Monica Gordon Pershey, Ed.D., CCC-SLP Associate Professor, Department of Speech and Hearing

1. A CASE STUDY OF LITERACY ACQUISITION IN AN ADULT WITH DEVELOPMENTAL DISABILITIESYAI/National Institute for People with Disabilities Annual International ConferenceNew York, NYMay 2005 Monica Gordon Pershey, Ed.D., CCC-SLP Associate Professor, Department of Speech and Hearing Cleveland State University Cleveland, OH mgpershey@att.net, m.pershey@csuohio.edu Thomas W. Gilbert, M.A., M.Ed. Clinician, QMRP, Northeast Care Center North Royalton, OH tgilbert@necare.org

2. Case History – Christine Born: 1956 to uneducated Greek immigrants Education: No formal schooling, family teaches self-care Medical: Congenital heart defect, developmentally disabled, functional good health Cognitive: IQ is 41 or 43 Language: Preschool range of functioning; communicates in English, also uses limited American Sign Language and Greek Speech: Dysarthria, apraxia, moderate intelligibility in known contexts Residence: Family home Occupation: County sheltered workshop – light assembly; helps in family’s mini-mart Gordon Pershey & Gilbert (2005) NRC

3. Baseline Literacy Attributes – Pre-Treatment Slosson Reading Test: Christine read “is” “up”; Wrote “Christine” and the letters of the alphabet to dictation Christine is interested in print – she is aware of print as communication Christine is interested in the functions of print in multiple social environments (family, work, peer groups, community) Christine has expectations that literacy will engender social contact (correspondence, reading about the social world) Christine prepares correspondence (messages, greeting cards) by asking family to tell her the letters she needs to write to spell the words she wants to put on paper Christine asks a habilitation supervisor if she could be taught to read and write – Tom is assigned to intervene Gordon Pershey & Gilbert (2005) NRC

4. Discovering the Literacy Process: Hypothesizing How to Intervene with Adults with Mental Retardation and Developmental Disabilities Hypothesizing functional capabilities needed for literacy: Interactions beyond parallel play: Need joint purpose between learner and clinician, the synergy of a working relationship Visual skills to see print: Acuity, tracking, processing and memory Language skills: Sentence repetition, engage in conversation, discourse skills (memory, topicality, story line); ability to determine parts of wholes (e.g., the door of the car, subcategories such as foods that are eaten for lunch in winter) Patience and persistence – Plan for years of instruction, not weeks or months Gordon Pershey & Gilbert (2005) NRC

5. Discovering the Literacy Process: Hypothesizing How to Intervene with Adults with Mental Retardation and Developmental Disabilities Similarities with Emergent Literacy: Moving Whole to Part to Whole: Whole: Logographic recognition - Highly reliant on context Part: Alphabetic recognition - See initial letters in words Whole: Orthographic reading – Deliberately or automatically scan letters, syllables, word parts, and whole words with flexibility and code awareness Reading is always a parallel examination of stimulus and memory (Smith, 1988) Gordon Pershey & Gilbert (2005) NRC

6. Discovering the Literacy Process: Hypothesizing How to Intervene with Adults with Mental Retardation and Developmental Disabilities Relevant Literature: Erickson, Koppenhaver, & Yoder, 1994; Kliewer & Landis, 1999 – Skills mastery delays access to authentic literacy materials; Advocate contextually-relevant instruction Katims, 2000; van Kraayenoord, 1994 - Access experiential background and metacognitive skills, such as ability to predict text events and to self- regulate to choose among learning strategies Ashby-Davis, 1981; Gillette, 1991- Echo reading; Impress methods Gordon Pershey & Gilbert (2005) NRC

7. How to Intervene: Demonstration, Guided Practice, Independent Practice Demonstration: Models of purposeful reading of extended text to facilitate four roles (Freebody, 1992) 1 - Text Participant: “This text matters to me!” (Funny, personal, useful) 2 - Text User: “This text was created so that I can _____.” 3 - Text Analyst: “This text reminds me of something I already know!” 4 - Code Breaker: “I can find some elements of the written code.” (Logos, whole words, letters, symbols) Gordon Pershey & Gilbert (2005) NRC

