ACQ Vol 11 no 2 2009

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ACQ Volume 11, Number 2 2009 121
reading are essential steps in any intervention, many clients
report ongoing difficulties at the level of connected text. Text
composition is a very complex undertaking relying on skill in
grammar and narrative as well as word retrieval and spelling
(in the written modality). In a first series of research studies,
we investigated the writing skills of a group of adults with a
history of childhood oral language impairment (LI). The story
writing of 10 adults with a history of LI was compared to a
group of 51 unimpaired individuals. Participants were asked
to write and tell the story of Cinderella. Stories were analysed
for length, grammatical complexity and accuracy of grammar,
punctuation and spelling, generic structure and cohesion.
The results indicated that, as a group, the adults with LI
showed no difference from the comparison group in the length
of their stories as measured by total number of words. The LI
group did, however, show reduced grammatical complexity in
their writing, as measured by mean length of t-unit. The LI
group made more errors in grammar, spelling and
punctuation than the comparison group. In contrast,
patterns of text organisation at the level of generic structure
and measures of cohesion did not distinguish the
performance of the LI group from the comparison group.
When the written stories were compared to the oral stories,
both groups produced significantly longer oral stories than
written, but showed no significant difference in complexity
(mean length of t-unit) between the two modalities. The oral
and written stories of adults with a history of LI were less
grammatically complex and more error filled than those of
comparison group. Thus, the writing of the adults with a
history of LI reflected their oral language skill. We are
continuing to analyse these data, looking at the text
cohesion and generic structure of the oral texts to determine
if these measures are a relative strength for the LI group in
oral stories as they are in the written stories.
References
Brunsdon, R. K., Coltheart, M., & Nickels, L. (2005).
Treatment of irregular word spelling in developmental surface
dysgraphia. Cognitive Neuropsychology, 22, 213–251.
Di Betta, A. M., & Romani, C. (2006). Lexical learning and
dysgraphia in a group of adults with developmental dyslexia.
Cognitive Neuropsychology, 23 (3), 376–400.
Kohnen, S., Nickels, L.,. Brunsdon, R., & Coltheart, M
(2008). Predicting generalisation in the training of irregular
word spelling: Treating lexical spelling deficits in a child.
Cognitive Neuropsychology, 25, 343–375.
Kohnen, S., Nickels, L., & Castles, A. (2009). Assessing
spelling skills and strategies: A critique of available
resources. Australian Journal of Learning Difficulties, 14,
113–150.
Mortensen, L., Smith-Lock, K.M., & Nickels, L. (In press).
Text structure and patterns of cohesion in narrative texts
written by adults with a history of lan-
guage impairment. Reading and Writing .
Smith-Lock, K.M., Mortensen, L., & Nickels, L. (In
press). Story writing skills of adults with a history language-
impairment. Reading and Writing.
learning is measured by how well these new words can be
read and/or spelled after exposure to the story. Results from
one of our single case studies shows that while training
can improve knowledge of spelling rules and spelling of
real words (even untrained ones), skill generalisation may
not necessarily extend to orthographic learning for the
acquisition of new words. Our findings support previous
research that reports orthographic learning deficits in adults
with developmental dyslexia/dysgraphia, indicating that
orthographic learning might remain impaired into adulthood.
Further case studies are currently underway to investigate
this issue in greater detail.
Evaluating treatment programs for
literacy impairments
The discipline of cognitive neuropsychology has made
important contributions to the conceptualisation of therapy for
language impairments. The cognitive neuropsychological
approach involves detailed assessment based on models of
language processing (e.g., dual route theory of reading for a
reading assessment) followed by individualised treatment
programs tailored to the language impairment identified by
the assessment.
While individually tailored remediation programs are a
promising avenue for successful intervention of language
disorders, they are also resource- and cost-intensive. There
are, however, programs (e.g., for the treatment of literacy
disorders in children) that are designed in such a way that
they most likely lead to improvement in the majority of children
with literacy disorders. Some of these programs are widely
used. The potential difficulty with such programs is that
developmental disorders of reading and spelling are very
heterogeneous: children present with very different problems
underlying their reading/spelling impairment (often, but not
always, leading to different symptoms). For example, most
people with reading/spelling difficulties have problems with
the rule-based knowledge (“phonics”, investigated by reading/
spelling non-words). However, at the same time, most people
with reading/spelling difficulties also find it difficult to read
and spell words that are not predictable from their writing
(i.e., irregular words like yacht, friend). But, crucially, not all
people present with difficulties in both of these areas, some
only have difficulties with rule-based knowledge and others
only with irregular words. Almost every person is different in
the extent to which their rule-based or irregular word knowledge
has developed. The cognitive neuropsychological approach
would argue that these different impairments require different
forms of intervention. Can the “one size fits all” approach of
the programs cater to these different needs?
Many of the widely used programs lack formal evaluation,
and hence, we cannot be sure how much these programs
improve reading and spelling. In particular, it is not clear how
and if children with different subtypes of reading and spelling
disorders benefit to the same degree (or benefit at all) from
such programs. We are currently using cognitive
neuropsychological methods in order to independently
evaluate different treatment programs for reading/spelling
problems. This research should allow clinicians to make
more specific predictions as to which children may or may
not benefit from receiving a particular program.
Effects of specific language
impairment on writing skills
Much of the published research on intervention with people
with reading and spelling/writing difficulties focuses on the
acquisition of single words. While single word spelling and
Correspondence to:
Associate Professor Lyndsey Nickels
NHMRC Senior Research Fellow
Macquarie Centre for Cognitive Science (MACCS)
Macquarie University, NSW 2109
phone: 02 9850 8448
fax: 02 9850 6059
email: