Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading...

8
Improving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert F. Newby, JoAnne Caldwell, and Donna R. Recht Five 8- to 10-year-old children with dysphonetic and dyseidetic dyslexia were given instruction in reading comprehension using a story grammar strategy in which story instruction was differentially designed to match the simultaneous or sequential mental processing strengths of each dyslexia subtype. A multiple baseline, single subject experimental design and statistical analyses indicated that the experimental treatments yielded statistically and clinically significant improvements in the proportion of qualitatively important story elements recalled by the subjects, when compared to baseline traditional remedial instruction. The results suggested that students with dyslexia can increase their reading comprehension with training in metacognitive strategies. The question of whether the results were attributable to the subtype- matched methods per se or to strategy training in general, as well as a number of methodological issues, is being explored in subsequent research. D yslexia is defined as a disorder char- acterized by extreme difficulty in learning to read despite normal intelli- gence, adequate instruction, adequate vi- sion and hearing, and sociocultural op- portunity (Hynd & Cohen, 1983). Most recent definitions presume an underlying neurological basis for this disorder and for learning disabilities in general (Ham- mill, Leigh, McNutt, & Larsen, 1981; Harris & Hodges, 1981). Once thought to be a unitary disorder, dyslexia is now thought to consist of several different subtypes. Subgroup Identification Several subgroups have been identified by logically sorting individuals with dys- lexia according to their patterns of defi- cits on various diagnostic tests. Kins- bourne and Warrington (1963) identified two groups, one exhibiting a language disorder and the other a nonverbal se- quential processing problem. Boder (Boder & Jarrico, 1982) described three groups, a dysphonetic group that ex- hibited difficulty using phonetic analysis, a dyseidetic group that had difficulties with whole word identification, and a mixed group. Bakker's research group (Bakker, 1984; Bakker, Moerland, & Goekoop-Hoefkens, 1981) distinguished between P-type and L-type dyslexics. P- type dyslexics overrelied on visual-spatial strategies for word identification, while L-type dyslexics overutilized sequential phonetic strategies. Mattis, French, and Rapin (1975) identified a language deficit group, a visual-spatial deficit group, and a group in which the children exhibited difficulty with articulatory and grapho- motor tasks. Denckla (1972) also iden- tified language deficit and visual-spatial deficit groups, but she added a third category, dyscontrol, which she described as "sweet, sloppy and silly." Lovett's research group (Lovett, 1987; Lovett, Ransby, & Barron, 1984; Lovett, Warren, Ransby, & Borden, 1987) used a battery of reading measures to identify an ac- curacy-disabled group that demonstrated problems in decoding proficiency and a rate-disabled group that exhibited a markedly deficient reading rate despite accurate performance in word recognition. Several subtypes have been identified through statistical methods of cluster analysis. Using a variety of reading mea- sures, Doehring, Trites, Patel, and Fie- dorowicz (1981) reported three subtypes: Type O exhibited an oral reading defi- ciency; Type A was described as having an associative disability reflected in poor auditory-visual matching; and Type S was characterized as having a sequential disorder. Petrauskas and Rourke (1979) used neuropsychological tests to identify three subtypes: One exhibited a language disorder deficit; a second was described as having a mixed linguistic/sequencing deficit; and the third had an articulation graphomotor dyscoordination deficit. Satz and Morris (1981) identified four subtypes: The first exhibited a global language impairment; the second had a specific language impairment; the third had a mixed language and perceptual im- pairment; and finally, the fourth group showed no neurological impairment, and their disability might have been caused by emotional or motivational problems. Lyon and Watson (1981) identified six subtypes, three of which seemed to re- flect different language disorders. The fourth displayed visual perception defi- cits and the fifth, deficits in auditory se- quencing. The sixth group corresponded to Satz and Morris' (1981) motivational emotional group. Although different researchers have not reached a definitive conclusion con- cerning the essential subtypes of dyslexia (for a review, see Harris, 1982; Hynd & Hynd, 1984), some common threads are emerging. Hynd and Cohen (1983) re- viewed the field and summarized the most commonly found subtypes as dys- phonetic, dyseidetic, and mixed. Bakker's (1984) P-type dyslexics are likely to ap- pear dysphonetic, while L-types show many features of dyseidetics. Lovett's (1987) accuracy-disabled group may con- sist largely of dysphonetics, who are in- accurate in phonetic analysis, whereas her rate-disabled group may correspond to the dyseidetic pattern, where poor sight word recognition leaves the reader with the tedious strategy of sounding out most words. Pirozzolo (1985) aptly ex- tended the labels for the basic dyspho- netic and dyseidetic subtypes to "auditory- linguistic dyslexia" and "visuo-spatial dyslexia," respectively. To summarize, dysphonetic or audi- tory-linguistic dyslexia refers to problems with sequential phonetic processing of written text, while visual-spatial dyslex- ia involves difficulty in processing words as wholes. Remaining differences in the subtype literature are probably based upon the subject selection criteria, tests, and methods used for grouping by vari- ous researchers. Subtyping offers the possibility of studies that test the efficacy of different instructional interventions Volume 22, Number 6, June/ July 1989 373 at COLUMBIA UNIV on July 17, 2015 ldx.sagepub.com Downloaded from

Transcript of Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading...

