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Teaching Health Literacy to Adult English Language Learners
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Module One - Health Literacy and Adult ESOL

The language experience approach (LEA) allows students to use their own language and experiences to create a story that is meaningful and personal to them. This is an integrated whole language approach which uses the experience, the oral language, and the interests of the students to develop writing and reading skills. Initially, the teacher writes what students dictate. Later, or in intermediate level classes, the students may write the story. This approach allows community building within the classroom as students work cooperatively to create a story from shared experiences. Finally, the language experience approach builds students' confidence as they feel that their thoughts and ideas have merit and worth. Through language experience they'll discover:

  • What I say, I can write (or someone can write for me).
  • What I can write, I can read (and others can read too).
  • I can read what I have written, and I can also read what other people have written for me to read.

Procedure for LEA:

  1. Choose stimulus for writing. Stimulus activity can be taken from any classroom topic or student activity. Pictures can also be used as prompts.
  2. Discuss the activity. Teachers should be prepared to ask simple questions about what is happening in the story to elicit the student narrative. (This also helps with students' listening skills).
  3. Once the whole story has been elicited orally, the teacher tells the students she will write it as they retell it. Although teachers can help out for clarity's sake, the story should be composed of the students' ideas and words.
  4. After the story is written, the teacher reads it and then students read the story individually or chorally.
  5. Follow-up with variation activities, such as, sentence strips, vocabulary work, grammar explanations, story dictation, or develop cloze activities from the story. Although LEA is most frequently used with beginning or low intermediate students. It can work very effectively with higher level groups by varying the complexity of the story the students create and sophistication of follow-up activities.

Language Experience Approach Stimulus Ideas

A class field trip to a local healthcare clinic can provide a wonderful stimulus for an LEA activity. Pictures for Adult ESL Health Literacy, a series of cartoon strip stories of various health literacy topics, is available free of charge for classroom use on the Center for Applied Linguistics (CAL) website.

Click on the link below for a picture story entitled "Emergency", designed as a prompt for a classroom language experience approach story. While looking at the picture, read the sample questions, written by Kate Singleton for the CAL website below.

Emergency Picture Stimulus for LEA

Sample questions for prompting a shared Language Experience Story:

First frame: What is happening in the picture? What do you see? What is the man's name? What's the matter with him? What is he saying? What does "ouch" mean? (What do you say in your language when you are hurt? We say "ouch" in English.)

Second frame: When is it now? How is the man now? What is he saying? Who is the woman? What is she saying?

Third frame: What does he answer?

Fourth frame: When is it now? How does he feel now? Does he go to the doctor in December? Why not?

Fifth frame: When is it now? What's happening? Where is he now? Where is he going? What room will he go to in the hospital? What will happen in the emergency room? (This can bring up vocabulary like surgery, operation, medicine, etc. Write this vocabulary on the board for students to copy down in their notebooks.)

Sixth frame: Now what month is it? Where is he now? What is he looking at? How much do you think the bill is for? How much does it cost to go to the emergency room? How much does surgery cost? How much does it cost to go in an ambulance? What is he thinking? How is he feeling? What can he do?

Adapted from Picture Stories for Adult ESL Health Literacy. This and other health related picture stories are available on the internet at the CAL website www.cal.org/caela/esl_resources/Health/healthindex.html.

Source and additional reading:  www.cal.org/digests/LANG_EXPER.HTML.

Click here for a printable PDF file of the questions and procedures above along with additional topics for discussion for your students.



The Language Experience Approach is an effective strategy for encouraging students to create stories using their own authentic language. Do you think this activity might help to introduce the concept of primary and preventive care to your students? Why or why not? Have you ever used LEA in your classroom or used photos or pictures to help encourage students to use their own words? Share your ideas by posting 3 to 5 sentences to the bulletin board.


Just for Fun

Word Search — Access to Healthcare Vocabulary

Click on this link to play a Word Search game based on vocabulary from this module. http://www.quia.com/ws/664461.html. Copy this link to use the game as a fun internet vocabulary game in your classroom or print the game and copy for your students.

Games can be an interesting addition to any classroom. To create your own games, go to www.guia.com for a free 30 day trial.


This web-based training program was developed by Florida Technet, through an Adult Education State Leadership Grant from the Florida Department of Education, Division of Community Colleges and Workforce Education.

Disclaimer: While every effort has been made to ensure the accuracy of this web-based training component, it is not an official publication of the Florida Department of Education.

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