Comprehensive Reading Instruction for Students with ID and DD

This section will provide ways to instruct students with ID and DD on particular skills that are important for growth in reading. The skills have been presented separately by area so that you can both understand the main processes of reading and learn ways to teach the skills effectively when working with students. However, it is important to recognize that reading should not be treated and taught as a set of unrelated sub-skills, nor do students need to master skills in one area to take part in instruction in another area. Students must have the opportunity to experience literacy in its cohesive sense in conjunction with opportunities to work on needed skills. Students of all needs and abilities need time to experience hearing and responding to good literature, to play with language, and to take risks with new ideas and conventions. They must also be given appropriate instruction and supports on their way to learning the conventions of literacy so that they too can interact with it meaningfully.

In 1997, Congress asked the National Institute of Child Health and Human Development (NICHD) to work in conjunction with the Department of Education to assemble a panel whose task would be to review all of the available research on teaching children to read and make recommendations for effective practices.1 This panel summarized the findings in what is known as the Report of the National Reading Panel (NRP; National Institute of Child Health and Human Development [NICHD], 2000), which outlined the five areas as crucial for students to develop to become good readers: phonemic awareness, phonics, comprehension, vocabulary, and fluency. Although the NRP did not focus on students with ID and DD, other researchers have begun to investigate these areas in relation to students with ID and DD and have determined that these same areas should be addressed when teaching reading to students with more significant forms of disability as well (Allor, Mathes, Roberts, Cheatham, & Al Otaiba, 2014; Beecher & Childre, 2012). Sometimes it can be difficult to know how to teach these important aspects of reading, given a student’s difference in memory, mobility, and/or speech. This section will give you some ideas for approaching these topics using research-supported strategies.

Phonemic Awareness

Phonemic awareness is the understanding that spoken words can be broken down into individual sounds. Words are spoken as a single pulse of sound. When we say the word cat, for instance, we do not break the word into its individual sounds. To read words, however, a student must understand that the letters in words represent individual sounds. Before that can happen, a student must be aware that there are individual sounds in words. These individual sounds are called phonemes. In the case of cat, the phonemes are /c/, /a/, and /t/. We must help a child become aware of phonemes so that letter-sound correspondences will make sense to the child. Developing this awareness may seem simple to an adult with good literacy skills, but for a child learning to break apart sounds in spoken words for the first time, it can be surprisingly challenging (see Chapter 3 for coverage of this topic in more depth).

Phonemic awareness instruction for students with ID and DD

Recent research has shown that students with ID and DD can benefit from similar types of explicit (i.e., direct and structured) instruction in phonemic awareness used with other students who need extra support in developing this skill. However, to be beneficial, the instruction may need to be modified to be more concrete, such as using objects as a visual cue, or providing more than one mode of learning, such as incorporating sign language in addition to verbal instruction (Beecher & Childre, 2012). For example, when bringing students’ attention to the initial sounds of words beginning with /p/, it might be helpful to set out a small toy pig or make the sign for pig to give the student a concrete visual reminder of the sound being learned. It has also been found that students with ID and DD may need a longer amount of time to acquire phonemic awareness skills (Allor, Mathes, Roberts, Jones, & Champlin, 2010).

In the case of a child who does not have reliable speech and/or bodily control, more creative ways are needed to help the student demonstrate his or her knowledge and understanding. Imagine for a moment working with a child who has limited reliable speech. The student can sometimes communicate a sound verbally; however, he often cannot produce the sound he is thinking of accurately enough for us to be certain that he understands. Instead of requiring the child to speak his responses aloud, one can create response boards to allow the child to point out his answers (Light & McNaughton, 2012).

Imagine that you would like your student to be able to blend three phonemes (individual sounds) together to blend a word. Since the student has difficulty producing speech, you will want to use pictures to which the student can point. It is easy to create your own set of picture words on card stock or you can find cards that are commercially available. Next, use the picture cards to model how phonemes can be blended into words. To begin, show the child a picture, for example, of a pig. Start by saying, “Here is a picture of a pig. Listen to me say the sounds in this word. /p/ /i/ /g/… pig. Do you hear the sounds I am saying? /p/ /i/ /g/… pig. I can break apart the sounds in the word pig, like this /p/ /i/ /g/. Then I can put them back together. /p/ /i/ /g/ is pig!” You would continue this using several, clear examples. You could also cut the picture of the pig into three pieces, moving each to present a sound.

