systematic review poster

RESEARCH POSTER PRESENTATION DESIGN © 2012

www.PosterPresentations.com

KelseyMandak,MA,CCC-SLP,DoctoralCandidate,PennStateUniversityJaniceLight,Ph.D.,PennStateUniversity,DavidMcNaughton,Ph.D.,PennStateUniversity

TheEffectsofLiteracyInterventionsonSingle-WordReadingforIndividualswhouseAidedAAC:ASystematicReview

Discussion &Implications

Conclusion

Introduction• Intoday’sworld,theacquisitionofliteracyskillsisnecessarytoparticipate

successfullyineducation,employmentsettings,andsociety.• Theacquisitionofliteracyskillsisespeciallyimportantforindividualswith

complexcommunicationneeds(CCN)whouseaugmentativeandalternativecommunication(AAC)(Foley&Wolter,2010;Light&McNaughton,2013).

• Upto90%ofindividualswithCCNenteradulthoodwithoutfunctionalliteracy(Foley&Wolter,2010).

• Withouttheacquisitionofliteracy,individualswhouseAACareboundtoberestrictedintheirparticipationin:

• Education• Employment• Relationships• Society

• Thus,thereisurgentneedtofindeffectivewaystopromoteliteracyamongindividualswhouseAACandpreventsuchnegativeoutcomes.

Results

Methods

Thesystematicsearchidentified24individualsacross9single-caseexperimentaldesignstudies.Acrossparticipant,intervention,andoutcomecharacteristics,theseindividualswereabletoacquiresingle-wordreadingskills.

• Acrossparticipant,intervention,andoutcomecharacteristics,individualswhousedaidedAACsuccessfullyacquiredsingle-wordreadingskillswithappropriateinstruction.

• ItisessentialthatprofessionalsprovideopportunitiesforindividualswhorelyonAACtodevelopfoundationalliteracyskillsinordertoincreasetheirlikelihoodofbecomingsuccessfulreadersandparticipatingfullyinlife.

AcknowledgementsThisresearchwassupportedinpartbyTheHintzFamilyEndowedChairinChildren’sCommunicativeCompetenceintheDepartmentofCommunicationSciencesandDisordersatPennStateUniversityGrant#H325D110008(ThePennStateAACLeadershipProject)fromtheU.S.DepartmentofEducation.Ihavenorelevantfinancialornonfinancialrelationship(s)withintheproductsorservicesdescribed,reviewed,evaluatedorcomparedinthispresentation.

Severalskillsplayaroleinliteracydevelopment(e.g.,phonologicalawarenessskills,letter-sound

correspondences,decoding,etc.).Ultimately,individualsneedto

integrate theseskillstoreadawiderangeoftextsfluentlywith

comprehension.

c a t

light

Singlewordreadingisvital,asonceanindividualwithCCNcandecodeorrecognizeafewwordsbysight,this

opensthedoortomeaningful,readingexperiences(Light,McNaughton,

Weyer,&Karg,2008)

Oranindividualmayfocusprimarilyontheorthographyofthewordandassociateitwithitsreferentbysight.

Ifdecoding,theindividuallooksattheletters,retrievesthesoundofeachletter,blendsthesounds,andthusdeterminestheword.

Onecriticalstepofliteracylearningisinstructioninreadingsinglewords.Whenapproachinga

writtenword,anindividualeither:

Decodestheword

Recognizesthewordbysight

InclusionCriteriaEachstudyhadto(a) haveatleastone

participantwhousedaidedAACoranentiretreatmentgroupthatusedaidedAAC

(b) beapeer-reviewedpublicationordissertation

(c) employanexperimentaldesign

(d) investigatetheeffectsofliteracyinstructionwithatleastonedependentvariablerelatedtosingle-wordreading

VeryLargeEffects

AcrossallagesElementary(60-144mo)Adolescent(12– 17years)Adult(≥18years)

AcrossallDiagnosesASD,DS,CP,IntellectualDisability,Other

• rangedfrom6to22yearsofage• 11(46%)werefemaleand13(54%)weremale• Autismspectrumdisorder(ASD)andcerebralpalsy(CP)werethemostprevalentdiagnoses(42%)

• TypeofaidedAAC– 16usedaspeech-generatingdevice(SGD),7usedlow-technologyAAC,1usedacombinationofthetwo

ParticipantCharacteristics

InterventionCharacteristics

• 4studiestookaphonologicalapproach,4studiestookasight-wordapproach,1studytookacombinationapproach

• Allinone-on-onesetting• Averaged12interventionsessionsperparticipant• Educatorsservedasinterventionistsin4studies,Researchersin5studies

• Variousinstructionalstrategieswereused

InterventionApproach VeryLargeEffectsacrossallinterventionapproaches,allinterventionists,andinterventions

usingvariousinstructionalstrategies.

