Grace: You’re listening to Speaking of Literacy, the Iowa Reading Research Center’s podcast on the field of speech-language pathology and its impact on literacy development.

Natalie: This is a podcast intended for educators, students, and any individuals that work with kids who want to better understand the role of professionals in the speech, language, and hearing science profession and how their work supports the teaching of literacy and reading skills.

Grace: We are your hosts, Grace Cacini…

Natalie: …and Natalie Schloss.

Grace: We are undergraduate students at the University of Iowa studying communication sciences and disorders and are assistive technology coordinators at the Iowa Reading Research Center. We have come together to educate others about this profession and to present the current research and how it relates to reading and writing. 

Natalie: We welcome everyone to join us on this journey as we uncover the facts and outline the roles and responsibilities speech-language pathologists have in the reading development of the individuals they work with. Throughout this podcast, we will often refer to speech-language pathologists as SLPs. You can find definitions for terms like this, as well as links to things we mention in the episode, in our listening companion.

Natalie: Welcome listeners to Speaking of Literacy. This episode, Grace and I are joined by Dr. Loveall, an assistant professor in the Department of Special Education and Communication Disorders at the University of Nebraska-Lincoln and director of the Learning Lab for Intellectual and Developmental Disabilities. Dr. Loveall's focus is on learning abilities of individuals with intellectual and developmental disabilities across the lifespan. Specifically, her research focuses on the study of reading skills and their underlying linguistic and cognitive processes with the goal of better understanding cognitive development and designing and implementing interventions for those who struggle with learning language or reading. I'm honored to welcome Dr. Loveall to the podcast. 

Susan: Thank you. I'm so happy to be here. 

Grace: Awesome. We're so excited to talk to you today. And we’re just going to have you start off by introducing yourself and giving us a little bit more information about you. 

Susan: Sure. So I am an assistant professor in special education in speech language pathology at the University of Nebraska in Lincoln, but I'm not actually a special educator, or an SLP, or an audiologist. I am a cognitive and developmental psychologist. But I do love being in this department because there's kind of a broader focus on working with and serving individuals who have delays, disabilities, differences, as well as their families. So it's a really great fit in that way. As a developmental psychologist, I'm really interested in how these skills develop across the lifespan, right? So I don't focus on any one specific area or age group, but rather kind of what these skills look like at different points in time and how they change. 

Grace: Yeah, that's awesome. Do you mind sharing, too, a little bit more about, like, your education journey, like how you got to Nebraska and kind of what that looked like for you, or how you got into these roles and positions and how you got interested in that?

Susan: Yeah, so my PhD is from the University of Alabama. I went to the University of Alabama, specifically to work with Frances Connors, who was doing a lot of really cool work on reading and learning in individuals who have intellectual disabilities. So that's where I went. While I was there, I was lucky enough to work on one of her NIH-funded grants that was looking at language and working memory in individuals with Down syndrome. And working on that project was really just a big shift in my, kind of, academic and professional journey because I realized how much I loved working with the individuals with Down syndrome and their families. So that's what I decided to focus my dissertation on. I was already interested in reading, but then that really shifted me to do my dissertation on reading in individuals with Down syndrome. After graduating, I did a post doc, a fellowship at the University of Kansas, which is where I'm from originally, is Kansas. From there, I took my first faculty position at the University of Mississippi, and so I was in the Department of Communication Sciences and Disorders there, and I also helped oversee a grant-funded preschool laboratory program for children who had speech and language communication delays and difficulties, a lot of whom also were on the autism spectrum. And then about five years ago, we moved back to the Midwest when the position became available here at UNL. 

Grace: Awesome. No, that’s a great, great path. You've had a lot of great opportunities, it sounds like, to get you where you are today. 

Natalie: We would love to learn more about your research. So a lot of your research focuses on people with intellectual disabilities in general. So how do overall reading skills of individuals with intellectual disabilities differ from their typically developing peers?

Susan: So, to receive a diagnosis of intellectual disability, an individual has to have limitations in intellectual functioning and adaptive functioning, and those difficulties have to be evident in the first 22 years of life, so the developmental period. However, there's, like, all different kinds of etiologies of intellectual disability. There's a lot of inter-individual variability across individuals with intellectual disability. So I just like to say that to explain that not everybody with an intellectual disability is the same, right? Just like in the typical population, there's tons of variability. But kind of that being said, we do see some kind of interesting areas of strength and weakness within individuals with intellectual disability. And so some of our, like, earliest research that I was doing was with students who had intellectual disabilities and, again, kind of all different etiologies. And so what we saw was that—or, and not just my research, but kind of more broadly—is that they're, you know, likely to have some difficulties with reading comprehension, which is the main goal. They could have some difficulties with word identification, but kind of more specifically the phonological components that feed into word identification, and then the language is really going to vary by individuals. 

Grace: Did you see any, like, specific strengths that maybe they had that typically developing children wouldn't have?

Susan: So, we do sometimes see what we would call relative strengths, right? So in one of our studies, we saw that they didn't perform worse than typically developing comparisons on a measure of orthographic processing and rapid automatized naming. So, you know, we call them “relative strengths” because they're not necessarily outperforming individuals with typical development, but they're also not performing worse, right? But the other part of this is, like, it depends on who you're comparing them to. So when we say we're comparing them to children with typical development, are these same-age peers? Probably not, right? They're probably younger peers who are matched on something else. So I know in one of our studies where we saw this relative strength in orthographic processing and RAN, or rapid automatized naming, they were mapped to a younger group of typically developing children who had similar verbal ability levels, if that makes sense. 

Grace: Yeah, that who comparison, I guess—It’s important to know who you’re comparing your test subjects to and that, right? 

Susan: Yeah, you know, you really can't make these kind of broad overarching claims that they're good at this or bad at that without saying relative to who or relative to what, at least when you're doing research with individuals with intellectual and developmental disabilities and differences. 

Grace: Now let's kind of turn a little bit towards another part of your research involved in surveying SLPs on their awareness and confidence with reading being a part of their scope of practice. I'm interested in how you feel this should be embedded in graduate programs or that based on that research you've done and, kind of, what alarming things you found or, or good things you found. 

Susan: Sure, yeah, so some colleagues and I did a survey of SLPs across the U.S. a few years ago and we were asking them these questions about, kind of, their knowledge, their confidence, and their experiences are around reading. SLPs have a huge scope of practice. I'm sure you guys know that. And that scope of practice involves reading. And I think a lot of people maybe forget—probably not SLPs—but a lot of people maybe forget that reading is language, right? It's written language, but it's still language. And so SLPs, in some ways, are like the perfect practitioners to get in there and help students who are struggling with reading because it has its foundations in language. So in our study, we surveyed SLPs across the United States, and we asked them about their scope of practice. We asked them about, you know, identifying, assessing, preventing, and providing interventions for reading disabilities. They felt like those things were actually within their scope of practice. So they are, if you look at ASHA, but we were curious if SLPs agreed with that, and so a majority did, right? They said, “Yes, we agree, these things are within our scope of practice.” But they also reported that they felt that literacy instruction was more heavily the responsibility of teachers than SLPs. And kind of as an aside, we weren't asking about working with students with intellectual disabilities specifically in this survey. We were just asking broadly about their experiences and opinions on reading. When we asked about their training, many didn't feel like their training was adequate—right—that they needed more graduate coursework dedicated to literacy. And I know this is hard because, again, SLPs have a huge scope of practice. You go through a two-year program, and there's a lot of things to learn, not only content-wise, but in the clinic. So there’s a lot to learn. So you're kind of asking, how should we go about this? I mean, obviously, I think we could embed literacy into multiple different courses. How much or how well that happens probably depends on the graduate program that somebody is a part of and if there's a faculty member there who has an interest in reading. But I always think, you know, that’s great. And then getting clinical experience as well, right? So they feel comfortable with how to assess, or they feel comfortable with how to help treat reading difficulties in their clients. I think we also saw that SLPs were reporting that they rarely were administering reading assessments in their day-to-day work. They were more confident in their ability to define different reading skills than they were in, like, providing therapy for certain reading skills. So I think there's a lot of variability within there. And I think it's hard to say, oh, graduate programs who are already covering so much and graduate students who already have to learn so much, you know, need to do more. But at the same time, the reality is a lot of kids—like SLPs in schools—a lot of kids that those SLPs serve, maybe for a speech or a language issue, are also going to have reading difficulties. And so having that knowledge can maybe then be used to also help support that child's reading skills. 

