Word Courses

Quick Instructions🔗

Word courses progressively introduce the students to learning to read and spell words. The general procedure for conducting the word courses is the same as for all lessons. For details on that procedure, see the general instructions or the full instructions below. This section contains quick instructions for the intervention part for word courses.

• Tier 0: If the student correctly reads or writes all the examples in the lesson, no intervention is needed. The tutor can move to the next lesson immediately.
• Tier 1: If the student misses some examples, the tutor performs explicit instruction on how to read or spell those words. A very simplified version of the procedure is as follows:
  • The tutor clarifies the meaning of the word if needed.
  • The tutor says the word out loud, clearly and at a normal pace, and has the student repeat after them.
  • The tutor then breaks the word into its individual sounds, by saying the word very slowly so that each sound is clearly heard, and has the student repeat after them.
  • The tutor then blends the sounds together by saying the word again, this time at a slower pace than normal speech, but without exaggerating the sounds, and has the student repeat after them.
  • The tutor goes through the letters of the word, maps them to the sound they make in the word, and has the student repeat after them.
• Tier 2: This tier should be engaged when an explicit warning to perform it appears after the student has gone through the lesson multiple times and the student still misses more than a couple of examples. A very simplified version of the procedure is as follows:
  • The tutor starts by performing the Tier 1 intervention for each of the words the student missed.
  • After that, taking the words in the lesson as a starting point, the tutor asks the student to find the result of substituting, deleting, or reversing sounds in a word.
  • If the student answers correctly, perform another exercise. Otherwise, break down the word into its individual sounds, like in the Tier 1 intervention, and then repeat the question. If the student answers incorrectly again, provide the answer and move to another exercise.
  • Perform around five or six exercises in total, mixing substitution, deletion, and reversal exercises.
• Tier 3: This tier should be engaged when an explicit warning to perform it appears after the student has gone through the lesson multiple times and the student still misses more than a couple of examples. A very simplified version of the procedure is as follows:
  • The tutor starts by performing the Tier 1 intervention for each of the words the student missed.
  • The tutor performs the same procedure as Tier 2 with a couple of changes:
    • The number of exercises is increased to around ten or twelve.
    • The tutor uses tokens to represent the phonemes in the exercises. When a phoneme is substituted, deleted, or the whole word is reversed, the tutor arranges the tokens accordingly to help the student visualize the sounds.
• Tier 4: A explicit warning to perform it appears when the student appears unresponsive to the previous tiers. This signals that the student may have a more severe reading difficulty and that the tutor should consider seeking help from a specialist. Such specialist can use Pictures Are For Babies for scheduling lessons and use their own protocols for intervention.

Full Instructions🔗

The second track of courses in Pictures Are For Babies introduces the student to single words. Starting with simple words, continuing through all one-syllable words, multi-syllable words, morphologically complex words, and ending by covering common words for many academic subjects.

The word courses are designed to support orthographic mapping from the very beginning. Orthographic mapping is the process by which readers store words for immediate, effortless retrieval. To accurately follow the principles of orthographic mapping, the tutor is asked to only mark an example as correct if the student can read the word quickly and automatically, without hesitation. A good rule of thumb is that the student should start to read the word in less than one second.

The general procedure for word courses is as follows:

• Each lesson contains multiple examples, which start as hidden. The tutor first looks at the lesson header to check if the lesson is a Reading or Dictation lesson.
• For reading lessons:
  • The tutor clicks on the first example to reveal it and shows it to the student.
  • The student should quickly and automatically read the word. If the student does so, the tutor clicks on the "✗" button to mark the example as correct, which turns into a "✓".
    • Students should be instructed to say "I don't know" if they do not know how to read the word. The tutor should make it clear that this is not a problem but a part of the learning process.
  • Repeat this process for all the examples in the lesson.
  • After the student goes through all the examples, the tutor performs an intervention. Refer to the intervention sections below for selecting the correct intervention and instructions.
• For dictation lessons:
  • The tutor instructs the student to look away from the screen to avoid reading the answers.
  • The tutor clicks on the first example to reveal it and reads it aloud to the student.
  • The student should quickly and automatically write the word on a piece of paper, notebook, or some other writing surface. If the student does so, the tutor clicks on the "✗" button to mark the example as correct, which turns into a "✓".
    • Students should be instructed to say "I don't know" if they do not know how to write the word. The tutor should make it clear that this is not a problem but a part of the learning process.
    • This is not a handwriting course. If the student is too young to write by hand, they can use one of the following alternatives:
      • Spell out the words to the tutor verbally and have the tutor write them down. For example, the student can say "c-a-t" for the word "cat" or "uppercase T-o-m" for the word "Tom".
      • Write on a table or computer keyboard.
      • Write using a stylus on a tablet or phone.
  • Repeat this process for all the examples in the lesson.
  • After the student goes through all the examples, the tutor performs an intervention. Refer to the intervention sections below for selecting the correct intervention and instructions.

The intervention protocol of the word courses is more complex because it uses a multi-tiered system of interventions that progressively give more support to the students that need it. Instructions on how to perform the different tiers of intervention are provided below. While the interface provides explicit warning on when to perform Tier 2, 3, and 4 interventions based on the past performance of the student, the tutor is free to perform any of the interventions at any time based on their judgement. For example, if the student has already been diagnosed with reading difficulties, the tutor can directly perform a Tier 2 or Tier 3 intervention from the beginning.

Note: In the instructions, the symbols inside slashes are part of the International Phonetic Alphabet (IPA) and unambiguously represent sounds. It is not necessary to learn the IPA, it is used here to make the difference between letter names and sounds clear. Their meaning can be inferred from the example words provided.

Tier 0 Intervention🔗

If the student correctly reads or writes all the examples in the lesson, no intervention is needed. The tutor can move to the next lesson immediately.

Tier 1 Intervention🔗

Tier 1 intervention is simply explicit instruction on how the words the student missed are read and spelled. The procedure below is done for each of those words. It is not necessary to do this for the words the student read or wrote correctly.

There are two stages for this process. First, the tutor demonstrates how the word is broken up into individual sounds and how those sounds blend together to form the word. This stage is done without any reference to writing. It is a purely auditory exercise that could be done with eyes closed. The second stage is to show how the word is written and how the letters map to the sounds.

The first stage develops basic phonemic skills called segmentation and blending and is done as follows:

• If the student does not know the meaning of the word, the tutor can explain it to them at this point. Using pictures and illustrations is allowed when that clarifies the meaning. Tutors can use the included dictionary to look up the meaning of words.
• The tutor should instruct the student to avoid looking at the screen, notebook, or any other writing surface.
• The tutor says the word out loud, clearly and at a normal pace.
• The tutor then asks the student to repeat after them.
• The tutor then breaks the word into its individual sounds, saying each sound clearly and slowly. Each sound should be clearly heard, including consonants. The easiest way to do this is to say the word in a slow, continuous, and exaggerated manner. The speed should be roughly three or four times slower than normal speech and there should be no pauses between individual sounds.
  • Consonants should be pronounced without adding an extraneous vowel sound at the end. For example, when saying the letter 't', the tutor should say /t/ and not 'tuh' (/tə/).
  • Sometimes it is not possible to do this without stopping because some sounds like /b/ and /d/ require a pause to be clearly heard. In those cases, the tutor should make the pause as short as possible.
• The tutor then asks the student to repeat after them.
• The tutor then blends the sounds together by saying the word again, this time at a slower pace than normal speech, but without exaggerating the sounds.
• The tutor then asks the student to repeat after them.

The second stage delivers explicit instruction on the grapheme-phoneme mappings of the word, that is, how the letters in the word map to the sounds that were shown to the student in the first stage. This is done as follows:

• The tutor instructs the student to look at the Pictures Are For Babies screen where the word is displayed.
  • The tutor can also write the word on a writing surface of their choice if they think it will help the student.
• The tutor goes through the word. For each letter in the word, the tutor says the name of the letter and then the sound it makes in the word. For example, when going through the word "cat", the tutor would say "the letter c makes the /k/ sound" and so on for the other letters.
  • When a group of two or more letters is used to represent a single sound, the tutor should point that out by saying the names of all the letters in the group and then saying the sound that the group makes. For example, in the word "ship", the tutor would say "the letters s and h make the /ʃ/ sound".
  • When a single letter makes more than one sound, the tutor should point that out by saying the name of the letter and then saying all the sounds that the letter makes. For example, in the word "box", the tutor would say "the letter x makes the /k/ and /s/ sounds".
  • When a letter is silent, the tutor should point that out by saying the name of the letter and then saying that it is silent. For example, in the word "knife", the tutor would say "the letter k is silent" and "the letter e is silent".
• In the very beginning, before students master the first two symbol courses, they may not be familiar with all the letters by their names. Fortunately, all the words they are shown at that stage are simple. The tutor can simply point to the letters and say the sound they make without involving the letter names. Later, when the student learns all the letter names, the tutor can start using them in the procedure.
• If the lesson is a dictation lesson, the tutor should also have the student write the word a few times after going through the above steps. Two or three times should be sufficient.

