INT J LANG COMMUN DISORD, JANUARY–FEBRUARY 2012,

VOL. 47, NO. 1, 27–34

Commentary
Interventions for children’s language and literacy difficulties
Margaret J. Snowling and Charles Hulme
Department of Psychology, University of York, York, UK
(Received 17 March 2011; accepted 20 July 2011)

Abstract
Against a backdrop of research on individual differences in reading disorders, this review considers a range of
effective interventions to promote reading and language skills evaluated by our group. The review begins by
contrasting the reading profiles seen in dyslexia and reading comprehension impairment and then argues that
different interventions will be required. It is well established that effective interventions for decoding deficits
(dyslexia) involve work on letter–sound knowledge, phonological awareness and reading practice to reinforce
emergent skills. In contrast, effective interventions for reading comprehension difficulties involve training to
promote oral language skills and text comprehension strategies. Together the findings of controlled trials provide a
robust evidence base that can be used to devise plans for the management of pre-school and school-aged children
with language learning difficulties.

Keywords: decoding, reading comprehension, dyslexia, poor comprehender, reading intervention, language
intervention

What this paper adds

This review shows that problems with word-level decoding are distinct from problems of reading comprehen-
sion. Different interventions are required to promote decoding and reading comprehension skills. Evidence-based
approaches to promote decoding involve training in letter knowledge, phoneme awareness and linking these during
text reading. To promote reading comprehension, approaches which work directly on text comprehension strategies
and on oral language skills are effective, with vocabulary instruction being a particularly important technique.

Introduction evidence-based interventions to promote language and

literacy skills evaluated by our group.
In their classic text Language by Ear and by Eye,
Kavanagh and Mattingley (1972) explored the relation-
ships between ‘speech and learning to read’. It was
The nature of reading disorders
claimed that ‘reading is parasitic upon speech’, and this
simple idea has dominated the field for many years. Reading is a complex skill that can dissociate to produce
However, it is increasingly clear that it is a narrow varying profiles of impairment (Bishop and Snowling
view. Aside from children who ‘can listen and speak 2004). The two most common forms of reading disorder
well’, yet have difficulty learning to read (dyslexia), are dyslexia, a specific difficulty with decoding print, and
the main risk factor for reading disorders is problem- reading comprehension impairment, a specific difficulty
atic language development. It follows that speech and with text comprehension. Dyslexia was first described
language therapists play a critical role in the identifi- at the end of the 19th century and has been the
cation of children who are likely to go on to have subject of scientific research for more than 40 years
literacy difficulties and should be well positioned to (Snowling 2009, Vellutino et al. 2004). In contrast,
provide management advice. The present review begins reading comprehension impairment (often referred to
by outlining the relationships between language and as the poor comprehender profile) has attracted much
reading difficulties before proceeding to discuss recent less research since it was first described during the 1980s

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Address correspondence to: Maggie Snowling, Department of Psychology, University of York, York YO10 5DD, UK; e-mail [email protected]
International Journal of Language & Communication Disorders
ISSN 1368-2822 print/ISSN 1460-6984 online  c 2010 Royal College of Speech & Language Therapists
DOI: 10.1111/j.1460-6984.2011.00081.x
28 Margaret J. Snowling and Charles Hulme
(Oakhill 1984), although a robust empirical base is now used to test a theory and to feedback and so modify it
emerging (Cain 2010). Poor comprehenders are often (a so-called virtuous circle). The interventions that will
characterized as having a hidden handicap because they be considered have been designed to target skills known
decode well and, on the surface, are fluent readers. to be deficient in poor readers and their findings have
It is only when they are asked questions about what been used not only to inform educational practice, but
they have read that their difficulties are revealed. Poor also to test and refine casual theories.
comprehenders are also neglected in the Diagnostic
and Statistical Manual (DSM-IV) of the American
Psychiatric Association (1994) which does not recognize Interventions to promote word level decoding and
reading comprehension impairment as a separate
fluency
category of reading disorder. Moreover, in the draft
version of the fifth edition of the Diagnostic and Statisti- The main ingredients of a teaching approach to promote
cal Manual (http://www.dsm5.org), specific reading word-level decoding skills is one that combines training
comprehension impairment is not listed as a form of in phonological awareness with training in letter–sound
reading disorder; rather it is considered to be a form of knowledge and in which these two skills are reinforced
language impairment. It is clearly important for children in the context of reading (Torgesen 2005, Snowling
with poor reading comprehension to be given better and Hulme 2011). Such an approach goes beyond
recognition within the school system where, at present, the contemporary emphasis on systematic ‘phonics’
their support needs are largely unmet. by ensuring that children have adequate phonological
Disorders of reading are relatively common in awareness skills and by ensuring that what is taught is
mainstream schools and this provides a strong case for practised in context which, in turn, can provide a vital
interventions not only for decoding difficulties but also bootstrapping resource for children who have significant
for reading comprehension impairments. The approach phonological difficulties.
to the two disorders needs to be distinct and to take Hatcher et al. (1994) were the first group of
account of the underlying nature of these difficul- researchers in the UK to assess the efficacy of different
ties. It also needs to draw on evidence of the efficacy forms of intervention for readers with dyslexic profiles
of treatments. This paper begins by reviewing the using a controlled design. Children participating in this
principles that are now well established for interven- study were identified through a countywide screening of
tions that target basic decoding skills before going on all children in their third year in school. Those selected
to discuss effective interventions to promote reading to take part in the study had reading skills that fell
comprehension. It also considers early interventions at within the bottom 10% of the population in terms
the foundations of reading skill and suggests these can of reading accuracy. The children were then randomly
be an important step toward reducing the number of allocated to one of four experimental conditions. In
poor readers in the school-aged population. three conditions the children received intervention, the
fourth was a control group that received ‘business as
usual’.
Interventions for language and reading
The three interventions that were trialled were
Hulme and Snowling (2009) have emphasized that theoretically motivated and based on best practice at the
a good starting point for developing an intervention time (Bradley and Bryant 1983, Clay 1985, Lundberg
is a causal theory. Within this view, the causes of a 1994). The interventions were delivered on a twice
reading disorder provide the theoretical motivation for weekly basis by skilled teachers for 20 weeks. Each
the design and content of an intervention; furthermore, teacher taught in each arm of the intervention to control
the findings from an intervention study will provide for the quality of delivery. There were three interven-
a test of the causal theory. This simple but important tions: reading alone (R) in which children read from
point underlines what was stated some 30 years ago by texts which were selected to be at the appropriate level
Bradley and Bryant (1983)—that the positive effects and teachers reinforced effective reading strategies to
of training phonological awareness on reading skill hone the children’s skills (for further details, see Hatcher
provides a ‘proof’ of the causal role of phonological 2006). The second condition was phonology alone
awareness in reading development. As shall be shown (P), which consisted of exercises training the develop-
below, this causal theory has in fact been modified in the ment of oral phonological awareness at syllable, rhyme
light of evidence that interventions that train phonolog- and phoneme levels following the ideas of Bradley
ical awareness alone are less effective than those which and Bryant (1983) but not involving letter work. The
link emergent phonological awareness with letter–sound third intervention, reading with phonology (R+P),
knowledge in the service of reading (Hatcher et al. combined the reading and phonology approaches. The
1994). Thus, the findings of applied research can be children receiving this intervention where trained in
Literacy interventions 29
phonological awareness and letter–sound knowledge Table 1. Outline of phonology and reading (P+R) sessions
and were encouraged through the reading of texts at the (Bowyer-Crane et al. 2008)
easy and instructional levels to practise their emergent Group session (30 min) Individual session (20 min)
skills. Introduction (4 min) Introduction (2 min)
At the end of the 20 weeks of intervention the New letter introduction (8 min) Working with sounds (3 min)
children who received the combined programme (R+P) Group book work (8 min) Sight word learning (5 min)
Segmentation or blending (5 min) Reading Books (10 min):
were significantly ahead of the other three groups in Plenary (5 min) Running record
reading accuracy, spelling and reading comprehension. Introduce new book
These gains in reading were maintained 5 months after
the intervention ceased, but at this stage the benefits of
spelling had weakened (it should be noted that spelling
was not explicitly taught within the programme). At points during the 20 weeks of the intervention. This
the time these findings challenged the theory that rate of improvement can be regarded as educationally
phonological deficits alone cause reading impairment, significant and is comparable with that found in other
since it was only when phonological awareness was studies internationally.
trained in the context of orthography that the impact on
reading was significant. Indeed, children who received Early intervention to circumvent decoding
the phonology alone (P) programme were ahead of
difficulties
the others in phonological awareness at the end of the
intervention but these gains had not generalized to their An obvious question that follows from the successful
literacy skills. implementation of interventions to promote decoding
The work of Hatcher et al. (1994) has been influen- skills is why wait for failure? A great deal is known about
tial in terms not only of theory, but also of practice, what places a child at risk of reading difficulties and
and they have influenced the direction of subsequent hence there would seem to be no good reason to wait
intervention trials conducted by our group. First, the until a child has failed before implementing a remedia-
principles and the sequence of activities used in the tion programme.
