SeeHearSpeak Podcast

0:00:12 Tiffany Hogan: Welcome to See Hear Speak Podcast Episode 40. In episode I talk with my longtime mentor, Hugh Catts, about key findings from his lifetime of work on the language basis of reading, early detection of dyslexia and reading comprehension. It’s so good to be back in the saddle recording this podcast for you, my dear listeners. What a year (or 3) it’s been. Thank you to you –parents, educators, SLPs, administrators –you are my heroes working to improve the lives of children, on child at a time, and look at you, taking your free time to listen to this podcast to learn more. Thank you!! Truly thank you! So, because of my long hiatus, podcast platforms thought the podcast has wrapped, that is was over. But alas I’m back and I’d truly appreciate your leaving a rating and even a review. It only takes a few mins but it means the world to me because that’s how the podcast platforms will know I’m back on! Speaking of being back at it, my sincere apologies for the sniffing you may hear from me during this episode. Rookie mistake recording when I’m stuffy. With all that said, let’s get to my conversation with Hugh Catts, Don’t forget to check outthe website,www.seehearspeakpodcast.com,to sign up for email alerts for new episodes and content, read a transcript of this podcast, access articles and resources that we discussed, and find more information about our guests. Cheers to a new year! Oops, I forgot to mention one more thing. I did something a little different with this podcast episode. Listen to the end, and I think you’ll know what I mean.

00:01:57 TH: Hugh Catts, welcome to SeeHearSpeak Podcast. I'll have you start by introducing yourself.

00:02:01 Hugh Catts: Hi, I'm Hugh Catts. I'm a professor at Florida State University and...

00:02:06 TH: It only took four years to get us together on this podcast, even though I think we talk quite a bit but it's great to get you on the podcast.

00:02:14 HC: We talk monthly but haven't done a podcast yet.

00:02:16 TH: That's right. So now we're gonna take those conversations to the listeners so that'll be great. One of my favorite topics is just thinking about how great it was being your student back in Kansas, and when I started as your student, you were beginning data collection on the Iowa study, which is quite famous in our field. I thought you could tell the listeners about the Iowa study.

00:02:35 HC: Yeah, that was such a great time in my career to have all the data that we had out of the Iowa study, and to have you and your fellow students, it was one of the highlights in my career with that project. But the project has interesting history. Bruce Tomlin, who was at University of Iowa, had a contract from NIH to estimate the incidence of specific language impairments or what we call more often, "developmental language disorders", and now, "DLD". And he tested 7000 kids in various schools around the state of Iowa in an epidemiologic study, meaning that he had a representative sample, and he had asked me before he started this study if I had early measures, pre-reading measures, if you will. And so I gave him a phonological awareness and a rapid naming measure, and they looked at this in kindergarteners, it was broken over two years 'cause there was so many kids. And during the second year, I accidentally ran into him at the University of Kansas, where I was, but he was there visiting another unit, I didn't even know he was there. And I ran into him in the hallway and we started talking about this, and I said, "Bruce, why don't we follow up on these kids?" And that unplanned meeting led to 10 years worth of NIH funding and a huge amount of data that we were able to analyze and write papers off of, it was just one of the lucky things in my career.

00:04:17 TH: Oh, and it's also funded my doctoral program, so I got really lucky that way too. [laughter] When I contacted you, you said, "We have a grant in, and I think it'll be funded hopefully next year," and then I waited a year and it was funded, so I was able to come in on that Iowa study. And when I came in, you had collected data for kindergarten, second and fourth graders, and we had started the data collection for eighth, 10th to 12th.

00:04:42 HC: Right.

00:04:42 TH: So it was a great time because we were able to analyze the data from kindergarten, second and fourth, but then we were collecting data, so I got lots of great experience doing both the analysis and the creation of measures and data collection processes. But having a look at longitudinal data like that was quite amazing. What were some of the main findings you remember from that data set?

00:05:07 HC: Yeah, my part, it was a group endeavour. There were seven or eight investigators in the Iowa project, and I was the one that was primarily interested in reading then its relationship to language impairment. So I think one of the more important findings from that study had to do with a relationship between dyslexia and specific language impairments. We had known for some time there was relationship there, but we had an epidemiologic sample, which means that it was representative of kids across the country, and so we could estimate the incidents of the overlap. So we found that if you took a group of kids that were identified as having SLI or Developmental Language Disorder, about a third of those kids qualified as having dyslexia, met the definition of having dyslexia. We find a bit more in a clinical sample, because for kids to get to the clinic, they typically have more severe language problems and those kids will have more cases of dyslexia. Or the other way around, if we identified kids on the basis of dyslexia, we find about 20% of those kids have severe enough language impairments that they could be referred to as having a DLD. Most kids with dyslexia have some language difficulties which contributes to their difficulties in word reading. So that was one of the projects that we had.

