A meta-analysis of the effects of foundational skills and multicomponent reading interventions on reading comprehension for primary-grade students.

This meta-analysis examined the effects on reading comprehension of foundational reading skills and multicomponent reading interventions provided to students with or at risk for reading difficulties or disabilities (students with RDs) in kindergarten through Grade 3. The meta-analysis included studies identified by Wanzek et al. (2016) and Wanzek et al. (2018), with an updated search through August of 2019, for a total of 47 included studies (m = 112; total student N = 7446). The weighted average effect on norm-referenced reading comprehension outcomes was estimated as g = 0.37, indicating that primary-grade interventions have an educationally meaningful effect on reading comprehension for students with RDs. Effects did not differ for interventions focused only on foundational reading skills and those that provided both foundational skills and comprehension instruction. Effects were significantly moderated by the measurement timepoint, with follow-up effect sizes being, on average, 0.16 smaller than immediate posttest effect sizes.

Trajectories of Response to Treatments in Children with ADHD and Word Reading Difficulties.

This study investigated patterns of response to intervention in children with co-occurring attention-deficit/hyperactivity disorder (ADHD) and reading difficulties (RD), who participated in a randomized clinical trial examining the efficacy of reading intervention, ADHD treatment, or combined treatments. Growth Mixture Modeling (GMM) was used to investigate trajectories of parent and teacher academic impairment ratings and child oral reading fluency, and whether trajectories were predicted by pre-treatment covariates (ADHD severity, reading achievement, phonemic awareness, rapid letter naming, anxiety, oppositional defiant disorder), for 216 children with ADHD/RD in 2nd-5th grade (61.1% male; 72.2% African American; 8.8 ± 1.3 years of age). GMM revealed three trajectories for academic impairment (6.9-24.2% stable, 23.7-78.7% moderately improving, and 14.1-52.1% steeply improving) and oral reading fluency (20.8% low improving, 42.1% moderate improving, and 37.1% high improving). Children in the reading intervention were more likely to be in the stable or moderately improving trajectory than those in the ADHD and combined treatments, who were more likely to be in the steeply improving trajectory for academic impairment. Relative to the ADHD intervention, children in the reading intervention were more likely to be in the high improving trajectory than the moderate or low improving trajectory for oral reading fluency. Children without comorbid anxiety and with better reading skills showed a more positive treatment response for teacher-rated academic progress and oral reading fluency. Results highlight the importance of examining individual differences in response to reading and ADHD interventions. Intervention modality predicted differences in parent/teacher ratings of academic progress as well as reading fluency.

The Effects of ADHD Treatment and Reading Intervention on the Fluency and Comprehension of Children with ADHD and Word Reading Difficulties: A Randomized Clinical Trial.

Many students with reading difficulties and disabilities (RD) also have Attention Deficit/Hyperactivity Disorder (ADHD). This randomized clinical trial compared the effects of ADHD treatment alone (medication, parent training), intensive reading intervention alone, and their combination on the reading fluency and comprehension of students with both disorders. Students with ADHD and RD were randomly assigned to receive (a) Reading Intervention only (n=74), (b) ADHD Treatment only (n=78), or (c) simultaneous Combined ADHD and RD Treatment (n=70). For phonemic decoding fluency, the Reading Intervention group and the Combined Treatment group both had significantly better outcomes than the ADHD Treatment group, but did not differ from one another. For passage comprehension, the ADHD Treatment group had significantly better outcomes than the Reading Intervention group, while the other groups did not differ from one another. ADHD treatment may support passage comprehension in this population, while fluent decoding is best supported through intensive reading intervention.

Fluid reasoning and reading difficulties among children with ADHD.

