Fluency Interventions for Elementary Students with Reading Difficulties: A Synthesis of Research from 2000–2019

Parent-implemented intervention for children in third to fifth grade with dyslexia

BACKGROUND

Few studies have investigated the acceptability and efficacy of intensive parent-implemented interventions for children with dyslexia.

METHODS

We carried out a randomized controlled trial on 22 dyslexic children from 3rd to 5th grade. Reading performance was measured before (T1) and after (T2) summer by a selection of tests from the BALE and EDA batteries. One group received a specific parent-implemented repeated reading training (RR group) and the other group received a general training based on a summer vacation workbook (SVW group), adapted for children with reading impairment. The training lasted 6 weeks during the summer vacation.

RESULTS

In both groups, the reading performances of the dyslexic children were stable before and after the summer. No group difference was found on our primary outcome corresponding to an aggregate score of the z-scores of the BALE reading lists of regular, irregular and pseudo-words. However, secondary analyses revealed that the score of the EDA subtest "number of words read in one minute" (tapping reading fluency) differed significantly between the two groups (T2-T1=0.17 SD for the RR group and T2-T1=-0.24 SD for the SVW group; P=0.015). Acceptability was generally good (dropout rate of 9% in the RR group).

CONCLUSIONS

A repeated reading intervention applied by parents may improve reading fluency of dyslexic children during summer vacation, with a good acceptability. Further studies are needed to confirm these findings.

Technology-assisted reading fluency interventions for students with reading difficulties: evidence from a meta-analytic approach of single case design studies

PURPOSE

The purpose of this article was to provide a quantitative review of technology-assisted reading fluency interventions for students with disabilities and select moderator variables that may modify the effects of the interventions.

MATERIALS AND METHODS

All reviewed 13 studies employed a single-case research design, targeting technology-assisted reading fluency interventions for students with learning disabilities (LDs) or learning difficulties. Studies were descriptively analysed and evaluated for methodological quality. Additionally, to examine the level and trend of reading fluency outcomes, Tau-U was calculated across the studies by measuring the impact of various moderator variables on the intervention effects.

RESULTS AND CONCLUSIONS

Overall, studies showed a moderate to strong effect on reading fluency and there was a significant difference in moderator variables such as student status, type of technology, and features of technology. While the current study found positive outcomes from technology-based fluency interventions for struggling readers suggesting the effectiveness of using technology for the improvement of reading fluency, educators should consider using a rubric when utilising tablets because of the limited instructional components. Possible explanations about intervention effects, moderator effects, and study qualities along with limitations and future research were discussed. Implications for rehabilitationThis article examined a quantitative review of technology-assisted reading fluency interventions for students with disabilities and those considered at-risk. From this examination, we suggest the following implications:More research is needed to explore the effectiveness of technology-assisted reading fluency interventions. Some studies exist exploring the effect of overall reading interventions, but more specific analyses are needed related specifically to fluency and technology-assisted fluency interventions.Due to continuous advancements in technology, more research is also needed related to the integration of tablets and applications (or apps) on reading fluency.The use of technology to teach fluency has a general positive outcome for at-risk students. However, these types of interventions are more effective if they also provide vocabulary support.

Translation and cultural adaptation of the HELPS Reading Fluency Program into Brazilian Portuguese: A report of systematic adaptation processes and initial evidence of efficacy

Introduction

Across multiples languages, research demonstrates the important relationship between reading fluency and comprehension. Put simply, a fluent reader has greater attention and memory resources to use higher-order functions in reading, resulting in better comprehension of text. Some reading fluency interventions have shown positive results in improving students' text reading fluency and comprehension; however, this research has predominantly been conducted with English-speaking students. For instance, until this report, a comprehensive search revealed only one prior study that evaluated an intervention strategy designed to improve students' reading fluency in Brazilian Portuguese and no prior studies evaluated an intervention program with that population of students.

Methods

The main goals of this two-part project were to (a) systematically translate, culturally adapt, and pilot test the Helping Early Literacy with Practice Strategies (HELPS) reading fluency program for use in Brazilian Portuguese (referred to as, HELPS-PB); and (b) conduct a preliminary quasi-experimental study of the HELPS-PB program with 23 students in grades 3 to 5 who needed a reading fluency intervention.