00:06:39 HC: Another analysis we did, and I think you helped on that, was we identified a group of kids that had problems in comprehension but didn't have problems in word reading. They're called poor comprehenders or have a specific comprehension deficit. And there had been some studies of these kids, but we had the largest sample to date of those children. And using the simple view, that is a reading comprehension combination of word reading and language comprehension, we proposed that if they didn't have decoding problems or word reading problems, they would have problems in language comprehension. So we gave that group of kids a battery of language measures. And by that time, they were in eighth grade, and we looked at their kindergarten, second, forth, and eighth grade performance on those, [0:10:01.4] ____ found indeed, poor comprehenders had a history of language problems. But the interesting thing that we didn't pay attention to at the time when we wrote that paper, 'cause we kinda had our blinders on, was that the language problems they had weren't nearly as severe as their reading comprehension problem.

00:07:48 HC: So these kids were maybe 1 1/4 standard deviations below the mean and reading comprehension, but were only maybe 2/3-3/4 of standard deviation below in their language abilities, suggesting that there was something else going on besides language problems that was leading to these kids having comprehension deficits. And we went on have looked at that, thought about that further that you'll probably get to it in a minute with some of the other studies. The other project that we had was one that I've been interested in for a number of years, and that was early identification of children with either word reading problems or reading comprehension. And since we had such a large sample, we actually had a sub-sample of those 7000 kids. We had good data in kindergarten, and so what we wanted to do is look to see what combination of factors in kindergarten would predict performance in word reading at second grade. Or I think we looked at reading comprehension at second and fourth grade or so forth. And we identified a number of factors that we could put together, and it would tell you the probability that a child would have a word reading problem.

00:09:09 HC: And it was one of the first studies that looked at it in this particular way of probabilistic notion of having a reading impairment, 'cause some kids are more at risk than other kids. And it was that study that kind of led to other work that I've done since then and led to other people in the field starting to look at these probabilistic models of reading outcome.

00:09:39 TH: So much I appreciated about that article. And one of them was just this idea that you gave a link, it was to a spreadsheet, so clinicians could readily give those assessments, and you intentionally had assessments and data they could collect readily, plug it into the spreadsheet and from the algorithm, you could then determine for each child what percent risk they had of having future reading problems.

00:10:06 HC: Right, right.

00:10:06 TH: So just to get really to that nitty-gritty for the listeners, you would plug the data in and say, "This child A has a risk 0.8 chance versus the other child who is 0.3," so you had to then think more probabilistically too in terms of where do I even have the cut point.

00:10:23 HC: Yeah, exactly. That's the reason we did it, so that we would have a cut point. Yeah, you're right. I'd forgotten about that. Mark Fae actually created the Excel file. That's what it was, it was just an Excel file at the time.

00:10:37 TH: Yeah.

00:10:38 HC: We weren't particularly sophisticated, we actually published that, but we had several hundred emails requesting additional information and they wanted that Excel file that they use to estimate probability.

00:10:58 TH: Was that 2001?

00:10:59 HC: Yeah, 2001 and that's probably one of the most cited studies I have, and I think is still the most cited study in that journal.

00:11:09 TH: Yes, that's right. And it won the article of the year.

00:11:10 HC: And people really resonated to it. Yeah.

00:11:13 TH: Yeah. Yeah, that's fantastic. And that work has really led to what we've done together too on thinking about prevention in our recent article in the reading the journal. Let's talk about that a bit.

00:11:25 HC: Yeah, the reason I've been interested in early identification is the idea that we'd like to address the problems of a reading disability, prior to all the negative consequences associated with it, that having a reading problem is more than a reading problem. And if you think about a child coming to school, it's had a perfectly normal, early development, socially gets around with other kids, is physically agile or whatever they get to school, and all of a sudden they can learn to do what all the other kids in the class are doing. And it can be very frustrating, it can lead to problems and self concept, anxiety. Kids start acting out. I mean, I know some of this personally, because reading problems run in my family and I wasn't a particularly good reader in the early grades. And I know I was disruptive in class and I still have a photo of me in my first grade class, and I'm in the back row with the girls because I was causing so much trouble upfront with the boys in the classroom, they've tried to put me in a separate space in the classroom.

00:12:40 HC: But kids, fortunately, I didn't have the problem, but other kids go on and engage in truancy, delinquency, so forth. So, I know that you resonated to that. And so you and I talked about a paper that we ended up writing, that argued for the prevention of reading disabilities rather than the diagnosis. And the reason for that was that there's now most states in the country have passed legislation to address dyslexia. And the focus tends to be on the diagnosis of dyslexia, on the testing for dyslexia, rather than the prevention of dyslexia. And by prevention, I don't mean preventing the neurological factors that might underlie it. I'm talking about preventing the reading difficulties and the negative consequences, and there is good evidence that we can reduce the reading problems and prevent some of those secondary consequences if we get in there early enough and do the identification and intervention.