R+P programme informed a classroom-based study With this in mind, Bowyer-Crane et al. (2008)
using mainstream teachers (Hatcher et al. 2004) and evaluated a 20-week intervention programme using
subsequently a modified version of the R+P programme the principles of the R+P intervention for children
was designed for implementation by trained teaching who entered school with poor speech and language
assistants (Hatcher et al. 2006a). This new programme development. The programme was a modification of
was next evaluated in a randomized controlled trial that used by Hatcher et al. (2006b) designed to be
which for children in Year 1 with reading difficulties suitable for younger children, and hence renamed the
(Hatcher et al. 2006b). The programme was delivered P+R programme. It comprised three main components:
on a daily basis by teaching assistants, alternating letter–sound work, segmenting and blending, and
between group and individual sessions. During the reading together and reading independently. Once again
group session children worked in groups of three on it alternated between group and individual sessions on a
activities to promote phonological awareness, letter– daily basis. Four children worked together in a group on
sound knowledge and sound linkage activities including letter–sound knowledge, segmenting and blending and
writing a simple story. In the individual sessions the in the individual sessions the work focused on reading
work focused on reading using both an easy book and but also incorporated work to reinforce knowledge of
a book with the instructional level determined through letters and sounds. A more detailed breakdown of the
the teacher’s use of a running record (Clay 1985). The activities is shown in Table 1.
children were randomly allocated to receive the interven- The children who took part in the intervention were
tion for either 20 or 10 weeks. The experimental group identified following screening in 23 large schools on the
received the intervention for 10 weeks in the spring term basis of their poor performance on tests of expressive and
and for 10 weeks in the summer term, while the waiting receptive vocabulary. The mean age of the children was
control group only received the intervention during 10 4 years 10 months (standard deviation = 3.3 months)
weeks in the summer term. This meant that for the first and their language levels were at roughly the 10th centile
10 weeks the impact of the intervention could be gauged for their age. Twenty-four per cent of the sample was in
against ‘business as usual’. receipt of free school meals and some 22.6% were rated
The findings of the intervention were extremely by their teachers as having behavioural difficulties.
encouraging. There was a clearly significant effect of The intervention was implemented by trained
intervention on reading accuracy scores on a standard- teaching assistants who were supported throughout the
ized test; the gains made were over 7 standard score intervention in fortnightly tutorials (for further details,
30 Margaret J. Snowling and Charles Hulme
see Carroll et al. 2011). These same teaching assistants comprehenders (Nation 2005). In contrast, reading
also delivered an oral language intervention (OL) in the comprehension impairment is associated with a wide
same classrooms. The children in the two intervention range of language processing difficulties, for example
programmes were assessed before the intervention, mid- with grammar and sentence structure, and for many
intervention after 10 weeks and post-intervention after of these children vocabulary knowledge is poor.
20 weeks. To assess maintenance of gains they were also Children with reading comprehension impairment also
seen 5 months after the intervention had finished. experience a range of difficulties with aspects of text
To evaluate the efficacy of the P+R programme, the processing. In particular, they have difficulty making
gains of the children on tests of reading and reading inferences that link sentences and make texts cohere
related skills were compared with those of the treated (Cain et al. 2000), and they have difficulty in monitor-
control group who received the OL intervention. These ing the sense of what they are reading and in using
analyses took account of the clustering of children within metacognitive strategies such as looking back on the
schools as well as baseline performance on each of text to resolve ambiguity. Against this backdrop, it is not
the dependent measures. Since there was no untreated surprising that many intervention studies have targeted
control group in this study, the findings are conservative. higher level text comprehension skills such as making
The results of the intervention were very encourag- inferences (Yuill and Oakhill 1988, Yuill and Joscelyne
ing. The outcomes for the children who had received 1988) as well incorporating the use of visual imagery
the P+R intervention were significantly better than to enhance the representation of text (Oakhill and Patel
those in the OL group for prose reading accuracy, non- 1991, Joffe et al. 2007). However, until recently the
word reading, spelling, and segmenting and blending. In majority of intervention studies for poor comprehen-
addition, gains for single-word reading were marginally ders have been relatively small in scale and have not
significant. It is possible to express these gains in terms of used random allocation of children to treatments.
