1. The York READing for MEaning Project
A randomised controlled trial of three interventions designed to improve poor comprehenders reading comprehension skills
Paula Clarke, Emma Truelove, Maggie Snowling, Charles Hulme
Centre for Reading and Language, Department of Psychology

2. The Simple Model of Reading
Poor comprehenders
Dyslexia
Typical
Reader
Poor Reader
Poor
Comprehender
Average word readers but poor at reading comprehension
10% of primary school aged children (Nation & Snowling,1997)
Unnoticed in the classroom
Persistent difficulties
(Ehlich, Remond & Tardieu, 1999; Cain & Oakhill, 2006)
- Listening Comprehension +
- Decoding +
The Simple Model of Reading
(after Gough & Tunmer, 1986)
Is there a core cognitive deficit in poor comprehenders?
Are there a number of different underlying cognitive deficits which might cause a poor comprehender profile?

3. Poor comprehenders
Evidence of impairments on a range of different language tasks:
Vocabulary
Nation, Clarke & Snowling, 2002; Nation, Clarke, Marshall & Durand, 2004, Stothard & Hulme,1992
Oral expression
Nation, Clarke, Marshall & Durand, 2004
Figurative language
Narrative skills
Cragg & Nation, 2006; Cain & Oakhill, 1996; 2006
Grammatical development
Nation, Clarke, Marshall & Durand, 2004; Nation & Snowling, 2000
Verbal reasoning
Inferencing
Oakhill, 1984; Cain & Oakhill, 1999; Nation, Clarke, Marshall & Durand, 2004

4. Different selection criteria and selection measures have been used.
Poor comprehenders
Evidence of impairments in other areas:
Comprehension monitoring
Erlich, Remond & Tardieu 1996; Yuill, Oakhill & Parkin, 1989; Cain, Oakhill & Bryant, 2004; Oakhill, Hart & Samols, 2005
Verbal working memory
Nation, Adams, Bowyer-Crane & Snowling, 1999; Cain & Oakhill, 2006; Cain, 2006
Suppression/Inhibition
Cain, 2006
However a key issue is that poor comprehender samples being examined across studies are not equivalent.
Different selection criteria and selection measures have been used.

5. Why is an intervention study needed?
There is no consensus concerning the core cognitive deficit in poor comprehenders.
The majority of studies have focused on highly selected samples of children and have been small in scale.
Studies have used largely cross sectional, control group comparison or correlational designs so have not yet been able to demonstrate causal influences.
A large scale intervention study will allow us to:
Examine different poor comprehender profiles and subgroups.
Investigate which factors drive response to intervention and improvements in reading comprehension.
Create resources and training programmes for schools (if the interventions evaluated can be shown to be effective).

6. Previous research Yuill and Oakhill (1988) - Inference Training
Oakhill & Patel (1991) Mental Imagery Training
Yuill and Joscelyne (1988) Story Structure & Inference Training
Johnson-Glenberg (2000) Verbal vs. Visual RT Training
Interventions teaching specific components of reading comprehension have generated some impressive results in poor comprehenders.
Promising findings have not yet been replicated.
Studies have focused largely on text level and metacognitive skills.
No studies have pulled these components together to create a comprehensive reading comprehension training programme.
The only study to include an untreated control group did not use a RCT design.

7. Project aims
To investigate three approaches to improving reading comprehension skills in poor comprehenders.
To compare these approaches to existing classroom practice by monitoring the performance of an untreated waiting control group.
To address the objectives of the primary framework (NLS) and equip teaching assistants with a wide range of skills and materials, useful in supporting children with reading comprehension and oral language difficulties.
Oral
Language
(OL)
Text
Comprehension
(TC)
Combined
(COM)

8. Oral Language Programme Text Comprehension Programme
The intervention programmes
Oral Language Programme
Vocabulary
Listening Comprehension
Figurative Language
Spoken Narrative
Text Comprehension Programme
Metacognitive Strategies
Reading Comprehension
Inferencing from Text
Written Narrative
Combined Programme
All eight components connecting oral language and text-based activities in an integrated and naturalistic approach.
All sessions contained both reading and listening comprehension to support complementary components.
Opportunities for children to encounter new vocabulary/idioms/inferences in both written and spoken language.

9. Session structure Introduction 3 mins Vocabulary 5 mins
Activity
Approx. time per session
Introduction
3 mins
Vocabulary
5 mins
Listening comprehension
7 mins
Figurative language
Spoken narrative
Plenary
Activity
Approx. time per session
Introduction
3 mins
Metacognitive strategies
5 mins
Reading comprehension
7 mins
Inferencing from text
Written narrative
Plenary

10. TC programme contents 1. Metacognitive Strategies (Cain, 1999)
Re-read (Garner, et al., 1984)
Look-back (Garner, 1982)
Think aloud (Farr & Connor, 2004)
Mental imagery (Oakhill & Patel, 1991)
Explain & reflect (McNamara, 2004)
2. Reading Comprehension (Reciprocal Teaching - Palinscar & Brown,1984,1985, Palinscar,1986)
Clarification
Summarisation
Prediction
Question generation
3. Inferencing from Text (Yuill & Oakhill, 1988)
Lexical inferencing
Bridging inferencing
Elaborative inferencing
Guessing missing information (Yuill & Joselyne, 1988)
Evaluative inferencing
4. Written Narrative
Story structure (Beck & McKeown, 1981; Pearson, 1982; Idol & Croll, 1987)
Sequencing
Story production

