Optimizing Literacy in English Language Learners

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Maria Adelaida Restrepo, Ph.D.,1and Shelley GrayQ11. ABSTRACT. Children in ..... Morrison Institute for Public Policy; Center for the. Future of Arizona; 2006. 3.
Optimizing Literacy in English Language Learners Maria Adelaida Restrepo, Ph.D.,1 and Shelley GrayQ11

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ABSTRACT

Children in the United States who are English language learners characteristically do not exhibit the same levels of reading achievement as their peers. The article describes the development of English literacy in English language learners and the relationship between a child’s second language (L2) and his or her native language (L1) in literacy development. It is organized first to consider the issue of language of instruction and language transfer, specifically the aspects of L1 literacy that appear to transfer to the second language (L2), English. It then discusses general principles for professionals working to optimize English literacy development in different models of literacy instruction for English language learners. We conclude that using the child’s L1 provides the children with strong language and literacy skills in both languages. KEYWORDS: Biliteracy, English language learners, language transfer

Learning Outcomes: As a result of this activity, the reader will be able to (1) identify factors that affect English language learners’ literacy development to optimize their learning, (2) discuss and consider the concept of language transfer in literacy instruction for English language learners, and (3) recognize the value of native language instruction for literacy and other factors in English language learners.

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his article provides a summary of what is currently understood regarding literacy development among English language learners (ELLs) in the United States (U.S.), drawing from research on U.S. ELLs as well as research on literacy development in other countries and languages. ELLs often speak a language other

than English at home and then begin to learn English when they enter school. These children are considered to be sequential bilinguals. Simultaneous bilingual or multilingual children, by comparison, are children who speak two or more languages by age 2.1 By focusing on children who are ELLs, this article considers

1 Department of Speech and Hearing Science, Arizona State University, Tempe, Arizona. Address for correspondence and reprint requests: M. Adelaida Restrepo, Ph.D., Associate Professor, Dept. of Speech and Hearing Science, Arizona State University, P.O. Box 870102, Tempe, AZ 85287-0102. E-mail: [email protected].

Emergent and Early Literacy Intervention: Etiological Perspectives; Guest Editor, Laura Justice, Ph.D. Semin Speech Lang 2007;28:25–34. Copyright # 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 5844662. DOI 10.1055/s-2007-967927. ISSN 0734-0478.

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the literacy development of children who are still in the process of learning English. These children may be monolingual in a language other than English, or they may have some working knowledge of English but have greater proficiency in another language (e.g., Spanish). Development of English literacy in ELLs is a dynamic and complex process that is the result of several factors working together: language proficiency in each language, literacy experiences prior to English literacy instruction, home factors, cognitive ability, language(s) of instruction, and transfer of language skills and literacy skills between languages. This article reviews research addressing how these factors affect development and how professionals, including speech-language pathologists (SLPs) and classroom teachers, can improve literacy outcomes in ELLs.

LITERACY ACHIEVEMENT AMONG ELLS The National Assessment of Education Progress (NAEP), also known as ‘‘the Nation’s Report Card,’’ assesses children across a variety of academic areas. The 2005 NAEP results for ELLs reported that 73% of these children scored below basic reading ability in fourth grade. Similar performance was reported for eighth graders, with 71% of ELLs scoring below basic reading ability. Although these statistics are discouraging, research indicates that ELLs can achieve literacy skills appropriate for their grade level if they receive effective literacy instruction. Their gains are not instantaneous, but with time they can succeed.2 Using the model of the National Reading Panel (NRP: National Institute of Child Health and Human Development, 2000), the National Literacy Panel for Language Minority Children and Youth (NLP; August 2006) reviewed the comprehensive research base concerning literacy development in ELLs. In their executive report, the NLP found that the same instructional approaches that facilitate reading in English speakers also facilitate reading in language minority children. These include instruction in phonemic awareness, vocabulary, letter knowledge, fluency, and comprehension strategies. In addition, the NLP outlined sev-

