Is the treatment weak or the test insensitive: Interrogating item difficulties to elucidate the nature of reading intervention effects.

Intervention research in education is sometimes criticized for the use of experimenter developed assessments, especially when these are over aligned with treatment. At the same time, intervention researchers sometimes prefer locally developed assessments because they appear to be more sensitive to treatment effects even when the test is not subject to the criticism of over alignment. This paper examines the question of test sensitivity to treatment effects for experimenter developed and standardized tests for the specific case of reading in grade 8. We examine similarities and differences between a specific experimenter developed test and widely used standardized reading assessment. Analyses show these particular tests to be quite comparable. The paper concludes with an examination of test sensitivity by simulating treatment effects of different magnitudes. These analyses highlight some potential limitations of the standardized test for detecting small to moderate effects depending on the ability range of the students participating in intervention. The implications for intervention research and identification of students under response to intervention are discussed.

Early Detection of Dyslexia Risk: Development of Brief, Teacher-Administered Screens.

Many states now mandate early screening for dyslexia, but vary in how they address these mandates. There is confusion about the nature of screening versus diagnostic assessments, risk versus diagnosis, concurrent versus predictive validity, and inattention to indices of classification accuracy as the basis for determining risk. To help define what constitutes a screening assessment, we summarize efforts to develop short (3-5 min), teacher-administered screens that used multivariate strategies for variable selection, item response theory to select items that are most discriminating at a threshold for predicting risk, and statistical decision theory. These methods optimize prediction and lower the burden on teachers by reducing the number of items needed to evaluate risk. A specific goal of these efforts was to minimize decision errors that would result in the failure to identify a child as at risk of dyslexia/reading problems (false negatives) despite the inevitable increase in identifications of children who eventually perform in the typical range (false positives). Five screens, developed for different periods during kindergarten, Grade 1, and Grade 2, predicted outcomes measured later in the same school year (Grade 2) or in the subsequent year (Grade 1). The results of this approach to development are applicable to other screening methods, especially those that attempt to predict those children at risk of dyslexia prior to the onset of reading instruction. Without reliable and valid early predictive screening measures that reduce the burden on teachers, early intervention and prevention of dyslexia and related reading problems will be difficult.

Longitudinal Changes in Disability Rating Scale Scores: A Secondary Analysis Among Patients With Severe TBI Enrolled in the Epo Clinical Trial.

OBJECTIVES: Long-term neurological response to treatment after a severe traumatic brain injury (sTBI) is a dynamic process. Failure to capture individual heterogeneity in recovery may impact findings from single endpoint sTBI randomized controlled trials (RCT). The present study re-examined the efficacy of erythropoietin (Epo) and transfusion thresholds through longitudinal modeling of sTBI recovery as measured by the Disability Rating Scale (DRS). This study complements the report of primary outcomes in the Epo sTBI RCT, which failed to detect significant effects of acute treatment at 6 months post-injury. METHODS: We implemented mixed effects models to characterize the recovery time-course and to examine treatment efficacy as a function of time post-injury and injury severity. RESULTS: The inter-quartile range (25th-75th percentile) of DRS scores was 20-28 at week1; 8-24 at week 4; and 3-17 at 6 months. TBI severity group was found to significantly interact with Epo randomization group on mean DRS recovery curves. No significant differences in DRS recovery were found in transfusion threshold groups. CONCLUSIONS: This study demonstrated the value of taking a comprehensive view of recovery from sTBI in the Epo RCT as a temporally dynamic process that is shaped by both treatment and injury severity, and highlights the importance of the timing of primary outcome measurement. Effects of Epo treatment varied as a function of injury severity and time. Future studies are warranted to understand the possible moderating influence of injury severity on treatment effects pertaining to sTBI recovery. (JINS, 2019, 25, 293-301).

Identification, Classification, and Treatment of Reading and Language Disabilities in Spanish-Speaking EL Students: Introduction to the Special Issue.

