13 Intellectual Disability and Developmental Disability

Paula Lombardi

Intellectual Disability and Developmental Disability

Intellectual Disability…… means significantly subaverage general intellectual functioning, existing concurrently [at the same time] with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance.

(Editor’s Note, February 2011: “Intellectual Disability” is a new term in IDEA. Until October 2010, the law used the term “mental retardation.”  In October 2010, Rosa’s Law was signed into law by President Obama.  Rosa’s Law changed the term to be used in future to “intellectual disability.” The definition of the term itself  did not change and is what has just been shown above.

and

Developmental Delay… …for children from birth to age three (under IDEA Part C) and children from ages three through nine (under IDEA Part B), the term developmental delay, as defined by each State, means a delay in one or more of the following areas: physical development; cognitive development; communication; social or emotional development; or adaptive [behavioral] development.

The following content is adapted from:Judith McKenzie, Severe to Profound Intellectual Disability: Circles of Care and Education, University of Cape Town Coursea- MOOC (CC-BY)

According to the  Diagnostic and Statistical Manual of Mental Disorders (DSM-5), intellectual disability is a disorder with onset during the developmental period, that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. Although this definition may seem simple, when we unpack the statement, we begin to realize that this is quite a complex disability.

What do we mean by intellectual functioning?  According to DSM-5, this relates to reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience, and is confirmed by both clinical assessment and individualized standardized intelligence testing.  This is where the intelligence quotient score or IQ score comes in.

Intellectual function is only part of the disability.  The other important part is adaptive functioning, which is defined as failure to meet developmental and sociocultural standards for personal independence and social responsibility.  Without ongoing supports, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, independent living, across multiple environments such as home, school, work, and community.

Adaptive Behavior

Adaptive behavior is much more about how a person manages in daily life and how they’re able to do the things that are expected of their age within their culture. The person with an intellectual disability can do much more if they get the right support.

The AAIDD definition, states that intellectual disability is a disability characterized by significant limitations in both intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. This disability originates before the age of 18.  You can see this on face value is very similar to the three important aspects of intellectual function, adaptive function and age onset like the DSM-5 definition.

When we take a closer look at the adaptive function, DSM-5 and AAIDD both identify three domains within their definitions. This is where we can start to get a bit of a better idea of what’s going on, these are the conceptual, social and practical domains.

  • Conceptual skills include language and literacy, money, time and number concepts and self-direction.
  • Social skills relate to interpersonal skills, social responsibility, self-esteem, gullibility, naivety, social problem solving, and the ability to follow rules or obey laws and to avoid being victimized.
  • Practical skills involve activities of daily living such as personal care, occupational skills, healthcare, travel, transportation, schedules routine, safety, use of money, and use of the telephone and those kinds of things.

In the disability summary template categorizes the adaptive behaviors by the subcategories you see within the ; conceptual, social skills and practical skills domains. Use the worksheet to take notes as you read the next sections which discusses adaptive behaviors in greater depth. From section 7 of the template:

  • Communication Skills
  • Self-Care
  • Social Skills
  • School/Home Living
  • Community Use 
  • Self-Management
  • Personal Health and Safety
  • Functional Academics
  • Leisure

IQ tests often give a fixed idea of the child’s potential to learn. At very low levels of IQ, the scores tend to become less reliable and quite difficult to assess. They are less helpful for understanding what the child needs. You might spend a lot of time and effort trying to get an IQ score, but this doesn’t always help us in developing the child’s skills. This may be more important with less severe levels of intellectual disability.  Finally, intelligence testing can be very culturally, and class biased. Tests are not always standardized on the children who are taking them, and this can lead to a poor performance.

The AAIDD definition, also introduces what they call additional considerations over and above intellectual functioning that need to be considered. They stress that it is important to look at the community environment that is typical of the individual’s peers and culture. This would include linguistic diversity and cultural differences in the way people communicate, move, and behave. Very importantly, they caution against only looking at a person’s deficit and state that every person, no matter what their disability, has strengths that we can build upon. The way to build on these strengths is through providing the right kind of support.

In conclusion, when we talk about intellectual disability, we’re not just talking about an individual who has impaired reasoning and learning ability. We’re talking about a person who interacts with others in day-to-day environments, and who with support, can learn and develop.

One of the very important considerations with intellectual disability is the severity of the disability. You might think that people with intellectual disability are all similar. But in fact, there are big differences that have an impact upon their ability to learn, as well as the support that they need. This is where the DSM-5 is helpful, as it gives a functional description of the different levels of severity.

The DSM-5 definition states that the level of severity is best understood by looking at the function of a person rather than by just looking at IQ scores. In fact, the classification discourages determining severity by reference to IQ. Instead of ending up with an IQ number, we get an idea of what the person can and cannot do, and more importantly, what we can do to support the child. The DSM looks at function in terms of the conceptual, social, and practical domains. We’re going to look at the four levels of intellectual disability in terms of severity, mild, moderate, severe, and profound. We will also look at them with regard to the three domains and the four levels.

Mild intellectual disability. In the conceptual domain, in very young children there might be no obvious problems present. But when it comes to school-age children, there are difficulties in learning, academic skills, and those involving reading, writing, arithmetic, time, or money. They might need curriculum adaptation. In adults, abstract thinking, short-term memory, and functional use of academic skills are reduced. This results in a somewhat concrete way of thinking. As regards to the social functioning domain, communication, conversation, and language are more concrete or immature than expected for age. There may be difficulties in regulating their emotions and behaving in age appropriate fashion. These difficulties don’t just appear in social situations. There’s also a limited understanding on risk in social situations, and social judgment is immature for their age. The person is at risk of being manipulated by others. For our practical functioning perspective, the individual may function age appropriately in personal care but may still need some support with complex daily living tasks in comparison to their peers. As an adult, support would include shopping, transportation, home, childcare organization, nutritious food preparation, banking, and money management. Recreational skills are the same as their peers, but judgment around well-being and organizing recreation time requires support. Employment is likely to be found in jobs that do not emphasize conceptual skills. Individuals generally need support to make health care decisions and legal decisions, and to learn to perform skilled vocation competently.

Moderate intellectual disability. From a conceptual function perspective, it is clear from the start, from an early age of the individual’s conceptual skills are well behind those of their peers. For preschoolers, their language and pre-academic skills develop slowly. For school aged children, progress in reading, writing, math and understanding of time and money develops more slowly across the school years, and the level achieved is limited compared with their peers. Such that as adults, academic skills development is typically at a primary school level. Support is required for academic skills in work and personal life. Ongoing support for conceptual task will be required across the lifespan. In the social functioning domain, the individual relies more on the spoken word, than the written word for communication. They’re able to have close relationships and have romantic partners. However, they may not perceive or interpret social cues accurately. Social judgment and decision-making abilities are limited, and caregivers must assist the person with important life decisions. Regarding practical functioning, the individual can do most activities of daily living, if the time is taken to teach him or her to become independent and reminders may be needed. He or she can do household chores although an extended period of teaching might be needed, and ongoing supports will be needed for adult level performance. Independent employment and jobs that require limited conceptual and communication skills can be achieved, but considerable support from co-workers and supervisors and others will be needed. In recreational skills, they usually require additional support and learning opportunities over an extended period of time. Challenging behavior might be present in a significant minority and cause social problems.

