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Reading Failure in Children and the Prevention Measures
Journal of EP, The research reported in this manuscript was supported by grant number HD30988 from the national Institute of Child Health and Human Development, and by grants from the national Center for Learning disabilities, and the Donald D. Hammill Foundation. Questions regarding the manuscript should be sent to the [CONFIDENTIAL] Abstract The effectiveness of three interventions for children with weak phonograph skills was studied. Two programs were compared with a third approach, which was a regular reading program. The children were provided with 88 hours of one-to-one instruction beginning the second semester of kindergarten and extending through second grade. The most phonemically explicit condition produced the strongest growth in word-level reading skills, but there were no differences between groups in reading comprehension. Word-level skills of children in the strongest group were in the middle of the average range. Growth curve analyses showed that beginning phonological skills, home background, and ratings of classroom behavior all predicted unique variance in growth of word level skills. This study was designed to contribute to our understanding of the instructional conditions that need to be in place to prevent reading disabilities in young children. Both the specific design of the study and the questions it addressed were derived from previous research and theory in two areas. The broadest context of the study is the new understanding of reading and reading disabilities we have acquired from research over the past 20 years (Adams, 1990, Metsala & Ehri, 1998), and the more focused context is previous research on instructional methods that accelerate reading development in young children who are either experiencing, or are at-risk for reading failure (Foorman, Fletcher, Francis, Schatschneider, & Mehta, 1998; Shanahan & Barr, 1995; Wasik & Slavin, 1993; Vellutino, Scanlon, Sipay, Small, Pratt, Chen, & Denckla, 1996). Within the broader context, perhaps the most important single conclusion about reading disabilities is that they are most commonly caused by weaknesses in the ability to process the phonological features of language (Liberman, Shankweiler, & Liberman, 1989). In particular, individual differences in phonological awareness and rapid automatic naming ability have been shown to exercise unique causal influences on the rate at which children acquire important early reading skills (Wagner, et al., 1997). These two cognitive/linguistic abilities have also been demonstrated to be the most salient disabilities of older children with reading disabilities (Fletcher, et al., 1994; Wolf, 1997). Discoveries about the core cognitive/linguistic problems of children who experience special difficulties learning to read are important to research on the prevention of reading disabilities for two reasons. First, they provide a means to accurately identify children at-risk for reading
disabilities before reading instruction begins (Torgesen & Burgess, 1998). This should allow preventive work to begin earlier in school and focus accurately on children who are most in need of preventive intervention. Second, use of selection criteria involving phonological skills allows identification of a more theoretically coherent sample for study than is frequently the case. Most previous research has focused on children identified for intervention by teacher nomination or socio-economic status (Wasik & Slavin, 1995). While children identified in this manner clearly constitute an "at-risk" group (Bowey, 1995), they are not as cognitively or linguistically coherent as groups identified by specific deficiencies on linguistic measures. The goal of the present study was to examine the effectiveness of several instructional procedures for a specific subset of children who are at-risk for reading difficulties; those who enter school delayed in the development of phonological skill. The most important impact of weaknesses in the ability to process phonological information is to make it very difficult for children to understand and apply the alphabetic principal in deciphering unfamiliar words in print (Siegel, 1989; Torgesen, in press). These early difficulties in acquiring phonemic decoding skills lead directly to delays in the development of orthographic reading skills which are one important basis of fluent reading (Ehri, 1998; Share & Stanovich, 1995). Children with reading disabilities show word-level reading problems from the beginning of reading instruction, and in the normal course of development, they almost never acquire average level skills in this area (Francis, Shaywitz, Stuebing, Shaywitz, & Fletcher, 1996; Juel, 1988). Evidence about the central role of word-level reading problems in children with phonetically based reading disabilities suggests that, to be successful with this population, interventions must contain powerful instruction and effective practice at this level. Consistent with this implication, two recent reviews of early intervention research using broadly defined samples of children concluded that the most successful programs to date have included systematic instruction to help children learn to decipher words in print (Pikulski, 1994; Wasik & Slavin, 1993). One study in particular (Iverson & Tunmer, 1993) provided specific evidence that the effectiveness of an early intervention program for at-risk children could be enhanced substantially by the addition of explicit instruction in phonemic decoding skills. However, both reviews also concluded that the most successful interventions were those that were derived from the most inclusive models of reading and which contained an appropriate balance of word and text level instruction, including instruction specifically focused on reading comprehension. Thus, previous research with children identified by teacher nomination or socio-economic status suggests that, to be maximally effective, early intervention programs need to contain a carefully orchestrated mix of instruction to help children construct the meaning of text as well as to read words accurately and fluently. A potential tension between the needs for instruction designed to build word reading skills and instruction focused on construction of meaning is brought into sharp focus by two recent, carefully controlled prevention studies. Brown and Felton (1990) contrasted two instructional approaches with a sample of children selected because of weaknesses in phonological development, and Foorman and her colleagues (Foorman, et al., 1998) contrasted three instructional approaches with first grade Title 1 children. In both cases, the instructional condition that contained the most explicit instruction in phonemic decoding skills produced the strongest growth in word-level reading skills, and the Title 1
reading skill among the least learning impaired children. In the present study, we used standardized measures of reading skill to assess overall level of reading outcomes, and we also separately examined performance of our weakest children. The study also employed growth curve methodology to provide information about characteristics of the children who were least responsive to instruction.