Next, you would introduce an activity to determine if the child can identify a word given its phonemes. To do this, you can set out three picture cards in front of the child (see Figure 1). First make sure the child knows what each picture represents by pointing to each and naming it: “Here is a dog, cat, and pig.” This is an important step so that the child knows that the picture of the cat, for example, is indeed a cat and not a kitten. You may need to repeat the words, depending on the student’s memory needs. Next, you tell the student that you are going to give him three sounds that when put together will make a word. Ask him to point to the word you are making. You would then say, “/p/ /i/ /g/” and determine whether the child can select the appropriate response.


Figure 1. Picture cards for phonemic awareness activity.

As the child progresses in the ability to blend phonemes, you can make the work more challenging by requiring attention to similar phonemes rather than the very different phonemes featured in the previous example (Light & McNaughton, 2012). For example, you may wish to have a student work on attending to differences in medial (middle) vowel sounds in words. In this case, you would use three words that have the same letter sounds except for the middle sound, such as bug, big, and bag. Notice how each of these words has /b/ as the initial phoneme and /g/ as the final phoneme. Your modeling in this situation would deliberately draw the child’s attention to the change in vowel sound between such similar words. To assess the student’s understanding, you would again give the student three pictures from which to choose that correspond with our words and follow the same process described above. If you say /b/ /a/ /g/, but the child points to the bug, it indicates that the student may have trouble attending to the middle sound in the words and would require further instruction and practice in this area.

Students with unique needs may need modifications to the above suggestions. For example, a student showing considerable difficulties with fine or gross motor skills or vision may need larger cards with which to work. If a child is having difficulty with the process, be sure that it is not the physical aspect of the task that is getting in the way. If there are barriers to the student’s participation, think creatively about or consult with others regarding how the task could be modified so that the child could successfully (but still meaningfully) take part.

There are numerous other phonemic awareness lessons and activities that can be done to help students acquire this important literacy skill. Above is just one example of a way in which to teach and assess phoneme blending. See Table 1 for some other activities that are likely to be helpful when teaching phonemic awareness. Given the example above, consider how these activities, too, could be modified so that students with speech and/or motor differences could participate.

Activities Examples
Table 1. Phonemic Awareness Activities and Examples
Sorting words by initial, medial, or final phoneme Give students 10 picture cards in which the pictures end with the sound /g/ or /d/. Have students sort the words into two categories by ending sound.
Identifying words with a particular phoneme Draw students’ attention to the first sound of a word, e.g., “Fan starts with /f/.” (Be sure to say the letter sound and not the letter name.) Ask students to come up with words that start with the same sound.
Segmenting words into individual phonemes Say a word aloud to students (e.g., sit). Demonstrate how to break the word into its individual sounds (i.e., /s/ /i/ /t/). Now give students some words to break into individual sounds. Guide students as necessary.
Identifying a word after removing or adding a phoneme to it Say to students, “Listen to this word: pit. What happens if we take away /p/?” (Be sure to say the letter sound and not the letter name.) Demonstrate how the word will now be: it. Now go through similar words with students one word at a time.
Creating a new word by replacing a phoneme in a given word Say to students, “Listen to this word: cat. If I take away /c/ and put /b/ in its place, we get bat. Now let’s change /b/ to /s/. What word do we get?” (Be sure to say the letter sounds and not the letter names.) Guide students as necessary.
Note. If a student does not seem to be able to attend to the phonemes in the words despite instruction, you may need to start with earlier skills. Provide the student with many opportunities to play and experiment with more general sounds in language, such as rhymes, syllables, and alliteration.


Phonics is the study and instruction of how letters and combinations of letters represent the individual sounds (phonemes) in words and how these sounds are blended together to make words. In the English language, we have 26 letters that are used in various combinations to represent approximately 44 phonemes. Studies have shown that for students who have difficulty learning letter-sound correspondences, explicit and systematic phonics instruction is necessary (NRP, 2000). These studies have mostly been conducted with students who have learning disabilities; however, the same outcomes have been found in newer research including students with ID and DD as well (e.g., Riepl, Marchand-Martella, & Martella, 2008; Lemons, et al., 2012). Explicit and systematic instruction in phonics means that students are taught specifically about letter-sound correspondences through carefully planned instruction. The instruction also includes modeling, along with opportunities for teacher-guided practice, beginning with those letter-sound correspondences that are most common and useful in beginning words (e.g., a, s, ch) and proceeding to those that are more complex (e.g., ow, ur, ey, -tch). Students are not expected to figure out these patterns on their own. To become adept at using letter-sound correspondences to decode, students must have many opportunities to practice using letters and letter combinations to represent the sounds of language. There are many games and activities that can be used with students to help them practice these skills in an engaging fashion (see Chapter 3 of this textbook for more examples).

Phonics instruction for students with ID and DD

To decode an unknown word, a child must be able to identify the correct phonemes for each of its letters, hold the phonemes in memory in the correct order, and then blend the sounds together to make a word. This can be a challenging task for any beginner but can be particularly difficult for students with ID and DD because they may have difficulty with short-term memory and/or initiation of spoken language or movement. For students with short-term memory difficulties, decoding can be very challenging because the students may have difficulty holding on to the sounds in order while decoding. By the time the students reach the ends of the words they are trying to figure out, it is common for them to have forgotten the beginning sounds (WETA Washington, DC, 2007). Additionally, many new learners find it helpful to sound out words aloud while simultaneously pointing to each letter; however, if a student cannot produce sounds or point to the letters on a page, decoding can prove quite a challenge for these reasons as well. These are only some of the issues that may arise that complicate the decoding process for students with ID and DD, but with creative means, barriers to students’ participation in phonics instruction can be reduced.

For a child who has significant short-term memory difficulties, it is necessary to reduce the memory load for certain tasks (Allor et al., 2010). For example, when teaching phonics, it is helpful to begin with simple two-phoneme words, such as at, up, and it. As the child becomes more adept at decoding these and has practice holding phonemes in his memory, the ability to decode longer words will likely increase. Further, as time goes on, many students will be able to “chunk” information that they have learned into retrievable pieces that will lessen the burden on their memories. For example, the blend st in words such as stop and past will become easily recognizable with practice over time so that a student will not have to deliberately think about each phoneme (/s/ and /t/) each time it is encountered in a word. That is, the student’s recognition of the word part will become automatic, and thus allow more attention to be paid to decoding newer or more difficult letter combinations.

A method for helping students with short-term memory problems learn to decode is Additive Sound-by-Sound Blending (Moats & Hall, 2010). In this technique, instead of sounding out all of the letters in a word in sequential order from left to right, and then blending them together, which is a typical blending strategy (e.g., /c/ /a/ /t/ → /cat/), the letters are blended one by one as a student moves through the word. The teacher writes the first two letters of a given word for the student to see and models how to blend those first two sounds. The teacher then writes the third letter of the word and demonstrates how to blend the first two sounds with the third sound. This continues until the last sound is blended and the word is identified. For example, in the word stop, the teacher would demonstrate how to blend the word, sound-by-sound, as follows: /s/, /st/, /stŏ/, /stop/. Each time a new letter is added, the reader starts at the beginning so that he or she has the opportunity to rehearse the previously blended phonemes as a unit, increasing the likelihood that the phonemes will be retained in memory when the end of the word is reached. With time, students can be guided to use this strategy independently.

For students who have difficulty with speech or movement, it may be necessary to change instructional materials or the way we ask students to interact with the materials we use for decoding instruction. It is helpful to increase the font size of traditional print materials if the fine motor skills required to move from one letter to the next when finger pointing is a challenge. It may also be helpful to assist students in pointing to each subsequent letter in a word by gently guiding their hands; however, it is important to make sure that a student is comfortable with this approach before attempting it, as some students may be extremely uncomfortable with physical touch, and creating discomfort will defeat the purpose of the activity. If a student has trouble with speech while decoding, we can say the sounds for the student. As the student points (or you guide the pointing), say each sound as you move through each grapheme in the printed word. Even though the student is not doing the physical process independently, with practice, he or she can still learn the concepts necessary to decode words silently to themselves while reading.

