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.

Enhancing word signing in hearing students with reading disorders using computer-based learning trials.

Multiple-baseline-across-word-sets designs were used to determine whether a computer-based intervention would enhance accurate word signing with four participants. Each participant was a hearing college student with reading disorders. Learning trials included 3 s to observe printed words on the screen and a video model performing the sign twice (i.e., simultaneous prompting), 3 s to make the sign, 3 s to observe the same clip, and 3 s to make the sign again. For each participant and word set, no words were accurately signed during baseline. After the intervention, all four participants increased their accurate word signing across all three word sets, providing 12 demonstrations of experimental control. For each participant, accurate word signing was maintained. Application of efficient, technology-based, simultaneous prompting interventions for enhancing American Sign Language learning and future research designed to investigate causal mechanisms and optimize intervention effects are discussed.

Effects of a visual perception-based occupational therapy program on reading and motor skills in children with developmental dyslexia: Single blind randomized cross-over study design.

This study aimed to examine the effects of a visual praxis-based occupational therapy (VPOT) program on reading and motor skills for children with developmental dyslexia (DD). Forty-two children were included in the study. Additionally, before VPOT, the Reading-Aloud and Reading-Comprehension Test 2 (ORSRC-2) and the Bruininks-Oseretsky Motor-Proficiency-Test-2-Brief Form (BOT2-BF) were applied to the participants. According to the study design, VPOT was applied to two sessions per week for 8 weeks to group A. During this period, group B was accepted as the control group. At the end of these 8 weeks, evaluation tests were applied to both groups. Then, group A was defined as the control group and Group B as the intervention group, and VPOT was applied to Group B. At the end of another 8 weeks, evaluation tests were applied to both groups for the third time. When the final ORSRC-2 results were examined, VPOT was found to be an effective program for improving reading skills. Additionally, when the final BOT2-BF results were examined, VPOT was determined to be effective in improving motor skills (p < 0.05). We believe that it is important to carry out comprehensive studies such as the VPOT program to solve problems in the physical and learning activities of children with DD.

Action video games and posterior parietal cortex neuromodulation enhance both attention and reading in adults with developmental dyslexia.

The impact of action video games on reading performance has been already demonstrated in individuals with and without neurodevelopmental disorders. The combination of action video games and posterior parietal cortex neuromodulation by a transcranial random noise stimulation could enhance brain plasticity, improving attentional control and reading skills also in adults with developmental dyslexia. In a double blind randomized controlled trial, 20 young adult nonaction video game players with developmental dyslexia were trained for 15 h with action video games. Half of the participants were stimulated with bilateral transcranial random noise stimulation on the posterior parietal cortex during the action video game training, whereas the others were in the placebo (i.e. sham) condition. Word text reading, pseudowords decoding, and temporal attention (attentional blink), as well as electroencephalographic activity during the attentional blink, were measured before and after the training. The action video game + transcranial random noise stimulation group showed temporal attention, word text reading, and pseudoword decoding enhancements and P300 amplitude brain potential changes. The enhancement in temporal attention performance was related with the efficiency in pseudoword decoding improvement. Our results demonstrate that the combination of action video game training with parietal neuromodulation increases the efficiency of visual attention deployment, probably reshaping goal-directed and stimulus-driven fronto-parietal attentional networks interplay in young adults with neurodevelopmental conditions.

Spelling Facilitates Reading: A Tutorial on the Spell-to-Read Approach.

PURPOSE: According to the American Speech-Language-Hearing Association (ASHA), prevention, identification, assessment, and intervention of children who are learning to read and write are within the scope of practice for school-based speech-language pathologists (SLPs). Furthermore, for SLPs who work in the school setting, it is not uncommon to have struggling readers and poor spellers on their caseloads. Importantly, for students who have difficulty in spelling, their spelling errors are among the early indicators of dyslexia and can provide a means for identifying readers who may benefit from early intervention. SLPs can both assess spelling skills and implement evidence-based spelling and literacy diagnosis and instruction. Spelling instruction in kindergarten through the high school grades that is heavily grounded in metalinguistic activities can provide access to mental representations of word spellings, pronunciations, and meanings; links between whole-word and phonics approaches to reading instruction; and a foundation for reading fluency and comprehension. CONCLUSIONS: Learning to spell is essential for learning to read. Accordingly, this tutorial aims to elucidate how to (a) assess and identify phases of spelling development and (b) teach spelling to facilitate reading through a listening-first approach.