This article serves as an introduction to the special issue on Identification, Classification, and Treatment of Reading and Language Disabilities in Spanish-speaking English Learners. The article explains the driving forces behind the need for the special issue, the global nature of linguistic diversity, and provides an overview of the five papers that comprise the special issue.

Moving Forward by Looking Back: Understanding Why Some Spanish-Speaking English Learners Fall Behind.

This study investigated early indicators of Spanish-speaking English learners (ELs) at risk for reading difficulties at the end of Grade 2 by examining their early bilingual oral language development, taking into account language of academic instruction. Standardized measures of reading and narrative samples were collected in English and Spanish from kindergarten to Grade 2 from 1,243 ELs primarily instructed in English or Spanish. Conditional growth curve models yielded four primary findings of reading and oral language development. First, ELs with low reading achievement at the end of Grade 2 demonstrated early reading difficulties during kindergarten. Second, although ELs demonstrated overall higher reading achievement in their instructed language, this difference decreased over time. Third, ELs with low reading achievement at the end of Grade 2 demonstrated lower oral language skills in each language over time. Fourth, ELs demonstrated overall higher oral language skills in their instructed language, yet these differences varied over time. The study provided a detailed description of the longitudinal relations among the bilingual reading and oral language skills of Spanish-speaking ELs during the early school years. These findings help to inform the processes of early identification and intervention for Spanish-speaking ELs who are likely to demonstrate reading achievement difficulties.

Bilingual Phonological Awareness: Construct Validation in Grade 1 Spanish-Speaking English Learners.

This study investigated the dimensionality of bilingual phonological awareness (PA) in English and Spanish by replicating a kindergarten model in Grade 1, and presents alternatives to modeling clustered data. English and Spanish tasks were analyzed from previously collected samples totaling 1,586 first grade Spanish-speaking English learners. Four distinct approaches to confirmatory factor analysis (CFA) models were examined: (a) uncentered student-level data, (b) student-level data centered at the classroom means, (c) classroom-level data, and (d) multilevel CFA. Results indicated that while the multilevel CFA provided the most comprehensive view of the data, the multi-level student-level estimates were not appreciably different from estimates based on student-level data centered at the classroom means, and multi-level classroom-level estimates were comparable to estimates based on the analysis of classroom means. Importantly, English and Spanish PA were statistically separable at the student-level, but minimally distinct (r = .86) and slightly less correlated than what has been reported for kindergarten (r = .93). At the classroom level, the correlation was moderate (r = .51), and substantially reduced compared to kindergarten (r = .83). The distinction at the classroom-level between kindergarten and Grade 1 implies that instruction differentiates the abilities across languages at the classroom-level, but less so at the student-level.

IQ-Achievement Discrepancy for Identification of Disabilities in Spanish-speaking English Learners.

This article examines the validity of IQ-achievement discrepancy and low achievement as criteria for the identification of disabilities in Spanish-speaking English-language learners (ELs) and the factors that moderate the validity of these approaches as bases for identification. While there has been a long history of examining the validity of different approaches to disability identification in monolinguals, there are no systematic approaches taken for ELs. Data from Grades 1 and 2 of a large longitudinal data set consisting of young Spanish-speaking students attending schools in the United States were used to empirically examine criteria for disability identification among language minority children-one of the first large-scale attempts. Findings indicated significant overidentification when the language of assessment was not matched to the language of the instruction, although the effects varied predictably over time and by language of instruction. Validation of classifications using measures external to the classification found that low achieving and discrepant children differ from typically developing children, and from one another in predictable ways based on differences in IQ. The study highlights the importance of taking into account the language of instruction and the severity of the cut-off to reduce misidentification of typically developing children.

Speaking and Reading in Two Languages: On the Identification of Reading and Language Disabilities in Spanish-Speaking English Learners.

Articles in this issue examine (1) the primary sources of variability in reading and language achievement among Spanish-speaking English learners (ELs) in the United States, (2) the extent to which poor performance at the end of grade 2 is identifiable in developmental trajectories beginning in kindergarten, (3) the relations among core reading constructs of phonological awareness and decoding in both English and Spanish and the factors that affect their relationship, (4) the performance of different approaches to identification and the factors that influence how well they work, as well as (5) the growing literature focused on intervention for reading problems in this population. This article examines the literature on language minority students and disability identification and analyzes a large-scale longitudinal dataset (>4,000 ELs; >15,000 observations) to systematically characterize and describe the oral language and reading development of Spanish-speaking children designated as ELs from kindergarten to second grade, considering a range of factors that may potentially contribute to that characterization and its relation to academic performance. This systematic characterization should facilitate the development of an empirical basis for a theoretically grounded framework of typical development in ELs in order to more precisely identify those children with language and learning disabilities.

Extending the Simple View of Reading to Account for Variation Within Readers and Across Texts: The Complete View of Reading (CVRi).

This study leverages advances in multivariate cross-classified random effects models to extend the Simple View of Reading to account for variation within readers and across texts, allowing for both the personalization of the reading function and the integration of the component skills and text and discourse frameworks for reading research. We illustrate the Complete View of Reading (CVRi) using data from an intensive longitudinal design study with a large sample of typical (N = 648) and struggling readers (N = 865) in middle school and using oral reading fluency as a proxy for comprehension. To illustrate the utility of the CVRi, we present a model with cross-classified random intercepts for students and passages and random slopes for growth, Lexile difficulty, and expository text type at the student level. We highlight differences between typical and struggling readers and differences across students in different grades. The model illustrates that readers develop differently and approach the reading task differently, showing differential impact of text features on their fluency. To be complete, a model of reading must be able to reflect this heterogeneity at the person and passage level, and the CVRi is a step in that direction. Implications for reading interventions and 21st century reading research in the era of "Big Data" and interest in phenotypic characterization are discussed.

Visual-motor integration skills: accuracy of predicting reading.

PURPOSE: This article investigated the contribution of visual-motor integration (VMI) to reading ability when known predictors of later reading outcomes were also present in the data analysis. METHODS: Participants included 778 first and second grade students from a large diverse urban district in Texas. The data were analyzed using multiple regression models with a forced entry of predictors for each regression model, and each model was run separately for each outcome. RESULTS: The results indicate that VMI drops out of the prediction models once more reading- and language-specific skills are introduced. CONCLUSIONS: Although VMI skills make a statistically significant contribution in some aspects of the regression model, the reduction in contribution reduces the predictive validity of VMI skills. Therefore, a VMI skill measure will not sufficiently determine if a child has a reading disability.

Beyond the bilingual advantage: The potential role of genes and environment on the development of cognitive control.

In recent years there has been considerable debate about the presence or absence of a bilingual advantage in tasks that involve cognitive control. Our previous work has established evidence of differences in brain activity between monolinguals and bilinguals in both word learning and in the avoidance of interference during a picture selection task. Recent models of cognitive control have highlighted the importance of a set of neural structures that may show differential tuning due to exposure to two languages. There is also evidence that genetic factors play a role in the availability of dopamine in neural structures involved in cognitive control. Thus, it is important to investigate whether there are interactions effects generating variability in language acquisition when attributed to genetic (e.g., characteristics of dopamine turnover) and environmental (e.g., exposure to two languages) factors. Here preliminary results from genotyping of a sample of bilingual and monolingual individuals are reported. They reveal different distributions in allele frequencies of the DRD2/ANKK1 taq1A polymorphism. These results bring up the possibility that bilinguals may exhibit additional flexibility due to differences in genetic characteristics relative to monolinguals. Future studies should consider genotype as a possible contributing factor to the development of cognitive control across individuals with different language learning histories.