8. How to Intervene: Demonstration, Guided Practice, Independent Practice Guided Practice: Auditory Impress Reading: Tom reads word by word, line by line, Christine echoes Emphasis on flow, sharing, cooperation A melody of voices Procedural Input – “This is what readers do” Auditory Input - Builds “Big Storage” of lengthier text Iconic Input – “This is what print does” – Connect visual wholes to spoken language Discourse Input – “Talking like a book,” Phrasing of sentences and passages; Sharing meaning allows for emphasis on code to be introduced later Gordon Pershey & Gilbert (2005) NRC

9. How to Intervene: Demonstration, Guided Practice, Independent Practice Guided Practice: Working with Whole Words Understanding words as parts of the whole text – read for flow and also read word by word Use controlled readers, HIGHLY predictable text (Laubach), simple story line reinforces making meaning from text Visual recognition: Are words seen as logos? Tom and Christine talk about words in text, locate individual words Christine builds a bank of reliable sight words Gordon Pershey & Gilbert (2005) NRC

10. How to Intervene: Demonstration, Guided Practice, Independent Practice Moving Towards Independence: Clinician’s voice drops out momentarily: Is Christine reading any of these words? Christine reads and Tom echoes Read in unison, not echoing Listen for Christine’s vocal inflections as she leads Christine signs words occasionally as she reads, reinforcing her comprehension Christine selects texts she wants to read – e.g., newsletters for special populations, trip announcements, flyers at work, greeting cards Maintain interdependence – Not pushing towards independence – Avoid breeding frustration Gordon Pershey & Gilbert (2005) NRC

11. How to Intervene: Demonstration, Guided Practice, Independent Practice Moving Towards Independence: Echo reading is supplemented with planned and incidental instruction: Build a sight word bank Word skills worksheets – matching, selecting among choices to show word recognition Explore letter-sound correspondences Analogies for onsets – if “bed” begins with /b/, get ready to say a /b/ word when you see “b” – think of a /b/ word that would make sense here Analogies for rimes – what word could this be if we see it ends in “--oon” Gordon Pershey & Gilbert (2005) NRC

12. How to Intervene: Demonstration, Guided Practice, Independent Practice Moving Towards Independence: Christine finds satisfaction in communicating through written language Eager to create her own texts – Language Experience Approach (Stauffer, 1970) – Christine dictates text for Tom to scribe (“Bessie’s Store”) Christine writes many notes, letters, and greeting cards - Christine asks family members to tell her the letters so she can spell the words she wants to write Continual experimentation with writing leads to independent creation of letters, messages, notes, and greetings using invented spelling Gordon Pershey & Gilbert (2005) NRC

13. Improvements in Christine’s Quality of Life Increased social participation: Library usage – borrowing books, story hour Attends weekend school for adults with developmental disabilities Recognizing coins and bills, counting money Better time telling skills Motivation to try to speak more clearly – more aware of target sounds and how they compare to her productions Personal reading: Prayers, letters, greeting cards Self-confidence: Volleyball, soccer, summer camp, group trips, dinner and movie dates Gordon Pershey & Gilbert (2005) NRC

14. Documented Accomplishments Christine and Tom have partner read several books, including abridged versions of The Wizard of Oz and The Secret Garden Christine demonstrates text comprehension by providing single-word, sign, and gestural responses to questions about characters, plot, setting, etc. Christine routinely writes notes to family, friends, workshop supervisors, and Tom Full Scale IQ was tested as 55 after five years of reading and writing interventions, an increase of 14 points from pretreatment. Gordon Pershey & Gilbert (2005) NRC