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eral critical factors that must be considered in ELL literacy development. First, educators must develop realistic expectations for ELLs. A child who enters kindergarten as a monolingual Spanish speaker cannot be expected to achieve grade level reading performance by the end of kindergarten. Conversely, expectations should not be lowered because a child comes from a nonmainstream cultural background. The implication of this point is that professionals who work with ELLs must have an understanding of the second language acquisition process so they can adjust their teaching to meet the children’s needs. This will support high but realistic expectations for ELL children, giving them time to learn English and to develop literacy skills. This approach has data-based support. For example, Lesaux and Siegel3 found that ELL children and their monolingual English-speaking peers achieved comparable levels of reading performance by second grade when their school district provided a balanced reading program in English that included phonological awareness instruction. In this study, ELL children at risk for reading failure received classroom-based, small-group phonological awareness instruction from classroom teachers and resource teachers three to four times per week for 20 minutes. Some children also continued to receive intervention in first grade. By second grade, most at-risk children achieved reading levels similar to those of their native Englishspeaking classmates and in some cases surpassed their peers. Second, the NLP also emphasized that it is important for educators to understand that although the developmental trajectories of ELLs are similar to those of monolingual English speakers, they may also differ in important ways. For example, studies have reported that the written language of ELLs, including alphabet knowledge, may outpace their development of phonemic awareness.4,5 ELL children often receive instruction targeting alphabet knowledge as soon as they enter school, before phonemic awareness has begun to develop. Thus, alphabet knowledge and phonemic awareness may develop concurrently among ELLs4 because, often, ELLs’ first encounter with consistent and maybe formal

OPTIMIZING LITERACY IN ENGLISH LANGUAGE LEARNERS/RESTREPO,GRAY

literacy instruction occurs when they receive instruction in letter names and sounds. Third, the NLP also noted that different native languages may differentially influence the development of English language proficiency and thus the development of literacy skills.6–8 We discuss this point more extensively later in this article. Fourth, the NLP cautioned that English language proficiency is critical if ELL children are to learn to read as their English-speaking peers do.9,10 Therefore, programs must ensure that children achieve English language proficiency so that they can be successful readers in English. At the same time, the panel noted that academic instruction in English, including reading, does not have to wait until children speak English fluently. Rather, English literacy instruction can start concurrently with English oral language instruction.

ment in English,12,17 these programs would not help children develop literacy in their native language, which would be ideal for their social, cultural, and career development. To become biliterate, however, literacy instruction must be balanced between two languages.18 Research indicates that children’s native language skills may facilitate or transfer to literacy development in English and that early native language skills predict later English literacy skill acquisition.19–22 If skills that the NRP found to facilitate English literacy acquisition, such as phonemic awareness, vocabulary, alphabet knowledge, and reading comprehension, do transfer from one’s native language to English, this lends support to bilingual and biliterate approaches to instruction. In the following sections, we provide a brief overview of current understanding concerning cross-language transfer of specific literacy skills.

LANGUAGE OF INSTRUCTION A topic of considerable debate related to English language proficiency is the language of instruction. The language of instruction is the language (e.g., English versus Spanish) that is used to provide content-area instruction to ELLs. Policies governing the language of instruction vary markedly across the United States. ELLs may receive literacy instruction in their native language initially and then make a transition to English, they may receive instruction in both languages, or they may receive instruction in English only. Some research is available to inform such policies. Specifically, research indicates that if preschool children receive oral language instruction in their native language only, their outcome in English literacy can be as good as or better than that of their monolingual peers by fifth grade.11 Further, bilingual instruction seems to have positive effects on both the native language and English literacy when compared with English-only instruction.12–15 In addition, bilingual instruction programs result in children who are biliterate, which is often associated with greater academic success and a stronger bicultural identity than ELL children who become literate in English only.16 Although quality English-only programs can lead to grade-level literacy achieve-

Phonemic Awareness Bialystok et al18 found that ELL children who spoke Cantonese as their native language transferred syllable awareness skills to English but not phonemic awareness skills, probably because the Cantonese alphabet is syllabic rather than phonemic. Wang, Park, and Lee23 found that phonemic awareness skills in Korean transferred to English but not orthographic knowledge, probably because the Korean alphabet represents individual phonemes but the orthography differs from English. This research suggests that when languages are similar in terms of alphabet, orthography, and phonemic representation (as are Spanish and English), transfer occurs. Several researchers have found that Spanish phonemic awareness facilitates English phonemic awareness and literacy development in ELL children who speak Spanish as their native language.19–22,24 However, other skills may or may not transfer.