Severe intellectual disability Within a conceptual function domain, we see that the individual generally has little understanding of written language or of concepts involving number, quantity, time, and money. Caregivers need to plan extensive support for problem-solving throughout the individual’s life. Within a social functioning domain, spoken language is quite limited in terms of vocabulary and grammar. Speech maybe single words or phrases and maybe supplemented through augmentative means such as gestures, signs, or pictures. Speech and communication tend to be focused on the here now within everyday events. Relationships with family members and familiar others are a great source of pleasure and help. Then in the practical domain, the individual requires support for all activities of daily living including meals, dressing, bathing, and toileting. The individual requires supervision at all times and cannot make responsible decisions regarding their well-being without some support from others. In adulthood, participation tasks at home, recreation, and work requires ongoing support in the systems, and learning new skills, always involves long-term teaching and ongoing support. Some individuals at this level might show behaviors that are difficult to handle.

Profound intellectual disability, in the conceptual domain, the individual has very limited conceptual skills and at best able to deal with concrete objects rather than symbols such as pictures or words. He or she may use objects for specific purposes, for self-care, work, and recreation. They can learn skills such as matching and sorting based on physical characteristics. However, there’s a high likelihood of additional motor or sensory impairments which make learning difficult. In the area of social functioning, the individual struggles with symbolic communication, speech or gesture. He or she might understand some simple instructions with gestures and expresses his or her own desires and emotions largely through non-verbal, non-symbolic communication. The individual enjoys relationships with well-known family members, caregivers, and familiar others, and initiates and responds to social interactions through gestural and emotional cues. Additional sensory and physical impairments, limit the amount and quality of social interaction. Extensive support might be needed to ensure that this interaction happens. Within the practical functioning domain, the individual is dependent on others for all aspects of daily physical care health and safety. He or she may or may not be able to participate in doing some of these activities. When the person does not have physical impairments, he or she can assist with simple chores around the home such as putting dishes away. With support, it is possible to engage him or her in vocational tasks that depend on simple actions with objects. Recreational activities may involve, listening to music, watching movies, going for walks, or water activities, all with the support of others. Additional physical and sensory impairments often limit the extent that the individual can participate in activities. Without support, they might spend a lot of time just watching others. These individuals might show difficult and disruptive behaviors in some cases.

Now, that we have looked at all these levels, remember these levels of severity are not absolute. It might be that the child is more impaired in one domain than in another, or that they fall on the border between levels. It is also true that, children at different levels might also have very similar needs.


The following text and IDEA definition above are excerpts from:  Center for Parent Information and Resources (2017). Intellectual Disability, Newark, NJ, Author. Retrieved 3.28.19 from https://www.parentcenterhub.org/intellectual / (public domain material)

Matthew’s Story

Matt is 15 years old. Because Matt has an intellectual disability, he has been receiving special education services since elementary school. These services have helped him tremendously, because they are designed to fit his special learning needs. Last year he started high school. He, his family, and the school took a good hard look at what he wants to do when secondary school is over. Does he want more education? A job? Does he have the skills he needs to live on his own?

Answering these questions has helped Matt and the school plan for the future. He’s always been interested in the outdoors, in plants, and especially in trees. He knows all the tree names and can recognize them by their leaves and bark. So this year he’s learning about jobs like forestry, landscaping, and grounds maintenance. Next year he hopes to get a part-time job. He’s learning to use public transportation, so he’ll be able to get to and from the job. Having an intellectual disability makes it harder for Matt to learn new things. He needs things to be very concrete. But he’s determined. He wants to work outside, maybe in the park service or in a greenhouse, and he’s getting ready!

What are the Signs of Intellectual Disability?

There are many signs of an intellectual disability. For example, children with an intellectual disability may:

  • sit up, crawl, or walk later than other children;
  • learn to talk later, or have trouble speaking,
  • find it hard to remember things,
  • not understand how to pay for things,
  • have trouble understanding social rules,
  • have trouble seeing the consequences of their actions,
  • have trouble solving problems, and/or
  • have trouble thinking logically.

How are Intellectual Disabilities Diagnosed?

Intellectual disabilities are diagnosed by looking at two main things. These are:

  • the ability of a person’s brain to learn, think, solve problems, and make sense of the world (called IQ or intellectual functioning); and
  • whether the person has the skills he or she needs to live independently (called adaptive behavior, or adaptive functioning).

Intellectual functioning, or IQ, is usually measured by a test called an IQ test. The average score is 100. People scoring below 70 to 75 are thought to have an intellectual disability. To measure adaptive behavior, professionals look at what a child can do in comparison to other children of his or her age. Certain skills are important to adaptive behavior. These are:

  • daily living skills, such as getting dressed, going to the bathroom, and feeding one’s self;
  • communication skills, such as understanding what is said and being able to answer;
  • social skills with peers, family members, adults, and others.

 To diagnose an intellectual disability, professionals look at the person’s mental abilities (IQ) and his or her adaptive skills. Both of these are highlighted in the definition of this disability within our nation’s special education law, the Individuals with Disabilities Education Act (IDEA). IDEA is the federal law that guides how early intervention and special education services are provided to infants, toddlers, children, and youth with disabilities.

Educational Considerations

A child with an intellectual disability can do well in school, but is likely to need the individualized help that’s available as special education and related services. The level of help and support that’s needed will depend upon the degree of intellectual disability involved.

General education. It’s important that students with intellectual disabilities be involved in, and make progress in, the general education curriculum. That’s the same curriculum that’s learned by those without disabilities. Be aware that IDEA does not permit a student to be removed from education in age-appropriate general education classrooms solely because he or she needs modifications to be made in the general education curriculum.

Supplementary aids and services. Given that intellectual disabilities affect learning, it’s often crucial to provide supports to students with ID in the classroom. This includes making accommodations appropriate to the needs of the student. It also includes providing what IDEA calls “supplementary aids and services.” Supplementary aids and services are supports that may include instruction, personnel, equipment, or other accommodations that enable children with disabilities to be educated with nondisabled children to the maximum extent appropriate.

Thus, for families and teachers alike, it’s important to know what changes and accommodations are helpful to students with intellectual disabilities. These need to be discussed by the IEP team and included in the IEP, if appropriate.

Adaptive skills. Many children with intellectual disabilities need help with adaptive skills, which are skills needed to live, work, and play in the community. Teachers and parents can help a child work on these skills at both school and home. Some of these skills include:

  • communicating with others;
  • taking care of personal needs (dressing, bathing, going to the bathroom);
  • health and safety;
  • home living (helping to set the table, cleaning the house, or cooking dinner);
  • social skills (manners, knowing the rules of conversation, getting along in a group, playing a game);
  • reading, writing, and basic math; and
  • as they get older, skills that will help them in the workplace.

