning as their neurotypical peers , but they typically are behind . You know , depending on the severity , one to four years behind .

It's really hard to determine in a classroom of five and six-year-olds who's talking like a four-year-old . I mean , that's very difficult . So , unlike dyslexia which you can , I would argue , see when you're asking a child to decode , you can really see the struggle and you can see wow , this is not right .

Children with DLD are much more hidden because they choose the language they use in the classroom . So if they're talking like a four-year-old first off , talking like a four versus six-year-old is very hard to distinguish . I mean , that's a nuance that requires testing . I struggle with that .

I know the hallmarks of DLD , so maybe I'm tuning into a few things , but I always like to have an assessment to show me what's going on , and so they also choose the words they use . So , you know , six-year-olds that might sound like four-year-olds , because they're just not talking as much , or they just they just don't want .

You know , there's many reasons , and so what we have to do is we have to test for it , because it's the individual difference at the lower end for language comprehension is really really missed . It's also not well known , even though the prevalence is the same as dyslexia . So the prevalence of just exactly the same , yes , so dyslexia . You know the range .

There's a range of prevalence , but you know a median kind of range is 10% . Dld is the same . It usually range . It's well . We have a few more specific kind of epidemiologic studies to look at prevalence and it's shown between 7% and 13% . So I go with 10% as the middle , which is a lot of people do .

So it's 10% of the population that has DLD or 10% with dyslexia . But let me tell you no one knows about DLD . Why is that ? Well , first off , dld has been really the purview of a speech language pathologist , so it's been . These are our babies , our kids , and as a speech language pathologist , these are the kids that I assessed , I looked for , I treated .

The other thing is that it's been called by so many different labels across the world and across research versus , you know , practice . So in research we used to call these children specific language impairment . Then in schools they are identified , as in the early grades , as having developmental delay .

In the early childhood they have a speech and language impairment and then later on they might be , you know , qualify as having a specific learning disability and comprehension . So , right there , in even one system , they're changing their labels and then in different you know ICD-9 codes , it's like expressive receptive disorder . These are all the same kids .

These are the same kids , just different labels for the same kids . So , in 2017 , there was a consensus across the world , literally across the world , to come up with one label so that we can actually start advocating for these kids that exist . And like , how do we do it ? So the label was decided to be developmental language disorder .

I will tell you , and you probably won't be surprised , that we are the very last country , really developing country , that's not using this consistently , because our setup is really complicated . So , for instance , australia , you know , as an example , they , you know , adopted it . They have the socialized medicine .

They're like , okay , everyone , now we shall call these children DLD in every way . And then they do it and they start working on the advocacy for these children and how to assess them and how to . Well , think about the United States , okay , what do we do ? Oh my God , 50 states . You have the medical , a billion districts .

Oh my God , that's even , that's just education , oh my God .

They have just now released a letter saying that developmental language disorder is not precluded by IDEA . You can use it just like dyslexia , and I almost feel teary telling you this because it has been such a long journey and I'm representing hundreds , thousands of people , hundreds and thousands of people that have been working on this .

So what I'm excited to see is that , with the same prevalence and with the shift on knowledge and language , that we can start recognizing these children because their outcomes are not good . Only 20% of them are ever , ever even identified for support .

And the children who are identified this is the most shocking part the children who are identified with DLD are those who one have an executive functioning difficulty that disrupts the classroom , that sends them for an evaluation that might get them language testing .

The second one is they have a mother or a father with high socioeconomic status who can fight for them . That's totally unacceptable , like that's a social justice issue , because the differences are really really , really clear .

The kids who get support have long-term outcomes , life outcomes that are dramatically better than those who don't , who are more likely to go into the juvenile justice system . They're more likely to lose employment . They I mean they're more likely to commit suicide .

This is a very , very big problem because we associate language with intelligence , so these children are often thought of as lazy , as unintelligent , as parents are blamed . So it becomes a really big family . You know struggle too .

So I'm really working hard to have the same recognition for developmental language disorders we have for dyslexia , and I think a huge part of that is SLPs working with educators and really trying to let this is these are not our kids , these are everyone's kids , they're in classrooms , and that it has to be part of the overall MTSS support system .

But that's a heavy lift , but I think we're getting there and a big part of it is focusing on language comprehension . I also want to say that 50 percent of children with dyslexia have DLD and 50% of children with DLD have dyslexia , and actually that's a you know that's that differs across situations . It can be very much higher than that .

It's always higher , never lower . So this is also one of those things where , when I talk to people who work with dyslexia , they're like I don't see kids with DLD . I'm like I know you do , I know you do , I know you do , and vice versa . If you're working with children with developmental language disorder , you have children with dyslexia .

They're sitting right in front of you . So we have to work together to support these children for both sides of the simple view of reading . So I'm really thankful that you asked about that question . It's a really important thing that working with these families is such a gift .

This is definitely one of those situations where it's no one's fault , but we just now are in a place where we can recognize this and start to move forward and I just think the future is bright and I can definitely link the letter to your resources , even , since I think that's something , yeah , to get out to the community and just start using the label and

start thinking about it . And there's been so much amazing work internationally to have a community . If you I , when I work with parents , it was always so sad for me when I would talk about you have dyslexia , cause I again , I had that unique position where I could assess all these different areas .

If I say you have dyslexia , they're like , okay , I know , okay , I . They were like , okay , great , I'm going to hook up with international dyslexia Association . I'm going to read these books . I'm going to have a community and I'm going to . I have these models and it's like bam , I have same with ADHD , adhd . Great , I'm going to get the attitude magazine .

I'm going to get in the community , I'm going to listen to the podcast . And these same kids if I said DLD , it was like crickets . There was no national organization to support them . There was no , you know , community support , but now there's a strong community .

People are identifying , kids are getting support , parents are feeling supported and and it's , like I said , such an honor to work with them because they , you know they are getting that support they need .

Just , you know , it helps you understand people better too , right , like you know , not even as a teacher , but just as a person , like when you're interacting with other people and you know , sometimes you can feel a little frustrated and it just helps , I think , at least me I'll speak for myself helps me be a little more patient and , like you know , I'm like

I always wonder , like what's going on for them . I , you know this might be hard for them . I need to like take a breath and it it does help you kind of be a better person to understand other people better .

And this is how I kind of think of that , along with the teacher side of what can I do to actually , you know , get some real , real , real help for for these students . So well , is there anything else before we go that you would like to share ? I mean anything about anything that we talked about today ? The floor is yours .

There's so many wonderful things happening , and I think we're going to really start to learn more about something called implementation science , which is something I'm so passionate about , which is really about exactly what you guys are passionate about , which is how do we get the evidence into practice and how do we also the flip side of that , how do we do a

better job in our research representing what's actually happening in practice ? So it goes both ways . I think that's something I'm really excited about , and it all relates to what we've discussed so far , and you guys are a big part of that , because dissemination in a friendly way is a big part of implementation science .