Many people associate foundational reading instruction with young children. Yet some students reach middle school or high school still struggling with the core skills that make reading possible. For these adolescents, reading difficulty can affect confidence, class participation, writing, and access to academic content across subjects.

A case report by Julia J. Yi, PhD, CCC-SLP, shows that older students can still make meaningful progress when reading intervention targets the specific skills they need. The study followed a 15-year-old student, referred to by the pseudonym “Cam,” who had significant word-level reading challenges. After nine one-hour intervention sessions over three months, Cam made remarkable improvements in decoding skills, sound-symbol knowledge, reading level, and confidence as a reader (Yi, 2025).

Why Adolescent Literacy Support Matters

Adolescents with reading challenges often carry years of frustration. They may avoid reading aloud, struggle with unfamiliar words, or lose confidence in their ability to keep up with peers. These challenges can become harder to address when students move into higher grades, where teachers expect them to read to learn rather than learn to read.

Speech-language pathologists (SLPs) can play an important role in this work. An SLP supports communication, language, and literacy, including the skills that help students connect sounds, letters, word parts, and meaning. This support can help identify whether an adolescent’s challenge comes from decoding, language comprehension, spelling, fluency, or a combination of needs.

A Case Focused on Word-Level Reading

Cam was in ninth grade when she reached out to her parents for help, and they connected with Dr. Julia Yi. Her oral language skills were generally within the average range, but her written language and word-level reading skills were much weaker. Before the intervention, her independent reading level was around third grade, and her instructional reading level was around fourth grade.

Testing showed that Cam’s reading challenges appeared to stem largely from limited sound-symbol knowledge. In other words, she did not consistently know how letters and letter patterns connect to sounds. That gap made it difficult for her to decode unfamiliar words, especially longer words.

This distinction matters. Reading intervention works best when it matches the student’s actual needs, and this case highlights the value of looking closely at the specific skills that are hindering progress.

What the Intervention Included

The intervention used several evidence-based approaches. Each session included direct, explicit instruction and practice. Cam learned sound-letter patterns she had not mastered, high-frequency prefixes and suffixes, and strategies for breaking longer words into manageable parts.

The intervention included:

  • Phoneme-grapheme instruction, which connects spoken sounds to written letters or letter patterns.
  • Morphology instruction, which teaches meaningful word parts such as prefixes and suffixes.
  • Flexible syllabication, which helps students divide longer words into readable parts.
  • Spelling practice, which reinforces word reading.
  • Reading fluency practice, which gives students supported practice with connected text.

The work was individualized. The researcher used Cam’s pre-test results to select the sound patterns and word parts taught in the sessions. This approach helped make the instruction individualized and targeted to her needs, rather than using a one-size-fits-all approach.  

What Changed After Nine Sessions

Cam made substantial gains after the intervention. Her word identification score improved by 1.5 standard deviations. Her sound-symbol knowledge improved by nearly two standard deviations. Her reading level increased from a third- and fourth-grade level to her current grade level (upper middle school/high school level).

The study also found growth beyond test scores. Cam’s reading self-efficacy improved, and her self-concept as a reader nearly doubled from 45 percent to 82.5 percent. Her parent also reported noticeable improvement in Cam’s reading skills and overall confidence.

Spelling improved less than other areas. The author notes that spelling may require more time, practice, and reading exposure. That finding is useful for clinicians and educators because it shows that progress may happen at different rates across literacy skills.

What This Means for Speech-Language Pathology

This case report offers a practical reminder for speech-language pathologists and future clinicians: adolescents with reading challenges still need access to foundational literacy support. Older students may benefit from explicit instruction in decoding skills, especially when intervention targets the exact sound-symbol and word structure knowledge they have missed.

For students in a speech-language pathology program, the study also shows how assessment guides treatment. The intervention was effective because it began with a clear understanding of Cam’s profile. Her spoken language strengths, weak decoding skills, and limited sound-symbol knowledge shaped the clinical plan.

That kind of individualized care sits at the center of strong SLP practice. Speech-language pathologists need to know how to assess literacy challenges, interpret results, select evidence-based strategies, and adapt intervention to the learner in front of them.

A Promising Result With Clear Limits

The outcome of this study is encouraging, but it comes from one case report. The findings cannot be applied to every adolescent with reading challenges. More research is needed with larger groups of students and varied learning profiles.

Still, Cam’s progress shows what can happen when a student receives targeted, evidence-based reading intervention. Her gains in decoding, reading level, and confidence suggest that it is never too late to support foundational literacy skills.

For adolescents who have struggled for years, the right reading intervention can do more than improve test scores. It can help rebuild access, confidence, and a stronger sense of what is possible. 

Citation

Yi, J. J. (2025). Integrating evidence-based approaches to address an adolescent’s word-level reading challenges: A case report. Communication Disorders Quarterly, 47(1), 36-49. https://doi.org/10.1177/15257401251325860