Reading Comprehension Deficits Research Articles

Developing an evidence-based reading intervention for early brain injury rehabilitation

AbstractIntroduction:Providing evidence-based services in areas with emerging or low-level evidence is a challenge for many clinicians. The aim of the current study was to apply a newly designed novel methodology to develop and describe a new intervention for cognitive-communication reading comprehension deficits in early acquired brain injury rehabilitation.Methods:An emergent multi-phase mixed methods design allowed phases of different research activity to build an evidence base of quantitative and qualitative data. A pragmatic clinical framework was developed to combine these traditional research findings with principles from knowledge translation and implementation science, evidence-based practice and intervention development models, clinical contextual practice guidelines and the Medical Research Council’s guidelines for developing and evaluating complex interventions, to create an evidence-based contextually driven clinical intervention.Results:The resulting reading comprehension intervention and service delivery model is presented and involves a multiple-strategy intervention across increasing level of reading comprehension complexity. In areas where traditional methodologies provide low-level evidence, this method provides an alternate way to conduct evidence-based clinical research.

Strategy-based reading comprehension therapy during early acquired brain injury rehabilitation: preliminary results

Introduction An evidence-based intervention and service delivery model for early acquired brain injury reading comprehension rehabilitation (involving multiple-strategy, hierarchical reading) was investigated with 3 clients <3 m post onset as part of their brain injury rehabilitation program. Materials and methods A multiple-baseline single case experimental design was used for each participant, with data analysed using Tau-U. Assessments of reading comprehension (impairment and activity level) were performed pre/post intervention, and at follow-up (3–6 months post-treatment). Participants’ perceptions of the intervention and service delivery model were captured via semi-structured interviews. Results All participants demonstrated improved reading comprehension post-intervention on all formal measures. At follow-up, reading comprehension was grossly maintained by 2 participants. The single case experimental design results (Tau-U) showed moderate-large intervention effect sizes for factual and inferential reading comprehension, two participants had significant (p = 0.01) changes. Participants reported overall positive experiences with the intervention. Conclusion The intervention and service delivery model were successfully implemented in clinical practice, and preliminary results show the intervention has clinical promise with an early acquired brain injury population. IMPLICATIONS FOR REHABILITATION Cognitive communication reading comprehension deficits occur following acquired brain injury and impact participation during rehabilitation and in the community. An evidence-based intervention for the early rehabilitation of cognitive communication reading comprehension deficits following acquired brain injury has been developed and trialled in clinical practice with adults <3 months post-acquired brain injury, via a series of single-case experimental designs. Improvements in reading comprehension skill and activity/participation occurred for all participants post-intervention; statistically significant changes occurred for 2 of 3 clients. Early rehabilitation of cognitive communication reading comprehension deficits can be successfully implemented as a component of a multidisciplinary rehabilitation program.

Concepções de leitura e formação do leitor nos anos iniciais do ensino fundamental nos documentos oficiais de ensino

The process of training a reader is built through stimulation and mediation, this process has often been addressed, for its difficulties in training a reader with autonomy, since the number of students who reach the end of elementary school with difficulties in reading a simple text, that is, with a deficit in reading comprehension. Through bibliographical studies on authors who have been discussing this problem, I will try to elucidate the process of training the reader, on the conceptions and methodologies that collaborate in the training of a proficient reader, based on the official teaching documents in the areas of reading, and through these I will try to highlight how reading lies within these documents and what contributions they bring to the training of the autonomous reader in the initial years of elementary school.

Sleep-dependent consolidation in children with comprehension and vocabulary weaknesses: it'll be alright on the night?

Vocabulary is crucial for an array of life outcomes and is frequently impaired in developmental disorders. Notably, 'poor comprehenders' (children with reading comprehension deficits but intact word reading) often have vocabulary deficits, but underlying mechanisms remain unclear. Prior research suggests intact encoding but difficulties consolidating new word knowledge. We test the hypothesis that poor comprehenders' sleep-associated vocabulary consolidation is compromised by their impoverished lexical-semantic knowledge. Memory for new words was tracked across wake and sleep to assess encoding and consolidation in 8-to-12-year-old good and poor comprehenders. Each child participated in two sets of sessions, one beginning in the morning (AM-encoding) and the other in the evening (PM-encoding). In each case, they were taught 12 words and were trained on a spatial memory task. Memory was assessed immediately, 12- and 24-hr later via stem-completion, picture-naming, and definition tasks to probe different aspects of word knowledge. Long-term retention was assessed 1-2months later. Recall of word-forms improved over sleep and postsleep wake, as measured in both stem-completion and picture-naming tasks. Counter to hypotheses, deficits for poor comprehenders were not observed in consolidation but instead were seen across measures and throughout testing, suggesting a deficit from encoding. Variability in vocabulary knowledge across the whole sample predicted sleep-associated consolidation, but only when words were learned early in the day and not when sleep followed soon after learning. Poor comprehenders showed weaker memory for new words than good comprehenders, but sleep-associated consolidation benefits were comparable between groups. Sleeping soon after learning had long-lasting benefits for memory and may be especially beneficial for children with weaker vocabulary. These results provide new insights into the breadth of poor comprehenders' vocabulary weaknesses, and ways in which learning might be better timed to remediate vocabulary difficulties.

Designing Occupational Therapy Home Programs for People With Aphasia: Aphasia-Friendly Modifications

Purpose The purpose of this article is to describe aphasia-friendly modification for occupational therapy assessments and home programs aimed at addressing upper extremity impairments for people post stroke. Method This article examines a case study example from a larger study (Wallace, Donoso Brown, Saylor, &amp; Lapp, 2018 ) that implemented aphasia-friendly material modifications into an occupational therapy home program. The participant was a 74-year-old man who survived a left hemisphere cerebrovascular attack 6 years prior to the study. The participant experienced upper extremity hemiparesis and aphasia post stroke and was appropriate for an occupational therapy home exercise program with aphasia-friendly modifications to facilitate comprehension of the home program. Aphasia-friendly modifications (e.g., gestures and visual aids) were made to assessments to support comprehension and participation. To support reading comprehension deficits during completion of the home program, the program materials had aphasia-friendly modifications, such as modified text, supportive images, and reduced cognitive load of exercises. Finally, research team members used supported conversational techniques during all study procedures. Results At the end of the home program, an interview with the participant revealed several outcomes regarding the home program and the aphasia-friendly modifications. The participant reported pictures and reduced text to be beneficial in understanding the instructions. He also indicated that he enjoyed completing the exercises independently (i.e., outside of a therapy office). The participant's motor function demonstrated changes in a positive direction, although not greater than the minimally detectable change for performance-based measures. Conclusions Aphasia-friendly modifications (e.g., modifying text, adding supportive images, and using gestures) were found to be supportive of participation in assessments for and creation of an upper extremity home program. Speech-language pathologists can support the participation of people with aphasia through interprofessional collaboration and consideration of environmental adaptations.

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

Oral reading fluency (ORF) deficits are a hallmark of reading difficulties. The impact of fluency struggles extends beyond word-level difficulties to include deficits in reading comprehension. Sixteen empirical studies conducted in 2000–2019 that examined ORF interventions among elementary students identified as having reading difficulties were reviewed to identify the characteristics (e.g., instructional variables, group size, type of interventionist) of effective ORF interventions and their impact on English oral reading fluency and reading comprehension outcomes. The systematic review revealed that interventions reported centered around repeated reading procedures (86.5%). Across the 16 studies, outcomes for oral reading fluency varied widely and most focused on speed and rate aspects rather than prosody. Effect sizes for rate and accuracy measures ranged from negligible to large (i.e., 0.01 to 1.18) and three studies found large effects for prosody outcomes. Effect sizes for reading comprehension ranged between non-significant and large significant effects. Findings support the use of repeated reading of text to build up ORF of students with reading difficulties. Interventions that were found to be most effective were those that were conducted one-on-one with a trained model of fluent word reading and accuracy. Findings also point to three gaps in our understanding: (1) the efficacy of interventions other than repeated reading, (2) effects of ORF interventions on prosody outcomes, and (3) sustainability of outcomes.

Learning Lexical Information Depends Upon Task, Learning Approach, and Reader Subtype

Learning to read relies upon the integration of phonological, orthographic, and semantic information. However, no studies have investigated how children with varying reading abilities learn phonological-orthographic (PO) and semantic aspects of novel words as a function of both learning approach (LA; e.g., learning new words in isolation or context) and outcome (fluency or comprehension). In this study, 45 children participated in three tasks that differentially tested PO and semantic attributes of novel pseudo-words learned through two learning approaches. Children were classified into groups as having dyslexia (DYS), having specific reading comprehension deficits (S-RCDs), or being typically developing readers (TD). Differences were found between groups, with S-RCD poorer than TD on semantic but not PO components of learning. Children with DYS displayed impaired results on both semantic and PO learning but showed an interaction on task by LA performance. Specifically, in the DYS group, isolation LA yielded better performance on PO learning, while context LA was better for semantic learning. These results indicate that (a) children with S-RCDs have a unique learning profile that is dissociable from DYS and TD and (b) reading impairments are not static but rather influence acquisition of reading skill in different ways, depending on reading profile.

Profile of hyperlexia: Reconciling conflicts through a systematic review and meta-analysis

Abstract It is believed that children with poor decoding skills and adequate listening comprehension skills exhibit a dyslexia-type syndrome. However, there is no consensus relating to the other problem that arises: children who have exceptional decoding but poor listening comprehension. Sometimes, these children have been labeled as “individuals exhibiting hyperlexia.” There is no clear understanding of the following aspects of hyperlexia: a) population criteria (e.g., typically vs. atypically developing children), b) specific criteria (e.g., precocity, definition of “good decoding”) on their associations with reading, and c) the applicability of reading theories to hyperlexia (e.g., phonemic awareness is critical in decoding; both decoding and listening comprehension contribute to reading comprehension). Therefore, we conducted a systematic and meta-analytic review to explore these questions. We found that despite good decoding and verbal short-term memory skills, individuals with hyperlexia exhibit poor listening, verbal working memory, and reading comprehension skills. Also, all but three studies identified hyperlexics from atypical developing populations; however, criteria to define “good decoding” varied and the onset of precocious decoding behavior was not consistently reported. Our meta-regression analysis suggests that decoding still predicted the performance of reading comprehension after controlling for listening comprehension, suggesting that the variations of defining “good decoding” led to different reading comprehension profiles (e.g., mild vs. severe reading comprehension deficit). Further, listening comprehension but not decoding is related to phonemic awareness, which may be due to the difficulty of understanding phonemic awareness tasks. However, it may also suggest that the current decoding theory is not applied to hyperlexia. Future suggestions for hyperlexia research are provided.

Academic and Behavioral Strategies to Enhance the Understanding of Expository Text for Secondary Students With EBD

Secondary students with emotional and behavioral disorders may experience a phenomenon known as the failure cycle where behavioral needs and academic deficits negatively impact learning, including reading comprehension. Self-regulated strategy development (SRSD) is one emerging method that addresses behavioral needs and reading comprehension deficits and allows for the integration of low-intensity behavioral strategies. This article demonstrates how two low-intensity behavioral strategies, opportunities to respond and behavior-specific praise, can be embedded in SRSD reading instruction.

Reading outcomes of children with delayed early vocabulary: A follow-up from age 2–16

BackgroundDelays in expressive vocabulary have been associated with lower outcomes in reading. AimThe aim is to conduct a long-term follow-up study to investigate if early expressive vocabulary delay (late talking) predicts reading development in participants age 16 and under. We examine further if the prediction is different in the presence of family risk for dyslexia (FR) and early receptive vocabulary delay. MethodsExpressive and receptive vocabulary skills were assessed at the age of 2–2.5 years, and reading skills in Grades 2, 3, 8 and 9 (age 8–16). The longitudinal sample consisted of 200 Finnish-speaking children, of which 108 had FR for dyslexia and 92 came from families without reading difficulties. We compared the reading development of five subgroups: 1) FR and no vocabulary delay; 2) FR and late talkers, 3) FR, late talkers and co-existing receptive vocabulary delay; 4) no FR and late talkers; and 5) no FR and no vocabulary delay. ResultsThe group with FR and expressive and receptive vocabulary delay had difficulties in reading comprehension, but not in reading fluency. The late talkers without receptive vocabulary difficulties tended to become typical readers. Conclusions and implicationsDelays in early vocabulary can lead to a reading comprehension deficit, with the specification that expressive vocabulary deficit alone can alleviate in time, whereas the combined deficit is a stronger risk marker.

Can the Relationship Between Rapid Automatized Naming and Word Reading Be Explained by a Catastrophe? Empirical Evidence From Students With and Without Reading Difficulties

The purpose of the present study was to explain the moderating role of rapid automatized naming (RAN) in word reading with a cusp catastrophe model. We hypothesized that increases in RAN performance speed beyond a critical point would be associated with the disruption in word reading, consistent with a “generic shutdown” hypothesis. Participants were 587 elementary schoolchildren (Grades 2–4), among whom 87 had reading comprehension difficulties per the IQ-achievement discrepancy criterion. Data were analyzed via a cusp catastrophe model derived from the nonlinear dynamics systems theory. Results indicated that for children with reading comprehension difficulties, as naming speed falls below a critical level, the association between core reading processes (word recognition and decoding) becomes chaotic and unpredictable. However, after the significant common variance attributed to motivation, emotional, and internalizing symptoms measures from RAN scores was partialed out, its role as a bifurcation variable was no longer evident. Taken together, these findings suggest that RAN represents a salient cognitive measure that may be associated with psychoemotional processes that are, at least in part, responsible for unpredictable and chaotic word reading behavior among children with reading comprehension deficits.

A Comparison of Incidental and Intentional Vocabulary Learning in English Language Learners with Reading Comprehension Deficits

A Comparison of Incidental and Intentional Vocabulary Learning in English Language Learners with Reading Comprehension Deficits

The Comprehension Problems of Children with Poor Reading Comprehension despite Adequate Decoding: A Meta-Analysis.

The purpose of this meta-analysis was to examine the comprehension problems of children who have a specific reading comprehension deficit (SCD), which is characterized by poor reading comprehension despite adequate decoding. The meta-analysis included 86 studies of children with SCD who were assessed in reading comprehension and oral language (vocabulary, listening comprehension, storytelling ability, and semantic and syntactic knowledge). Results indicated that children with SCD had deficits in oral language (d = -0.78, 95% CI [-0.89, -0.68], but these deficits were not as severe as their deficit in reading comprehension (d = -2.78, 95% CI [-3.01, -2.54]). When compared to reading comprehension age-matched normal readers, the oral language skills of the two groups were comparable (d = 0.32, 95% CI [-0.49, 1.14]), which suggests that the oral language weaknesses of children with SCD represent a developmental delay rather than developmental deviance. Theoretical and practical implications of these findings are discussed.

Correlatos electrofisiológicos de la lectura en niños con trastorno por déficit de atención/hiperactividad

To investigate whether or not the deficits in executive functions in the attention deficit hyperactivity disorder (ADHD) affect reading comprehension and identify a potential biological marker of this neuropsychological endophenotype through event-related potentials (ERP). The phenotypic association between reading comprehension and the specific functions of inhibition and working memory is studied. The sample consisted of 52 children with ADHD (8-13 years) divided in two groups according to the presence (TDAH-; n = 27; percentile < 30) or the absence (TDAH+; n = 25; percentile > 50) of reading comprehension deficits and a control group (n = 27). The executive functions were evaluated. The ERPs were assessed during a task in which anaphoric sentences of different lengths were presented, recording the ERP in the last adjective of the sentence that required a gender agreement. Working memory and inhibition were associated to reading comprehension performance. The ADHD+ group and the control group seem to detect the disagreement at 100 ms, while the ADHD- group does not activate its working memory until 250 ms. The delay in the implementation of the working memory mechanisms helps us to understand the deficits in reading comprehension of the ADHD- group.

The relation between text reading fluency and reading comprehension for students with autism spectrum disorders

Deficits in reading comprehension have been well documented in individuals with autism. Researchers have begun to identify predictors of reading comprehension; we sought to add to this knowledge base by investigating the role of text reading fluency in the prediction of reading comprehension in a sample of individuals with higher functioning autism (HFASD). A comprehensive reading battery was administered to students with HFASD (N=68) and age- matched typically developing (TD) students (N=38). Significant differences were detected between the HFASD and TD samples on every reading measure, favoring the TD sample. Structural Equation Models with the HFASD indicates that text reading fluency significantly predicts reading comprehension above and beyond the contribution of other reading variables which have been shown to be significant predictors in previous studies. This finding has important implications for the treatment of reading deficits in individuals with HFASD.

Reading Comprehension Deficits in Adolescents: Addressing Underlying Language Abilities.

The purpose of this article is to discuss reading comprehension deficits in adolescents in relation to their word reading skills and lexical and syntactic development. Although reading comprehension strategies (e.g., "Find the main idea") are often recommended, it is argued that before these can be effective, students' underlying language deficits should be addressed. Data from a longitudinal study are analyzed to determine the relationship between reading comprehension, word reading, and lexical and syntactic development in adolescents. The findings indicate that poor reading comprehension in adolescents is predicted by concurrent deficits in word reading ability, lexical development, and syntactic development. When poor comprehension is accompanied by deficits in word reading ability and/or lexical and syntactic development, intervention should target the underlying areas of deficiency. Studies designed to improve reading comprehension in adolescents are needed.

Understanding poor comprehenders in different orthographies: Universal versus language‐specific skills

Despite an emerging focus on poor comprehenders in recent reading research, a number of unresolved issues concerning the cognitive and linguistic underpinnings of this disorder remain. In this special issue, we bring together a set of six papers examining the strengths and weaknesses of different types of poor comprehenders across multiple languages, including English, French and Chinese. Key findings of these studies show that certain oral language skills, such as morphological awareness and syntactic awareness, are related to reading comprehension deficits in different languages, suggesting their universality. Intriguingly, dissociability and co‐occurrence of reading comprehension difficulties have been identified in bilingual children whose L1 and L2 are quite disparate, with some bilinguals exhibiting reading comprehension deficits in a single language, while others display these deficits in both languages. These issues and their implications for future research are further discussed.

“Decoding versus comprehension”: Brain responses underlying reading comprehension in children with autism

Despite intact decoding ability, deficits in reading comprehension are relatively common in children with autism spectrum disorders (ASD). However, few neuroimaging studies have tested the neural bases of this specific profile of reading deficit in ASD. This fMRI study examined activation and synchronization of the brain’s reading network in children with ASD with specific reading comprehension deficits during a word similarities task. Thirteen typically developing children and 18 children with ASD performed the task in the MRI scanner. No statistically significant group differences in functional activation were observed; however, children with ASD showed decreased functional connectivity between the left inferior frontal gyrus (LIFG) and the left inferior occipital gyrus (LIOG). In addition, reading comprehension ability significantly positively predicted functional connectivity between the LIFG and left thalamus (LTHAL) among all subjects. The results of this study provide evidence for altered recruitment of reading-related neural resources in ASD children and suggest specific weaknesses in top-down modulation of semantic processing.

Understanding specific reading comprehension deficit: A review.

A substantial population of children and adolescents struggle with reading comprehension despite adequate phonemic decoding (word-level reading) and intellectual ability. Individuals with this pattern of performance are considered to have specific reading comprehension deficit(S-RCD).Despite two decades of study on the profiles of behavioral performance associated with S-RCD, there is no current consensus on the causal mechanisms of the disorder. Recent progress in identifying such mechanisms includes studies that have utilized comprehension age match and longitudinal designs which have identified several comprehension subskills that are predictive of S-RCD development. However, disagreement persists over which deficits are core to S-RCD, which are comorbid and which are simply a consequence of poor comprehension. Further, almost no research on this disorder has sought to identify neurobiological endophenotypes that may enhance our understanding of causal mechanisms. Here, we offer a review of the literature on core language and higher-level language deficits associated with S-RCD, including studies that examine the neurobiological basis of this disorder. What emerges is a relatively consistent pattern of subclinical impairments across a range of comprehension subskills that may put pressure on the complex process of reading comprehension. These subskills include semantic and grammatical processing, inference making, and other higher-level language skills such as comprehension monitoring. This disorder also appears to have a neurobiological basis, though further study is needed to establish the precise disruption in neurocircuitry. Suggestions for further research include the continued use of online, temporally-sensitive measures such as eye-tracking and event-related potential, additional studies of the neurobiology of the disorder, as well as longitudinal tracking and identification of early behavioral and brain markers for S-RCD prior to formal schooling.

Linguistic and Cognitive Profiles of 8- to 15-Year-Old Children With Specific Reading Comprehension Difficulties

This article presents two studies investigating the role of executive functioning in written text comprehension in children and adolescents. In a first study, the involvement of executive functions in reading comprehension performance was examined in normally developing children in fifth grade. Two aspects of text comprehension were differentiated: literal and inferential processes. The results demonstrated that while three aspects of executive functioning (working memory, planning, and inhibition processes) were significantly predictive of the performance on the inferential questions of the comprehension test, these factors did not predict the scores on the literal tasks of the test. In a second experiment, the linguistic and cognitive profiles of children in third/fifth and seventh/ninth grades with a specific reading comprehension deficit were examined. This analysis revealed that the deficits experienced by the less skilled comprehenders in both the linguistic and the executive domains could evolve over time. As a result, linguistic factors do not make it possible to distinguish between good and poor comprehenders among the group of older children, whereas the difficulties relating to executive processing remain stable over development. These findings are discussed in the context of the need to take account of the executive difficulties that characterize less skilled comprehenders of any age, especially for remediation purposes.