Results and Discussion

This report documents the processes and successful adaptation of existing English- and Spanish-versions of HELPS into a new HELPS-PB program. It also offers preliminary evidence showing that students receiving HELPS-PB significantly improved their text reading fluency comparted to students in a control group. Implications for research, practice, and the adaptation of reading fluency programs into other languages are discussed.

Longitudinal changes in brain activation underlying reading fluency

Reading fluency-the speed and accuracy of reading connected text-is foundational to educational success. The current longitudinal study investigates the neural correlates of fluency development using a connected-text paradigm with an individualized presentation rate. Twenty-six children completed a functional MRI task in 1st/2nd grade (time 1) and again 1-2 years later (time 2). There was a longitudinal increase in activation in the ventral occipito-temporal (vOT) cortex from time 1 to time 2. This increase was also associated with improvements in reading fluency skills and modulated by individual speed demands. These findings highlight the reciprocal relationship of the vOT region with reading proficiency and its importance for supporting the developmental transition to fluent reading. These results have implications for developing effective interventions to target increased automaticity in reading.

Improving English reading fluency and comprehension for children with reading fluency disabilities

In the English language, students who read words accurately but have impairments in reading fluency are under-studied. The associated difficulties they have with comprehending text make it particularly important to delineate effective interventions for these students. Counter to suggestions that these readers need interventions focused on text reading, we examined the effects of a decoding-focused intervention. The intervention targeted decoding-related skills, including speeded training on sublexical spelling patterns. We examined the efficacy of this program for students with fluency-defined disabilities, and compared gains to those for students with accuracy-defined disabilities. In the initial phase of the program, readers with fluency-defined disabilities made greater gains in fluency, while readers with accuracy-defined disabilities made larger gains in word reading accuracy. The mean fluency score for readers with fluency-defined disabilities came within the average range across the intervention, as did reading comprehension for both groups. Readers' mastery on speeded learning of sublexical spelling patterns predicted unique variance in fluency outcomes, beyond variance accounted for by pre-test fluency and word reading accuracy. The results support intervention approaches focused on decoding-related skills for students who have fluency-defined disabilities and are consistent with theories of reading fluency that identify a role for automaticity with sublexical spelling patterns.

External Validation of BMT-i Computerized Test Battery for Diagnosis of Learning Disabilities

Background: Learning disabilities (LDs) are a major public health issue, affecting cognitive functions and academic performance for 8% of children. If LDs are not detected early and addressed through appropriate interventions, they have a heavy impact on these children in the social, educational, and professional spheres, at great cost to society. The BMT-i (Batterie Modulable de Tests informatisée, or "computerized Adaptable Test Battery") enables fast, easy, reliable assessments for each cognitive domain. It has previously been validated in children ages 4-13 who had no prior complaints. The present study demonstrates the sensitivity of the BMT-i, relative to reference test batteries, for 191 children with cognitive difficulties. Materials and Methods: These 191 subjects were included in the study by the 14 pediatricians treating them for complaints in five cognitive domains: written language [60 (cases)]; mathematical cognition (40); oral language (60); handwriting, drawing, and visuospatial construction (45); and attention and executive functioning (45). In accordance with a predefined protocol, the children were administered BMT-i tests first, by their pediatricians, and reference tests later, by specialists to whom the BMT-i test results were not disclosed. Comparison of BMT-i and reference test results made it possible to evaluate sensitivity and agreement between tests. Results: For each of the five domains, the BMT-i was very sensitive (0.91-1), and normal BMT-i results were highly predictive of normal results for specialized reference tests [negative likelihood ratio (LR-): 0-0.16]. There was close agreement between BMT-i and reference tests in all domains except attention and executive functioning, for which only moderate agreement was observed. Conclusion: The BMT-i offers rapid, reliable, simple computerized assessments whose sensitivity and agreement with reference test batteries make it a suitable first-line instrument for LD screening in children 4-13 years old.