Supporting reading in Williams syndrome

 

There are typically three ways to read words. One is a logographic approach in which children do not read any particular letters or the word itself but they recognise the shape of a word within a context. For example, very young children might recognise the word school because of the ‘ool’ shape. My own sister thought she could read when she was five years old because on the motorway she could recognise the word “exit”. This is the very first step in learning to read. The two other routes of reading are a phonics approach or sight word learning approach. In the phonics approach, children learn to recognise the letters and their matching sounds. Once the children know the letters and their sounds, the phonics approach allows children to read words that they have never seen before. For example, a child that has learned the letters C, A, T, B, and S can read the words: ‘cat’, ‘bat’, ‘sat’, ‘at’, ‘cab’ etc. Although the phonics approach is very good for learning to read new words you have never seen before, it requires you to break down the words in letters, sound each of these letters out, keep track of which letter you have sounded out and which one is next in line, and then blend of the different sounds back together at the very end. This approach therefore requires a lot of ‘working memory’ or the ability to hold information in mind and manipulate that information. In some languages, especially in English, not all words are written the way they are pronounced. For example, Leicester is not pronounced “lajtsesta”. So, for these words a phonics approach cannot be used and children need to learn to read some words by heart or use a ‘sight word reading approach’.

What approach works best for children with Williams syndrome?

Looking at their overall strengths and difficulties, children with Williams syndrome (WS) generally have good verbal short term memory (repeating information they have just heard) and have good phonological abilities. However, working memory abilities are lower than children of a similar chronological age. In addition, children with WS, also learn at a slower pace.
Reading abilities have been found to be delayed in children with WS. Yet, the abilities that relate to early reading proficiency, such as good phonological awareness and good vocabulary abilities, are similar to typically developing children. Still, there is a lot of variability in the reading abilities of children with WS with some children being quite fluent readers and others struggling to read. This is mainly because many children find it difficult to learn the letter-sound combinations. Finally, many individuals with WS who do read quite fluently still find it difficult to understand what they are reading.

There is only one study that I know of that has examined whether children with WS would benefit from a phonics approach or a sight word reading approach to reading. Beccera and colleagues (2009) included 44 children with WS aged 8 to 17 years old in their study and divided them according to their educational plan and parental reports in to those children who primary followed a phonics approach and those who followed mainly a whole word approach. They found that children who primarily followed a phonics approach had better reading outcomes compared to those in the whole-word approach. However, some caution is required when interpreting this study as children were not randomly allocated to a group in this study and the children in the phonics-approach had better working memory and higher overall cognitive abilities (they did find that reading levels correlated with overall IQ) than those children in the sight word reading approach.

So, what can we conclude thus far?
Young children with WS often struggle with early reading abilities because of 1) their overall language delay and limited vocabulary and we know that language and vocabulary is a precursor for reading in WS, 2) they have limited working memory abilities and thus they struggle to break down a word into their individual sounds, keep track of the letters they have sounded out, and then blend the sounds back together, 3) they have overall learning difficulties which makes both learning sound-letter combinations and learning sight word reading difficult.

In sum, using just one approach is unlikely to help children with WS to read. The Reading and Language Intervention (RLI) designed by Down Syndrome Education International and at The Centre for Reading and Language at the University of York, for children with Down Syndrome includes a reading strand and language strand. The reading strand focuses on both phonics and sight word reading whilst the language strand teaches vocabulary, utilising visual approaches to introduce and reinforce the meaning of new words in a variety of different contexts. Although we have no studies that have examined the impact of RLI training for children with WS, seeing the multi-faceted approach to reading and what we know about reading in WS, this approach might benefit children with WS as well as those with Down syndrome.

Reference:
Becerra AM, John AE, Peregrine E and Mervis CB (2009). Reading Abilities of 9 – 17-Year- Olds with Williams Syndrome: Impact of Reading Method. Front. Hum. Neurosci. Conference Abstract: 12th International Professional Conference on Williams Syndrome. doi: 10.3389/conf.neuro.09.2009.07.030

For more information about the Reading and Language Intervention (RLI) see: https://www.dseinternational.org/en-gb/resources/teaching/rli/design/