Videoconferencing Interventions for Children with Reading and Spelling Difficulties: A Pilot Study.

Background: Many children in rural and remote areas do not have access to professionals providing literacy interventions. However, delivery of services through videoconferencing would increase access and choice for end users. Introduction: This pilot study investigated the efficacy of videoconferencing literacy interventions. As videoconferencing platforms become easier and cheaper to use, this form of telehealth delivery is increasing in popularity. However, there is currently no strong evidence base to support this practice. Materials and Methods: We studied 18 children, aged 7-12 years, with poor reading and/or spelling, and whose literacy interventions were videoconferenced into their homes and/or schools. Children were tested on three reading measures: (1) reading words, (2) reading nonwords, and (3) letter-sound knowledge, twice before their interventions commenced and once after their intervention concluded. Results: Children's raw and standardized scores on 2 of 3 outcome measures increased significantly more during the intervention than in the no-intervention period before their training commenced. Discussion and Conclusions: This study demonstrates that videoconferencing is a promising delivery mode for literacy interventions, and the results justify running a larger, randomized controlled trial.

Phonics training for English-speaking poor readers.

BACKGROUND: The reading skills of 16% of children fall below the mean range for their age, and 5% of children have significant and severe reading problems. Phonics training is one of the most common reading treatments used with poor readers, particularly children. OBJECTIVES: To measure the effect of phonics training and explore the impact of various factors, such as training duration and training group size, that might moderate the effect of phonics training on literacy-related skills in English-speaking poor readers. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, 12 other databases, and three trials registers up to May 2018. We also searched reference lists of included studies and contacted experts in the field to identify additional studies. SELECTION CRITERIA: We included studies that used randomisation, quasi-randomisation, or minimisation to allocate participants to a phonics intervention group (phonics training only or phonics training plus one other literacy-related skill) or a control group (no training or non-literacy training). Participants were English-speaking poor readers with word reading one standard deviation below the appropriate level for their age (children, adolescents, and adults) or one grade or year below the appropriate level (children only), for no known reason. Participants had no known comorbid developmental disorder, or physical, neurological, or emotional problem. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included 14 studies with 923 participants in this review. Studies took place in Australia, Canada, the UK, and the USA. Six of the 14 included studies were funded by government agencies and one was funded by a university grant. The rest were funded by charitable foundations or trusts. Each study compared phonics training alone, or in conjunction with one other reading-related skill, to either no training (i.e. treatment as usual) or alterative training (e.g. maths). Participants were English-speaking children or adolescents, of low and middle socioeconomic status, whose reading was one year, one grade, or one standard deviation below the level expected for their age or grade for no known reason. Phonics training varied between studies in intensity (up to four hours per week), duration (up to seven months), training group size (individual and small groups), and delivery (human and computer). We measured the effect of phonics training on seven primary outcomes (mixed/regular word reading accuracy, non-word reading accuracy, irregular word reading accuracy, mixed/regular word reading fluency, non-word reading fluency, reading comprehension, and spelling). We judged all studies to be at low risk of bias for most risk criteria, and used the GRADE approach to assess the quality of the evidence.There was low-quality evidence that phonics training may have improved poor readers' accuracy for reading real and novel words that follow the letter-sound rules (standardised mean difference (SMD) 0.51, 95% confidence interval (CI) 0.13 to 0.90; 11 studies, 701 participants), and their accuracy for reading words that did not follow these rules (SMD 0.67, 95% CI 0.26 to 1.07; 10 studies, 682 participants). There was moderate-quality evidence that phonics training probably improved English-speaking poor readers' fluency for reading words that followed the letter-sounds rules (SMD 0.45, 95% CI 0.19 to 0.72; 4 studies, 224 participants), and non-word reading fluency (SMD 0.39, 95% CI 0.10 to 0.68; 3 studies, 188 participants), as well as their accuracy for reading words that did not follow these rules (SMD 0.84, 95% CI 0.30 to 1.39; 4 studies, 294 participants). In addition, there was low-quality evidence that phonics training may have improved poor readers' spelling (SMD 0.47, 95% CI -0.07 to 1.01; 3 studies, 158 participants), but only slightly improve their reading comprehension (SMD 0.28, 95% CI -0.07 to 0.62; 5 studies, 343 participants). AUTHORS' CONCLUSIONS: Phonics training appears to be effective for improving literacy-related skills, particularly reading fluency of words and non-words, and accuracy of reading irregular words. More studies are needed to improve the precision of outcomes, including word and non-word reading accuracy, reading comprehension, spelling, letter-sound knowledge, and phonological output. More data are also needed to determine if phonics training in English-speaking poor readers is moderated by factors such as training type, intensity, duration, group size, or administrator.

Can verbal working memory training improve reading?

The aim of the current study was to determine whether poor verbal working memory is associated with poor word reading accuracy because the former causes the latter, or the latter causes the former. To this end, we tested whether (a) verbal working memory training improves poor verbal working memory or poor word reading accuracy, and whether (b) reading training improves poor reading accuracy or verbal working memory in a case series of four children with poor word reading accuracy and verbal working memory. Each child completed 8 weeks of verbal working memory training and 8 weeks of reading training. Verbal working memory training improved verbal working memory in two of the four children, but did not improve their reading accuracy. Similarly, reading training improved word reading accuracy in all children, but did not improve their verbal working memory. These results suggest that the causal links between verbal working memory and reading accuracy may not be as direct as has been assumed.

Are comorbidities of poor reading related to elevated anxiety in children?

Studies of the association between dyslexia and mental health have typically tried to minimise the influence of dyslexia comorbidities on the outcomes. However, in the "real world", many children with dyslexia have these comorbidities. In this study, we tested (1) if children with dyslexia with three common comorbidities - inattention, hyperactivity, language difficulties - experience more anxiety than children with dyslexia without these comorbidities; and (2) if any type of comorbidity is related to a certain type of anxiety (reading, social, generalised, or separation). The data of 82 children with dyslexia (mean age = 9 years and 4 months; 25 girls) were analysed using Fisher exact tests, which revealed that those with inattention (40.54%) or hyperactivity (42.30%) were statistically significantly more likely to experience elevated anxiety than children with dyslexia without these comorbidities (8.11 and 14.28%, respectively). This was not the case for language difficulties (24.5% versus 30%). Spearman ρ correlations (α = .05) indicated significant moderate relationships between inattention and reading anxiety (.27), social anxiety (.37), and generalised anxiety (.24); and between hyperactivity and social anxiety (.24) and generalised anxiety (.28). There were no significant correlations between language and anxiety. Examination of highly inter-correlated variables suggested a specific relationship between one type of comorbidity (inattention) and one type of anxiety (reading anxiety).

Getting to grips with the heterogeneity of developmental dyslexia.

The aim of this study was to better understand the heterogeneity of developmental dyslexia by identifying the most common deficits in the reading systems of children with dyslexia with different poor word reading profiles. We classified the word reading profiles of 138 children with developmental dyslexia using nonword and irregular-word reading tests and then used independent experimental tests to explore the cognitive deficits within their word reading systems. The most common deficit associated with primary sublexical impairment (i.e., poor nonword reading) was poor grapheme-phoneme conversion (GPC) knowledge. The most common deficits associated with primary lexical impairment (i.e., poor irregular-word reading) were an impaired orthographic lexicon plus impaired links between this lexicon and the phonological lexicon and semantic knowledge. Finally, the most common deficits associated with mixed reading impairment (i.e., poor nonword reading and poor irregular-word reading) were poor GPC knowledge, an impaired orthographic lexicon, poor links between this lexicon and the phonological lexicon and semantic knowledge, and poor phonological output. We discuss the implications of these findings for theories of reading and for the diagnosis and treatment of dyslexia.

Phonics training for English-speaking poor readers.

BACKGROUND: Around 5% of English speakers have a significant problem with learning to read words. Poor word readers are often trained to use letter-sound rules to improve their reading skills. This training is commonly called phonics. Well over 100 studies have administered some form of phonics training to poor word readers. However, there are surprisingly few systematic reviews or meta-analyses of these studies. The most well-known review was done by the National Reading Panel (Ehri 2001) 12 years ago and needs updating. The most recent review (Suggate 2010) focused solely on children and did not include unpublished studies. OBJECTIVES: The primary aim of this review was to measure the effect that phonics training has on the literacy skills of English-speaking children, adolescents, and adults whose reading was at least one standard deviation (SD), one year, or one grade below the expected level, despite no reported problems that could explain their impaired ability to learn to read. A secondary objective was to explore the impact of various factors, such as length of training or training group size, that might moderate the effect of phonics training on poor word reading skills. SEARCH METHODS: We searched the following databases in July 2012: CENTRAL 2012 (Issue 6), MEDLINE 1948 to June week 3 2012, EMBASE 1980 to 2012 week 26, DARE 2013 (Issue 6), ERIC (1966 to current), PsycINFO (1806 to current), CINAHL (1938 to current), Science Citation Index (1970 to 29 June 2012), Social Science Citation Index (1970 to 29 June 2012), Conference Proceedings Citation Index - Science (1990 to 29 June 2012), Conference Proceedings Citation Index - Social Science & Humanities (1990 to 29 June 2012), ZETOC, Index to Theses-UK and Ireland, ClinicalTrials.gov, ICTRP, the metaRegister of Controlled Trials, ProQuest Dissertations and Theses, DART Europe E-theses Portal, Australasian Digital Theses Program, Education Research Theses, Electronic Theses Online System, Networked Digital Library of Theses and Dissertations. Theses Canada portal, www.dissertation.com, and www.thesisabstracts.com. We also contacted experts and examined the reference lists of published studies. SELECTION CRITERIA: We included studies that use randomisation, quasi-randomisation, or minimisation to allocate participants to either a phonics intervention group (phonics alone, phonics and phoneme awareness training, or phonics and irregular word reading training) or a control group (no training or alternative training, such as maths). Participants were English-speaking children, adolescents, or adults whose word reading was below the level expected for their age for no known reason (that is, they had adequate attention and no known physical, neurological, or psychological problems). DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias, and extracted data. MAIN RESULTS: We found 11 studies that met the criteria for this review. They involved 736 participants. We measured the effect of phonics training on eight outcomes. The amount of evidence for each outcome varied considerably, ranging from 10 studies for word reading accuracy to one study for nonword reading fluency. The effect sizes for the outcomes were: word reading accuracy standardised mean difference (SMD) 0.47 (95% confidence interval (CI) 0.06 to 0.88; 10 studies), nonword reading accuracy SMD 0.76 (95% CI 0.25 to 1.27; eight studies), word reading fluency SMD -0.51 (95% CI -1.14 to 0.13; two studies), reading comprehension SMD 0.14 (95% CI -0.46 to 0.74; three studies), spelling SMD 0.36 (95% CI -0.27 to 1.00; two studies), letter-sound knowledge SMD 0.35 (95% CI 0.04 to 0.65; three studies), and phonological output SMD 0.38 (95% -0.04 to 0.80; four studies). There was one result in a negative direction for nonword reading fluency SMD 0.38 (95% CI -0.55 to 1.32; one study), though this was not statistically significant.We did five subgroup analyses on two outcomes that had sufficient data (word reading accuracy and nonword reading accuracy). The efficacy of phonics training was not moderated significantly by training type (phonics alone versus phonics and phoneme awareness versus phonics and irregular word training), training intensity (less than two hours per week versus at least two hours per week), training duration (less than three months versus at least three months), training group size (one-on-one versus small group training), or training administrator (human administration versus computer administration). AUTHORS' CONCLUSIONS: Phonics training appears to be effective for improving some reading skills. Specifically, statistically significant effects were found for nonword reading accuracy (large effect), word reading accuracy (moderate effect), and letter-sound knowledge (small-to-moderate effect). For several other outcomes, there were small or moderate effect sizes that did not reach statistical significance but may be meaningful: word reading fluency, spelling, phonological output, and reading comprehension. The effect for nonword reading fluency, which was measured in only one study, was in a negative direction, but this was not statistically significant.Future studies of phonics training need to improve the reporting of procedures used for random sequence generation, allocation concealment, and blinding of participants, personnel, and outcome assessment.

Low self-concept in poor readers: prevalence, heterogeneity, and risk.

There is evidence that poor readers are at increased risk for various types of low self-concept-particularly academic self-concept. However, this evidence ignores the heterogeneous nature of poor readers, and hence the likelihood that not all poor readers have low self-concept. The aim of this study was to better understand which types of poor readers have low self-concept. We tested 77 children with poor reading for their age for four types of self-concept, four types of reading, three types of spoken language, and two types of attention. We found that poor readers with poor attention had low academic self-concept, while poor readers with poor spoken language had low general self-concept in addition to low academic self-concept. In contrast, poor readers with typical spoken language and attention did not have low self-concept of any type. We also discovered that academic self-concept was reliably associated with reading and receptive spoken vocabulary, and that general self-concept was reliably associated with spoken vocabulary. These outcomes suggest that poor readers with multiple impairments in reading, language, and attention are at higher risk for low academic and general self-concept, and hence need to be assessed for self-concept in clinical practice. Our results also highlight the need for further investigation into the heterogeneous nature of self-concept in poor readers.

Sight Word and Phonics Training in Children With Dyslexia.

The aims of this study were to (a) compare sight word training and phonics training in children with dyslexia, and (b) determine if different orders of sight word and phonics training have different effects on the reading skills of children with dyslexia. One group of children (n = 36) did 8 weeks of phonics training (reading via grapheme-phoneme correspondence rules) and then 8 weeks of sight word training (reading irregular words as a whole), one group did the reverse (n = 36), and one group did phonics and sight word training simultaneously for two 8-week periods (n = 32). We measured the effects of phonics and sight word training on sight word reading (trained irregular word reading accuracy, untrained irregular word reading accuracy), phonics reading (nonword reading accuracy, nonword reading fluency), and general reading (word reading fluency, reading comprehension). Sight word training led to significant gains in sight word reading measures that were larger than gains made from phonics training, phonics training led to statistically significant gains in a phonics reading measure that were larger than gains made from sight word training, and both types of training led to significant gains in general reading that were similar in size. Training phonics before sight words had a slight advantage over the reverse order. We discuss the clinical implications of these findings for improving the treatment and assessment of children with dyslexia.