Natalie: So, because we know SLPs have such a wide scope of practice, and it's hard to fit everything into the two years of grad school, would you have any recommendations for how clinicians who may be interested in reading or find themselves with a lot of kids on their caseload who are targeting reading skills can stay up to date with the findings on literacy research?

Susan: Yeah, I think you're, you know—your podcast, for example, is a great place to start. So I do think—and we talk about this a lot—there is a research to practice gap, right, where we have researchers doing really cool research, and we have SLPs out in the schools doing really good work, but they don't always connect the way that we would like them to. So in terms of, you know, resources, ASHA,, I think, has their evidence-based portal. Other resources, I think CEUs—in our survey, we had a lot of SLPs say that they got a lot of their knowledge about reading from CEUs, and that's how they were staying up to date. So I think that's always a great option as well. 

Natalie: Yes, that gap between the research and clinical practice is something that keeps coming up.

Susan: Yeah. And I think, you know, I could see it going a few ways. So I could see researchers and practitioners trying to do a better job of collaborating. And so, what that might look like is, for example,  Making sure students, when you graduate, you feel comfortable reading and interpreting research articles, right? And on the flip side, researchers maybe need to do a better job of partnering with clinicians who are out, kind of, in the field, so that we're asking questions that are meaningful, important, and can have a practical application to what they're doing. I also have been excited seeing, like, really people like you who are trying to help bridge that gap, right? Because I think there's a place for that too. So not just researchers, not just practitioners, but people who want to be in the middle, helping with that translation. And so I'm excited to see more things like that coming out. 

Grace: It takes everyone, you know, so it's great to kind of have that support and know that we're headed somewhat in the right direction, slowly, as more people get involved. Let's kind of turn a little bit more into going back to your research that's more specific to the Down syndrome community. You have some really, really interesting work surrounding that. We'd love to know, like, what we know about reading skills and development for individuals with Down syndrome and your findings. 

Susan: Yeah, this is definitely one of my favorite populations to work with, and we do see a fairly unique reading profile. But again, I'll give that same caveat, right? There's still a lot of variation across individuals, a lot of variability across individuals. I would say in a general and a really broad sense, individuals with Down syndrome have difficulties with speech and language, right? That's one of the most commonly cited phenotypic difficulties—speech and language—but they have relative strengths in visual processing. It kind of depends on what visual skills you're talking about, but they do have some relative strengths with visual skills. And we see that really broad pattern reflected in their reading profile. There tend to be difficulties with the phonological skills, so things like phonological awareness, phonological decoding, phonological memory—those tend to be areas of difficulty. Interestingly though, they tend to have a relative strength in word identification. So, even though we think about decoding as feeding into word ID, and they have difficulties with decoding, they have pretty good word identification skills. And so some researchers have kind of hypothesized that it might be their visual skills that are helping them, right? That they're able to, kind of, acquire a large number of sight words with their strengths and visual processing. And then, kind of, if you talk about the language domain of reading, you also see this kind of uneven profile where they have some relative strengths in vocabulary, but then more difficulties with grammar and syntax. And then with reading comprehension, there's not a ton of research on it, but it does seem to be an area of difficulty for them. That's going to vary a lot based on the individual. And then the other skill I'll talk about just briefly because I am interested in it is orthographic processing. So we think about orthographic processing as being one of the subskills of word identification along with decoding. And it also seems to be an area of relative strength. So we have these difficulties in phonological skills, grammar, and syntax—probably reading comprehension. And then we have some strengths in word identification and orthographic processing. 

Grace: So when you're thinking about kind of closing that gap or trying to get these messages out SLPs that are working with individuals that have a Down syndrome diagnosis, what goals should SLPs and teachers look to address in, kind of, approaching reading?

Susan: Yeah, a great question. I think it depends on a variety of factors, right? So what’s the individual's age? What is their motivation and interest around reading? What's their current skill set? And what are their goals and their family's goals around reading, right? These are all kind of important things to consider. And so the goals are going to look different and should look different depending on the individual. In early childhood, I think there's a lot that we can do. So we want SLPs and teachers, particularly early childhood special educators, to work with parents to build rich home literacy and rich home language environments, right? And this can and should start at birth. So, I’m currently working with some colleagues at Arizona State, University of Minnesota, and Washington State University on an intervention called Babble Boot Camp. And so this is the idea that we know that individuals with Down syndrome are at risk for speech and language delays, and also reading difficulties. We also know that they have Down syndrome from birth, right, if not before. So the idea is that, since we know that, that they're at risk, and we can identify it so early in development, then we need to get in there as soon as possible to start supporting parents. So, parents can build these rich environments for their kids to maybe, maybe help prevent some of the speech and language delays that they are at risk for. And so, with Babble Boot Camp, it's called that because it got its start with kids with classic galactosemia, which is a totally different population that is also identified very early in development and at high risk for speech and language delays, and they've had some success in testing this. If we get in there early, we support parents, and we teach them how to work with their child, then we can maybe help prevent some of those speech and language delays. And so, in infants with Down syndrome, they actually vocalize less than typically developing infants. And infant vocalizations are really important, right? Because we, as adults, respond to children's vocalizations. And so, the more a child vocalizes, the more input they get from adults—the more language input they get, right? So the idea behind Babble Boot Camp and where it got its name is we could tell parents that—your child's not going to vocalize as much. That doesn't mean you shouldn't be providing this rich language input, right? So, that's a long answer, but basically I think SLPs and early childhood special educators can work with parents, like, immediately to, kind of, teach them tools to build these rich environments so they can, you know, respond to their infant’s babbling. They can talk to their child a lot, give them a word bath, if you will. As they get a little bit older, they can teach them vocabulary words. They can teach them letter sounds. They can learn to adjust their language to meet their child's developmental needs, right, to help them understand the language that they're hearing. And then, in terms of the home literacy environment, they can be reading with their child. They can make those reading experiences really interactive to get the child engaged and interested in reading. So those are all things that we can do in infancy or that SLPs can do in infancy. Then, as a child gets older and is starting school and is starting to begin formal education and, kind of, making that transition from emergent literacy skills to learning how to read and learning how to identify words, I think there's, again, like a lot that SLPs can do, right? Knowing what they do about language, they can help support those phonological skills that students with Down syndrome are going to have difficulty with.  I've seen some really cool research coming out recently on how to adapt phonics interventions for students with Down syndrome. So you're still teaching them phonics, but kind of building in some supports for areas that we know they're going to have difficulty with while also capitalizing on areas of strength. So, for example, Chris Lemon's intervention, took a phonics intervention, adapted it to support their strengths and visual processing by using what they called “highly imageable words,” right, so things that are easily pictured. And so they paired those pictures with words to help support decoding. They took target letters, printed them, made them, kind of, bigger so they could be physically manipulated during activities. And those are also helpful because they're going to help support difficulties in working memory, right? Like having something there physical that you can keep looking at and referring to is going to help support difficulties in working memory. And then they also did things like they took the instructions for the intervention, and they modified the language to reduce the cognitive load that the participants were dealing with. So have you ever been trying to learn, like, a new card game or a new board game, and somebody reads you the instructions, and you're like,  “I missed that whole thing. I heard the first step, and now I've lost everything else”? Okay, well, so often that's what we do to kids in the classroom, right? We're, like, giving them these long, complicated instructions that involve tons of language. And for kids with Down syndrome, who we know sometimes have difficulty with language, it's too much, right? We've lost them before we've even started because we gave them way too complicated of instructions. And so that's something that Chris Lemons did when they modified the instructions to reduce the cognitive load on the participants. And then the other thing that they did is they built in opportunities for the participants to respond nonverbally by pointing towards, so they could still demonstrate that they understood or could demonstrate the answer but without having to produce it with speech. So, I think there's some really cool things there that we're seeing. And I think these are all things that would be, you know, not too hard for SLPs to kind of incorporate either: visual supports, making things more imageable, printing things out so there’s an opportunity to manipulate them, reducing the language that we're using when we're giving instructions. All of those things would be, I think, easy for SLPs to, kind of, incorporate. And then as we move into reading comprehension and using reading as a tool, there's less research on this, but we can certainly work to help readers with Down syndrome build their background knowledge and their vocabulary to understand what they're reading. And we can do things like help them find the main idea of a text, make predictions about what might happen next, generate questions. All those strategies that we would use and teach to other students, we can also use and teach to students with Down syndrome. 