effect size: letter knowledge, d = 0.4; spelling, d = 0.4; Together with Paula Clarke, we set out to compare
non-word reading, d = 0.4; prose reading accuracy, d = three intervention programmes to promote reading
0.4; and segmenting and blending, d = 0.7. Moreover, comprehension skills which were specifically designed
comparison of the outcomes of these children in relation for poor comprehenders (Clarke et al. 2010). Building
to a large sample of 700 classroom peers 5 months after on the evidence that interventions which target
the intervention were pleasing with more than 50% now metacognitive strategies involved in text comprehen-
performing within the average range for early word- sion can be effective, the first intervention involved text
reading skills (7% had standard reading scores above level training within the written language domain (text
115). comprehension, TC). The second intervention took as
In summary, training children in phoneme its starting point the finding that poor comprehen-
segmentation and blending and reinforcing this work ders exhibit a range of oral language difficulties beyond
through reading activities was an effective interven- phonology and hence included training activities to
tion for promoting basic reading skills for children promote vocabulary, figurative language and listening
who entered school with poorly developed speech and comprehension skills (oral language, OL). Finally, an
language. The effect of the intervention were maintained integrated programme was devised that incorporated
5 months after it ceased and it is perhaps important to activities to improve oral language and to enhance
note that the gains generalized to non-word reading, text level processing. This intervention (combined,
a pure test of decoding. Preliminary analysis suggests COM) contained all of the activities in the TC and
that the benefits of the P+R programme on reading OL programmes but was specially designed to foster
were mediated by gains in phoneme awareness and an integrative approach. The children with reading
letter knowledge (Hulme, in preparation). Thus, it comprehension impairment who took part in this trial
is possible to improve significantly the reading skills were selected by screening about 1000 children in
of children who show poor decoding (dyslexia) by 20 Year 4 classes. In each class, the eight children
systematic training in phoneme awareness, letter–sound with the weakest comprehension skills in the presence
knowledge and reading. of adequate decoding were selected. They were then
allocated randomly to one of four groups, either to
receive one of the interventions or to participate as a
Interventions to promote reading comprehension
waiting list control who would receive the intervention
In many ways, the cognitive profile associated with at the end of the trial.
reading comprehension impairment directly contrasts When designing these programmes, the intention
with that associated with dyslexia. Whereas children was to make the text comprehension (TC) and oral
with dyslexia have pervasive phonological deficits, language (OL) programmes as parallel as possible with
phonological skills are typically normal in poor the former delivered through written language and the
Literacy interventions 31
latter through spoken language. In practice, this is not
feasible because some activities lend themselves very
directly to one modality or the other. Accordingly, the
programmes were similar in that they each contained
four components, but not all of the components were
parallel. Both programmes built upon strategies from the
reciprocal teaching approach whereby children worked
together with their tutor to reflect on their comprehen-
sion of a text and in the discourse aimed to clarify and
summarize their understanding, to generate questions
and to make predictions. In the TC arm this strategy
was used with written texts and in the OL programme
in relation to listening. The two programmes were also
parallel in their inclusion of narrative which was taught Figure 1. Gains in reading comprehension made by children
through writing stories in the TC intervention and receiving the text comprehension (TC), oral language (OL) and
combined (COM) approaches relative to ‘waiting’ controls (on the
through telling stories in the OL intervention. The other Wechsler Individual Achievement Test (WIAT-II) at immediate post-
two components of each intervention differed. In the TC intervention (light bars) and 11 months later (dark bars)).
programme there was work on metacognitive strategies
and inferencing from text, whereas in the oral language
intervention there was explicit teaching of vocabulary
using a multiple context approach (Beck et al. 2002) of the children in the oral language intervention was
as well as activities to promote knowledge of figurative now significantly ahead of that of the children in the
language. The combined programme (COM) included TC and COM arms, indicating that they had made
all eight components with children given opportunities a gain of some 7 standard score points over that of
to learn new vocabulary and idioms and to use inferences controls.
