The effects of a tier 2 reading comprehension intervention aligned to tier 1 instruction for fourth graders with inattention and reading difficulties.

This study reports a secondary analysis from a quasi-experimental design study (N = 13 schools) to examine the effects of aligned Tier 1 (T1) and Tier 2 (T2) instruction for a subsample of fourth graders with inattention and reading difficulties. Of this sample (N = 63 students), 100% received free- or reduced-price lunch, 92% identified as Hispanic, and 22% received special education services. T1 instruction focused on implementing practices to support reading comprehension and content learning during social studies instruction. The aligned T2 intervention focused on remediating reading comprehension difficulties using the same evidence-based practices implemented in T1, thus supporting students with connecting learning and applying skills across settings. Schools were assigned to one of three conditions: (a) aligned T1-T2 instruction; (b) nonaligned T1-T2 instruction, in which T1 and T2 practices were not intentionally aligned; or (c) business-as-usual (BaU) T1 and T2 practices. No significant differences were detected between the nonaligned T1-T2 and BaU conditions on student outcomes. However, large, statistically significant effects were detected in favor of the aligned T1-T2 condition compared to BaU on measures of content knowledge (Unit 1 ES = 0.85; Unit 2 ES = 1.46; Unit 3 ES = 0.79), vocabulary (Unit 1 ES = 0.88; Unit 2 ES = 0.85), and content reading comprehension (ES = 0.79). The aligned T1-T2 condition also outperformed the nonaligned T1-T2 condition on content knowledge (Unit 2 ES = 1.35; Unit 3 ES = 0.56), vocabulary (Unit 1 ES = 0.82), and the content reading comprehension assessment (ES = 0.69). Various effect sizes were not different from zero after correcting for clustered data. Although the magnitude of the effect sizes suggested promise, additional research is needed to fully understand the effects of aligned instruction on the reading outcomes of students with inattention and reading difficulty.

Middle school matters: examining the effects of a schoolwide professional development model to improve reading comprehension.

Many middle school students perform below grade-level standards in reading (National Center for Education Statistics, Washington, 2019), and recent observation studies demonstrate middle school teachers' limited use of reading comprehension practices within content area instruction (e.g., science and social studies; as reported by Greenleaf (in: Hinchman (ed) Adolescent literacies: A handbook of practice-based research, Guilford Press, 2017)). In this experimental pilot study, we aimed to boost middle schoolers' reading comprehension outcomes by providing schoolwide professional development (PD) on integrating reading comprehension practices within content instruction for English language arts, social studies, and science teachers. Six schools were matched into pairs and randomized to the schoolwide PD or a business-as-usual (BAU) condition. Content area teachers in schools assigned to the PD condition received distributed PD resources to support implementation, and coaching in one reading comprehension practice in the fall (i.e., get the gist) and one in the spring (i.e., asking and answering questions). Contrary to traditional PD, this PD was implemented across three content areas, was narrow in scope but long in duration (one practice per semester), focused on practices that could feasibly be integrated into content area instruction, and included ongoing coaching in content area teams. Students in schools assigned to the PD condition significantly outperformed those in the BaU condition on a measure of main idea generation (ES = 0.29) but not on measures of asking and answering questions (ES = 0.11) and general reading comprehension (ES = - 0.09). Findings suggest promise for implementing schoolwide approaches embedded within content area instruction to improve reading comprehension performance for middle school students.

Current State of the Evidence: Examining the Effects of Orton-Gillingham Reading Interventions for Students With or at Risk for Word-Level Reading Disabilities.

Over the past decade, parent advocacy groups led a grassroots movement resulting in most states adopting dyslexia-specific legislation, with many states mandating the use of the Orton-Gillingham approach to reading instruction. Orton-Gillingham is a direct, explicit, multisensory, structured, sequential, diagnostic, and prescriptive approach to reading for students with or at risk for word-level reading disabilities (WLRD). Evidence from a prior synthesis and What Works Clearinghouse reports yielded findings lacking support for the effectiveness of Orton-Gillingham interventions. We conducted a meta-analysis to examine the effects of Orton-Gillingham reading interventions on the reading outcomes of students with or at risk for WLRD. Findings suggested Orton-Gillingham reading interventions do not statistically significantly improve foundational skill outcomes (i.e., phonological awareness, phonics, fluency, spelling; effect size [ES] = 0.22; p = .40), although the mean ES was positive in favor of Orton-Gillingham-based approaches. Similarly, there were not significant differences for vocabulary and comprehension outcomes (ES = 0.14; p = .59) for students with or at risk for WLRD. More high-quality, rigorous research with larger samples of students with WLRD is needed to fully understand the effects of Orton-Gillingham interventions on the reading outcomes for this population.

The Effects of a Paraphrasing and Text Structure Intervention on the Main Idea Generation and Reading Comprehension of Students with Reading Disabilities in Grades 4 and 5.