Grace: That’s awesome. I think that gives a really good understanding of ways that parents can help [and] ways that SLPs can help educators. I think that was a great answer to give a lot of our scope of our audience, like, something they can do, or ideas, even, because I think it's very easy to get stuck in, “Okay, we know these things, but how do I implement that? Or what does that really look like?” So getting a clear idea of, like, being all the research that you've done, what has clearly worked in implementing those types of activities, for sure. 

Susan: We need more research though. So I will like always throw that out there. You know, you see thousands and thousands of studies for other groups and there's a much smaller body of research that we're working on when we're talking about teaching students with intellectual disability or students with Down syndrome. 

Natalie: Right, and I think, going back to that intervention you were talking about, I love how it highlights the strengths or, like, the relative strengths, too. Because when I was listening to you explain the relative strengths of a lot of individuals with Down syndrome, [it] was that word recognition and the visual cues. But we still know that phonics are extremely important, and we need that for reading comprehension, like, reading and literacy. But we also want to support what they are really, really good at. So, yeah, it’s like a good mix of both of them, and combing them for the best outcomes.

Susan: Absolutely. You know, many kids, including kids with Down syndrome, start with sight words. And, like, that's okay, right? Like, it's a really great place to start is to say, “Oh, these funny symbols that are written down on this paper represent something in my environment or represent something that I know.” That's a great place to start, but if we don't help them break the letter-sound barrier, then they're not going to be able to read new words by themselves. So, yes, I agree. We can take some of their strengths, utilize them, and use them to teach sight words, but don't give up on the decoding and the phonics and the phonological skills. 

Grace: For sure. No, I think that's very helpful for our listeners. Something else we had been wanting to talk to you about is—we came across the Self-Teaching Hypothesis, and [we were] wondering if you can explain more what that Self-Teaching Hypothesis for reading is. 

Susan: Yeah, it's a kind of a cool hypothesis. I think it popped up in the 80s and 90s. And so the Self-Teaching Hypothesis suggests that children learn orthographic structures of words through phonological decoding. In other words, when we sound out a new word, we kind of incidentally self-teach the orthographic representation or the spelling pattern. So that's the idea behind the Self-Teaching Hypothesis. 

Grace: Now, how can that Self-Teaching Hypothesis benefit individuals with intellectual disabilities? 

Susan: Good question. So it can benefit all of us, right? It does benefit all of us. When we decode, we learn the orthographic structure of a word, and then both the decoding and orthographic knowledge feed into word identification. So, it can benefit students with intellectual disability, just like it does others, in that, by decoding, they can strengthen their orthographic processing, and then that, in turn, is going to strengthen their word identification skills, which, in turn, is going to help them become stronger readers, right? We did a study—gosh, it’s been many years ago, now—with with students with intellectual disability, where we taught them two lists of non-words, right? So we use non-words to ensure that they didn't know these words, that they were new to them. And we taught one list just by telling them, like, “Here's this non-word. Here's how you say it. Repeat it.” And then we had them try to decode the other list of non-words, right? And so, according to the Self-Teaching Hypothesis, what we would find is that they would have learned the orthographic structure of the words that they were having to decode better than they learned the orthographic structure of the words that I just taught to them, right?  And we saw that that was true. So we went back three to five days later, tested them on their orthographic knowledge of those non-words, and they did better on the words that they were asked to decode versus the words that we just taught to them. 

Natalie: And I think it shows again just how connected the speech, language, and reading are because they're hearing the words and then having to understand something about those graphemes and how they are represented in the words. 

Susan: And, you know, it—when you make them decode, or when you ask them to decode, it draws their attention to the letters, which is what you're saying, to the graphemes. And then they're producing the sounds that they think go along with those graphemes and trying to put it all together into a word. And so it's a great strategy. And over time, we learn what words look like in our language, right? We learn the spelling patterns of our language. And that's what orthographic processing is. And that's why it's a predictor of word identification, because we start to, kind of, put together, “Oh, it's really common to have, you know, ‘-cks’ at the end of a word. It's not very common to have it at the beginning of a word.” Or, you know, you just start to learn those letter patterns and how they sound in words. 

Natalie: So, one of your studies we found really interesting was looking into the Simple View of Reading. So, could you tell listeners what this framework to reading is about and what you found out through your studies? 

Susan: Yeah, absolutely. So, the Simple View of Reading is this really well supported, simple model, as the name implies, of reading comprehension. It was proposed by Gough and Tunmer in the 80s, I believe, and they basically say reading comprehension, which is the goal of reading—right, is understanding what you read—is predicted by two things: word identification, or your ability to recognize printed words, and language comprehension, your understanding of words, right? And so they kind of said if either of these skills is difficult or impaired, reading comprehension is going to be negatively impacted. So that's the Simple View of Reading. It’s been really well supported in kids with typical development. And the other thing that I would say is, the typical development that we see is that the importance and the contribution of those two subskills kind of varies across reading development. So in earlier stages, word identification—they’re both important—but, in earlier stages, word identification is maybe a little bit more important, right? Where children have to learn how to identify printed words, otherwise they're never going to get to reading comprehension. So, anyway, across reading development, the importance and contribution of these two subskills kind of varies. So in early reading development, word identification is maybe a little bit more important because they have to learn how to identify printed words, right? As they get more efficient at that, the shift kind of happens where language comprehension becomes a little bit more important, right? So they've gotten pretty good at recognizing printed words. Now it's really all about how well they understand the words or how well they comprehend them. And so we've done a couple studies on the Simple View with individuals with Down syndrome. One of them was a study with adolescent and adult readers with Down syndrome. So, we basically tested them on these three kind of constructs: reading comprehension, word identification, and language comprehension. And what we saw was that the Simple View was supported and that, together, word identification and language comprehension explained a significant amount of the variance in reading comprehension outcomes. But interestingly, in this sample, when we looked at the two predictors individually, it was all about language comprehension, so they were good enough readers in terms of their word identification skills—you still have to have them, you can't not have word identification skills—but they were good enough at that, that the shift had kind of happened and it was all about how well they understood the words that they were reading. And we are, right now, collecting data on a slightly younger group of students with Down syndrome—so school-age, so 8 to 18, kind of in that range—and we're testing the Simple View model again, and we'll if we see that same pattern. So, one, is the Simple View supported? And in younger readers, right, where maybe those skills are still developing, do we see that word identification is more important? Or, at least, maybe, they're more equally important in those younger readers. So we'll see what we see. 