15. Conclusions Christine’s literacy capabilities flourished under socially stimulating conditions. Non-threatening, socially relevant interactions with Tom facilitated her development. Literacy was communicatively relevant to Christine. She viewed literacy as enhancing her ability to communicate with others. Cognitively, Christine exhibited self-direction in her learning and metacognition as she approached literacy tasks. Thus, Christine experienced many of the social, intellectual, and behavioral conditions reported in the literature to be contributing factors in literacy acquisition in adults with mental retardation and developmental disabilities (Barudin & Hourcade, 1990; Katims, 2000; Kliewer & Landis, 1999 van Kraayenoord, 1994). Gordon Pershey & Gilbert (2005) NRC

16. Implications This case study has generated evidence that literacy instruction for adults with mental retardation and developmental disabilities can utilize an eclectic, whole to part to whole approach. There is a need for further research into literacy acquisition in adults with mental retardation and developmental disabilities to explore how literacy acquisition is both a linguistically mediated social process and a socially mediated linguistic process. Gordon Pershey & Gilbert (2005) NRC

17. Tom’s Discovery of the Literacy Process Client’s Interest in Print Client’s Interest in his/her Multiple Social Environments Desire to Grow Socially, Behaviorally Desire for Contact: Literacy Serves a Need for Communication; Expectation of Subsequent Social Participation With Insight Comes Joy: Changes in Their Self-Concept, Rights, Power Gordon Pershey & Gilbert (2005) NRC

18. Functional Prerequisites Beyond Parallel Play: Need Joint Purpose and Synergy Between Teacher and Learner Visual Acuity to See Print Language Skills: Repeat Sentences Engage in Conversation and Discourse (Memory, Topicality, Story Line) Parts of Wholes (The Door of the Car; Foods that are Common at Lunch) Patience and Persistence on the Part of the Teacher and Learner: Plan for Years of Instruction, Not Weeks Gordon Pershey & Gilbert (2005) NRC

19. The Developmental Reading Process: What Do Typically Developing Readers Do? Moving Whole to Part to Whole Logographic Recognition (This is Probably Sight Word Reading) COKE PEPSI MASTER CARD VISA Highly Reliant on Context Alphabetic Recognition: See Initial Letters of Words then Surmise what the Word Might Be Orthographic Reading: Deliberately or Automatically Scan the Letters, Syllables, and Word Parts throughout an Entire Word (hotel) Gordon Pershey & Gilbert (2005) NRC

20. Aoccdrnig to rscheearch at Txes M&A Uinervtisy, it deosn't mttaer in waht oredr the ltteers in a wrod are, the olny iprmoetnt tihng is taht the frist and lsat ltteer be in the rghit pclae. The rset can be a total mses and you can sitll raed it wouthit a porbelm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Gordon Pershey & Gilbert (2005) NRC

21. redblue greenbrown tanyellow purpleorange pinkblack brown red yellowpurple blue green tanorange Gordon Pershey & Gilbert (2005) NRC

22. The Developmental Reading Process: What Do Typically Developing Readers Do? Pattern Detection Prepares the Reader for Rule Application The Heuristic Precedes the Logorhythm Experimentation with Writing Occurs Concurrently with these Phases A Spelling Conscience Develops in the Orthographic Phase Reading is Always a Parallel Examination of Stimulus and Memory Ideally Occurs with Automaticity Gordon Pershey & Gilbert (2005) NRC

23. How to do the Teaching DEMONSTRATION GUIDED PRACTICE INDEPENDENT PRACTICE Gordon Pershey & Gilbert (2005) NRC

24. How to do the Teaching Facilitate Four Roles (Freebody, 1992) Text Participant This Text Matters to Me! (Interesting, Funny, Personal, Useful) Text User This Text Was Created So that I Could _____ (Read a Story, Receive an Invitation, Take Medicine) Text Analyst This Text Reminds Me of Other Texts (Frequent User) Code Breaker I Can Find Certain Aspects of the Written Code (Punctuation, Letters, Words) Gordon Pershey & Gilbert (2005) NRC

25. How to do the Teaching Step 1: Language Listening and Use Auditory Input Builds “Big Storage” for Lengthier Text Iconic Input: This is What Print Does Procedural Input: This is What Readers Do Gordon Pershey & Gilbert (2005) NRC

