And more...

Chester et al. enrolled school-aged children with ASD in group social skills training that included play (unstructured or semi-structured) for 8 weeks. They found that participants gained social skills (as rated by parents, teachers, and the children themselves) compared to waiting controls.  

Conlon et al. looked at narratives (via the ERNNI) produced by 8-year-old boys and girls with ASD and average nonverbal intelligence. While we know that children with ASD often struggle with narratives in general, there may be important gender-related differences. This study found that girls’ stories were more complete, included more information about characters’ intentions, and were easier to follow (i.e. they had better referencing).

Joseph used word boxes (a low-tech method using drawn rectangles and letter tiles) to teach sound segmentation, word identification, and spelling skills to three third graders with autism, and found that all children improved on sound segmentation and word ID and two children improved on spelling. 

Montallana et al. studied inter-rater reliability of the VB-MAPP Milestones and Barriers assessments. The VB-MAPP is commonly used to assess and plan intervention for children with ASD, but we haven’t known much about its psychometrics. While the milestones section had largely moderate to good reliability, agreement between raters on barriers was poor to moderate.  

Thirumanickam et al. found that a video-based modeling intervention was effective in increasing conversational turn-taking in a small number of adolescents with ASD who used AAC—BUT, only when provided with additional instruction (least-to-most prompting). They stated that for students with ASD, some level of prompting is likely required to engage in video-based interventions.


Chester, M., Richdale, A. L., & McGillivray, J. (2019). Group-Based Social Skills Training with Play for Children on the Autism Spectrum. Journal of Autism and Developmental Disorders. Advance online publication. doi:10.1007/s10803-019-03892-7

Conlon, O., Volden, J., Smith, I. M., Duku, E., Zwaigenbaum, L., Waddell, C., … Pathways in ASD Study Team. (2019). Gender Differences in Pragmatic Communication in School-Aged Children with Autism Spectrum Disorder (ASD). Journal of Autism and Developmental Disorders. Advance online publication. doi:10.1007/s10803-018-03873-2

Joseph, L. M. (2018). Effects of word boxes on phoneme segmentation, word identification, and spelling for a sample of children with autism. Child Language Teaching and Therapy34(3), 303–317.

Montallana, K. L., Gard, B. M., Lotfizadeh, A. D., & Poling, A. (2019). Inter-Rater Agreement for the Milestones and Barriers Assessments of the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). Journal of Autism and Developmental Disorders. Advance online publication. doi:10.1007/s10803-019-03879-4

Thirumanickam, A., Raghavendra, P., McMillan, J. M., & van Steenbrugge, W. (2018). Effectiveness of video-based modelling to facilitate conversational turn taking of adolescents with autism spectrum disorder who use AAC. Augmentative and Alternative Communication, 34(4), 311–322.

Throwback (2017): A 2-in-1 intervention for reading and vocabulary

So many words in English are spelled irregularly and don’t follow the rules for how they should be sounded out. These are usually taught as “sight words,” but that’s A LOT of memorizing for our clients to do. To give us a hand in teaching irregular words, Dyson et al. tested a treatment based on a theory of reading that says children trying to recall a word’s pronunciation (phonology) can get help from knowing how it is spelled (orthography) or what it means (semantics).  


The researchers recruited 5–to 7-year-olds whose teachers reported that they struggled with reading. During 20-minute, twice weekly, small-group sessions, children listened to a puppet say an irregular word (e.g., mystery, referee, piano) incorrectly and tried to figure out what it should have said. Then, they listened to definitions of the words and completed a writing worksheet so they could get more practice with spelling them (examples in Appendix B).

After just 8 weeks of treatment, children improved significantly over the control group on: (1) accuracy reading the taught words, (2) accuracy reading a list of similar, untaught words, (3) vocabulary knowledge for taught words, AND (4) vocabulary knowledge for untaught words. If your students struggle with reading irregular words, this treatment might be a great way to target multiple skills at once.