Grace: Yeah, for sure. It'll be something to look out for. 

Natalie: So would that potentially shift the, like, goal of literacy intervention for individuals with Down syndrome if we know that they are efficiently using word recognition? 

Susan: Yes, I absolutely think so. And that was, kind of, one of our takeaways of that study was that, you know, we need to be—SLPs, teachers, parents—need to be cognizant that once they've achieved a certain level of word identification—and again, it's not that word identification doesn't matter anymore, you shouldn't work on that, right? You want to be a fluid, quick, and efficient word reader, but we also need to incorporate training on language comprehension and support those skills if we want them to be able to become strong reading comprehenders. 

Grace: Yeah, that makes a lot of sense. First, would you like to add anything before I ask the last question I always ask? 

Susan: So, I want to give a little shout out if I can. We have a book club here in our department that is a collaboration with our Down syndrome association called “the book club.” It is made up of young adults with Down syndrome. We meet on Thursdays, and we are currently reading the Percy Jackson series. And it's, like, the highlight of my week every week to go to book club. We get, kind of, the social aspect where we get to hang out with friends and chat and joke, but we also get kind of to enjoy these books, and it's really fun to dive into them with the book club members and talk about them. So a shout out to Alicia Davis who leads the book club and all of my book club member friends. 

Grace: That's awesome. I love that idea. Love it! 

Natalie: And it's supporting literacy throughout their entire life. 

Susan: Yeah, and that's the goal, right? That's what I always say: The goal is to get to a point where we can use reading as a tool. And so that could be for learning other academic skills, that could be for a job, that could be because you want to socialize with your friends, that could be because you want to read a book because you enjoy it, right? So whatever it is, that's the goal is to get to a place where we can use reading as a tool. And, actually, something I'm particularly kind of interested in future research is how becoming a strong reader might have cognitive benefits for, kind of, individuals with Down syndrome or other intellectual disabilities. We know it does for, kind of, typical development, but what about those groups? 

Natalie: We look forward to that! 

Grace: Yes, we'll have all your information in our show notes for everyone to keep following along on this awesome research. So my last question I love to end with ‘cause it's usually always the hardest one—or the best one, the best one for last. So if you had one piece of advice to give to parents and/or educators that are listening to this podcast concerned about a child's written language processing or comprehension, what would you want to share with them? 

Susan: That is a hard question. 

Grace: Leave everyone with one more thing if they got through to this point. 

Susan: So, the standard advice that I give to parents of a young child with Down syndrome is to really advocate to get an SLP on their early intervention team. So that's not exactly what you're asking, I don't think, but I do think it's important. And, like I said, they’ll know their child has Down syndrome right at birth, if not before, and so I really encourage them to advocate for an SLP on the team and start asking what they can do immediately to support their child's language development, which, in turn, is going to support their later literacy development. 

Grace: Yeah, no, that’s awesome. I think that's a great place to kind of leave everyone with. We can't thank you enough.

Susan: Yeah, thank you for having me. It was really fun to talk about this stuff. 

Grace: Speaking of Literacy is a podcast from The Iowa Reading Research Center at the University of Iowa. It’s produced, edited, and mixed by Grace Cacini and Natalie Schloss, with support from Bailey Christensen. Expert review by Nina-Lorimor Easley, Lindsay Seydel, Stephanie Edgren, and Ramona Parrish, with additional review provided by Kate Will, Olivia Tonelli, and Sydney Smithgall. 

Natalie: For further credits, including audio and music attribution, please see the link in the show notes. For definitions of key terms and links to research mentioned in the episode, check out our listening guide.

Visit us online at for more information and additional literacy resources for educators and families. You can also follow us on X at @IAReading or on Instagram at @iowareadingresearchcenter.

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Susan Loveall, MA, PhD, Director of the Learning Lab for Developmental and Intellectual Disabilities at the University of Nebraska-Lincoln


“Seize The Day” Andrey Rossi

Licensed under Music Vine