Page 1: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

Improving the Reading Comprehension of Children with Dysphonetic and Dyseidetic

Dyslexia Using Story Grammar

Robert F. Newby, JoAnne Caldwell, and Donna R. Recht

Five 8- to 10-year-old children with dysphonetic and dyseidetic dyslexia were given instruction in reading comprehension using a story grammar strategy in which story instruction was differentially designed to match the simultaneous or sequential mental processing strengths of each dyslexia subtype. A multiple baseline, single subject experimental design and statistical analyses indicated that the experimental treatments yielded statistically and clinically significant improvements in the proportion of qualitatively important story elements recalled by the subjects, when compared to baseline traditional remedial instruction. The results suggested that students with dyslexia can increase their reading comprehension with training in metacognitive strategies. The question of whether the results were attributable to the subtype-matched methods per se or to strategy training in general, as well as a number of methodological issues, is being explored in subsequent research.

Dyslexia is defined as a disorder char-acterized by extreme difficulty in

learning to read despite normal intelli-gence, adequate instruction, adequate vi-sion and hearing, and sociocultural op-portunity (Hynd & Cohen, 1983). Most recent definitions presume an underlying neurological basis for this disorder and for learning disabilities in general (Ham-mill, Leigh, McNutt, & Larsen, 1981; Harris & Hodges, 1981). Once thought to be a unitary disorder, dyslexia is now thought to consist of several different subtypes.

Subgroup Identification

Several subgroups have been identified by logically sorting individuals with dys-lexia according to their patterns of defi-cits on various diagnostic tests. Kins-bourne and Warrington (1963) identified two groups, one exhibiting a language disorder and the other a nonverbal se-quential processing problem. Boder (Boder & Jarrico, 1982) described three groups, a dysphonetic group that ex-hibited difficulty using phonetic analysis, a dyseidetic group that had difficulties with whole word identification, and a mixed group. Bakker's research group (Bakker, 1984; Bakker, Moerland, & Goekoop-Hoefkens, 1981) distinguished between P-type and L-type dyslexics. P-

type dyslexics overrelied on visual-spatial strategies for word identification, while L-type dyslexics overutilized sequential phonetic strategies. Mattis, French, and Rapin (1975) identified a language deficit group, a visual-spatial deficit group, and a group in which the children exhibited difficulty with articulatory and grapho-motor tasks. Denckla (1972) also iden-tified language deficit and visual-spatial deficit groups, but she added a third category, dyscontrol, which she described as "sweet, sloppy and silly." Lovett's research group (Lovett, 1987; Lovett, Ransby, & Barron, 1984; Lovett, Warren, Ransby, & Borden, 1987) used a battery of reading measures to identify an ac-curacy-disabled group that demonstrated problems in decoding proficiency and a rate-disabled group that exhibited a markedly deficient reading rate despite accurate performance in word recognition.

Several subtypes have been identified through statistical methods of cluster analysis. Using a variety of reading mea-sures, Doehring, Trites, Patel, and Fie-dorowicz (1981) reported three subtypes: Type O exhibited an oral reading defi-ciency; Type A was described as having an associative disability reflected in poor auditory-visual matching; and Type S was characterized as having a sequential disorder. Petrauskas and Rourke (1979) used neuropsychological tests to identify

three subtypes: One exhibited a language disorder deficit; a second was described as having a mixed linguistic/sequencing deficit; and the third had an articulation graphomotor dyscoordination deficit. Satz and Morris (1981) identified four subtypes: The first exhibited a global language impairment; the second had a specific language impairment; the third had a mixed language and perceptual im-pairment; and finally, the fourth group showed no neurological impairment, and their disability might have been caused by emotional or motivational problems. Lyon and Watson (1981) identified six subtypes, three of which seemed to re-flect different language disorders. The fourth displayed visual perception defi-cits and the fifth, deficits in auditory se-quencing. The sixth group corresponded to Satz and Morris' (1981) motivational emotional group.

Although different researchers have not reached a definitive conclusion con-cerning the essential subtypes of dyslexia (for a review, see Harris, 1982; Hynd & Hynd, 1984), some common threads are emerging. Hynd and Cohen (1983) re-viewed the field and summarized the most commonly found subtypes as dys-phonetic, dyseidetic, and mixed. Bakker's (1984) P-type dyslexics are likely to ap-pear dysphonetic, while L-types show many features of dyseidetics. Lovett's (1987) accuracy-disabled group may con-sist largely of dysphonetics, who are in-accurate in phonetic analysis, whereas her rate-disabled group may correspond to the dyseidetic pattern, where poor sight word recognition leaves the reader with the tedious strategy of sounding out most words. Pirozzolo (1985) aptly ex-tended the labels for the basic dyspho-netic and dyseidetic subtypes to "auditory-linguistic dyslexia" and "visuo-spatial dyslexia," respectively.