11. OL programme contents
1. Vocabulary (Multiple Context Learning, Beck, McKeown & Kucan, 2002)
Graphic Organisers (Nash & Snowling, 2006)
Verbal Reasoning
Mnemonic Strategies (Levin, 1993; Peters & Levin, 1986; Graves & Levin, 1989)
Illustrations
2. Listening Comprehension (Reciprocal Teaching - Palinscar & Brown,1985; Palinscar,1986)
Clarification
Summarisation
Prediction
Question generation
3. Figurative Language
Idioms (Legler, 1991)
Riddles (Yuill, 1988)
Jokes (Yuill, in press)
Similes and metaphors
4. Spoken Narrative
Story structure (Beck & McKeown, 1981; Pearson, 1982; Idol & Croll, 1987)
Sequencing
Story production

12. Phases of the project Oct 2006 8-9 years Oct 2007 9-10 years Oct 2008
Screening
Intervention development
T1 assessment
T2 assessment
T3 assessment
T4 assessment
Control
Block 1
Control
Block 2
Block 1
Block 2
Oct
2006
8-9
years
Oct
2007
9-10
years
Oct
2008
10-11
years
Oct
2009

13. Participant flow Not meeting inclusion criteria (n = 634)
Excluded (n = 45)
2 schools excluded due to low numbers of children showing poor comprehender profile
Absent for key measures (n=13)
Refused to be assessed (n = 2)
Group Screening (Oct-Dec 2006)
Y4 children in 23 schools in York & N.Yorks; eligible for assessment (n = 1120)
Group assessments: Listening Comp (n = 1042); Ravens (n = 1054);
Spelling (n = 1045); Numerical ops (n = 1050)
Complete data on key measures (n= 977)
Individual Screening (Jan-Feb 2007)
21 schools; eligible for assessment (n = 296)
Individual assessments: NARA reading comp (n = 284); TOWRE (n = 282); WASI Verbal IQ (n = 277)
Complete data on key measures (n= 282)
Not meeting inclusion criteria
(n = 114)
Excluded on behavioural grounds (n =1)
Declined to participate in intervention (n = 7)
Selection & Pre-test (Feb-Apr 2007)
21 schools
Selected for intervention (n =168)

14. Eligibility criteria Eligibility criteria Sample size
Discrepancy in standard score points between NARA II reading comprehension and TOWRE real word reading efficiency.
NARA II reading accuracy standard scores of 85 and above.
NARA II reading comprehension scores of 105 and below.
Age appropriate spelling ability.
Non-Verbal IQ of 85 or above.
Of these children, we selected eight children within each school with the greatest discrepancies.
Sample size
Power calculations for this study were carried out using estimates of effect sizes from previous studies of a similar nature. 
A sample size of 40 children in each arm of the intervention provides 90% power to detect a difference of 0.6 standard deviations between the control group and the three intervention groups combined (with alpha = 0.05 two-tailed).

15. Selection & Pre-test (Feb-Apr 2007)
Participant flow
Selection & Pre-test (Feb-Apr 2007)
21 schools
Selected for intervention (n =168)
Random allocation to intervention groups
(Apr-Jul 2007)
20 schools
Block 1 of intervention programmes
(n = 157)
Mid-Intervention Assessments
(n = 159)
OL programme
Took part in block 1 of intervention (n = 39)
TC programme
Took part in block 1 of intervention (n = 40)
COM programme
Took part in block 1 of intervention (n = 39)
Waiting Control
Took part in block 1 of intervention (n = 39)
Intervention:
Excluded (n = 8)
1 school withdrawn from project
Declined to participate in intervention (n = 1)
Moved school (n = 2)
OL programme
Took part in block 2 of intervention (n = 38)
Post-intervention assessments (n = 38)
TC programme
Took part in block 2 of intervention (n = 40)
Post-intervention assessments (n = 40)
COM programme
Took part in block 2 of intervention (n = 38)
Post-intervention assessments (n = 38)
Waiting Control
Took part in block 2 of intervention (n = 39)
Post-intervention assessments (n = 39)
(Sept-Dec 2007)
Block 2 of intervention programmes
(n = 155)
Post-Intervention Assessment
(n = 159)
Intervention:
Moved school (n = 2)
Post-intervention Assessments (wave 1) (n=155)
In new schools (n = 4)