Background: Children with attention-deficit/hyperactivity disorder (ADHD) commonly experience difficulties in reading and in fluid reasoning (Gf). According to Cattell's Investment Theory (1987), Gf is a causal factor in the development of crystallized knowledge (Gc) and academic skills; therefore, the co-occurrence of reading and Gf difficulties within ADHD may not be coincidental. Methods: In the present study with children with both ADHD and reading difficulties (n = 187; 61% male; Mage = 9.2), we utilized mediation analyses to test direct and indirect (through Gc, phonemic awareness, and rapid automatized naming [RAN]) effects of Gf on four basic reading skills: untimed word recognition, untimed phonemic decoding, word reading efficiency, and phonemic decoding efficiency. Results: The direct effect of Gf on all reading skills was nonsignificant; however, significant indirect effects were observed. Specifically, Gf exerted an effect indirectly onto all reading skills through a serial and joint mechanism comprised of Gc and phonemic awareness (i.e., Gf → Gc → phonemic awareness → reading achievement). Gf also exerted an effect indirectly onto untimed word recognition and phonemic decoding through phonemic awareness (i.e., Gf → phonemic awareness → untimed word recognition/untimed phonemic decoding). Conclusion: Results build upon Cattell's Investment Theory by linking Gf with reading difficulties among children with ADHD, suggesting that such difficulties may arise from weaknesses in Gf and insufficient investment of Gf into reading through Gc and phonemic awareness.

Early reading skill profiles in typically developing and at-risk first grade readers to inform targeted early reading instruction.

This study identified distinct, homogeneous latent profiles of at-risk (n = 141) and not at-risk (n = 149) first grade readers. Separate latent profile analyses were conducted with each subgroup using measures of phonological awareness, decoding, linguistic comprehension, and oral reading fluency. This study also examined which measures best differentiated the latent profiles. Finally, we examined differences on two measures of reading comprehension as a function of profile membership. Results showed two latent profiles of at-risk students and three latent profiles of not at-risk students. Latent profiles were generally rank ordered with regard to achievement across measures. However, the higher performing at-risk profile and the lowest performing not at-risk profile were nearly identical across measures. Phonological awareness and decoding measures were best at differentiating latent profiles, but linguistic comprehension was also important for the lowest performing students. Oral reading fluency was limited to distinguishing the highest achieving students from the other profiles, and did not perform well with the lower achieving profiles. Most of the pairwise comparisons of reading comprehension scores were consistent across measures, but the nearly identical profiles showed a significant difference on only one reading comprehension measure. Implications for identifying at-risk first grade readers and designing targeted early reading interventions for at-risk students are discussed.

Gender Moderates Association Between Emotional-Behavioral Problems and Text Comprehension in Children with Both Reading Difficulties and Adhd.

Evidence suggests that higher order linguistic functioning such as text comprehension is particularly vulnerable to emotional modulation. Gender has been identified as an important moderating variable in emotional expression such that girls tend toward internalizing emotions (e.g., sadness, anxiety) whereas boys tend toward externalizing emotions (e.g., anger, combativeness), which may influence the relationship between emotion and text comprehension. The present study examined whether gender moderates the relationship between emotional-behavioral problems and text comprehension among children (n = 187; boys= 115, girls = 72) with both word reading difficulties (RD) and attention-deficit/hyperactivity disorder (ADHD), a sample widely acknowledged to be at increased risk for developing emotional-behavioral problems such as anxiety, poor academic self-concept, and delinquency. A moderated regression analysis tested for the significance of two separate interaction terms (i.e., gender × externalizing problems, gender × internalizing problems) after controlling for gender, IQ, basic reading skills, cognitive-linguistic processes closely related to reading, attentional problems, internalizing problems, and externalizing problems. Results indicated that gender significantly and uniquely moderates the relationship between emotional-behavioral problems and text comprehension. Specifically, text comprehension was relatively lower among girls with relatively higher externalizing problems, whereas no such association was observed among boys. These results contribute to our understanding of cognition-emotion interactions within reading development and raise important implications.

Comparing treatments for children with ADHD and word reading difficulties: A randomized clinical trial.

OBJECTIVE: This trial compared attention-deficit/hyperactivity disorder (ADHD) treatment alone, intensive reading intervention alone, and their combination for children with ADHD and word reading difficulties and disabilities (RD). METHOD: Children (n = 216; predominantly African American males) in Grades 2-5 with ADHD and word reading/decoding deficits were randomized to ADHD treatment (medication + parent training), reading treatment (reading instruction), or combined ADHD + reading treatment. Outcomes were parent and teacher ADHD ratings and measures of word reading/decoding. Analyses utilized a mixed models covariate-adjusted gain score approach with posttest regressed onto pretest. RESULTS: Inattention and hyperactivity/impulsivity outcomes were significantly better in the ADHD (parent Hedges's g = .87/.75; teacher g = .67/.50) and combined (parent g = 1.06/.95; teacher g = .36/41) treatment groups than reading treatment alone; the ADHD and Combined groups did not differ significantly (parent g = .19/.20; teacher g = .31/.09). Word reading and decoding outcomes were significantly better in the reading (word reading g = .23; decoding g = .39) and combined (word reading g = .32; decoding g = .39) treatment groups than ADHD treatment alone; reading and combined groups did not differ (word reading g = .09; decoding g = .00). Significant group differences were maintained at the 3- to 5-month follow-up on all outcomes except word reading. CONCLUSIONS: Children with ADHD and RD benefit from specific treatment of each disorder. ADHD treatment is associated with more improvement in ADHD symptoms than RD treatment, and reading instruction is associated with better word reading and decoding outcomes than ADHD treatment. The additive value of combining treatments was not significant within disorder, but the combination allows treating both disorders simultaneously. (PsycINFO Database Record

The effect of achievement test selection on identification of learning disabilities within a patterns of strengths and weaknesses framework.

Few empirical investigations have evaluated learning disabilities (LD) identification methods based on a pattern of cognitive strengths and weaknesses (PSW). This study investigated the reliability of LD classification decisions of the concordance/discordance method (C/DM) across different psychoeducational assessment batteries. C/DM criteria were applied to assessment data from 177 second-grade students based on 2 psychoeducational assessment batteries. The achievement tests were different, but were highly correlated and measured the same latent construct. Resulting LD identifications were then evaluated for agreement across batteries on LD status and the academic domain of eligibility. The 2 batteries identified a similar number of participants as having LD (80 and 74). However, indices of agreement for classification decisions were low (κ = .29), especially for percent positive agreement (62%). The 2 batteries demonstrated agreement on the academic domain of eligibility for only 25 participants. Cognitive discrepancy frameworks for LD identification are inherently unstable because of imperfect reliability and validity at the observed level. Methods premised on identifying a PSW profile may never achieve high reliability because of these underlying psychometric factors. An alternative is to directly assess academic skills to identify students in need of intervention.

The Impact of Intensive Reading Intervention on Level of Attention in Middle School Students.

The purpose of the study was to estimate the impact of reading intervention on ratings of student attention over time. We used extant data from a longitudinal randomized study of a response-based reading intervention to fit a multiple-indicator, multilevel growth model. The sample at randomization was 54% male, 18% limited English proficient, 85% eligible for free or reduced-price lunch, 58% African American, and 32% Hispanic. Reading ability was measured by using the Woodcock-Johnson III Tests of Achievement. Attention was measured by using the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale. Findings indicate that intensive, response-based reading intervention over 3 years improved reading achievement and behavioral attention in middle school struggling readers, with treatment directly affecting reading, which in turn influenced attention. In the business-as-usual condition, there was no relation between improved reading and attention. The results are consistent with a correlated liabilities model of comorbidity. The results do not align with the inattention-as-cause hypothesis, which predicts that reading intervention should not affect attention. The findings do not support, but do not necessarily preclude, the phenocopy hypothesis. The results are especially pertinent for older students who may be inattentive partly because of years of struggling with reading.

The Effect of Reading Duration on the Reliability and Validity of Middle School Students' ORF Performance.

We evaluated the technical adequacy of oral reading fluency (ORF) probes in which 1,472 middle school students with and without reading difficulties read fluency probes for 60 s versus reading the full passage. Results suggested that the reliability of 60-s probes (rs ≥ .75) was not substantively different than full passage probes (rs ≥ .77) among struggling readers and typically developing readers in Grades 6 to 8. The correlation of 60-s and the full passage probes with norm-referenced measures of ORF ranged from .32 to .83, and the correlation with norm-referenced measures of reading comprehension ranged from .32 to .54, indicating that both measures were moderately valid and adequate for use among middle school students. Last, full passage probes with sensitivity rates ranging from .40 to .45 were only slightly more sensitive for identifying at-risk readers than 60-s probes, with sensitivity rates ranging from .36 to .40, suggesting that the full passage probes identified a slightly higher percentage of at-risk students with reading difficulties.

AGREEMENT AND COVERAGE OF INDICATORS OF RESPONSE TO INTERVENTION: A MULTI-METHOD COMPARISON AND SIMULATION.

PURPOSE: Agreement across methods for identifying students as inadequate responders or as learning disabled is often poor. We report (1) an empirical examination of final status (post-intervention benchmarks) and dual-discrepancy growth methods based on growth during the intervention and final status for assessing response to intervention; and (2) a statistical simulation of psychometric issues that may explain low agreement. METHODS: After a Tier 2 intervention, final status benchmark criteria were used to identify 104 inadequate and 85 adequate responders to intervention, with comparisons of agreement and coverage for these methods and a dual-discrepancy method. Factors affecting agreement were investigated using computer simulation to manipulate reliability, the intercorrelation between measures, cut points, normative samples, and sample size. RESULTS: Identification of inadequate responders based on individual measures showed that single measures tended not to identify many members of the pool of 104 inadequate responders. Poor to fair levels of agreement for identifying inadequate responders were apparent between pairs of measures In the simulation, comparisons across two simulated measures generated indices of agreement (kappa) that were generally low because of multiple psychometric issues inherent in any test. CONCLUSIONS: Expecting excellent agreement between two correlated tests with even small amounts of unreliability may not be realistic. Assessing outcomes based on multiple measures, such as level of CBM performance and short norm-referenced assessments of fluency may improve the reliability of diagnostic decisions.

Anxiety and Response to Reading Intervention among First Grade Students.

BACKGROUND: For school-aged children with reading difficulties, an emerging and important area of investigation concerns determining predictors of intervention response. Previous studies have focused exclusively on cognitive and broadly defined behavioral variables. What has been missing, however, are studies examining anxiety, which is among the most commonly experienced difficulty for youth. OBJECTIVE: The present study examined anxiety among children classified as typically achieving or showing inadequate/adequate response following an intervention for reading problems. METHODS: Participants were 153 ethnically-diverse children (84 male, 69 female) evaluated in the winter and spring of their first-grade academic year. Children completed several standardized measures of reading achievement involving decoding and fluency along with a multidimensional anxiety rating scale. RESULTS: Repeated measures ANOVA revealed significant main effects for time and scale and significant interactions for time*scale and group*scale. Logistic regression examined whether anxiety predicted response to intervention (Y/N) at the end of the school-year. CONCLUSIONS: Results showed overall decreases in anxiety over time, with the exception of the harm avoidance area which increased and also interacted with group (children with decoding/fluency difficulties reported less harm avoidance than typically achieving children). The harm avoidance area was most pertinent across analyses highlighting the potential importance of targeting this area; however, none of the anxiety scales predicted response group at the end of the intervention. Ongoing research is needed in this area in order to identify characteristics of inadequate responders to reading intervention programs and/or inform interventions that incorporate these socioemotional factors.

Reaction time variability associated with reading skills in poor readers with ADHD.