Method
Participants Children were selected to participate in the study using a two tiered screening process. During September, all kindergarten children in 13 elementary schools (N=1436) were given the Letter Naming task which required them to name as many of the 26 uppercase letters as they could. The sample screened was 51% male, 71.9% White, 26% African American, .6% Hispanic, and 1.5 % Asian. Children scoring in the bottom 30% on the Letter Naming task were given three additional tasks: Phoneme Elision (a measure of phonological awareness), Serial Naming of Numbers (a measure of rapid automatic naming ability), and the Vocabulary subtest of the Stanford-Binet Intelligence Test, Fourth Edition (Thorndike, Hagen, & Sattler, 1986). These, and all other tests administered in this study are completely described in an appendix that is available from the first author. Eighteen students were dropped from the second screening because they were repeating kindergarten, were already assigned to receive extensive special education support, spoke English as a second language, or moved. 180 children who obtained the lowest combined scores on the Letter Naming and Phoneme Elision task, and who had an estimated Verbal Intelligence score above 75, were selected for the study. Because so few of the 413 children who received the second screening tests were able to identify number names correctly, there was not an exclusionary criterion based on the Serial Naming task. Children were randomly assigned within school to one of 4 conditions: (1) a no- treatment condition; (2) a regular classroom support (RCS) condition; (3) the embedded phonics (EP) condition; and, (4) the phonological awareness plus synthetic phonics (PASP) (aka Lindamood; added by CRC) condition. Each of the 13 schools in which the interventions were delivered had roughly equal numbers of children in each instructional condition. Descriptive characteristics of children on the screening measures for each of the four groups is given in Table 1. The groups were not significantly different from one another on any of the
TABLE 1: Descriptive Characteristics of Children in the Four Experimental Conditions
Variable No Treatment RCS
PASP
(Lindamood; added by CRC)
EP
Age (months) 66.0 (3.6) 64.9 (3.3)^ 65.8 (3.8)^ 65.2 (3.2)
Verbal IQ (est.) 91.8 (9.2) 90.7 (6.8)^ 92.4 (9.0)^ 92.7 (10.7)
Letter Name
2.5 (1.7)
Knowledge
2.4 (1.7) 2.0 (1.7) 2.4 (1.7)
Phoneme Elision 1.4 (1.5) 1.5 (1.5)^ 1.3 (1.5)^ 1.4 (1.6)
Sex Ratio 23M / 22F 26M / 19F^ 24M / 21F^ 23M / 22F
Racial Balance 24AF / 21W / 0H 23AF / 21W^ / 1H^ 22AF / 22W / 1H^ 25AF / 20W / 0H
AF=African W=White American H=Hispanic
screening variables, although the minority representation in this sample was higher than in the population from which the sample was selected. Pretests The 135 children in the three treatment groups were given a battery of pre-tests. The battery covered a wide variety of cognitive abilities and pre-reading skills in order to estimate child characteristics that might influence responsiveness to the study's educational interventions. The children in the no-treatment group did not receive the pretest battery, but their reading and phonological development was monitored over time using smaller batteries. The pretests were administered during the months of November and December of the children's first semester in Kindergarten. The pre-test battery included measures of three types of phonological processing including phonological awareness (Sound Matching, Sound Categorization, and Blending Phonemes), verbal short-term memory (Memory for Digits and Recalling Sentences), rapid automatic naming ability (Rapid Color Naming, Rapid Object Naming, Rapid Letter Naming). We also measured expressive and receptive language using four subtests (Oral Directions, Word Structure, Sentence Structure, and Recalling Sentences) from the Clinical Evaluation of Language Fundamentals- Revised (Semel, et al., 1987), general verbal ability (Listening Comprehension, Boston Naming Test), nonverbal ability (Pattern Analysis, Copying), and visual processing skill (Visual Matching, Visual Memory). Finally, we included a variety of measures of reading and reading related knowledge and skill (Word Identification and Word Attack subtests from the Woodcock Reading Mastery Test-Revised (Woodcock, 1987), a list of real words and list of nonwords that increased more gradually in difficulty than the standardized tests, and a measure of letter sound knowledge. We also sent home a general questionnaire about the home literacy environment. Each year we also asked the children’s classroom teachers to complete the The Multigrade Inventory for Teachers (Agronin, Holahan, Shaywitz, & Shaywitz, 1992) as a measure of academically related
phonemes in words using mouth/form pictures, colored blocks, and letters to represent the phonemes in words. Although children in this condition spent most of their time building phonemic awareness and phonemic decoding skills, they also began reading text as soon as they showed reasonably mastery of an initial group of 10 consonants and three vowels. We used the Poppin Readers (Smith, 1992) and the Early Literacy Series (Hannah, 1993) which have been specially produced to provide phonemically decodable text as children progress through the Auditory Discrimination in Depth program. As soon as children began work on multisyllable words, they did their oral reading in trade books or books they brought from class. Also at this point, they began receiving direct, fluency building practice in recognizing words from a list of words that occurred with high frequency in printed English (Fry, Kress, & Fountoukidis, 1993). During oral reading activities, the children were encouraged to rely on their skills in phonological decoding, but were also encouraged to ask whether the pronunciation of an unfamiliar word "makes sense" in the context of the story. Additionally, the teachers discussed the meaning of passages with the children in order to help focus their attention on the importance of comprehension as the end goal of the reading process. The Embedded Phonics (EP) program. In its early phases, the instructional periods in this program consisted of four main activities: a) learning to recognize small groups of whole words by using word level drill and word games, b) instruction in letter-sound correspondences in the context of the sight words being learned, c) writing the words in sentences, and d) reading the sentences that were written. Stimulation of phonological awareness was done during writing activities in which the children were asked to identify the beginning and subsequent sounds in words before writing them. Some letter sounds (short vowels, r-controlled vowels) were taught through memorization of picture-word cards, but most grapheme-phoneme correspondences were taught in the context of word reading and writing activities. As soon as soon as children had a small vocabulary of high frequency words, they began learning words from a basal series that contained short stories made from the words they were learning (HBJ Bookmark Series). Although the stories were read orally after the words in them were learned, the primary emphasis during the entire "basal" phase was on acquiring word level reading skills (sight vocabulary and phonemic decoding skills). Even when reading sentences, however, the children were consistently and explicitly shown how they could combine what they knew about the "sounds" in words with what they knew about the meaning of the sentence in order to help them identify individual words. After students finished the first grade reader ( Together We Go ) in the basal series, the emphasis of the program shifted from learning to read by writing to learning to read by reading. Student- teacher discussion focused on constructing the meaning of the stories that were read. Although less time was spent on individual word drills, the children continued to receive direct instruction in new "sight words", but rather than being taken from the basal series, their words came from the same list of high-frequency words that was used in the PASP (essentially the program used by CRC) program. Writing activities during this phase of instruction continued to include generation of sentences containing specific words, but also included more free writing and writing summaries of stories that were read.
The Regular Classroom Support Condition (RCS). The children assigned to this condition received individual tutoring in the activities and skills taught in their regular classroom reading programs. The activities provided to children in this group necessarily varied somewhat across the different schools in the study because of the slightly different orientations toward reading instruction of the regular classroom teachers involved in the study. The activities varied from "phonics" oriented activities such as explicit instruction in letter-sound correspondences, to intermediate activities involving sight word drill, to activities focusing on meaningful communication such as writing in journals or discussing stories that the teacher read. A more specific time by activity breakdown will be provided when the activities of all three instructional conditions are compared. Selection and training of tutors and volunteer The nine project tutors had varying degrees of experience teaching young children. At the time they were interviewed and selected to participate in the project, each of the tutors in the project had been rated by the project director on a five point scale in three areas related to experience and expertise in teaching reading. The tutors were matched in pairs on their total ratings, and one member of each pair was randomly assigned to either the EP or PASP (essentially the program used by CRC) conditions. The ninth tutor, whose total rating score was very close to the overall average, was assigned to the PASP condition. Tutors initially received 18 hours of training in the instructional program to which they were assigned. Training for tutors in the PASP (essentially the program used by CRC) program was provided by Patricia Lindamood, and tutors in the EP program were trained by Elaine Rose, who has used methods very similar to those in the EP program in University based and private clinical practice for approximately 15 years Each of the tutors was assigned to instruct children in the RCS condition as well as the EP or PASP (essentially the program used by CRC) program. However, since the RCS condition involved following the instructional suggestions of each child's regular classroom teacher, no special training was provided relevant to this condition. The tutors had an initial meeting with the child's regular classroom teacher in which the classroom reading program was discussed, and ways in which the project tutor could support that program were identified. Following this initial meeting, the project tutors met with the regular classroom teachers on a weekly or bi-weekly basis (depending upon teacher preference) to discuss specific instructional activities for children in the RCS condition. All tutors were carefully instructed not to use specific techniques from either the EP or PASP (essentially the program used by CRC) program in teaching children in the RCS group, unless those procedures were part of the child's regular classroom reading program. Once instruction began, our tutors met bi-weekly with their project consultant and the project director and coordinator for a three hour inservice training period (the PASP (essentially the program used by CRC) and EP groups met separately). During the week prior to these meetings,
instructional conditions in the number of either type of session, and the total average instructional time across conditions was about 88 hours (47 hours from tutors and 41 hours from volunteer). Time spent on various types of instructional activity was monitored in two different ways across conditions. Approximately one of every four tutor led sessions for the PASP (essentially the program used by CRC) and EP programs was video-taped for supervision purposes. In the RCS condition, tutors described the instructional activities that occurred within each session and classified them into one of four categories. They did not indicate the amount of time spent on each activity, but simply whether or not the activity was part of the session. Thus, for the PASP (essentially the program used by CRC) and EP programs, it was possible to estimate the percentage of instructional time spent on each activity, and for the RCS condition, it was possible to determine the frequency with which different types of instructional activities occurred across sessions. Although activities occurred in the PASP (essentially the program used by CRC) condition that did not occur in the EP condition, and vice versa, it was possible to identify three general categories of instructional activities that were roughly comparable across conditions. The first category involved the activities designed to stimulate phonological awareness, teach letter-sound correspondences, and practice reading and writing individual words in which the emphasis was on phonemic decoding. Over the course of the study, tutors in the PASP (essentially the program used by CRC) condition spent 74% of their time on this type of activity, verses 26% for the EP condition. The second category involved direct instruction and practice in acquiring sight words. Time spent on this activity in the PASP (essentially the program used by CRC) condition was 6%, while for the EP condition, it was 17%. The last category involved reading or writing connected text, which included sentence to book level activity. Twenty percent of the time in the PASP condition was spent on this activity, compared to 57% in the EP condition. According to these estimations, children in the PASP condition spent significantly more time developing phonological awareness and phonemic decoding abilities, whereas children in the EP condition spent significantly more time learning sight words and participating in meaningful print experiences. The tutors in the RCS condition were asked to classify their instructional activities in each session into one of four categories. The categories were: (1) sight word learning; (2) phonological awareness and phonemic decoding; (3) spelling; and, (4) meaning-emphasis activities with connected text. Over the course of the study, the total frequency of occurrence of these different types of activity within sessions was 24% for sight word activities, 24% for phonics activities, 9% for spelling activities, and 43% for meaning-emphasis activities. Thus, although the specific activities focused on different content, the overall distribution of instructional focus for the RCS program was more similar to the EP program than to the PASP (essentially the program used by CRC) program. Results
Preliminary Analyses Over the two and a half years of the study, we experienced a 23% drop out rate, so that the sample at the end of second grade contained 138 children. The number of children remaining in each condition was 32, 37, 33, and 36 for the control group, RCS, PASP (essentially the program used by CRC) , and EP groups, respectively. The only children who were lost from the study were those who moved to distant communities, since we followed children as they changed schools locally. When we began the study, the children were attending 13 elementary schools, and by the end of the study, they were scattered among 23 different schools. Twenty six percent of the sample had been retained in either kindergarten or first grade, and there was a significant difference in retention rate across conditions, χ^2 (3) = 8.7, p < .05, with the percentages for the no treatment group, RCS, EP, and PASP (essentially the program used by CRC) conditions being 41%, 30%, 25%, and 9%, respectively. The percentage of children who were referred for special services in the schools, either special education or Title 1 reading programs, also differed (NTC = 22%, RCS = 24%, EP= 42%, and PASP = 18%). Although the difference was not statistically significant in the overall comparison, χ^2 (3) = 5.8, p > .05, if just the two experimental conditions (PASP vs. EP) are compared, the difference in referral rate for special services is very reliable, χ^2 = 13.7, p < .01. The difference in retention rate across conditions presents two kinds of problems for determining the instructional effects of our interventions. If first and second grade children are combined together in the analyses, then the different conditions would contain disproportionate numbers of children who had not received second grade level classroom instruction. This would constitute an obviously confounding difference in the "background" instructional experiences of children across conditions. However, it could be argued that second grade level instruction would be too difficult (and hence unprofitable) for the children who were retained, and comparisons involving all the children provides the most realistic assessment of the "practical" effects of each instructional condition. The obvious alternative to using all children in the analyses would be to equate conditions on background instructional experiences by using only children who had completed second grade at the end of the study. However, this type of analysis would seriously underestimate the differential effects of the instruction provided to the PASP (essentially the program used by CRC) group, because a higher percentage of children with the most serious learning problems (assuming that was the cause of their retention) would be eliminated from the other groups. For example, because of the high proportion of retentions in the no treatment control group, there were only 19 children in this group in second grade at the end of the study. What would it mean to compare the scores of this select group of children (very likely the most intact learners in the group) to a much more complete group of children from the PASP condition?