Computerized Executive Functions Training: The efficacy on reading performance of children with dyslexia.

This study aimed to test the efficacy of a newly developed computer-based game naming computerized executive functions (CEF) task on the reading ability of children suffering from dyslexia. Forty dyslexic school students from the fourth and fifth grades were randomized to one of the experimental and control groups. Subjects of the experimental group received 12 sessions of Computerized Executive Functions Training (CEFT), while subjects of the control group played a neutral computer game throughout the 12 sessions. All participants responded to the Reading and Dyslexia Test (NEMA) as the pre- and post-test measure. Results revealed a significant improvement in the reading ability of subjects of the experimental group compared to the control group. Subjects of the experimental group indicated a greater improvement in some components of the NEMA scale including word reading, word chains reading, picture naming, text comprehension, word comprehension and letter fluency relative to the control group. CEFT had no significant effect in modifying the category fluency, phoneme elimination and rhyming components of the NEMA scale. Applying CEFT improves the reading performance of children with dyslexia by enforcing their cognitive abilities like working memory, inhibition control and cognitive flexibility which are necessary for normal reading ability.

The COVID generation: Online dyslexia treatment equally effective as face-to-face treatment in a Dutch sample.

Due to pandemic-induced lockdown(s) in 2020, dyslexia treatment was forced to move to online platforms. This study examined whether Dutch children who received online treatment progressed as much in their reading and spelling performance as children who received the usual face-to-face treatment. To this end, 254 children who received treatment-as-usual were compared to 162 children who received online treatment with Bayesian methods. The advantage of a Bayesian approach is that it can provide evidence for and against the null hypothesis whereas frequentist approaches only provide evidence against it. We found that children in the online treatment condition received slightly fewer treatment sessions but progressed equally after controlling for the number of sessions compared to the treatment-as-usual condition. These results have clinical and practical implications as they show that reading treatment can be successfully delivered online.

The challenge of remote treatment in neuropsychological intervention for reading and spelling in dyslexia: A prospective observational cohort study.

Telemedicine approaches have proved to be valuable solutions for the delivery of treatment for many health-related issues, and crucial during the pandemics. Nonetheless, the efficacy of such Web-based practices in developmental dyslexia needs to be thoroughly evaluated. To this aim, the effects of a multi-componential program for neuropsychological intervention in dyslexia delivered as an outpatient program were compared with those obtained with a remotely delivered, Web-based treatment, based on the same methodological principles and delivered with the same duration and intensity. The treatment-related changes obtained with a combination of visual hemisphere-specific stimulation and training of visual-spatial attention through action video games, were compared to those obtained through remote treatment via the Tachidino Web-based platform. Both treatments had a duration of 4 weeks. The same battery of reading and phonemic awareness tests was delivered in presence, before and after treatment, as well as at 6-months follow-up. User satisfaction was assessed through parents and user questionnaires. Both treatments were significantly and similarly effective in improving reading speed, reading accuracy, and writing accuracy. No reduction in the effects was observed after treatment discontinuation. The Web-based treatment may thus offer a valid alternative to in-person intervention, optimizing the flexibility, capillary diffusion and cost-effectiveness of intervention.

Combined multi-session transcranial alternating current stimulation (tACS) and language skills training improves individual gamma band activity and literacy skills in developmental dyslexia.

Developmental dyslexia is characterized by the pathologically diminished ability to acquire reading and spelling skills. Accurate processing of acoustic information at the phonemic scale is crucial for successful sound-to-letter-mapping which, in turn, is elemental in reading and spelling. Altered activation patterns in the auditory cortex are thought to provide the neurophysiological basis for the inaccurate phonemic perception. Recently, transcranial electrical stimulation has been shown to be an effective method to ameliorate cortical activation patterns in the auditory cortex. In a sample of children and adolescents with dyslexia, we investigated the effect of multi-session transcranial alternating current stimulation delivered concurrently with a phonological training and in combination with a behavioral literacy skills training. Over a 5-week period the participants received 10 training sessions while gamma-tACS was administered over bilateral auditory cortex. We found that gamma-tACS shifted the peak frequency of auditory gamma oscillations reflecting a more fine-grained processing of time-critical acoustic information. This amelioration was accompanied by increased phonemic processing skills. Moreover, individuals who received gamma-tACS showed significant improvements in their spelling skills four months after the intervention. Our results demonstrate that multi-session gamma-tACS enhances the effects of a behavioral intervention and induces long-term improvement on literacy skills in dyslexia.

