“I wish…I think…I wonder…”: Improving parents’ shared book readings

Shared book reading can be a sweet moment between parent and child—while also serving to improve a child’s literacy skills. The trick is figuring out how to help parents make the most of these interactions. This pilot study examined the effects of a short training on parent–child storybook readings. While this study focused on Deaf/Hard-of-Hearing preschoolers, most outcomes focused on the changes in the parents’ skills—meaning you can apply this across many populations.

Researchers recorded multiple shared book readings at each of three stages in the experiment: before training parents, in the “intervention period” (the two weeks following the parent training), and eight weeks after training. The training was only twenty minutes long (very do-able for real world clinicians!) and included a very short power point, a two-minute video model, and discussion with the parents. The authors focused on these topics for parent training:

  • Switching mindset from “education” to gaining insight into the child’s thoughts

  • No such thing as right or wrong

  • Increasing use of wait time

  • Increasing conversational turns

  • Making phonemic awareness fun and silly (like making up nonsense words by taking words in the text and changing one phoneme)

  • Using open ended prompts: “I wish…”  “I think…” “I wonder…” “What do you think?”

Parents were also given two booklets from the National Institute for Literacy and a few wordless picture books to add to their home collection.

When measuring parent interaction types, the authors split prompts into two categories:

Open-Ended Prompts

Questions that encourage open-ended discussion: “What do you think…

Indirect prompts such as “I think…” or “I hope…” paired with wait time

Closed-Ended or Right/Wrong Prompts

WH questions about the story text: “What is that?” “Where is her bone?

Questions about the story text that encourage one word answers

Yes/no questions or “how many” questions

For only spending twenty minutes on parent training, researchers saw some encouraging changes! Both the total number of parent–child exchanges and the percentage of open-ended prompts increased from baseline, through the intervention and retention stages. The percentage of words spoken by the child was also higher in the intervention and retention stages (though only the intervention stage showed a statistically significant difference from baseline levels). Because a dip was shown in all outcomes during the retention stage, eight weeks after training, it looks like clinicians will probably need to follow-up with parents periodically.

For more along these lines, check out our reviews about supporting parents to complete literacy programs, teaching vocabulary via shared readings, and improving the narrative comprehension of children with ASD.

Nelson, L. H., Stoddard, S. M., Fryer, S. L., & Muñoz, K. (2019). Increasing Engagement of Children Who Are DHH During Parent–Child Storybook Reading. Communication Disorders Quarterly. doi:10.1177/1525740118819662

Collaboration for the win!


This study looked at the effect of interactive storybook reading (ISR) on the vocabulary skills of six preschoolers who are deaf or hard of hearing. They found that students were able to describe vocabulary words accurately after three weeks of intervention (four days per week, 15 minutes per day), and generalized their ability to describe vocabulary words to pictures that had not been presented during ISR. However, this study has some meaningful limitations—so why bring it to your attention?

Two big reasons. First, the article includes TONS of details on how to implement the intervention. Do you need a review on dialogic reading and interactive storybook reading? How about a refresher on why ISR is effective for students who are DHH? Would you like a description of the types of questions to ask during ISR? Materials and examples? How and when to get baseline, generalization, and maintenance measures? Check out the article!

Second, this study was a collaborative effort. Researcher and clinician (in this case, a TODHH) worked together to design and implement a study to see if this kind of intervention was feasible, ecologically valid, and effective in the classroom setting. And the intervention was actually adjusted to include word-meaning instruction, based on the TODHH’s recommendation. Involving clinicians in the research process offers a good chance that the interventions being studied will actually be used. We want to see more collaborations like this!


Trussell, J. W., Hasko, J., Kane, J., Amari, B., & Brusehaber, A. (2018). Interactive storybook reading instruction for preschoolers who are deaf and hard of hearing: A multiple probe across behaviors analysis. Language, Speech, and Hearing Services in Schools. Advance online publication. doi:10.1044/2018_LSHSS-17-0085

Closing the gap in reading and writing skills of preschoolers with hearing loss


This study compared 19 preschoolers with hearing loss (who used amplification and spoken language) to 14 hearing preschoolers, with the goal of measuring “…change across a 6-month period in emergent literacy skills…”.

The researchers identified a myriad of language, phonological, and print knowledge skill gaps for the preschoolers with hearing loss compared to hearing peers (exception: letter name/sound knowledge… yay alphabet time). However, the growth rate of these skills was similar between groups (e.g. morphosyntax and vocabulary grew at the same rate for both groups). The authors state, “Although children with hearing loss generally demonstrated positive change in emergent literacy skills, their initial performance was lower than that of children with normal hearing, and rates of change were not sufficient to catch up to their peers over time.” Note also that all the kids with hearing loss were receiving speech­–language services—meaning, out business-as-usual may not quite be enough to close the literacy gap for children with hearing loss.

Importantly, this study shows us which of the skills are most likely to be problematic in preschoolers with hearing loss— that is, phonological awareness and print concepts (as tested in the Preschool Print and Word Awareness Test). The authors suggest, “Treatment plans should be developed with these particular difficulties in mind, devoting sufficient resources to scaffold these skills in particular.” And this statement is based on not only their study results, but previous studies as well (see article for review). Nonetheless, this isn’t a treatment study. And we definitely need more treatment studies in order to truly guide us in what needs done for preschoolers with hearing loss in order to efficiently close the literacy gap.

Werfel, K.L. (2017). Emergent Literacy Skills in Preschool Children With Hearing Loss Who Use Spoken Language: Initial Findings From the Early Language and Literacy Acquisition (ELLA) Study. Language, Speech, and Hearing Services in Schools, 48, 249–259.

Early language predicts later language in CI users

Castellanos et al. provide a longitudinal study on cochlear implant (CI) users > seven years post-implantation. Most of their test subjects were implanted as toddlers. Using the MacArthur–Bates Communicative Development Inventories (CDI), they found that “expressive language skills obtained in early toddlerhood are clinically meaningful and strongly predictive of long-term language and executive functioning outcomes in school-age and young adult CI users.” There are implications for use of the CDI as a screening tool. The background of this article is particularly interesting; the authors discuss the impact of early auditory deprivation on not just speech–language skills but executive functions as well.

See: Castellanos, I., Pisoni, D.B., Kronenberger, W.G., & Beer, J. (2016). Early expressive language skills predict long-term neurocognitive outcomes in cochlear implant users: evidence from the MacArthur–Bates Communicative Development Inventories. American Journal of Speech-Language Pathology. Advance online publication. doi:10.1044/2016_AJSLP-15-0023.

Morphological instruction for children who are deaf or hearing impaired

If you have students on your caseload who are deaf or hearing impaired (DHH) and demonstrating difficulties with morphology in reading comprehension, expressive language, and/or spelling, see this systematic review. This article identifies 13 papers all on morphological skills and/or instruction for the DHH population (kids ages 3–21 years). For SLPs, it's nice to have resources with all the current available evidence on one topic in one paper. Overall, the authors found that “explicit morphological or morphographic instruction may be a potentially positive practice, along with morphology instruction implemented using signed communication, particularly fingerspelling."
From the reviewed articles, “... all of the research teams recommended that students who are DHH would benefit from morphological or morphographic instruction.” The intervention studies targeted both derivational morphology (e.g. adding the noun-to-adjective suffix -al to the ends of words like dismissal) and inflectional morphology (e.g. work/works/working). One study paired morphological training with phonological training, resulting in greater benefits to speech perception and grammar skills, compared to either training alone. 

See: Trussell, J.W., Easterbrooks, S.R. (2016). Morphological Knowledge and Students Who Are Deaf or Hard-of-Hearing. Communication Disorders Quarterly. doi: 10.1177/1525740116644889