Transition planning. It’s extremely important for families and schools to begin planning early for the student’s transition into the world of adulthood. Because intellectual disability affects how quickly and how well an individual learns new information and skills, the sooner transition planning begins, the more can be accomplished before the student leaves secondary school.

IDEA requires that, at the latest, transition planning for students with disabilities must begin no later than the first IEP to be in effect when they turn 16. The IEP teams of many students with intellectual disabilities feel that it’s important for these students to begin earlier than that. And they do.

(Center for Parent Information & Resources, 2017)


The following text is an excerpt from: Educational Psychology. Chapter 5  Authored by: Kelvin Seifert and Rosemary Sutton. Located athttps://open.umn.edu/opentextbooks/BookDetail.aspx?bookId=153LicenseCC BY: Attribution

As a teacher, you may hear more than one term for describing students with intellectual disabilities. If the disability is mild, teachers sometimes refer to a student with the disability simply as a slow learner, particularly if the student has no formal, special supports for the disability, such as a teaching assistant hired specifically to assist the student. If the disability is more marked, then the student is more likely to be referred to either as having an intellectual disability. Keep in mind, that actual intellectual disabilities are always more than cognitive: they also involve challenges about adapting to everyday living.

Levels of support for individuals with intellectual disabilities
Intellectual disabilities happen in different degrees or amounts, though most often are relatively mild. Traditionally the intensity or “amount” of the disability was defined by scores on a standardized test of scholastic aptitude (or “IQ test”). Because of the insensitivity of such tests to individuals’ daily social functioning, however, current trends are toward defining intensities by the amount of support needed by the individual. Table 13 summarizes the most commonly used scheme for this purpose, one created by the American Association on Intellectual and Developmental Disabilities (AAMR, 2002). Levels of support range from intermittent (just occasional or “as needed” for specific activities) to pervasive (continuous in all realms of living).
Table 12: Levels and areas of support for intellectual disabilities

table 12

Teaching students with intellectual disabilities
There are many specific techniques that can help in teaching students with mild or moderate intellectual disabilities, but most can be summarized into three more general strategies. The first is to give more time and practice than usual; the second is to embed activities into the context of daily life or functioning where possible; and the third is to include the child both in social and in academic activities, rather than just one or the other. Let us look briefly at each of these ideas

Giving more time and practice than usual
If a student has only a mild intellectual disability, he or she can probably learn important fundamentals of the academic curriculum—basic arithmetic, for example, and basic reading. Because of the disability, though, the student may need more time or practice than most other students. He or she may be able to read many words by sight (day, night, morning, afternoon, etc.), but need longer than other students to recognize and say them. Or the student may know that 2 + 3 = 5, but need help applying this math fact to real objects; you (or a helper) might need to show the student that two pencils plus three pencils make five pencils.

Giving extra help takes time and perseverance, and can try the patience of the student (and of you, too). To deal with this problem, it may help to reward the student frequently for effort and successes with well-timed praise, especially if it is focused on specific, actual achievements; “You added that one correctly”, may be more helpful than “You’re a hard worker”, even if both comments are true. Giving appropriate praise is in turn easier if you set reasonable, “do-able” goals by breaking skills or tasks into steps that the student is likely to learn without becoming overly discouraged. At the same time, it is important not to insult the student with goals or activities that are too easy or by using curriculum materials clearly intended for children who are much younger. Setting expectations too low actually deprives a student with an intellectual disability of rightful opportunities to learn—a serious ethical and professional mistake (Bogdan, 2006). In many curriculum areas, fortunately, there already existing materials that are simplified, yet also appropriate for older students (Snell, et al., 2005)  Special education teacher-specialists can often help in finding them and in devising effective ways of using them.

Adaptive and functional skills ( & Impact on Learning)
Students with intellectual disabilities present, especially clear examples of a universal dilemma of teaching: since there is not enough time to teach everything, how do we choose what to teach? One basis for selecting activities is to relate learning goals to students’ everyday lives and activities, just as you would with all students. This strategy addresses the other defining feature of intellectual disability, the student’s difficulties with adapting to and functioning in everyday living. In teaching addition and subtraction, for example, you can create examples about the purchasing of common familiar objects (e.g. food) and about the need to make or receive change for the purchases. Similar considerations apply to learning new reading or oral language vocabulary. Instead of simply learning words in a “basic reading” series (or reading textbook), try encouraging the student to learn words that are especially useful to the student’s own life. Often the student, not you yourself, is the best person to decide what these words actually are.

An adaptive, functional approach can help in nonacademic areas as well. In learning to read or “tell time” on a clock, for example, try focusing initially on telling the times important to the student, such as when he or she gets up in the morning or when schools starts. As you add additional times that are personally meaningful to the student, he or she works gradually towards full knowledge of how to read the hands on a clock. Even if the full knowledge proves slow to develop, however, the student will at least have learned the most useful clock knowledge first.

Include the student deliberately in group activities
The key word here is inclusion: the student should participate in and contribute to the life of the class as much as possible. This means that wherever possible, the student attends special events (assemblies, field days) with the class; that if the class plays a group game, then the student with the disability is part of the game; that if classmates do an assignment as a group, then if at all possible the student is assigned to one of the groups. The changes resulting from these inclusions are real, but can be positive for everyone. On the one hand, they foster acceptance and helpfulness toward the child with the disability; classmates learn that school is partly about providing opportunities for everyone, and not just about evaluating or comparing individuals’ skills. On the other hand, the changes caused by inclusion stimulate the student with the disability to learn as much as possible from classmates, socially and academically. Among other benefits, group activities can give the student chances to practice “belonging” skills—how to greet classmates appropriately, or when and how to ask the teacher a question. These are skills, I might add, that are beneficial for everyone to learn.

( Seifert and Sutton, 20o9)


The following  section is an excerpt from chapter 9. Literacy Instruction for Students with Intellectual and Developmental Disabilities by Michelle A. Duffy is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License

Literacy Instruction for Students with Intellectual and Developmental Disability

Abstract

This chapter addresses research-based literacy instruction for students with intellectual and developmental disabilities. It begins with a discussion of these disabilities, highlighting some common impairments that exist across such disability labels which can make literacy learning a challenge. Examples are provided that outline ways to address literacy skills, specifically in the area of reading. In addition, this chapter invites teachers to consider the ways in which traditional forms of literacy instruction can result in barriers to some students’ participation in literacy learning and encourages finding ways to remove such barriers so that all students, including those with more significant forms of disability, can benefit

Learning Objectives

After reading this chapter, readers will be able to

  1. define what it means to presume competence in the learning potential of students with intellectual and developmental disabilities, and discuss the significance in doing so;
  2. identify common barriers to literacy learning that often exist in classroom settings for students with intellectual and developmental disabilities and describe ways to remove these barriers; (UDL)
  3. discuss evidence-based ways to instruct students with intellectual and developmental disabilities in phonemic awareness, phonics, comprehension, vocabulary, and fluency;
  4. design instructional reading activities and experiences for students with intellectual and developmental disabilities that effectively meet their needs in skill development while also maintaining their meaningful participation in the inclusive literacy classroom.

