Accelerating chronically unresponsive children to tier 3 instruction: what level of data is necessary to ensure selection accuracy?

Are students with learning disabilities correctly diagnosed in Turkey?

There has been an ongoing debate on how to diagnose learning disability (LD), with experts proposing different approaches. Very limited research is available on the diagnosis of LD in Turkey. This study aims to analyze the problems related to the diagnosis of LD in Turkey. For this purpose, the intelligence test results of the diagnosed students, the opinions of the teachers who referred them for the diagnosis, and the views of the child psychiatrists and psychological counselors involved in the diagnosis were examined. The results showed that the IQ-Achievement Discrepancy approach is implemented in Turkey. It was also revealed that the students' Wechsler Intelligence Scale for Children (WISC-R) average score was 80.31, and teachers mostly reported the weaknesses of the students during the diagnosis process. Psychological counselors and psychiatrists pointed out the outdatedness of the tools used in the diagnosis, the limited number of measurement instruments to be used in the diagnosis, referral of too many students, and the lack of specialists to work in the diagnosis. The results are discussed on the basis of diagnostic approaches.

Sequence Processing in Music Predicts Reading Skills in Young Readers: A Longitudinal Study

Musical abilities, both in the pitch and temporal dimension, have been shown to be positively associated with phonological awareness and reading abilities in both children and adults. There is increasing evidence that the relationship between music and language relies primarily on the temporal dimension, including both meter and rhythm. It remains unclear to what extent skill level in these temporal aspects of music may uniquely contribute to the prediction of reading outcomes. A longitudinal design was used to test a group-administered musical sequence transcription task (MSTT). This task was designed to preferentially engage sequence processing skills while controlling for fine-grained pitch discrimination and rhythm in terms of temporal grouping. Forty-five children, native speakers of Portuguese (Mage = 7.4 years), completed the MSTT and a cognitive-linguistic protocol that included visual and auditory working memory tasks, as well as phonological awareness and reading tasks in second grade. Participants then completed reading assessments in third and fifth grades. Longitudinal regression models showed that MSTT and phonological awareness had comparable power to predict reading. The MSTT showed an overall classification accuracy for identifying low-achievement readers in Grades 2, 3, and 5 that was analogous to a comprehensive model including core predictors of reading disability. In addition, MSTT was the variable with the highest loading and the most discriminatory indicator of a phonological factor. These findings carry implications for the role of temporal sequence processing in contributing to the relationship between music and language and the potential use of MSTT as a language-independent, time- and cost-effective tool for the early identification of children at risk of reading disability.

Predicting and Evaluating Treatment Response: Evidence Toward Protracted Response Patterns for Severely Impacted Students With Dyslexia

Great strides have been made in the development of effective methods of instruction for children with dyslexia. However, individual response to treatment varies, and weaknesses persist for some students with dyslexia despite otherwise effective instruction. Continued efforts are needed to support the prospective identification of poor response, particularly in routine intervention settings. The current study addressed whether indicators of dyslexia risk as outlined by hybrid diagnostic models predict response in children who received Tier 3 dyslexia intervention in their schools. The program's efficacy has been previously documented in remediating reading abilities in children with dyslexia. Data were examined from 115 elementary-age children who received routine Tier 3 dyslexia intervention in their schools. Logistic regression revealed powerful effects of preintervention fluency and gender in predicting response, with weaker effects of decoding and rapid naming. Attention-deficit/hyperactivity disorder status also played a role in predicting response. Phonological awareness and listening-reading comprehension discrepancy did not predict response. Profile analyses indicated near- and far-transfer of skill for the adequate response group, whereas growth in the poor response group was limited to near-transfer. Findings support a continuum of severity that may be associated with less robust growth and generalization over the course of the intervention.

Targeted school-based interventions for improving reading and mathematics for students with or at risk of academic difficulties in Grades K-6: A systematic review

Background

Low levels of numeracy and literacy skills are associated with a range of negative outcomes later in life, such as reduced earnings and health. Obtaining information about effective interventions for children with or at risk of academic difficulties is therefore important.

Objectives

The main objective was to assess the effectiveness of interventions targeting students with or at risk of academic difficulties in kindergarten to Grade 6.

Search Methods

We searched electronic databases from 1980 to July 2018. We searched multiple international electronic databases (in total 15), seven national repositories, and performed a search of the grey literature using governmental sites, academic clearinghouses and repositories for reports and working papers, and trial registries (10 sources). We hand searched recent volumes of six journals and contacted international experts. Lastly, we used included studies and 23 previously published reviews for citation tracking.

Selection Criteria

Studies had to meet the following criteria to be included: Population: The population eligible for the review included students attending regular schools in kindergarten to Grade 6, who were having academic difficulties, or were at risk of such difficulties. Intervention: We included interventions that sought to improve academic skills, were conducted in schools during the regular school year, and were targeted (selected or indicated). Comparison: Included studies used an intervention-control group design or a comparison group design. We included randomised controlled trials (RCT); quasi-randomised controlled trials (QRCT); and quasi-experimental studies (QES). Outcomes: Included studies used standardised tests in reading or mathematics. Setting: Studies carried out in regular schools in an OECD country were included.

Data Collection and Analysis

Descriptive and numerical characteristics of included studies were coded by members of the review team. A review author independently checked coding. We used an extended version of the Cochrane Risk of Bias tool to assess risk of bias. We used random-effects meta-analysis and robust-variance estimation procedures to synthesise effect sizes. We conducted separate meta-analyses for tests performed within three months of the end of interventions (short-term effects) and longer follow-up periods. For short-term effects, we performed subgroup and moderator analyses focused on instructional methods and content domains. We assessed sensitivity of the results to effect size measurement, outliers, clustered assignment of treatment, risk of bias, missing moderator information, control group progression, and publication bias.

Results

We found in total 24,414 potentially relevant records, screened 4247 of them in full text, and included 607 studies that met the inclusion criteria. We included 205 studies of a wide range of intervention types in at least one meta-analysis (202 intervention-control studies and 3 comparison designs). The reasons for excluding studies from the analysis were that they had too high risk of bias (257), compared two alternative interventions (104 studies), lacked necessary information (24 studies), or used overlapping samples (17 studies). The total number of student observations in the analysed studies was 226,745. There were 93% RCTs among the 327 interventions we included in the meta-analysis of intervention-control contrasts and 86% were from the United States. The target group consisted of, on average, 45% girls, 65% minority students, and 69% low-income students. The mean Grade was 2.4. Most studies included in the meta-analysis had a moderate to high risk of bias.The overall average effect sizes (ES) for short-term and follow-up outcomes were positive and statistically significant (ES = 0.30, 95% confidence interval [CI] = [0.25, 0.34] and ES = 0.27, 95% CI = [0.17, 0.36]), respectively). The effect sizes correspond to around one third to one half of the achievement gap between fourth Grade students with high and low socioeconomic status in the United States and to a 58% chance that a randomly selected score of an intervention group student is greater than the score of a randomly selected control group student.All measures indicated substantial heterogeneity across short-term effect sizes. Follow-up outcomes pertain almost exclusively to studies examining small-group instruction by adults and effects on reading measures. The follow-up effect sizes were considerably less heterogeneous than the short-term effect sizes, although there was still statistically significant heterogeneity.Two instructional methods, peer-assisted instruction and small-group instruction by adults, had large and statistically significant average effect sizes that were robust across specifications in the subgroup analysis of short-term effects (ES around 0.35-0.45). In meta-regressions that adjusted for methods, content domains, and other study characteristics, they had significantly larger effect sizes than computer-assisted instruction, coaching of personnel, incentives, and progress monitoring. Peer-assisted instruction also had significantly larger effect sizes than medium-group instruction. Besides peer-assisted instruction and small-group instruction, no other methods were consistently significant across the analyses that tried to isolate the association between a specific method and effect sizes. However, most analyses showed statistically significant heterogeneity also within categories of instructional methods.We found little evidence that effect sizes were larger in some content domains than others. Fractions had significantly higher associations with effect sizes than all other math domains, but there were only six studies of interventions targeting fractions. We found no evidence of adverse effects in the sense that no method or domain had robustly negative associations with effect sizes.The meta-regressions revealed few other significant moderators. Interventions in higher Grades tend to have somewhat lower effect sizes, whereas there were no significant differences between QES and RCTs, general tests and tests of subdomains, and math tests and reading tests.

Authors’ Conclusions

Our results indicate that interventions targeting students with or at risk of academic difficulties from kindergarten to Grade 6 have on average positive and statistically significant short-term and follow-up effects on standardised tests in reading and mathematics. Peer-assisted instruction and small-group instruction are likely to be effective components of such interventions.We believe the relatively large effect sizes together with the substantial unexplained heterogeneity imply that schools can reduce the achievement gap between students with or at risk of academic difficulties and not-at-risk students by implementing targeted interventions, and that more research into the design of effective interventions is needed.

Are Individual Differences in Response to Intervention Influenced by the Methods and Measures Used to Define Response? Implications for Identifying Children With Learning Disabilities

Response to intervention (RTI) has been promoted for nearly 20 years as a valid supplement to or alternative method of learning disability (LD) identification. Nevertheless, important unresolved questions remain about its role in disability identification. We had two purposes when conducting this study of 229 economically and racially diverse poor readers in Grades 4 and 5 in 28 public elementary and middle schools in Nashville. First, we examined predictors of the children's response to a reading comprehension tutoring program. Second, we explored the utility of different methods (growth vs final status) and measures (near- and mid-transfer vs far-transfer) in operationalizing "response," and whether these contrasting methods and measures identified similar children. Findings indicated students with higher pretreatment scores on expressive vocabulary, nonverbal IQ, teacher ratings of attention, and reading comprehension measures were more likely classified as responsive with final status methods. Students with lower pretreatment comprehension scores were more likely identified as responsive with growth methods. These and other findings suggest "response" is strongly context dependent, raising questions about the validity of RTI as a means of disability identification.

Socioeconomic Status and Reading Disability: Neuroanatomy and Plasticity in Response to Intervention

Although reading disability (RD) and socioeconomic status (SES) are independently associated with variation in reading ability and brain structure/function, the joint influence of SES and RD on neuroanatomy and/or response to intervention is unknown. In total, 65 children with RD (ages 6-9) with diverse SES were assigned to an intensive, 6-week summer reading intervention (n = 40) or to a waiting-list control group (n = 25). Before and after, all children completed standardized reading assessments and magnetic resonance imaging to measure cortical thickness. At baseline, higher SES correlated with greater vocabulary and greater cortical thickness in bilateral perisylvian and supramarginal regions-especially in left pars opercularis. Within the intervention group, lower SES was associated with both greater reading improvement and greater cortical thickening across broad, bilateral occipitotemporal and temporoparietal regions following the intervention. Additionally, treatment responders (n = 20), compared with treatment nonresponders (n = 19), exhibited significantly greater cortical thickening within similar regions. The waiting control and nonresponder groups exhibited developmentally typical, nonsignificant cortical thinning during this time period. These findings indicate that effective summer reading intervention is coupled with cortical growth, and is especially beneficial for children with RD who come from lower-SES home environments.

Longitudinal outcomes of an individualized and intensive reading intervention for third grade students

Early intervention is known to reduce reading disabilities; however, treatment response is variable, and some students have persistent deficits that require intensive supports. This study examined the immediate and 1-year outcomes of an individualized and intensive reading program for third grade students, which was delivered throughout the school day for an average of 189 hr of instruction over 3 months. These students' performances were compared with two comparison groups, including poor readers who received small group supports and good readers who did not have additional reading instruction. The intensive group showed an improvement in word recognition and decoding fluency immediately after the program and 1 year later, and there was a decrease in significant reading impairments from 62% before intervention to 35% at follow-up. Furthermore, baseline reading, spelling, phonological awareness, and rapid naming skills were predictive of persistent reading deficits at a later time point. Although improvements in reading skills were shown, a significant gap between poor and good readers persisted in the third and fourth grades. This study illustrates the importance of a tertiary intensive reading program, but also the need for continuing supports.

Predicting Reading Problems 6 Years Into the Future: Dynamic Assessment Reduces Bias and Increases Classification Accuracy

Purpose

The purpose of this study was to examine how well a kindergarten dynamic assessment of decoding predicts future reading difficulty at 2nd, 3rd, 4th, and 5th grade and to determine whether the dynamic assessment improves the predictive validity of traditional static kindergarten reading measures.

Method

With a small variation in sample size by grade, approximately 370 Caucasian and Hispanic students were administered a 3-min dynamic assessment of decoding and static measures of letter identification and phonemic awareness at the beginning of kindergarten. Oral reading fluency was then assessed at the end of Grades 2–5. In this prospective, longitudinal study, predictive validity was estimated for the Caucasian and Hispanic students by examining the amount of variance the static and dynamic assessments explained and by referring to area under the curve and sensitivity and specificity values.

Results

The dynamic assessment accounted for variance in reading ability over and above the static measures, with fair to good area under the curve values and sensitivity and specificity. Classification accuracy worsened when the static measures were included as predictor measures. The results of this study indicate that a very brief dynamic assessment can predict with approximately 75%–80% accuracy, which kindergarten students will have difficulty in learning to decode up to 6 years into the future.

Conclusions

Dynamic assessment of decoding is a promising approach to identifying future reading difficulty of young kindergarten students, mitigating the cultural and linguistic bias found in traditional static early reading measures.

Response-To-Intervention in Finland and the United States: Mathematics Learning Support as an Example

Response to Intervention (RTI) was accepted in the early 2000s as a new framework for identifying learning difficulties (LD) in the U.S. In Finland, a similar multi-tiered framework has existed since 2010. In the present study, these frameworks are presented from the viewpoint of the role of assessment and instruction as expressed in documents that describe the frameworks, as it seems that these two components of RTI are the most disparate between the U.S. and Finland. We present a suggestion for the Finnish framework as an example of support in mathematics learning that incorporates principles of RTI (such as systematized assessment and instruction, cyclic support, and modifiable instruction). Finally, recommendations are presented for further refining and developing assessment and instruction policies in the two countries.

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.

Development of First-Graders' Word Reading Skills: For Whom Can Dynamic Assessment Tell Us More?

Dynamic assessment (DA) of word reading measures learning potential for early reading development by documenting the amount of assistance needed to learn how to read words with unfamiliar orthography. We examined the additive value of DA for predicting first-grade decoding and word recognition development while controlling for autoregressive effects. Additionally, we examined whether predictive validity of DA would be higher for students who have poor phonological awareness skills. First-grade students (n = 105) were assessed on measures of word reading, phonological awareness, rapid automatized naming, and DA in the fall and again assessed on word reading measures in the spring. A series of planned, moderated multiple regression analyses indicated that DA made a significant and unique contribution in predicting word recognition development above and beyond the autoregressor, particularly for students with poor phonological awareness skills. For these students, DA explained 3.5% of the unique variance in end-of-first-grade word recognition that was not attributable to autoregressive effect. Results suggest that DA provides an important source of individual differences in the development of word recognition skills that cannot be fully captured by merely assessing the present level of reading skills through traditional static assessment, particularly for students at risk for developing reading disabilities.

Response to Instruction in Preschool: Results of Two Randomized Studies with Children At Significant Risk of Reading Difficulties

Although response-to-instruction (RTI) approaches have received increased attention, few studies have evaluated the potential impacts of RTI approaches with preschool populations. This manuscript presents results of two studies examining impacts of Tier II instruction with preschool children. Participating children were identified as substantially delayed in the acquisition of early literacy skills despite exposure to high-quality, evidence-based classroom instruction. Study 1 included 93 children (M age = 58.2 months; SD = 3.62) attending 12 Title I preschools. Study 2 included 184 children (M age = 58.2 months; SD = 3.38) attending 19 Title I preschools. The majority of children were Black/African American, and about 60% were male. In both studies, eligible children were randomized to receive either 11 weeks of need-aligned, small-group instruction or just Tier I. Tier II instruction in Study 1 included variations of activities for code- and language-focused domains with prior evidence of efficacy in non-RTI contexts. Tier II instruction in Study 2 included instructional activities narrower in scope, more intensive, and delivered to smaller groups of children. Impacts of Tier II instruction in Study 1 were minimal; however, there were significant and moderate-to-large impacts in Study 2. These results identify effective Tier II instruction but indicate that the context in which children are identified may alter the nature of Tier II instruction that is required. Children identified as eligible for Tier II in an RTI framework likely require more intensive and more narrowly focused instruction than do children at general risk of later academic difficulties.

Early response-to-intervention measures and criteria as predictors of reading disability in the beginning of third grade

We explored the usefulness of first and second grade reading measures and responsiveness criteria collected within a response-to-intervention (RtI) framework for predicting reading disability (RD) in third grade. We used existing data from 387 linguistically diverse students who had participated in a longitudinal RtI study. Model-based predictors of RD were analyzed using logistic regression; isolated measure/criteria combinations for predicting RD were analyzed using classification analysis. Models yielded superior classification rates compared to single measure approaches and did not systematically misclassify English learners. However, particular first and second grade measure/criteria combinations also showed promise as isolated predictors of RD in word reading/text fluency. Model-based approaches were required for acceptable classification of students with RD in comprehension. Although the former finding is promising for early identification of students in need of more intensive instruction in lexical or fluency-based skills, the latter finding reaffirms literature attesting to the complexity of RD in comprehension and difficulty of predicting deficits using early measures of reading, which primarily assess word reading skill. Results replicated well with an independent sample, thus enhancing confidence in study conclusions. Implications regarding the use of RtI for predicting RD are discussed.

Understanding Inadequate Response to First Grade Multi-Tier Intervention: Nomothetic and Idiographic Perspectives

The purpose of this study was to use a mixed methods approach to learn about inadequate response to a year-long multi-tier RTI model that allowed first-grade students to move up and down tiers. Participants were 156 students who received supplemental intervention services during a larger multi-tier RTI study involving classrooms and 522 students across 10 schools. Findings from an all-subset regression indicate letter word reading, the fluency composite, and blending words explained the most variance (15%) in response among initial skills. Adding additional teacher ratings of behavior and academics, accounted for a small amount of additional variance (3%) in group membership. The ROC curve analysis indicated 87.5% of students were correctly classified, yielding a sensitivity of 85.3 and a specificity of 65.0. Findings from qualitative observations of intervention sessions suggest inadequate responders demonstrated physical and verbal task avoidance and displayed emotions of hopelessness and shame. Implications for practice are discussed.

To Wait in Tier 1 or Intervene Immediately: A Randomized Experiment Examining First Grade Response to Intervention (RTI) in Reading

This randomized controlled experiment compared the efficacy of two Response to Intervention (RTI) models - Typical RTI and Dynamic RTI - and included 34 first-grade classrooms (n = 522 students) across 10 socio-economically and culturally diverse schools. Typical RTI was designed to follow the two-stage RTI decision rules that wait to assess response to Tier 1 in many districts, whereas Dynamic RTI provided Tier 2 or Tier 3 interventions immediately according to students' initial screening results. Interventions were identical across conditions except for when intervention began. Reading assessments included letter-sound, word, and passage reading, and teacher-reported severity of reading difficulties. An intent-to-treat analysis using multi-level modeling indicated an overall effect favoring the Dynamic RTI condition (d = .36); growth curve analyses demonstrated that students in Dynamic RTI showed an immediate score advantage, and effects accumulated across the year. Analyses of standard score outcomes confirmed that students in the Dynamic condition who received Tier 2 and Tier 3 ended the study with significantly higher reading performance than students in the Typical condition. Implications for RTI implementation practice and for future research are discussed.

Examining the predictive validity of a dynamic assessment of decoding to forecast response to tier 2 intervention

The purpose of this study was to examine the role of a dynamic assessment (DA) of decoding in predicting responsiveness to Tier 2 small-group tutoring in a response-to-intervention model. First grade students (n = 134) who did not show adequate progress in Tier 1 based on 6 weeks of progress monitoring received Tier 2 small-group tutoring in reading for 14 weeks. Student responsiveness to Tier 2 was assessed weekly with word identification fluency (WIF). A series of conditional individual growth curve analyses were completed that modeled the correlates of WIF growth (final level of performance and growth). Its purpose was to examine the predictive validity of DA in the presence of three sets of variables: static decoding measures, Tier 1 responsiveness indicators, and prereading variables (phonemic awareness, rapid letter naming, oral vocabulary, and IQ). DA was a significant predictor of final level and growth, uniquely explaining 3% to 13% of the variance in Tier 2 responsiveness depending on the competing predictors in the model and WIF outcome (final level of performance or growth). Although the additional variances explained uniquely by DA were relatively small, results indicate the potential of DA in identifying Tier 2 nonresponders.

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.

Responsiveness-to-intervention: a decade later

In this introduction to this special issue, "A Decade Later," we provide an overview of the accomplishments as well as the persistent questions surrounding RTI. We organize this discussion within 3 categories: assessment, instruction, and policy. Within each of these sections, we also highlight how the articles in the present special issue expand upon the key issues. Developed initially for the early grades (kindergarten through third grade) and primarily in the area of reading, many-although not all-of these issues speak to the expansion of RTI to address a broader set of academic content areas and the full range of grade levels.