A Synthesis of Research on Effective Interventions for Building ...

394(Table 2 continued)Author/participantTreatment description/sampleage/design size/treatment duration Dependent measures Results/effect sizes (d)Rose, 19849.5–13.1 yearsAlternating treatment designRose & Beattie, 19868.7–11.6 yearsAlternating treatment designSmith, 1979 (Study 1);8 yearsMultiple baseline,multi-element designSmith, 1979 (Study 2)12 yearsMulti-element singlesubjectdesignN = 6 Baseline: Oral reading only, no previewing. Silent previewing: Student read passagesilently before reading it aloud tothe teacher. Listening previewing: Teacher readpassage aloud while student followedalong. Then student read passagealoud to teacher.Length and duration: Approximately25 days <strong>of</strong> intervention. Length <strong>of</strong> dailyintervention not specified.N = 4 Baseline: Daily individual oral reading,introduction to new words, practice <strong>of</strong>new words via flash cards, sentenceconstruction using new words, andworksheet practice. Listening previewing: Teacher readsassigned passage orally at relativelyslow conversational rate (approximately130–160 wpm) as students followalong. All other instructional proceduressame as baseline. Taped previewing: Identical to listening,except teacher had prerecorded thetaped passage and students followedalong with the tape.Length and duration: 3–4-min. sessionsdaily. Approximately 30 days <strong>of</strong> interventionalternating between 3 conditions.N = 2 Baseline: Children read a passage atinstructional level without support. Modeling: Teacher read child’s passagefor 1 minute at 100 wpm. Childcontinued reading from where teacherstopped. Follow-up: Students read passage additionaltime.Length and duration: Not specified, allconditions administered once.N = 1 Baseline: Child read a passage at instructionallevel without support. Modeling: Teacher read passage for1 minute at 100 wpm. Child continuedreading from where teacher stopped. Modeling with correction: Same asmodeling, plus corrections providedduring student reading.Words read correctly per minute Listening previewingled to faster readingrates. Both silent and listeningpreviewing appearedto be morebeneficial thanbaseline.Oral reading fluency Listening and tapedReading accuracypreviewing resultedin increased oralreading rates relativeto baseline. Listening previewingprocedure was morebeneficial than tapedpreviewing for 3 <strong>of</strong> 4participants. Error rates were noteffected by the previewingprocedures.Words read correctly per minute Intervention resultedErrors per minutein increased speedand accuracy forboth students.Words read correctly per minute Speed and accuracyErrors per minuteincreased with eachadditional interventioncomponent. Maximum speed andaccuracy achievedunder the modelingwith correction andpreviewing condition.(Table continues)

VOLUME 35, NUMBER 5, SEPTEMBER/OCTOBER 2002 395(Table 2 continued)Author/participantTreatment description/sampleage/design size/treatment duration Dependent measures Results/effect sizes (d )Smith (continued)Vaughn et al., 20008.5–8.8 yearsQuasi-experimentalpretest–posttestcomparison design Modeling with correction and previewing:After modeling, student reread themodeled portion and continued to readfor 5 minutes. Follow-up: Student read passage additionaltime.Length and duration: Not specified, allconditions administered once.Partner Reading (PR; n = 7): Partnerstook turns reading (3 minutes each)with the more pr<strong>of</strong>icient reader readingfirst. 1-minute, timed reading followed.Collaborative Strategic Reading (CSR;n = 9): Partners used four-strategy approachto reading textLength and duration: 2–3 sessionsweekly for 12 weeks; approximately 25miuntes per session for PR and 45minutes per session for CSR.Gray Oral Reading Test, rate b PR vs. CSR: d = .69Gray Oral Reading Test, accuracy b PR vs. CSR: d = .65Gray Oral Reading Test, PR vs. CSR: d = .30comprehension bTest <strong>of</strong> Reading Fluency, words PR vs. CSR: d = .16correct per minute baNegative d reflects positive outcome favoring treatment listed first. b Statistical comparisons were not possible because <strong>of</strong> the small sample size in each group.ency than the control sample (d = .17),but there were no significant differencesbetween the repeated readingcondition and the control condition onmeasures <strong>of</strong> fluency (d = .10) or comprehension(d = .01). Moreover, on amaze task, effect sizes were small butsignificant when the repeated readingwith partners condition was comparedwith the control condition (d = .24) andslightly higher, though still moderate,when the sustained reading conditionwas compared with the control condition(d = .38).Modeling by audiotape or computer.Results from four samples (N = 12) addressedthe question <strong>of</strong> whether an audiotapedor computer model or preview<strong>of</strong> the text to be read by thestudents in the sample improved thereading fluency <strong>of</strong> students with LD.Of the four samples, one used a casestudy design (Moseley, 1993) and threeused a single-subject design (Daly &Martens, 1994; Gilbert, Williams, & Mc-Laughlin, 1986; Rose & Beattie, 1986).In the case study sample, the modelwas provided through a speech synthesizer,with the pace controlled bythe student. In this case, the student’sreading fluency decreased from 76words correct per minute at pretest to63 words correct per minute during theintervention. However, at the followuptest <strong>of</strong> fluency, the student read at112 words correct per minute, suggestingthat the overall impact <strong>of</strong> the interventionmay have been positive. In one<strong>of</strong> the single-subject designs, Rose andBeattie (1986) compared listening previewing,in which the teacher modeledreading <strong>of</strong> the text, with a taped preview,in which the student controlledthe tape and followed along readingwith the tape. For three <strong>of</strong> the four students,the teacher-modeled reading <strong>of</strong>the text was more effective than thetaped model.Daly and Martens (1994) compared ataped model <strong>of</strong> passage reading withrepeated reading without a model andwith audiotaped reading <strong>of</strong> a relatedword list. On measures <strong>of</strong> passagereading accuracy and fluency, thetaped reading model resulted in consistentlybetter performance than repeatedreading without a model andtaped words. The taped words conditionresulted in better performance ona measure <strong>of</strong> word reading accuracyfor three <strong>of</strong> the four participants in thestudy.Gilbert et al. (1986) compared ataped model <strong>of</strong> fluent reading followedby three repeated readings to abaseline condition in which the teacherintroduced vocabulary and importantphonics elements and the studentsilently read the passage once. Fluencyand accuracy improved for all threestudents in both conditions.Repeated Reading Interventionswith Multiple Features. Three groupsamples and four single-case samples(N = 52) involved interventions that includedrepeated reading as one <strong>of</strong> severalinstructional features. The meaneffect size across interventions on measures<strong>of</strong> fluency was d = .71 and rangedfrom d = .20 to d = 1.17. These studiesare listed in Table 3.Simmons, Fuchs, Fuchs, Mathes, andHodge (1995) compared an interventionthat combined an effective teachingcomponent and peer-mediated repeatedreading to traditional readinginstruction. On a measure <strong>of</strong> oral readingfluency, the students who receivedthe combination <strong>of</strong> effective teaching

396TABLE 3Studies Examining Repeated Reading with Multiple FeaturesAuthor/participantTreatment description/sampleage/design size/treatment duration Dependent measures Results/effect sizes (d)Simmons, Fuchs, Fuchs,Mathes, & Hodge, 19959.47–9.91 yearsTreatment–ComparisonD. Fuchs, Fuchs, Mathes, &Simmons, 1996Mean age = 9.87 years(PALs group); 10.09years (No PALs group)Treatment–ComparisonSutton, 1991Ages not providedPre–Posttest design Effective teaching plus peer tutoring(ET+PT; n = 11): Effective instructionalprinciples and peer tutoring using repeatedreading (3 readings/passagefor first 4 weeks, 2 readings/passagefor second 4 weeks), story retells, andparagraph summarization. Comparison (C; n = 29): Traditionalreading instruction.Duration: 800 minutes Peer Assisted Learning (PALs; n = 20):Partner reading with retell (one repeatedreading), paragraph summary,and prediction relay. No PALs (n = 20): Traditional readinginstruction.Duration: 1,350 minutesN = 17Four-element condition:1. Teacher modeled reading <strong>of</strong> story.2. Target students read to tutor partners.3. Partner reading.4. Target student read story to teacher.No. <strong>of</strong> words read in 3 min. ET + PT > C;ET + PT vs. C: d = .73No. <strong>of</strong> words read in 3 min. No significant differences(delayed)between groups;ET + PT vs. C: d = .53No. comprehension questions ET + PT > C;correct ET + PT vs. C: d = .82No. comprehension questions No significant differencescorrect (delayed)between groups;ET + PT vs. C: d = .36No. maze items correct in 2 min. ET + PT > C;ET + PT vs. C: d = 1.00Matched words in recall summaries No significant differencesbetween groups;ET + PT vs. C: d = 1.05Total words in recall summaries No significant differencesbetween groups;ET + PT vs. C: d = .78SAT ComprehensionNo significant differencesbetween groups;ET + PT vs. C: d = .56;Mean effect size (ET +PT vs. C): d = .73Average number <strong>of</strong> words read PALs vs. No PALs:orally in 3 min. d = .20Average number <strong>of</strong> correct PALs vs. No PALs:responses to 10 comprehension d = .63questionsNumber <strong>of</strong> maze items correct PALs vs. No PALs:d = .49Mean effect size (PALsv. No PALs): d = .44Brigance Test <strong>of</strong> Oral Reading Posttest vs. Pretest:(words per minute) d = 1.17Brigance Test <strong>of</strong> Oral Reading Posttest vs. Pretest:(errors per minute) a d = .91;Mean effect size(Posttest vs. Pretest):d = 1.04Weinstein & Cooke, 19928 years 1 month–10 years2 monthsMulti-treatment, singlesubjectdesign (ABACA)N = 4Baseline: Each student read first set <strong>of</strong>3 passages for first baseline phaseand the intervention conditions. Sameprocedure was used for the second set<strong>of</strong> passages. Third set <strong>of</strong> 3 passageswas used for final baseline.Intervention (10 min./day):1. Students listened to taped model at100 wpm.2. Students asked to read passagequickly and accurately.Oral reading fluency All students madeprogress over baseline;mean gains rangingfrom 16.1 to 39.4words correct perminute. Mean gain for thefixed-rate phase = 62% Mean gain for the improvementphase= 58%(Table continues)