16. Baseline characteristics of each group
Whole sample
TOWRE Real words
110.48
108.88
108.30
108.70
109.09
TOWRE Nonwords
106.45
106.33
109.13
106.18
107.02
TOWRE Total
110.20
109.18
108.85
109.68
NARA II Reading accuracy
102.93
104.33
101.55
NARA II Reading comprehension
92.95
93.36
92.82
92.99
WIAT II Reading comprehension
94.31
95.43
96.38
97.77
95.96
CELF Listening comprehension
78.75*
80.42
87.36*
83.06
82.40
WASI Vocabulary (t score)
38.31
40.32
39.44
38.26
39.07
WASI Similarities (t score)
47.40
49.05
49.97
49.49
48.97
WASI VIQ
89.41
92.03
91.89
91.00
91.07
Ravens Matrices NVIQ
99.26
100.23
100.66
100.78
WMTBC Listening recall
94.50
94.19
93.08
92.19
93.49
WOND Numerical operations
97.53
98.98
97.59
95.30
97.35
*Statistically significant between groups difference (p<0.05)

17. Intervention delivery
Two 10-week blocks of intensive teaching in individual and pair sessions.
Each session is 30 mins.
Children receive 2 pair sessions and 1 individual session per week (1½ hours per week).
Teaching took place in designated areas within school (small classrooms/meeting rooms etc.).
Teaching times varied depending upon existing timetabled commitments.
Monday
Tuesday
Wednesday
Thursday
Friday
Pair OL (ab)
Pair TC (cd)
Pair COM (ef)
Individual OL (a)
Individual OL (b)
Individual TC (c)
Individual TC (d)
Individual COM (e)
Individual COM (f)
Tutorial (2 hrs every alternate week)
Prep time
(2 hrs per week)
1.5 hours
3 hours per week

18. Treatment fidelity Manuals
Detailed, prescriptive manual and pre-prepared worksheets, readers and resources
Training
Training took place over 3.5 days. Delivered by the research team.
Fortnightly tutorials
Opportunity to monitor delivery of programmes by discussing experiences, ideas and observations. Some sessions took the form of top up training in which we focused on particular components of the programmes.
Observations
Each TA was observed by a member of the research team at least twice in each intervention block. Careful records were kept and onsite feedback and support was given.
Filmed sessions
Five TAs gave us permission to film teaching sessions.

19. Primary outcome measures
WIAT II Reading Comprehension
Children read (aloud or silently) a range of passages and sentences (narrative, adverts, non-fiction information etc.) Includes literal, inference and vocabulary dependent question types.
NARA II Reading Comprehension (Form 2 at pretest, Form 1 at post test)
Children read aloud short passages then answer a range of literal and inferential open ended questions.
TORCH Reading Comprehension
Silent reading. Comprehension assessed using a cloze procedure. Responses require a range of skills including inferencing and vocabulary knowledge.

20. Secondary measures Measure Corresponding Component Measure Measure
TOLC Inferencing
Inferencing from text
CMS Story Recall
Listening Comprehension
WASI Vocabulary
Vocabulary
WASI Verbal Similarities
CELF Listening to Paragraphs
Measure
WMTBC Listening Recall
Complex Working Memory
NARA II
Passage Reading Accuracy
TOWRE
Reading Efficiency
WOND Numerical Operations
CONTROL TASK
Myself as a Learner
Self Esteem
Strengths and Difficulties Questionnaire
Teacher report of behaviour
Measure
Corresponding Component
Story Writing
Written Narrative
Beaver & Hedgehog Stories
Metacognitive Strategies
Reading Attitudes Questionnaire
Reading Comprehension
Storytelling
Spoken Narrative
Vocabulary (target & non-target)
Vocabulary
Idioms (target & non-target)
Figurative Language

21. Data collection & analysis
T1 data was collected in school by the research team (blind) and the trained teaching assistants (blind at this point).
T2 & T3 data was collected by the research team (blind).
Testing conditions varied across schools.
Some assessments were individually administered, others were group administered.
All score sheets analysed blind.
10% double marking for reliability where necessary.
Missing data estimated using data imputation.
Regression based approach used, controlling for performance at T1.
Report 95% robust confidence intervals.
Describe the process

22. Reading comprehension
WIAT II
NARA II

23. Listening comprehension
CELF Listening to paragraphs

24. Vocabulary
p<0.001
p<0.01
p<0.001
Taught
Non taught

25. Verbal IQ WASI Vocabulary WASI Verbal Similarities WASI Verbal IQ
p<0.05
WASI Vocabulary
WASI Verbal Similarities
p<0.05
WASI Verbal IQ

26. Points to consider
The groups do not significantly differ in terms of changes in performance on the control task (Numerical Operations).
Additional bespoke and standardised measures are currently being analysed (e.g. narrative, comprehension monitoring).
How do we interpret the improvements in verbal IQ?
Might certain core skills be better suited to different teaching approaches?
Further exploration of how the different standardised measures of comprehension correspond to the content of the programmes is required.

27. Conclusions What’s next?
20-week intervention programmes can produce significant gains in both expressive vocabulary and reading comprehension in poor comprehenders.
Importantly these gains are relative to an untreated waiting control group.
What’s next?
Further data collection at T4 to examine maintenance effects.
Statistical analyses to examine subgroups response to intervention.
Investigate whether expressive vocabulary improvement is a mediating factor in reading comprehension gains.
Development of waiting control group intervention.

28. Research Team Many thanks to: Liaison Group Teaching Assistants
Schools
Children
Many thanks to:
Contact: