What Makes TPE Unique? Integrated Dyslexia/Speech-Language Therapy

When I came to work at True Potential Education in May of this year, I was already more prepared than many speech-language pathologists to work with dyslexia. My graduate education, like that of many in my profession, was heavy on the side of verbal language disorders and light on written language disorders. I, however, had entered the field knowing I wanted to work with dyslexia so I completed additional post-graduate training as soon as I was able and got a job at a private practice where my caseload included children with dyslexia as well as speech and verbal language disorders.

I knew that dyslexia often co-occurs with developmental language disorders. I had learned that as a factoid in a Childhood Language Disorders course, and I saw the proof in the children on my caseload. Many of the kids who came to me with dyslexia concerns also had a history of speech sound disorders or language delays. Parents of children I saw for speech and language frequently reported that their child was flagged on a first grade dyslexia screener or noticed they were struggling with reading and writing when they began kindergarten. 

Over time, more and more of my caseload had goals for both written language skills and speech or verbal language. I was beginning to understand the depth of the connection between these deficits, and was careful to screen kids with verbal language disorders for written language deficits and vice versa. However, I continued to target these skills separately in therapy for the most part. When I came to TPE, the training I received in the integrated therapy technique revolutionized my understanding of dyslexia and how to treat it.

What Is Integrated Therapy?

TPE’s speech-language pathologists are trained not just to identify all a student’s speech and language deficits and target each skill individually. Instead we integrate speech, verbal and written expression, and listening and reading comprehension skills into each session based on the individual student’s needs. For example, a student who substitutes /f/ for /th/ while speaking will target articulation of the sound while simultaneously building memory and syntax skills by repeating the target word in a complex grammatically correct sentence and tying in spelling skills by writing it. Although I would have targeted each of these skills individually in traditional speech-language therapy, this integrated approach encourages connections to form more quickly between spoken and written language skills and allows students to generalize skills.

Why Does It Matter?

Spoken and written language are two sides of the same coin. 

Speech and written language share the same purpose: communicating information, needs, and feelings to others. Both the sounds that make up our language and the letters printed on a page are a means of encoding those ideas so we can express our own thoughts and understand the thoughts of others.

Children who struggle with verbal language often struggle with written language. 

Dyslexia and spoken language disorders are separate diagnoses, and there is not sufficient evidence to identify a common cause. However, they frequently co-occur. One study found that 54% of children with developmental language disorders also have dyslexia and 71% of children with dyslexia demonstrate a developmental language disorder.

Dyslexia can lead to verbal language deficits, and language disorders cause children to be at-risk for written language difficulties.

Beginning in late elementary years, vocabulary growth is closely tied to reading. Children who are better readers tend to read more, providing more opportunity for vocabulary growth. In fact, about a third of children with dyslexia had reduced vocabulary compared to peers in the absence of a diagnosed verbal language disorder. Conversely, preschoolers with spoken language delays often enter school with reduced phonological awareness skills and word knowledge compared to their peers, which may lead to difficulty acquiring reading and writing skills. Integrated treatment ties these related skills together to support overall language growth.

Practicing target skills in a variety of contexts encourages generalization.

Generalization is the ability to use a skill in everyday life–with different people, in different places, and in different contexts. Generalization is the ultimate goal for therapy targets. By practicing skills in different contexts–written and spoken, receptive and expressive–the integrated therapy framework provides more opportunities to work toward generalization throughout the therapy process.

Who Is It For?

Integrated therapy is ideal for students who would benefit from support in both spoken and written language. This framework allows them to build on existing strengths while addressing target skills in a way that maximizes generalization.

TPE has solutions for students who only need support in one modality as well! Our speech-language pathologists treat a range of speech and language disorders, including speech sound production, listening comprehension, verbal expression, stuttering, and vocal quality. TPE also has an experienced team of dyslexia interventionists to support reading and writing skills individually.

For more information about the services we offer, explore services on our website or give us a call at 515-218-8445.

Sources:

Helland, W. A., Posserud, M.-B., Helland, T., Heimann, M., & Lundervold, A. J. (2016). Language impairments in children with ADHD and in children with reading disorder. Journal of Attention Disorders, 20(7), 581–589. Doi: 10.1177/1087054712461530

Snowling M.J., Hayiou-Thomas M.E., Nash H.M., & Hulme C. (2022). Dyslexia and Developmental Language Disorder: comorbid disorders with distinct effects on reading comprehension. J Child Psychol Psychiatry, 61(6), 672-680. doi: 10.1111/jcpp.13140. Epub 2019 Oct 20. PMID: 31631348; PMCID: PMC7317952.