The Relation of Knowledge-Text Integration Processes and Reading Comprehension in 7th- to 12th-Grade Students.

The integration of knowledge during reading was tested in 1,109 secondary school students. Reading times for the second sentence in a pair (Jane's headache went away) were compared in conditions where the first sentence was either causally or temporally related to the first sentence (Jane took an aspirin vs. Jane looked for an aspirin). Mixed-effects explanatory item response models revealed that at higher comprehension levels, sentences were read more quickly in the causal condition. There were no condition-related reading time differences at lower comprehension levels. This interaction held with comprehension- and inference-related factors (working memory, word and world knowledge, and word reading efficiency) in the models. Less skilled comprehenders have difficulty in knowledge-text integration processes that facilitate sentence processing during reading.

The Contribution of Attentional Control and Working Memory to Reading Comprehension and Decoding.

Little is known about how specific components of working memory, namely, attentional processes including response inhibition, sustained attention, and cognitive inhibition, are related to reading decoding and comprehension. The current study evaluated the relations of reading comprehension, decoding, working memory, and attentional control in 1,134 adolescent students. Path analyses were used to assess the direct and indirect effects of working memory and aspects of attentional control on reading comprehension and decoding. There were significant direct effects of working memory, sustained attention, and cognitive inhibition on reading comprehension, but not decoding. There was a significant direct effect of working memory and response inhibition on decoding, but not comprehension. These results suggest that different aspects of attentional control are important for decoding versus comprehension.

Predicting reading outcomes with progress monitoring slopes among middle grade students.

Effective implementation of response-to-intervention (RTI) frameworks depends on efficient tools for monitoring progress. Evaluations of growth (i.e., slope) may be less efficient than evaluations of status at a single time point, especially if slopes do not add to predictions of outcomes over status. We examined progress monitoring slope validity for predicting reading outcomes among middle school students by evaluating latent growth models for different progress monitoring measure-outcome combinations. We used multi-group modeling to evaluate the effects of reading ability, reading intervention, and progress monitoring administration condition on slope validity. Slope validity was greatest when progress monitoring was aligned with the outcome (i.e., word reading fluency slope was used to predict fluency outcomes in contrast to comprehension outcomes), but effects varied across administration conditions (viz., repeated reading of familiar vs. novel passages). Unless the progress monitoring measure is highly aligned with outcome, slope may be an inefficient method for evaluating progress in an RTI context.

Early development of saliency-driven attention through object manipulation.

In the first years of life, infants progressively develop attention selection skills to gather information from visually clustered environments. As young as newborns, infants are sensitive to the distinguished differences in color, orientation, and luminance, which are the components of visual saliency. However, we know little about how saliency-driven attention emerges and develops socially through everyday free-viewing experiences. The present work assessed the saliency change in infants' egocentric scenes and investigated the impacts of manual engagements on infant object looking in the interactive context of object play. Thirty parent-infant dyads, including infants in two age groups (younger: 3- to 6-month-old; older: 9- to 12-month-old), completed a brief session of object play. Infants' looking behaviors were recorded by the head-mounted eye-tracking gear, and both parents' and infants' manual actions on objects were annotated separately for analyses. The present findings revealed distinct attention mechanisms that underlie the hand-eye coordination between parents and infants and within infants during object play: younger infants are predominantly biased toward the characteristics of the visual saliency accompanying the parent's handled actions on the objects; on the other hand, older infants gradually employed more attention to the object, regardless of the saliency in view, as they gained more self-generated manual actions. Taken together, the present work highlights the tight coordination between visual experiences and sensorimotor competence and proposes a novel dyadic pathway to sustained attention that social sensitivity to parents' hands emerges through saliency-driven attention, preparing infants to focus, follow, and steadily track moving targets in free-flow viewing activities.

Benchmarking signal quality and spatiotemporal distribution of interictal spikes in prolonged human iEEG recordings using CorTec wireless brain interchange.

Neuromodulation through implantable pulse generators (IPGs) represents an important treatment approach for neurological disorders. While the field has observed the success of state-of-the-art interventions, such as deep brain stimulation (DBS) or responsive neurostimulation (RNS), implantable systems face various technical challenges, including the restriction of recording from a limited number of brain sites, power management, and limited external access to the assessed neural data in a continuous fashion. To the best of our knowledge, for the first time in this study, we investigated the feasibility of recording human intracranial EEG (iEEG) using a benchtop version of the Brain Interchange (BIC) unit of CorTec, which is a portable, wireless, and externally powered implant with sensing and stimulation capabilities. We developed a MATLAB/SIMULINK-based rapid prototyping environment and a graphical user interface (GUI) to acquire and visualize the iEEG captured from all 32 channels of the BIC unit. We recorded prolonged iEEG (~ 24 h) from three human subjects with externalized depth leads using the BIC and commercially available clinical amplifiers simultaneously in the epilepsy monitoring unit (EMU). The iEEG signal quality of both streams was compared, and the results demonstrated a comparable power spectral density (PSD) in all the systems in the low-frequency band (< 80 Hz). However, notable differences were primarily observed above 100 Hz, where the clinical amplifiers were associated with lower noise floor (BIC-17 dB vs. clinical amplifiers < - 25 dB). We employed an established spike detector to assess and compare the spike rates in each iEEG stream. We observed over 90% conformity between the spikes rates and their spatial distribution captured with BIC and clinical systems. Additionally, we quantified the packet loss characteristic in the iEEG signal during the wireless data transfer and conducted a series of simulations to compare the performance of different interpolation methods for recovering the missing packets in signals at different frequency bands. We noted that simple linear interpolation has the potential to recover the signal and reduce the noise floor with modest packet loss levels reaching up to 10%. Overall, our results indicate that while tethered clinical amplifiers exhibited noticeably better noise floor above 80 Hz, epileptic spikes can still be detected successfully in the iEEG recorded with the externally powered wireless BIC unit opening the road for future closed-loop neuromodulation applications with continuous access to brain activity.

Effects of Tier 3 Intervention for Students With Persistent Reading Difficulties and Characteristics of Inadequate Responders.

This article describes a randomized controlled trial conducted to evaluate the effects of an intensive, individualized, Tier 3 reading intervention for second grade students who had previously experienced inadequate response to quality first grade classroom reading instruction (Tier 1) and supplemental small-group intervention (Tier 2). Also evaluated were cognitive characteristics of students with inadequate response to intensive Tier 3 intervention. Students were randomized to receive the research intervention (N = 47) or the instruction and intervention typically provided in their schools (N = 25). Results indicated that students who received the research intervention made significantly better growth than those who received typical school instruction on measures of word identification, phonemic decoding, and word reading fluency and on a measure of sentence- and paragraph-level reading comprehension. Treatment effects were smaller and not statistically significant on phonemic decoding efficiency, text reading fluency, and reading comprehension in extended text. Effect sizes for all outcomes except oral reading fluency met criteria for substantive importance; however, many of the students in the intervention continued to struggle. An evaluation of cognitive profiles of adequate and inadequate responders was consistent with a continuum of severity (as opposed to qualitative differences), showing greater language and reading impairment prior to the intervention in students who were inadequate responders.

Longitudinal Examination of Morphosyntactic Skills in Bilingual Children: Spanish and English Standardized Scores.

PURPOSE: This study aimed to examine changes in English and Spanish morphosyntactic standardized scores over time in bilingual children. METHOD: One hundred bilingual children participated in this longitudinal study. The average age of the children at the beginning of the study was 5;11 (years;months). A subset of the participants was identified as children with developmental language disorder (DLD, n = 43). Children completed behavioral testing in Spanish and English at three time points over a period of 2 years. Growth curve modeling was employed to analyze longitudinal data. RESULTS: Distinct patterns of Spanish and English language growth were observed. While the average standard score in English increased, the average score in Spanish decreased over time for both groups. Children with DLD showed persistent language difficulties in both Spanish and English over time in comparison to their peers. CONCLUSIONS: The results of this study provide evidence of a shift in language proficiency from Spanish to English for bilingual children with and without language disorders. This study also shows that bilingual children with DLD show a protracted but parallel growth in morphosyntactic skills in comparison to children without DLD. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23671464.

Exploring Genetic and Neural Risk of Specific Reading Disability within a Nuclear Twin Family Case Study: A Translational Clinical Application.

Imaging and genetic studies have characterized biological risk factors contributing to specific reading disability (SRD). The current study aimed to apply this literature to a family of twins discordant for SRD and an older sibling with reading difficulty. Intraclass correlations were used to understand the similarity of imaging phenotypes between pairs. Reading-related genes and brain region phenotypes, including asymmetry indices representing the relative size of left compared to right hemispheric structures, were descriptively examined. SNPs that corresponded between the SRD siblings and not the typically developing (TD) siblings were in genes ZNF385D, LPHN3, CNTNAP2, FGF18, NOP9, CMIP, MYO18B, and RBFOX2. Imaging phenotypes were similar among all sibling pairs for grey matter volume and surface area, but cortical thickness in reading-related regions of interest (ROIs) was more similar among the siblings with SRD, followed by the twins, and then the TD twin and older siblings, suggesting cortical thickness may differentiate risk for this family. The siblings with SRD had more symmetry of cortical thickness in the transverse temporal and superior temporal gyri, while the TD sibling had greater rightward asymmetry. The TD sibling had a greater leftward asymmetry of grey matter volume and cortical surface area in the fusiform, supramarginal, and transverse temporal gyrus. This exploratory study demonstrated that reading-related risk factors appeared to correspond with SRD within this family, suggesting that early examination of biological factors may benefit early identification. Future studies may benefit from the use of polygenic risk scores or machine learning to better understand SRD risk.

Evaluation of an integrated personalized feedback intervention for hazardous drinkers with elevated anxiety sensitivity and PTSD symptoms: Protocol for a randomized controlled trial.

Background: Hazardous drinking and posttraumatic stress disorder (PTSD) are commonly co-occurring conditions among adults. Motivational enhancement interventions, such as personalized feedback interventions (PFI), have demonstrated efficacy for reducing hazardous drinking. Emerging though scant literature has evaluated PFI for co-occurring PTSD and hazardous alcohol use. A transdiagnostic risk factor that may underlie this co-occurrence and inform novel PFI development is anxiety sensitivity (AS). Objective: To use a randomized controlled trial to evaluate the efficacy of a novel, computer-based PFI for hazardous drinkers with at least subclinical PTSD and elevated AS (AP-PFI), against a time-matched comparison condition (C-PFI). Methods: Participants (N = 100) will be recruited and enrolled from the Houston, TX community. The study includes: an in-person visit (baseline diagnostic assessment, a brief intervention, and a post-intervention assessment) and two follow-up assessments (1-week and 1-month). Participants who meet study inclusion criteria will be randomized to one of two conditions at baseline: AP-PFI or C-PFI. AP-PFI will consist of a brief, single-session, computer-delivered, PFI-based intervention that provides integrative and normative feedback about alcohol use, AS, and PTSD symptoms. C-PFI will be time-matched but will only include alcohol-related feedback. Conclusions: AP-PFI is designed to provide feedback about alcohol use, PTSD symptoms, and AS and their interplay and deliver psychoeducation on harm-reduction techniques, interoceptive exposure exercises, and stress management strategies. The intervention may address extant gaps in treatment for these co-occurring conditions by providing a brief, evidence-based, motivational enhancement intervention that is cost-effective with potential to be disseminated across a variety of healthcare settings.