Behavioral Attention: A Longitudinal Study of Whether and How It Influences the Development of Word Reading and Reading Comprehension among At-Risk Readers

Language and reading in attention-deficit/hyperactivity disorder and comorbid attention-deficit/hyperactivity disorder + developmental language disorder

Background

The current study sought to examine whether psycholinguistic assessments could discriminate children and adolescents with developmental language disorder (DLD) from those with attention-deficit/hyperactivity disorder (ADHD; combined or inattentive subtype) and comorbid DLD + ADHD.

Methods

The Clinical Evaluation of Language Fundamentals-Screening Test (CELFST; Wiig et al., 2013), the Comprehensive Test of Phonological Processing (nonword repetition subtest; Wagner et al., 2013), and the Test of Word Reading Efficiency (sight word and phonemic decoding subtests; Torgesen et al., 2012) were examined in 441 children and adolescents between 6 and 16 years of age.

Results

The presence of a language disorder (with or without ADHD) predicted poor performance across tasks. Children and adolescents with ADHD (combined vs. inattentive) only significantly differed in sight word reading, in favor of those with combined type. Measures of reading efficiency could distinguish between the two types of ADHD, but not between other groups. Interestingly, scores on the standard language screener were no worse for children with ADHD + DLD than children with DLD only.

Conclusions

The combination of comorbid ADHD + DLD did not appear to be associated with lower language abilities, sight word reading, or phonemic decoding relative to DLD alone. Reading efficiency was effective in discriminating between ADHD subtypes. These findings offer valuable insights into differential diagnosis and the identification of comorbidity.

The Engaged Learners Program: Effects on Student Engagement During Small Group Reading Instruction

In this study we tested the usability, feasibility, social validity, and effectiveness of Engaged Learners, a behavior support program designed to be integrated into small group reading interventions. Participants included eight Grade 3 to 5 students with co-occurring reading difficulties and inattention. A concurrent multiple-baseline design was utilized to test the effects of Engaged Learners on engagement outcomes. Visual analysis and effect sizes indicated an improvement in engagement for seven students. Interventionists and students viewed the Engaged Learners program to be effective and socially valid. Limitations included lower than expected levels of fidelity for one interventionist and high student absenteeism. More research is needed to identify the extent to which Engaged Learners can support reading outcomes. Educators seeking an effective behavior support program that requires minimal training and coaching may consider integrating Engaged Learners into their small group reading instruction.

Cognitive Predictors of the Overlap of Reading and Math in Middle School

Math and reading skills are known to be related, and predictors of each are well researched. What is less understood is the extent to which these predictors, uniquely and collectively, overlap with one another, are differentially important for different academic skills, and account for the overlap of math and reading. We examined 20 potential predictors from four domains (working memory, processing speed, attention, and language) using latent variables and both timed and untimed achievement skill, in a sample (N=212) of at-risk middle schoolers, half of whom were English learners. The predictors accounted for about half of the overlap among achievement skills, suggesting that other factors (e.g., domain specific skills) might also be relevant for the overlap. We also found some differential prediction (language for reading, working memory for math). The present results extend and refine our understanding of the contribution of these cognitive predictors for reading and math.

Contributions of attentional control, hyperactivity-impulsivity, and reading skills to performance on a fourth-grade state writing test

Writing proficiency facilitates higher achievement in educational and professional endeavors, yet most students fail to meet national writing benchmarks by the end of high school. Attentional control and overall reading skill are documented to result in better writing quality; however, most research on these relationships has focused on early elementary students (K-3rd grade. This project evaluated the relationship between attentional control, hyperactivity-impulsivity, word reading, and reading comprehension to overall writing performance on a high-stakes writing test. Participants included 266 fourth-grade struggling readers who completed the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN; Swanson et al., 2001, 2012) for attentional control and hyperactivity-impulsivity, the Woodcock-Johnson III (WJ-III; Woodcock et al., 2001) Letter-Word Identification test for word reading, the WJ-III Passage Comprehension test for reading comprehension, and the State of Texas Assessments of Academic Readiness (STAAR) writing test for overall writing. Hyperactivity-impulsivity was not related to word reading (β = 0.02, p > .05), reading comprehension (β = 0.06, p > .05), or writing (β = 0.14, p > .05), whereas attentional control (β = 0.51, p < .01) and reading comprehension (β = 0.55, p < .001) contributed to overall writing. Reading comprehension (β = 0.55, p < .01) had a greater impact on writing than word reading (β = 0.13, p > .05), which suggests that as academic rigor increases in the upper elementary school grades (4th grade and higher), basic skills are less predictive of success on complex tasks such as writing. Implications for increasing writing proficiency through research and practice are discussed.

Evaluating the Simple View of Reading for Children With Attention-Deficit/Hyperactivity Disorder

The 'simple view of reading' is an influential model of reading comprehension which asserts that children's reading comprehension performance can be explained entirely by their decoding and language comprehension skills. Children with ADHD often exhibit difficulty across all three of these reading domains on standardized achievement tests, yet it is unclear whether the simple view of reading is sufficient to explain reading comprehension performance for these children. The current study was the first to use multiple indicators and latent estimates to examine the veracity of key predictions from the simple view of reading in a clinically-evaluated sample of 250 children with and without ADHD (ages 8-13, Mage=10.29, SD=1.47; 93 girls; 70% White/Non-Hispanic). Results of the full-sample structural equation model revealed that decoding and language comprehension explained all (R2=.99) of the variance in reading comprehension for children with and without ADHD. Further, multigroup modeling (ADHD, Non-ADHD) indicated that there was no difference in the quantity of variance explained for children with ADHD versus clinically-evaluated children without ADHD, and that the quantity of explained variance did not differ from 100% for either group. Sensitivity analyses indicated that these effects were generally robust to control for monomethod bias, time sampling error, and IQ. These findings are consistent with 'simple view' predictions that decoding and language comprehension are both necessary and together sufficient for explaining children's reading comprehension skills. The findings extend prior work by indicating that the 'simple view' holds for both children with ADHD and clinically-evaluated children without ADHD.

Are Reading Interventions Effective for At-Risk Readers with ADHD? A Meta-Analysis

OBJECTIVE

Utilizing a multi-level meta-analytic approach, this review is the first to systematically quantify the efficacy of reading interventions for school-aged children with ADHD and identify potential factors that may increase the success of reading-related interventions for these children.

METHOD

18 studies (15 peer-reviewed articles, 3 dissertations) published from 1986 to 2020 (N = 564) were meta-analyzed.

RESULTS

Findings revealed reading interventions are highly effective for improving reading skills based on both study-developed/curriculum-based measures (g = 1.91) and standardized/norm-referenced achievement tests (g = 1.11) in high-quality studies of children with rigorously-diagnosed ADHD. Reading interventions that include at least 30 hours of intervention targeting decoding/phonemic awareness meet all benchmarks to be considered a Level 1 (Well-Established) Evidence-Based Practice with Strong Research Support for children with ADHD based on clinical and special education criteria.

CONCLUSIONS

Our findings collectively indicate that reading interventions should be the first-line treatment for reading difficulties among at-risk readers with ADHD.

Comorbidity in Reading Comprehension and Word-Problem Solving Difficulties: Exploring Shared Risk Factors and Their Impact on Language Minority Learners

The purpose of this study was threefold: to examine unique and shared risk factors of comorbidity for reading comprehension and word-problem solving difficulties, to explore whether language minority (LM) learners are at increased risk of what we refer to as higher order comorbidity (reading comprehension and word-problem solving difficulties), and to examine the profiles of at-risk LM learners compared with at-risk non-LM learners. At-risk (LM n = 70; non-LM n = 89) and not-at-risk (LM n = 44; non-LM n = 114) students were evaluated on foundational academic (word reading, calculation), behavioral (behavioral attention), cognitive (working memory, processing speed, nonverbal reasoning), and language (vocabulary, listening comprehension) measures in English. Results indicated listening comprehension was the only shared risk factor for higher order comorbidity. Furthermore, LM learners were 3 times more likely to be identified as at risk compared with non-LM learners. Finally, among at-risk learners, no differences were found on cognitive dimensions by language status, but LM learners had lower reading and listening comprehension skills than non-LM learners, with a relative advantage in behavioral attention. Results have implications for understanding higher order comorbidity and for developing methods to identify and intervene with higher order comorbidity among the growing population of LM learners.

Connections between Mathematics and Reading Development: Numerical Cognition Mediates Relations between Foundational Competencies and Later Academic Outcomes

We examined longitudinal relations between 1^st-grade cognitive predictors (early nonverbal reasoning, processing speed, listening comprehension, working memory, calculation skill, word-problem solving, word-reading fluency, attentive behavior, and numerical cognition) and 2^nd-grade academic outcomes (calculations, word-problem solving, and word reading) in 370 children (M _age = 6.55 years, SD _age = 0.33 years at the start of the study) who were identified as at-risk or not-at-risk for mathematics disability. Path analysis mediation models revealed that numerical cognition, assessed at an intermediary timepoint, mediated the effects of processing speed, working memory, calculation skill, word-problem solving, and attentive behavior on all 3 outcomes. Findings indicate that multiple early domain-general cognitive abilities are related to later mathematics and reading outcomes and that numerical cognition processes, which may track ease of forming symbol-concept associations, predict later performance across both academic domains.

Does preschool children's self-regulation moderate the impacts of instructional activities? Evidence from a randomized intervention study

There is strong evidence linking children's self-regulation with their academic and behavioral outcomes. These relations have led to the development of interventions aimed at improving academic outcomes by promoting self-regulation, based in part on the idea that self-regulation promotes the development of academic skills. Although a considerable number of studies have examined the degree to which interventions designed to improve aspects of self-regulation have a positive impact on academic outcomes, only a few studies have examined the degree to which children's self-regulation moderates the effects of academic interventions. The goal of this study was to examine whether self-regulation, indexed by a direct assessment of executive function and teacher-rated attention, moderated the uptake of early literacy interventions for 184 children (average age = 58 months, SD = 3.38; 66% Black/African American, 28% White; 59% male) at risk for reading difficulties who participated in a randomized controlled trial examining the efficacy of Tier 2 interventions in preschool. Multilevel models were used to examine the degree to which children's self-regulation moderated the impacts of the interventions. The results of this study provided little evidence that self-regulation moderated the impacts of the interventions and call into question the likelihood of a causal relation between self-regulation and academic achievement.

The Effects of Choice on the Reading Comprehension and Enjoyment of Children with Severe Inattention and no Attentional Difficulties

It has been proposed that enhancing motivation supports the learning of children with Attention Deficit Hyperactivity Disorder (ADHD). Less is known if inattentive children with no ADHD diagnosis may similarly benefit, when being motivated to engage in an academic task. Using a repeated-measures design, this study investigated the effects of text choice as an intrinsic motivator on the reading comprehension and enjoyment of Year 4 children attending mainstream primary schools (N = 92; aged 8–9 years; 48 boys); comparing those with no attentional difficulties and severe inattention. We hypothesized that 1) choice would increase reading comprehension and enjoyment 2) choice would increase the reading comprehension and enjoyment of children both with severe inattention and no attentional difficulties 3) choice effects would be significantly greater for children with severe inattention than those with no attentional difficulties. Children participated in a reading intervention that included a Choice (experimental) and a No Choice (control) condition. Child inattention was measured via a Virtual Reality Continuous Performance Task (Omission errors, Reaction Time Variability) and Teacher Ratings. Choice significantly increased reading comprehension, but not enjoyment compared with no choice. Choice improved the reading comprehension of children with both severe inattention and no attentional difficulties. Choice did not benefit the reading of severely inattentive children more than that of children with no attentional difficulties. These findings underline the educational benefits of choice for young readers both with severe inattention and no attentional difficulties, which are further discussed drawing on existing theory and research.

Sustained attention and behavioral ratings of attention in struggling readers

Attention is correlated with reading, but the extent to which behavioral ratings and sustained attention relate to reading skills is unclear. We assessed 245 4th and 5th grade struggling readers (mean age = 10.3 years) on behavioral ratings of attention, sustained attention, and reading over a school year. Contributions of behavioral ratings and sustained attention were considered cross-sectionally and longitudinally in the context of other important predictors of reading. Results suggest that sustained measures and behavioral ratings assess distinct, yet overlapping, aspects of attention. Both types of attention accounted for unique variance in comprehension, but not word reading accuracy or fluency, when evaluated cross-sectionally. Results also support the role of behavioral ratings of attention in fluency and in comprehension growth. Findings suggest that multidimensional assessment of attention is useful when considering its relation to reading, and highlights the need to integrate conceptualizations of attention that arise from different theoretical approaches.

Narrative comprehension and engagement with e-books vs. paper-books in autism spectrum condition

BACKGROUND AND AIMS

Children with autism spectrum condition often have specific difficulties with narrative comprehension, a skill which has a strong association with both concurrent and longitudinal reading comprehension. A better understanding of narrative comprehension skills in autism spectrum condition has the potential to provide insight into potential later reading comprehension difficulties and inform early targeted intervention. In the current study, the main objective was to investigate how differences in the medium of story presentation (paper-book vs. e-book) and differences in story narration (adult narration vs. in-app narration) would influence narrative comprehension in general, and between groups (autism spectrum condition and a receptive language-matched control group). We were also interested in how task engagement (visual attention and communication) differed between group and conditions and whether task engagement was related to narrative comprehension.

METHOD

Forty-two children with autism spectrum condition and 42 typically developing children were read a story either via a paper-book or an e-book with interactive and multimedia features. The e-book was either narrated by the experimenter (adult narrated iPad condition) or narrated by an in-app voiceover (e-book narrated iPad condition). Children's behaviour during storybook reading was video recorded and coded for engagement (visual attention and communication). They then completed two measures of narrative comprehension: multiple-choice questions (measuring recall of literal information) and a picture ordering task (measuring global story structure).

RESULTS

Contrary to predictions, we did not find any significant group or condition differences on either measure of narrative comprehension, and both groups demonstrated a similar level of narrative comprehension across the three conditions. We found differences in engagement between conditions for both groups, with greater visual attention in the e-book conditions compared to the paper-book condition. However, visual attention only significantly correlated with narrative comprehension for the typically developing group.

CONCLUSION

Overall, this study suggests that children with autism spectrum condition are just as able as language-matched peers to comprehend a narrative from storybooks. Presenting a story on an iPad e-book compared to a paper-book does not influence narrative comprehension, nor does adult narration of the story compared to in-app narration. However, on-task engagement is linked to narrative comprehension in typically developing children.Implications: Taken together, our findings suggest that e-books may be more successful than paper-based mediums at encouraging visual attention towards the story, but no better at supporting narrative comprehension and eliciting communication.

Executive Function: Association with Multiple Reading Skills

Executive function (EF) is related to reading. However, there is a lack of clarity around (a) the relative contribution of different components of EF to different reading components (word reading, fluency, comprehension), and (b) how EF operates in the context of known strong language predictors (e.g., components of the Simple View of Reading or SVR), and other skills theoretically related to reading (e.g., vocabulary, processing speed) and/or to EF (e.g., short-term memory, motor function). In a large sample of 3rd to 5th graders oversampled for struggling readers, this paper evaluates the impact of EF derived from a bifactor model (Cirino, Ahmed, Miciak, Taylor, Gerst, & Barnes, 2018) in the context of well-known covariates and demographics. Beyond common EF, five specific factors (two related to working memory, and factors of fluency, self-regulated learning, and behavioral inattention/metacognition) were addressed. EF consistently showed a unique contribution to already-strong predictive models for all reading outcomes; for reading comprehension, EF interacted with SVR indices (word reading and listening comprehension). The findings extend and refine our understanding of the contribution of EF to reading skill.

Are working memory and behavioral attention equally important for both reading and listening comprehension? A developmental comparison

We investigated the extent to which working memory and behavioral attention predicted reading and listening comprehension in grades 1 through 3 and, whether their relative contributions differed by modality and grade. Separate grade samples (N = 370; ns = 125, 123, and 122 for grades 1, 2, and 3 respectively) completed multiple measures of word reading, working memory, and parallel measures of reading and listening comprehension. Teachers and parents provided behavioral attention ratings. Concurrently, working memory was more important for listening than for reading comprehension and predicted significant variance in both modalities across grades, after controlling for background measures and behavioral attention ratings. For both modalities, working memory explained the greatest proportion of variance in grade 3. Behavioral attention predicted variance in grades 1 and 2 for reading comprehension and all grades for listening comprehension. Subsidiary analyses demonstrated that the influence of working memory and behavioral attention on reading comprehension was indirect, through word reading and listening comprehension both concurrently and also longitudinally between grades 1-3. These findings indicate that delivery of classroom materials orally will not always be beneficial to the young beginner reader or one who struggles with word decoding, and that children with poor working memory/attention may require additional support to access meaning from both written and spoken text.

Reading Comprehension in Latin America: Difficulties and Possible Interventions

Reading comprehension (RC) is below the international standard in many countries of Latin America (LA). Here we review factors that might be associated with failure in RC of the first language in LA. Then we present interventions reporting beneficial impact on RC in typically developing students from English-speaking countries and discuss their possible applicability in LA. We conclude that research-based pedagogical interventions are currently available to promote RC at school and may be suitable to implement in LA in order to improve RC.

Pathways to Third-Grade Calculation Versus Word-Reading Competence: Are They More Alike or Different?

Children (n = 747; 6.5 years) were assessed on domain-general processes and mathematics and reading-related competencies (start of first grade), addition retrieval (end of second grade), and calculations and word reading (end of third grade). Attentive behavior, reasoning, visuospatial memory, and rapid automatized naming (RAN) indirectly contributed to both outcomes, via retrieval. However, there was no overlap in domain-general direct effects on calculations (attentive behavior, reasoning, working memory) versus word reading (language, phonological memory, RAN). Results suggest ease of forming associative relations and abilities engaged during the formation of these long-term memories are common to both outcomes and can be indexed by addition-fact retrieval, but further growth in calculations and word reading is driven by different constellations of domain-general abilities.