Evidence Based Reading Strategies for Struggling Readers with Learning Disabilities and Emotional Disorders

Abstract

Students with learning disabilities often exhibit academic and functional skills challenges that include limited ability to read, write, listen, speak, or complete other academic or functional tasks. A large proportion of children with LD are also at increased risks for emotional or behavioral problems. When LDs are not properly addressed, children with LD may begin to exhibit behavioral challenges that may further impede their academic performance. One of the key areas of deficit in academic performance among children with LD lies in reading. Research shows that students with EBD or LD perform approximately 2.2 grades below standard performance in reading. Part of the reason for their reading deficits is attributed to proliferation of instructional methods that are not backed by empirical evidence. In order to address this reading performance-gap, there is a need to examine closely what instructional practices are effective and under what circumstances. This chapter examines some commonly used reading interventions for this group of students with EBD and establishes the evidence supporting their effectiveness. Recommendations for future practice are suggested.

1. Introduction

The population of students aged 3–2 with learning disabilities (LD) in USA was approximately 33% of the total number of students receiving special education services under IDEA as of 2019/20 [1]. As a result, LD has been considered the most common disability category among individuals aged 3–21. Learning disability constitutes a group of brain disorders that affect a broad range of academic and functional skills including the ability to read, write, listen, speak, reason, or complete mathematical tasks [2]. Although there is a technical definition for LD [3], LD are not identical across all individuals. Instead, the types of LD vary from individual to individual [4]. For example, while one child with a LD may struggle with reading and spellings, another child may love reading but struggle with math. Some children may struggle with understanding communication, whereas others struggle with organization. In other individuals, LD may exist as specific difficulties involving coordination, self-control, or attention. Such difficulties extend to schoolwork and can impede learning to read, write, or do math.

According to research, some categories of LD can appear more common in certain age ranges compared to others. For examples, signs and symptoms that are typically common among preschool children include problems pronouncing words, trouble finding the right word, difficulty rhyming, trouble learning the alphabet, numbers, colors, shapes, days of the week, difficulty following directions or learning routines, difficulty controlling crayons, pencils, and scissors, or coloring within the lines, and trouble with buttons, zippers, snaps, learning to tie shoes [4]. Among ages 5–9, the most common signs and symptoms include trouble learning the connection between letters and sounds, inability to blend sounds to make words, confusing basic words when reading, slow to learn new skills, consistently misspelling words and making frequent errors, trouble learning basic math concepts, and difficulty telling time and remembering sequences [4]. Finally, signs and symptoms common to students aged between 10 and 13 include difficulty with reading comprehension or math skills, trouble with open-ended test questions and word problems, dislike of reading and writing, poor handwriting, poor organizational skills, trouble following classroom discussions and expressing thoughts aloud [4].

LD can affect an individual’s quality of life. Research shows that approximately 75% of students with LD exhibit social skills deficits that distinguish them from their non-LD peers [5, 6]. Some studies have reported high unemployment rates among adults with LD [7, 8, 9], low literacy and adult adjustment to economic issues [10], and social and emotional problems in adult life [11, 12].

2. Connection between LD and EBD

Learning disability and emotional disorders have been observed to potentially co-occur or interconnect [8, 13, 14]. According to the Learning Disabilities Association of America, most children with LD usually have comorbid conditions, most of which include behavioral/emotional issues and ADHD [8]. If LDs are not properly addressed at younger ages, they can develop into behavioral disorders when the children grow into adolescents [14]. Sections of prior research also show that some children with LD often exhibit challenges associated with creating and maintaining social relationships [15, 16]. This is usually a result of processing problems which make it difficult for children with LD to pick up social cues. Other related emotional problems common in children with LD include poor concentration, attention deficit, lack of social interactions and self-confidence, and emotional distractions among others [17]. Another earlier study [18] indicated several learning and behavioral characteristics commonly occurring in children with LD, which include attention disorders, social skills deficits, psychological processing deficits, and information processing problems. Smith et al. [19] asserted that several characteristics of LD often create challenges associated with social and emotional regulation. Other sections of previous research have also reported higher than normal rates of behavioral problems among children with LD [20]. Given the connection between LD and EBD, some interventions designed for students with EBD may often be effective to address academic and functional skills deficits across students with LD.

3. Reading challenges in LD

One of the key areas of deficit in academic performance among children with LD lies in reading. Research shows that a large proportion of learning disabilities are often associated with reading deficits [21]. When LD interconnects with behavioral disorders, students perform approximately 2.2 grades below standard performance in reading [22]. Reading skills deficits among children with LD present several problems in other areas including poor performance in other subjects, lower academic grades, behavioral problems, and inattention [8]. Worse more, poor reading outcomes have been shown to be associated with numerous lifelong problems including high school dropout, juvenile delinquency, and high probability to enter juvenile justice system [23].

There are two types of reading deficits in LD, basic reading problems and reading comprehension problems [24]. Basic reading problems occur when students have a difficulty understanding the relationship between sounds, letters, and words [24]. The basic reading problems are generally considered the elementary reading skills that are an essential pre-requisite for students to be able to develop higher order reading skills like comprehension. Reading comprehension problems occur when students are unable to understand the meaning of words, phrases, and paragraphs [4]. Reading comprehension is more complex as it involves a lot more “cognitive and linguistic skills” [25]. Overall, signs of reading difficulty include problems with letter and word recognition understanding words and ideas reading speed and fluency general vocabulary skills [4].

In LD, reading problems are considered to be the most common learning deficit more than any other area of academic performance, yet the skills are so fundamental that they affect other learning areas [26]. The National Reading Panel Report Reading identifies 5 areas essential to effective early reading, which are phonemic awareness, phonics, fluency, vocabulary, and comprehension [27]. Students with learning disabilities in reading generally show severe deficits in the 5 areas as shown by poor phonemic awareness, challenges in learning phonics and decoding words, and struggles to comprehend written materials due to language processing deficits [28].

Decoding constitutes the most elementary reading skill that emergent learners need to acquire before they can begin to work on fluency. The skill consists of a set of sub skills that include word recognition, word identification, word attack, and sight word recognition. Emergent readers rely on decoding skills to read text until they build sight word vocabulary, or words they can remember without decoding. The ability to decode depends on several sub skills related to sound/symbol relationships embedded in phonics. Decoding is particularly important in predicting early learners’ future skills in reading comprehension and other complex reading skills. Previous studies show that early coding skills are associated with improved and wider reading habits in and out of school [29]. On the other hand, children that struggle with decoding early on usually tend to worsen in reading skills in later grades [30].

Oral reading fluency. Early readers rely on good decoding skills and sight word vocabulary in order to become fluent readers. Emergent readers who are beginning to learn and apply decoding skills may have very limited fluency. When students lack fluency, it implies that they are not yet reading with confidence and may still be struggling with decoding some of the text. Fluency is more likely to build as new readers become more aware of advanced phonemic skills like deleting, substituting, and reversing phonemes. In some cases, students may be familiar with many sight words but find it difficult to read fluently, for example, they may read in a choppy, word-by-word manner. In cases like these, such students may have speech or language processing issues that prevent them from becoming fluent readers. In other cases, text may be too challenging, or the reader may not be getting enough practice to build confidence, thereby making it difficult for them to develop fluency. Common fluency problems include omissions, substitution, mispronunciation of words, hesitation, and inversion.

Reading comprehension deficit entails a difficulty understanding the meaning of text read (e.g., the sequence, relationships, inferences, or deeper meaning of text). Whilst many students develop elementary phonemic awareness skills, a substantial number of students with LD will face difficulties developing comprehension skills. Reading comprehension is particularly complex as it requires the coordination of “multiple levels of language and cognitive functioning” ([31], p. 2). Children with LD think, process, and understand information differently from other students. Reading comprehension skills deficits in children with LD are often compounded by several factors that include lack of vocabulary or understanding of words, inability to connect ideas in the text to larger issues, difficulties recalling basic facts, difficulties recalling sequency low attention or concentration issues while reading, and a challenge in determining important ideas in text.

4. Evidence based strategies

In order to address reading deficits in students with LD, there has been an increased emphasis to adopt evidence-based instructional practices that are supported by strong empirical evidence. Part of prior research on this topic indicated the existence of practices that are either ineffective or are not empirically demonstrated to be effective [32, 33]. Furthermore, prior research indicates some obstacles associated with finding evidence-based practices by teachers [34]. For instance, lack of trust of research in preference for personal experience by teachers tends to lead teacher to rely more on practices they perceive to be effective as opposed to research based. Sometimes, teachers’ personal beliefs and feelings of self-efficacy tend to result in them picking up practices that they perceive to be effective even if they are not backed by data.

Evidence based instructional practices are characterized by four elements of focus, namely experimental research, high quality methodological rigor, more supporting studies, and demonstrated quantitative effects [35]. Regarding experimental designs, the expectation is for an instructional approach to be supported by empirical studies conducted using experimental designs that demonstrate a clear functional relationship between interventions and target outcomes. In educational research, these include group or single case designs. Group designs are typically considered the gold standard in education and other fields and have traditionally been used in majority of experimental research in social science. Although these methods have been demonstrated to be effective, they tend to mask individual differences among individual participants. The nature of populations in special education particularly makes it difficult to entirely rely on group designs. Single case designs on the other hand evaluate the effectiveness of an intervention on a single unit of analysis. The single subject acts as both the control and experimental unit, with pre-treatment scores serving as baseline and intervention scores functioning as the posttest scores.

The second factor considered in identifying EBP is the quality of research supporting a practice [35]. Essentially, research quality is targeted at ensuring validity of research findings [36]. In order for a study to be valid, researchers must control for potential threats to validity to the greatest extent possible (e.g., history, maturation, statistical regression, selection, experimental mortality; [37]). Researchers using SCDs and group designs take measures to control for extraneous variables that either correlate with independent variables of interest in influencing the outcome variables, or influence both independent and dependent variables in a manner that makes it difficult to ascertain the nature of relationship between the variables of interest [36]. Failure to control for extraneous variables can result in biased outcomes, whose findings cannot be applied to participants (i.e., lacking internal validity) or non-participants (i.e., lacking external validity; [38]).

Quantity of studies supporting an instructional practice must be sufficient enough to ensure that findings are generalizable to populations not included in the primary studies [35]. Studies conducted in a single environment, with the sample of participants drawn from a single population limit the chances that findings are generalizable to non-participants. More studies investigating a single intervention, conducted at different times, in different places, and with different participants therefore increase the possibility of findings being applicable to individuals who did not participate in the studies [39]. Finally, EBP further requires that researchers demonstrate, in quantitative terms, the magnitude of effect of the researched interventions [35]. More specifically, researchers use statistical methods to assess the changes in outcomes of interest that are a result of interventions. In educational research, meta-analyses are typically used to synthesize quantitative effects of interventions across multiple studies. In order to determine the EBP recommended in this chapter, we conducted a meta-analysis study which also examined the methodological rigor of the primary studies on reading interventions for EBD [40].

5. Evidence based reading strategies for LD and EBD

Phonological awareness constitutes the most basic or elementary skill in reading. It involves the detection and manipulation of sound. It is regarded one of the strongest predictors for a child’s future reading success [41, 42]. Phonological awareness creates the skills to segment and blend words together to produce reading and spelling. Children with weak phonologic awareness skills are likely to struggle to read and write properly [42]. All other future reading skills like fluency, comprehension, and vocabulary build from an initial set of these important skills.

As indicated before, children with LD typically struggle to develop the basic phonological skills. However, previous research has demonstrated some potentially effective strategies for teaching phonemic awareness. The Phonological Awareness Training for Reading (PATR; [43]) is an early reading curriculum program which is designed to teach students sound structures. The program is divided into four phases which include warm up, sound blending, sound segmentation, and reading and spelling. The four phases are organized strategically to build the reading skills from learning sounds, blending the sounds, segmenting the words to make meaningful words, and subsequently to present the phonemes in words and apply to reading and spelling. Several studies have examined the efficacy of PATR in improving phonological skills and subsequent academic improvements in behavioral and social domains (e.g., [44, 45, 46, 47]). The studies listed were examined for methodological rigor using the Council for Exceptional Children Quality standards (i.e., CEC: [39]). Across the studies, researchers found significant improvements in academic, social, and behavioral outcomes. For example, Lane et al. [46] reported significant improvement in reading fluency measures indicated in the DIBLES and reduction in total disruptive behaviors, negative social interactions. Other studies have been reported to have found positive effects of PATR on phonological awareness across populations with LD (e.g., [48, 49]).

Corrective reading is a direct instruction remedial reading program that is designed to teach a wide range of reading skills among struggling readers. It involves creating step-by-step lessons focusing on two main domains which are decoding and comprehension [50]. Each of the two domains have four sequential levels of instruction that focus on teaching foundational skills for non-readers to 7th grade-level materials. When used in decoding instruction, corrective instruction targets to address core reading deficits like word identification errors, addition and omission of words, erratic grasp of grapheme and phoneme relationships, and poor comprehension. Reading challenges associated with comprehension include inability to follow multi -steps directions, poor auditory memory and statement repetition, poor analytical skills, and deficient vocabulary [51]. This manual specifies the corrective reading strategies that are tailor made for decoding skills across three levels of decoding (word attacks, decoding strategies, and skills applications) and comprehension (thinking basics, comprehension skills, and concept applications).

When examined for literacy skills for adolescent readers, literature shows some mixed findings regarding the efficacy of corrective reading for this group of students. A synthesis of literature by the What Works Clearing House indicated a lack of evidence regarding the efficacy of corrective reading for struggling adolescent readers [38, 52]. When examined for methodological rigor using the WWC evidence standards, several studies on corrective reading were found lacking in evidence due to failure to address the WWC standards (See [38, 52]). However, a recent review of literature analyzing the methodological rigor of primary studies on reading interventions for students with EBD using the CEC quality indicators showed that corrective reading was supported as an effective instructional practice across at least 4 single case design studies and 2 group experimental studies [40]. All across, the strategy was observed to close the reading achievement gap for students with EBD. Corrective reading intervention strategy has also been identified as a tier 3 EBP ideal for the learning needs of students who are most at risk or who fail to respond to tier 2 instructional methods [53]. The publisher for corrective reading instructional programs list various formats of the program that are tailored for different grades and content areas (see [53]).

Concept mapping strategies consist of creation of visual organizers of elements in reading texts, the aim for which is to help readers organize new information and make meaningful connections between ideas in a text. Ideally, concept maps target reading comprehension skills. Commonly used strategies for teaching concept mapping include modeling the identification of ideas or concepts in a text, organizing ideas into categories of similar or related information, or using lines and arrow to indicate connections in ideas [54]. Other methods of concept mapping that have been investigated include the use of graphic organizers [55, 56, 57]. A meta-analysis examining the efficacy of graphic organizers among students in grades 4–12 identified with LD indicated reported increases in various literacy areas including vocabulary, comprehension, and inferential knowledge across studies [58]. In our meta-analysis of reading interventions for EBD [40], there was not sufficient studies to support the minimum necessary studies to supporting the efficacy of concept/story mapping among students with EBD. However, when literature was further examined for use of concept mapping on students with learning disabilities, more literature emerged which reported significant increases across various outcome domains in reading comprehension (e.g., [55, 56, 58]).

Direct instruction is an explicit or systematic teaching approach that breaks down learning into smaller steps and uses various approaches to deliver the skills, including lectures, tutorials, participatory learning, discussion, recitation, and observations. Direct instruction to teach reading has taken many formats including one-on-one to group instruction. In both formats, teachers use strategies like drilling, storytelling, sequencing, scaffolding. When using scaffolding, teachers model uses of concepts. More common formats of direct instruction that have been thoroughly researched include explicit model of instruction using scaffolding [59]. This approach breaks down DI intro 5 steps consisting of orientation, presentation, structured practice, guided practice, and independent practice. It has been used to teach varying forms of reading skills including phonemic awareness [46, 60, 61], reading fluency [62, 63]. In our meta-analysis [40], there were no studies that applied direct instruction for comprehension-based outcomes. Across other reading outcomes (i.e., phonemic awareness, vocabulary, and oral reading fluency), direct instruction methods were examined in at least 5 group designs and at least 14 single case designs [40]. Several other meta-analyses have examined the effectiveness of direct instruction on academic outcomes for students with LD. For example, a meta-analysis examining effectiveness of reading instruction in science for students with LD reported positive effect sizes for reading instruction across various reading outcome in science, including vocabulary, reading fluency, and comprehension of science materials [64]. When examined for the evidence base for direct instruction, the WWC did not contain any studies across different direct instruction mediums.

Peer mediated instructional approaches are a variation of instruction that involves two or more students work together to problem solve. PALS have been identified to be very helpful for students with disabilities since they promote academic, social, and communication skills to all learners. Peers participate in orientation sessions where they learn social and academic support strategies for use within both teacher-directed and student-initiated activities. As students with and without disabilities gain familiarity with working together, school staff fade back their direct support gradually to promote student independence. In the studies that utilized PALS, high performing students were paired with low performing students and were coached to take turns in being mentees and mentors. The approach was modified to include adult modeling of desired skills immediately before completion of the activities by students. In another study [65], students were paired together to alternate roles of coach and reader and were taught decoding skills that corresponded with teacher directed instruction for the day. Students would alternate the roles, with the stronger readers beginning the sessions as coaches. The study findings indicated that PALS was effective in increasing students’ reading outcomes on letter sound correspondence and blending probes. Other studies in which PALS were examined include Lane et al. [45], Staubitz et al. [66], and Sutherland and Snyder, [67]. Across the three studies, authors reported positive reading outcomes in the domains of oral reading fluency and comprehension. Other earlier studies have also documented positive gains in reading among student with LD as a result of PALS (e.g., [68]). Other studies have examined PALS across multiple learning outcomes (e.g., [69, 70]).

6. Conclusion

When selecting instructional practices for teaching reading skills to students with LD, it is important for teachers to adopt methods that are sufficiently demonstrated to be effective. As indicated in prior research, some teachers had relied on instructional practices that were not evidence-based. Part of the reasons for this was teachers’ lack of knowledge regarding what practices are effective or not, lack of skills to find EBP, and a traditional preference for methods they perceived to be effective. The emphasis on EBP in the field ensures that teachers are selecting interventions that are backed by data and empirical evidence, as well as high quality research. With EBP, teachers can substitute the practices that were formally dominant with interventions that are more likely to produce positive results for students. Evidence-based reading interventions for students with LD can help close the skills gap in this group of students.