Linkages between neuropsychological functioning (i.e., response inhibition, processing speed, reaction time variability) and word reading have been documented among children with attention-deficit/hyperactivity disorder (ADHD) and children with Reading Disorders. However, associations between neuropsychological functioning and other aspects of reading (i.e., fluency, comprehension) have not been well-documented among children with comorbid ADHD and Reading Disorder. Children with ADHD and poor word reading (i.e., ≤25th percentile) completed a stop signal task (SST) and tests of word reading, reading fluency, and reading comprehension. Multivariate multiple regression was conducted predicting the reading skills from SST variables [i.e., mean reaction time (MRT), reaction time standard deviation (SDRT), and stop signal reaction time (SSRT)]. SDRT predicted word reading, reading fluency, and reading comprehension. MRT and SSRT were not associated with any reading skill. After including word reading in models predicting reading fluency and reading comprehension, the effects of SDRT were minimized. Reaction time variability (i.e., SDRT) reflects impairments in information processing and failure to maintain executive control. The pattern of results from this study suggest SDRT exerts its effects on reading fluency and reading comprehension through its effect on word reading (i.e., decoding) and that this relation may be related to observed deficits in higher-level elements of reading.

The construction of visual-spatial situation models in children's reading and their relation to reading comprehension.

Readers construct mental models of situations described by text to comprehend what they read, updating these situation models based on explicitly described and inferred information about causal, temporal, and spatial relations. Fluent adult readers update their situation models while reading narrative text based in part on spatial location information that is consistent with the perspective of the protagonist. The current study investigated whether children update spatial situation models in a similar way, whether there are age-related changes in children's formation of spatial situation models during reading, and whether measures of the ability to construct and update spatial situation models are predictive of reading comprehension. Typically developing children from 9 to 16 years of age (N=81) were familiarized with a physical model of a marketplace. Then the model was covered, and children read stories that described the movement of a protagonist through the marketplace and were administered items requiring memory for both explicitly stated and inferred information about the character's movements. Accuracy of responses and response times were evaluated. Results indicated that (a) location and object information during reading appeared to be activated and updated not simply from explicit text-based information but from a mental model of the real-world situation described by the text; (b) this pattern showed no age-related differences; and (c) the ability to update the situation model of the text based on inferred information, but not explicitly stated information, was uniquely predictive of reading comprehension after accounting for word decoding.

An Experimental Evaluation of Guided Reading and Explicit Interventions for Primary-Grade Students At-Risk for Reading Difficulties.

Considerable research evidence supports the provision of explicit instruction for students at risk for reading difficulties; however, one of the most widely implemented approaches to early reading instruction is Guided Reading (GR; Fountas & Pinnel, 1996), which deemphasizes explicit instruction and practice of reading skills in favor of extended time reading text. This study evaluated the two approaches in the context of supplemental intervention for at-risk readers at the end of Grade 1. Students (n = 218) were randomly assigned to receive GR intervention, explicit intervention (EX), or typical school instruction (TSI). Both intervention groups performed significantly better than TSI on untimed word identification. Significant effects favored EX over TSI on phonemic decoding and one measure of comprehension. Outcomes for the intervention groups did not differ significantly from each other; however, an analysis of the added value of providing each intervention relative to expected growth with typical instruction indicated that EX is more likely to substantially accelerate student progress in phonemic decoding, text reading fluency, and reading comprehension than GR. Implications for selection of Tier 2 interventions within a response-to-intervention format are discussed.

Adequate versus inadequate response to reading intervention: an event-related potentials assessment.

Three visual event-related potential components to the second of two sequentially presented words that rhymed or not discriminated children who improved (AR) from those who failed following (IR) reading intervention. Right hemisphere P100 amplitudes discriminated Typically Developing (TD) children from AR children but IR from AR children over left hemisphere sites. N200 amplitudes across hemispheres discriminated TD from IR children and AR from IR children. P300 hemisphere differences differentiated TD from AR and IR children. P300 amplitudes discriminated rhyming from non-rhyming words across children. Results extend prior work asserting that normalization and compensatory mechanisms are active during successful interventions.

Anxiety and inattention as predictors of achievement in early elementary school children.