Students who experience difficulty with short-term memory, speech, and movement may also benefit from working with various computer programs and tablet/smart phone applications to practice decoding skills. Numerous programs and applications exist that guide students in learning to segment and blend phonemes (e.g. L’Escapadou’s Montessori Crosswords, an application for iPhone/iPad) or that will read unknown words in online stories for students, sometimes even breaking up words into their individual phonemes, to demonstrate how letters represent the sounds of language (e.g., Starfall Education’s Starfall-Learn to Read). The extent to which students can use these programs independently will vary; however, again, students can interact with the programs with a teacher when guidance is needed. See Table 2 for a list of selected iPhone/iPad applications that specifically target decoding skills.

Table 2. Selected Phonics Applications for iPhone/iPad
Application Developer
Montessori Crosswords L’Escapadou
Bob Books Reading Bob Books Publications
Hooked on Phonics Learn to Read Hooked on Phonics
Starfall Learn to Read Starfall Education
Simplex Spelling Phonics series Pixwise Software
ABC Reading Magic series Preschool University

Overreliance on memorization

Because students with ID and DD have so often been taught to read by being asked to memorize words, you may encounter students who rely exclusively on this method of word identification. Although some students have been successful in learning to read to a degree with this approach, problems arise as students attempt to read more challenging texts. As text difficulty increases, complicated, unique, and multisyllabic words become more common, and one needs a reliable decoding strategy to know how to read unknown words (Copeland & Keefe, 2007). We cannot expect children to simply memorize every word that they may one day encounter, or we run the risk of relegating them to a minimum level of reading ability.

When students are used to reading solely or almost solely through the recognition of sight words, it can be difficult to teach them to rely on letter-sound correspondences to decode words. This author once worked with a student who had memorized so many words, she could read nearly fluently at the fourth-grade level. However, the student had no strategy for identifying unknown words beyond looking at the first letter of a word and guessing. Despite this student’s ability to recognize certain lengthy words by sight, she could not decode unknown words with more than two letters. Interestingly, she could not practice newly learned letter patterns with simple words such as bat or hug, as she had memorized all of them, and therefore did not have to use her new decoding skills to read them. To encourage the student to use phonics knowledge to decode words, the student had to be instructed with non-words (or nonsense words) such as lig or rup. These words had not been memorized so she had to make use of her knowledge of phonics to figure them out. With this information, the student could eventually be taught to use the decoding strategies to figure out longer, unknown real words such as ex/pect or mis/trust.

Comprehension and Vocabulary

The main purpose of reading is to comprehend a text’s message or meaning. It is not enough to be able to decode the words on a page if those words do not mean anything to the reader. Decoding is an important aspect of learning to read because to independently read text, we must first be able to identify the words on a page before we can understand them; however, there is much more to reading than word identification.

When strong readers read, they think about what they are reading (Harvey & Goudvis, 2000; Snow, 2002). They pay attention to the message of the text. When reading fiction, strong readers consider the actions of the characters, they relate those actions to their experiences, they weigh those actions against their own values, and they make predictions about what might happen next. Strong readers do not do this consciously; it just seems to happen, and is a part of the enjoyment of the reading process. However, interacting with the text in such a way is also an imperative part of making sense of the story. When weighing a character’s choices, we develop understandings of that character, including understandings that may not be specifically outlined in the text. For example, from attending to a character’s choices, we can determine whether the character is good or evil, or careful or impulsive. So much of what we understand from the text comes from thinking deeply about the reading (Pressley & Afflerbach, 1995). Strong readers also pay attention to whether or not what they are reading makes sense. When strong readers come across a sentence they do not understand, they may track back, wondering if something was misread. They may take note of vocabulary they do not know and make a decision about how to proceed (e.g., look up the word, use context to define the word, skip the word having gotten the gist of the idea).

It is sometimes thought that readers will automatically comprehend a text’s meaning once they have learned to decode words, but this is not always the case for students with or without disabilities (Donin, 2004). Many students need instruction in learning how to think about what they read and how to monitor their own thinking. That is, they must learn how to become metacognitive about their reading and reading processes. Much research has been conducted and many activities created to address this learning need with students (see Chapter 4 for more discussion on this topic).