26. How to do the Teaching Step 2: Connect Visual Wholes to Spoken Language Logographic Phase: Seeing Word Wholes Understanding Word Wholes as Part of the Language Whole For Some Clients this Constitutes Whole Word Recognition For Other Clients, this is Matching “Some Language” to “Some Logos” Gordon Pershey & Gilbert (2005) NRC

27. How to do the Teaching Step 3: Talking Like a Book A Melody of Voices: Repetition, Impress Predictable Phrasing at the Sentence and Passage Levels Facility with Meaning Allows for Later Emphasis on the Code The Teacher is Very Involved: The Process is about Communication with the Learner, Teacher Models Patience and Concentration, Sharing the Meaning of Text The Teacher’s Voice Drops Out: “Are They Reading Anything Yet?” Gordon Pershey & Gilbert (2005) NRC

28. How to do the Teaching Step 4: Reliable Sight Words: Maintain Focus on Instruction “Interdependence” - Don’t Push for Independence Learned by Repetition and Connection to Meaning Might be Function or Content Words Laubach or Other Repetitive Texts Featuring Story Lines A Word Keeps Coming Up in the Story and is Reliably Recognized The Learner Still Struggles with the Bulk of Text Independence May Tax a Learner’s Frustration Tolerance Gordon Pershey & Gilbert (2005) NRC

29. How to do the Teaching Step 5: Pattern Detection -- Begin to Teach Letter Recognition for Letters that Occur at Beginnings of Words Pair Letters to Sounds Analogy: If “Bed” Begins with the /b/ Sound, When You See a “b” Get Ready to Say a Word that Begins with /b/ -- Then Think of a /b/ Word that Would Make Sense Here Stress How Sounds Recur in Different Words - Start a Personal Dictionary of Sight Words by First Letter/Initial Sound Move to Word Families or Spelling Correspondences -oon: moon, balloon, noon, soon, afternoon -ch: lunch, such, batch, pinch Gordon Pershey & Gilbert (2005) NRC

30. How to do the Teaching Step 6: Finding One’s Own Mistakes Can the Learner Monitor for Miscues? Self-Correct? Monitoring What We See, What We Say, What We Hear Ourselves Say, What the Text Means, How Meaning Changes as We Go Along Miscues Reveal Three Types of Errors: Reading the Wrong Symbol (A Visual Error) Attaching the Wrong Meaning (Wrong Guess of What the Word is in Context) Errors Involving Sentence Structure (Not Accounted for by Dialect) Gordon Pershey & Gilbert (2005) NRC

31. How to do the Teaching Step 7: Word Awareness and Word Study Finding Similarities and Differences Among Words: Rhymes, Singular/Plural, Compound, Different by 1 Letter Taking Words Apart in Any Way Sounding Out Words Gordon Pershey & Gilbert (2005) NRC

32. FAQ’s When, and how often, do I correct the learner? Keep corrections to substantial concerns related to text meaning About 80% accuracy is sufficient Ignore dialect errors Take the learner’s temperament into account Does the learner want to be corrected or not? What will help vs. what will aggravate the learner? Gordon Pershey & Gilbert (2005) NRC

33. FAQ’s Is this Whole Language? No. But the “wisdom” of whole language has been taken into account: Readers crack the code by going from whole to part to whole. Connected text is more meaningful than flash cards. Letters are only important to people who have seen the flow of words on a page and want to crack that code. Learning to read entails a series of insights. Gordon Pershey & Gilbert (2005) NRC

34. FAQ’s What about Phonics Instruction? Phonics teaches the rules of English orthography. Learners are ready for phonics when they have good pattern detection skills and can apply consistent rules. Shouldn’t I teach survival words first? A learner who is capable of reliable identification of sight words may benefit from supplemental instruction in survival words presented in isolation. Survival words might also be detected in text passages. Logographic readers may recognize some survival words that have strong visual associations, such as a stop sign. Gordon Pershey & Gilbert (2005) NRC