00:13:58 TH: Yeah, I really relate to that. Because one of my sons, we have a family history too, but one of my sons is having difficulty, I know, I've talked to you about that, and going with what I know, very early on in early childhood, getting some of those pre-reading measures. And also just going to those IEP meetings, I have to tell the people in the IEP meeting, "I'm the keeper of the self-esteem." So I'm really working at home to counter the negative feelings that are inevitable, even in a very good situation, with good intervention. It's still, like you said, the formative experience they have in education, so just making sure they have outside interests, that he has outside interests that he's getting what he needs. But, I was involved in the passing of the dyslexia law here. And it's really, it's been, I think a real study of how a law can have this real effect just across the board, because to really get good early identification, there's so many factors involved, right? So, first you have to then evaluate, what are you doing at the curriculum level for word reading, anyway? So it's like the whole curriculum has to be revised, then thinking about what measure you're using and then thinking about how you're gonna analyze that data. So let's talk about what's involved in this early identification of dyslexia. What are the many aspects to consider?

00:15:20 HC: Yeah, well, first you make a really good point about that. The law was intended to identify kids with dyslexia, but I actually talked to somebody that's a prominent person in the field of dyslexia and he sees the law more as a general education law because of the impact it's gonna have on reading instruction in the classroom because if with inappropriate reading instruction we're gonna end up with all the kids looking like they have reading problems and so to not overwhelm the MTSS program or special education and so forth, we're gonna have to have a good instruction to begin with. But, if we go to what's involved in early identification, the best indicator of risk for dyslexia and the way that I define dyslexia is as a severe and persistent word reading problem, right? I think a definition like that works better within the school system, we don't have to think about the neurological basis of it or pinpoint a particular cognitive deficit associated with it. It's a severe and persistent problem in word reading that's unexplained on the basis of instruction. So the child is provided with very good instruction, like it appears in the classrooms, but after some period of time it is persistent, then we could identify that child is having dyslexia, right?

00:17:08 HC: But my argument is we don't wait to identify dyslexia, we try to prevent it early on by looking at kids initial performance and learning the letters of the alphabet, the sounds of the letters when they first begin learning to read words, and decoding words, how are they doing there as well. That's not enough because it takes a while for kids to spread themselves out in their word reading ability because there's a lot of factors that can lead to being on the low end of the distribution if you will, in word reading or in letter naming, that are not predictive of later reading performance. So they'll pass a literacy experience. So if a child comes in school without much literacy experience, they're not gonna know as many letters, it's gonna take them a little bit longer to gain proficiency on something like DIBELS, or AIMSweb measures there, and they're gonna perhaps look to be at risk, right? Same thing if we look at word reading. Initially, word reading has a poor effect to it. There's lots of kids down there at the bottom, but with time, they spread themselves out. So to not wait, you don't wanna wait until the end of first grade, which it might be before we can get something that looks more like a normal distribution of word reading to identify the kids at the bottom, we can look to other factors that might be predictive of their later outcome.

00:18:41 HC: One of them, you already mentioned or I did too, family history. So there's a 50% chance that if your sibling has dyslexia, that they're gonna have that condition as well, so we ought to be paying attention to that early on, that should be part of the intake, so when parents sign kids up for school, we would wanna find something about their family history, we'd also wanna know something about their language development. We've known for many years that one of the precursors to having a reading problem is a developmental language problem. So kids that are late to talk, kids that show some early problems with grammar are gonna be at a heightened risk. Not all those kids end up with dyslexia, but that's an additional factor that we wanna look at. And then beyond that, we can think about phonological factors, phonological awareness, we've known that that's part of the so-called science we're reading now, everybody's attention is directed at that. And most kids who have problems in learning to read words have some difficulties in phonology, but not all.

00:19:58 HC: So our relationship between phonological awareness and word reading has primarily been based on group studies that have studied kids who have reading problems, or at risk for reading problems and kids that don't, and when you look at the mean scores, you find out that there's a big difference there and led us to believe that phonological awareness, the phonological memory is an important contributor to word reading ability. But when you look it at a case space way, we find that not all kids who have phonological difficulties, pretty severe phonological difficulties end up having word reading problems, and not all kids who have word reading problems have phonological difficulties. So it is an important factor to look at, but we also have to look at other factors beyond that, and there's a number of models now that attempt to look at multiple factors related to identification of risk. Yaacov Petscher and I have one that's called Cumulative Risk and Resilience Model that talks about risk factors beyond phonological awareness, like oral language ability, attention, visual factors, or some indication that a smaller sub-group of kids that end up with dyslexia have visual problems.

00:21:22 HC: And then we also include environmental factors like trauma. That's an interesting one because in the past, we've ruled out kids as having a learning disability or dyslexia on the basis of environmental factors. But many of the kids who have problems, environmental factors like poverty or trauma, also have some of the other things that can lead to poor outcomes, and it's a combination of the trauma in addition to the phonological, oral language, visual problems that are leading to the poor outcomes. So we put the emphasis back on that so that we don't under-identify, which we are doing at the moment, we're under-identifying kids with poverty as having learning disabilities, because we're assuming that it has something to do with the environment, but there's a substantial portion of those kids who also have other factors that contribute to it.

00:22:32 HC: And then on the other side, we have factors that will limit the impact of the risk factors, and you mentioned it yourself in a supportive parent being one of those that helps with, encourages a child to not take a negative attitude toward reading in school. Supportive teachers, I remember you tell me about your son's teacher who... What was it your son came home and said? What was... Tell me...