Introduction

Students with intellectual and developmental disabilities have generally been taught literacy using a curriculum focusing on functional life skills (Katims, 2000). Through functional skills curricula, students are frequently taught to recognize and write a limited number of the sight words to support their participation in the community or at work (Mosley, Flynt, & Morton, 1997). For example, a student might be taught to recognize the words danger and exit for safety purposes and the days of the week to read a work schedule. Although learning such words would be beneficial, a functional skills approach to literacy instruction does not equip students with the skills needed to identify words beyond the specific sight words they have been taught. This inhibits their abilities to read and write for other purposes, and therefore, limits their opportunities to take part more fully in their communities (Copeland & Keefe, 2007). Students with intellectual and developmental disabilities may not be afforded other types of literacy instruction because it is often believed that they are incapable of learning other, more sophisticated aspects of literacy (Kluth & Chandler-Olcott, 2008).

According to Joseph and Seery (2004), The potential for individuals with [intellectual disabilities] to grasp and generalize literacy skills has been underestimated by many educators and researchers” (p. 93). Although research is still limited in the area of higher-level literacy instruction (i.e., literacy instruction that extends beyond a functional skills approach) for students with intellectual disabilities and developmental disabilities, a number of studies have shown that students with such disabilities have learned to decode words, comprehend narrative and expository texts, and write for expression (e.g., Allor, Mathes, Roberts, Jones, & Champlin, 2010; Conners, Rosenquist, Sligh, Atwell, & Kiser, 2006; Pennington, Stenhoff, Gibson, & Ballou, 2012).

Up until quite recently, it has been difficult to determine what constitutes good evidence-based literacy instruction for students with intellectual disabilities and developmental disabilities (Lemons, Mrachko, Kostewicz, & Paterra, 2012). This difficulty is largely because much of the research done on best reading practices has not included this population of students. Further, conventional wisdom once suggested that students with intellectual and developmental disabilities might need qualitatively different instruction than their peers without disability labels. It makes sense, though, that on some level, the same type of high-quality instruction that works with other struggling students should be beneficial to any student, despite disability label. Researchers have recently begun to test this premise, and the results are promising. In this chapter, you will learn more about literacy instruction for students with intellectual and developmental disabilities and how to devise lessons to meet their individual needs in reading.

Changing Perspectives

There is no doubt about the importance of literacy in our society. Among other things, being literate increases one’s ability to learn independently, to gain and maintain employment, and to care for oneself. Access to literacy instruction, therefore, is imperative. Too often, however, educators and other adults in the lives of students with intellectual disability (ID) and developmental disability (DD) have assumed that these students would not be able to benefit from literacy instruction because they view the tasks involved to be too complicated or unnecessary for students with ID and DD to understand or perform. This view has led many educators to forego literacy instruction for the children or to address it in superficial ways.

Presuming Competence

The first step in helping a child with ID or DD to become literate is to presume competence (Biklen & Burke, 2006) in his or her abilities to gain such knowledge and skills. This means to put aside doubts and preconceived notions about what a student may be able to accomplish based on a student’s label of disability, estimates of IQ, or assumed limitations and instead, teach as if the child will learn. Put another way, to presume competence in students is to act on the belief “that all individuals can acquire valued skills if given appropriate structures and supports” (Copeland & Keefe, 2007, p. 2).

Literacy Initiations and Access to Instruction

While many students with ID and DD interact with texts in traditional ways, some students with such disabilities may interact with texts in ways that seem unusual or different than how students without such disabilities interact with texts. For example, some students, particularly those with autism spectrum disorder (ASD), may be interested in a book’s texture or fascinated by how a book looks when it is spun around. Other students may be interested in and insist on reading books on one specific topic for a substantial period of time. Take for example the ways in which Steven, a boy with ASD and an intellectual disability, reads for information:

He had with him, as always, several different public library books, all related to butterflies and insects. He laid three of the books, opened, on the floor, then centered himself among them, glancing at each of the exposed pages. He then flipped to the next page of each book and repeated the process. (Kliewer & Biklen, 2001, p. 5)

Students like Steven are sometimes dismissed as readers because their teachers misinterpret their unique ways of interacting with texts as indications that they are not attending to and/or are not ready for instruction involving the written word. Others feel compelled to restrict students’ access to texts that they worry might be topics of overfocus, insisting that the student read something other than books about their favorite subjects. However, students’ interactions with texts should be welcomed despite differences. A child’s spinning of a book or investigation of the book’s texture should never be taken as a sign that the child is not ready for literacy instruction. Nor should we avoid inviting them to use texts in more conventional ways. On the contrary, students will benefit from learning to use texts in the intended fashion. An important understanding, though, is that there is nothing wrong with interacting with texts in unusual ways. As long as a child is interested in texts, teachers should use the child’s interactions as a starting point for further invitations to literacy growth and also encourage the child to interact with texts in ways that are pleasing to them.

Students with ID and DD can learn literacy skills, but a pitfall of many educators in helping the students attain literacy is to focus only on early or basic literacy skills in the absence of other more meaningful, generative, and socially-based forms of literacy. For example, a student who has not mastered the alphabet might not be invited to respond to read-alouds through discussion, drama, or art, and may be excluded from story time altogether. This is because it is often thought that students will not be able to benefit from other literacy activities until early skills are mastered. This assumption is incorrect, however, and can be detrimental to student learning. One does not need to be able to read words or even identify letters to be able to take part in classroom read-alouds and response activities, and much can be learned about literacy through taking part in such activities. Through read-alouds, for instance, students are provided with a model of fluent reading, how a story is structured, and what the purposes are for various kinds of texts. While the teaching of skills is important and should not be denied to students with disabilities, reading must also not be construed as a linear and rigid process for which only some students are able to participate (Kliewer & Biklen, 2001).

Augmentative and Alternative Communication (AAC)

Many students who have ID or DD also have complex communication needs (CCN). Some students may not use speech to communicate. Others may not have reliable speech, that is, speech that consistently and accurately reflects the message the speaker wishes to convey (Broderick & Kasa-Hendrickson, 2001). Some students may have reliable speech, but their speech may be difficult for others to understand. Teaching literacy skills to a student who is not verbal or who has unreliable speech can seem daunting. As teachers, we often expect students to communicate their knowledge through speaking, particularly as students learn to read. Think about how you would work with a typically-developing kindergartener on letter sounds. You would likely show the child a letter on the chalkboard or on a flashcard and ask the child to respond orally with the sound of the letter. Similarly, when meeting with a student to assess his or her reading ability, you would likely want to hear the child read a passage so you could make note of his or her strengths and struggles during oral reading. How then, can a teacher approach such important learning activities and assessments when working with a child who does not speak? How could the child show a teacher his or her competence in reading? How can a teacher determine a child’s understanding as new skills are taught?