VOLUME 35, NUMBER 5, SEPTEMBER/OCTOBER 2002 397(Table 3 continued)Author/participantTreatment description/sampleage/design size/treatment duration Dependent measures Results/effect sizes (d )Weinstein (continued)3. For fixed criterion phase, each studentreread the passage twice daily until heor she met the specified criterion <strong>of</strong>90 wcpm.4. For improvement phase, studentsreread a passage until they achieved3 successive improvements.5. Results were plotted and shared withstudent immediately. Generalization improvedafter improvementphase from 5%to 89% but was mixedfor fixed-rate phase,ranging from –25% to56%.a These effect sizes were changed to positive numbers to reflect a growth in student accuracy rather than a decrease in errors.and repeated reading performed significantlybetter than the comparisonsample. Similar significant differenceswere found for a measure <strong>of</strong> comprehensionand for a maze measure. Althoughno other significant differenceswere noted, the mean effect size for thecombination intervention versus thecontrol sample was moderate to largeat d = 73. D. Fuchs et al. (1997) compareda partner reading interventionthat included repeated readings <strong>of</strong> textand comprehension activities (paragraphsummarization and predictionactivities) to a traditional reading program,yielding a low to moderatemean effect size <strong>of</strong> d = .44.A four-element intervention implementedby Sutton (1991), which includeda combination <strong>of</strong> teachermodeledreading, target students’rereading to a tutor, peer-paired reading,and target students’ rereading tothe teacher, resulted in a considerableincrease in reading rate and a decreasein reading errors, with a large mean effectsize <strong>of</strong> d = 1.04. Weinstein andCooke (1992) used a similar interventionin a single-subject design in whichstudents listened to a taped model beforerereading the passage to a particularcriterion and then examining theirprogress as it was plotted on a graph.The four participating students all experiencedincreased fluency as a result<strong>of</strong> this intervention.Other Elements That Influence FluencyPerformance in Repeated ReadingInterventions. Various other elements<strong>of</strong> interventions may affect readingfluency. Studies that addressedthese elements are listed in Table 4.Amount <strong>of</strong> text. A. L. Cohen (1988)compared the amount <strong>of</strong> text presentedto students as they repeatedlyread passages from a computer screen.One sample (N = 16) was presented apassage at a rate <strong>of</strong> three to five wordsat a time, whereas a second sample(N = 16) had control over the amount<strong>of</strong> text that was presented. Both sampleswere compared to a control sample.No significant differences werenoted between the repeated readingsamples. The sample that receivedonly three to five words per screenscored significantly higher on measures<strong>of</strong> single- and multisyllabic wordreading accuracy. Both repeated readingsamples demonstrated improvedfluency over the control condition, witha large mean effect size <strong>of</strong> d = 1.98. Effectsize comparisons <strong>of</strong> the two repeatedreading groups were small,with the exception <strong>of</strong> reading accuracy(ranging from d = .56 to d = .89), favoringthe controlled presentation <strong>of</strong> threeto five words per screen.Text difficulty. Three samples (N =37) were studied to better understandthe influence <strong>of</strong> text difficulty in repeatedreading interventions. Sindelar,Monda, and O’Shea (1990) comparedrepeated reading <strong>of</strong> instructional-leveltexts (defined as text that could be readat 50–100 words per minute with twoor fewer errors) to repeated reading <strong>of</strong>mastery-level texts (defined as text thatcould be read at more than 100 wordsper minute). Statistically significantdifferences on a measure <strong>of</strong> oral readingfluency favored the mastery-leveltext sample (d = 1.57). However, theinstructional-level sample significantlyoutperformed the mastery-level sampleon accuracy (d = .61). No significantdifferences were identified on the measure<strong>of</strong> comprehension.In a related study, Rashotte and Torgesen(1985) compared repeated reading<strong>of</strong> text that included a high proportion<strong>of</strong> overlapping words withrepeated reading <strong>of</strong> text in which therewas a low degree <strong>of</strong> overlap. Therewere no significant differences betweengroups. However, the condition inwhich there were few overlappingwords performed better than the conditionwith a high degree <strong>of</strong> overlap onall measures.Number <strong>of</strong> repetitions. To determinethe number <strong>of</strong> times that studentsshould repeatedly read text for themost fluency benefit, the findings fromtwo samples (N = 54) are relevant.O’Shea et al. (1987) used a factorial designto study the relative influence <strong>of</strong>the number <strong>of</strong> repetitions on fluency.They used three intervention levels: asingle reading, three repeated readings,and seven repeated readings. Ona measure <strong>of</strong> oral reading fluency,main effects were identified with significantdifferences between all groups.Seven readings resulted in higher performancethan three readings, whichwas significantly better than a singlereading. On a measure <strong>of</strong> story retelling,there were no differences between