in both written and spoken language (for further details, In summary, for children who reach middle-
see http://www.readingformeaning.co.uk). school age and have specific difficulties with reading
The three different interventions to promote reading comprehension, a number of different approaches
comprehension were delivered by trained teaching appear to be effective. Children showed benefits
assistants in three sessions each week, two involving when following a systematic intervention programme
children working in dyads and one being an individ- delivered through the written modality, incorpo-
ual session. The teaching assistants were supported in rating activities to improve reading comprehension
fortnightly tutorials and they also each received a visit strategies, inferencing skills, and the understand-
during which their teaching was observed and feedback ing of story structure and narrative (TC). Similar
was provided. The children receiving the interventions benefits on reading comprehension can be observed
and the children in the waiting control group were following an oral language intervention that focuses
assessed at pre-intervention (Time 1), 10 weeks later on promoting listening comprehension, vocabulary,
at mid-test (T2), and 10 weeks later at the end of figurative language and oral narrative skills (OL).
the intervention post-test (T3). The children were also Moreover, there are equal benefits of combining the two
followed for 11 months before they were reassessed to approaches. However, in terms of sustained benefits,
investigate maintenance of gains. After this follow-up the oral language approach shows the most promising
testing the children in the waiting list control group results in that the children who received this programme
received a version of the COM programme delivered by continued to forge ahead after the intervention ceased.
the same teaching assistants for 20 weeks. It is intriguing to consider what caused the sustained
Figure 1 shows the gains made in standard score effects of the OL programme on reading comprehen-
points by the children in the three intervention sion after the end of the treatment. A further statistical
conditions compared with progress made by the waiting analysis suggested that gains in vocabulary skill at Time 3
list controls, controlling in each case for baseline partially mediated developments in reading comprehen-
performance. As shown, all three interventions brought sion at Time 4 for children who received the OL
about significant gains in text comprehension after 20 programme. A simple explanation of this finding is that
weeks of training. The average gain in standard scores growth in vocabulary increases an individual’s ability to
was 3 points, which is small but statistically significant. understand not only single words, but also sentences and
Figure 1 also shows the scores of the children when arguably increases resources that are available for making
assessed 11 months later at follow-up. All the gains inferences across the text. An alternative view might be
remained significant, but strikingly the performance that children who receive oral language training become
32 Margaret J. Snowling and Charles Hulme
somehow more engaged with learning and this accounts Table 2. Outline of oral language (OL) sessions (Bowyer-Crane
for the further gains which they made. et al. 2008)
The findings of this intervention trial have a number Group session (30 min) Individual session (20 min)
of theoretical implications. First text-level intervention is Introduction (5 min) Introduction (2 min)
an effective strategy for promoting reading comprehen- New vocabulary multi-sensory Vocabulary revision (5 min)
sion and furthermore, the effect is specific to reading and learning (5 min)
Vocabulary reinforcement (7 min) Narrative task (5 min)
not mathematics. This finding underlines the efficacy of Speaking/listening/inferencing Listening, speaking and
text comprehension approaches and suggests that the (10 min) inferencing (5 min)
inefficient use of reading strategies may be one cause Plenary/best listener (3 min) Plenary (3 min)
of reading comprehension failure. However, perhaps
somewhat counter-intuitively, oral language interven-
tions also impact reading comprehension and their
impact appears to be at least partially mediated by these children on tests of oral language at the end of
vocabulary growth. This finding suggests that oral the intervention and 5 months later, comparing their
language difficulties are a causal risk factor for reading performance with that of children who received the
comprehension impairment and perhaps more specifi- phonology P+R programme.
cally vocabulary deficits may be a critical causal factor. The OL intervention brought about pleasing gains
in children speaking skills. There was evidence that
the children had learned and retained the specific
vocabulary that they had been taught during interven-
Early intervention to promote the foundations of
tion and they now obtained significantly better scores
reading comprehension on tests of expressive grammar than the P+R group.
There are now a number of longitudinal studies that Children’s narrative skills had also improved, though
have followed the progress of children learning to read gains were only marginally significant. It was notable,
and have used retrospective analysis to ascertain the however, that the impact of the intervention on a
characteristics of children who go on to have reading standardized test of expressive vocabulary and on a test
comprehension difficulties (Catts et al. 2008, Nation et of listening comprehension was not significant and
al. 2010). These studies show that problems of reading the programme did not show any transfer to reading
comprehension, and in particular the poor comprehen- comprehension at this early stage in development.
