Aptitude–Treatment Interactions Revisited: Effect of Metacognitive Intervention on Subtypes of Written Expression in Elementary School Students

We examined the effectiveness of a metacognitive intervention for written language performance, based on the Hayes model of written expression, for 73 fourth-grade (n = 38) and fifth-grade (n = 35) students. The intervention consisted of twenty 45-min writing lessons designed to improve their awareness of writing as a problem-solving process. Each of the lessons addressed some aspect of planning, translating, and reflecting on written products; their self-regulation of these processes; and actual writing practice. All instruction was conducted in intact classrooms. Prior to the intervention, all students received a battery of neurocognitive tests measuring executive functions, attention, and language. In addition, preintervention writing samples were obtained and analyzed holistically and for errors in syntax, semantics, and spelling. Following the intervention, the writing tasks were readministered and cluster analysis of the neurocognitive data was conducted. Cluster analytic procedures yielded 7 reliable clusters: 4 normal variants, 1 Problem Solving weakness, 1 Problem Solving Language weaknesses, and 1 Problem Solving strength. The response to the single treatment by these various subtypes revealed positive but modest findings. Significant group differences were noted for improvement in syntax errors and spelling, with only spelling showing differential improvement for the Problem Solving Language subtype. In addition, there was a marginally significant group effect for holistic ratings. These findings provide initial evidence that Writing Aptitude (subtype) x Single Treatment interactions exist in writing, but further research is needed with other classification schemes and interventions.

Contribution of Lower Order Skills to the Written Composition of College Students With and Without Dyslexia

There has been a growth in students with dyslexia attending university. These students commonly rate writing as one of their greatest problem areas. Our research set out to describe the effects of dyslexia on the writing skills of students compared to age-matched peers and a spelling-skill-matched group. Generally, the texts of the students with dyslexia were poorer than age controls but not poorer than the spelling-skill controls. However, there were no major differences in "higher order" skills such as ideas and organization with the chronological age controls, only in "lower order" transcription skills such as spelling and handwriting fluency. The students with dyslexia made more spelling errors in their essays than one would predict given their dictated spelling skills.

Pilot study of telephone tutoring in reading skills

This study tested the feasibility of tutoring children in reading via telephone sessions. 19 children received tutoring from any of 6 tutors for an average of 7.6 hr. per month. Initially, these children were an average of 10.4 yr. old, in average Grade 4.8, and averaged 2.9 grade levels behind their grade expectations on the Slosson Oral Reading Test. Before tutoring the children had progressed on the Slosson at an average of 0.44 grade levels per year (95% CI = 0.30 to 0.57). The children participated in telephone tutoring for an average of 1.5 yr. During tutoring the students progressed at an average of 2.0 grade levels per year (95% CI = 1.2 to 2.8). The rate of progress during tutoring was significantly greater than that before tutoring (p<.001). The relations between tutors and students appeared to be positive and pleasant. Telephone tutoring seems to be a practical and feasible service delivery method which should be tested further.

Double-decision lexical tasks in thought-disordered schizophrenic patients: a path towards cognitive remediation?

It has been shown that schizophrenics have certain difficulties in the processing of semantic context. These difficulties have usually been evaluated using lexical decision tasks with semantic priming. In this study, we chose to examine the idea of an abnormality in the early stages of semantic context processing in thought-disordered schizophrenics using two double lexical decision tasks: one with a high (25%) and one with a low (15%) proportion of related words to assess the participants' competency in controlled and possibly also more automatic context processing. The results obtained in 40 control participants and 40 schizophrenic patients revealed no significant differences in the amplitude of semantic priming between the two groups. These results suggest that, in the disorganized schizophrenic subjects evaluated in this study, the context processing processes mobilized by the employed tasks were unimpaired.

Neuropsychological intervention in kindergarten children with subtyped risks of reading retardation

Kindergarten children at risk of developing language problems were administered the Florida Kindergarten Screening Battery. A principal components analysis revealed a verbal and a visual-spatial component and subsequent discriminant function analyses a high verbal/low visual-spatial group (LAL: Latent L) and a high visual-spatial/low verbal group (LAP: Latent P). LAL- and LAP-children were considered at risk for developing an L- or P-type of dyslexia, respectively. As is common practice with children suffering from manifest L- or P- dyslexia, the LAL- and LAP-kindergartners received right and left hemisphere stimulation, respectively. The outcomes were compared with those of bilateral hemispheric stimulation and no intervention. Reading tests were administered in primary school Grades 1 and 5/6; teachers' evaluation of reading took place in Grade 5/6. Overall, the LAL- and LAP- groups showed significant backwardness in word and text reading, both at early and late primary school. Types of intervention made a difference though: not significantly backward in early word, late word, and late text reading were the LAL-children who had received right hemisphere stimulation. Nonintervened LAP-children did not show significant backwardness in early word reading and late text reading, nor did LAP-children who had received left hemisphere or bilateral stimulation. Early text reading was not affected by any treatment. Teacher's evaluations were in support of these findings.

Strategies for Lowering Attrition Rates and Raising NCLEX-RN ® Pass Rates

This study was designed to determine strategies to raise the NCLEX-RN pass rate and lower the attrition rate in a community college nursing program. Ex-post facto data were collected from 213 former nursing student records. Qualitative data were collected from 10 full-time faculty, 30 new graduates, and 45 directors of associate degree nursing programs in Texas. The findings linked the academic variables of two biology courses and three components of the preadmission test to completion of the nursing program. A relationship was found between one biology course, the science component of the preadmission test, the HESI Exit Examination score, and the nursing skills course to passing the NCLEX-RN. Qualitative data indicated preadmission requirements, campus counselors, remediation, faculty, test-item writing, and teaching method were instrumental in completion of the program and passing the NCLEX-RN.

Layers of reading intervention in kindergarten through third grade: changes in teaching and student outcomes

In this study, students and their teachers participated in a layered approach to reading intervention in kindergarten through third grade that included professional development for teachers in scientifically based reading instruction, ongoing measurement of reading progress, and additional small-group or individual instruction for students whose progress was insufficient to maintain grade-level reading achievement. Reading outcomes were compared with historical control groups of students in the same schools. The findings revealed overall improvements in reading, improved reading for students who began the study in high-risk categories, and decreases in the incidence of reading disability at the end of third grade. Implications for scaling up are discussed.

An Evaluation of the Nursing Success Program

The Nursing Success Program was developed to enhance retention of baccalaureate nursing students. Reading comprehension scores are used to identify students who are at risk for failure and direct them into the retention program that addresses their skill deficits. To evaluate the program, the authors assessed reading comprehension, graduation rates, and ethnic diversity.

A Review of Intervention Studies to Promote NCLEX-RN Success of BaccalaureateStudents

Numerous studies have identified factors to predict NCLEX-RN but few have evaluated interventions to promote success. An integrative literature review of intervention studies used in baccalaureate programs to improve NCLEX-RN success demonstrated that although pass rates increased, researchers were limited in their ability to attribute success specifically to the interventions. Further investigation using more rigorous designs with larger, diverse student groups to evaluate both type and timing of various interventions is recommended.

Rehabilitation strategies for patients with homonymous visual field defects

Homonymous visual field defects (HVFDs) are among the most common disorders that occur in brain damage, particularly after stroke. They lead to considerable disabilities, particularly with reading and visual exploration. A variety of different approaches, including optical aids and visual training techniques, have been examined for the rehabilitation of these HVFDs. Despite the considerable ingenuity that has been applied and anecdotal evidence that has accumulated, rigorously controlled trials that clearly establish efficacy of any method are lacking.

Phonologische und orthographische Verarbeitungsfähigkeiten in der Worterkennung und Rechtschreibung legasthener Jugendlicher und junger Erwachsener im Deutschen und Englischen

The present study addressed the question whether there is a relationship between phonological and orthographic processes of reading and spelling in adolescents and young adults with and without dyslexia in German and English. On the evidence of the Linguistic Coding Differences Hypothesis and results of the latest research in foreign language learning the hypothesis is tested if there is a relationship between phonological and orthographic knowledge on the one hand and decoding and spelling performance on the other hand in German adolescents and young adults reading and spelling German and English words. This hypothesis was tested with the statistical method of structural equation modeling and therefore the research population was divided into the following groups: group 1 with dyslexia in reading (n = 93), group 2 with dyslexia in spelling (n = 93), group 3 without dyslexia in reading (n = 95), and group 4 without dyslexia in spelling (n = 95). Results of data analysis show that the postulated prediction model fits only the data of the dyslexia group for reading and spelling, but not for the control group. Also the model for both groups does not fit. The results of the pilot study show that it is necessary to modify diagnostic instruments of measurement and to separate scales of phonological and orthographic processes.

Évaluation ouverte de l’efficacité de la prise en charge en milieu spécialisé de 31 enfants avec un trouble spécifique sévère du langage oral/écrit

INTRODUCTION

Up to 3 percent of the children in France present severe and specific language and/or reading disorders, despite regular remedial therapies. Few studies have measured the effectiveness of treatment administered in a specialist unit.

PATIENTS AND METHOD

The aims of this study, focusing on children diagnosed as dysphasic and/or dyslexic, were: During the academic year 2001-2002, 31 children (18 dyslexic and 13 dysphasic) were attending school in our unit. The teaching program and intensive speech therapy (3 hours/week) were tailored for each child according to his/her specific disorders. Reading, spelling and numeracy developmental skills of each child were evaluated by appropriate tools at the beginning and at the end of the year. Impairment was defined by measuring the gap between the observed and the expected skills, according to each child's age. Using a self-control method, progress achieved by each child throughout the year was calculated with each tool, in each subject, by subtracting the impairments disclosed at the beginning from those disclosed at the end of the year. Progression was classified within three groups according to the progress normally expected over an academic year (i.e. nine months) from children with no disabilities attending school regularly; a progression fewer than three months was considered as no progression. Uni- and multivariate analyses including age (< or= or />9), type of pathology (dysphasia/dyslexia), and intellectual quotient (IQ) as covariates was carried out to search for independent prognosticators.

RESULTS

The entire group demonstrated during the year significant progress for reading (p = 0.0001), spelling (p = 0.0001) and numeracy (p = 0.0001). Nineteen children (61 percent) showed more progress in reading than normally expected over nine months. Out of the remaining 12 children, 10 demonstrated more progress in spelling and/or numeracy than normally expected over nine months. All three reading evaluation tools disclosed a progression although one was less efficient (p = 0.05). Multivariate analysis disclosed age< or=9 and dysphasia as independent progress prognosticators.

CONCLUSION

Placement in a specialist unit allows children suffering from severe dyslexia and dysphasia to lessen the gap in reading, spelling and numeracy. The two prognosticators disclosed highlight the importance of early diagnosis (i.e. before nine years old) and treatment of specific language and/or reading disorders.

Tachistoscopic treatment of dyslexia changes the distribution of visual–spatial attention

Twelve children with developmental dyslexia underwent a four-month treatment with tachistoscopic presentation of words, according to Bakker's methodology. One group received standard lateral presentation of words on a PC screen, while the other group received the same stimuli in random lateral position. The spatial distribution of visual attention was measured by means of the Form-Resolving Field (FRF; ), which was administered along with reading tests, before and after treatment. The FRF of children who received random presentation widened at -12.5 degrees on the left side, while the FRF in the group that received standard lateral presentation narrowed at that position. Both groups significantly improved in reading accuracy for both words and nonwords. Some hypotheses are proposed concerning the mechanisms responsible for the changes in the FRF and their correlation with improvements in word and nonword reading. The results of the present study are also compared with data suggesting a left "minineglect" in dyslexia.

Understanding college students with learning disabilities

The percentage of full-time college freshmen reporting disabilities at 4-year institutions remained stable (6-8%) between 1988 and 2000. By 2000, two in five freshmen with disabilities (40%) reported having a learning disability. In 2002, learning disabilities accounted for 51% of special education classifications. The effects of chronic school failure frequently shape the experience of students with learning disabilities. This article reviews common learning disabilities found in college students and provides suggestions for helping these students.

Auditory training improves neural timing in the human brainstem

The auditory brainstem response reflects neural encoding of the acoustic characteristic of a speech syllable with remarkable precision. Some children with learning impairments demonstrate abnormalities in this preconscious measure of neural encoding especially in background noise. This study investigated whether auditory training targeted to remediate perceptually-based learning problems would alter the neural brainstem encoding of the acoustic sound structure of speech in such children. Nine subjects, clinically diagnosed with a language-based learning problem (e.g., dyslexia), worked with auditory perceptual training software. Prior to beginning and within three months after completing the training program, brainstem responses to the syllable /da/ were recorded in quiet and background noise. Subjects underwent additional auditory neurophysiological, perceptual, and cognitive testing. Ten control subjects, who did not participate in any remediation program, underwent the same battery of tests at time intervals equivalent to the trained subjects. Transient and sustained (frequency-following response) components of the brainstem response were evaluated. The primary pathway afferent volley -- neural events occurring earlier than 11 ms after stimulus onset -- did not demonstrate plasticity. However, quiet-to-noise inter-response correlations of the sustained response ( approximately 11-50 ms) increased significantly in the trained children, reflecting improved stimulus encoding precision, whereas control subjects did not exhibit this change. Thus, auditory training can alter the preconscious neural encoding of complex sounds by improving neural synchrony in the auditory brainstem. Additionally, several measures of brainstem response timing were related to changes in cortical physiology, as well as perceptual, academic, and cognitive measures from pre- to post-training.

The development of a computer-assisted cognitive remediation program for patients with schizophrenia

In the last decade, impairments in several cognitive domains have been recognized as a central feature of schizophrenia. Consistent evidence has accumulated that documents the contribution of these deficits to poor outcome in social and occupational functioning, and thus they are important targets for psychosocial as well as pharmacological intervention. After reviewing the literature on cognitive remediation for brain injury as well as schizophrenia patients, consulting with research groups which have implemented cognitive remediation programs for schizophrenia, and conducting pilot work with patients, our group has developed a broadly-targeted computer-based remediation intervention that is based on using exercises that engage several cognitive capacities simultaneously, teaching of a set of cognitive strategies by a supportive therapist in a one-on-one setting, and addressing many of the treatment issues that are specific to schizophrenia. The strategies that are emphasized in the intervention are derived from the learning and remediation literatures and include the following: 1) Verbalization to enhance encoding and recall of stimuli; 2) Breaking problems down to promote organized problem solving; 3) Articulation of problem solving to encourage deliberate responding and self-monitoring; 4) Self-checking of performance and adjustment as necessary; 5) Strategic probe questions to prompt participants to monitor their work and make planful responses; 6) Scaffolding aids to provide ongoing support as needed. We are currently conducting a randomized trial of the intervention in which patients complete 24 sessions of remediation or an equivalent number of sessions with a therapist using computer games that have minimal cognitive demand. Our initial experience with the intervention is encouraging and suggests that it is feasible, the tasks are extremely well-received and patients are willing to come to the clinic several times per week to work on them. It is premature to assess whether participation in cognitive remediation is effective in improving cognition, but patients have thus far demonstrated improvement on trained computer exercises. The potential of psychosocial and pharmacological interventions, alone and in combination, for cognitive impairment in schizophrenia is a promising research issue.

Psychoanalysis as cognitive remediation: Dynamic and Vygotskian perspectives in the analysis of an early adolescent dyslexic girl

The interface of neurocognitive problems and dynamic concerns are examined in the treatment of an early adolescent dyslexic girl. Despite previous intensive remediation, she had been unable to master reading and spelling, but made remarkable progress after a relatively brief period of psychoanalysis. Psychoanalytic and Vygotskian perspectives are integrated to provide a model of how play, within the analytic context, is mutative for learning disabled children. Through the process of reexteriorization in the transference, play allows for the interpretation and resolution of traumatic situations which have become associated with learning. As the act of learning becomes separate from the personal and affective context in which it took place, the child gains access to other, more normative, functions of play. These functions include the development of the capacity to separate meaning from action and the ability to understand words as generalized categories which represent objects, rather than being part of the specific object named. These two capacities, fundamental to the development of abstract thought, will support reflective awareness and help modulate affective states. The abilities furthered in play also act to remediate one component of dyslexia-the difficulty separating context from more abstract bits of knowledge. Finally, the child learns to "play at reality, " often trying on the new role of "student". As Vygotsky notes, play is essential in allowing the child to become aware of what she knows. For a dyslexic child, for whom reading may never become completely a part of procedural memory, becoming conscious of what he knows may also enhance mastery of the skills of phonological processing, albeit more slowly than normally developing readers. The pleasure in play and the repetition it generates aids the internalization of the task and the development of automaticity.

Student retention practices in associate degree, entry-level dental hygiene programs

PURPOSE

The main purpose of this study was to investigate student retention strategies and practices implemented in associate degree, entry-level dental hygiene programs. Included are student attrition issues, academic standards, re-entry policies, and clinical remediation strategies.

METHODS

A survey consisting of forced choice and open-ended questions was mailed to 31 randomly selected associate degree, entry-level dental hygiene programs. Surveys were analyzed using descriptive statistics and frequency distributions. Open-ended questions were analyzed using the constant comparative qualitative method to identify recurring themes.