Vocabulary Knowledge Vocabulary knowledge may transfer between languages, but evidence to this effect is not conclusive. August, Carlo, Dressler, and Snow25 argued for further research in this area because if vocabulary does transfer this

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would support vocabulary instruction in the native language; conversely, if it does not, vocabulary instruction would need to occur in English. A large study with Cuban families in Miami15 found that some literacy skills transferred across languages but that oral language skills such as vocabulary did not. However, their vocabulary measures were standardized and normed on monolingual populations. Other researchers have argued that vocabulary in the L1 has a facilitative role in the development of the second language in the early stages of the second language acquisition but not when the child is fluent in both languages.26 For example, three studies have found that instruction in the L1 led to faster English vocabulary acquisition in ELLs than instruction in English only.27–29 Others have found that Spanish cognates facilitate comprehension of English cognates30–32 and that those instructed in Spanish have significantly better comprehension of English cognates.33 Although it is not directly related to transfer, Proctor and colleagues34 found that vocabulary in the L1 in second grade was a strong predictor of English reading comprehension in fourth grade students, indicating that native Spanish was important for English comprehension. In summary, vocabulary in the L1 may transfer to English and it predicts vocabulary and literacy in English, at least during the early stages of English language and literacy acquisition. However, transfer may not occur in later stages of language development.

Alphabet Knowledge There is some evidence that alphabet knowledge in the L1 transfers to English and that this is facilitated by the similarity of the language’s alphabetic principles.18,23,33 Specifically, research suggests that letter names in one language transfer to the second language when alphabet instruction occurs in the L1 and the alphabets are similar, as in Spanish and English.35,36 If alphabet instruction is provided solely in English, there is a negative relationship between letter knowledge in the L1 and letter knowledge in English, indicating that the more letter knowledge the child has in English, the less knowledge the child has in the native

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language. These results indicate that unless children receive balanced alphabetic instruction in both languages, the language of instruction will benefit that alphabet only.

Reading Comprehension Research concerning the transfer of comprehension skills between languages is very limited. However, ELL children who come to U.S. schools with good literacy skills and comprehension strategies in their L1 tend to do well in school, to use their L1 strategies for English comprehension, and to benefit in additional ways from their L1 skills.11,16,30,31 Therefore, students who are literate in their L1 will be more successful in English if they use their L1 skills to aid English comprehension. In summary, English literacy development in ELLs is similar to that of monolingual English speakers in that the same skills that affect reading in English speakers, including phonemic awareness, vocabulary, alphabet knowledge, and reading comprehension strategies, affect reading in English by ELLs. In addition, evidence indicates that a child’s L1and English interact, with some transfer of skills, such as phonemic awareness. When planning literacy instruction for ELLs, consideration of the effects of transfer is important.

OPTIMIZING LITERACY DEVELOPMENT FOR ELLS

Model 1: Oral Proficiency in English before English Literacy Instruction Benefits Pang and Kamil37 reviewed four models applicable to teaching literacy skills to ELLs, as presented in Table 1. The premise of the first model is that children must gain oral language proficiency in English before they can benefit from literacy instruction in English; therefore, children are not taught English literacy skills early in their schooling. Pang and Kamil point out that although oral proficiency clearly affects reading, research has not yet specified the level of proficiency needed to support emergent

OPTIMIZING LITERACY IN ENGLISH LANGUAGE LEARNERS/RESTREPO,GRAY

Table 1

Models of Literacy Instruction

Develop English Proficiency before Formal Literacy Instruction

Develop L1 Literacy while Child Learns English

Develop Biliteracy

Develop English Literacy

Instruction focuses

Instruction focuses

Instruction focuses on

Instruction focuses on using

on developing oral

on L1 content

L1 and English literacy

strategies that predict

English proficiency

and literacy and

development. Recognizes

English literacy including

before teaching

on oral English

that both languages

phonemic awareness,

English literacy.

development.

are related.

letter knowledge, and vocabulary.

literacy in L2. In addition, results of the NLP do not support this approach.

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Model 2: Support Curricular Development in L1 as English Is Acquired The premise of the second model is that children need to continue developing their conceptual knowledge in L1 as they learn to speak, read, and write English; therefore, children receive academic instruction in L1 while they are developing their English skills. Two key factors in the success of this approach are the teachers’ proficiency in L1 and a systematic approach to instruction. Merely having bilingual staff in a program is not sufficient. This is illustrated in findings by Kan and Kohnert,38 who found that ELL children attending a preschool that was considered bilingual did not continue to develop their L1 vocabulary (Hmong). They concluded that most of the actual language instruction in the classroom occurred in English, although the staff interacted with the children in both languages. Teachers can support L1 development in several ways that do not require full-day L1 instruction. Restrepo and colleagues (unpublished data, 2006Q2) evaluated the impact of a 30-minute-per-day early literacy intervention provided in Spanish to Spanish-speaking children attending English-only programs. They found that children who received this intervention that included phonemic awareness instruction, vocabulary instruction, book reading, and letter knowledge continued to increase sentence length and complexity and letter knowledge in