Once the tutor has gone through the full procedure for all the words the student missed, the intervention is complete and the tutor can continue with the next lesson.

Here are some examples of how to do the full procedure with a few different words:

• Using the word "cat":

  • The tutor says "cat" and has the student repeat.
  • The tutor says /k/...-/a/.../t/ slowly and fluidly and has the student repeat.
  • The tutor says "cat" at a slightly slower pace than normal and has the student repeat.
  • The tutor points to the word "cat" and says:
    • "the letter c makes the /k/ sound"
    • "the letter a makes the /æ/ sound"
    • "the letter t makes the /t/ sound"

• Using the word "ship":

  • The tutor says "ship" and has the student repeat.
  • The tutor says /ʃ/.../ɪ/.../p/ slowly and fluidly and has the student repeat.
  • The tutor says "ship" at a slightly slower pace than normal and has the student repeat.
  • The tutor points to the word "ship" and says:
    • "the letters s and h make the /ʃ/ sound"
    • "the letter i makes the /ɪ/ sound"
    • "the letter p makes the /p/ sound"

• Using the word "take":

  • The tutor says "take" and has the student repeat.
  • The tutor says /t/.../eɪ/.../k/ slowly and fluidly and has the student repeat.
  • The tutor says "take" at a slightly slower pace than normal and has the student repeat.
  • The tutor points to the word "take" and says:
    • "the letter t makes the /t/ sound"
    • "the letter a makes the /eɪ/ sound"
    • "the letter k makes the /k/ sound"
    • "the letter e is silent"

The procedure works for any word. It is not necessary that the word follows simple phonetic rules. In fact, the procedure does not require any knowledge of rules or technical terms like "long vowel", "silent e", or others. This is not only aligned with the principles of orthographic mapping, but also makes the tutoring role accessible to anyone without such knowledge. The tutor simply goes through the sounds and letters of the word as they are. The reasoning is fully explained in the commentary section. Here are more examples with words that do not match simple rules and more complex words.

• Using the word "have":

  • The tutor says "have" and has the student repeat.
  • The tutor says /h/.../æ/.../v/ slowly and fluidly and has the student repeat.
  • The tutor says "have" at a slightly slower pace than normal and has the student repeat.
  • The tutor points to the word "have" and says:
    • "the letter h makes the /h/ sound"
    • "the letter a makes the /æ/ sound"
    • "the letter v makes the /v/ sound"
    • "the letter e is silent"

• Using the word "straight":

  • The tutor says "straight" and has the student repeat.
  • The tutor says /s/.../t/.../ɹ/.../eɪ/.../t/ slowly and fluidly and has the student repeat.
  • The tutor says "straight" at a slightly slower pace than normal and has the student repeat.
  • The tutor points to the word "straight" and says:
    • "the letters s and t make the /s/ sound"
    • "the letter r makes the /ɹ/ sound"
    • "the letters a and i make the /eɪ/ sound"
    • "the letter g is silent"
    • "the letter h is silent"
    • "the letter t makes the /t/ sound"

• Using the word "discredit":

  • The tutor says "discredit" and has the student repeat.
  • The tutor says /d/.../ɪ/.../s/.../k/.../ɹ/.../ɛ/.../d/.../ɪ/.../t/ slowly and fluidly and has the student repeat.
  • The tutor says "discredit" at a slightly slower pace than normal and has the student repeat.
  • The tutor points to the word "discredit" and says:
    • "the letter d makes the /d/ sound"
    • "the letter i makes the /ɪ/ sound"
    • "the letter s makes the /s/ sound"
    • "the letter c makes the /k/ sound"
    • "the letter r makes the /ɹ/ sound"
    • "the letter e makes the /ɛ/ sound"
    • "the letter d makes the /d/ sound"
    • "the letter i makes the /ɪ/ sound"
    • "the letter t makes the /t/ sound"

The procedure is even the same for words borrowed from other languages.

