Early Identification and Intervention for Young Children with Reading/Learning Disabilities

Joseph R. Jenkins, University of Washington & Rollanda E. O'Connor, University of Pittsburgh
Learning Disabilities Summit: Building a Foundation for the Future White Papers

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EARLY INTERVENTION FOR STUDENTS AT RISK FOR READING/LEARNING DISABILITIES

Because alphabetic reading skills provide the basis for developing orthographic reading skills, and because students with R/LDs encounter difficulty acquiring alphabetic reading skills, early intervention researchers have concentrated their efforts on teaching these skills and their prerequisites, specifically phonological awareness and graphophonemic knowledge. That is, researchers have attacked the very phonological weaknesses that are thought to cause word-level reading problems. In the sections that follow, we review research on teaching phonological awareness, decoding, and fluent reading.

Teaching Phonological Awareness

Individual differences in prereaders' phonological awareness are one of the best predictors of later success in learning to read (Elbro, 1996; MacLean et al., 1988; Share et al., 1984). The strong relationship between phonological awareness and reading achievement remains even after children have received several years of reading instruction (Wagner et al., 1997), suggesting a reciprocal relationship between the two skills (Ehri, 1979; Perfetti et al., 1987). However, it is the early predictive value of phonological awareness along with its theoretical status as a prerequisite for gaining insight into the alphabetic principle that has attracted the interest of prevention-oriented researchers.

Working inside and outside classrooms, teachers and researchers have used a variety of activities to teach phoneme awareness. Some instructional programs have emphasized sound categorization or phoneme identity (e.g., classifying pictures of objects on the basis of common beginning, middle, or ending sounds; Bradley and Bryant, 1985; Byrne & Fielding-Barnsley, 1993). Some researchers have used concrete visual aids such as Say-It-And-Move-It tasks (e.g., moving a plastic tile to represent each sound in a spoken word; Ball & Blachman, 1991) or a task modeled after Elkonin (1973)--given pictures of objects or spoken words (e.g., fan), children are asked to move a disk to or mark one in a series of boxes as they say each phoneme in the word (Blachman, Ball, Black, & Tangel, 1994; Vadasy, Jenkins, & Pool, 2000). Others have used a variety of metaphonological tasks (e.g., rhyming games, clapping for words in a sentence, syllables in a word, or phonemes in words; synthesizing the speech of a puppet who spoke only in segmented speech; identifying the initial sound in names and words; Lundberg, Frost, & Petersen, 1988; O'Connor, Jenkins, Slocum, & Leicester, 1993; O'Connor, Notari-Syverson, & Vadasy, 1996; Torgesen, Morgan, & Davis, 1992). A comprehensive listing of resources for assessing and instructing phonological awareness can be found in Torgesen and Mathes (2000).

Major questions pertaining to teaching phonological awareness include the following: Can phonological awareness be taught to children before they begin reading instruction? Does teaching phonological awareness either before formal reading instruction or alongside formal reading instruction affect either beginning decoding or word reading? Does combining phonological awareness and alphabetic instruction result in stronger effects on phonological awareness and reading than teaching phonological awareness alone? Does early phonological awareness instruction affect later reading development of students who are at risk for reading problems? Do the effects of early phonological awareness training persist beyond the earliest stages of reading development?

To address these questions, Bus and van Ijzendoorn (1999) conducted a meta-analysis of 32 published articles that tested the effects of phonological awareness training. Bus and van Ijzendoorn reported training effect sizes of d = 0.73 and 0.70 on measures of phonological awareness and reading, respectively. However, effect sizes on reading real words were smaller than on simpler forms of reading (e.g., determining which of two printed words matches a spoken word) (d = 0.34 vs. 0.85, respectively). Students whom Bus and van Ijzendoorn categorized as experiencing problems in the early stages of learning to read showed significantly smaller effects on measures of phonological awareness than students classified as "normal" (d = 0.54 vs. 1.16, respectively), but the two groups showed similar effects on reading measures (d = 0.60 vs. 0.40, respectively). Further, effects of phonological awareness training on reading, measured 18 months after the end of treatment, were not significant (d = 0.16).

Meta-analyses like Bus and van Ijzendoorn's are useful in estimating treatment effects across many studies (e.g., students given phonological awareness training show a better grasp of the segmental features of language than do untrained students). Meta-analyses can also provide information about particular variables (e.g., treatments combining phonemic awareness and letter-sound instruction yield larger reading effects than phonemic awareness by itself). However, because meta-analyses combine effects from many disparate studies that vary in context (e.g., preschool, kindergarten, or primary school), vary in type of training (e.g., purely phonetic, combined with letters, or within reading instruction), and depend on the researchers' classification of studies (e.g., should "normal populations" include urban students from low-income families who often are at risk for reading failure?), they do not answer other questions of importance to prevention-oriented researchers. For example, does phonemic awareness training with at-risk kindergarten students lead to better reading outcomes at the end of first grade, and is the answer to this question qualified by the type of reading program (code vs. whole language emphasis) that students receive? Individual studies focusing on particular research questions must be consulted to fill out the picture painted by meta-analyses. Below, we examine some of the major questions pertaining to phonemic awareness instruction, along with a selection of the highest quality studies addressing these questions.

Do children benefit from phonemic awareness instruction in preschool and kindergarten? Targeted phonemic awareness instruction with prereading children (preschool and kindergarten) leads to significant gains in phonological awareness and in word-level reading skills (e.g., Ball & Blachman, 1991; Bradley and Bryant, 1985; Byrne & Fielding-Barnsley, 1993). In these studies research staff provided phonemic awareness instruction outside the classroom to typically developing youngsters, with some groups taught to represent sounds with letters of the alphabet. Groups who received a combination of phonemic and alphabetic tasks showed significantly stronger performance on reading measures. In fact, few studies of prereaders report effects from pure phonemic awareness training (without teaching letter sounds) on reading tasks administered immediately after training (Cunningham, 1990) or following a year of formal reading instruction (Lundberg et al., 1988).

Phonemic awareness instruction has also proven beneficial when delivered by kindergarten teachers rather than research staff. In one study, kindergarten teachers and their assistants gave 11 weeks of phonemic awareness training (10-13 hours of instruction in 15-20-minute lessons) to low-income, inner-city youngsters (Blachman et al., 1994). The experimental group used Say-It-And-Move-It and Elkonin-like segmentation tasks, and received direct instruction in letter names and sounds. Children who had mastered several letter names and sounds also used letter tiles to form words in the Say-It-And-Move-It task. Compared to a control group that did not receive phonological awareness lessons, the experimental group performed significantly higher at the end of the year on measures of phoneme segmentation, spelling, and an experimenter-designed measure of reading phonetically regular words and nonwords. The groups did not differ on the Word Identification subtest of the WRMT. O'Connor et al. (1996), who unlike Blachman et al. (1994) included students with disabilities in their treatment, reported similar results in a kindergarten study of teacher-implemented phonological awareness instruction.

Does explicit phonemic awareness instruction add to the effects of phonics instruction for beginning readers? Whereas many typically developing students easily acquire phonemic insight, graphophonemic knowledge, and the application of these skills to decode words, students with R/LDs encounter difficulties with these skills right from the start. This fact has led some prevention researchers to conclude that merely incorporating phonemic awareness training in kindergarten is insufficient to overcome the challenges faced by students at risk for R/LD. Rather, kindergarten programs should also include systematic instruction of early reading skills.

Fuchs and colleagues conducted three kindergarten studies examining the contributions of explicit phonemic awareness instruction, decoding instruction, and their combination. In their first study, Fuchs et al. (2001) compared three groups: an untreated control; one that received phonemic awareness instruction; and one that received both phonemic awareness and decoding instruction. Classroom teachers and peer-tutoring dyads conducted all instruction. Phonemic awareness instruction was based on Ladders to Literacy (O'Connor, Notari-Syverson, & Vadasy, 1998). Decoding instruction was delivered through PALS, a peer-mediated format developed by the researchers. On phoneme awareness tests at the end of kindergarten, the treatment groups did not differ, but outperformed the control. On word identification, decoding, and spelling tests, however, the decoding plus phonological awareness group surpassed the other two groups, which did not differ from each other. By October of grade 1, the pattern of effects on phonological and reading tasks was similar to the earlier results, but the groups no longer differed significantly.

In their second study, Fuchs et al. (2001) compared three kindergarten groups: decoding (PALS), decoding plus phonemic awareness, and an untreated control. In non-Title 1 schools, the two treatment groups performed comparably at the end of the year on reading and spelling outcomes, and both groups surpassed the control group. Finally, in a third study, Fuchs and Fuchs (2001) compared four kindergarten groups: decoding with and without phonological awareness training; phonological awareness alone; and a control group. Again, the researchers found no evidence that phonological awareness training added to the effects of their decoding program. Together, these three kindergarten studies raise questions about the added value of phonemic awareness instruction in learning to read words, when students also receive systematic decoding instruction.

In a related study using another version of PALS, Mathes, Torgesen, & Allor (2001) examined how the quantity of phonological awareness instruction affected first graders' reading growth. The PALS treatment emphasized phonics and story reading, but also included practice in segmenting spoken words into sounds. Low achieving students who received PALS along with computer-assisted phonological awareness training performed no better than students who received PALS alone. More phonological awareness practice did not add value.

If struggling readers' critical deficit is a lack of phonemic awareness, why were they not helped by training in this skill? One possibility is that explicit instruction of phonics implicitly teaches phoneme awareness. That is, instruction that clearly specifies grapheme-phoneme relationships, gives practice in converting graphemes to phonemes, and assists students in assembling word pronunciations from strings of graphemes may be sufficient to establish the level of phoneme awareness necessary for learning to read. In any case, these three kindergarten studies found strong word-reading effects from explicit phonics instruction, whether or not it was supplemented with explicit phonemic awareness training.

The absence of a phonemic awareness training effect in the context of an explicit phonics intervention is a reminder that care is needed in interpreting the necessary relationship between phonemic awareness and alphabetic reading skill. Although alphabetic reading skill may depend on phonemic awareness, the two skills may develop concurrently, rather than sequentially, under certain instructional conditions.

Not to be overlooked in the kindergarten studies by Fuchs and colleagues is the large number of low achieving students (i.e., those most at-risk for R/LD) who registered no gains in reading, even with explicit decoding and phonemic awareness instruction. This brings us to the next question.

For students at risk for R/LDs, does phonological awareness instruction in kindergarten result in better phonological awareness and reading performance? Few researchers report the percentage of children who, despite training, fail to acquire segmental language and decoding skills (i.e., nonresponders), and those researchers who do report this statistic find that as many as 30% of low achieving kindergarten students do not show increased phonological awareness (Torgesen et al., 1992) and 50% show no increases in reading performance (Fuchs et al., 2001). Of course, these students might show a stronger response with longer and/or more intense instruction. By and large, studies reporting long-term reading effects of early training in phonemic awareness have been conducted with typically developing youngsters, not students at risk for R/LD (Bradley and Bryant, 1985; Byrne & Fielding-Barnsley, 1993, 1995; Lundberg et al., 1988).

Does the type of reading instruction students receive affect their need for explicit teaching of phonological awareness? Teaching students phonological awareness in kindergarten may be less important if they subsequently receive explicit and systematic instruction in phonics. By contrast, if first graders are left to figure out the code on their own (e.g., in a classroom with insufficient phonics instruction), kindergarten instruction in phonological awareness and graphophonemic relations may be critical. Because many studies combine phonological awareness and phonics instruction, it is difficult to separate the contributions of each. However, the value added by phonological awareness instruction may be diminished when phonics is explicitly taught (Fuchs & Fuchs, 2001; Fuchs et al., 2001). Consistent with this possibility are findings from first-grade studies that show initial level of phonemic awareness, often a strong predictor of reading success, loses its predictive power in classrooms with strong code-based instruction (Compton, 2000; Perfetti et al., 1987).

How much phonological awareness is needed? It will also be important to determine how much phonological awareness is enough for getting a start on word reading. By plotting performance on onset-rime segmentation against word-reading ability, Stahl and Murray (1994) concluded that segmenting into onset-rime is necessary for reading. On the basis of their analysis of phonemic segmenting and reading, O'Connor et al. (1996) concluded that children may need to be able to isolate two or more phonemes correctly within spoken words to facilitate reading. In a study that measured children from kindergarten through third grade, Good et al. (2001) established minimum scores for kindergarten segmenting of 25-35 segments per minute (i.e., children could provide most sounds in three-phoneme words) as indicators of children who would pass the Oregon state reading assessment at the end of third grade. Beyond three-phoneme segmentation, faster segmenting (e.g., 10 words in less than 1 minute) or deeper segmenting (e.g., four- and five-phoneme words) does not appear to improve reading outcomes at the end of first grade (Good et al., 2001; O'Connor & Jenkins, 1999). Merely isolating the first sound in words appears to be insufficient for reading words through a decoding process, and if segmenting advances no further than first-sound identification, this level may encourage the "use the first sound and guess" strategy for word identification that persists well into the elementary years for many children with RD.

Even though important questions remain unanswered about teaching phonological awareness (e.g., the contribution of phonemic awareness training to reading acquisition under different reading instructional approaches), we recommend a conservative approach (e.g., providing such training to kindergarten children). A short list of sensible actions follows:

Fostering Phonemic Awareness: Sensible Actions

1. Teach phonemic awareness early--in preschool, kindergarten, and first grade.
2. With novices, begin instruction using larger (easier) linguistic units (e.g., words, syllables) and progress to smaller units (i.e., phonemes), but be sure that children can segment words into phonemes by the end of kindergarten.
3. Teach phonemic awareness in conjunction with letter sounds.
4. Encourage spelling/writing early in literacy instruction because it prompts children to notice the segmental features of language.
5. Emphasize the sounds in spoken words when teaching phonics.
6. Assess students' phonemic awareness regularly until children attain proficiency, and permit no one to lag behind in developing this insight.
7. Provide students with whatever additional help they need to become sensitive to the segmental features of spoken language.

Teaching Alphabetic Reading Skill (Decoding)

Because students with R/LD have poorly developed alphabetic reading skill, and because this skill serves as a platform for acquiring orthographic reading proficiency, instructional researchers have sought effective ways to help students master decoding. Research has focused on three important questions--the relative effectiveness of more- and less-explicit instruction in establishing decoding and word-reading skill, the relative value of an instructional focus on phonemes or rime units, and the effects of layered interventions for at-risk readers.

Do beginning readers develop better decoding skills from more- versus less-explicit phonics instruction? When researchers have compared more and less explicit approaches to teaching phonics on decoding outcomes, they consistently report an advantage for more explicit approaches (National Reading Panel, 2000). We illustrate these findings by examining three particularly strong studies. Besides the level of explicitness of phonics instruction, these studies differ on several other dimensions: length (1 to 3 years); instructional arrangements (individual tutoring or classroom-level instruction); and type of comparison group (a well-specified alternative treatment or an undefined control group).

Torgesen et al. (1999) compared three approaches to beginning reading instruction for students whose performance on phonological processing measures were predicted to be in the bottom 10% of readers. Research staff tutored the students from mid-kindergarten through grade 2. The Phonological Awareness at an oral-motor level plus Synthetic Phonics (PASP) group received Auditory Discrimination in Depth, or ADD (Lindamood & Lindamood, 1984). ADD emphasizes how phonemes are produced and teaches grapheme-phoneme conversions explicitly (in isolation), along with how to use this knowledge to decode words. An Embedded Phonics (EP) group received less explicit phonics, with grapheme-phoneme instruction delivered in the context of learning to read and write sight words. A Regular Classroom Support (RCS) group received tutoring in the activities and skills taught in the regular classroom. The final group was a No-Treatment Control (NTC).

The primary focus of the study was on the PASP and EP groups. As students in these two groups acquired graphophonemic knowledge and word-reading skill, they spent an increasing proportion of lesson time on text reading. However, whereas PASP students spent 80% of lesson time on word-level activities and 20% on text-level activities, EP students spent 43% and 57% on word- and text-level activities, respectively. At the end of grade 2, the ADD group significantly outperformed the other groups in decoding and word identification; the EP, RCS, and NTC groups did not differ.

Other early intervention researchers have reported similarly strong effects in decoding for at-risk first-grade students who receive explicit phonics tutoring. However, in these latter studies the effectiveness of tutorial instruction was contrasted with regular classroom instruction alone (e.g., Vadasy, Jenkins, & Pool, 2000) or as demonstration of changes in reading ability of tutored students (Vellutino et al., 1996).

Early intervention has not been limited to supplemental tutoring. Blachman, Tangel, Ball, Black, and McGraw (1999) found strong effects from small-group instruction from classroom teachers, beginning in kindergarten and continuing through grade 1 for some students, and through grade 2 for those still struggling at the end of first grade. Kindergarten instruction focused on phonemic awareness and letter sounds, consistent with Blachman et al. (1994). In first grade, children were assigned to classes on the basis of their phonemic awareness and word-reading ability so that teachers could teach relatively homogeneous small groups. Following a review of kindergarten lessons, first-grade instruction consisted of daily 30-minute lessons, following a five-step reading program: (1) review and introduction of graphophonemic relations; (2) sound-blending letters to form words and using a letter board to spell words; (3) fluency building using flash cards; (4) reading phonetically controlled text; and (5) writing to dictation. Time spent reading stories and rereading increased as students acquired proficiency on word-level skills. Second-grade teachers continued using the five-step program with students reading below grade level. Control students received an equivalent amount of basal reading instruction. Treatment children significantly surpassed control children on phonemic awareness, decoding, word identification, and spelling tests at the end of grades 1 and 2.

In contrast to Torgesen et al. (1999) and Blachman et al. (1999) who examined multiyear treatments, Foorman, Francis, Fletcher, Schatschneider, & Mehta (1998) studied progress of Title I first- and second-grade students in a single-year comparison of three classroom approaches. Direct Code (DC) teachers gave explicit instruction in phonemic awareness and explicit phonics (42 phonic rules) using Open Court's Collection for Young Scholars (1995). Students practiced in decodable texts, and also read from Big Books to develop oral language and comprehension skills. In a second approach, Embedded Code (EC), teachers emphasized phonemic awareness and a common list of spelling patterns (word families) as well as a variety of comprehension strategies. Students learned an analogy strategy for reading new words with familiar spelling patterns, and read from predictable books. In the third treatment, Implicit Code (IC), teachers followed a whole-language philosophy. They emphasized comprehension and integrated reading, writing, and spelling activities, but did not provide explicit phonics instruction. Growth curve analyses over four first-grade measurement points revealed significantly stronger progress by the DC group on phonological awareness and word reading. The DC group also significantly surpassed the other groups on an end-of-year word-reading measure (a combination of nonword and real-word tests), and scored higher on passage comprehension than the EC group did. EC and IC groups did not differ on any outcomes. DC seemed especially stronger in assisting the lowest achieving students to acquire some word-reading skill.

In these three studies, groups that made the largest gains in decoding received decontextualized instruction in phonemic awareness and grapheme-phoneme relationships, and were shown how to use graphophonemic information to read words. This is not entirely surprising, as Brophy (2000) noted: "... bear in mind that most assessments of the relative effectiveness of explicit versus implicit methods of teaching anything, regardless of subject matter, have favored the explicit methods" (p. 176). More at issue is the transfer effects of instructional explicitness of decoding skill on subsequent skills farther downstream in the reading process (e.g., word identification, fluency, and comprehension).

Do explicit phonics treatments result in stronger word identification skill for beginning readers? Most explicit phonics treatments that obtain significant effects on decoding also find effects on word identification. However, effect sizes on word identification measures are often smaller than those observed for decoding. For example, using nonword tests for decoding and real-word tests for word identification, we figured respective effect sizes for decoding versus word identification to be 0.86 versus 0.33 for Blachman et al. (1999) at grade 1; 0.60 and 0.25 for Fuchs et al. (2001) at kindergarten; 0.88 versus 0.48 for Torgesen et al. (1999) PASP and EP at grade 2; 1.16 and 0.87 for Vadasy et al. (2000) at grade 1.

Findings on the value of explicit decoding instruction for word identification divide according to the stage of reading development of the students studied. For beginning readers, more explicit phonics approaches yield stronger word-reading skill (Foorman et al., 1998; Torgesen et al., 1999). By contrast, more- and less-explicit decoding approaches yield similar word-reading outcomes in research on older, remedial R/LD readers (Torgesen et al., 2001; Wise, Ring, & Olson, 2000). Should we conclude that explicit decoding instruction "works" for beginning readers but not for remedial readers? Such a conclusion would be premature. Nevertheless, age-qualified results serve as a reminder to exercise caution in forming general conclusions about the benefits of explicit phonics instruction.

Several studies comparing more and less explicit phonics approaches are exceptionally well designed and methodologically sound, but they are few, and comparing approaches to reading instruction is a tricky business. While it is possible to characterize different reading programs on a single dimension (for example, degree of phonics explicitness), each program is composed of many properties that can influence learning (e.g., quality of examples, attention to reviews, scaffolding of student learning). Moreover, few of the more prevalent approaches that special education teachers use have been examined. Comparative research using explicit programs like Reading Mastery, Corrective Reading, or Read Well are needed.

Should decoding instruction emphasize phonemes or phonograms (word families)? In principle, there are advantages to each approach. Focusing on phonemic units (/a/, /sh/, /ea/) forces learners to attend to every letter, something readers must eventually do. By contrast, instruction that focuses on phonograms (-at, -ate, -art) regularizes vowel pronunciations for words within a family. Teaching phonograms also helps learners chunk letter groups in ways that can speed word recognition.

In their study of beginning at-risk readers, Foorman et al. (1998) found faster word learning in classrooms teaching phoneme-level decoding than classrooms emphasizing either phonograms or whole language. Notably, first graders receiving phonograms instruction performed no better than those receiving whole-language instruction. More evidence favoring a phoneme emphasis comes from a training experiment by Berninger et al. (2000) who compared several kinds of instructional modeling for word reading (letter-phoneme; onset and rime-pronunciation; letter spelling-whole-word pronunciation), singly and in combination. Treatment groups also received decontextualized instruction on graphophonemic relations and phonemic awareness, using Berninger's (1998) "Talking Letters" and practiced assisted text reading. On a test of the taught words, all experimental groups outperformed a contact control group (who received phonological and orthographic awareness instruction along with assisted text reading), but did not differ from each other. However, on a test of transfer words, the letter-phoneme pronunciation group, the spelling-whole-word pronunciation group, and the group that received a combination of both these kinds of instructional modeling differed significantly from the control group. Groups given instructional modeling of onset and rime-pronunciations fared no better than students who received no word-level instruction. Thus, both Foorman et al.'s (1998) classroom research and Berninger's et al. (2000) clinical research found an advantage for phoneme over onset-rime instructional emphases.

However, the instructional advantage of phonemes over onset-rimes may depend on the child's reading level. Working with older (7- to 12-year-old) students with severe reading disabilities, Lovett has reported inconsistent results for these approaches across several studies. However, in her longest running study, Lovett et al. (2000) compared various combinations of graphophonemic and phonograms emphases, as well as pure versions of each, with the constraint that all groups received 70 hours of intervention. Children were given graphophonemic instruction followed by phonograms instruction, phonograms instruction followed by graphophonemic instruction, graphophonemic instruction alone, or phonograms instruction alone. Overall, Lovett et al. found no advantage for graphophonemic versus phonograms instruction. Combining the two approaches, however, produced performance superior to that of either approach by itself. In addition, on a few measures of word reading, graphophonemic instruction followed by phonograms instruction appeared stronger than the reverse order. Thus, in deciding between graphophonemic and phonogram instructional approaches, the jury awaits more definitive evidence.

Should beginning reading instruction be confined to decodable texts? Some reading authorities believe that beginning reading instruction, particularly for children at risk for reading problems, should employ text that is consistent with the phonics that children have been taught (Carnine, Silbert, & Kame'enui, 1997). With the exception of a few high-frequency irregular words necessary for creating stories (e.g., said, the), only words made up of previously taught letter-sound correspondences should appear in sentence or story reading. Other authorities contend that consistency between phonics and text is an open question (Allington & Woodside-Jiron, 1998). Only two studies have addressed this issue. Juel and Roper-Schneider (1985) found a decoding advantage for typically developing first graders taught with phonetically transparent text, relative to students who received the same phonics instruction but read from less phonetically consistent text. The groups did not differ on an end-of-year reading achievement test.

More recently, Peyton, Jenkins, Vadasy, and Sanders (2001) studied three groups of at-risk first graders. Two groups received supplemental one-to-one reading instruction from nonteacher tutors, using the same phonics program, Sound Partners (Vadasy et al., 2001). During the story reading component of the lessons, students in the more-decodable group read texts that were highly consistent with the phonics program (i.e., a high proportion of the words appearing in the texts were composed of taught letter-sounds alone). Those words that could not be decoded from previously taught graphophonemic correspondences were taught in isolation before they appeared in stories. In contrast, students in the less-decodable group read stories composed primarily of high-frequency words, with an emphasis on predictable text. A control group received regular instruction from classroom and Title 1 teachers, but were not given the supplementary one-to-one lessons. At the end-of-year reading, the tutored groups surpassed the control group on a broad array of decoding, word reading, accuracy in context, and comprehension measures. However, the more- and less-decodable groups did not differ significantly on any measure. In interpreting these findings, it must be remembered that the more- and less-decodable text treatments were supplemental to classroom reading instruction, in which students read from a variety of texts that bore little relationship to the supplemental phonics lessons. Under these circumstances, text differences may not carry the weight that some authorities claim.

How can schools organize assessment and instruction to prevent and/or ameliorate R/LDs? Most early intervention research on R/LD has compared the relative effectiveness of specific instructional approaches (e.g., Foorman et al., 1998, Torgesen, et al., 1999). Results of these studies remind us again how much students vary in their responsiveness to instruction. Even with explicit and intense decoding instruction, researchers find between 15 and 30% of at-risk students still perform significantly below average in decoding and word identification (e.g., Torgesen et al., 1999; Vellutino et al., 1996). If these students are to become competent word readers, they will require longer, more intense, or different treatments than they received. In line with this thinking are two recent studies that attempt to adjust treatment length and intensity according to student response.

Blachman et al. (1999) provided longer treatments to students who required more help by reconstituting and linking kindergarten and first-grade instruction for at-risk students, and then extending treatment into second grade for students who had not completed the intervention program. Because Blachman et al. did not report standard scores for the lowest performing students, we cannot determine the number of students who finished grade 2 still reading at an unsatisfactory level. Nevertheless, the lowest achieving treated students strongly outperformed their counterparts in the control group (ES = 1.4 and 1.24 in decoding and word identification, respectively). On a nonword decoding test, treated students in the bottom quartile tripled the performance level of control students. Blachman et al. obtained these results by organizing homogeneous, small-group instruction (including the assignment of students to classroom), designing lessons that emphasized phonemic awareness and alphabetic reading skills, and adjusting treatment duration according to students' progress. Students did not receive supplemental services from remedial and special education teachers. Despite these impressive results, it is unlikely that even high-quality general education, no matter how well organized, will be sufficient to meet the needs of students with R/LDs.

O'Connor, Fulmer, Harty, and Bell (2001) provide a model for primary schools attempting to accommodate students at risk for R/LDs who do not thrive even within high-quality general education classrooms. Focusing on grades 1 and 2, these researchers linked professional development for general and special education teachers, redesigned classroom literacy instruction, periodically assessed student performance, and provided supplemental instruction for struggling students. Literacy instruction addressed phonological and print awareness, oral language, word analysis, comprehension, writing activities, and fluency. In Layer 1 of O'Connor et al.'s intervention, classroom teachers received professional development to help them deliver literacy instruction that was geared to the needs of struggling students. Layer 2 of the intervention used periodic reading assessments to identify children requiring additional help. Research personnel provided small, homogeneous group instruction (2-3 students) to struggling students for 25-30 minutes, three times per week. Depending on students' needs, small-group instruction emphasized either alphabetic reading skills (e.g., letter sounds, sounding-out, word analysis) or fluency (e.g., reading and rereading decodable texts).

At the end of second grade, reading scores of average and low achieving students (including students with disabilities) who received the layered intervention were compared to those of control students. Treated students performed significantly higher on word identification, nonword reading, fluency, and comprehension. The fluency scores of the lowest performing students (Figure 4) indicate a strong advantage for those in the intervention group over those in the control group. Whereas 23 control students read fewer than 50 words per minute, 16 intervention students fell below this criterion. When criterion performance was set lower, at 25 words per minute, 11 control versus only 2 intervention students failed to achieve this criterion. Together, the studies of Blachman et al. (1999) and O'Connor et al. (2001) suggest that schools can reduce the number of students who fail to respond to interventions by lengthening the intervention period and by providing supplemental instruction for students experiencing the most difficulties.

Not surprisingly, many important questions remain unanswered or partially answered regarding the teaching of decoding. Here are some things we don't know. Is it important to confine beginning reading practice to decodable text? What level of decoding skill is necessary for fast, accurate word identification and comprehension? How should we teach those children who do not reach adequate levels of decoding and word-reading skill despite receiving our strongest treatments? Research like O'Connor et al.'s (2001) is sorely needed to identify specialized intervention approaches for students who do not respond to enhanced classroom instruction.

Even though important questions remain about teaching phonics (e.g., the relative emphasis on decontextualized phonics instruction and text reading practice), we recommend a conservative approach (i.e., providing sufficient explicit phonics instruction for students to read nonwords easily). A short list of sensible actions follows:

Promoting Alphabetic Reading: Sensible Actions

1. Teach grapheme-phoneme conversions explicitly right from the start.
2. Teach graphophonemic relations directly and systematically, not with worksheets.
3. Assess graphophonemic knowledge frequently until children attain proficiency.
4. To bolster word-level reading skill, encourage spelling/writing, right from the start.
5. Teach sounding-out, right from the start.
6. Provide beginning readers with ample opportunity to practice reading words that are consistent with their phonics instruction.
7. As students' decoding of short words reaches proficiency, teach strategies for reading multisyllabic words.
8. Find ways to provide more instruction in decoding for those who need it.

Promoting Orthographic Reading Skill (Fluency)

Fluent reading is an important aspect of reading ability for two reasons. First, slow, effortful reading ruins motivation to read and reduces the chances that individuals will choose reading over other activities. Second, reading fluency and comprehension are intertwined; slow reading detracts from comprehension. Children should achieve a level of word reading that is relatively effortless.

Relative to age peers, students with RD have far fewer words stored in memory, in part because their limited decoding skills result in fewer successful independent learning trials, and in part because they spend less time reading and cover less ground when they do read. And most discouraging to these students (and their teachers) is the extraordinarily high number of encounters with specific words needed to secure the words in orthographic memory. Lacking breadth of word knowledge, students with RD exhibit slow, halting, error-laced reading--that is, reading that lacks fluency. Although we understand a considerable amount about factors that contribute to fluency, a number of important questions remain about ways to facilitate its development in students with RD.

What level of decoding is necessary before broad reading will boost fluency? Because it is the principal mechanism by which individuals gain repeated exposure to words in print, wide reading is essential for developing fluency. However, in the early stages of reading acquisition, bypassing decoding instruction in favor of wide reading is a recipe for failure. Nevertheless, we lack information about the level of decoding proficiency necessary if wide reading is to have its intended effect on fluency. Chall (1996) proposed that reading fluency develops after students have mastered basic decoding skills. Research is needed on the effects of text reading practice for students at different stages of decoding proficiency.

How does text difficulty affect the development of fluency? That is, what level of reading accuracy in texts is required for students to develop fluency from practice in those texts? A variant on the previous question, this one focuses more on the reader-text interaction than on absolute levels of decoding proficiency. Instructional reading level (i.e., the minimum level of reading accuracy in a text for the student to benefit most from direct instruction) is said to range from 90 to 95%, depending on the reading authority.

Instructional level is itself something of an ambiguous term because it does not specify the nature of instruction. For example, must the first reading of texts used in repeated readings achieve a 95% level to maximize word learning and fluency growth? Is a 95% accuracy level required for "assisted reading" interventions (e.g., reading with the assistance of audiotapes or a more able reader)?

How should fluency instruction be organized? Teachers can organize fluency practice in a variety of ways. Studies examining repeated reading and continuous (nonrepeated) reading suggest that both produce gains (Dowhower, 1987; Samuels, 1979; Shany & Biemiller, 1995). Repeated reading provides students with multiple repetitions of the same words within a short time. Continuous reading exposes students to a wider volume of words (i.e., more different words). Very few studies comparing repeated and continuous reading have been performed with struggling readers, and only one of these was conducted with children in the age range covered by this paper. Vadasy (2001) obtained equivalent growth from repeated and continuous reading treatments with second-grade poor readers, consistent with findings obtained with slightly older (third grade) readers (Rasinski, 1990; Vaughn et al., 2000).

Criteria used in repeated readings treatments are also at issue, without a clear advantage for either performance criteria (number of words read per minute) or number of readings. Research is needed on target fluency levels used in repeated readings and the number of rereadings that optimize fluency development. Finally, attempts to improve fluency through reading word lists instead of texts also show beneficial effects, and it is not clear if text or word list practice produces better outcomes (Tan & Nicholson, 1997; van den Bosch, van Bon, & Schreuder, 1995).

How can we encourage students with R/LD to increase their volume of reading? Information is needed about how to make reading practice easier and more enjoyable for students who struggle with reading. Some possible areas to examine include the effectiveness and appeal of assisted reading with audiotape or computer software, and providing students with reading material that matches their interests--topical books and magazines, biographies, and books with the appeal of Harry Potter.

Does word study add to the effects of text reading practice? Assuming that increased text reading (with the aid of adults, tapes or software, or rereading opportunities) can raise the volume of words encountered in text, it should result in expanded reading vocabulary and faster word recognition. We still must determine whether extensive text practice by itself is sufficient to improve fluency, especially for students who do not learn words easily. For these students, some portion of reading instruction may still need to be reserved for word study. How should such word study by conducted to maximize its effects by focusing on words misread in text; words that have been categorized in ways to make spelling and pronunciation patterns more explicit; or subword units (Mercer, Campbell, Miller, Mercer, & Lane, 2000)?

Even though important questions remain unanswered about how best to promote reading fluency (e.g., an emphasis on repeated readings practice or on wide reading), teachers can make fluency an instructional focus. A short list of sensible actions follows:

Building Fluency: Sensible Actions

1. Find ways to make text reading easier for students with RD, using various forms of assisted reading (audiotapes, computer programs, choral reading, and partner reading).
2. Experiment with texts of various levels of difficulty.
3. Motivate students to read more by taking into account their interests, the variety of reading materials available to them, and the personal, linguistic, and cultural relevance of texts. Consult with the school librarian or someone knowledgeable about children and literature.
4. Develop areas of interest and teach students to feed those interests through reading.
5. Experiment with supplements to text reading such as word and subword study, word lists, and the proportion of time devoted to text- and word-level practice.
6. Measure students' text fluency regularly to inform instructional decision making.

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