Conceptions and Misconceptions: What Do School-Based Speech-Language Pathologists Think About Dyslexia?

PURPOSE: The purpose of this exploratory study was to evaluate speech-language pathologists' (SLPs') conceptions and misconceptions about dyslexia. METHOD: Participants were 86 school-based SLPs. They completed an online survey on which they rated their agreement and disagreement with true and false statements related to the scientific evidence about the nature of dyslexia and interventions for dyslexia, as well as common misconceptions about dyslexia. RESULTS: There was considerable variability among SLPs' agreement and disagreement with the statements. Critically, despite abundant contrary evidence in the literature, many SLPs believe that dyslexia involves a visual processing deficit. CONCLUSIONS: These findings suggest that many school-based SLPs hold misconceptions about dyslexia, especially those related to dyslexia being a visual disorder. The identified misconceptions may contribute to some SLPs' reluctance to incorporate reading and prereading skills into speech-language assessment and intervention. SLPs need greater knowledge of dyslexia to provide more effective evaluations and intervention services.

Effects of a phonics intervention in a randomized controlled study in Swedish second-grade students at risk of reading difficulties.

Teaching phoneme awareness to children at risk for early reading difficulties has been recognized as successful in several studies. In this randomized controlled trial (RCT)-study, we add to this research by optimizing core procedural as well as teaching components in a phonics-directed intervention and extend the RCT reading intervention research into a semi-transparent language context. The aim of the present study was to evaluate the effects of a novel Swedish intensive phonics program. This randomized controlled pre-test and post-test intervention study targeted second-grade students with early reading difficulties. Students were identified by a repeated screening procedure and allocated to intervention (n = 34) and control (n = 34) conditions. A 9-week intensive phonics-based program was administrated one-to-one, by special education teachers in Swedish mainstream elementary schools. Results show an improvement in the intervention group, compared with the controls on all outcome measures. Findings indicate that the supplementary phonics program, delivered with high intensity, can significantly increase word reading skills and reading comprehension in second-grade students with early reading difficulties.

On Support for Dyslexic Students in Senior-High School and Higher Education.

It is very difficult to provide dyslexic students in senior-high school or higher education with all necessary textbooks in ordinary accessible format such as multimedia DAISY. Here, a new approach to provide them with a new type of accessible textbooks named "Fixed-Layout DAISY" is shown. In it, the whole page is treated as a multi-layer picture, the front layer of which has the same form as the original PDF. A DAISY (EPUB3) player can read out any texts together with highlighting them. It does not have the reflow function. The page layout is always kept as same as the original. It does not have information either in which order texts on the page should be read out, and readers need to click a text block on a page where they want to read. Dyslexic people can see and click a place where they want to read, and obviously, Fixed-Layout DAISY should work for them. Fixed-Layout DAISY can be produced almost automatically from an original "e-born PDF" by making use of our OCR system, and it should be very helpful for the dyslexic students to get accessible version of their textbooks.

Effects of a developmental dyslexia remediation protocol based on the training of audio-phonological cognitive processes in dyslexic children with high intellectual potential: study protocol for a multiple-baseline single-case experimental design.