The objective of this study was to examine the relations among anxiety, inattention, and math/reading achievement, as well as the mediating/moderating role of inattention in the anxiety-achievement association both concurrently and longitudinally. Participants included 161 ethnically diverse children (aged 6-8) and their teachers. At the middle and end of first grade (approximately 5 months apart), students completed measures of anxiety and achievement while their teachers completed a measure of inattention. For the concurrent analyses, greater harm avoidance anxiety was associated with better attention, which was in turn related to better achievement. For the longitudinal analyses, mid-year inattention interacted with harm avoidance and separation anxiety to predict end of year reading fluency. For those rated as more attentive, greater separation anxiety symptoms were associated with decreased fluency performance while greater harm avoidance symptoms were associated with increased performance. Findings were discussed in terms of the importance of considering socioemotional variables in the study of children's academic achievement and the potential utility of early anxiety prevention/intervention programs, especially for children experiencing academic difficulties who also show internalizing behaviors.

Effects of Tier 3 Intervention for Students With Persistent Reading Difficulties and Characteristics of Inadequate Responders.

This article describes a randomized controlled trial conducted to evaluate the effects of an intensive, individualized, Tier 3 reading intervention for second grade students who had previously experienced inadequate response to quality first grade classroom reading instruction (Tier 1) and supplemental small-group intervention (Tier 2). Also evaluated were cognitive characteristics of students with inadequate response to intensive Tier 3 intervention. Students were randomized to receive the research intervention (N = 47) or the instruction and intervention typically provided in their schools (N = 25). Results indicated that students who received the research intervention made significantly better growth than those who received typical school instruction on measures of word identification, phonemic decoding, and word reading fluency and on a measure of sentence- and paragraph-level reading comprehension. Treatment effects were smaller and not statistically significant on phonemic decoding efficiency, text reading fluency, and reading comprehension in extended text. Effect sizes for all outcomes except oral reading fluency met criteria for substantive importance; however, many of the students in the intervention continued to struggle. An evaluation of cognitive profiles of adequate and inadequate responders was consistent with a continuum of severity (as opposed to qualitative differences), showing greater language and reading impairment prior to the intervention in students who were inadequate responders.

Response to intervention for reading difficulties in the primary grades: some answers and lingering questions.

The purpose of this article is to describe the current research base and identify research needs related to response to intervention (RTI) frameworks in primary-grade reading. Research is reviewed on early reading instruction and intervention, the implementation of multitiered reading interventions, and the determination of intervention responsiveness. Areas identified as in need of research include (a) the conditions under which early reading interventions are most effective in RTI contexts, (b) multitiered interventions for students with limited English proficiency, (c) reading instruction for students who make limited progress in Tier 3 intensive interventions, (d) criteria for determining intervention responsiveness, and (e) the effects of fully implemented RTI frameworks. Although RTI research may be expensive and difficult to implement, it may contribute to improved reading outcomes for many students who are otherwise at risk of serious negative life consequences.

An Experimental Study of Scheduling and Duration of "Tier 2" First-Grade Reading Intervention.

This study compared the effects on reading outcomes of delivering supplemental, small-group intervention to first-grade students at risk for reading difficulties randomly assigned to one of three different treatment schedules: extended (4 sessions per week, 16 weeks; n = 66), concentrated (4 sessions per week, 8 weeks; n = 64), or distributed (2 sessions per week, 16 weeks; n = 62) schedules. All at-risk readers, identified through screening followed by 8 weeks of oral reading fluency (ORF) progress monitoring, received the same Tier 2 reading intervention in groups of 2 to 4 beginning in January of Grade 1. Group means were higher in word reading and ORF at the final time point relative to pretest; however, the groups did not differ significantly on any reading outcome or on rates of adequate intervention response. Of potential covariates, site, age, free lunch status, program coverage rate, and tutor were significantly related to student outcomes; however, the addition of these variables in multivariate models did not substantially change results. Rates of adequate intervention response were lower than have been reported for some first-grade interventions of longer duration.