To summarize, dysphonetic or audi-tory-linguistic dyslexia refers to problems with sequential phonetic processing of written text, while visual-spatial dyslex-ia involves difficulty in processing words as wholes. Remaining differences in the subtype literature are probably based upon the subject selection criteria, tests, and methods used for grouping by vari-ous researchers. Subtyping offers the possibility of studies that test the efficacy of different instructional interventions

Volume 22, Number 6, June/ July 1989 373 at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from

Page 2: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

for dyslexics by using subtype by treat-ment paradigms. The research program described here began investigating the ef-fectiveness of such a paradigm in rela-tion to reading comprehension.

Subgroup Treatment

Several research programs have begun to test differential instructional programs for subtypes of children with reading dis-abilities. Bakker et al. (1981) developed differential classroom/instructional and laboratory treatments for children with P-type or L-type dyslexia. The P-type group, presumed to overrely on right-hemisphere visual-spatial strategies, re-ceived compensatory left-hemisphere stimulation by projecting words to the right visual field and hence to the left hemisphere, and by presenting reading instructional tasks with all special type-faces and pictures removed in order to focus students' attention on the linguistic aspects of the text. The converse treat-ments were used with the L-type group: left visual field word presentations and perceptually complex texts with letters within individual words printed in dif-ferent typefaces. Results indicated electro-physiological evidence of the differential treatment effects with the two subtypes, that is, increased evoked response ampli-tudes in the previously weaker hemisphere.

Fiedorowicz and Doehring (1984) ad-ministered three instructional methods matched to children in their Type O, Type A, and Type S subtypes (Doehring et al., 1981). All treatments involved presentation of letters, syllables, and words on computer monitor screens. The Type O treatment involved reading orally as accurately and quickly as possible. Type A children matched an auditory sample with a visual item. Type S sub-jects matched a visual sample with a visual item. Compared to delayed-treat-ment controls, all subjects improved on the directly trained procedures, on recog-nition of isolated words, and on phonics skills.

Accuracy-disabled and rate-disabled subtypes were given one of three treat-ments by Lovett et al. (1984). The De-coding Skills (DS) program focused on word recognition and spelling skills us-ing a phonics approach for regular words and a sight vocabulary approach for ir-

regular ones. The Oral and Written Lan-guage Stimulation (OWLS) program in-volved intensive work on oral language comprehension, reading comprehension, and written composition. The Classroom Survival Skills (CSS) program was a con-trol procedure involving social skills, classroom etiquette, life skills, and self-help techniques. Accuracy-disabled chil-dren improved their decoding of both regular and irregular words through the DS program only. The DS and OWLS programs were equivalent in the mag-nitude of improvements for the rate-disabled group. It was suggested that only readers who are rate disabled may benefit significantly from a comprehen-sive language stimulation program. On the other hand, readers with more severe disabilities (i.e., accuracy disabled) may lack a linguistic basis for such a program.

The present study moved beyond all but the OWLS program described by Lovett et al. (1984) by focusing instruc-tion on the reading comprehension of the 2 subtypes of dyslexia, as opposed to word recognition or other more elemen-tary decoding aspects of the reading pro-cess. Another major difference from prior research was that the treatments here were specifically designed to build upon the strengths of children with dyslexia, rather than remediate their deficits. This approach was guided by neuropsycho-logical models of instruction that use methods that compensate for children's processing weaknesses by strengthening and diversifying their areas of strengths (Hynd & Cohen, 1983; Kaufman, Kauf-man, & Goldsmith, 1984). The Kaufmans' program, which emphasizes sequential or simultaneous mental processing strengths, is one of the most explicitly formulated neuropsychological models in the litera-ture at present, but it has not yet been subjected to empirical outcome research. Finally, the present study incorporated instructional methods and materials that are presently in use in many schools in the United States, rather than novel, laboratory-based procedures.

The specific goal of the present study was to increase the narrative text com-prehension of children with dysphonetic or dyseidetic dyslexia. Story grammar (Baker & Stein, 1978) was taught as a strategy for understanding and remem-bering stories. Story grammar describes

parts of a well-formed story: setting, characters, problem, episodes, and reso-lution of the problem. These parts are in-tuitively understood by adults (Stein, 1979), but not well understood or utilized by children (Spiegel & Fitzgerald, 1986). Explicit instruction and directed practice in selecting and recording the story grammar elements have enhanced the reading comprehension of average readers (Whaley, 1981) and poor readers (Fitz-gerald & Spiegel, 1983). Although story grammar in narrative text has increased reading comprehension in general groups of poor readers, it has not been used with a specific dyslexic population.

METHOD

Subjects

The subjects were 4 children with dys-phonetic dyslexia and 3 with dyseidetic dyslexia aged 8 to 10 years (mean = 9.13) who applied for tutoring services at a college-based, professionally staffed reading clinic. Three of the 7 received learning disability services in the schools. All subjects were diagnosed using Boder and Jarrico's (1982) dysphonetic, dyseidet-ic, and mixed criteria based upon specific reading and spelling patterns. The dys-phonetic subtype was intended to fit the broader concept of auditory-linguistic dyslexia reviewed above; the dysphonetic subtype, visuo-spatial dyslexia. In 2 cases, subjects with reading quotients above 80 were included because of clearly deficient scores on the reading compre-hension battery. Because this study was concerned with comprehension instruc-tion, more weight was given to the com-prehension reading scores than to the reading quotient, which is based upon word recognition. Additional criteria in-cluded (a) at least average intelligence, as indicated by any of the three mental pro-cessing global scales on the Kaufman Assessment Battery for Children (Kauf-man & Kaufman, 1983); (b) at least 1 year below current grade placement in reading comprehension for Grades 1 through 3 or at least 2 years below grade level for Grades 4 and above, as diag-nosed by an informal reading inventory (Johns, 1985) and by standardized achievement batteries administered by