• Using the word "anime":
  • The tutor says "anime" and has the student repeat.
  • The tutor says /æ/.../n/.../ɪ/.../m/.../eɪ/ slowly and fluidly and has the student repeat.
  • The tutor says "anime" at a slightly slower pace than normal and has the student repeat.
  • The tutor points to the word "anime" and says:
    • "the letter a makes the /æ/ sound"
    • "the letter n makes the /n/ sound"
    • "the letter i makes the /ɪ/ sound"
    • "the letter m makes the /m/ sound"
    • "the letter e makes the /eɪ/ sound"

Tier 2 Intervention🔗

Phonemic awareness is the ability to hear, identify, and manipulate individual sounds in spoken language. It is a critical skill for reading and writing, as it allows students to understand how sounds map to letters and to efficiently store words in long-term memory for quick retrieval. Deficits in these abilities are the most common cause of reading difficulties, which is why Tier 2 intervention consists of exercises that explicitly target them.

After the student has answered a lesson multiple times, the following warning message will appear if their performance indicates a phonemic awareness deficit:

If the student performs poorly on this exercise, consider providing a Tier 2 intervention to detect and correct deficits in phonological awareness. See the manual for detailed instructions.

If after asking the student to read or write the examples in the lesson, the student still misses more than a couple of examples, the tutor should perform a Tier 2 intervention. The procedure is as follows:

• The tutor starts by performing the Tier 1 intervention for each of the words the student missed.
• After that, taking the words in the lesson as a starting point, the tutor performs several of the following exercises. All the examples should be done orally, without any reference to writing. The student should be instructed to avoid looking at the screen, notebook, or any other writing surface.
  • Substitution: These exercises involve asking the student to say what a word would sound like if a specific sound were replaced with another sound.
    • The tutor takes a word from the lesson and says it out loud, then asks the student, what the word would become if one of their sounds were changed to another sound.
      • For example, the tutor says "cat", then asks "Change /t/ with /n/. What word do you get?"
      • The student should answer "can".
    • If the student answers correctly, the tutor moves to another exercise.
    • If the student answers incorrectly, the tutor breaks down the word into its individual sounds, like in the Tier 1 intervention, and then repeats the question.
      • For example, the tutor says /k/.../æ/.../t/ slowly and fluidly. Then asks "Change /t/ with /n/. What word do you get?"
    • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.
  • Deletion: These exercises involve asking the student to say what a word would sound like if a specific sound were removed.
    • The tutor takes a word from the lesson and says it out loud, then asks the student, what the word would sound like if one of their sounds were removed.
      • For example, the tutor says "stake", then asks "Remove the /s/ sound. What word do you get?"
      • The student should answer "take".
    • If the student answers correctly, the tutor moves to another exercise.
    • If the student answers incorrectly, the tutor breaks down the word into its individual sounds, like in the Tier 1 intervention, and then repeats the question.
      • For example, the tutor says /s/.../t/.../eɪ/.../k/ slowly and fluidly. Then asks "Remove the /s/ sound. What word do you get?"
    • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.
  • Reversal: These exercises involve asking the student to say what a word would sound if all the sounds were reversed. This is a more advanced exercise that should only be done a fraction of the time. Most of the time, the tutor should focus on substitution and deletion exercises. Reversal exercises should only be done for simple words, as reversing more complex words is very difficult and sometimes impossible.
    • The tutor takes a word from the lesson and says it out loud, then asks the student, what the word would sound like if all the sounds were reversed.
      • For example, the tutor says "name", then asks "What word do you get if you reverse the sounds?"
      • The student should answer mane (/meɪn/).
    • If the student answers correctly, the tutor moves to another exercise.
    • If the student answers incorrectly, the tutor breaks down the word into its individual sounds, like in the Tier 1 intervention, and then repeats the question.
      • For example, the tutor says /n/.../eɪ/.../m/ slowly and fluidly. Then asks "What word do you get if you reverse the sounds?"
    • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.
• In substitution and deletion exercises, the tutor should make sure that they pick a variety of positions to change or remove, not only the first or last sound. For example, in words like "abide", "straight", or "trample", tutors should ask the student to change or remove the middle sounds as well.

