ACQ Vol 11 no 2 2009

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78 ACQ Volume 11, Number 2 2009 ACQuiring knowledge in speech, language and hearing
has also been particularly neglected with this population
(Koppenhaver & Yoder, 1992). Many individuals with complex
communication needs have physical disabilities that prevent
them from being able to write using a pencil, or type using
a standard computer keyboard. Unfortunately, this has led
to reduced opportunities to explore the alphabet and learn
to compose written text. There are a number of alternative
pencils available that can give these individuals access to the
alphabet and the independence to write. These include low-
tech options such as alphabet flip charts (see the Alternative
Pencils developed by the Center for Literacy and Disability
Studies, ) as well as higher tech
options like Intellikeys (IntelliTools). For many more ideas,
strategies, and resources relating to supporting individuals
with complex communication needs to engage in word
study, guided reading, self-directed reading, and writing
lessons, refer to Erickson and Koppenhaver (2007).
Addressing individual needs
The Whole-to-Part Model (Cunningham, 1993) is also a
useful reference point for considering the role of the speech
pathologist in supporting literacy development in individuals
with complex communication needs (and other individuals
with literacy learning difficulties). The model can be used to
examine individuals’ profiles of ability and prioritise targets for
instruction. Researchers at the Center for Literacy and
Disability Studies employ an assessment process that relates
to this model. It involves comparing performance across
each of the constructs of the Whole-to-Part Model to
determine the area of greatest need, and insuring that the
area of greatest need receives the “greatest proportion of
available time and intervention, and intervention is delivered
by the most highly qualified personnel” (Erickson et al., 2006,
p. 321).
This process encourages professionals to consider word
identification, language comprehension, and print processing
as possible priorities for intervention. In addition to providing
comprehensive instruction as part of the individual’s
daily educational program, speech pathologists or other
professionals target the areas of greatest need during
direct intervention. If the area of greatest need is language
comprehension, then that will be the target for intervention.
In contrast, if the area of greatest need is word identification,
then the focus of intervention will be on building decoding
skills and automatic word identification. The team will
determine which professionals are most capable of providing
the type of intervention that the individual needs.
This intervention approach holds much promise for
promoting collaboration between team members. It uses
individual profiles to divide the labour and capitalises
on the relative strengths and qualifications of available
professionals. It allows each professional to focus energy
on a particular instructional approach or intervention, or on
figuring out how to infuse a particular language or literacy
goal into the existing curriculum. This is more effective and
efficient than all professionals feeling they are responsible for
learning all aspects of literacy instruction. The effectiveness
of this approach is therefore highly dependent on regular
communication between team members (Erickson et al.,
2006; Erickson & Clendon, 2005).
Targeting language and literacy
simultaneously
The Whole-to-Part Model (Cunningham, 1993) is also
important because it supports the integration of language
had limited knowledge of phoneme–grapheme relationships
and were unable to figure out unfamiliar words encountered
when reading (Erickson, 2006). Various researchers (e.g.,
Cupples & Iacono, 2002; Hoogeveen, Smeets, & vand der
Houven, 1987; Joseph & McCachran, 2003) have now
demonstrated that this belief was unfounded and that if
individual learning characteristics are taken into account,
then these individuals can respond positively to analytic
reading instruction.
The overemphasis on sight word instruction for individuals
with developmental disabilities has also meant that
insufficient attention has been placed on other critically
important constructs involved in the reading process.
Research has clearly demonstrated that children who are
at risk for literacy learning difficulties do not always have
isolated word identification problems. Many children have
problems with the other constructs in the Whole-to-Part
Model, namely language comprehension and/or print
processing. This finding holds true for children with and
without developmental disabilities. In fact, as few as 14% of
2nd graders classified as poor readers have isolated word
reading deficits (Catts, Fey, Zhang, & Tomblin, 1999), and
even fewer children with autism have isolated word reading
deficits (Nation, Clark, Wright, & Williams, 2006). Given the
understanding that individuals with complex communication
needs often have deficits in vocabulary knowledge (Bishop,
Byers Brown, & Robson, 1990), morphosyntactic knowledge
(Soto, 1997, 1999), and receptive language in general
(Binger & Light, 2008), it is reasonable to expect that this
population would also have a relatively low portion of poor
readers who struggle exclusively with word reading.
Comprehensive literacy instruction means that individuals
with complex communication needs must have daily
opportunities to build their skills across all the areas of
the Whole-To-Part Model. This includes comprehensive
word identification instruction that focuses on recognising
words automatically (sight words) and strategies to decode
unknown words. It also includes reading comprehension
lessons that focus on developing background knowledge
and schemata, expanding and enriching vocabulary,
developing knowledge of text structure, and teaching
metacognitive strategies (Staskowski & Creaghead, 2001).
There must also be frequent opportunities for individuals
to engage in self-directed reading where individuals can
choose books and read for pleasure independently in order
to build their print processing skills. A myriad of books and
other print materials that represent a variety of different text
genres should be readily available. Historically, this has been
a challenge for individuals with complex communication
needs as many have reading levels far below those expected
for their chronological age. Finding books that are interesting
and motivating to older readers has been a struggle.
Thankfully, the increase in resources available on the Internet
is helping to rectify this situation with a large number of
books being made available electronically. An example of this
is the new Tarheel Reader website
created by researchers at the University of North Carolina
at Chapel Hill that provides a collection of free, easy-to-
read, and accessible books on a wide range of topics. It is
possible to make your own books or to browse through the
large collection of books that other people have made.
In addition to requiring frequent opportunities to read,
individuals with complex communication needs must
also have numerous opportunities to engage in writing for
meaningful purposes. Writing instruction is an area that