Text comprehension training for disabled readers: an evaluation of reciprocal teaching and text analysis training programs

The Diagnosis and Treatment of Reading and/or Spelling Disorders in Children and Adolescents

BACKGROUND

3-11% of children and adolescents suffer from a reading andor spelling disorder. Their poor written-language skills markedly impair their scholastic performance and are often associated with other mental disorders. A great deal of uncertainty still surrounds the question of the appropriate methods of diagnosis and treatment.

METHODS

We systematically searched for pertinent publications in databases and literature reference lists, summarized the evidence in six tables, and examined some of it in a meta-analysis. Recommendations were developed in a consensus conference.

RESULTS

A reading and/or spelling disorder should only be diagnosed if performance in these areas is below average. It should be determined whether an attention deficit-hyperactivity disorder, anxiety disorder, or disorder of arithmetical skills is also present. Reading and spelling performance should be reinforced with systematic instruction about letter-sound and sound-letter correspondences, letter-syllable-morpheme synthesis, and sound-syllablemorpheme analysis (g' = 0.32) (recommendation grade A). Spelling ability responds best to spelling-rule training (recommendation grade A). Irlen lenses, visual and/or auditory perceptual training, hemispheric stimulation, piracetam, and prism spectacles should not be used (recommendation grade A).

CONCLUSION

Evidence- and consensus-based guidelines for the diagnosis and treatment of reading and/or spelling disorders in children and adolescents are now available for the first time. Reading and spelling abilities should be systematically and comprehensively reinforced, and potential comorbid disorders should be sought and treated appropriately. The efficacy of many treatments now in use has not been documented; if they are to be used in the future, they must be tested in randomized, controlled trials. For adult sufferers, adequate diagnostic instruments and therapeutic methods are not yet available.

Effectiveness of treatment approaches for children and adolescents with reading disabilities: a meta-analysis of randomized controlled trials

Children and adolescents with reading disabilities experience a significant impairment in the acquisition of reading and spelling skills. Given the emotional and academic consequences for children with persistent reading disorders, evidence-based interventions are critically needed. The present meta-analysis extracts the results of all available randomized controlled trials. The aims were to determine the effectiveness of different treatment approaches and the impact of various factors on the efficacy of interventions. The literature search for published randomized-controlled trials comprised an electronic search in the databases ERIC, PsycINFO, PubMed, and Cochrane, and an examination of bibliographical references. To check for unpublished trials, we searched the websites clinicaltrials.com and ProQuest, and contacted experts in the field. Twenty-two randomized controlled trials with a total of 49 comparisons of experimental and control groups could be included. The comparisons evaluated five reading fluency trainings, three phonemic awareness instructions, three reading comprehension trainings, 29 phonics instructions, three auditory trainings, two medical treatments, and four interventions with coloured overlays or lenses. One trial evaluated the effectiveness of sunflower therapy and another investigated the effectiveness of motor exercises. The results revealed that phonics instruction is not only the most frequently investigated treatment approach, but also the only approach whose efficacy on reading and spelling performance in children and adolescents with reading disabilities is statistically confirmed. The mean effect sizes of the remaining treatment approaches did not reach statistical significance. The present meta-analysis demonstrates that severe reading and spelling difficulties can be ameliorated with appropriate treatment. In order to be better able to provide evidence-based interventions to children and adolescent with reading disabilities, research should intensify the application of blinded randomized controlled trials.

Evaluating the efficacy of remediation for struggling readers in high school

Preliminary efficacy data are reported for a research-based reading intervention designed for struggling readers in high school. PHAST PACES teaches (a) word identification strategies, (b) knowledge of text structures, and (c) reading comprehension strategies. In a quasi-experimental design, 268 intervention and 83 waiting list control students meeting criteria for reading disability were assessed before and after their semester. After 60 to 70 hours of PHAST PACES instruction, struggling readers demonstrated significant gains on standardized tests of word attack, word reading, and passage comprehension and on experimental measures of letter-sound knowledge and multisyllabic word identification relative to control students. An average effect size of .68 was revealed across these outcome measures. One year follow-up data on 197 PHAST PACES students revealed an average trend to decelerated growth after the intervention, except for passage comprehension outcomes that demonstrated continued growth over follow-up.

Exploration of strategies for facilitating the reading comprehension of high-functioning students with autism spectrum disorders

Many students with autism spectrum disorders show good decoding combined with poor comprehension. Twenty adolescent students with autism spectrum disorders participated in a study concerning the effects of three kinds of facilitation on reading comprehension. In a within-subjects design, each students read passages under four conditions: answering prereading questions, completing cloze sentences embedded in the text, resolving anaphora by identifying relevant antecedents, and control (reading only). A repeated measures analysis of variance indicated that conditions differed significantly in their effects on reading comprehension. Post hoc contrasts showed that the effects of anaphoric cuing were statistically significant and medium in size; the effects of prereading questions and cloze completion were small and not statistically significant. Instructional implications for text preparation, remedial instruction, and the design of educational software are discussed.

Transfer effects across contextual and linguistic boundaries: evidence from poor readers

We report two experiments that are consistent with two hypotheses about poor, nonfluent readers: (1) fluency gains in text reading skill transfer across contextual and linguistic boundaries and (2) these fluency gains enable higher-order comprehension operations to function in the processing of text. We conclude that unlike the fluent reader, the nonfluent reader does not completely integrate the surface characteristics (words) of the text and the message of the text. Word-level representations remain free to support transfer across various processing episodes. Thus, a variety of reading experiences aimed at promoting word recognition fluency will provide benefits to the developing reader.