der profile, are predated by impairment in oral language These findings have a number of implications. First, it
skills including vocabulary and grammar. Together with is clearly possible to bring about gains in vocabulary
the results of the intervention described above, these and expressive language skills during the early school
findings suggest that oral language difficulties are a years. However, these gains do not directly transfer
causal risk factor in reading comprehension impairment. to improvements in reading skill (we can infer they
This then is prima facie evidence to support the early might do if they were to incorporate specific work
implementation of programmes that foster oral language on letter, sounds and phonological awareness). It
development in children with such difficulties. More follows that poor language is not a direct cause of poor
generally, such difficulties will impact on a child’s ability decoding ability though poor language is known to
to listen in the classroom and to benefit from the be a risk factor for more general reading difficulties
education which they receive, much of which will be (Snowling et al. 2000). The findings leave open the
delivered initially through the spoken modality and later possibility that oral language training delivered prior
through written and textual materials. to reading instruction within which both emergent
We have already described an early intervention language and literacy skills are brought together could
which we evaluated for children who enter school be a more effective approach (for one example, see
with poorly developed speech and language. It will be http:/www.york.ac.uk/psychology/research/groups/crl/
recalled that these children were randomly allocated research/nuffield-language/).
to receive either the P+R programme or an alterna-
tive treatment. The alternative treatment was an OL
Implications for evidence-based practice
programme and it is to this that we now turn. The
OL programme comprised three main components: The present review has focused on randomized trials
speaking and listening, vocabulary training and narrative evaluating interventions that promote language and
work. It was delivered on a daily basis for 20 weeks literacy for delivery in mainstream school settings.
alternating between small group and individual sessions. Underlying this work is the theoretical assumption that
Further details of the content of the interventions are oral language is the foundation for written language
shown in Table 2. We examined the performance of skills; this tenet, embodied in the ‘Simple View of
Literacy interventions 33
Reading’ (Gough and Tunmer 1986), formed the the recommendations of the report. Our discussion
backdrop to the Rose (2006) review into the teaching of highlights an approach that can be effective for some
reading, which, in turn, led to the implementation of the children, and one which might be delivered by health
phonic curriculum in English schools. Hence, according and education services working together in the interests
to Rose it is important to ensure that ‘best practice for of the child.
beginner readers provides them with a rich curriculum
that fosters all four interdependent strands of language:
Conclusions
speaking, listening, reading and writing’ (p. 16). An
obvious question that follows on from this assertion is Language and phonological skills are the foundations
really the nub of the present review: What therefore of literacy development. Intervention programmes
should be done for the child who comes to the task of targeted to improve phonological skills and letter
reading with poorly developed oral language skills? More knowledge in at-risk children can be effective in
contentious perhaps: What are the roles of the different promoting decoding skills during the early years and
(health and education) professionals involved with these also in poor readers at later stages of development. At
children? present there is good evidence that early intervention for
From the perspective of research our view is straight- oral language development can have positive effects, but
forward. If a child is poorly prepared to learn to as yet the evidence that such programmes affect longer-
read and/or is experiencing reading difficulties, an term reading outcomes is lacking. Notwithstanding this,
integrated approach is vital. It may not matter who children who have poor reading comprehension in the
delivers an intervention; what matters more is that middle-school years can benefit from targeted interven-
an evidenced-based intervention is chosen that fits the tion programmes that promote either text comprehen-
child’s additional needs and that the person delivering sion or oral language skills.
it is properly trained and supported. In the indepen- This review has distinguished reading disorders
dent review of ways to support children with dyslexia that affect decoding from reading disorders that affect
and other literacy difficulties Rose (2009) argued for a comprehension. Arguably, however, this is a false
‘3 waves’ approach. Some of the points made in this dichotomy and in any school population the children
review are critical to the current discussion. Thus, if who have pure decoding or pure comprehension difficul-
children are being taught using a systematic phonics ties will be small relative to those who have more general
approach, delivered within a language-rich curriculum reading problems. In short, neither dyslexia nor reading
(Wave 1), then teachers will be well positioned to comprehension impairment is a diagnostic entity with
identify early a child who is progressing more slowly clear-cut boundaries (Rose 2009, Snowling 2009). It
than his or her peers. For such a child, the first step follows that targeted interventions need to focus on
is to differentiate the curriculum within Wave 1. For the dimensions that underpin disorders and in this
children who need to ‘catch up’, a Wave 2 programme endeavour both education and speech and language
can be implemented, while a more individualized therapy have key roles to play.
approach may be appropriate for those more severely
affected. Acknowledgements
Within this framework there are promising findings:
there is good evidence that teachers can rate the progres- This review is based on the International Journal of Disorders of
Language and Communication Annual Lecture 2010 given by Maggie
sion of their pupils in phonics accurately, and that the Snowling. The research described here was funded by the Economic
children they judge to be progressing poorly show many and Social Research Council, the Nuffield Foundation, and North
of the characteristics of children with dyslexia (Snowling Yorkshire Local Authority. Preparation of the review was supported
et al. 2011). As discussed above, our group has provided by Wellcome Programme Grant Number 082036/2/07/Z. Declara-
evidence of some effective catch-up programmes (for tion of interest: The authors report no conflicts of interest. The
authors are responsible for the content and writing of the review.
other examples, see Brooks 2007, and Duff and Clarke
2011).
However, why wait for failure? Indeed, Allen (2011) References
places early intervention before children fail at the heart ALLEN, G., 2011, Early Intervention—The Next Steps. 2011 (available
of the political agenda, reinforcing a view that we share. at: http://www.dwp.gov.uk/docs/early-intervention-next-
Put simply, it is important to foster the development of steps.pdf).
oral language skills as a foundation for literacy develop- American Psychiatric Association, 1994, DSM IV Diagnostic and
ment. Moreover, although Allen advocates ‘greater use Statistical Manual, 4th edn (Washington, DC: American
Psychiatric Association).
of evidence based programs . . . and early intervention BECK, I. L., MCKEOWN, M. G. and KUCAN, L., 2002, Bringing
strategies that are proven to work’ (p. 67), not a single Words to Life: Robust Vocabulary Instruction (New York, NY:
oral language intervention programme is listed within Guildford).
34 Margaret J. Snowling and Charles Hulme
BISHOP, D. V. M. and SNOWLING, M. J., 2004, Developmental JOFFE, V. L., CAIN, K. and MARIC, N., 2007, Comprehension
dyslexia and specific language impairment: same or different? problems in children with specific language impairment:
Psychological Bulletin, 130, 858–888. does mental imagery training help? International Journal of
BOWYER-CRANE, C., SNOWLING, M. J., DUFF, F., CARROLL, J. Language and Communication Disorders, 42, 648–664.
M., FIELDSEND, E., MILES, J., et al., 2008, Improving KAVANAGH, J. F. and MATTINGLEY, I. G. (eds), 1972, Language by
early language and literacy skills: differential effects of an Ear and by Eye: The Relationships between Speech and Reading
oral language versus a phonology with reading intervention. (Cambridge, MA: MIT Press).
Journal of Child Psychology and Psychiatry, 49, 422–432. LUNDBERG, I., 1994, Reading difficulties can be predicted and
BRADLEY, L. and BRYANT, P. E., 1983, Categorising sounds and prevented: a Scandinavian perspective on phonological
learning to read—a causal connection. Nature, 301, 419– awareness and reading. In C. Hulme and M. J. Snowling
521. (eds), Reading Development and Dyslexia (London: Whurr),
BROOKS, G., 2007, What Works for Children with Literacy Difficul- pp. 180–199.
ties? The Effectiveness of Intervention Schemes (London: NATION, K., 2005, Children’s reading comprehension difficulties. In
Department for Education and Skills) (available at: M. J. Snowing and C. Hulme (eds), The Science of Reading: A
http://www.dfes.gov.uk/research). Handbook (Oxford: Blackwell), pp. 248–266.
CAIN, K., 2010, Reading Development and Difficulties (Oxford: NATION, K., COCKSEY, J., TAYLOR, J. S. H. and BISHOP, D. V.
Wiley-Blackwell). M., 2010, A longitudinal investigation of early reading and
CAIN, K., OAKHILL, J. and BRYANT, P., 2000, Investigating the causes language skills in children with poor reading comprehension.
of reading comprehension failure: the comprehension–age Journal of Child Psychology and Psychiatry, 51(9), 1031–1039.
match design. Reading and Writing, 12(1–2), 31–40. OAKHILL, J., 1984, Inferential and memory skills in children’s
CARROLL, J. M., BOWYER-CRANE, C., DUFF, F., HULME, C. and comprehension of stories. British Journal of Educational
SNOWLING, M. J., 2011, Effective Intervention for Language Psychology, 54, 31–39.
and Literacy in the Early Years (Oxford: Wiley-Blackwell). OAKHILL, J. and PATEL, S., 1991, Can imagery training help children
CATTS, H. W., BRIDGES, M. S., LITTLE, T. D. and TOMBLIN, J. B., who have comprehension problems? Journal of Research in
2008, Reading achievement growth in children with language Reading, 14, 106–115.
impairments. Journal of Speech and Hearing Research, 51, ROSE, J., 2006, Independent Review of the Teaching of Early Reading
1569–1579. (London: DFES-0201-2006) (available at: https://www.