Augmentative and alternative communication (AAC) refers to the techniques and supports used by individuals with limitations in spoken language to enhance their ability to communicate. While these supports are often bundled under the term AAC, there are important differences in augmentative versus alternative communication. Augmentative communication refers to the techniques and supports used in addition to speech, spoken sounds, or gestures, while alternative communication refers to techniques or supports used in place of speech and gestures (Copeland & Keefe, 2007). Numerous options for AAC exist, including “manual sign language, as well as non-electronic and electronic communication devices and software options” (p. 132), which vary in complexity (e.g., high-tech, low-tech) and expense. A common high-tech AAC device used by students is the Dynavox, which is a computerized touch screen that allows users to select words and symbols indicating what they would like to communicate. The device, in turn, speaks out these choices digitally. Lower-tech supports might include teacher-created boards with letters, numbers, and/or pictures made with clip art to which students can point to communicate their needs and responses.

Students with ID and DD can often benefit from AAC in literacy learning. In deciding which AAC supports to use, a teacher must consider the particular needs of each student. Not all supports or devices will be appropriate for all students with disabilities. It would not be appropriate, for example, to require a student to use a particular support simply because it is less expensive or already on hand. In addition, some students with limited speech may already be making use of certain AAC devices in their daily lives. If this is the case for a particular student, finding a way to incorporate that device into the child’s literacy learning will be of utmost importance. For students who have difficulty with reliable speech or producing speech that is readily understood by others, finding a way for the students to communicate their knowledge without the need to speak can be beneficial. The ways in which AAC can be used to supplement and enhance a student’s literacy learning are innumerable. Several examples will be given throughout the next section on comprehensive literacy instruction for students with ID and DD.

Comprehensive Reading Instruction for Students with ID and DD

This section will provide ways to instruct students with ID and DD on particular skills that are important for growth in reading. The skills have been presented separately by area so that you can both understand the main processes of reading and learn ways to teach the skills effectively when working with students. However, it is important to recognize that reading should not be treated and taught as a set of unrelated sub-skills, nor do students need to master skills in one area to take part in instruction in another area. Students must have the opportunity to experience literacy in its cohesive sense in conjunction with opportunities to work on needed skills. Students of all needs and abilities need time to experience hearing and responding to good literature, to play with language, and to take risks with new ideas and conventions. They must also be given appropriate instruction and supports on their way to learning the conventions of literacy so that they too can interact with it meaningfully.

In 1997, Congress asked the National Institute of Child Health and Human Development (NICHD) to work in conjunction with the Department of Education to assemble a panel whose task would be to review all of the available research on teaching children to read and make recommendations for effective practices.1This panel summarized the findings in what is known as the Report of the National Reading Panel (NRP; National Institute of Child Health and Human Development [NICHD], 2000), which outlined the five areas as crucial for students to develop to become good readers: phonemic awareness, phonics, comprehension, vocabulary, and fluency. Although the NRP did not focus on students with ID and DD, other researchers have begun to investigate these areas in relation to students with ID and DD and have determined that these same areas should be addressed when teaching reading to students with more significant forms of disability as well (Allor, Mathes, Roberts, Cheatham, & Al Otaiba, 2014; Beecher & Childre, 2012). Sometimes it can be difficult to know how to teach these important aspects of reading, given a student’s difference in memory, mobility, and/or speech. This section will give you some ideas for approaching these topics using research-supported strategies.

Phonemic Awareness

Phonemic awareness is the understanding that spoken words can be broken down into individual sounds. Words are spoken as a single pulse of sound. When we say the word cat, for instance, we do not break the word into its individual sounds. To read words, however, a student must understand that the letters in words represent individual sounds. Before that can happen, a student must be aware that there are individual sounds in words. These individual sounds are called phonemes. In the case of cat, the phonemes are /c/, /a/, and /t/. We must help a child become aware of phonemes so that letter-sound correspondences will make sense to the child. Developing this awareness may seem simple to an adult with good literacy skills, but for a child learning to break apart sounds in spoken words for the first time, it can be surprisingly challenging (see Chapter 3 for coverage of this topic in more depth).

Phonemic awareness instruction for students with ID and DD

Recent research has shown that students with ID and DD can benefit from similar types of explicit (i.e., direct and structured) instruction in phonemic awareness used with other students who need extra support in developing this skill. However, to be beneficial, the instruction may need to be modified to be more concrete, such as using objects as a visual cue, or providing more than one mode of learning, such as incorporating sign language in addition to verbal instruction (Beecher & Childre, 2012). For example, when bringing students’ attention to the initial sounds of words beginning with /p/, it might be helpful to set out a small toy pig or make the sign for pig to give the student a concrete visual reminder of the sound being learned. It has also been found that students with ID and DD may need a longer amount of time to acquire phonemic awareness skills (Allor, Mathes, Roberts, Jones, & Champlin, 2010).

In the case of a child who does not have reliable speech and/or bodily control, more creative ways are needed to help the student demonstrate his or her knowledge and understanding. Imagine for a moment working with a child who has limited reliable speech. The student can sometimes communicate a sound verbally; however, he often cannot produce the sound he is thinking of accurately enough for us to be certain that he understands. Instead of requiring the child to speak his responses aloud, one can create response boards to allow the child to point out his answers (Light & McNaughton, 2012).

Imagine that you would like your student to be able to blend three phonemes (individual sounds) together to blend a word. Since the student has difficulty producing speech, you will want to use pictures to which the student can point. It is easy to create your own set of picture words on card stock or you can find cards that are commercially available. Next, use the picture cards to model how phonemes can be blended into words. To begin, show the child a picture, for example, of a pig. Start by saying, “Here is a picture of a pig. Listen to me say the sounds in this word. /p/ /i/ /g/… pig. Do you hear the sounds I am saying? /p/ /i/ /g/… pig. I can break apart the sounds in the word pig, like this /p/ /i/ /g/. Then I can put them back together. /p/ /i/ /g/ is pig!” You would continue this using several, clear examples. You could also cut the picture of the pig into three pieces, moving each to present a sound.

Next, you would introduce an activity to determine if the child can identify a word given its phonemes. To do this, you can set out three picture cards in front of the child (see Figure 1). First make sure the child knows what each picture represents by pointing to each and naming it: “Here is a dog, cat, and pig.” This is an important step so that the child knows that the picture of the cat, for example, is indeed a cat and not a kitten. You may need to repeat the words, depending on the student’s memory needs. Next, you tell the student that you are going to give him three sounds that when put together will make a word. Ask him to point to the word you are making. You would then say, “/p/ /i/ /g/” and determine whether the child can select the appropriate response.