RESULTS

There was an 80% (n=25) return response to the survey. The findings of this study determined that dental hygiene programs are graduating, on average, a higher percentage (83%) of students when compared to two-year, associate degree programs in general (46%). The primary reasons reported by respondents for student attrition included: academic difficulties (88%), dissatisfaction with career choice (76%), family/personal responsibilities (72%), and clinical skill difficulties (56%). A wide variety of retention strategies were reported. Those most often cited were academic remediation (92%), clinical skill development/remediation (84%), academic advising (84%), financial aid assistance (84%), and tutoring (80%). Participating programs also reported setting high academic and ethical standards. Specific criteria for student re-entry were discussed.

CONCLUSION

The findings of this study suggest that associate degree, entry-level dental hygiene programs are committed to student retention and make considerable efforts to help students succeed. Student retention efforts could be enhanced for those student groups identified as possibly being at high risk for attrition. The findings and recommendations in this investigation may assist associate degree, entry-level dental hygiene programs in their efforts to retain a higher percentage of students.

[Training children in event recall: benefits of a brief narrative elaboration training]

The present study evaluates a training designed to enhance children's free reports about an observed event. A total of 64 children aged 6 and 9 years was included. All participants watched a short video and were individually questioned about it one week later. Half of the children were trained previous to the interview to use picture cards as retrieval cues. There were 4 picture cards to help remembering setting, persons, actions and dialogues and emotions of the persons. Results revealed a clear age effect and a significant increase in the amount of correctly remembered information in the training group, while the amount of incorrectly remembered information was equal in both groups. Therefore, the easy-to-use training has been shown to improve children's event reports. Results are discussed with regard to earlier training studies.

Establishing Progression Policies with the HESI Exit Examination: A Review of the Evidence

Schools of nursing across the United States are seeking ways to ensure their pass rates on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) remain above acceptable levels. One way schools of nursing have been seeking to ensure adequate pass rates is by implementing progression policies. These policies prevent students from taking the NCLEX-RN by either preventing student graduation or withholding permission by the school for the student to take the examination. Many of these policies rely heavily, and sometimes solely, on the Health Education Systems, Incorporated (HESI) Exit Examination as a primary predictor of students' NCLEX-RN outcomes. While the HESI Exit Examination can be a useful tool as part of a school's assessment program, it is not able to accurately predict NCLEX-RN failure; therefore, educators are cautioned in using it as the sole predictor of NCLEX-RN outcomes. Schools would be well served by considering more of the evidence available on predictors of student NCLEX-RN outcomes when considering implementation of progression policies.

The Use of Discriminant Function Analysis to Predict Student Success on the NCLEX-RN

Predicting whether a student will be successful on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) has been an important endeavor for faculty in schools of nursing for the past 2 decades. Extensive documentation exists in the literature concerning research aimed at exploring the academic and nonacademic predictors of success on the NCLEX-RN. Reviews of the findings of these studies indicate that various factors emerge as academic predictors of success. The results of this study suggest that first-time success on the NCLEX-RN can be predicted with a high level of accuracy using existing student data. The findings also support the belief that it is possible to identify students who may be at risk for unsuccessful first time performance on the NCLEX-RN. Early identification of at-risk students will promote timely intervention strategies to optimize the students' potential for success.

Early reading instruction for children with reading difficulties: meeting the needs of diverse learners

Several multiple-probe-across-participants design studies were employed to evaluate the effectiveness of a supplemental tutoring intervention using Read Well (Sprick, Howard, & Fidanque, 1998-2000). In Year 1, we conducted two studies with 7 first-, second-, and third-grade children (1 girl and 6 boys), who were classified as having learning disabilities, having attention-deficit disorder, or being English language learners and were identified by their teachers as poor readers. The results of the two studies indicated that 3 of the 5 children who received Read Well instruction showed improvement in passage fluency. Student performance on other measures of reading and comprehension was varied. Differences in student characteristics and in the amount of Read Well instruction received (2 to 7 weeks) seemed to account for the differences in performance. In Year 2, we implemented the same tutoring intervention for a longer duration (up to 16 weeks) and included 5 children in second and third grades (2 girls and 3 boys) with reading difficulties. Two of these children had previously participated in the Year 1 studies. The results indicated growth in reading, spelling, and comprehension for most children. Overall, the findings from Year 1 and 2 studies indicate the benefits of increased instructional intensity and duration for children who struggle with emerging reading skills.