Spanish. Children who received no Spanish intervention stagnated in their L1 development. Other studies converge with Restrepo and colleagues’ findings. Spanish and English instruction were compared in a study conducted with first grade Latino children.39 The Spanish instruction increased early literacy abilities in both English and Spanish; however, the group who received English-only instruction increased skills only in English, not in Spanish. A study by Vaughn and colleagues40 had different findings with first graders. They found that L1 instruction did not improve English language literacy skills to a greater extent than English-only instruction. These results suggest that L1 instruction will not delay English acquisition, although dual language instruction may be more beneficial for literacy gains in both languages.

Model 3: Provide Balanced Oral Language and Literacy Instruction in Both Languages The premise of the third model is that there is an interdependent relationship between language and literacy development in L1 and L2 and that society benefits from bilingual, biliterate adults; therefore, oral language and literacy instruction is provided in L1 and in English in a balanced manner with the goal of children becoming bilingual and biliterate. NLP results suggest that such dual language programs result in better English reading achievement than English-only programs. Further, programs that teach literacy in both

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languages demonstrate literacy benefits in L1. To be effective, however, dual language instruction must be planned, systematic, and purposeful (Kan and Kohnert38; Restrepo and colleagues, unpublished data, 2006). Slavin and Cheung14 completed a meta-analysis of reading comprehension programs and found that studies that paired reading instruction in L1 and in English had results that were as good as or better than those of English-only instructional programs. Further, research demonstrates that L1 performance is a significant predictor of second language and literacy performance10,12,25,34,41,42; therefore, ELLs in the early stages of literacy development will benefit from literacy instruction in both languages. However, studies with positive outcomes also suggest that instruction in each language should occur at separate times, not together within the same instructional session. Gomez, Freeman, and Freeman43 suggested that bilingual instruction could be implemented in different ways depending on the needs of the children, the community, and staff availability. For example, they reported on a 50/ 50 model of instruction in which children received instruction in L1 about half of the time and L2 the other half. In such models, L1 and English instruction may be divided into half-day and half-day, alternating days, or alternating weeks. These approaches maximize the number of children taught by the limited supply of bilingual teachers who can team teach with English-speaking teachers. If personnel limitations do not permit balanced instruction, a daily L1 program for 30 to 45 minutes that addresses specific language and literacy objectives could be effective (Restrepo and colleagues, unpublished data, 2006). When no teaching staff can instruct in the L1, a concerted effort must be made to train and utilize parents and other volunteers who speak children’s native languages. Teachers should also educate families about the importance of supporting their child’s L1 development at home.

Model 4: Focus on Factors Known to Predict Reading Success The premise of the fourth model is that children can capitalize on their existing L1 oral

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language and literacy knowledge to help them learn English literacy skills; therefore, systematic and explicit literacy instruction is provided in English in meaningful contexts, but children do not typically receive instruction in their L1. Instead, instruction focuses on skills known to predict reading success, such as phonemic awareness and letter knowledge, with attention to helping children develop cross-linguistic strategies such as recognizing cognates. The NLP found that teaching focused on skills including phonemic awareness, phonics, fluency, vocabulary, and text comprehension benefited ELLs as well as native Englishspeaking children. They also noted that writing instruction is important for ELLs. TagoilelagiLeota, McNaughton, MacDonald, and Farry44 noted that children who start school with strong skills in their L1 can be successfully taught the beginning stages of reading and writing in English, but this requires expert teaching and comes at the cost of continuing development in the oral language and literacy of their L1. In this model, teachers of ELLs in the early stages of English acquisition should use multisensory teaching techniques, such as visual aids, predictable classroom routines, and handson activities. Repetition of vocabulary across a variety of contexts is important. For later stages of development, ELLs need multiple opportunities to practice and use their newly acquired language and literacy skills and time to formulate their sentences and responses. ELLs also need daily opportunities to interact with children who are monolingual English speakers and with peers who are proficient in English as their second language. Instructional and social groups should vary so that children have opportunities to practice using their L1 and English throughout the day. If a child comes to school literate in the L1, many aspects of that knowledge may transfer to English, depending on the similarity of the L1 and L2 phonology and orthography. Along this line, Pang and Kamil37 suggested that teachers help children use their existing knowledge of phonological and phonemic awareness to build the same skills in English. Teachers can also help children build English vocabulary by showing them how to figure out word meaning