35. FAQ’s What can I do about learners with autism? A literacy learner needs to have some interest in his/her social environments and a desire to grow socially. This teaching approach requires a high degree of interpersonal contact, in part provided to nurture the learner’s desire for contact. Learners with autism who see literacy as an avenue to communication may engage in this approach. Literacy is important to clients who have the expectation of subsequent increased social participation when they become readers. Gordon Pershey & Gilbert (2005) NRC

36. FAQ’s What can I do with my lowest functioning clients? Begin by reading aloud to them, directing visual attention to the print as you read. Gordon Pershey & Gilbert (2005) NRC

37. References Adams, M.J. (1994). Beginning to read: Thinking and learning about print.Cambridge, MA: The MIT Press. Ashby-Davis, C. (1981). A review of three techniques for use with remedial readers. The Reading Teacher, 34(5), 534-538. Barudin, S.I. & Hourcade, J.J. (1990, Sept.). Relative effectiveness of three methods of reading instruction in developing specific recall and transfer skills in learners with moderate and severe mental retardation. Education and Training in Mental Retardation, 286-291. Bennett, J., Jaccoma, R., & Weinstein, L. (Eds.). (1997). So far: Words from learners. Markham,Ontario: Fitzhenry Whiteside. Carpenter, C. D., Bloom, L. A., & Boat, M. B. (1999). Guidelines for special educators: Achieving socially valid outcomes, Intervention in School and Clinic, 34(30, 143-149. Erickson, K.A., Koppenhaver, D.A. & Yoder, D.E. (1994). Literacy and adults with developmental disabilities. Philadelphia, PA: National Center on Adult Literacy. Farrell, M., & Elkins, J. (1991). Literacy and the adolescent with Down syndrome. In C. Denholm (Ed.), Adolescents with Down syndrome: International perspectives on research and programme development. Victoria, BC: University of Victoria. Gordon Pershey & Gilbert (2005) NRC

38. References Feuerstein, R., Rand, Y., & Hoffman, M. B. (1979). The dynamic assessment of retarded performance: The learning potential assessment device, theory, instruments, and techniques. Baltimore: University Park Press. Fowler, A.E., Doherty, B.J., & Boynton, L. (1995). The basis of reading skill in young adults with Down syndrome. In L. Nadel & D. Rosenthal (Eds.), Down syndrome: Living and learning in the community (pp. 182-196). New York: Wiley-liss. Freebody, P. (1992). A socio-cultural approach: resourcing four roles as a literacy learner. In A. Watson & A. Badenhop (Eds.), Prevention of Reading Failure (pp.48-60). NSW: Scholastic Australia Pty. Ltd. Gillette, T.L. (1991). Improving oral reading in mentally handicapped adults through increased opportunity and practice. Masters Thesis, Nova University. Giordano, G. (1996). Literacy programs for adults with developmental disabilities. San Diego: Singular Publishing. Gipe, J.P., Duffy, C.A. & Richards, J.C. (1993). Helping a nonspeaking adult male with cerebral palsy achieve literacy. Journal of Reading, 36(5), 380-389. Gordon Pershey & Gilbert (2005) NRC

39. References Hoffman, M. B. (1979). The dynamic assessment of retarded performance: The learning potential assessment device, theory, instruments, and techniques. Baltimore: University Park Press. Katims, D. S. (2000). Literacy instruction for people with mental retardation: Historical highlights and contemporary analysis. Education and Training in Mental Retardation and Developmental Disabilities, 35(1), 3-15. Kozol, J. (1985). Illiterate America. New York: New American Library. Laiken, D.S. (1989). Great illustrated classics: The Wizard of Oz by L. Frank Baum. New York: Baronet Books. Lalli, J.S. & Browder, D.M. (1993). Comparison of sight word training procedures with validation of the most practical procedure in teaching reading for daily living. Research in Developmental Disabilities, 14, 107-127. Laubach, F.C., Kirk, E.M., & Laubach, R.S. (1991). Laubach way to reading. Syracuse, NY: New Readers Press, Publication Division of Laubach Literacy International. Moni, K.B., & Jobling, A. (2000a). Ignoring the frontiers: Teaching poetry to adolescents with Down syndrome. Social Alternatives, 19(3),36-39. Gordon Pershey & Gilbert (2005) NRC