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As the child progresses in the ability to blend phonemes, you can make the work more challenging by requiring attention to similar phonemes rather than the very different phonemes featured in the previous example (Light & McNaughton, 2012). For example, you may wish to have a student work on attending to differences in medial (middle) vowel sounds in words. In this case, you would use three words that have the same letter sounds except for the middle sound, such as bugbig, and bag. Notice how each of these words has /b/ as the initial phoneme and /g/ as the final phoneme. Your modeling in this situation would deliberately draw the child’s attention to the change in vowel sound between such similar words. To assess the student’s understanding, you would again give the student three pictures from which to choose that correspond with our words and follow the same process described above. If you say /b/ /a/ /g/, but the child points to the bug, it indicates that the student may have trouble attending to the middle sound in the words and would require further instruction and practice in this area.

Students with unique needs may need modifications to the above suggestions. For example, a student showing considerable difficulties with fine or gross motor skills or vision may need larger cards with which to work. If a child is having difficulty with the process, be sure that it is not the physical aspect of the task that is getting in the way. If there are barriers to the student’s participation, think creatively about or consult with others regarding how the task could be modified so that the child could successfully (but still meaningfully) take part.

There are numerous other phonemic awareness lessons and activities that can be done to help students acquire this important literacy skill. Above is just one example of a way in which to teach and assess phoneme blending. See Table 1 for some other activities that are likely to be helpful when teaching phonemic awareness. Given the example above, consider how these activities, too, could be modified so that students with speech and/or motor differences could participate.

Activities Examples
Table 1. Phonemic Awareness Activities and Examples
Sorting words by initial, medial, or final phoneme Give students 10 picture cards in which the pictures end with the sound /g/ or /d/. Have students sort the words into two categories by ending sound.
Identifying words with a particular phoneme Draw students’ attention to the first sound of a word, e.g., “Fan starts with /f/.” (Be sure to say the letter sound and not the letter name.) Ask students to come up with words that start with the same sound.
Segmenting words into individual phonemes Say a word aloud to students (e.g., sit). Demonstrate how to break the word into its individual sounds (i.e., /s/ /i/ /t/). Now give students some words to break into individual sounds. Guide students as necessary.
Identifying a word after removing or adding a phoneme to it Say to students, “Listen to this word: pit. What happens if we take away /p/?” (Be sure to say the letter sound and not the letter name.) Demonstrate how the word will now be: it. Now go through similar words with students one word at a time.
Creating a new word by replacing a phoneme in a given word Say to students, “Listen to this word: cat. If I take away /c/ and put /b/ in its place, we get bat. Now let’s change /b/ to /s/. What word do we get?” (Be sure to say the letter sounds and not the letter names.) Guide students as necessary.
Note. If a student does not seem to be able to attend to the phonemes in the words despite instruction, you may need to start with earlier skills. Provide the student with many opportunities to play and experiment with more general sounds in language, such as rhymes, syllables, and alliteration.

Phonics

Phonics is the study and instruction of how letters and combinations of letters represent the individual sounds (phonemes) in words and how these sounds are blended together to make words. In the English language, we have 26 letters that are used in various combinations to represent approximately 44 phonemes. Studies have shown that for students who have difficulty learning letter-sound correspondences, explicit and systematic phonics instruction is necessary (NRP, 2000). These studies have mostly been conducted with students who have learning disabilities; however, the same outcomes have been found in newer research, including students with ID and DD as well (e.g., Riepl, Marchand-Martella, & Martella, 2008; Lemons, et al., 2012). Explicit and systematic instruction in phonics means that students are taught specifically about letter-sound correspondences through carefully planned instruction. The instruction also includes modeling, along with opportunities for teacher-guided practice, beginning with those letter-sound correspondences that are most common and useful in beginning words (e.g., a, s, ch) and proceeding to those that are more complex (e.g., ow, ur, ey, -tch). Students are not expected to figure out these patterns on their own. To become adept at using letter-sound correspondences to decode, students must have many opportunities to practice using letters and letter combinations to represent the sounds of language. There are many games and activities that can be used with students to help them practice these skills in an engaging fashion (see Chapter 3 of this textbook for more examples).

Phonics instruction for students with ID and DD

To decode an unknown word, a child must be able to identify the correct phonemes for each of its letters, hold the phonemes in memory in the correct order, and then blend the sounds together to make a word. This can be a challenging task for any beginner but can be particularly difficult for students with ID and DD because they may have difficulty with short-term memory and/or initiation of spoken language or movement. For students with short-term memory difficulties, decoding can be very challenging because the students may have difficulty holding on to the sounds in order while decoding. By the time the students reach the ends of the words they are trying to figure out, it is common for them to have forgotten the beginning sounds (WETA Washington, DC, 2007). Additionally, many new learners find it helpful to sound out words aloud while simultaneously pointing to each letter; however, if a student cannot produce sounds or point to the letters on a page, decoding can prove quite a challenge for these reasons as well. These are only some of the issues that may arise that complicate the decoding process for students with ID and DD, but with creative means, barriers to students’ participation in phonics instruction can be reduced.

For a child who has significant short-term memory difficulties, it is necessary to reduce the memory load for certain tasks (Allor et al., 2010). For example, when teaching phonics, it is helpful to begin with simple two-phoneme words, such as atup, and it. As the child becomes more adept at decoding these and has practice holding phonemes in his memory, the ability to decode longer words will likely increase. Further, as time goes on, many students will be able to “chunk” information that they have learned into retrievable pieces that will lessen the burden on their memories. For example, the blend st in words such as stop and past will become easily recognizable with practice over time so that a student will not have to deliberately think about each phoneme (/s/ and /t/) each time it is encountered in a word. That is, the student’s recognition of the word part will become automatic, and thus allow more attention to be paid to decoding newer or more difficult letter combinations.

A method for helping students with short-term memory problems learn to decode is Additive Sound-by-Sound Blending (Moats & Hall, 2010). In this technique, instead of sounding out all of the letters in a word in sequential order from left to right, and then blending them together, which is a typical blending strategy (e.g., /c/ /a/ /t/ → /cat/), the letters are blended one by one as a student moves through the word. The teacher writes the first two letters of a given word for the student to see and models how to blend those first two sounds. The teacher then writes the third letter of the word and demonstrates how to blend the first two sounds with the third sound. This continues until the last sound is blended and the word is identified. For example, in the word stop, the teacher would demonstrate how to blend the word, sound-by-sound, as follows: /s/, /st/, /stŏ/, /stop/. Each time a new letter is added, the reader starts at the beginning so that he or she has the opportunity to rehearse the previously blended phonemes as a unit, increasing the likelihood that the phonemes will be retained in memory when the end of the word is reached. With time, students can be guided to use this strategy independently.