Dyson, H., Best, W., Solity, J., & Hulme, C. (2017). Training mispronunciation correction and word meanings improves children’s ability to learn to read words. Scientific Studies of Reading, 21(5), 392-407. doi:10.1080/10888438.2017.1315424

Early speech and language disorders affect later spelling

SLPs are well-aware that speech, language, and literacy are all interconnected, but we’re also aware that they’re not necessarily interconnected in a nice, clear, easy-to-understand way. This study helped to sharpen our vision on whether we should expect later spelling difficulty in children with early speech and language disorders.

First, a quick refresher. There are a couple of skills kids need in order to have good spelling skills. One is phonological awareness. The other is RAN, or rapid automatized naming (e.g., naming a set of colors or animals as fast as possible). While RAN is usually studied in the context of reading, it can also affect spelling, and can predict spelling difficulty in children, especially for irregular words (see here for more on RAN and spelling).  In addition to the skills associated with spelling, there is also a genetic factor: spelling difficulty (and reading, learning, language, etc.) can run in families. On top of all of that, we know from existing research and clinical experience that children with speech sound and language disorders are at risk for later reading and spelling impairments.  

The authors tested participants from a large longitudinal study to explore how these factors contribute to spelling ability in middle- and high-school students. Children who were tested between 4- and 6-years of age were split into groups* based on diagnosis:

  • No SSD/DLD

  • SSD only

  • SSD + DLD

  • CAS (these children also all had DLD)

All children were assessed again at middle school or high school age on phonological awareness, RAN, reading decoding, and spelling. Interestingly, the results indicated that having SSD alone was not associated with spelling difficulty in later school years, but children with SSD + DLD and children with CAS (who also met criteria for DLD) showed continued spelling difficulty into middle- and high-school. Taking a closer look at the underlying skills needed for spelling, phonological awareness was related to spelling scores at middle- and high-school, but RAN was only related to spelling scores in the high school group.


The authors also looked at heritability of spelling skills. Heritability looks at the probability that differences in a trait (in this case, spelling) occur because of genetic reasons and not because of environmental factors or by chance. Controlling for diagnosis and socio-economic status, the authors found strong heritability only in the high school group, meaning that genetic factors are probably more important in later spelling skills while environmental factors are more at play in the earlier years. Based on the results of the study, authors suggest we should keep a close eye on children with early SSD and DLD and intervene for those students who are showing early signs of spelling and reading difficulty.

*SSD = speech sound disorder; DLD = developmental language disorder; CAS = childhood apraxia of speech)


Lewis, B. A., Freebairn, L., Tag, J., Benchek, P., Morris, N. J., Iyengar, S. K., …, & Stein, C., M. (2018). Heritability and longitudinal outcomes of spelling skills in individuals with histories of early speech and language disorders. Learning and Individual Differences. Advance online publication. doi: 10.1016/j.lindif.2018.05.001

Perspectives & Tutorials

Beyond Social Skills: Supporting Peer Relationships and Friendships for School-Aged Children with Autism Spectrum Disorder

Clinical Implications for Working with Nonmainstream Dialect Speakers: A Focus on Two Filipino Kindergarteners

This clinical focus piece is a useful resource on the features of Phillipine English, a variety of English spoken by many Filipinos and influenced by Tagalog (with English, the other official language of the Philippines). The authors discuss two case studies and give some general recommendations for working with nonmainstream dialect speakers, so it’s worth a look even if you don’t have any current clients from this background.

Ending the Reading Wars: Reading Acquisition From Novice to Expert

This is a really good paper. No extra description needed… just go check it out! And it’s open-access (party, party!)

Illustrating a Supports-Based Approach Toward Friendship with Autistic Students

Individual differences in children’s pragmatic ability: A review of associations with formal language, social cognition, and executive functions

A Multilinguistic Approach to Evaluating Student Spelling in Writing Samples

A lot of SLPs don’t feel confident addressing our kiddos’ writing and spelling needs. But… yeah—we need to go there. This clinical focus piece describes a system for assessing spelling that capitalizes on our skills analyzing spoken language samples to classify subtypes of spelling errors that are either phonological, orthographic, or morphological in nature. The informal method they describe would be useful for describing skills, setting goals, and tracking progress.