BUT,thelargesteffectswerethosestudiesthat:

• UsedaPhonologicalapproachorCombinationapproach

• Includederrorcorrectionanderroranalysis• Hadinterventionimplementedbyeducators,ratherthanresearchers

• Included15ormoreinterventionsessions• Usedthefollowingmeasurementtasks

– Text-spokenChoices– Text-PictureChoices– SpokenWord-TextChoices

Whatwasbeingmeasured?

• Allstudieshadsamedependentvariable:Accuracyofreadingsinglewords

• Studiesvariedinmeasurementtaskused(seebelow)

Toinvestigatetheeffectsofliteracyinstructiononsingle-wordreadingofindividualswhouseaidedAAC.

(a)Whataretheeffectsofliteracyinterventionsonthesingle-wordreadingofindividualswhouseaidedAAC?

(b)Doeffectsdifferacrossparticipantandinterventioncharacteristics?

Purpose of Review

“Your choices are MOP, DOG, DOLL, FROG. Is

it MOP?” [waits for response], and so on.

Text-SpokenChoicesInstructorpresentswrittenword.

dog

Instructorpresentsfourspokenchoices.Learnerchoosesfromthespokenchoices.

Text-PictureChoicesInstructorpresentswrittenword.

dog

Learnerchoosesapicture.

“dog”Instructorsaysaword.

Learnerchoosesawrittenword.

SpokenWord-TextChoicesInstructorpresentsapicture.

Learnerchoosesawrittenword.

Picture-TextChoices

Effects?

Effects?

ElectronicDatabaseSearchERIC,PubMed,PsycInfo,andProquest

DissertationandTheses

Searchtermcategories(a) “intervention”or“instruction”,AND

(b) “AAC”or“augmentativecommunication”or“alternativecommunication”,AND

(c) “decoding”or“wordidentification”or“wordrecognition”or“wordreading”or“sightwords”.

AncestrySearchAuthorSearchReliabilityCheck

DataExtraction&

Coding

(a) studyidentification(b) participantcharacteristics(c) interventionandindependentvariables(d) dependentvariables(e) outcomemeasures(f) qualityofevidence

EffectSizes(a) GainScores(b) PND(c) Tau-U

ReliabilityCheck

Variousmeasurementtasks

ParticipantsItisnotwellunderstoodwhichparticipantsbenefitmostfromwhichinterventions.

• Moreresearchisnecessaryforspecificagegroupsanddiagnoses,withincreasedspecificitywhendescribingparticipants.

Mostparticipantswereelementaryschool-agedchildrenoradolescentswithASD.

• HighlightstheneedforresearchwithyoungchildrenandadultswhouseAAC.

Intervention

Educatorsmustnotallowindividuals’ages,priorliteracyexperiences,andcurrentlanguageskillstoimpacttheirexpectationsforfutureskillacquisition.

Theeffectsofinterventionsincludingphonologicalawarenessandphoneticsinstructionweregreaterthanthosethatfocusedonsight-wordinstructionalone.

• Withoutfluencyinfoundationalphonologicalskills,readingwillrequiresignificantcognitiveresourcesforindividualswithCCN.

• Thereisstilltheneedforsight-wordidentification,asnotallwordsaredecodable.Althoughbothapproacheswereindividuallyveryeffective,thecombinationofbothbolsteredtheinterventioneffectiveness.

Theinstructionalstrategiesacrossthestudiesrevealtheimportanceofdirectandsystematicinstruction,appropriatescaffolding(e.g.,modeling,timedelay,etc.),feedback,andtheuseoferrorcorrectionandanalysis.

• Correctivefeedbackprovidesincreasedopportunitiesforlearnerstorespondandpracticenewskills.

• Identifyinglearners’patternsofresponsesthrougherroranalysescanprovidevaluableinformationonhowtoadaptinstructionaswellasfutureinterventions.

LearnerswithCCNareunabletoparticipateviaspokenresponsesandthusinstructorsmustuseadaptationstomeasureinterventionoutcomesandprogress.Therewerefourdistincttasksusedtoassesssingle-wordreadingacrossthestudies.

• Thedemandsofthetasksvary.• LEASTDEMANDINGà donot

requirephonologicalrecodingText-SpokenChoicesSpokenWord-TextChoices

• MOSTDEMANDINGà requirephonologicalrecoding

• ClosertoactualreadingdemandsPicture-TextChoicesText-PictureChoices

Educatorsshouldtakebothaphonologicalandsight-wordapproachtointerventionbyteachingtheskillstodecodeaswellasrecognizewholewords.

Withbothapproaches,evidence-basedinstructionalstrategiesarenecessarytoensuresuccess.

InstructionalApproach

InstructionalStrategies

AlternativeResponseModes

Educatorsmayneedtoadapttaskstocompensateforlearners’inabilitytoprovideoralresponses.Itisnecessarytobecognizantofthedemandsof

readingandcarefullyanalyzethetaskstoreplicatethesedemands.

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Included Studies