40. References Moni, K.B., & Jobling, A. (2000b). LATCH-ON: A literacy course for young adults with Down Syndrome. Journal of Adolescent and Adult Literacy, 44, 40-49. Moni, K., & Jobling, A. (2001). Reading related literacy learning of young adults with Down syndrome: findings from a three year teaching and research program. International Journal of Disability, Development and Education, 48 (4), 377-394. Moutray, C. (1997). An exercise in juggling: Facilitating an adult literacy program. Paper presented at the 40th Leadership Conference and Biennial Council of Pi Lambda Theta, San Diego, CA. Mulvaney, D.E., Fitzhugh, L.C., & Wagner, B.R. (1980). Teaching elementary spelling to a retarded resident by another retarded resident. Perceptual and Motor Skills, 51, 523-526. Pershey, M.G., & Gilbert, T.W. (2002). Christine: A case study of literacy acquisition by an adult with developmental disabilities. Mental Retardation, 40(3), 219-234. Raphael, D., Brown, I., Renwick, R., & Rootman, I. (1996). Assessing the quality of life of persons with developmental disabilities: Description of a new model, measuring instruments, and initial findings. International Journal of Disability, Development, and Education, 43(1), 25-42. Gordon Pershey & Gilbert (2005) NRC

41. References Rootman, I. (1996). Assessing the quality of life of persons with developmental disabilities: Description of a new model, measuring instruments, and initial findings. International Journal of Disability, Development, and Education, 43(1), 25-42. Ruiter, I. D. (2000). Allow me! A guide to promoting communication skills in adults with developmental delays. Toronto: The Hanen Centre. Smith, F. (1988). Joining the literacy club: Further essays into education. Portsmouth, NH: Heinemann. Smith, P. (1999). Drawing new maps: A radical cartography of developmental disabilities. Review of Educational Research, 69(2), 117-144. Speaking of equality: A guide to choosing an inclusive literacy program for people with an intellectual disability. (1995). North York, Ontario: The Roeher Institute. Speaking of equality: Making literacy programs accessible to people with an intellectual disability. (1995). North York, Ontario: The Roeher Institute. Storey, K. & Horner, R. H. (1991). An evaluative review of social validation research involving persons with handicaps. The Journal of Special Education, 25(3), 352-401. Gordon Pershey & Gilbert (2005) NRC

42. References Sturm, J. & Koppenhaver, D. A. (2000). Supporting writing development in adolescents with developmental disabilities. Topics in Language Disorders, 20(2), 73-92. Trent, S.C., Artiles, A.J. & Englert, C.S. (1998). From deficit thinking to social constructivism: A review of theory, research, and practice in special education. In D.P. Pearson & A. Iran- Nejad, (Eds.), Review of research in educa­tion, Vol. 23 (pp.277-307). Washing­ton, DC:American Educational Research Association. Van Kraayenoord, C.E. (1994). Literacy for adults with an intellectual disability in Australia. Journal of Reading, 37(7), 608-310. van Kraayenoord, C. E., Moni, K.B., Jobling. A., & Ziebarth, K. (2002). Broadening approaches to literacy education for young adults with Down syndrome. In M. Cuskelly, S. Buckley, & A. Jobling (Eds.), Down syndrome across the lifespan pp.93-106. London: Whurr.Young, L., Moni, K.B., Jobling, A., & vanKraayenoord, C.E. (2004). Literacy Skills of Adults with Intellectual Disabilities in Two Community-Based Day Programs. International Journal of Disability, Development and Education, 51 (1), 83-97. Wehmeyer, M.L. & Metzler, C.A. (1995). How self-determined are people with mental retardation? The National Consumer Survey. Mental Retardation, 33(2), 111-119. Gordon Pershey & Gilbert (2005) NRC