398TABLE 4Studies That Examined Other Elements <strong>of</strong> Repeated Reading InterventionsAuthor/participantTreatment description/sampleage/design size/treatment duration Dependent measures Results/effect sizes (d)A. L. Cohen, 19888 years 7 months–13 years2 monthsMultiple-group comparison Processing Power (PP; n = 16): Repeatedreading (4 times) with text presented3–5 words at a time. Repetitive Reading (RR; n = 16): Repeatedreading (4 times) with studentcontrol <strong>of</strong> text amount. No-treatment comparison (C; n = 15).Duration: 195–202 minutesParagraph reading speed RR vs. PP: d = .19(practiced)Paragraph reading accuracy PP vs. RR: d = .56(practiced)Paragraph reading speed PP vs. RR: d = .26(unpracticed)Paragraph reading accuracy PP vs. RR: d = .19(unpracticed)Reading fluency, final text PP vs. RR: d = .30;PP vs. C: d = 1.58;RR vs. C: d = 1.25Reading accuracy, final text PP vs. RR: d = .89;PP vs. C: d = 3.02;RR vs. C: d = 2.09Word reading speed (single PP > C; insufficient insyllable,practiced)formation for dWord reading speed (multisyllable, PP > C; insufficient inpracticed)formation for dWord reading speed (unpracticed) No significant differencesbetweengroups; insufficientinformation for dPassage comprehensionNo significant differencesbetweengroups; insufficientinformation for d;Mean effect size for repeatedreading interventions:d = 1.98Lovitt, T. W., & Hansen, C. L.,19768–12 yearsOne-group pretest–posttest Baseline (B) (N = 7): Students readaloud to the teacher. Teacher suppliesmissed or mispronounced words.Teacher records responses and studentsrespond to written comprehensionquestions after reading. Treatment (T): Students reread or skiplevelled passages contingent on theircorrect word rate and comprehensionscores. Drill was provided on portions<strong>of</strong> reading that were problematic.Duration: 800 minutesCorrect word rate (cwpm)Orral error rate (epm)Percentage <strong>of</strong> comprehensionquestions correctAll students improvedin correct rate. Meangain <strong>of</strong> 9.3 cwpm. Increasesranged from2.4 cwpm to 15.3cwpm.Four <strong>of</strong> the seven participantsdecreasedtheir error rates. Themean error rate improvedfrom 31 epmto 2.9 epm. Decreasesranged from.5 to –.9 epm.All students improved intheir comprehensionresponses, with amean increase <strong>of</strong>11.9% and a range<strong>of</strong> 5.7% to 16.1%.Sindelar, Monda, & O’Shea, 1990Age not reportedTreatment–ComparisonRepeated reading–Instructional level(I; n = 17): Reread text 3 times at50–100 wpm.Repeated reading–Mastery level (M;n = 8): Reread text 3 times at 100 wpmor faster.Oral reading fluencyM > I; M vs. I(1 reading): d = 2.31;M vs. I (3 readings):d = 1.57(Table continues)

399(Table 4 continued)Author/participantTreatment description/sampleage/design size/treatment duration Dependent measures Results/effect sizes (d)Sindelar (continued)Duration: Each condition administeredonce.Errors per minute aNumber <strong>of</strong> propositions retoldI > M; M vs. I (1 reading):d = .88;M vs. I (3 readings):d = .61No significant differencesbetweengroups; M vs. I(1 reading): d = .78;M vs. I (3 readings):d = .34Rashotte & Torgesen, 1985(based on dissertation byRashotte, 1984)8.6–12 yearsMultiple treatment designN = 12 Repeated reading, no overlappingwords (NO): Read stories 4 times withabout 20 words in common acrossstories. Repeated reading with high overlap(HO): Same as NO but with about 60words in common. Sustained Reading (SR): Read 4 differentstories each day.Duration: 7 daysReading rate (slope <strong>of</strong> progress) Both interventions withrepeated readingperformed significantlybetter thansustained reading onreading rate.NO vs. HO: d = .18;NO vs. SR: d = .65;HO vs. SR: d = .35;HO slope, SRslope > 0Reading accuracy (slope <strong>of</strong> NO vs. HO: d = .26;progress) a NO vs. SR: d = .52;HO vs. SR: d = .24;HO slope, SRslope > 0Passage comprehension (slope No significant differ<strong>of</strong>progress)ences betweengroups; NO vs. HO:d = .10;NO vs. SR: d = .08;HO vs. SR: d = .17;Mean effect size, repeatedreading vs.sustained reading:d = .34O’Shea, Sindelar, & O’Shea,198711.3–13.6 years2 (Focus) ´ 3 (No. <strong>of</strong> readings)factorial designN = 29 Repeated Reading 7 (R7): Read text 7times. Repeated Reading 3 (R3): Read text 3times. Reading (R): Read text once.Duration: Each treatment administeredonce.Oral reading fluencyStory retellR7 > R3 > RInsufficient informationto calculate ES.R7, R3 > RInsufficient informationto calculate ES.Sindelar, Monda, & O’Shea,1990Age not reported2 (Reading level) ´ 2 (No.<strong>of</strong> readings) factorialdesignSmith, 1979 (Study 2)12 yearsN = 25 Reading text once (R1). Repeated reading (R3): Reread text 3times.Duration: Each condition administeredonce.N = 1 Baseline: Child read a passage at instructionallevel without support.Oral reading fluency R3 > R1, R3 vs. R1:d = 2.70Oral reading accuracy R1 > R3, R3 vs. R1:d = –.62Number <strong>of</strong> propositions retold R3 > R1, R3 vs. R1:d = 1.67;Mean effect size (R3 vs.R1): d = 1.25Words read correctly per minute Fluency and accu-Errors per minuteracy increased with(Table continues)

400JOURNAL OF LEARNING DISABILITIES(Table 4 continued)Author/participantTreatment description/sampleage/design size/treatment duration Dependent measures Results/effect sizes (d)Smith (continued)Multi-element singlesubjectdesign. Modeling: Teacher read passage for1 minute at 100 wpm. Child continuedreading from where teacher stopped. Modeling with correction: Same asmodeling, plus corrections providedduring student reading. Modeling with correction and previewing:After modeling, student reread themodeled portion and continued to readfor 5 minutes. Follow-up: Student read passage additionaltime.Length and duration: Not specified, allconditions administered once.each additional interventioncomponent.Maximum fluencyand accuracyachieved under themodeling with correctionand previewingcondition.Weinstein & Cooke, 19928 years 1 month–10 years2 monthsMulti-treatment, singlesubjectdesign (ABACA)N = 4Baseline: Each student read first set <strong>of</strong>3 passages for first baseline phase.The same passages were used in theintervention conditions. Same procedurewas used for the second set <strong>of</strong>passages. Third set <strong>of</strong> 3 passageswere used for final baseline.Intervention (10 min./day):1. Students listened to taped model at100 wpm.2. Students asked to read passagequickly and accurately.3. For fixed criterion phase, each studentreread the passage twice daily until heor she met the specified criterion <strong>of</strong> 90wcpm.4. For improvement phase, studentsreread a passage until they achieved3 successive improvements.5. Results were plotted and shared withstudent immediately.Oral reading fluency All students madeprogress over baseline;mean gainsranging from 16.1 to39.4 words correctper minute. Mean gain for thefixed-rate phase =62% Mean gain for the improvementphase =58% Generalization improvedafter improvementphase from 5%to 89% but wasmixed for fixed-ratephase, ranging from–25% to 56%.aNegative d reflects positive outcome favoring treatment listed first.the repeated reading conditions, butboth repeated reading conditions resultedin significantly higher scoresthan the single reading condition.Similarly, Sindelar et al. (1990) foundthat rereading text three times resultedin significantly better performance ona measure <strong>of</strong> oral reading fluency thanreading the text once. Similar differenceswere noted on a comprehensionmeasure.Types <strong>of</strong> feedback. Findings from onesingle-subject sample relate to the influence<strong>of</strong> feedback during repeatedreading. Smith (1979) found that followingteacher modeling <strong>of</strong> fluentreading, providing the correct wordswhen the student read words incorrectlyduring oral reading resulted inan increase <strong>of</strong> more than 20 words correctper minute over baseline, and errorsdecreased from 13.6 to 9.4 errorsper minute.Criteria for repeated reading. Elevensingle-subject samples studied the influence<strong>of</strong> establishing particular criteriafor repeated-reading interventions.Using an alternative treatment design,Weinstein and Cooke (1992) comparedrepeated reading using a criterion <strong>of</strong>90 words per minute (fixed rate) witha criterion based on individual improvementas a basis for increasing thedifficulty <strong>of</strong> the text. They found thefixed-rate criterion more effective thanthe individual improvement criterion,although the individual improvementseemed to facilitate generalization tounpracticed text.Similar to the fixed criterion conditionstudied by Weinstein and Cooke(1992), Lovitt and Hansen (1976) designedan intervention that requiredstudents to meet a particular set <strong>of</strong> criteria(> 75 words read correctly perminute, < 4.5 errors per minute, and87% comprehension questions correct)in order to skip a difficulty level <strong>of</strong> text.

VOLUME 35, NUMBER 5, SEPTEMBER/OCTOBER 2002 401If the three criteria were not met in7 days, the reader received drill andpractice on the difficult words andphrases in the text. The researchers reportedthat all participating studentsimproved in reading fluency duringthe performance-based advancementcondition by 10 words correct perminute and answered almost 12%more comprehension questions accurately.These results were maintainedat follow-up.Word Practice InterventionsNine single-subject samples were studiedto examine the effectiveness <strong>of</strong> decodinginterventions on improvingreading fluency (see Table 5). O’Shea,Munson, and O’Shea (1984) applied analternating treatment design to comparethe relative effectiveness <strong>of</strong> aword drill procedure and a phrase drillprocedure. Each procedure was basedon words missed during an initial oralreading baseline phase. Words missedafter oral reading were placed on flashcards, and students were given the opportunityto practice on half <strong>of</strong> thewords in isolation (word drill). Alternatively,in the phrase drill condition,the error words were practiced in contextualphrases. There were negligibledifferences between alternating treatmentconditions for isolated wordreading and reading fluency. Significantdifferences between conditionswere demonstrated only on a measure<strong>of</strong> passage reading accuracy, favoringthe phrase drill condition.Employing a multi-element design,Daly and Martens (1994) comparedtaped previewing <strong>of</strong> words read in alist to participating students to repeatedreading conditions. Studentsdemonstrated greater word readingaccuracy in this taped words conditionthan in the baseline or repeated readingconditions. However, on measures<strong>of</strong> passage reading fluency and accuracy,the repeated reading conditionwas consistently more effective.DiscussionFluency has been identified as an essentiallink between word analysis andcomprehension <strong>of</strong> text and is considereda necessary tool for learning fromTABLE 5Studies Examining Fluency Practice at the Word LevelNumber <strong>of</strong> students/Author/participanttreatment description/age/design length and duration Dependent measures ResultsDaly & Martens, 19948 years 10 months–11 years11 monthsMulti-element designN = 4* All conditions followed a model, drill,and train to criterion lesson structure.* Subject Passage Preview (SP): Readpassage silently and reread for assessment.* Listening Passage Preview (LP): Listenedto audiotaped (130 wpm) passage,read list <strong>of</strong> unknown words, andreread passage for assessment.* Taped Words (TW): Read aloud alongwith audiotaped word list (80 wpm).Reread list and read passage for assessment.Length and duration: Session length notspecified. Treatments lasted 21 days.Passage reading accuracy * LP > SP > TW onPassage reading fluencyaccuracy and fluencyWord reading accuracy<strong>of</strong> passage reading.Word reading fluency * TW condition outperformedSP and LPon measures <strong>of</strong> wordreading accuracyand fluency.O’Shea, Munson, & O’Shea,19847–11 yearsAlternating treatmentdesignN = 5* Baseline (Word supply): When an errorwas made during oral reading, theteacher supplied the word.