The Place of Morphology in Learning to Read in English

Promoting Conditional Use of Communication Skills for Learners with Complex Communication Needs: A Tutorial

Stepping Stones to Switch Access

Feel clueless when working with switch users? Get stuck in “cause-and-effect” land? In this piece from ASHA’s SIG 12, switch-access expert Linda Burkhart lays out a progression of switch skills and possible target activities from the very earliest stages of learning (I hit a button and a thing happens!) all the way to building automaticity with two-switch scanning. This is one to keep handy if you have clients with complex communication needs.

Going beyond best practice with at-risk readers

I think we can all agree that there’s a lot of research out there aimed at improving literacy outcomes for at-risk readers, and that the use of evidence-based practices is crucial to literacy success. But what about those students who still struggle to read, despite our use of evidence-based practices?  How do we get to those students?

The authors of this study looked at the evidence, identified the most effective current practices, and designed a new theory-driven intervention package to improve reading outcomes for those at-risk poor readers. They compared their Direct Mapping and Set-for-Variability Intervention (DMSfV for short) to a Current or Best Practices (CBP) approach with a big group of first graders with low word-reading scores. Interventions were delivered in small groups outside of the classroom for 30 minutes, 3 times a week for 10 weeks.

The CBP approach included typical phonics strategies (like blending and segmenting phonemes), along with teaching sight words and doing shared book reading.

The DMSfV included three components:

  1. Direct mapping: Teaching grapheme–phoneme correspondences, and then, critically, applying them by linking to texts, e.g., learning /sh/ and then reading a book with lots of /sh/ words
  2. Vowel digraphs: Teaching the various ways to pronounce vowel sequences and the rules associated with them, like how when vowels are paired together, the first one is usually long and the other is silent, as in “boat”
  3. Set-for-variability strategies: Teaching the students strategies to read “exception” words (those with spelling-sound inconsistencies), and how vowels and vowel digraphs can be pronounced differently (“ou” in touch versus soul)

A key goal of the DMSfV* intervention was to teach the skills necessary to read words even when they broke standard phonic rules.


So, which intervention was more effective?

Immediately after the intervention, the DMSfV group performed significantly better on word reading and spelling measures. Five months later, they performed significantly better on word reading and sentence comprehension tasks. Despite this success, though, half of the children still remained relatively weak word readers and needed ongoing support—there’s no magic solution here. The takeaway? It seems that some struggling students will benefit from stepping outside of the box of current practices, even when those practices are generally effective. There is more than one evidence-based way to teach reading, and some students will benefit differently from different approaches.

If this study calls out to you, check out the full article (and don’t miss the Appendix!). The authors have included a lot of detail about the intervention procedures and materials, including the specific story books used and the frequency of specific phonemes/vowel digraphs in each story. If you’re working on vowels with a student, this list might be valuable!

*“Dims fuv”? We like our acronyms pronounceable!

Savage, R., Georgiou, G., Parrila, R., & Maiorino, K. (2018). Preventative reading interventions teaching direct mapping of graphemes in texts and Set-for-Variability aid at-risk learners. Scientific Studies of Reading, 22, 225–247. doi:10.1080/10888438.2018.1427753.

The roles of spelling exposure and print referencing in vocabulary instruction

This article begins with a literature review that differentiates simply exposing a child to the spelling of a word in print from explicitly referencing that spelling in print, referred to as print referencing. When using print referencing, the researchers prompted students to point to the target word in print. The goals of the study were to 1) determine the effect of spelling exposure on learning pronunciations and meanings of vocabulary words, 2) compare the effects of spelling exposure and print referencing on vocabulary word learning, and 3) compare the vocabulary word learning of advanced and less advanced readers.


The 45 first-grade participants in the study all had knowledge of 18 or more letter–sound combinations. Students were split into two groups: one group received spelling exposure intervention only and the other received spelling exposure plus print referencing intervention. Students in the spelling exposure only group 1) saw the picture + word card, 2) were told the pronunciation/meaning of the word, and 3) repeated the pronunciation/meaning. For the print referencing group, researchers additionally drew students’ attention to the spelling on the card by prompting students to point to it. Note that cards without any printed word at all were also compared.


  • Spelling being included on the picture cards supported word pronunciation (even 14 days later!)
  • Print exposure alone was sufficient to support learning word meanings (print referencing didn’t help… nor did print referencing help pronunciations).

Although print referencing did not have a significant effect on vocabulary word learning, the study suggests that spelling exposure facilitates first graders’ learning of word pronunciations—and remembering these pronunciations—which the authors note is more challenging than learning word meanings. The study’s results support prior findings in similar research with second and fifth graders.

Chambre, S. J., Ehri, L. C., & Ness, M. (2017). Orthographic facilitation of first graders’ vocabulary learning: does directing attention to print enhance the effect? Reading and Writing, 30(5), 1137–1156.

Writing and spelling as essential components of successful language and literacy—what’s our role, here?

Some school-based SLPs, as soon as they see the words “writing” or “spelling” immediately push the topic aside. “Not my job,” they may say. However, the written modality of language matters. It’s not just about phonemic, phonological, and semantic awareness. Orthographic and morphological awareness (tied to both written and spoken language), are crucial components of good language and literacy skills as well.

Now, before we move on to the newly-published studies, it’s important to set the stage by getting everyone on board with caring about writing and spelling. First, I’d highly recommend this tutorial. It explains the rationale behind morphological awareness instruction and lays out how to do it. Apel & Werfel (2014) state:

“In the 1970s, phonological awareness, the ability to analyze the sound structure of words (Mattingly, 1972), emerged as a major topic in reading research. By the 1980s, studies evaluating the effects of explicit teaching of phonological awareness on reading achievement in the preschool and early elementary school years abounded (e.g., Bus, 1986; Lundberg, Frost, & Petersen, 1988; Olofsson & Lundberg, 1983; Treiman & Baron, 1983; Williams, 1980)... Bus and van Ijzendoorn (1999), however, warned that although it is clear that phonemic awareness training results in increased reading skills, we should not conclude that phonemic awareness is the single most important factor in literacy achievement…”

If you’re looking for more resources on the links between spelling, language, and literacy, this and this are excellent resources, too. Now, onto the recent research:

  • Good et al. provide a tutorial on spelling instruction for children with language impairment. They lay out an explicit 10-week program, with lessons the SLP may provide twice weekly.
  • McNeill et al. provide some early evidence that young children with inconsistent speech sound disorder (“40% or more inconsistent speech errors”, but not apraxia of speech) have particular difficulty with spelling, despite their language and reading skills.
  • McMaster et al. examined the current literature base to determine the impact of early writing intervention, as well as which writing interventions have the best evidence to support them. They found that improvement to handwriting and spelling result in increases in quantity and linguistic quality of student writing. This article, itself, doesn’t describe actions SLPs may take in the therapy room. Instead, it points you toward evidence-based options, such as “Self-Regulated Strategy Development” as a writing intervention for children with low reading and language skills (learn more about SRSD from resources like this and this.)
  • Pavelko et al. demonstrate that the writing skills of four-year-old children with language disorders (with typical cognitive skills and without other neurological disorders) are below what would be expected. They suggest that SLPs work closely with teachers and OTs to support writing as an essential early literacy skill in these children.

Now, all this information can feel really overwhelming, really quickly, for the SLP who isn't already considering writing in therapy. It’s important to recognize that supporting students in written language is the responsibility of several integral professionals—SLPs, OTs, and teachers. SLPs certainly cannot tackle it alone effectively.

So, where should the SLP start?

  1. Recognize that you’re not fully supporting literacy development if you’re not considering written language, in addition to oral language.
  2. Again, I’d go back to the Apel & Werfel (2014) tutorial for examples of instructional techniques that you can start incorporating right away. They state, “By integrating morphological awareness instruction into the services they provide, clinical scientists (aka SLPs) and other educators will be providing their students with a strong tool to aid written language skills.” The other good option would be the Good et al. (2017) article. These two articles have, by far, the most explicit examples of what an SLP may do. 

Apel, K., & Werfel, K. (2014). Using morphological awareness instruction to improve written language skills. Language, Speech, and Hearing Services in Schools, 45, 251–260.

Ehri, L.C., & Rosenthal, J. (2017). Spellings of Words: A Neglected Facilitator of Vocabulary Learning. Journal of Literacy Research, 39(4), 389–409.

Good, J.E., Lance, D.M., & Rainey, J. (2017). The use of direct spelling instruction for children with language impairment. Communication Disorders Quarterly. Advance online publication. doi: 10.1177/1525740117702455.

McMaster, K.L., Kunkel, A., Shin, J., Jung, P.-G., & Lembke, E. (2017). Early writing intervention: a best evidence synthesis. Journal of Learning Disabilities. Advance online publication: 10.1177/0022219417708169.

McNeill, B.C., Wolter, J., & Gillon, G.T. (2017). A comparison of the metalinguistic performance and spelling development of children with inconsistent speech sound disorder and their age-matched and reading-matched peers. American Journal of Speech­–Language Pathology, 26, 456-468.

Pavelko, S.L., Lieberman, R.J., Schwartz, J., Hahs-Vaughn, D., & Nye, C. (2017). The development of writing skills in 4-year-old children with and without specific language impairment. Clinical Linguistics and Phonetics. Advance online publication. doi: 10.1080/02699206.2017.1310298.

Does multisensory instruction support reading?

Reading programs generally feature many components, any of which could contribute to teaching literacy skills.

The Orton-Gillingham approach (upon which several popular reading programs are based) is highly structured, and emphasizes the crucial role of language in literacy instruction. It also often includes a multisensory component, which is the purposeful addition of various auditory, visual, and tactile cues to aid learning.
The purpose of this study was to examine whether that “multisensory” component supports literacy instruction. Over a six- to seven-week period, eleven 2nd grade students (half with dyslexia, half without) were taught, “letter name, sound production, word reading, and word spelling,” using a small set of non-English letters and sounds. Participants served as their own controls, participating in each a “structured language” condition, and a similar condition with additional “multisensory” components. The two intervention conditions were, “…adapted from Orton-Gillingham-based programs and followed a systematic sequential structured language approach.” They differed only in inclusion of multisensory features. These multisensory features included students:

  • watching themselves produce sounds in the mirror
  • skywriting letters with full-body gross motor movement
  • manipulating 3D plastic letters
  • using sequential finger tapping to mark phonemes while blending
  • finger-writing letters on various surfaces (e.g. carpet square, tray of sand)

The authors found that, “…both structured language and multisensory instruction had a positive treatment effect for participants,” but, “…there did not appear to be an overall advantage for either intervention.” The authors state that, “Lack of overall multisensory advantage suggested overall positive effects for both interventions were likely not due to the simultaneous multisensory input but to the embedded Orton-Gillingham structured language components common to both reading interventions…”
Schlesinger, N.W., & Gray, S. (2017). The impact of multisensory instruction on learning letter names and sounds, word reading, and spelling. Annals of Dyslexia. Advance online publication. doi: 10.1007/s11881-017-0140-z.

*NEW*: Check out these perspective pieces!

Recall that The Informed SLP provides you with monthly reviews of empirical research (obviously... you're reading it right now!) This includes both quantitative and qualitative studies, levels 1a–3 (per ASHA). 

What hasn’t been covered to-date, however, are “Opinion” or “Perspective Pieces”Why doesn’t TISLP review perspective pieces? A few reasons: 1) they’re considered a lower level of evidence, 2) they tend to cover many points, referencing many different studies, rather than providing *a* new piece of evidence, which makes them tough to review in the TISLP style of brevity, and 3) these articles tend to be more readable by clinicians, so there's simply less need for a TISLP review. 

However! We're about to switch things up and, at least start TELLING you about these.
The thing is, if you're not reading these perspective pieces, you're really missing out. Many of them provide fantastic information for clinicians. So, as of January 2017, we've been collecting perspective pieces so that once every three months (or more often, if a bunch were published), we can provide you with links to the relevant ones. So—here ya go! January–March: