A meta-analysis of the RTI literature for children at risk for reading disabilities

Detecting reading difficulties in Spanish in older elementary students in the context of the Response to Intervention model

Detecting students with reading difficulties (RD) is particularly important in the context of the Response to Intervention (RTI) model, in terms of both research and professional practice. However, there is no unanimous agreement on the best procedure to carry it out. In addition, most of the research in this field has been carried out in the English language, and there is little evidence on how these measures behave in other languages. This study focuses on identifying the best procedure for detecting RD in Spanish in older elementary students, comparing the validity, accuracy and goodness of fit of three different universal screening assessment approaches-the Psychometric Assessment Approach, the Curriculum-Based Assessment Approach and the Teacher Detection Approach-using RTI as a criterion to determine the goodness of fit of the different approaches. A total of 154 fifth-year primary students participated in this study. The results reveal that the multivariate inclusion of the evaluation approaches used is the best means of ensuring an efficient, valid assessment when attempting to identify RD among fifth graders. This finding has practical implications for the implementation of the RTI model in the field of RD.

What We Know and Need to Know about Literacy Interventions for Elementary Students with Reading Difficulties and Disabilities, including Dyslexia

The purpose of this paper is to describe what we know and what we still need to learn about literacy intervention for children who experience significant difficulties learning to read. We reviewed 14 meta-analyses and systematic reviews of experimental and quasi-experimental studies published in the last decade that examined the effects of reading and writing interventions in the elementary grades, including research focused on students with reading difficulties and disabilities, including dyslexia. We attended to moderator analyses, when available, to further refine what we know and need to learn about interventions. Findings from these reviews indicate that explicit and systematic intervention focusing on the code and meaning dimensions of reading and writing, and delivered one-to-one or in small groups, are likely to improve foundational code-based reading skills, and to a lesser extent, meaning-based skills, across elementary grade levels. Findings, at least in the upper elementary grades, indicate that some intervention features including standardized protocols, multiple components, and longer duration can yield stronger effects. And, integrating reading and writing interventions shows promise. We still need to learn more about specific instructional routines and components that provide more robust effects on students' ability to comprehend and individual differences in response to interventions. We discuss limitations of this review of reviews and suggest directions for future research to optimize implementation, particularly to understand for whom and under what conditions literacy interventions work best.

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.

Identifying Determinants of Dyslexia: An Ultimate Attempt Using Machine Learning

Research based on traditional linear techniques has yet not been able to clearly identify the role of cognitive skills in reading problems, presumably because the process of reading and the factors that are associated with reading reside within a system of multiple interacting and moderating factors that cannot be captured within traditional statistical models. If cognitive skills are indeed indicative of reading problems, the relatively new nonlinear techniques of machine learning should make better predictions. The aim of the present study was to investigate whether cognitive factors play any role in reading skill, questioning (1) the extent to what cognitive skills are indicative of present reading level, and (2) the extent to what cognitive skills are indicative of future reading progress. In three studies with varying groups of participants (average school-aged and poor readers), the results of four supervised machine learning techniques were compared to the traditional General Linear Models technique. Results of all models appeared to be comparable, producing poor to acceptable results, which are however inadequate for making a thorough prediction of reading development. Assumably, cognitive skills are not predictive of reading problems, although they do correlate with one another. This insight has consequences for scientific theories of reading development, as well as for the prevention and remediation of reading difficulties.

A meta-analysis of the effects of foundational skills and multicomponent reading interventions on reading comprehension for primary-grade students

This meta-analysis examined the effects on reading comprehension of foundational reading skills and multicomponent reading interventions provided to students with or at risk for reading difficulties or disabilities (students with RDs) in kindergarten through Grade 3. The meta-analysis included studies identified by Wanzek et al. (2016) and Wanzek et al. (2018), with an updated search through August of 2019, for a total of 47 included studies (m = 112; total student N = 7446). The weighted average effect on norm-referenced reading comprehension outcomes was estimated as g = 0.37, indicating that primary-grade interventions have an educationally meaningful effect on reading comprehension for students with RDs. Effects did not differ for interventions focused only on foundational reading skills and those that provided both foundational skills and comprehension instruction. Effects were significantly moderated by the measurement timepoint, with follow-up effect sizes being, on average, 0.16 smaller than immediate posttest effect sizes.