* Word drill: Words were supplied byteacher during oral reading. After reading,students were drilled on half <strong>of</strong>error words using 5" ´ 8" flash cards.* Phrase drill: Same procedure as control.After reading, words were drilledusing phrases in which they occurredin text.Length and duration: 30 min. sessions/day for 10 days; 300 min.No significant differ-ences between drillconditions andcontrol.Significant effects favor-ing phrase drill.Negligible differencesbetween conditions.Error words read correctlyin isolationError words read correctlyin passage contextWords read correctly per minutein daily reading passage

402JOURNAL OF LEARNING DISABILITIESreading (Chall, 1983). The relationship<strong>of</strong> fluent oral reading and overall readingability is supported by both empiricaland clinical evidence (Meyer &Felton, 1999; Rasinski, Padak, Linek, &Sturtevant, 1994; Reutzel & Hollingsworth,1993). Despite the importance<strong>of</strong> fluency, its essential role in buildingoverall reading ability has only recentlybeen highlighted (NRP, 2000).Fluency appears to be particularlyimportant for students with significantreading problems, because they <strong>of</strong>tenhave labored reading with manypauses, which results in slow and disconnectedoral reading. This effortfulreading is problematic because it focusesreading at the decoding andword level, which makes comprehensionvirtually impossible. Chall (1979)described these readers as “glued toprint” (p. 41) and unable to delight inthe reading <strong>of</strong> text. The students withLD who were the target group for thissynthesis represent a large subgroup <strong>of</strong>dysfluent readers.The National Reading Panel (2000)summarized findings about guided repeatedoral reading as a means to improvefluency and indicated that theoverall weighted effect size produced amoderate effect for repeated oral reading.The NRP presented the case thatinstruction in guided oral reading is animportant part <strong>of</strong> a reading programand is associated with gains in fluencyand comprehension. Oral reading interventionswere found to be superiorto instruction encouraging students toread silently. Furthermore, the NRPreported that good and poor readersboth benefited from the repeatedguided reading, although they maybenefit differentially from different aspects<strong>of</strong> the treatment (Faulkner &Levy, 1999). However, the NRP readingfluency synthesis did not address theextent to which individuals with LDmight benefit from fluency interventionsor the extent to which other types<strong>of</strong> fluency interventions (other thanoral repeated reading) might be associatedwith improvements in fluencyand other aspects <strong>of</strong> reading.The purpose <strong>of</strong> this study was toprovide a synthesis <strong>of</strong> the research onfluency interventions conducted withstudents with LD. Our goal was to locateall intervention studies publishedand all dissertations conducted withinthe past 25 years that evaluated the effects<strong>of</strong> fluency training on elementarystudents with LD. The comprehensivesearch yielded 24 studies: 8 multiplegroup, 5 single group, and 11 casestudies or single-subject design studies.Two <strong>of</strong> the single-group studieswere part <strong>of</strong> factorial designs that alsoincluded other samples.Before interpreting the findings <strong>of</strong>the present synthesis, it is important tonote that effect sizes can be consideredonly within the context <strong>of</strong> the comparisonswith which treatment groupswere contrasted. Because effect sizesare largely dependent on the nature <strong>of</strong>the comparison groups, it is criticalthat a synthesis include detailed informationregarding the comparisons. Forthis reason, Tables 1 through 5 includedetails <strong>of</strong> both treatment and comparisonconditions. However, comparisongroups differ considerably across samples,complicating the interpretation <strong>of</strong>the findings. The interpretations thatfollow were developed with this limitationin mind.In general, the findings from thissynthesis suggested that repeatedreading interventions for studentswith LD are associated with improvementsin reading rate, accuracy, andcomprehension. This would providesupport for the theory <strong>of</strong> automaticityproposed by LaBerge and Samuels(1974) and extended as a verbal efficiencymodel by Perfetti (1977, 1985).These studies, and the theory supportingthem, provide evidence that thefocus on developing students’ rapidprocessing <strong>of</strong> print by reading targetpassages more than once is <strong>of</strong>ten effectiveas a means to improve accuracyand speed, and ultimately leads to betterunderstanding <strong>of</strong> text.One procedure for enhancing fluencyis for teachers to model reading<strong>of</strong> text by reading aloud to students(Dowhower, 1987; H<strong>of</strong>fman, 1987;Smith, 1979). Repeated reading with amodel seems to be more effective thanrepeated reading with no model, particularlyfor students with low fluency(e.g., Rose & Beattie, 1986; Smith, 1979).Tape- or computer-modeled readingseems more effective than having nomodel but may not be as effective asteacher modeling (Daly & Martens,1994; Rose & Beattie, 1986). Furthermore,having text read initially by amodel promoted comprehension, perhapsbecause it allowed students t<strong>of</strong>ocus initially on the