BACKGROUND: The significant prevalence of children with high intellectual potential (HIP) in the school-age population and the high rate of comorbidity with learning disabilities such as dyslexia has increased the demand for speech and language therapy and made it more complex. However, the management of dyslexic patients with high intellectual potential (HIP-DD) is poorly referenced in the literature. A large majority of studies on HIP-DD children focus on the screening and diagnosis of developmental dyslexia, but only a few address remediation. Developmental dyslexia is a severe and persistent disorder that affects the acquisition of reading and implies the impairment of several underlying cognitive processes. These include deficits in Categorical Perception, Rapid Automatized Naming, and phonological awareness, particularly phonemic awareness. Some authors claim that HIP-DD children's underlying deficits mainly concern rapid automatized naming and phonological awareness. Thus, the purpose of this study is to present a remediation protocol for developmental dyslexia in HIP-DD children. This protocol proposes to compare the effects on reading skills of an intensive intervention targeting categorical perception, rapid automatized naming, and phonemic analysis versus standard speech therapy remediation in HIP-DD children. METHODS: A multiple-baseline single-case experimental design (A1BCA2) will be proposed to 4 French HIP-DD patients for a period of 30 weeks. Intervention phases B and C correspond to categorical perception training and rapid automatized naming training. During phases B and C, each training session will be associated with phonemic analysis training and a reading and writing task. At inclusion, a speech and language, psychological, and neuropsychological assessment will be performed to define the four patients' profiles. Patients will be assigned to the different baseline lengths using a simple computerized randomization procedure. The duration of the phases will be counterbalanced. The study will be double blinded. A weekly measurement of phonological and reading skills will be performed for the full duration of the study. DISCUSSION: The purpose of this protocol is to observe the evolution of reading skills with each type of intervention. From this observation, hypotheses concerning the remediation of developmental dyslexia in HIP-DD children can be tested. The strengths and limitations of the study are discussed. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04028310 . Registered on July 18, 2019. Version identifier is no. ID RCB 2019-A01453-54, 19-HPNCL-02, 07/18/2019.

Intervention targeting different visual attention span components in Chinese children with developmental dyslexia: a study based on Bundesen's theory of visual attention.

Within the framework of the theory of visual attention (TVA), the visual attention span (VAS) deficit among individuals with developmental dyslexia has been ascribed to the problems entailed by bottom-up (BotU) and top-down (TopD) attentional processes. The former involves two VAS subcomponents: the visual short-term memory storage and perceptual processing speed; the latter consists of the spatial bias of attentional weight and the inhibitory control. Then, what about the influences of the BotU and TopD components on reading? Are there differences in the roles of the two types of attentional processes in reading? This study addresses these issues by using two types of training tasks separately, corresponding to the BotU and TopD attentional components. Three groups of Chinese children with dyslexia-15 children each in the BotU training, TopD training, and non-trained active control groups were recruited here. Participants completed reading measures and a CombiTVA task which was used to estimate VAS subcomponents, before and after the training procedure. Results showed that BotU training improved both the within-category and between-category VAS subcomponents and sentence reading performance; meanwhile, TopD training enhanced character reading fluency through improving spatial attention capacity. Moreover, benefits on attentional capacities and reading skills in the two training groups were generally maintained three months after the intervention. The present findings revealed diverse patterns in the influences of VAS on reading within the TVA framework, which contributes to enriching the understanding of VAS-reading relation.

Rethinking Literacy Intervention: Addressing a Practice Gap With Best Practices From Multisensory Structured Language Approaches.

PURPOSE: Dyslexia is increasingly being defined, assessed, diagnosed, and treated in the educational system. The purpose of this clinical focus article is to elucidate ways in which speech-language pathologists (SLPs) can rethink how to implement literacy interventions to incorporate best practices from multisensory structured language (MSL) approaches and how they can be influential participants in the conversations of how to define and implement services for students who have written language disorders, including dyslexia, in the school setting. METHOD: This clinical focus article provides an operational definition of dyslexia, discusses the various roles and responsibilities of SLPs with respect to dyslexia, and describes the well-established evidence-based practices of MSL approaches as a means of rethinking literacy intervention. RESULTS: Using a case study scenario based on an individual diagnosed with dyslexia, this clinical focus article presents similarities and differences between traditional speech-language pathology intervention approaches and MSL approaches to literacy intervention. CONCLUSIONS: MSL strategies may be considered in literacy intervention as a means to optimize the academic gains of children with dyslexia in a school setting. Furthermore, SLPs should be considered integral participants in discussions of policies and practices related to the diagnosis and treatment of literacy disorders, including dyslexia. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23228483.

Word reading transfer in two distinct languages in reading interventions: How Chinese-English bilingual children with reading difficulties learn to read.

PURPOSE: Skills developed from literacy training in L1 are shown to transfer to reading in L2 when both languages involve an alphabetic writing system. However, transfer of literacy skills between a logographic L1 and an alphabetic L2 is less studied. This study examined whether the gain in literacy skills after an 8-week training on 1) Chinese character recognition or 2) English phonics, may generalize across the two languages in Chinese elementary students with reading disabilities. METHODS: Chinese-speaking students identified with reading difficulties were randomly assigned to the Chinese intervention (Chinese character orthography training), English intervention (English phonics training), and control groups. Their Chinese and English literacy skills were measured before and after the interventions. RESULTS: Though training on the orthography of Chinese characters significantly improved performance in Chinese word reading and Chinese orthographic awareness, our results did not provide evidence for the generalization of word-decoding skills from L1 Chinese to word reading in L2 English. However, phonics training in L2 English benefitted not only English word reading, but also cross-language word reading in L1 Chinese. CONCLUSION: We postulated that teaching children analytical skills in decoding words in an alphabetic writing system might likewise benefit their word decoding in a logographic script.

Speech therapy to overcome dyslexia in primary schoolers.

This research was aimed to investigate changes in the reading technique and in terms of its semantic charge in primary schoolers diagnosed with dyslexia, which occur as a result of the integrated use of speech therapy techniques. The study was performed between 2016 and 2019 in 6 schools of Moscow and Almaty. It enrolled 194 and 200 children, respectively, who were examined with form I to III inclusive. The study revealed that 13% of children had reading speed disorders; they were constituted group 1. Another 11% had reading comprehension disorders; they constituted group 2. In group 1, by form III, the number of reading repetitions increased twofold. In group 2, the number of children, who read in words and phrases, increased by half; in group 1, it doubled. This research showed clear progress in children with technical dyslexia vs. those with semantic dyslexia. Based on the results, it is possible to develop a methodology for speech therapy techniques that can be suitable not only for speech therapists, but also for primary school teachers, as well as for parents of dyslectic children.

Short report on a syllable-based intervention to improve phonemic awareness and reading in children with DLD.

With fragile phonological representations, children with developmental language disorder (DLD) risk failure when learning to read. The study reported that teaching letters-to-syllable relationships can improve phonemic awareness skills or reading performances of three French-speaking children with DLD, using a single case methodology with an AB design. These findings are promising for children at risk of reading disability and extend current knowledge concerning syllable-based teaching for developing literacy.

Speech therapy and hyperbaric oxygen for aphasia after carbon monoxide intoxication.

Acute carbon monoxide (CO) intoxication may result in delayed neurological sequelae, which can include amnesia, ataxia, aphasia, emotional lability, disorientation, dysphagia, and other manifestations. A 27-year-old man reported symptoms of aphasia with agraphia and alexia in a review after CO intoxication. The patient received outpatient speech therapy, as well as repeated sessions of hyperbaric oxygen for 15 days, interspersing speech therapy with hyperbaric oxygen therapy for two months. After this period of combined treatment the aphasic symptomatology remitted, and oral and written language was normal. The complete disappearance of aphasia with agraphia and alexia confirms the efficacy of the combined intervention. More data from large clinical studies are needed to assess the outcomes of hyperbaric oxygen treatment in patients with delayed neurological sequelae after CO intoxication, but this case suggests it may be a good therapeutic option in combination with specific speech therapy.

Examining fidelity reporting within studies of foundational reading interventions for elementary students with or at risk for dyslexia.

Early access to evidence-based reading intervention improves outcomes for students with or at risk for reading difficulties. Additionally, teacher implementation of reading interventions plays a key role in the efficacy of reading interventions. Previous research suggests the influence of intervention implementation fidelity on student language and literacy outcomes is more significant for lower-performing students and students with disabilities, such as dyslexia. However, recent syntheses have suggested that less than half of reading intervention studies report treatment fidelity data. This meta-analysis examined fidelity reporting within reading intervention studies for students with or at risk for dyslexia in Grades K-5. We aimed to record the frequency and extent of fidelity reporting, explore associations between study or intervention features and fidelity reporting, and compare mean intervention effect sizes for studies reporting fidelity and those that did not. A total of 51 studies were included. Results indicated that 75% of studies reported fidelity data. Studies reporting fidelity primarily focused on adherence and dosage data with little to no information reported for other dimensions of fidelity (i.e., quality, responsiveness, differentiation). Suggestions for improving reporting of treatment fidelity data are discussed.