Comprehension and vocabulary instruction for students with ID and DD

Students with ID and DD bring some extra challenges when learning to comprehend text. For example, students who have difficulty with working memory, which is the ability to mentally hold and manipulate information, will often have trouble remembering what they have read, so giving them strategies to maintain information in memory is important. Students with language delays and language processing difficulties might have trouble understanding certain vocabulary. In addition, a number of students, particularly those with ASD, may have trouble making inferences if they interpret language at a literal level (Kluth & Chandler-Olcott, 2008). In addressing these skills, students should have the opportunity to read, listen to, and work with quality literature and other texts that are age-appropriate, though it may be necessary to modify some aspects of the texts based on student need (Browder, Trela, & Jiminez, 2007). It is also important to note that students with ID and DD might have trouble expressing or demonstrating their understanding, which can be misinterpreted as lack of comprehension (Kluth & Chandler-Olcott, 2008).

Recent research suggests that teaching students with ID and DD strategies to monitor their own comprehension (i.e., to become metacognitive) can be helpful (Hudson & Test, 2011; Whalon & Hanline, 2008). One way to achieve this is to conduct frequent think-alouds when reading aloud to your students (Harvey & Goudvis, 2000; Doğanay Bilgi & Özmen, 2014). During think-alouds, teachers stop reading at certain points to explain their own thinking and how they are figuring out what is going on or how they are responding to the story. For example, during a fiction read-aloud, teachers might stop to make a prediction about what might happen next. They would be explicit in talking about what was noticed in the story that has caused them to make the prediction. Similarly, for students who have difficulty with making inferences, teachers can stop at predetermined points in the text, draw students’ attention to certain clues (e.g., a character’s described expression or behavior), and specifically explain how such clues can help tell us about the characters. Students can be asked to actively participate during think-alouds as well. For example, you might ask the students, “What kind of face might someone make if he or she is up to something sneaky?” The students could then be encouraged to make a “sneaky” face, and then you could bring their attention to where the text refers to a “sly smile” or “shifty eyes.”

Think-alouds are also helpful ways to guide students in understanding new vocabulary. You can stop after reading a sentence containing a challenging word and describe to the students how you use context to figure out the word’s meaning. You can also just stop and discuss an interesting word and encourage students to use it throughout the day. Notice how think-alouds do not require any reading to be done by the students. This is a perfect example of how to get students who are currently non-readers to interact meaningfully in literacy and work on higher-level skills.

Another way to work with students on comprehension is to get students actively involved in conversations around text that they have read. One way to do this is through Reciprocal Teaching (Palincsar & Brown, 1984). In Reciprocal Teaching, students read and then in groups take part in discussion by predicting what will happen next, generating questions about the text, clarifying difficult parts, and summarizing what they have read. Students in such groups take one of these strategies and become the groups’ “clarifier,” “summarizer,” or other role. For example, the clarifier might explain the meaning of a challenging vocabulary word identified by the questioner and share strategies for figuring it out. Students with ID and DD may benefit from a modified form of Reciprocal Teaching (Lundberg & Reichenberg, 2013) where texts are broken into smaller portions and where students work together on one strategy at a time. Teachers can scaffold the students’ strategy usage by teaching them to begin questions with question words (e.g., who, what, where) or begin summarizing sentences with a simple set of sequencing words (e.g., first, then, last). When providing instruction in inclusive groups, such modifications can be provided as well for any students who need them.

Students with ID and DD may also need explicit instruction around concepts and vocabulary terms to increase their comprehension (Knight, Spooner, Browder, Smith, & Wood, 2013). To teach concepts and vocabulary explicitly, Knight et al. suggest beginning with a topic (e.g., photosynthesis, civil rights, deforestation) and then choosing a set of words needed for comprehension of the given topic. Each of these words would then be taught individually, making definitions concrete by offering pictures or other visuals in the explanation and providing the students with both examples and non-examples of the terms. For instance, in teaching the term precipitation, Knight et al. incorporated pictures of clouds with rain and clouds alone. They specifically explained how only the clouds with the rain “counted” as precipitation. These authors also used graphic organizers to show the relationships between the set of words being taught, for example, placing the words precipitation, condensation, and evaporation on simple drawings of scenes with clouds and rain or snow, and using arrows to describe how one term led to the next. Students were then guided in their own completion of the graphic organizers.