374 Journal of Learning Disabilities at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from

Page 3: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

schools; (c) confirming evidence of dysphonetic or dyseidetic miscues (oral reading errors) judged qualitatively by reading specialists on an informal read-ing inventory; and (d) at least average mental processing standard score in the area of presumed strength (simultaneous for children with a dysphonetic pattern and sequential for a dyseidetic pattern) on the Kaufman Assessment Battery for Children. Four out of 5 subjects showed substantially better mental processing in their area of presumed strength as op-posed to the area of presumed weakness, and three of these differences were sta-tistically significant according to the criteria set by the test authors. Table 1 details diagnostic data on each of the subjects, excluding 2 children with a dysphonetic pattern who were dropped from the study later because reliability checks on the instructional method re-vealed inaccurate adherence to the treat-ment protocol. Five of the 7 children were Caucasian and two were black; all came from middle class backgrounds.

Instruction

The focus of instruction was on stu-dent comprehension of the information read. Certain general procedures were the same for both the baseline and experi-mental instruction periods. Five vocabu-

lary words that were conceptually impor-tant for the story content were selected and taught with a focus on student under-standing. For each word, the teacher used a piece of paper that was divided into four squares. The vocabulary word was written in the first square and dis-cussed in a sentence and in a real life con-text. From the discussion, the student generated an example that was written in the second square and a nonexample that was written in the third square. The final square was reserved for a definition in the student's own words. These vocabu-lary sheets were displayed on the walls and reviewed periodically. Across stu-dents, mastery of the words was so high that it did not differentiate the baseline from the experimental phases.

Next, a narrative story from children's literature or from a basal reader written at each subject's instructional level was presented. During the baseline instruc-tion, the teacher followed standard read-ing instruction procedure: The teacher set a purpose for reading that was tied to the content of the story, the student orally read the story, and afterward retold the story and answered an equal proportion of literal and inferential questions. Dur-ing the experimental phase, the teacher again set the purpose and asked the stu-dent to read the story orally. A major part of the session, however, was spent

teaching the story grammar strategy. All students were taught over the course of the first experimental sessions that stories generally contain the following parts: a main character, a setting, a problem en-countered by the main character, events or attempts on the part of the main char-acter to solve the problem, and a solu-tion or resolution to the problem. Stu-dents were told that using these parts would help them to remember the story better.

Teachers used the initial stories to il-lustrate each component and gradually shifted the responsibility for identification to the students. Story grammar instruc-tion with children who were dysphonetic attempted to capitalize on their simul-taneous mental processing strengths by using pictographs (see Figure 1). As an individual story component was identi-fied by the students, they drew or brief-ly notated it on separate index cards, without regard for sequential order. Stu-dents who were dyseidetic were given a sequentially based instruction. Using the prepared outline (see Figure 2), they were taught to first identify the main char-acter, then the setting, and so on in a prescribed order. All students were en-couraged to look at and reread the cards and outline prior to recall; however, they were not allowed to see them during the recall itself. Throughout the experimen-

Subject

A

B

C

D

E

* Sequential

Sex Age Grade

Male

8-10

3rd

Male

8-6

3rd

Male

9-1

3rd

Female

8-7

3rd

Female

10-8

5th

School-reported reading

grade level

2nd

2nd

1st

-

TABLE 1 Demographic and Test Data on Five Subjects

Boder reading quotient

88

82

67

76

80

vs. Simultaneous significantly different at p <

Boder dyslexia

classification

Dyseidetic

Dysphonetic

Dysphonetic

Dyseidetic

Dyseidetic

.05.

Johns reading comprehension

grade level

Familiar 2nd

Unfamiliar 2nd

Familiar 2nd

Unfamiliar 2nd

Familiar primer

Unfamiliar preprimer

Familiar 2nd

Unfamiliar primer

Familiar 3rd

Unfamiliar 3rd

Kaufman Assessment Battery for Children

standard scores

Sequential

Simultaneous

Composite

Sequential

Simultaneous

Composite

Sequential

Simultaneous

Composite

Sequential

Simultaneous

Composite

Sequential

Simultaneous

Composite

91 79*

81

102

114*

110

95

109*

104

108

112

112

104

94

98

Volume 22, Number 6, June/July 1989 375 at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from

Page 4: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

tal sessions, students were repeatedly asked to verbalize the parts of the story and how identification of these words would aid their recall. In order to moni-tor how reliably tutors were applying the instructional methods, one of the authors (DR) observed randomly distributed ses-sions by each of the three tutors.

Following the story-based instruction, word recognition instruction ensued in both baseline and experimental phases. In the baseline, students received stan-dard phonetic word recognition instruc-tion that was appropriate for their read-ing level but undifferentiated according to their subtype. In the experimental phase, those with a dysphonetic pattern were taught using a combined auditory-visual-kinesthetic approach, while those with a dyseidetic pattern were taught using a more phonetic word phonogram approach.

Procedure

Each student was given two 70-minute, one-to-one tutoring sessions per week for 7 weeks. An experimental single subject design was used. Multiple baseline mea-sures were taken across subjects (Barlow & Hersen, 1984), as follows: Each sub-ject was randomly assigned to start with two, four, or six baseline sessions of traditional remedial tutoring, after which strategy instruction on story grammar matched to the appropriate dyslexia sub-type was introduced for the next eight sessions. This single subject design was utilized to focus the study on each in-dividual subject's time course of response to instruction, rather than obscuring in-dividual differences in response by group-ing all subjects' data together for analysis.

Outcome Measures

Outcome measures were taken at the end of each session following the word recognition skills component of the les-son, using the passage that had been covered during that session. They in-cluded (a) number of words read orally in 1 minute, starting at the beginning of the passage, discounting miscues; (b) per-centage of words taught during the word recognition component that were read correctly in list format; and (c) number

376

BT Character

© 1

Problem

5?-©

C « i i ^ « « «JB V I f A l l l J

A

Event

© 1

Solution

s

Figure 1. Story mapping cards for dysphonetics (used in order chosen by reader).

Character V

M/

Setting:

Problem

W

Events:

M/ Solution:

vj/ Figure 2. Story mapping sheet for dyseidetics (completed in the sequence indicated).

Journal of Learning Disabilities at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from

Page 5: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

of idea units recalled from the passage. Two different methods were used to mea-sure idea units, both based on proposi-tional analysis (Clark & Clark, 1977) of verbatim transcripts from audiotapes of free recall periods. Instructions during the free recall periods were to "tell me everything you can remember from the story we read today." Unlimited response time was allowed, and further encourage-ment for more details (e.g., "Can you remember anything else?") was provided by the tutor as necessary. The first recall measure, termed here "quantitative anal-ysis," was to count all propositions in the story and all propositions in the students' recall, then to compute the percentage of all propositions from the passage that were recalled. The second, called "quali-tative analysis," was to construct a com-posite of important idea units in the story using the independent judgment of two of the three authors. Each student's recall was compared to the composite, and the idea units were counted to compute the percentage of propositions in these com-posites that were recalled. The qualitative method was devised to measure subjects' comprehension of the most important or central ideas in each story, in contrast with the quantitative approach of cata-loguing every detail from the story text. No penalties were applied for incorrect ideas or intrusions in the free recall. However, credit was not given for cur-rent inferences. The quantitative and qualitative scoring was done by one author (JC). A random sample was in-dependently rescored by another author (DR). Interrater reliability checks in-dicated a correlation of .98 for both number of propositions and the percent-age of recall that matched the adult summaries.

RESULTS

Each of the outcome measures was plotted on contiguous graphs and sub-jected to standard visual analysis pro-cedures for multiple baseline designs (Barlow & Hersen, 1984). The main goals in interpreting these graphs were to iden-tify the effects of intrasubject variability due to overly familiar or unfamiliar story topics, to evaluate whether stable base-line performance had been established,

and to determine if the levels or slopes across time of each subject's performance on each outcome measure differed be-tween baseline and treatment. Because lengths of baselines were randomly as-signed among subjects, increases in level or variability between baseline and treat-ment could be reasonably attributed to treatment effects.

The oral reading and vocabulary mea-sures showed no treatment effects. Spe-cifically, the number of words read correctly in context in 1 minute varied minimally to moderately within each sub-ject, but neither the overall levels nor the slopes of the values across time changed substantially from baseline to treatment. The number of miscues during the 1-

minute readings were uniformly low and stable across sessions for all subjects. The percentage of words recognized correct-ly in list format was uniformly high for all subjects during the treatment phases, but these were not judged to be meaning-fully different from the very high base-line levels on this measure (see Note 1).

The quantitative comprehension recall measure showed an ambiguous treatment effect (see Figure 3). Subject B showed a slightly higher percentage of proposi-tions recalled during treatment (4% to 23%) than during baseline (2% to 6%), but the magnitudes of the levels in both conditions were low and not substantially different from each other. Subject D showed wide variability but no consistent

1 2 3 4 5 6 7 8 9 1011 121314

SESSIONS

Figure 3. Percentage of ideas recalled from whole stories in each session (filled data points indicate dysphonetic subjects; open points, dyseidetics).

Volume 22, Number 6, June/July 1989 377 at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from

Page 6: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

pattern of level or slope changes between baseline and treatment. Subjects A, C, and E showed low and stable levels across both conditions.

Clear treatment effects were found using the qualitative analysis method, in-cluding increased variability of perfor-mance for 4 of the 5 subjects (A, B, C, and E on Figure 4) and, after an initial and expected period of one or two ses-sions to adjust to the new treatment, in-creased levels of performance for 4 of the 5 subjects (A, B, D, and E on Figure 4). Baselines were not ideally stable for Sub-jects B, C, and D, although the retro-spectively discovered intrusion of several overly familiar stories may have been the major cause of this for the latter 2 sub-

jects. Slope changes between baseline and treatment were thereby difficult to evaluate.