For students who have difficulty with speech or movement, it may be necessary to change instructional materials or the way we ask students to interact with the materials we use for decoding instruction. It is helpful to increase the font size of traditional print materials if the fine motor skills required to move from one letter to the next when finger pointing is a challenge. It may also be helpful to assist students in pointing to each subsequent letter in a word by gently guiding their hands; however, it is important to make sure that a student is comfortable with this approach before attempting it, as some students may be extremely uncomfortable with physical touch, and creating discomfort will defeat the purpose of the activity. If a student has trouble with speech while decoding, we can say the sounds for the student. As the student points (or you guide the pointing), say each sound as you move through each grapheme in the printed word. Even though the student is not doing the physical process independently, with practice, he or she can still learn the concepts necessary to decode words silently to themselves while reading.

Students who experience difficulty with short-term memory, speech, and movement may also benefit from working with various computer programs and tablet/smart phone applications to practice decoding skills. Numerous programs and applications exist that guide students in learning to segment and blend phonemes (e.g. L’Escapadou’s Montessori Crosswords, an application for iPhone/iPad) or that will read unknown words in online stories for students, sometimes even breaking up words into their individual phonemes, to demonstrate how letters represent the sounds of language (e.g., Starfall Education’s Starfall-Learn to Read). The extent to which students can use these programs independently will vary; however, again, students can interact with the programs with a teacher when guidance is needed. See Table 2 for a list of selected iPhone/iPad applications that specifically target decoding skills.

Table 2. Selected Phonics Applications for iPhone/iPad
Application Developer
Montessori Crosswords L’Escapadou
Bob Books Reading Bob Books Publications
Hooked on Phonics Learn to Read Hooked on Phonics
Starfall Learn to Read Starfall Education
Simplex Spelling Phonics series Pixwise Software
ABC Reading Magic series Preschool University

Overreliance on memorization

Because students with ID and DD have so often been taught to read by being asked to memorize words, you may encounter students who rely exclusively on this method of word identification. Although some students have been successful in learning to read to a degree with this approach, problems arise as students attempt to read more challenging texts. As text difficulty increases, complicated, unique, and multisyllabic words become more common, and one needs a reliable decoding strategy to know how to read unknown words (Copeland & Keefe, 2007). We cannot expect children to simply memorize every word that they may one day encounter, or we run the risk of relegating them to a minimum level of reading ability.

When students are used to reading solely or almost solely through the recognition of sight words, it can be difficult to teach them to rely on letter-sound correspondences to decode words. This author once worked with a student who had memorized so many words, she could read nearly fluently at the fourth-grade level. However, the student had no strategy for identifying unknown words beyond looking at the first letter of a word and guessing. Despite this student’s ability to recognize certain lengthy words by sight, she could not decode unknown words with more than two letters. Interestingly, she could not practice newly learned letter patterns with simple words such as bat or hug, as she had memorized all of them, and therefore did not have to use her new decoding skills to read them. To encourage the student to use phonics knowledge to decode words, the student had to be instructed with non-words (or nonsense words) such as lig or rup. These words had not been memorized so she had to make use of her knowledge of phonics to figure them out. With this information, the student could eventually be taught to use the decoding strategies to figure out longer, unknown real words such as ex/pect or mis/trust.

Comprehension and Vocabulary

The main purpose of reading is to comprehend a text’s message or meaning. It is not enough to be able to decode the words on a page if those words do not mean anything to the reader. Decoding is an important aspect of learning to read because to independently read text, we must first be able to identify the words on a page before we can understand them; however, there is much more to reading than word identification.

When strong readers read, they think about what they are reading (Harvey & Goudvis, 2000; Snow, 2002). They pay attention to the message of the text. When reading fiction, strong readers consider the actions of the characters, they relate those actions to their experiences, they weigh those actions against their own values, and they make predictions about what might happen next. Strong readers do not do this consciously; it just seems to happen, and is a part of the enjoyment of the reading process. However, interacting with the text in such a way is also an imperative part of making sense of the story. When weighing a character’s choices, we develop understandings of that character, including understandings that may not be specifically outlined in the text. For example, from attending to a character’s choices, we can determine whether the character is good or evil, or careful or impulsive. So much of what we understand from the text comes from thinking deeply about the reading (Pressley & Afflerbach, 1995). Strong readers also pay attention to whether or not what they are reading makes sense. When strong readers come across a sentence they do not understand, they may track back, wondering if something was misread. They may take note of vocabulary they do not know and make a decision about how to proceed (e.g., look up the word, use context to define the word, skip the word having gotten the gist of the idea).

It is sometimes thought that readers will automatically comprehend a text’s meaning once they have learned to decode words, but this is not always the case for students with or without disabilities (Donin, 2004). Many students need instruction in learning how to think about what they read and how to monitor their own thinking. That is, they must learn how to become metacognitive about their reading and reading processes. Much research has been conducted and many activities created to address this learning need with students (see Chapter 4for more discussion on this topic).

Comprehension and vocabulary instruction for students with ID and DD

Students with ID and DD bring some extra challenges when learning to comprehend text. For example, students who have difficulty with working memory, which is the ability to mentally hold and manipulate information, will often have trouble remembering what they have read, so giving them strategies to maintain information in memory is important. Students with language delays and language processing difficulties might have trouble understanding certain vocabulary. In addition, a number of students, particularly those with ASD, may have trouble making inferences if they interpret language at a literal level (Kluth & Chandler-Olcott, 2008). In addressing these skills, students should have the opportunity to read, listen to, and work with quality literature and other texts that are age-appropriate, though it may be necessary to modify some aspects of the texts based on student need (Browder, Trela, & Jiminez, 2007). It is also important to note that students with ID and DD might have trouble expressing or demonstrating their understanding, which can be misinterpreted as lack of comprehension (Kluth & Chandler-Olcott, 2008).

Recent research suggests that teaching students with ID and DD strategies to monitor their own comprehension (i.e., to become metacognitive) can be helpful (Hudson & Test, 2011; Whalon & Hanline, 2008). One way to achieve this is to conduct frequent think-alouds when reading aloud to your students (Harvey & Goudvis, 2000; Doğanay Bilgi & Özmen, 2014). During think-alouds, teachers stop reading at certain points to explain their own thinking and how they are figuring out what is going on or how they are responding to the story. For example, during a fiction read-aloud, teachers might stop to make a prediction about what might happen next. They would be explicit in talking about what was noticed in the story that has caused them to make the prediction. Similarly, for students who have difficulty with making inferences, teachers can stop at predetermined points in the text, draw students’ attention to certain clues (e.g., a character’s described expression or behavior), and specifically explain how such clues can help tell us about the characters. Students can be asked to actively participate during think-alouds as well. For example, you might ask the students, “What kind of face might someone make if he or she is up to something sneaky?” The students could then be encouraged to make a “sneaky” face, and then you could bring their attention to where the text refers to a “sly smile” or “shifty eyes.”

Think-alouds are also helpful ways to guide students in understanding new vocabulary. You can stop after reading a sentence containing a challenging word and describe to the students how you use context to figure out the word’s meaning. You can also just stop and discuss an interesting word and encourage students to use it throughout the day. Notice how think-alouds do not require any reading to be done by the students. This is a perfect example of how to get students who are currently non-readers to interact meaningfully in literacy and work on higher-level skills.