This study examined the effects of a small group intervention targeting paraphrasing and text structure instruction on the main idea generation and reading comprehension of students with reading disabilities in Grades 4 and 5. Students (N = 62) were randomly assigned to receive the Tier 2-type intervention or business-as-usual instruction. Students in the intervention received 25, 40-minute lessons focused on paraphrasing sections of text by identifying the main topic and the most important idea about that topic. Students utilized the text structure organization to inform their main idea generation. Results yielded statistically significant, positive effects in favor of the intervention group on near-transfer and mid-transfer measures of text structure identification (g = 0.75) and main idea generation (g = 0.70), but no statistically significant effect on a far-transfer measure of reading comprehension. These findings provide initial support for utilizing this instruction to improve students' main idea generation on taught and untaught structures.

Current Evidence on the Effects of Intensive Early Reading Interventions.

Many students at risk for or identified with reading disabilities need intensive reading interventions. This meta-analysis provides an update to the Wanzek and Vaughn synthesis on intensive early reading interventions. Effects from 25 reading intervention studies are analyzed to examine the overall effect of intensive early reading interventions as well as relationships between intervention and student characteristics related to outcomes. The weighted mean effect size (ES) estimate (ES = 0.39), with a mean effect size adjusted for publication bias (ES = 0.28), both significantly different from zero, suggested intensive early reading interventions resulted in positive outcomes for early struggling readers in kindergarten through third grades. There was no statistically significant or meaningful heterogeneity in the study-wise effect sizes. Exploratory examination of time in intervention, instructional group size, initial reading achievement, and date of publication are provided.

The Effects of Reading Fluency Interventions on the Reading Fluency and Reading Comprehension Performance of Elementary Students With Learning Disabilities: A Synthesis of the Research from 2001 to 2014.

Fluent word reading is hypothesized to facilitate reading comprehension by improving automatic word reading, thus releasing a reader's cognitive resources to focus on meaning. Many students with learning disabilities (LD) struggle to develop reading fluency, which affects reading comprehension. This synthesis extends Chard, Vaughn, and Tyler's (2002) review, synthesizing fluency intervention research from 2001 to 2014. The search yielded 19 studies examining reading fluency and comprehension outcomes of reading fluency interventions for students with LD in kindergarten through 5th grade. Results showed repeated reading (RR), multicomponent interventions, and assisted reading with audiobooks produced gains in reading fluency and comprehension. Providing a model of fluent reading and performance feedback, using easier level text, setting a performance criterion, and practicing RR with peers also contributed to improved outcomes. Findings suggest that RR remains the most effective intervention for improving reading fluency for students with LD. Limitations include sample size, only three group design studies, and infrequent use of standardized measures.

Assessing challenges in end-of-life conversations with elderly patients with multiple morbidities.

INTRODUCTION: This study reports on physicians' experiences in conducting end-of-life conversations with elderly patients who suffered from multiple co-morbidities (MCM). Our hypothesis was that both the lack of prognostic certainty and the lack of good communication tools contributed to physicians' discomfort with conducting EOL conversations with patients and families of patients with these conditions especially when compared with patients and families of patients who had a single, clear terminal diagnosis (e.g. pancreatic cancer). METHODS: Focus group questions were semi-structured and explored three general themes: (1) differences between having an end-of-life conversation with patients/families with MCM versus those with a single, terminal diagnosis; (2) timing of the end-of-life conversation; and (3) approaches to the end-of-life conversation. RESULTS: Three themes emerged: (1) It is more difficult for them to have EOL conversations with patients with MCM and their families, as opposed to conversations with families and patients who have a clear, terminal diagnosis. (2) In deciding when to raise the subject of EOL care, participants reported that they rely on a number of physical and/or social signs to prompt these discussions. Yet a major reason for the difficulty that providers face in initiating these discussions with MCM patients and families is that there is a lack of a clear threshold or prompting event. (3) Participants mentioned three types of approaches to initiating EOL conversations: (a) direct approach, (b) indirect approach, (c) collaborative approach. CONCLUSION: Prognostic indicies and communication scripts may better prepare physicians to facilitate end-of-life conversations with MCM patients/families.

Peer contagion of depressogenic attributional styles among adolescents: a longitudinal study.

This study examined longitudinal associations between adolescents' and their friend's depressive symptoms and depressogenic attributional style. Participants included 398 adolescents in grades six through eight at the outset of the study. Adolescents completed peer nominations to identify reciprocated and unreciprocated best friendships as well as measures of depressive symptoms and depressogenic attributional style at an initial time point, and again 11 months later. Results revealed that best friends' reported level of depressive symptoms was prospectively associated with adolescents' own depressive symptoms and with adolescents' depressogenic attributional style. Moderator effects suggested that friends' attributional styles were prospectively associated with adolescents' own attributional styles for those involved in reciprocated friendships. Lastly, findings offered preliminary support for adolescents' Time 2 depressive symptoms as a mediator of the association between friends' depressive symptoms and adolescents' attributional style. Findings have important implications for cognitive and interpersonal models of adolescent depression, as well as the study of peer contagion effects.