OPTIMIZING LITERACY IN ENGLISH LANGUAGE LEARNERS/RESTREPO,GRAY

using translation, cognates, and word substitution in texts. Pang and Kamil37 emphasized that cognate instruction should highlight the orthographic similarity and derivational morphology of cognates as well as teaching false cognates. When a child’s L1 and English do not share cognates, a special emphasis should be placed on vocabulary instruction and the strategies of word substitution and translation. For a summary of models of literacy instruction, see Table 1. Anderson and Roit45 provided several additional strategies that teachers can use to help ELLs improve English reading comprehension. First, teachers should allow children to respond to questions about texts and to participate in discussions using their first language. This enhances their ability to use language flexibly. Second, teachers should promote high-level vocabulary in English rather than more common ‘‘surface’’ vocabulary comprising common nouns, verbs, and adjectives. Similarly, teachers are encouraged to teach the meaning of high-frequency words that carry important meaning in English but that are not concrete (e.g., few, some). This is critically important because depth of word knowledge in both languages is predictive of reading comprehension.25 Third, Anderson and Roit cautioned against teaching vocabulary out of context and against parsing the context of a story or expository text into such small parts that the meaning of the whole is lost. When children are helped to differentiate main ideas from details, they learn what is important and what they should remember. Fourth, teachers should help students be risk takers in English by engaging them in conversations about texts and experiences. This provides practice formulating and producing complete sentences that communicate complex ideas. Anderson and Roit45 also suggested several teaching strategies that support children’s comprehension building. These include shared reading, where teachers read and reread texts to children; semantic webbing, where teachers and children create graphic organizers that link ideas within and across texts; predicting, where children make educated guesses about future events in a story and then revisit their predictions to assess their accuracy; the use of im-

agery, where children are encouraged to draw pictures about texts and to compare their interpretations; teaching text structure so that children understand that texts that are written for different purposes have different organizational configurations (e.g., story grammar versus science experiment report); encouraging children to share their perceptions about why certain parts of a text are difficult to understand and what helps them when they do not understand, thereby engaging metalinguistic skills; requiring children to explain what a text means and to compare their interpretation with others; reading texts about topics that are culturally relevant and familiar to ELLs; and, finally, creating many opportunities for children to engage in peer-to-peer conversations about topics that interest them. This provides valuable English practice in a low-risk social environment. Each of the four models of instruction reviewed by Pang and Kamil37 utilizes a different approach to the language of instruction at school, but this is only part of the picture for ELLs. Valuing children’s home languages, whether or not instruction occurs in those languages, will positively affect children’s socialization and their view of education and literacy. Research suggests that home language programs lead children to value their home language and reading.12 Parent training programs to increase the quantity and quality of reading with children from low-income and low-education homes, whether they are ELL or not, is critical to reducing the gap in literacy and vocabulary at preschool entry. Programs that lend books in the child’s native language, that train parents to increase the amount of reading with children, and that teach parents effective interactive reading techniques all are shown to have a positive effect on children’s language and literacy skills.46 Of particular importance to professionals who work with ELL children and their families is challenging the assumption that ELL parents are illiterate and cannot help their children. Often, the parents of ELL children are literate, but this is not recognized because professionals cannot communicate with them easily in spoken language. Even if instances in which adults in the home are not literate or have limited literacy skills, families can have meaningful

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interactions with children using books. For example, when ELL children bring books home that they have read at school, they can retell the story or read them to their family. In addition, they can have conversations with their parents about the books and the activities related to the book. Moreover, there are now programs specifically designed to facility home literacy activities. There is a great variety of books that have stories and expository text available in different languages or that are available bilingually. It is also important to note that asking families whose L1 is not English to speak English at home does not serve any purpose. Strong language and communication skills in the L1 lead to strong English language skills; therefore, families of ELLs should focus on developing good language and communication in the home language.47

SUMMARY In summary, the National Literacy Panel emphasized that literacy instruction alone is not sufficient to ensure that ELLs achieve reading and writing proficiency in English. Children must also receive instruction that supports a high level of oral proficiency in English, including instruction in vocabulary knowledge, listening comprehension, syntactic skills, and metalinguistics. Programs with well-planned, systematic language and literacy instruction in L1 and in English can result in children who are bilingual and biliterate. When bilingual programs are not an option, instructional programs should be designed to help children leverage their L1 and literacy skills to become literate in English at the same time that they value their L1 and provide homes with literacy support, such as home lending programs and training.