00:23:06 TH: Oh, yeah. So he said, "I really like my new teacher," it's his first grade teacher, and I said, "Why?" He goes, "Well, she says she doesn't care how we do as long as we try," and I said, "Well, haven't all your teachers said that?" He goes, "No, but she really means it. [laughter] She just really wants us to try." So that growth mindset for sure is being modeled by her, which I think is so great. I think what you've talked about here in terms of what's involved, even thinking about the definition of dyslexia and what you mentioned about how we sometimes have excluded certain kids. And I think it also makes me think a lot about how we do research versus what's done in the schools. Because in research, we have the privilege, I guess you would say, or maybe even the edict that we do need to exclude certain kids, because we're really trying to get to a specific research question and analyze what is, like what's the impact of this particular ability on reading aside from, let's say, poverty.

00:24:05 TH: So, we have that. But then if you take the science of reading and extrapolate that to practice, in practice you don't have that. You can't really exclude kids. And you shouldn't, right? 'Cause all the kids need help. So, I love what you're doing with Yaacov, looking at all of these factors. Because you're saying, "We're not excluding anyone. We're actually taking all of the children, looking at all the variables associated like phonological processing." And I know a big article or a book chapter that influenced our thinking a lot early on was that one by Hollis Scarborough, the Beautiful Hypothesis, Ugly Facts. And I love that. And you're getting into those ugly facts of, "This is what it is." We have to look across. And even defining dyslexia, we have, in the past just defined it by certain characteristics about cognitive processes. But I love your definition to say it's just word reading problems that are persistent. That's it. That's the core.

00:25:00 HC: And unexplained.

00:25:01 TH: And unexplained. Unexplained, right. Cool. 'Cause it can't just be poor instruction.

00:25:05 HC: That's right.

00:25:05 TH: You can't have, it's not that. It's that you have a difficulty in word reading that needs to be addressed. And I've done, I know you've done a lot of teacher trainings too, but recently I was doing one, and one of the educators said, "I don't think I've had a child with dyslexia under my special-ed umbrella before." And I said, "Well, do you have someone whose learning qualifies for services as learning disabled word reading?" And she said, "Oh yeah, I have a ton of those." [laughter] And I said, "Well, those are children with dyslexia." It's been so co-oped, I think, and historically used by the medical field that one of the big parts of the law is that schools can now use the word dyslexia, acknowledge dyslexia. And so it's a shift, to think, "What is dyslexia?" It's not mystical in that way. It is a word reading problem that we have to address considering all of these big components. So, I appreciate that, that aspect.

00:26:01 HC: Yeah. I think that's one of the major problems that school systems are gonna have to work with, is how do you operationally define dyslexia? And we offered some suggestions on that in a paper in the journal Learning Disabilities, recently to kind of address to that. And it wasn't purely right. There's other people around the world that had been addressing this for sometimes and had been concerned about the medical-based definition of dyslexia was making it harder for it to be operationalized in school systems.

00:26:37 TH: Absolutely. So then we've been working about this, thinking about early identification of dyslexia, but never lost that desire to do more work in the language basis of reading. So then we were able to move forward when I was an assistant professor and you were in Kansas, and then moved to Florida State, we worked on the LARRC study, which was another opportunity to follow kids longitudinally with even more measures and a tighter timeline. So we followed them from pre-K to grade three. So five years each year, we followed them. And LARRC stands for Language and Reading Research Consortium, that we involved, I think 14 investigators total. Let's talk about what are some of the major findings from that study as related to what we did in the Iowa Study, and even around word reading and listening comprehension.

00:27:26 HC: Yeah, yeah. That was another great opportunity. When you look back at your career as you move forward, these coincidences that just come about. And we had no idea what that study was gonna lead to. You say it was short term, we still have colleagues of ours that are following those kids, and I think you're involved in some of that work too.

00:27:51 TH: We are. Yeah, that's right. We are following.

00:27:53 HC: It was a five-year study, but it's now up to 10 years, yeah. That was interesting. IES was gonna fund five different groups of researchers to study reading comprehension and look at ways to try to improve reading comprehension. They were concerned about the low performance of kids on either national, the NAEP or on state exams and so forth, and had done a pretty good job of improving word reading instruction through No Child Left Behind. People talk about No Child Left Behind being a failure, well, it may not have changed what some people hoped it would change, but it certainly changed word reading instruction in many school districts. I know here in Florida, with Early Reading First, it made a big difference in the word reading ability of kids. And I know, Tiffany, when we were working on the Iowa project, I think you remember us looking at the performance on word reading tests that had been norm before and after the No Child Left Behind and what a difference it was on those scores?

00:29:12 TH: Well, it's interesting. It leads to LARRC in that way too, because the failure came from the fact that they said, "Well, reading scores didn't improve." But the reading scores were reading comprehension, now word reading. And as we know, word reading is one part of reading comprehension. So, you can't address one part and expect for those outcomes to change. And so that also, I think, led to the Institute of Education Sciences saying, "Let's do this initiative called Reading for Understanding." And I remember Shelley saying, "We need a speech language pathologist to be a part of this." So it was nice to have that language aspect from our angle focusing on younger children. And I remember too those projects, a lot of people were really interested when they said reading comprehension, people went in with proposals that were junior high and high school, 'cause they're like, "Well, that's when comprehension matters." And we came in and said, "But wait, hold on. From a speech-language pathologist perspective, we know and the work that you've done in Iowa, that the language base just starts before." So we had a reading comprehension grant that started in pre-k, which I think was mind-boggling for some people. Right?

00:30:17 HC: Yeah, that's right.

[laughter]

00:30:20 TH: Yeah, 'cause it involves not only following kids on longitudinally, but involved also creating a classroom-based intervention in language comprehension, and doing a randomized control trial all in five years, which was basically like four or five R01s. So it was really challenging, but well, we learned so much from it. What did you take from it?

00:30:40 HC: Well, we learned quite a bit from it. I think we had data, longitudinal data, looking at the development of comprehension and looking at factors that contributed to reading comprehension, so we did some nice studies that supported the simple view of reading. We also had some nice studies that were done looking at second language learners and what factors predicted their performance. One group, Lida and Shelley in Arizona had a sample that allowed us to look at those kids and whether their Spanish language abilities predicted their English language reading. And I still have a doc student that's analyzing some of that data. So that was a wonderful data set. The other part I thought was the intervention program. Like you said, we put together a whole year's worth of intervention materials that... What we didn't realize at first, how unique it was in terms of that they were centered around content, so we had soil science or whatever it was, and then there was another one around animals, and there were some narratives texts in there as well. And we worked on things like text structure and a comprehension monitoring and vocabulary and a number of different things. And that curriculum now is being used in other studies as well.

00:32:23 TH: Yeah, actually, we have those. That's online for free. I can link it in the podcast resources, but that curriculum, which is a full-year full classroom curriculum for pre-K, K, 1st and second and third, it has, as you mentioned, two expository text units, animals and Earth materials, and two fiction, fiction and folktales, and I continued on with Mindy Bridges and Shayne Piasta, and we now are using the strong efficacy data from the classroom instruction and we, led by Mindy Bridges, created a tier two version of that. So small groups who have failed language screenings and now we're running a randomized control trial to look at how that improves language skills in first graders as the starting point. And so, yeah, we are continuing that on, yeah.

00:33:11 HC: That's great.

00:33:13 TH: But you're right, the content is critical to that.

00:33:16 HC: Yeah, and then the other thing, I think we learned not only in our group, but in the other groups, is just how hard it is to change performance on reading comprehension standardized measures that we've been concerned with trying to improve performance on the NAEP or on state exams, that's a big push by state districts to try to improve their performance on the exams, and I know speech pathologists wanna do things that are gonna improve performance on some of the standardized tests of reading comprehension that we use. And I think that the LARRC study solidified it for me is that it's just near impossible to do that in the short run, that we have some of the best people in the country with backgrounds in reading comprehension trying to improve reading comprehension, and very few of the projects got any sort of improvement on standardized reading tests. We did get some, they were small, but it didn't mean we didn't have effects. We actually did get effects in components of reading in our comprehension monitoring, in our narrative comprehension. We got impacts, but on those measures, we didn't. And I think it's where we've gone wrong in thinking about reading comprehension. It's the most complex thing that you or I do on a daily basis.

00:34:52 HC: Maybe some of our stats that we might do, but most people out there, it's the most complicated thing you do. And to think that you can reduce it down to a single test and induce something in a short term to make somebody better at that, is unrealistic. And I thought a lot about why it is that we think that way, and I believe it has something to do with the fact that we talk about reading comprehension in the same breath that we talk about phonological awareness, phonics, and fluency, these more skill-based type activities or abilities, if you will, that are teachable and they're teachable in the short period of time, and they're very different than reading comprehension. And I think what happened was that one of the major things is that people have misrepresented the findings of the national reading panel into this five big ideas notion, right? Well, there's not five big ideas, there was one really big idea and two or three small ideas. And that when you realize that, you realize that we can change these things, but changing one's ability to understand text such that you can understand multiple texts requires much more than working on skills that may be underlying. Certainly working on word reading. Most kids that have comprehension problems have word reading problems, so working on that is gonna improve it.

00:36:34 HC: You can also teach kids to be more strategic about their reading, that's gonna improve their comprehension. But those two alone will not move the needle enough to where it will get big changes in that we won't reach some ceiling effect, if you will, on something like the NAEP. That the NAEP is a fair measure of what you know about all sorts of things that's on the NAEP. And the one way you get that to improve is, kids need to know more about different things that they read about, that background knowledge is a critical factor in whether you understand what you read. And so we're beginning to think about teaching reading within the context of also teaching knowledge that science and social studies and other subject matters are critical to improving reading comprehension. And so what some people are thinking about now is rather than measuring reading comprehension on something like the NAEP or the others, is measure kids ability to read and write about subject matter that they've been taught during the previous year. Then you get an idea of not only reading and writing ability, but you get an idea of how much they've learned about the curriculum and so forth.

00:38:00 TH: I think that makes great sense. And I know you have a recent paper on that as well that you wrote. Who was that for? American...

0:38:07 HC: The American Educator is a bit about that, talked about our reading comprehension and some of the thoughts about comprehension. And it was largely coming out of LARRC and seeing just how complicated it was to try to improve comprehension that led me to... I guess my training in cognitive science got pushed aside by the thinking around reading, we did simplify comprehension for many years in reading. We measured it with a test.

00:38:49 TH: Yes, exactly.

00:38:50 HC: And I think that seeing it in operation there, it was an eye-opener to me. It was like almost an "Aha" moment for me in terms of what one needed to do.

00:39:06 TH: Absolutely. And it's got me thinking a lot too, working with schools that do have very stellar word reading curricula. And even schools that focus on children with dyslexia, they're so good at teaching a child to read words and they do it. Even if it's a bit laborious, even if you have the carryover effect of having spelling problems and having some fluency or rate difficulty, those children are really learning how to read over time. But they're still struggling in reading comprehension, so them saying, "What's the missing piece? What are we doing? What's happening here?" And these are sometimes families that do have really strong knowledge, but then that child has the underlying deficit in language comprehension, and you see people chase after working memory. You see people chase after executive function. But really, a lot of that is language, and even those skills, we know language is a huge factor to it, so I think that, you know, such a missing piece...

00:40:05 HC: Even the language part should be knowledge-based. I remember that I gave a talk one time, a speech pathologist wanted to know what materials to use to teach language knowledge, and the answer was, "Whatever materials they're using in the school." Go get the children's books, the textbook for the science or social studies and use that to teach the language. Teach the language of the book at the same time you're teaching the subject matter that's being taught within the book. And you're more likely to learn, to understand the meaning of a word if it's in the context that's supported by the knowledge that's presented in that text.

00:40:56 TH: Yeah, I know on the podcast I had with Elena Plante, the podcast was on assessment, but she said that speech language pathologist's will look to a test like the CELF or the Clinical Evaluation of Language Fundamentals, for therapy goals. And she tells him, "Don't look there, that's for diagnostic. You need to go into the classroom, grab a worksheet. That's what you do to get functional language goals and helping them there too." So we've followed this trajectory a bit. We talked about the Iowa study and LARRC and I know you had another study in there with Mindy. I wanted you to talk a bit about your newest project with Harvard and The Zuckerberg Foundation and how that's going.

00:41:37 HC: Yeah, that's been another... God, you think about these just lucky opportunities, you know?

00:41:41 TH: They were lucky.

00:41:43 HC: A phone call came one afternoon from John Gabrieli at MIT asking if I might be interested in working with him and people from Harvard on developing some screening assessments to help identify kids at risk for reading and language problems. They had gotten a grant from the Chan Zuckerberg Initiative to try to improve reading in children. And the project got named Reach Every Reader project and it's run out of Harvard, the city and the school of education there is the primary investigator on it. And so Yaacov Petscher and I and our team have been developing screening tools. But also in the process, learning a lot more about screening about assessment as it relates to dyslexia. It's this project that led us to develop that Cumulative Risk and Resilience Model. And so we've got a bit a work done, but the pandemic has really been problematic for us because we've needed to collect data in the schools and with the pandemic that's been shut down. But we have gone online and have collected data virtually and we're back in the schools now, and so hopefully in a few years we'll have some screening measures to identify dyslexia. And I know you're interested in identifying DLD and I was interested right from the beginning, so I put in about as many measures that measure early language ability as measure word reading ability.

00:43:33 HC: And the nice thing about these assessments is that they're adaptive so that within maybe as few as seven items, you can get an estimate of the child's performance, because you kinda bounce around ability by your particular response to a given item determines what next item you get is, and so it'll be easy or harder and you can quickly get an estimate of language ability doing that. And if you have three or four measures, you can better pinpoint language ability because for the most part, early on where we're working, it's kind of a single skill and/or skill or ability, I say. I don't really wanna call language skill. And so we can get a pretty good estimate of that within a short period of time, so hopefully in the next few years we'll have a measure of that.

00:44:26 TH: Oh, that's great.

00:44:27 HC: Yeah.

00:44:28 TH: And I'm being mindful of our time. But I have two final questions I always ask everyone, and that is, what are you working on now you're most excited about?

00:44:35 HC: Yeah, I think the most exciting thing I'm most excited about at the moment related to this Reach Every Reader study is how we deal with the diversity within the schools, we talked about that a little bit earlier. But we're doing some of this testing out in California which has a huge population of kids that their home language is something other than English, so they come to school with varying levels of English. But how do you develop a set of screening materials that will allow you to identify which of those kids are at risk for later reading problems? And we know just because you have another language, it doesn't mean that it's that problem, or I wouldn't even call it a problem, that issue that leads to having a reading disability. And so we're working with Lilly Duran from University of Oregon and our team here is working, they're thinking about whether we can use measures of their home language to give us some idea of likelihood and, how do we work through those problems? I'm working with Lisa Fenton and Lakisha Johnson... Jackson at... A word reading problem. She'll kill me.

