Adults With Low Literacy Skills: How SLPs Can Help Speech-language pathologists actively aid those with poor literacy skills. Much attention has been devoted to understanding language and literacy development and to proposing methods for SLPs to provide effective intervention. Unfortunately, the attention devoted to studying literacy and language skills is unequally distributed across the lifespan, with the majority of ... Features
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Features  |   August 01, 2011
Adults With Low Literacy Skills: How SLPs Can Help
Author Notes
  • Daphne Greenberg, is associate professor in the Department of Educational Psychology and Special Education at Georgia State University. Her research interests focus on family literacy, health literacy, instructional interventions for struggling adult readers, and word-reading processes of both children and adults. She can be reached at dgreenberg@gsu.edu.
    Daphne Greenberg, is associate professor in the Department of Educational Psychology and Special Education at Georgia State University. Her research interests focus on family literacy, health literacy, instructional interventions for struggling adult readers, and word-reading processes of both children and adults. She can be reached at dgreenberg@gsu.edu.×
  • Jacqueline Laures-Gore, PhD, CCC-SLP, is associate professor of communication disorders at Georgia State University. Her research interests include adult language and motor speech disorders. She can be reached at spejsl@langate.gsu.edu.
    Jacqueline Laures-Gore, PhD, CCC-SLP, is associate professor of communication disorders at Georgia State University. Her research interests include adult language and motor speech disorders. She can be reached at spejsl@langate.gsu.edu.×
Article Information
Normal Language Processing / Features
Features   |   August 01, 2011
Adults With Low Literacy Skills: How SLPs Can Help
The ASHA Leader, August 2011, Vol. 16, online only. doi:10.1044/leader.FTR7.16102011.np
The ASHA Leader, August 2011, Vol. 16, online only. doi:10.1044/leader.FTR7.16102011.np
Speech-language pathologists actively aid those with poor literacy skills. Much attention has been devoted to understanding language and literacy development and to proposing methods for SLPs to provide effective intervention. Unfortunately, the attention devoted to studying literacy and language skills is unequally distributed across the lifespan, with the majority of researchers focusing on children’s literacy skills.
The National Assessment of Adult Literacy (2003), however, reported that approximately 93 million adults in the United States (45% of the population) read below the high-school level, and approximately 30 million (14% of the population) have difficulty reading typical materials encountered in their homes, neighborhoods, and workplaces (National Assessment of Adult Literacy, 2003). They have difficulty completing job applications, reading to their children, understanding prescription labels, and voting. Many of these adults’ reading difficulties were unrecognized or unremediated during their childhood (Snow & Strucker, 2000). Elish-Piper (2007) explains that this heterogeneous population includes adults of all ages, income levels, ethnicities, and educational backgrounds.
Low literacy affects the entire society. People who have low literacy skills cost the United States up to $238 billion in health care (17% of annual health care costs) and more than $225 billion in crime, loss of tax revenue, and low productivity in the workplace. More than 60% of all inmates in state and federal corrections facilities have difficulty reading. Recent research addressing health literacy in adults has shown that low literacy skills are related to decreased knowledge about health issues such as diabetes, hypertension, weight loss, and stroke (Fang, Panguluri, Machtinger, & Schillinger, 2009; Kennen et al., 2005; Williams, Parker, Baker, & Nurss, 1998).
Language Skills of Adults With Low Literacy Skills
Historically, it was believed that adults who have reading deficiencies do not necessarily have similar deficiencies in oral-language skills because of their daily exposure to and experience with oral language over their lifetime. In essence, it was thought that lifelong daily exposure and experience with oral language should make up for the lack of exposure to print that adults with reading difficulties experienced (Hoffman, 1978). However, evidence suggests that adult poor readers do demonstrate weak oral-language skills. For example, Sticht (1982) found that adults reading at the fifth-grade level also perform at the fifth-grade level answering multiple-choice questions 0about a passage they had just heard. Similarly, adults who read at the third-grade level have been found to have listening-comprehension skills at the fourth-grade level and antonym-production skills at the sixth-grade level (Gold & Johnson, 1982).
Researchers studying object-naming skills in adult struggling readers have found that they not only have object-naming difficulties, but also exhibit frequent phonological errors during naming tasks (Cantwell & Rubin, 1992; Dietrich & Brady, 2001) Furthermore, Greenberg, Ehri, and Perin (1997) found that compared to children of similar reading level, adults on average scored consistently lower that the children on phonological tasks of segmentation and deletion. On receptive vocabulary, the Peabody Picture Vocabulary Test scores of the adults were extremely low—in the first percentile. Finally, research on adults who read below the sixth-grade level continues to paint a consistent picture of their difficulty with oral-language skills, indicating that they have deficient syntactic, confrontation-naming, receptive-vocabulary, and phonological skills (Taylor, Greenberg, Laures-Gore, & Wise, in press; Hall, Greenberg, Laures-Gore, & Pae, under review; Greenberg et al., 2011).
Role of the SLP
There is a paucity of research in the adult literacy field (e.g., Curtis, 2006; Greenberg, 2008; Krudenier, 2002) and considerable discord between the needs of adults who have difficulty reading and the availability of research-based methods to address these needs. Federal agencies recently began an attempt to build this foundation by funding researchers across universities and private industry to study reading instruction in adults with low literacy skills. The results of some these studies are published in a special issue of the Journal of Research on Educational Effectiveness (Volume 4, 2011); however, there is a continuing need to explore further and understand adults who struggle with reading. Given the SLP’s crucial role in developing the language skills of children, the field must also explore ways in which SLPs can add to the building of an empirically and theoretically based understanding of language skills in adults with low literacy skills.
SLPs providing services to adults with low literacy skills must first administer assessments to determine whether a client actually needs help. Finding an appropriate test, however, can be difficult. The equivalencies are based on children’s scores and may have different meanings for adults (Perin, 1991); research is beginning to show that adults and children do not necessarily exhibit the same reading profile patterns even when matched on word-reading scores (Greenberg et. al., 1997; Nanda, Greenberg, & Morris, 2010). Finally, most tests have not been standardized on adults with extreme reading difficulties and therefore may not capture information the same way they do with children (Greenberg, Pae, Morris, Calhoon, & Nanda, 2009). When testing adults who have difficulty reading, SLPs should keep some important caveats in mind. They should reassure clients that many people find the tests difficult. As Greenberg (2008) suggests, the client should not be informed of grade-equivalency scores, because unless counseling is available, clients may be disturbed to discover how poorly they read.
As Greenberg (2008) recommends, only strengths and weaknesses should be shared. If assessments indicate that an adult would benefit from literacy instruction, the SLP should have a referral list of community-based literacy organizations ready to share. The client should be informed that free (or low-cost) adult literacy help is available and that the program is qualified to help adults with their reading.
The SLP also may want to work on phonological and vocabulary skills with the client. McShane (2005) offers some advice when working with adults on such skills. For example, when working with adults who would benefit from vocabulary instruction, she recommends that “real life” words should be emphasized through multiple exposures in several different contexts: “...this guideline suggests teaching words they will encounter in real life settings, such as family or work-related terms” (p. 63). When working on phonological skills, she recommends these skills be taught explicitly and systematically, i.e., the skills are “...logically sequenced and directly taught” (p. 42).
Adults with low literacy skills pose a challenge for the country. However, SLPs can contribute positively to remediating this issue by addressing the language difficulties exhibited by this population and by aiding in the development of a greater theoretically based understanding of the problem.
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August 2011
Volume 16, Issue 10