A two-tailed / test comparing the mean percentage across all subjects of ideas recalled in the last two baseline sessions (40%) with the last two experimental ses-sions (62%) was significant for the qual-itative data, / = 3.39(4), p < .05, but not significant for the quantitative data, / = 0.04(4), p < .10.

DISCUSSION

These results provide initial evidence that children with dyslexia can benefit from strategy instruction to increase their

recall of the qualitatively important ideas from reading passages to statistically and clinically significant higher levels. Chil-dren with dyslexia, like normally achiev-ing readers (Whaley, 1981) and delayed readers (Fitzgerald & Spiegel, 1983) can effectively use metacognitive methods to organize their understanding of reading material. Although qualitative reading improvements were seen in both sub-types, a smaller proportion of children with the dysphonetic pattern (1/2) than those with the dyseidetic pattern (3/3) showed clear increases in the levels of ideas recalled during the treatment phase. If substantiated in further research, this finding would parallel Lovett et al.'s (1984) report that accuracy-disabled readers did not show as much word recognition improvement as rate-disabled readers in a comprehensive language stimulation program.

Selection of instructional materials for the current study was based primarily upon the readability level of each story, although effort was also made to choose narratives about topics that were mod-erately familiar to the subjects. However, some selections proved to be overly familiar (i.e., "The Little Red Hen," Sub-ject C, Session 2), so recall probably represented memory of what had been previously heard or read more than what had been specifically read during the ses-sion. Conversely, some topics proved to be quite unfamiliar for particular sub-jects (e.g., circuses, Subject E, Session 9). The facilitative effect of background knowledge upon reading comprehension has been well documented (Pearson, 1985). In the present study, it may have contributed to outlier scores. More care in passage selection with regard to this variable is warranted in future studies. In addition to the objectively specified facilitative effect of story grammar in-struction, outlined above, informal ana-lysis of recall transcripts provided evidence for changes in the structure of some subjects' understanding of text materials. For example, in baseline, Sub-ject E's recall of each story was non-sequential and random. As experimental instruction progressed, her recall became more sequential and specific. When asked to recall, she started with "the setting is. . . , the characters are. . . , the prob-lem is. . . , then . . . and the problem

O O

Ul U

100

75

50

25

0

75

50

25

0

75

50

25

0

75

50

25

0

75

50

25

0

BASELINE TREATMENT

Subject A

Subject C

Subject D

I I I I M I I I Subject E

' ' ' ' '

1 2 3 4 5 6 7 8 9 1011 121314

SESSIONS Figure 4. Percentage of ideas recalled from adult summaries in each session (filled data points indicate dysphonetic subjects; open points, dyseidetics).

378 Journal of Learning Disabilities at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from

Page 7: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

got fixed by. . . ." This type of improve-ment in the metacognitive organization of the subjects' recall will be explored further in future studies using method-ology currently under development.

Several important questions for follow-up arose. First, did the differential dysphonetic/simultaneous versus dyseidet-ic/sequential strategies have specific benefit for the matching subtypes of dyslexia, or was metacognitive strategy training in general without specific tailor-ing to subtype just as effective? Some variant of a single case reversal design (Barlow & Hersen, 1984) with alterna-tions between the simultaneous and se-quential treatments for all subjects may be most apt for addressing this question, although continuing effects of prior training may complicate the interpreta-tion of results in a reversal design such as ABAB. Second, subjects in the pres-ent sample read, mapped, and recalled the story all in one 70-minute class. There is a need to determine the stability of such recall over longer periods of time. Third, it will be important to test the transfer of the comprehension skills demonstrated here to other settings be-sides the tutoring sessions themselves, as well as the stability of gains after treat-ment terminates. Lovett et al. (1987) have found some transfer effects in a word recognition training program for ac-curacy-disabled readers. It is virtually certain that longer term and more inten-sive interventions need to be tested to substantially benefit typical children with dyslexia. Finally, it would be helpful to develop more sensitive measures of oral reading skill and vocabulary develop-ment as well as more focused, subtype-tailored training methods for these more elementary reading skills. Smith's (1986) provocative theory that improvements in readers' comprehension may actually fa-cilitate more elementary reading skills without necessarily training the latter is certainly worth exploring in dyslexic pop-ulations. All of these questions are being addressed in a continuing research program.

ABOUT THE AUTHORS

Robert F. Newby is an assistant professor and child neuropsychologist in the Department of Neurology at the Medical College of Wisconsin. He received

his PhD in clinical psychology from the University of Kansas. JoAnne Caldwell is an associate pro-fessor of reading/language arts at Cardinal Stritch College. She received her PhD in educational psy-chology from Marquette University. Donna Recht is the director of the Cardinal Stritch College Reading Clinic and an assistant professor in psy-chology and reading/language arts. She received her MST and CAS from the University of Chicago in reading and supervision, and her PhD from Mar-quette University in educational psychology. Ad-dress: Robert F. Newby, Neuropsychology Section, Medical College of Wisconsin, 1000 N. 92nd St., Milwaukee, WI53226.

AUTHORS* NOTES

1. We thank Gordonna Komassa, Linda Schulteis, and Denise Leifer for their help in tutoring the children for this study at the Cardinal Stritch Col-lege Reading and Learning Center; and Lynette Satermo for typing the manuscript. 2. Portions of this study were presented at the Third World Congress on Dyslexia in Chania, Greece, June 27 to July 3, 1987.

NOTE

1. Data for the oral reading and vocabulary mea-sures are not presented here because of space limita-tions. They can be obtained from the authors.

REFERENCES

Baker, L., & Stein, N. (1978). The development of prose comprehension skills. In C. Santa & B. Hayes (Eds.), Children's prose comprehension: Research and practice. Newark, DE: International Reading Association.

Bakker, D.K. (1984). The brain as a dependent variable. Journal of Clinical Neuropsychology, 5, 1-16.

Bakker, D.K., Moerland, R., & Goekoop-Hoefkens, M. (1981). Effects of hemisphere-specific stimula-tion on the reading performance of dyslexic boys: A pilot study. Journal of Clinical Neuropsy-chology, 3, 155-159.

Barlow, D.H., & Hersen, M. (1984). Single case ex-perimental designs: Strategies for studying be-havior change. New York: Pergamon Press.

Boder, E., & Jarrico, S. (1982). The Boder test of reading and spelling patterns. New York: Grune & Stratton.

Clark, H, & Clark, E. (1977). Psychology and language. New York: Harcourt.

Denckla, M.B. (1972). Clinical syndromes in learn-ing disabilities: The case for "splitting" versus "lumping." Journal of Learning Disabilities, 5, 401-406.

Doehring, D.G., Trites, R.L., Patel, P.G., & Fie-dorowicz, C.A. (1981). Reading disabilities: The interaction of reading, language, and neuropsy-chological deficits. New York: Academic Press.

Fiedorowicz, C.A., & Doehring, D.G. (1984, Feb-ruary). Computer-assisted training of three sub-types of reading disability. Paper presented to the 12th Annual International Neuropsychological Society Meeting, Houston, TX.

Fitzgerald, J., & Spiegel, D. (1983). Enhancing children's reading comprehension through instruc-tion in narrative structure. Journal of Reading Behavior, 15, 1-17.

Hammill, D.D., Leigh, J.E., McNutt, G., & Larsen, S.C. (1981). A new definition of learning dis-abilities. Learning Disability Quarterly, 4, 336-342.

Harris, A.J. (1982). How many kinds of reading disability are there? Journal of Learning Dis-abilities, 15, 456-460.

Harris, T.L., & Hodges, R.E. (1981). A dictionary of reading and related terms. Newark, DE: Inter-national Reading Association.

Hynd, G. W., & Cohen, M. (1983). Dyslexia: Neuro-psychological theory, research, and clinical dif-ferentiation. New York: Grune & Stratton.

Hynd, G. W., & Hynd, C. (1984). Subtypes of dys-lexia: Neuroanatomical/neurolinguistic perspec-tive. Reading Research Quarterly, 14, 482-498.

Johns, J. (1985). Basic reading inventory. Dubuque, IA: Kendall-Hunt.

Kaufman, A.S., & Kaufman, NL. (1983). Kauf-man assessment battery for children: Interpretive manual. Circle Pines, MN: American Guidance Service.

Kaufman, A.S., Kaufman, N.L., & Goldsmith, B.Z. (1984). Kaufman sequential or simultaneous. Circle Pines, MN: American Guidance Service.

Kinsbourne, M., & Warrington, E. (1963). De-velopmental factors in reading and writing back-wardness. British Journal of Psychology, 54, 145-156.

Lovett, M. W. (1987). A development approach to reading disability: Accuracy and speed criteria of normal and deficient reading skill. Child Develop-ment, 58, 234-260.

Lovett, M. W., Ransby, M.J., & Barron, R. W. (1984, February). Word type and subtype effects in dyslexic children's response to remedial treat-ment. Paper presented at the 12th Annual Meeting of the International Neuropsychological Society, Houston, TX.

Lovett, M. W., Warren, P. W., Ransby, M.J., & Borden, S.L. (1987, February). Training the word recognition skills of dyslexic children: Treatment and transfer effects. Paper presented at the 15th annual meeting of the International Neuropsy-chological Society, Washington, DC.

Lyon, R„ & Watson, B. (1981). Empirically derived subgroups of learning disabled readers: Diagnostic characteristics. Journal of Learning Disabilities, 14, 256-261.

Mattis, S., French, J.H, & Rapin, I. (1975). Dyslex-ia in children and adults: Three independent neuro-psychological syndromes. Developmental Medicine and Child Neurology, 17, 150-163.

Pearson, R.D. (1985). Changing the face of reading comprehension instruction. Reading Teacher, 38, 724-738.

Petrauskas, R.J., & Rourke, B.P. (1979). Identifica-tion of subtypes of retarded readers: A neuropsy-chological, multivariate approach. Journal of Clinical Neuropsychology, 1, 17-37.

Pirozollo, F.J. (1985). Neuropsychological and neuroelectrical correlates of developmental read-ing disability. In C.T. Best (Ed.), Hemispheric function and collaboration in the child (pp. 309-325). Orlando, FL: Academic Press.