Another important aspect in improving comprehension is to attain fluency in reading. When a person reads with fluency, he or she can recognize words automatically, read at an appropriate pace, attend to punctuation so that reading sounds like speech, known as prosody (Rasinski, 2012), and maintain these skills throughout the length of a text, known as endurance (Deeney, 2010). Being able to read fluently allows for greater comprehension because less effort is needed in decoding the text, and therefore, more attention can be directed toward making sense of the text (Griffith & Rasinski, 2004; NRP, 2000). A common way to assess students’ fluency is to measure their oral reading fluency (ORF), which involves counting the number of words a student can correctly read in a minute. There are general guidelines for expected oral reading rates of student by instructional grade level. For example, the average fluency score for students in the middle of first grade is reading 23 words correct per minute (WCPM). This increases to about 53 for average readers by the end of first grade (Hasbrouck & Tindal, 2006).

Fluency instruction for students with ID and DD

Measures of ORF have been used to assess the fluency rate and fluency growth of students with ID and ASD, and such measures are appropriate when students’ disabilities do not interfere with fluent speech. For students who do not have reliable speech or for whom the physical act of speaking creates difficulty, ORF is not likely to be the best measure of these students’ reading fluency. Remember, the purpose of achieving fluency in reading is not to be a great oral reader, per se, but to read easily enough that there is thorough comprehension of the text. A student may not be able to read fluently aloud, but this does not mean that he or she cannot process text fluently in her mind. How do we know if students are reading fluently during silent reading if we cannot hear them read? Certainly determining this can be tricky, but it can be done. The Qualitative Reading Inventory-5 (Leslie & Caldwell, 2011) provides passages for which both ORF and silent reading fluency (SRF) can be determined. In giving an SRF assessment, a student’s reading is timed, and the evaluator asks the student to indicate when he or she is finished, and the number of words per minute can be calculated. To be sure that the student has actually processed the text, you can ask the student to respond (through AAC or other means) to a quick literal comprehension question or two.

The downside to using SRF measures is that you will not get the same information about the types of struggles the student is having in decoding words or in phrasing that an oral reading fluency measure would provide, since you cannot hear the student read. Therefore, deciding which measures to use will be a matter of thinking critically about the students’ needs and what precisely it is you are trying to assess. For example, for a student with some reliable speech, it might make sense to have the student do a short read aloud for which you can do an analysis of her mistakes, and then provide the silent reading task to assess silent reading fluency.

There is, of course, more to fluency than assessment. Once we have determined students’ reading rates, we will need to provide appropriate instruction. If a student’s rate is low, he or she may need more instruction in identifying words accurately and automatically. Therefore, interventions in decoding and recognition of irregularly spelled words will likely be beneficial. However, as discussed, fluency encompasses more than accurate decoding. For any student, with or without disabilities, providing a model of fluent reading is important (Griffith & Rasinski, 2004). Students must be given the opportunity to hear books and other texts read aloud by expert readers to begin to understand how fluent reading should sound.

Another way to provide instruction in fluency to students with ID and DD is to have students reread texts after providing corrective feedback on areas in need of growth (Hua et al., 2012). Begin by having students read a text at their highest instructional reading levels (i.e., the highest reading level at which they can read without frustration and where errors do not have a strong negative impact on the students’ comprehension), taking note of word errors and timing them. Next, correct the word errors making sure they can correctly identify the words. Discuss with them what you noticed about their reading. Do they read word by word or in few-word phrases? Do they attend to punctuation and read with expression? Choose an area to bring to their attention and explain the adjustment you would like made. Model the adjustment if necessary. Next, have them reread the same text with the new skill in mind twice, again making note of word errors and timing them. This method will allow you to keep track of their WCPM over readings and provide direct instruction related to any particular areas of need.

For students who have substantial issues in developing reading fluency or who need to access texts above their individual reading levels, AAC can be used to provide accommodations. For example, if a student needs to read a text for a science class that is too difficult for him or her to read fluently and independently, text-to-speech software can be used to help that student gain access to the text.


1: For more information about the formation of the panel, please visit Eunice Kennedy Shriver National Institute of Child Health and Human Development (2013). Return