We summarize some of the most important findings from research evaluating the hypothesized causes of specific reading disability (dyslexia) over the past four decades. After outlining components of reading ability, we discuss manifest causes of reading difficulties, in terms of deficiencies in component reading skills that might lead to such difficulties. The evidence suggests that inadequate facility in word identification due, in most cases, to more basic deficits in alphabetic coding is the basic cause of difficulties in learning to read. We next discuss hypothesized deficiencies in readingrelated cognitive abilities as underlying causes of deficiencies in component reading skills. The evidence in these areas suggests that, in most cases, phonological skills deficiencies associated with phonological coding deficits are the probable causes of the disorder rather than visual, semantic, or syntactic deficits, although reading difficulties in some children may be associated with general language deficits. Hypothesized deficits in general learning abilities (e.g., attention, association learning, cross-modal transfer etc.) and low-level sensory deficits have weak validity as causal factors in specific reading disability. These inferences are, by and large, supported by research evaluating the biological foundations of dyslexia. Finally, evidence is presented in support of the idea that many poor readers are impaired because of inadequate instruction or other experiential factors. This does not mean that biological factors are not relevant, because the brain and environment interact to produce the neural networks that support reading acquisition. We conclude with a discussion of the clinical implications of the research findings, focusing on the need for enhanced instruction.

http://www.dr-hatfield.com/educ538/docs/Vellutino,+etal+2004.pdf

Specific reading disability (dyslexia): what have we learned in the past four decades?

The authors report a systematic meta-analytic review of the relationships among 3 of the most widely studied measures of children's phonological skills (phonemic awareness, rime awareness, and verbal short-term memory) and children's word reading skills The review included both extreme group studies and correlational studies with unselected samples (235 studies were included, and 995 effect sizes were calculated) Results from extreme group comparisons indicated that children with dyslexia show a large deficit on phonemic awareness in relation to typically developing children of the same age (pooled effect size estimate: -137) and children matched on reading level (pooled effect size estimate: -057) There were significantly smaller group deficits on both rime awareness and verbal short-term memory (pooled effect size estimates: rime skills in relation to age-matched controls, -093, and reading-level controls, -037; verbal short-term memory skills in relation to age-matched controls, -071, and reading-level controls, -009) Analyses of studies of unselected samples showed that phonemic awareness was the strongest correlate of individual differences in word reading ability and that this effect remained reliable after controlling for variations in both verbal short-term memory and rime awareness These findings support the pivotal role of phonemic awareness as a predictor of individual differences in reading development We discuss whether such a relationship is a causal one and the implications of research in this area for current approaches to the teaching of reading and interventions for children with reading difficulties

https://psycnet.apa.org/journals/bul/138/2/322.pdf

Phonological skills and their role in learning to read: A meta-analytic review.

Objectives To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. Data sources We searched MEDLINE®, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For health literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. Review methods We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of health literacy to include numeracy and oral (spoken) health literacy. We excluded intervention studies that did not measure health literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. Results We included good- and fair-quality studies: 81 studies addressing health outcomes (reported in 95 articles including 86 measuring health literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in health literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, and, among seniors, poorer overall health status and higher mortality. Health literacy level potentially mediates disparities between blacks and whites. The strength of evidence of numeracy studies was insufficient to low, limiting conclusions about the influence of numeracy on health care service use or health outcomes. Two studies suggested numeracy may mediate the effect of disparities on health outcomes. We found no evidence concerning oral health literacy and outcomes. Among intervention studies (27 randomized controlled trials [RCTs], 2 cluster RCTs, and 13 quasi-experimental designs), the strength of evidence for specific design features was low or insufficient. However, several specific features seemed to improve comprehension in one or a few studies. The strength of evidence was moderate for the effect of mixed interventions on health care service use; the effect of intensive self-management inventions on behavior; and the effect of disease-management interventions on disease prevalence/severity. The effects of other mixed interventions on other health outcomes, including knowledge, self-efficacy, adherence, and quality of life, and costs were mixed; thus, the strength of evidence was insufficient. Conclusions The field of health literacy has advanced since the 2004 report. Future research priorities include justifying appropriate cutoffs for health literacy levels prior to conducting studies; developing tools that measure additional related skills, particularly oral (spoken) health literacy; and examining mediators and moderators of the effect of health literacy. Priorities in advancing the design features of interventions include testing novel approaches to increase motivation, techniques for delivering information orally or numerically, "work around" interventions such as patient advocates; determining the effective components of already-tested interventions; determining the cost-effectiveness of programs; and determining the effect of policy and practice interventions.

/pdf/health-literacy-interventions-and-outcomes-an-updated-chswt8nilu.pdf

Health literacy interventions and outcomes: an updated systematic review.

The cradle of thought : exploring the origins of thinking

Background: This study compares the efficacy of two school-based intervention programmes (Phonology with Reading (P + R) and Oral Language (OL)) for children with poor oral language at school entry. Methods: Following screening of 960 children, 152 children (mean age 4;09) were selected from 19 schools on the basis of poor vocabulary and verbal reasoning skills and randomly allocated to either the P + R programme or the OL programme. Both groups of children received 20 weeks of daily intervention alternating between small group and individual sessions, delivered by trained teaching assistants. Children in the P + R group received training in letter-sound knowledge, phonological awareness and book level reading skills. Children in the OL group received instruction in vocabulary, comprehension, inference generation and narrative skills. The children’s progress was monitored at four time points: pre-, mid- and post-intervention, and after a 5-month delay, using measures of literacy, language and phonological awareness. Results: The data are clustered (children within schools) and robust confidence intervals are reported. At the end of the 20-week intervention programme, children in the P + R group showed an advantage over the OL group on literacy and phonological measures, while children in the OL group showed an advantage over the P + R group on measures of vocabulary and grammatical skills. These gains were maintained over a 5-month period. Conclusions: Intervention programmes designed to develop oral language skills can be delivered successfully by trained teaching assistants to children at school entry. Training using P + R fostered decoding ability whereas the OL programme improved vocabulary and grammatical skills that are foundations for reading comprehension. However, at the end of the intervention, more than 50% of at-risk children remain in need of literacy support. Keywords: Early intervention, oral language, phonological awareness, early literacy, RCT.

/pdf/improving-early-language-and-literacy-skills-differential-1zxuhnlsyx.pdf

Improving early language and literacy skills: differential effects of an oral language versus a phonology with reading intervention

Background. Previous studies have shown that the phonological deficits that characterise dyslexia persist into adulthood. There is a growing number of dyslexic students in higher education for whom sensitive diagnostic tests of their reading and reading related difficulties are required.



Aims. The main aim of this study was to compare the cognitive skills of dyslexic students with those of their non-dyslexic peers, and to ascertain the impact of cognitive difficulties on their study skills. A second aim was to produce guidelines for the assessment of dyslexia in higher education.



Sample. The performance of 23 dyslexic students was compared with that of a comparison group of 50 students from the same university who did not report a history of reading difficulty.



Method. Participants completed standardised tests of IQ, reading, spelling and arithmetic and tests tapping phonological processing, verbal fluency and speed of processing. Their performance on a set of study-related tasks including proof reading and precis writing was also assessed and they completed the Brown ADD scales.



Results. Although dyslexic students did not differ in general cognitive ability from controls, they had deficits in reading and reading related phonological processes. Discriminant function analyses indicated that dyslexia in adulthood can be confirmed with 95% accuracy using only four tests: spelling, nonword reading, digit span and writing speed.



Conclusions. The study highlighted the difficulties of dyslexic adults. The persisting difficulties of dyslexic students that affect their study skills need to be recognised by HE institutions so that appropriate support programmes can be put in place.

Cognitive assessment of dyslexic students in higher education

Background: This study evaluated the effectiveness of an intervention for reading-delayed children in Year-1 classes Methods: A sample (N ¼ 77) of children drawn from 14 schools representing those with the weakest reading skills were randomly allocated to one of two groups A 20-week intervention group received the intervention for two consecutive 10-week periods, while a 10-week intervention group only received the intervention for the second 10 weeks of the study The programme was delivered in daily 20-minute sessions that alternated between small group (N ¼ 3) and individual teaching The programme combined phoneme awareness training, word and text reading, and phonological linkage exercises Results: The children receiving the intervention during the first 10-week period made significantly more progress on measures of letter knowledge, single word reading, and phoneme awareness than children not receiving the intervention However, the children who only received the intervention during the second 10-week period made rapid progress and appeared to catch up with the children who had been given the more prolonged intervention Failure to respond to the intervention was predicted by poor initial literacy skills and being in receipt of free school meals Conclusion: A reading intervention programme delivered on a daily basis by trained teaching assistants is an effective intervention for children who show reading delays at the end of their first year in school However, around one-quarter of the children did not respond to this intervention and these children would appear to need more intensive or more prolonged help to improve their reading skills Keywords: Reading intervention, remedial teaching, reading difficulties, randomised controlled trial

Efficacy of small group reading intervention for beginning readers with reading‐delay: a randomised controlled trial

Dyslexia in secondary school. A practical handbook for teachers, parents and students

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Cognitive assessment of dyslexic students in higher education

Efficacy of small group reading intervention for beginning readers with reading‐delay: a randomised controlled trial

Dyslexia in secondary school. A practical handbook for teachers, parents and students