The Relative Effects of Instruction Linking Word Reading and Word Meaning Compared to Word Reading Instruction Alone on the Accuracy, Fluency, and Word Meaning Knowledge of 4th-5th Grade Students With Dyslexia

This within-subjects experimental study investigated the relative effects of word reading and word meaning instruction (WR+WM) compared to word-reading instruction alone (WR) on the accuracy, fluency, and word meaning knowledge of 4th-5th graders with dyslexia. We matched word lists on syllables, phonemes, frequency, number of definitions, and concreteness. We assigned half the words to WR and half to WR+WM. Word reading accuracy, word reading fluency, and word meaning knowledge were measured at pretest, immediately following each intervention session, and at posttest, administered immediately following the 12, 45-minute, daily instructional sessions. Compared to WR instruction alone, WR+WM significantly improved accuracy (d = 0.65), fluency (d = 0.43), and word meaning knowledge (d = 1.92) immediately following intervention, and significantly improved accuracy (d = 0.74), fluency (d = 0.84), and word meaning knowledge (d = 1.03) at posttest. Findings support the premise that word meaning knowledge facilitates accurate and fluent word reading, and that instruction explicitly integrating word reading and word meaning may be an effective support for upper elementary students with dyslexia.

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

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

Is "Response/No Response" Too Simple a Notion for RTI Frameworks? Exploring Multiple Response Types With Latent Profile Analysis

We conducted a secondary analysis of data from a randomized control trial to explore this question: Does "response/no response" best characterize students' reactions to a generally efficacious first-grade reading program, or is a more nuanced characterization necessary? Data were collected on 265 at-risk readers' word reading prior to and immediately following program implementation in first grade and in spring of second grade. Pretreatment data were also obtained on domain-specific skills (letter knowledge, decoding, passage comprehension, language) and domain-general skills (working memory, non-verbal reasoning). Latent profile analysis of word reading across the three time points with controls as a local norm revealed a strongly responsive group (n = 45) with mean word-reading z scores of 0.25, 1.64, and 1.26 at the three time points, respectively; a mildly responsive group (n = 109), z scores = 0.30, 0.47, and 0.55; a mildly non-responsive group (n = 90), z scores = -0.11, -0.15, and -0.55; and a strongly non-responsive group (n = 21), z scores = -1.24, -1.26, and -1.57. The two responsive groups had stronger pretreatment letter knowledge and passage comprehension than the two non-responsive groups. The mildly non-responsive group demonstrated better pretreatment passage comprehension than the strongly non-responsive group. No domain-general skill distinguished the four groups. Findings suggest response to early reading intervention was more complicated than response/no response, and pretreatment reading comprehension was an important predictor of response even with pretreatment word reading controlled.

A Snapshot of RTI Implementation a Decade Later: New Picture, Same Story

Response to intervention (RTI) has evolved from its first decade of implementation. Because states guide and regulate policy and practice at the state and local education agency levels, it is important to understand their critical role in RTI implementation. A systematic review of all 50 state education agency websites was conducted to provide an updated "snapshot" of states' interpretation of RTI a decade after IDEA regulations were finalized. Findings revealed substantive progress towards developing approaches to systematic supports to students, with a major trend in adoption of multi-tiered system of support (MTSS) models. Findings also documented continued variation in how states are communicating about tiered systems on such matters as the roles of tiered systems in schoolwide prevention frameworks, meeting special education requirements, and aligning multiple systems within schools. Implications for special education services for students with learning disabilities are discussed.

The Relationship Between Study Quality and the Effects of Supplemental Reading Interventions: A Meta-Analysis

Empirical studies investigating supplemental reading interventions for students with or at-risk for reading disabilities in the early elementary grades have demonstrated a range of effect sizes. Identifying the findings from high quality research can provide greater certainty of findings related to the effectiveness of supplemental reading interventions. This meta-analysis investigated how four variables of study quality (study design, statistical treatment, Type I error, and fidelity of implementation) were related to effect sizes from standardized measures of foundational reading skills and language/comprehension. The results from 88 studies indicated that year of publication was a significant predictor of effect sizes for both standardized measures of foundational reading skills and language/comprehension, with more recent studies demonstrating smaller effect sizes. Results also demonstrated that with the exception of research design predicting effect sizes on foundational reading skills measures, study quality was not related to the effects of supplemental reading interventions. Implications for research and practice are discussed.

Academic outcomes of flipped classroom learning: a meta-analysis

CONTEXT

The flipped classroom (FC), reversing lecture and homework elements of a course, is popular in medical education. The FC uses technology-enhanced pre-class learning to transmit knowledge, incorporating in-class interaction to enhance higher cognitive learning. However, the FC model is expensive and research on its effectiveness remains inconclusive. The aim of this study was to compare the efficacy of the FC model over traditional lecture-based (LB) learning by meta-analysis.

METHODS

We systematically searched MEDLINE, PubMed, ERIC, CINAHL, EMBASE, reference lists and Association for Medical Education in Europe (AMEE) conference books. Controlled trials comparing academic outcomes between the FC and LB approaches in higher education were considered eligible. The main findings were pooled using a random-effects model when appropriate.

RESULTS

Forty-six studies (9026 participants) were included, comprising four randomised controlled trials (RCTs), 19 quasi-experimental studies and 23 cohort studies. Study populations were health science (n = 32) and non health science (n = 14) students. The risk of bias was high (36/37 articles). Meta-analyses revealed that the FC had significantly better outcomes than the LB method in examination scores (post-intervention and pre-post change) and course grades, but not in objective structured clinical examination scores. Subgroup analyses showed the advantage of the FC was not observed in RCTs, non-USA countries, nursing and other health science disciplines and earlier publication years (2013 and 2014). Cumulative analysis and meta-regression suggested a tendency for progressively better outcomes by year. Outcome assessments rarely focused on behaviour change.

CONCLUSIONS

The FC method is associated with greater academic achievement than the LB approach for higher-level learning outcomes, which has become more obvious in recent years. However, results should be interpreted with caution because of the high methodological diversity, statistical heterogeneity and risk of bias in the studies used. Future studies should have high methodological rigour, a standardised FC format and utilise assessment tools evaluating higher cognitive learning and behaviour change to further examine differences between FC and LB learning.

Early Identification of Reading Difficulties: A Screening Strategy that Adjusts the Sensitivity to the Level of Prediction Accuracy

Early screening for reading difficulties before the onset of instruction is desirable because it allows intervention that is targeted at prevention rather than remediation of reading difficulties. However, early screening may be too inaccurate to effectively allocate resources to those who need them. The present study compared the accuracy of early screening before the onset of formal reading instruction with late screening six months into the first year of instruction. The study followed 164 Danish students from the end of Grade 0 to the end of Grade 2. Early screening included measures of phonemic awareness, rapid naming, letter knowledge, paired associate learning, and reading. Late screening included only reading. Results indicated that reading measures improved substantially as predictors over the first six months of Grade 1, to the point where late reading measures alone provided as much information as the early measures combined. In the light of these results and a less than perfect early screening accuracy, a new strategy for screening is introduced and discussed. The strategy proposes multi-point screening with gradually increasing sensitivity to strike a balance between manageable screening procedures and outcomes and early identification of students who are most likely in need of extra resources. Copyright © 2017 John Wiley & Sons, Ltd.

Agreement Among Traditional and RTI-based Definitions of Reading-Related Learning Disability with Preschool Children

To investigate approaches for identifying young children who may be at risk for later reading-related learning disabilities, this study compared the use of four contemporary methods of indexing learning disability (LD) with older children (i.e., IQ-achievement discrepancy, low achievement, low growth, and dual-discrepancy) to determine risk status with a large sample of 1,011 preschoolers. These children were classified as at risk or not using each method across three early-literacy skills (i.e., language, phonological awareness, print knowledge) and at three levels of severity (i.e., 5th, 10th, 25th percentiles). Chance-corrected affected-status agreement (CCASA) indicated poor agreement among methods with rates of agreement generally decreasing with greater levels of severity for both single- and two-measure classification, and agreement rates were lower for two-measure classification than for single-measure classification. These low rates of agreement between conventional methods of identifying children at risk for LD represent a significant impediment for identification and intervention for young children considered at-risk.

Meta-Analyses of the Effects of Tier 2 Type Reading Interventions in Grades K-3

This meta-analysis extends previous work on extensive Tier 3 type reading interventions (Wanzek & Vaughn, 2007; Wanzek et al., 2013) to Tier 2 type interventions by examining a non-overlapping set of studies addressing the effects of less extensive reading interventions for students with or at risk for reading difficulties in Grades K-3. We examined the overall effects of these interventions on students' foundational skills, language, and comprehension as well as the intervention features that may be associated with improved outcomes. We conducted four meta-analyses on 72 studies to examine effects on (1) standardized foundational skill measures (mean ES = 0.54), (2) not-standardized foundational skill measures (mean ES = 0.62), (3) standardized language/comprehension measures (mean ES = 0.36), and (4) not-standardized language/comprehension measures (mean ES = 1.02). There were no differences in effects related to intervention type, instructional group size, grade level, intervention implementer, or the number of intervention hours.

Comparing Bilingual to Monolingual Learners on English Spelling: A Meta-analytic Review

This study reports on a meta-analysis to examine how bilingual learners compare with English monolingual learners on two English spelling outcomes: real-word spelling and pseudo-word spelling. Eighteen studies published in peer-reviewed journals between 1990 and 2014 were retrieved. The study-level variables and characteristics (e.g. sample size, study design and research instruments) were coded, and 29 independent effect sizes across the 18 retrieved studies were analysed. We found that bilinguals outperformed monolinguals on real-word spelling overall and more so in early grades, but monolinguals outperformed bilinguals on pseudo-word spelling. Further, bilinguals at risk for reading difficulties did better on real-word spelling than monolinguals at risk for reading difficulties. Having investigated systematic sources of variability in effect sizes, we conclude that in comparison with their monolingual peers, bilingual learners, especially those from alphabetic L1 backgrounds, are able to master constrained skills, such as English spelling, in the current instructional context. Copyright © 2016 John Wiley & Sons, Ltd.

Meta-Analysis With Complex Research Designs: Dealing With Dependence From Multiple Measures and Multiple Group Comparisons

Previous research has shown that treating dependent effect sizes as independent inflates the variance of the mean effect size and introduces bias by giving studies with more effect sizes more weight in the meta-analysis. This article summarizes the different approaches to handling dependence that have been advocated by methodologists, some of which are more feasible to implement with education research studies than others. A case study using effect sizes from a recent meta-analysis of reading interventions is presented to compare the results obtained from different approaches to dealing with dependence. Overall, mean effect sizes and variance estimates were found to be similar, but estimates of indexes of heterogeneity varied. Meta-analysts are advised to explore the effect of the method of handling dependence on the heterogeneity estimates before conducting moderator analyses and to choose the approach to dependence that is best suited to their research question and their data set.

Neuroimaging of reading intervention: a systematic review and activation likelihood estimate meta-analysis

A growing number of studies examine instructional training and brain activity. The purpose of this paper is to review the literature regarding neuroimaging of reading intervention, with a particular focus on reading difficulties (RD). To locate relevant studies, searches of peer-reviewed literature were conducted using electronic databases to search for studies from the imaging modalities of fMRI and MEG (including MSI) that explored reading intervention. Of the 96 identified studies, 22 met the inclusion criteria for descriptive analysis. A subset of these (8 fMRI experiments with post-intervention data) was subjected to activation likelihood estimate (ALE) meta-analysis to investigate differences in functional activation following reading intervention. Findings from the literature review suggest differences in functional activation of numerous brain regions associated with reading intervention, including bilateral inferior frontal, superior temporal, middle temporal, middle frontal, superior frontal, and postcentral gyri, as well as bilateral occipital cortex, inferior parietal lobules, thalami, and insulae. Findings from the meta-analysis indicate change in functional activation following reading intervention in the left thalamus, right insula/inferior frontal, left inferior frontal, right posterior cingulate, and left middle occipital gyri. Though these findings should be interpreted with caution due to the small number of studies and the disparate methodologies used, this paper is an effort to synthesize across studies and to guide future exploration of neuroimaging and reading intervention.

Long Term Effects of First Grade Multi-Tier Intervention

The purpose of this study was to compare the long term effects of two first grade RTI models (Dynamic and Typical RTI) on the reading performance of students in second and third grade. Participants included 419 first grade students (352 in second grade and 278 in third grade after attrition). Students were classified based on first grade screeners as at-risk or not at-risk and then based on their response to intervention (no risk [NR], relative easy to remediate [ER] and requiring sustained remediation [SR]). Students in the Dynamic RTI condition had higher reading comprehension scores at the end of third grade. At the end of second grade, ER and SR students had lower reading scores than NR students. At the end of third grade, there were no differences in reading skills between ER and NR students, but SR students had lower scores than NR students. ER students in the Dynamic RTI condition had higher reading scores at the end of second grade than those in the Typical RTI condition. Limitations and directions for future research are discussed.

Componential model of reading (CMR): validation studies

The three current models of identifying learning disabilities: discrepancy model, RtI, and Componential Model of reading are discussed in terms of their utility.

Is Response to Intervention and Gifted Assessment Compatible?

There is considerable interest in applying Response to Intervention (RtI) as a schoolwide methodology for instruction, assessment, and intervention for students who, early in their academic careers, are struggling academically. Supporters contend that the tiered service delivery model holds great promise for many students who otherwise would fall behind and end up with a disability label. It is unclear whether RtI is compatible with gifted learners, although a number of authorities in the gifted field are advocating for its adoption for all students, including high-ability students. This article provides a rationale for why gifted education should consider RtI assessment protocols compatible with gifted learners, discusses the implications of RtI’s core requirements and assessment measures for gifted learners, and offers a model for implementing RtI for gifted learners.