content <strong>of</strong> the passagebefore they read it themselves(Monda, 1989; Rose & Beattie, 1986).Asking peers, who are <strong>of</strong>ten betterreaders, to serve as the model for studentswith LD was investigated in severalstudies reported here and reviewedin separate syntheses (Elbaum,Vaughn, Hughes, & Moody, 1999;Mathes & Fuchs, 1994). Repeated readingwith a partner as a means to improvingfluency has yielded somewhatequivocal results (e.g., Marston, Deno,Dongil, Diment, & Rogers, 1995), althoughthere are few studies documentingits effectiveness alone (Marstonet al., 1995; Mathes & Fuchs, 1994).In a separate analysis <strong>of</strong> the effects <strong>of</strong>peer tutoring on broad reading outcomes,cross-age tutoring was associatedwith higher mean weighted effectsizes (.50) than cooperative partners(.00), and with peer tutoring, the role <strong>of</strong>the student within the pair had a significanteffect on outcomes, with reciprocaltutor–tutee roles demonstratinglow mean weighted effect sizes (.09; Elbaum,Vaughn, Hughes, & Moody,2000).Speed and accuracy have traditionallybeen considered the hallmarks ormost essential features <strong>of</strong> fluency(LaBerge & Samuels, 1974; Samuels,1997). Most researchers agree that accuracyin itself is insufficient and thatstudents need to read rapidly if theyare going to understand the connectionsthat need to be made betweenideas in print (Nathan & Stanovich,1991). Variables associated with effects

VOLUME 35, NUMBER 5, SEPTEMBER/OCTOBER 2002 403for fluency include controlling the difficulty<strong>of</strong> text and providing feedbackfor words missed. Advancing studentsthrough progressively more difficulttext based on their performance seemsto enhance their overall fluency (Lovitt& Hansen, 1976; Weinstein & Cooke,1992), as does correction and feedbackfor words read incorrectly (Smith,1979). Rereading text many times andto many different people and providingprogressively more difficult textwith feedback and correction formissed words may be the componentsessential to improving fluency.Another approach to fluency buildingis to provide struggling readerswith text chunked in words or phrasesas a means <strong>of</strong> improving fluency andcomprehension (Young & Bowers, 1995).The research in this review reveals thatvarying the amounts <strong>of</strong> text presentedin repeated reading does not seem tochange the outcome. However, controllingthe amount <strong>of</strong> text presentedmay be beneficial for students who areexperiencing difficulty with readingaccuracy, as it may force them to focuson the words for a longer period <strong>of</strong>time (A. L. Cohen, 1988).Several researchers have argued thatfluency is enhanced when reading addressesthe meaning <strong>of</strong> the text (Anderson,Wilkinson, & Mason, 1991). Atleast for struggling readers and studentswith dyslexia in the third grade,a fluency intervention (repeated reading)and a comprehension intervention(collaborative strategic reading) wereboth associated with gains in fluencyand comprehension (Vaughn et al.,2000). In this synthesis we found thatalthough comprehension was not typicallythe focus <strong>of</strong> the intervention, inmany cases fluency growth was associatedwith growth in comprehension(e.g., Simmons et al., 1995; Sindelaret al., 1990). In the lone study wherecomprehension instruction was combinedwith repeated reading (D. Fuchset al., 1997), the effect sizes for growthin comprehension were moderate andexceeded the effect sizes for fluency.Additional research focusing on the relationshipbetween fluency and comprehensionfor students with LD iswarranted.Rereading text or repeated oral readingis perhaps the best documented approachto improving fluency (NPR,2000; Rashotte & Torgesen, 1985) andhas been associated with improvedoutcomes for young students (e.g.,O’Shea et al., 1987) and for college students(Carver & H<strong>of</strong>fman, 1981). Generally,intervention research on fluencydevelopment for students with LD hasbeen dominated by research on repeatedreading. This likely reflects theapplication <strong>of</strong> the theory that fluentreading is promoted by frequent opportunitiesto practice with familiartext and to increase exposure to words.It may also be influenced by the findingthat repeated readings do improvefluency for students with LD. Furthermore,rereading the same text moretimes is better than fewer.Future <strong>Research</strong>Like most research syntheses, thisstudy both answers questions andraises new ones. Questions that wouldbe valuable to address in future researchinclude,1. What aspects <strong>of</strong> guided oral readingare associated with positiveoutcomes in fluency? To what extentdo these aspects differ basedon the reading level <strong>of</strong> the student?What about the decoding ability <strong>of</strong>the student?2. When students are reading, atwhat level is repeated reading associatedwith the greatest gains influency? What about comprehension?3. Most research questions haveasked about the extent to whichfluency intervention, particularlyrepeated reading, influences comprehension.What about the extentto which comprehension instructioninfluences outcomes in fluency?This question is promptedby the strong correlation betweenfluent reading and comprehension(Dowhower, 1987; Shinn, Good,Knutson, Tilly, & Collins, 1992).4. How much text needs to be includedin the repeated reading interventionto most effectively influencefluency? Does this vary byage and reading level <strong>of</strong> students?Should reading material bechunked and repeated at thephrase level, sentence level, ormultiple sentence level? Some researchhas suggested that wordlevelreading (repeated), such aswith flash cards, is associated withimproved outcomes in comprehension(Tan & Nicholson, 1997).5. Is there a small number <strong>of</strong> studentsfor whom automaticity is not possible(e.g., due to neurological difficulties),in which case fluencybuilding may be exceedingly difficult?What is the best way to buildcomprehension for these students?6. Are the effects <strong>of</strong> fluency-buildingactivities sustainable? Only onestudy in the present corpus (Simmonset al., 1995) included afollow-up measure <strong>of</strong> fluency.Although Simmons et al. (1995)reported no significant differenceson this measure, further researchshould focus on this issue.Implications for PracticeFor many struggling readers, particularlystudents with LD, becoming a fluentreader is a challenge that must beovercome in order to progress from decodingto understanding what is read.Despite the integral role <strong>of</strong> fluency inreading development, fluency has notplayed a prominent role in reading instruction(Allington, 1983). Because <strong>of</strong>this apparent lack <strong>of</strong> attention to fluencydevelopment, recent syntheses <strong>of</strong>research on reading have highlightedthe importance <strong>of</strong> including fluencybuilding as part <strong>of</strong> daily instruction(Chard, Simmons, & Kameénui, 1998;NRP, 2000; Snow, Burns, & Griffin,1998). The importance <strong>of</strong> becoming afluent reader warrants careful atten-

404JOURNAL OF LEARNING DISABILITIEStion to the evidence documentingwhich interventions are most effectiveat promoting reading fluency. To date,research on fluency interventions forstudents with LD has focused almostexclusively on repeated reading interventions.The results <strong>of</strong> the presentsynthesis have provided a more detailedlook at which features <strong>of</strong> interventionsmake them more effective orless effective.Generally, the findings <strong>of</strong> this synthesissuggest that students with LDwho are experiencing difficulties withfluent reading would benefit from interventionsthat have multiple componentsfocusing attention on increasingthe rate and accuracy <strong>of</strong> reading. Thefindings <strong>of</strong> the present synthesis supportearlier findings suggesting thatopportunities to practice reading andrereading familiar text is one way forstudents with LD to enhance theirreading fluency. Although silent readinghas become a popular feature <strong>of</strong>reading instruction nationwide, thereis little evidence to suggest that it is aneffective way to build students’ fluency.Equal attention should be paid torepeated reading <strong>of</strong> text for studentswho continue to struggle with readingfluency.Another salient finding that has implicationsfor classroom instruction isthat students benefit from having amodel <strong>of</strong> fluent reading. As repeatedreading is implemented, it will be importantfor teachers to consider thebest way to model fluency before studentsengage in repeated reading.Seemingly, the most effective way todo this is by having an adult providethat model. Realistically, however, resourcesare not always available for anadult to model fluent reading. In thesecases, an audiotaped or computergeneratedmodel is an effective substitute.Moreover, the findings <strong>of</strong> thissynthesis support earlier findings (Elbaumet al., 1999) suggesting that usinggrouping practices that allow morepr<strong>of</strong>icient readers to guide less ablereaders is also an effective way to buildfluency.Several other intervention featuresshould be considered as teachers developinstructional activities for fluencydevelopment. In instances wherecorrective feedback was combinedwith repeated reading, students weremore successful at boosting their fluency,primarily by decreasing theirreading errors. Moreover, fluency appearsto develop more quickly if deliberateattention is given to setting criteriaand adjusting the difficulty level <strong>of</strong>text as students progress.Although more research is needed tobetter understand how reading fluencyand comprehension are related,the results <strong>of</strong> this synthesis support thecombination <strong>of</strong> instructional componentsthat focus students’ attentionboth on increasing their fluency and onimproving their understanding <strong>of</strong>what they read. It is important to notethat modeling <strong>of</strong> fluent reading alsoseems to boost students’ comprehension,as they not only hear how askilled reader reads but are able to understandthe text rather than focusingall their attention on decoding. Moreover,repeated reading interventionsthat were combined with comprehensionactivities enhanced both fluencyand comprehension. Thus, it wouldseem to confirm the importance <strong>of</strong> includingboth these elements in dailyinstruction.The findings <strong>of</strong> the present reviewprovide strong support for the implementation<strong>of</strong> fluency-building activitiesfor students with learning disabilities.Given the narrowly definedpopulation <strong>of</strong> students considered inthis review, further research is neededto understand the extent to which repeatedreading and other fluencybuildingactivities can enhance academicoutcomes for all readers.ABOUT THE AUTHORSDavid J. Chard, PhD, is an assistant pr<strong>of</strong>essor<strong>of</strong> special education at the University <strong>of</strong> Oregon.His current interests include teacher developmentand effective instruction in early literacyand numeracy. 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