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SEMINARS IN SPEECH AND LANGUAGE/VOLUME 28, NUMBER 1

45. Anderson V, Roit M. Linking reading comprehension instruction to language development for language-minority students. Elementary School J 1996;96:295–309Q27 46. Whitehurst GJ, Arnold DS, Epstein JN, Angell AL, Smith M, Fischel JE. A picture book reading intervention in day-care and home for children

2007

from low-income families. Dev Psychol 1994;30: 679–689 47. Kohnert K, Yim D, Nett K, Kan PF, Duran L. Intervention with linguistically diverse preschool children: A focus on developing home language(s). Lang Speech Hear Serv Sch 2005;36: 251–266

Author Query Form (SSL/00291) Special Instructions: Author please write responses to queries directly on proofs and then return back. Q1: Please provide academic degree(s) for second author. Q2: Per journal style, unpublished data is listed in the text but not the reference list. If the article has been accepted for publication, please provide the journal (or book) title, and the reference will be added to the list at page proof stage. Q3: Author initials correct as written? Q4: Cannot find a title to match the journal Read Res Qrtly (in reference 7 Verhoeven, 1990). Q5: Please provide volume and page numbers in reference 8 Q6: Cannot find a title to match the journal Topics in Lang Dis (in reference 9 Gottardo, 2002). Q7: Please fill in date when the online database was accessed. Q8: Cannot find a title to match the journal Ed Policy (in reference 13 Rolstad, Mahoney, Glass, 2005). Q9: Please complete year of publication in reference 15. Q10: Cannot find a title to match the journal TESOL Quarterly (in reference 16 Saville-Troike, 1984). Q11: Please fill in date when the online database was accessed. Q12: Cannot find a title to match the journal Contemporary Ed Psych (in reference 21 Cisero, Royer, 1995). Q13: Cannot find a title to match the journal Applied Psycholin (in reference 24 Dickinson, McCabe, Clark-Chiarelli, Wolf, 2004). Q14: Cannot find a title to match the journal Learn Disabil Res Practice (in reference 25 August, Carlo, Dressler, Snow, 2005). Q15: Cannot find a title to match the journal J Lang Speech Hear Serv Sch (in reference 28 Perozzi, Chavez-Sanchez, 1992). Do you mean ‘‘Lang Speech Hear Serv Sch? Q16: Please verify the page numbers (90-12) (in reference 31 Jimenez, Garcia, Pearson, 1996). Q17: Cannot find a title to match the journal Read Res Quarterly (in reference 31 Jimenez, Garcia, Pearson, 1996). Q18: Cannot find a title to match the journal Appl Psycholinguistics (in reference 32 Nagy, McClure, Mir, 1997).

Q19: Please clarify reference 33; is this a book or a journal publication? If it is a book or pamphlet, please provide the publisher and city of publication. Q20: Cannot find a title to match the journal Appl Psycholinguistics (in reference 35 Rolla San Francisco, Carlo, August, Snow, 2006). Q21: Cannot find a title to match the journal Reading and Writing (in reference 36 Rolla San Francisco, Mo, Carlo, August, Snow, 2006). Q22: Please provide the missing volume number in this journal reference. (in reference 39 Kan, Kohnert, 2005). Q23: Cannot find a title to match the journal Scien Studies Read (in reference 39 Carlisle, Beeman, 2000). Q24: Cannot find a title to match the journal Read Res Quarterly (in reference 41 Carlo, August, McLaughlin, Snow, Dressler, Lippman, 2004). Q25: Cannot find a title to match the journal Bilingual Research Journal (in reference 43 Gomez, Freeman, Freeman, 2005). Q26: Cannot find a title to match the journal International Journal of Bilingual Education & Bilingualism (in reference 44 Tagoilelagi-Leota, McNaughton, MacDonald, Farry, 2005). Q27: Cannot find a title to match the journal The Elementary School Journal (in reference 45 Anderson, Roit, 1996).

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Francis Eppes Professor of Communication Disorders, Florida State University, Tallahassee, FL (Editor) Third Edition

Beginning with the latest neurophysiological and psychological models of tinnitus, the book goes on to cover evaluation tools; counseling options and methods; treatment with hearing aids, wearable and nonwearable noise generators, and music; tinnitus-related insomnia; and quality-of-life issues. You will also find sample handouts to allow for effective communication with patients. Highly experienced clinicians from around the world give you the practical strategies you need to confidently apply each therapeutic approach. With key clinical information for implementing all current therapies, Tinnitus Treatment: Clinical Protocols is an essential professional resource.

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