00:45:56 TH: I think it's Johnson, I do think it's Johnson. [laughter]

00:45:59 HC: Johnson, right.

00:46:01 TH: I'll check it.

00:46:02 HC: Well, you know the word finding problems I have here.

00:46:03 TH: Oh, yeah. I know, me too.

00:46:03 HC: I can't remember your name from time to time.

00:46:05 TH: Me too.

[laughter]

00:46:07 HC: But they are working on, so that they can use a sentence repetition task that help us identify language problems that aren't identified on the basis of dialect. So sentences that are sensitive to dialect, sentences that aren't and we can look at differential performance to prevent dialect from impacting our judgments about language impairment.

00:46:35 TH: That's very interesting. We've been working with our school partners as well on this, because in the grant I have where we're identifying DLD language impairment, we go in and we immediately rule out anyone who's not a primary English speaker and in our districts that can be 50% of children and we know that's not right. You know, we do. And so they have varied levels of English proficiency, and one thing we've been working with our district on is looking at a response to intervention. So they're all getting English stimulation, and we look at how they perform on the measure, let's say Fall and then look at Winter and it's the change in their English proficiency. It's just one measure, it doesn't mean English proficiency is the key to anything here, that's not what I'm saying, it's just a way to measure their language learning ability as...

00:47:23 HC: I think you're right there, that would be a useful indication of perhaps risk if you're slow to learn English.

00:47:31 TH: It's tricky for us because that district has over 80 languages spoken, so we don't have the luxury of going in and having every single language measured, which I wish we did, but that's just not realistic. So I think getting some of those ideas is very helpful.

00:47:47 HC: A lot more diversity than there was when we were working on the Iowa project.

T00:47:51 TH: Oh, yeah. [laughter] Yes. So true.

00:47:55 HC: So that's the most exciting part for me. I'm really enjoying that. It's expanding the way... I'm learning things about topics that I didn't know that much about, and so forth.

00:48:03 TH: And you're getting in the nitty-gritty in the schools too.

00:48:06 HC: Yeah.

00:48:07 TH: More than you probably have in the past, really, getting to see some of the barriers that they have. And I'm excited that you're interested in the DLD screening. You know, it's funny 'cause you got me interested in DLD screening and then you worked more on the dyslexia aspect and I went off to work with the DLD and then we came back around. So, [chuckle] it never leaves.

00:48:26 HC: And now you're convincing me, and yeah, I'm telling people there, if they're gonna develop a screener for dyslexia, you're gonna have to pay attention to DLD 'cause these kids are twice impaired, if you will, they're gonna have problems in word reading but also in comprehension because of language problems.

00:48:46 TH: Especially the ones that... It's not a majority, but a large group. The estimates, right, like you said are... I always say 50% as an average of those kids will have typical word reading. So they look "Okay" and then over time when they aren't doing well, unfortunately, they're called lazy or inattentive and sometimes they're called late emerging poor readers. But we know they've had the language difficulties all along, so trying to get them to focus on that language screening ahead of time. It's such a great opportunity because schools are so focused on screening period that it's great to think about screening for other aspects as well. I have a doctoral student who's focused on screening for ADHD as well. In Massachusetts, our law actually says screening for learning disabilities such as dyslexia and others, so we have a bit of a hook with our districts too to think about other difficulties that would cause learning problems over time.

00:49:41 HC: One good thing about the screening tools is they're alerting us to the individual differences that we should pay attention to anyway.

00:49:46 TH: Yes.

00:49:48 HC: So the teachers are now seeing the types of things in kids that... They already have pretty good insight into what kids are gonna have trouble in and we use teacher feedback in our early identification algorithms or whatever. But this is expanding the knowledge of what child behaviors are indicative of risk.

00:50:18 TH: I think you're exactly right. And also this work has got me interested in implementation science and really thinking about those partnerships and listening to our stakeholders, educators, teachers. They know best and learning, creating, and I know you're doing this with Reach Every Reader, you're creating an instrument that will work and fit into the school environment. And so many times we would create things outside of the school environment and ask clinicians and teachers and administrators to fit it in, whereas if you create it with those partners, you're more likely... I was just reading a quote yesterday actually, thinking about implementation science, that really got me. It was a study that was done showing what research is implemented in practice. It really had nothing to do with the effect size or even the value of the research, nothing about how effective it was for outcomes, it had everything to do with how well it matched the practice setting. So if it matches, it's put into practice.

00:51:17 HC: Exactly. That's one of the things that I'm worried about where the screeners has to have good face validity.

00:51:22 TH: Yes.

00:51:23 HC: The people in the schools have to recognize it as potentially being worthwhile or it won't be used, and that's not a fault of the schools. That's human behavior is that what seems to make sense to us is what we gravitate toward.

00:51:42 TH: Absolutely. And I think there's now more frameworks out there, a science around this, so now we can use those frameworks to do better now that we know. My last question for you, thank you again for this time, it's been fantastic. What is your favorite book from childhood or now?

00:52:00 HC: Yeah, I thought you were gonna ask me that question. For being a poor reader early on, I'm a pretty avid reader.

00:52:07 TH: Yes, you are.

00:52:09 HC: And I don't think I started reading very much until I was out of high school. I maybe have read Great Expectations 'cause I was forced to in school, but I love to read and I know you and I always talked about the books we loved. We were always connected that way in terms of liking the same books and the same movies and so forth and we'd come in and tell you, "I just read this book," and so forth. But my problem is I don't remember any of the titles or very many of them. But I can tell you my favorite book is called A Land Remembered. And it's a historical fiction of Florida, and anybody I've ever told about the book and I've given multiple copies to other people and you kinda have to have a Florida connection to appreciate it. But it's a wonderful book about what Florida was like in the 1900s, early 1900s, 1800s. A great story.

00:53:15 TH: Oh, that's great. That's great. Well, I know you turned me on to Pillars of the Earth and we really liked Ghost Map.

00:53:20 HC: Yeah. That was one of our favorite books. Ghost Map. Oh, I forgot about that.

00:53:24 TH: God, so good. Such a good one.

00:53:26 HC: Were you guys listening to this Ghost Map? It's just a wonderful book about the guy who figured out what caused cholera.

00:53:34 TH: Yep, exactly.

00:53:35 HC: And how long it took him to convince his other fellow medical people what caused it. And I talk about that in my doctoral seminar about confirmation bias and how they were so convinced it had something to do with the stink...

00:53:59 TH: Yes. They thought it was... Yes.

00:54:01 HC: And the stench in London, right?

00:54:02 TH: Yep. They thought you could smell it and get it. [chuckle]

00:54:04 HC: Yeah, yeah. And it took years for them to... He had the proof right there in the well.

00:54:14 TH: Yeah. Exactly. [laughter] Right there in the well. [chuckle]

00:54:19 HC: Yeah. What's the guy's name that wrote that book? Jerry...

00:54:22 TH: I'll have to look it up and put it in our resources.

00:54:23 HC: No, no. Johnson. His last name is Johnson that wrote that book, yeah.

00:54:27 TH: Yeah. It was really good. Yeah, I'm still an avid reader and now they have the apps you can use, so like the Goodreads. Now that's how I keep track of my books now 'cause it's hard for me to know too, but yeah, that's great.

00:54:41 HC: We've still got a fairly wide-size library here. We give a lot of books away back to the library and other places when they have book drives and stuff like that. We still do keep a lot of books around 'cause one of the nice things about having a limited memory is you can go back and read that book over again and it's like a new experience.

[laughter]

00:55:00 TH: That's right. Totally.

[laughter]

H00:55:03 C: I've read, Land Remembered, twice. And probably in another couple of years, I'll be good to go to read it again.

[laughter]

00:55:10 TH: That's right.

00:55:11 HC: I don't remember much of it.

00:55:13 TH: It'll be like, "I just remember this was such a good book." I've never read a book twice, but I want to. It's kind of silly, but I should.

00:55:21 HC: Yeah. The longer you have between times, the more you forgot, it seems like a new read.

00:55:28 TH: Yeah, I'm sure it would seem like that for me for many of the books, especially I read back in the doctoral program, which was a long time ago.

00:55:34 HC: Yeah, but you know, the way you think about books, it changed too. And so, that may have been a really good book for you at that moment in time where you were, and it might not be any more. I don't know if I read Pillars of the Earth, now, if I would like it as much as I did when I read it back then.

00:55:54 TH: That's true. Yeah, that goes right back to that reading comprehension, that interactive model. Where it's like, what you bring to the book at the time is so different. Yeah, it is. Yeah, that's so true. Well, thank you so much, I know you gotta head out. And I just really appreciate chatting with you.

00:56:10 HC: Yeah, it's been wonderful, Tiffany. I'm sorry that it took, I think you're at 39 episodes, before you and I got together to talk, but maybe we can do another one, some time in the future as well.

00:56:25 TH: I would love that. This is a great one, though, to get me back in the saddle because it's been a while. I'm glad to be back with this one.

00:56:31 HC: Welcome back!

00:56:31 TH: Thank you.

00:56:33 HC: I'm glad to be one of the early ones since you come back.

00:56:37 TH: Thank you.

00:56:41 TH: TF: Check out www.seehearspeakpodcast.com for helpful resources associated with this podcast including, for example, the podcast transcript, research articles, and speaker bios. You can also sign up for email alerts on the website or subscribe to the podcast on Apple Podcasts or any other listening platform, so you will be the first to hear about new episodes. Thank you for listening and good luck to you, making the world a better place by helping one child at a time.

00:57:14: Alright

00:57:15 TH: What’s going on? What was that?

00:57:18 HC: That was a dog coming down our little steps.

00:57:19 TH: Oh no ting ting ting ting

[laughter]