CLARKE, P. J., SNOWLING, M. J., TRUELOVE, E. and HULME, C., 2010, education.gov.uk/publications/standard/publicationDetail/
Ameliorating children’s reading comprehension difficulties: a Page1/DFES-0201-2006).
randomised controlled trial. Psychological Science, 21, 1106– ROSE, J., 2009, Identifying and Teaching Children and Young
1116. People with Dyslexia and Literacy Difficulties (London:
CLAY, M., 1985, The Early Detection of Reading Difficulties, 3rd edn DCSF-00659-2009) (available at: https://www.education.
(Tadworth: Heinemann). gov.uk/publications/standard/publicationDetail/Page1/DFES-
DUFF, F. J. and CLARKE, P. J., 2011, Practitioner Review: reading 0201-2006).
disorders: what are the effective interventions and how should SNOWLING, M. J., 2009, Changing concepts of dyslexia: nature,
they be implemented and evaluated? Journal of Child Psychol- treatment and co-morbidity. Journal of Child Psychology
ogy and Psychiatry, 52(1), 3–12. and Psychiatry Virtual Issue on-line, November (available at:
GOUGH, P. B. and TUMNER, W. E., 1986, Decoding, reading http://www.wiley.com/bw/vi.asp?ref=0021-9630&site=1).
and reading disability. Remedial and Special Education, 7, SNOWLING, M. J., BISHOP, D. V. M. and STOTHARD, S. E., 2000,
6–10. Is pre-school language impairment a risk factor for dyslexia
HATCHER, P., 2006, Phonological awareness and reading interven- in adolescence? Journal of Child Psychology and Psychiatry, 41,
tion. In M. J. Snowling and J. Stackhouse (eds), Dyslexia, 587–600.
Speech and Language: A Practitioner’s Handbook, 2nd edn SNOWLING, M. J., DUFF, F., PETROU, A., SCHIFFELDRIN, J. and
(London: Whurr), pp. 167–197. BAILEY, A. M., 2011, Identification of children at risk of
HATCHER, P. J., GOETZ, K., SNOWLING, M. J., HULME, C., GIBBS, dyslexia: the validity of teacher judgements using ‘phonic
S. and SMITH, G., 2006a, Evidence for the effectiveness of phases’. Journal of Research in Reading, 34(2), 157–170.
the Early Literacy Support Programme. British Journal of SNOWLING, M. J. and HULME, C., 2011, Evidence-based interven-
Educational Psychology, 73, 351–367. tions for reading and language difficulties: creating a virtuous
HATCHER, P. J., HULME, C. and ELLIS, A. W., 1994, Ameliorating circle. British Journal of Educational Psychology, 81(1), 1–23.
early reading failure by integrating the teaching of reading TORGESEN, J., 2005, Recent discoveries on remedial interventions for
and phonological skills: the phonological linkage hypothesis. children with dyslexia. In M. J. Snowing and C. Hulme (eds),
Child Development, 65, 41–57. The Science of Reading (Oxford: Blackwell), pp. 521–537.
HATCHER, P. J., HULME, C., MILES, J. N. V., CARROLL, J. M., VELLUTINO, F. R., FLETCHER, J. M., SNOWLING, M. J. and SCANLON,
HATCHER, J., GIBBS, S., et al., 2006b, Efficacy of small group D. M., 2004, Specific reading disability (dyslexia): what have
reading intervention for beginning readers with reading- we learned in the past four decades? Journal of Child Psychology
delay: a randomized controlled trial. Journal of Child Psychol- and Psychiatry, 45(1), 2–40.
ogy and Psychiatry, 47, 820–827. YUILL, N. and JOSCELYNE, T., 1988, Effect of organisational cues
HATCHER, P. J., HULME, C. and SNOWLING, M. J., 2004, Explicit and strategies on good and poor comprehenders’ story
phoneme training combined with phonic reading instruction understanding. Journal of Educational Psychology, 80, 152–
helps young children at risk of reading failure. Journal of Child 158.
Psychology and Psychiatry, 45(2), 338–358. YUILL, N. and OAKHILL, J., 1988, Effects of inference training on
HULME, C. and SNOWLING, M. J., 2009, Developmental Disorders of poor reading comprehension. Applied Cognitive Psychology, 2,
Language, Learning and Cognition (Oxford: Wiley-Blackwell). 33–45.