Volume 22, Number 6, June/July 1989 379 at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from

Page 8: Improving the Reading Comprehension of Children with ... · PDF fileImproving the Reading Comprehension of Children with Dysphonetic and Dyseidetic Dyslexia Using Story Grammar Robert

Satz, P., & Morris, R. (1981). Learning disability subtypes: A review. In F.J. Pirozzollo & M.C. Wittrock (Eds.), Neuropsychological and cogni-tive processes in reading (pp. 150-172). New York: Academic Press.

Smith, F. (1986). Insult to intelligence. New York: Arbor.

Spiegel, D., & Fitzgerald, J. (1986). Improving reading comprehension through instruction about story parts. Reading, Teacher, 39, 676-682.

NATIONAL ASSOCIATION CONVENTION C NATIONAL ASSOCIATION CONVENTION CALENDAR

May 23-26, 1989 • Child Welfare League of America • Chicago, Illinois • Contact: 440 First St. NW, Washington, DC 20001; 202/638-2952

May 24-28, 1989 • Association for Behavior Analysis • Milwaukee, Wisconsin • Con-tact: 258 Wood Hall, Western Michigan University, Kalamazoo, MI 49008; 616/387-4494

May 28-June 1,1989 • American Association on Mental Retardation, Annual Con-ference • Chicago, Illinois • Contact: 1719 Kalorama Rd. NW, Washington, DC 20009; 202/387-1968

June 4-6,1989 • Behavioral Teratology Society • Richmond, Virginia • Contact: PO Box 708, Greenfield, IN 46140; 317/467-4894.

June 25-29, 1989 • The American Associa-tion for Counseling and Development and the British Association for Counselling • West London, United Kingdom • Contact: 5999 Stevenson Ave., Alexandria, VA 22304; 703/823-9800

July 9-28,1989 • Kephart Special Education Symposia • Breckenridge, Colorado • Contact: Kephart Center, University of Northern Colorado, Greeley, CO 80639; 303/351-2306

August 11-15,1989 • American Psychological Association, Annual Conference • New Orleans, Louisiana • Contact: 1200 17th NW, Washington, DC 20036

August 30-September 1,1989 • Second Euro-pean Logo Conference • Gent, Belgium • Contact: State University Gent, Depart-ment of Education —EDIF, H. Dunantlaan 1, B-9000 Gent, Belgium; 91/25 41 00 ext. 342 or 354.

September 24-26, 1989 • CEC/CCBD Topical Conference on Behavioral Dis-orders • Charlotte, North Carolina • Con-tact: CEC, 1920 Association Dr., Reston, VA 22091-1589; 703/620-3660

October 4-6,1989 • The Fourth International Symposium on Exceptional Children and Youth • Bangor, Maine • Contact: De-partment of Education and Cultural Ser-vices, State House Station #23, Augusta, ME 04333; 207/289-5950

October 19-21, 1989 • Learning Disabilities Association of Canada, Seventh National Conference • St. John's Newfoundland • Contact: PO Box 7122, St. John's, Canada NF A1E 3Y3; 709/753-0383.

October 21-25, 1989 • CEC/DEC 5th Inter-national Early Childhood Conference on Children with Special Needs • Minnea-polis, Minnesota • Contact: CEC, 1920 Association Dr., Reston, VA 22091-1589; 703/620-3660

October 26-28, 1989 • 11th International Conference on Learning Disabilities • Denver, Colorado • Contact: CLD, PO Box 40303, Overland Park, KS 66204; 913/492-8755

Stein, N. (1979). How children understand stories: A developmental analysis (Vol. 2). In L. Katz (Ed.), Current topics in early childhood educa-tion. Norwood, NJ: Ablex.

Whaley, J. (1981). Story grammar and reading in-struction. Reading Teacher, 34, 762-771.

- October 28, 1989 • The Second New England • Joint Conference on Specific Learning

Disabilities. • Brockton, Massachusetts • Contact: 340 Foster St., North Andover,

; MA 01845; 508/682-6154

November 3-6, 1989 • National Association for the Education of Young Children, An-nual Conference • Atlanta, Georgia • Contact: 1834 Connecticut Ave. NW, Washington, DC 20009; 202/232-8777

November 8-12, 1989 • Tourette Syndrome National Conference • McLean, Virginia • Contact: 42-40 Bell Blvd., Bayside, NY 11361; 718/224-2999

November 9-10, 1989 • Society for Behavioral Pediatrics • Cambridge, Massachusetts • Contact: 241 East Gravers Ln., Philadel-phia, PA 19118; 215/248-9168

November 17-20, 1989 • American Speech-Language-Hearing Association, Annual Convention • St. Louis, Missouri • Con-tact: 10801 Rockville Pike, Rockville, MD 20852; 301/897-5700

November 29-December 2, 1989 • Orton Dyslexia Society, 40th Annual Conference • Dallas, Texas • Contact: 724 York Rd., Baltimore, MD 21204

December 7-9, 1989 • TASH: The Associa-tion for Persons with Severe Handicaps, 16th Annual Conference • San Francisco, California • Contact: 7010 Roosevelt Way NE, Seattle, WA 98115; 206/523-8446

380 Journal of Learning Disabilities at COLUMBIA UNIV on July 17, 2015ldx.sagepub.comDownloaded from