The exercises should primarily focus on the words from the lesson. It is not necessary that the result of substitution, deletion, or reversal exercises is a word from the lesson or even a real word. The goal is to develop the student's phonemic awareness, not to teach them new words. As their phonemic awareness improves and their sight vocabulary grows, the tutor can expect that the need for Tier 2 interventions will decrease.

The tutor should conduct around five or six exercises in total, mixing substitution, deletion, and reversal exercises. Once those are done, the intervention is complete and the tutor can continue with the next lesson.

Below are additional examples of how to run the exercises with a few different words.

• Using the word "robbery" and a substitution task:

  • The tutor says "robbery" and asks "Change the /b/ sound to /p/. What word do you get?"
  • The student should answer "roppery" (/ˈɹɑpəri/). This is a made-up word, which is fine for this exercise.
  • If the student answers incorrectly, the tutor says /ɹ/.../ɑ/.../b/.../ə/.../ɹ/.../i/ slowly and fluidly and asks the same question again.
  • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.

• Using the word "antique" and a deletion task:

  • The tutor says "antique" and asks "Remove the /k/ sound. What word do you get?"
  • The student should answer anti (/ænˈtiː/).
  • If the student answers incorrectly, the tutor says /æ/.../n/.../t/.../i/.../k/ slowly and fluidly and asks the same question again.
  • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.

• Using the word "nap" and a reversal task:

  • The tutor says "nap" and asks "What word do you get if you reverse the sounds?"
  • The student should answer "pan".
  • If the student answers incorrectly, the tutor says /n/.../æ/.../p/ slowly and fluidly and asks the same question again.
  • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.

Tier 3 Intervention🔗

Most students will respond well to the Tier 2 intervention, as it targets the most common causes of reading difficulties. However, Tier 3 adds additional phonemic work with multisensory support to help students who struggle even after Tier 2 interventions. In addition, Tier 3 intervention should be done on a 1-on-1 basis. This is not an issue for most students, since Pictures Are For Babies is designed to be used in a 1-on-1 tutoring setting. However, if the tutor is working with a group of students, they should make sure students receive some level of individual attention during Tier 3 interventions.

If the student continues to struggle with a lesson, the following warning message will appear:

If the student performs poorly on this exercise, consider providing a Tier 3 intervention to detect and correct deficits in phonemic awareness and include additional multisensory support. See the manual for detailed instructions."

If after asking the student to read or write the examples in the lesson, the student still misses more than a couple of examples, the tutor should perform a Tier 3 intervention. The procedure is as follows:

• The tutor starts by performing the Tier 1 intervention for each of the words the student missed.
  • The tutor performs the segmentation and blending exercises as described in the Tier 1 intervention section. If the student struggles to follow along, the tutor can repeat a few times. No multisensory support is used at this stage because the goal is to develop phonemic skills, which are auditory in nature.
  • The tutor can introduce additional multisensory support when teaching the letter-sound mappings similar to those used when introducing individual symbols. See the Symbol Courses section for more details.
  • If the lesson is a dictation lesson, the tutor should also have the student write the word down a few more times than during the normal Tier 1 intervention. Five times should be sufficient.
• Then perform the same procedure as the Tier 2 intervention with a few differences:
  • The number of exercises is increased to around ten or twelve.
  • The tutor introduces multisensory support by using some type of token to represent each of the phonemes in the exercises. The token can be a physical object, like a coin. Ideally, the tokens have multiple colors to make it easier for the student to follow along.
    • Tutors can make their own tokens out of colored paper, cardboard, or other materials.
  • When performing the exercises, the tutor arranges the tokens in a line in front of the student. When a phoneme is substituted, deleted, or the whole word is reversed, the tutor arranges the tokens accordingly. This step helps the student visualize the sounds and lower the cognitive load of tracking the sounds in their head.

Below are some examples of how the tokens are used in the exercises. Circle emojis are used to represent the tokens.

• Using the word "cat" and a substitution task:

  • The tutor arranges the tokens as follows: 🟠🟡🔵
  • The tutor says "cat" and asks "Change /t/ to /n/. What word do you get?" They substitute the last token with a different color token, like this: 🟠🟡🟢
  • The student should answer "can" (/kæn/).
  • If the student answers incorrectly, the tutor rearranges the tokens to the original order 🟠🟡🔵 and says /k/.../æ/.../t/ slowly and fluidly.
  • Then the tutor asks "Change /t/ to /n/. What word do you get?" and rearranges the tokens to 🟠🟡🟢 again.
  • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.