Another way to work with students on comprehension is to get students actively involved in conversations around text that they have read. One way to do this is through Reciprocal Teaching (Palincsar & Brown, 1984). In Reciprocal Teaching, students read and then in groups take part in discussion by predicting what will happen next, generating questions about the text, clarifying difficult parts, and summarizing what they have read. Students in such groups take one of these strategies and become the groups’ “clarifier,” “summarizer,” or other role. For example, the clarifier might explain the meaning of a challenging vocabulary word identified by the questioner and share strategies for figuring it out. Students with ID and DD may benefit from a modified form of Reciprocal Teaching (Lundberg & Reichenberg, 2013) where texts are broken into smaller portions and where students work together on one strategy at a time. Teachers can scaffold the students’ strategy usage by teaching them to begin questions with question words (e.g., who, what, where) or begin summarizing sentences with a simple set of sequencing words (e.g., first, then, last). When providing instruction in inclusive groups, such modifications can be provided as well for any students who need them.

Students with ID and DD may also need explicit instruction around concepts and vocabulary terms to increase their comprehension (Knight, Spooner, Browder, Smith, & Wood, 2013). To teach concepts and vocabulary explicitly, Knight et al. suggest beginning with a topic (e.g., photosynthesis, civil rights, deforestation) and then choosing a set of words needed for comprehension of the given topic. Each of these words would then be taught individually, making definitions concrete by offering pictures or other visuals in the explanation and providing the students with both examples and non-examples of the terms. For instance, in teaching the term precipitation, Knight et al. incorporated pictures of clouds with rain and clouds alone. They specifically explained how only the clouds with the rain “counted” as precipitation. These authors also used graphic organizers to show the relationships between the set of words being taught, for example, placing the words precipitationcondensation, and evaporation on simple drawings of scenes with clouds and rain or snow, and using arrows to describe how one term led to the next. Students were then guided in their own completion of the graphic organizers.

Fluency

Another important aspect in improving comprehension is to attain fluency in reading. When a person reads with fluency, he or she can recognize words automatically, read at an appropriate pace, attend to punctuation so that reading sounds like speech, known as prosody (Rasinski, 2012), and maintain these skills throughout the length of a text, known as endurance (Deeney, 2010). Being able to read fluently allows for greater comprehension because less effort is needed in decoding the text, and therefore, more attention can be directed toward making sense of the text (Griffith & Rasinski, 2004; NRP, 2000). A common way to assess students’ fluency is to measure their oral reading fluency (ORF), which involves counting the number of words a student can correctly read in a minute. There are general guidelines for expected oral reading rates of student by instructional grade level. For example, the average fluency score for students in the middle of first grade is reading 23 words correct per minute (WCPM). This increases to about 53 for average readers by the end of first grade (Hasbrouck & Tindal, 2006).

Fluency instruction for students with ID and DD

Measures of ORF have been used to assess the fluency rate and fluency growth of students with ID and ASD, and such measures are appropriate when students’ disabilities do not interfere with fluent speech. For students who do not have reliable speech or for whom the physical act of speaking creates difficulty, ORF is not likely to be the best measure of these students’ reading fluency. Remember, the purpose of achieving fluency in reading is not to be a great oral reader, per se, but to read easily enough that there is thorough comprehension of the text. A student may not be able to read fluently aloud, but this does not mean that he or she cannot process text fluently in her mind. How do we know if students are reading fluently during silent reading if we cannot hear them read? Certainly determining this can be tricky, but it can be done. The Qualitative Reading Inventory-5 (Leslie & Caldwell, 2011) provides passages for which both ORF and silent reading fluency (SRF) can be determined. In giving an SRF assessment, a student’s reading is timed, and the evaluator asks the student to indicate when he or she is finished, and the number of words per minute can be calculated. To be sure that the student has actually processed the text, you can ask the student to respond (through AAC or other means) to a quick literal comprehension question or two.

The downside to using SRF measures is that you will not get the same information about the types of struggles the student is having in decoding words or in phrasing that an oral reading fluency measure would provide, since you cannot hear the student read. Therefore, deciding which measures to use will be a matter of thinking critically about the students’ needs and what precisely it is you are trying to assess. For example, for a student with some reliable speech, it might make sense to have the student do a short read aloud for which you can do an analysis of her mistakes, and then provide the silent reading task to assess silent reading fluency.

There is, of course, more to fluency than assessment. Once we have determined students’ reading rates, we will need to provide appropriate instruction. If a student’s rate is low, he or she may need more instruction in identifying words accurately and automatically. Therefore, interventions in decoding and recognition of irregularly spelled words will likely be beneficial. However, as discussed, fluency encompasses more than accurate decoding. For any student, with or without disabilities, providing a model of fluent reading is important (Griffith & Rasinski, 2004). Students must be given the opportunity to hear books and other texts read aloud by expert readers to begin to understand how fluent reading should sound.

Another way to provide instruction in fluency to students with ID and DD is to have students reread texts after providing corrective feedback on areas in need of growth (Hua et al., 2012). Begin by having students read a text at their highest instructional reading levels (i.e., the highest reading level at which they can read without frustration and where errors do not have a strong negative impact on the students’ comprehension), taking note of word errors and timing them. Next, correct the word errors making sure they can correctly identify the words. Discuss with them what you noticed about their reading. Do they read word by word or in few-word phrases? Do they attend to punctuation and read with expression? Choose an area to bring to their attention and explain the adjustment you would like made. Model the adjustment if necessary. Next, have them reread the same text with the new skill in mind twice, again making note of word errors and timing them. This method will allow you to keep track of their WCPM over readings and provide direct instruction related to any particular areas of need.

For students who have substantial issues in developing reading fluency or who need to access texts above their individual reading levels, AAC can be used to provide accommodations. For example, if a student needs to read a text for a science class that is too difficult for him or her to read fluently and independently, text-to-speech software can be used to help that student gain access to the text.

Summary

Until quite recently, students with ID and DD have been taught literacy skills through a functional skills curriculum, and have often not been offered access to instruction to help them learn to decode words, read with fluency, and comprehend texts. However, recent research has shown that students with ID and DD can benefit from similar types of research-based reading instruction that is recommended for students without ID and DD.

Planning beneficial, appropriately balanced literacy instruction for students with ID and DD is not easy, but is possible. Educators must be sure not to reduce student learning to only a basic skills approach, but instead, find a way to incorporate skills into comprehensive literacy learning that includes, among other important aspects, access to quality literature, student discussion, and active participation. In addition, educators must be able to think about all of the needs and abilities their students bring to the table and orchestrate the learning of each individual child through careful planning and creativity. Educators must also find ways to break down barriers to students’ participation in literacy learning through modifications to materials and teaching approaches and through the use of AAC as appropriate.


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