• Using the word "tramp" and a deletion task:

  • The tutor arranges the tokens as follows: 🟠🟡🟢🔵🟣
  • The tutor says "tramp" and asks "Remove the /t/ sound. What word do you get?" They remove the first token so that the tokens look like this: 🟡🟢🔵🟣.
  • The student should answer "ramp" (/ræmp/).
  • If the student answers incorrectly, the tutor rearranges the tokens to the original order 🟠🟡🟢🔵🟣 and says /t/.../r/.../æ/.../m/.../p/ slowly and fluidly.
  • Then the tutor asks "Remove the /t/ sound. What word do you get?" and removes the first token again.
  • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.

• Using the word "map" and a reversal task:

  • The tutor arranges the tokens as follows: 🟠🟡🟢
  • The tutor says "map" and asks "What word do you get if you reverse the sounds?" They rearrange the tokens to look like this: 🟢🟡🟠.
  • The student should answer "pam" (/pæm/).
  • If the student answers incorrectly, the tutor rearranges the tokens to the original order 🟠🟡🟢 and says /m/.../æ/.../p/ slowly and fluidly.
  • Then the tutor asks "What word do you get if you reverse the sounds?" and rearranges the tokens to 🟢🟡🟠 again.
  • If the student answers incorrectly again, the tutor provides the answer and moves to another exercise.

Tier 4 Intervention🔗

Most students will respond to the Tier 2 and Tier 3 interventions, as they target the most common cause of reading difficulties. Based on the most successful interventions for reading difficulties, only 5-10% of students will need a more intensive intervention. These students have reading difficulties caused by deficits in phonemic awareness and additional cognitive or neurological issues. The most common types of additional issues are:

• Working Memory: Difficulty holding and manipulating information in short-term memory.
• Processing Speed: Slow cognitive processing that affects reading fluency.
• Rapid Automatized Naming (RAN): Slow retrieval of verbal labels.
• Executive Function: Problems with attention, inhibition, cognitive flexibility
• ADHD - Attention and impulse control issues that compound reading difficulties
• Language Disorders (DLD): Developmental language disorder affecting vocabulary, syntax, comprehension.
• Hearing Impairment: Given the phonological nature of fluent reading, they create additional barriers to phonological development.
• Some combination of two or more of the above in addition to phonemic awareness deficits.

If the student continues to struggle with a lesson, the following warning message will appear:

If the student performs poorly on this exercise, consider providing a Tier 4 intervention. This tier is for students with complex reading disabilities that are caused by phonemic awareness deficits and additional cognitive or neurological issues. This tier should be handled by a reading specialist. They can use this application as a structured curriculum and automated scheduler while running their own interventions. See the manual for detailed instructions.

As the warning indicates, this tier should be handled by a reading specialist. Unlike the previous tiers, which asked tutors to perform phonemic tasks that are easy for fluent readers, the other causes of reading difficulties cannot be fixed via simple exercises delivered by minimally trained tutors. This does not mean that Pictures Are For Babies is not useful for these students. On the contrary, reading specialists can use Pictures Are For Babies as a structured curriculum and automated scheduler while running their own interventions.

It is important to note that the figure of 5-10% of students falling in this category is a conservative estimate. Some studies have been able to reduce the number to as low as two or three percent. Unless the student has been diagnosed with additional issues by a professional, it is recommended that tutors exhaust the Tier 2 and Tier 3 interventions before seeking the help of a reading specialist, as phonemic awareness deficits are the most common cause of reading difficulties and almost always present in more complex cases.

Another point of note is that the students falling in this category may struggle to fluently read and write past an elementary school level. However, with the right interventions and the support of Pictures Are For Babies and a reading specialist, they can often reach a level of reading and writing that allows them to function independently in daily life.

While not yet proven in a controlled study, some strategies used by Pictures Are For Babies may be helpful for these students. For example, spaced repetition, interleaving, and retrieval practice might help students with working memory and rapid automated naming issues. Every lesson in the program is a form of retrieval practice and spaced repetition and interleaving are built into the scheduling algorithm.