Interventions for Reading Comprehension

Before beginning:

1) Update your reporting information with us. This is required for reporting ASHA CEUs, but only needs done once annually:

2) This is an online, text-based course, with printable and audio access options. Select alternate access (optional) if you wish:

Also, note that:

  • You must take a quiz and survey at the end. These are required for reporting ASHA CEUs. Buttons are at the bottom of this page.

  • Also, this course contains links out to other websites. The links are provided for deeper reading, but are not required to fully understand and complete this course. If the links are distracting to you, don’t click; if you like the extra information, enjoy!



The ability to understand what you read is one of the most important outcomes of education. And, we know it’s one of the biggest challenges for our students with language and learning disabilities. Unfortunately, it’s also an area where we simply don’t have a lot of very effective interventions up our sleeves. No quick fixes here. Below, you’ll find a collection of recent research reviews that will give a little context around this topic (some people would call this “admiring the problem”), and then a lot of ideas for how to help. The focus here is less on packaged “programs” than on principles—what types of skills and strategies can you teach to have the biggest impact on the ultimate goal of reading comprehension?

 

Reading comprehension—how do we fix that, anyway?

When you have a question without an answer, what do you do?  Review the past 30 years of research, perhaps? The authors of this study did just that—reviewing 14 studies on the effectiveness of reading comprehension interventions in improving comprehension outcomes for middle school students (Grades 6-8) with a learning disability (LD).

They found that teaching students how to summarize and find the main idea was effective in improving the understanding of text. Essentially, students improved their comprehension when they were taught to read text, choose what is most important, and then express this in a shortened form. The authors additionally found that self-monitoring tools (on top of summarization/finding the main idea) helped improve reading comprehension. In self-monitoring interventions, students were taught to assess whether or not a target behavior occurred—for example, “Did I identify the main character of this paragraph?” 

Okay, so these findings deal with what to teach. What about how to teach it?  The authors stated that the most consistent finding across the 14 studies was the use of explicit instruction—modeling, feedback, and opportunities for practice including guided and independent practice.

So far, so good, right?  Not so fast. Almost all of the studies measured students’ reading comprehension with researcher-developed measures. So what?  As the authors point out, researcher-developed measures often tell us if students who received treatment are applying the specific strategy that they were taught (think “teaching to the test”). Improvement on a standardized measure would be a more convincing indication of true changes in a student’s reading comprehension. So even though students across the studies made improvements in their reading comprehension, we must keep this limitation in mind.

Finally, if this synthesis piques your interest, check out the summary tables in the article for an individual look at each study (e.g., what exactly were the researcher-developed measures?) and see if any are relevant to you and your students.

Solis, M., Ciullo, S., Vaughn, S., Pyle, N., Hassaram, B., & Leroux, A. (2011). Reading comprehension interventions for middle school students with learning disabilities. Journal of Learning Disabilities. doi: 10.1177/0022219411402691.



Improving reading and comprehension skills in the middle grades—we’re in it for the long haul

4.png

When students reach the upper-elementary years (4th and 5th grades, or ages 9–11), the curricular demands for reading get harder, and it gets harder for us to help struggling readers keep up. To address this need, Vaughn et al. tested an intervention targeting both word reading (i.e., decoding text) and reading comprehension (i.e., understanding what you read) for upper-elementary students.

Students in this study were 8–12 years old and were randomized to either the study intervention or to a control condition where they received whatever intervention their schools gave them. The study intervention was intense, with 30- to 45-minute group sessions, 5 days a week for the majority of the school year (October–April; almost 45 hours of intervention on average). The first phase of the intervention targeted word reading and reading fluency (sample lessons here). Then, students moved on to reading expository and narrative text, with comprehension practice (answering questions, summarizing, etc.; sample lessons here) and word practice (morphology instruction along with continued reading fluency practice).

Children in the intervention group improved significantly compared to control children on an experimenter-developed measure of word reading and on a measure of reading fluency. They did not improve significantly on measures of reading comprehension. Unfortunately, this is pretty typical; most reading comprehension intervention studies see mixed results or no improvement at all.

Improving word reading skills in upper-elementary students is hard, and improving comprehension is even harder. This is an all-hands-on-deck kind of problem, with intensive services needed to help students catch up. The authors conclude that “…students with significant reading difficulties require intensive reading instruction for many years. Students in fourth grade and beyond with intractable reading difficulties may require intensive interventions provided by highly qualified clinicians throughout their schooling.”

Vaughn, S., Roberts, G. J., Miciak, J., Taylor, P. & Fletcher, J. M. (2018). Efficacy of a word- and text-based intervention for students with significant reading difficulties. Journal of Learning Disabilities. doi:10.1177/0022219418775113.

 

Teaching text structures to boost comprehension: What makes for a good intervention?

If your work brings you into contact with the Common Core standards, you probably know that they majorly up the ante for students to read and interact with expository (so, informational, not narrative) text, starting as early as kindergarten. A popular strategy to help students understand these texts is to teach the structures: cause-and-effect, compare/contrast, problem/solution, etc. The idea is that knowing the underlying organization of the information helps us create a working model of it in our minds, leading to better understanding and recall.

This article is a meta-analysis of expository text structure intervention research, meant to figure out, overall, if teaching text structures looks like a helpful approach for comprehension (for students with and without a learning disorder), and what characteristics of interventions give the biggest bang for their buck. They looked at 21 peer-reviewed studies from 1970 on that: a) used a targeted text structure intervention, b) provided data for students with LD, and c) looked at some measure of comprehension as an outcome.

Big Picture: Teaching text structures had a large, positive impact on reading comprehension.

The Finer Points: What made for a particularly good intervention?

  • Scaffolding of instruction, either by students gradually taking more ownership over the use of strategies, or gradually increasing the complexity of the passages

  • Focusing on just one or two structures, especially the ones that are easiest to recognize, like cause-and-effect and compare/contrast (but watch out: which structures work best might vary by content area…)

  • Intervention delivered by adults who understand text structures well themselves, as well as the treatment strategies. Seems like a no-brainer, but interventions that were led by researchers rather than less-specifically trained teachers were more successful.

  • The younger the student, the larger the improvement, as measured by standardized reading tests. So, think early elementary school. Students with learning disabilities showed the biggest benefits.

  • Treatments of 11–20 hours were more successful than either shorter or longer ones.

It’s important to note that some of these specific findings are preliminary, or need to be taken with caution, just because of the fairly limited pool of evidence they are coming from. Even keeping that in mind, teaching expository text structures is definitely good practice for a range of learners. The authors specifically recommend that we:

  • Explicitly describe text structures and teach associated signal words

  • Model uses of the strategy

  • Consider using graphic organizers

  • Turn over responsibility for the strategy to students over time

Pyle, N., Vasquez, A.C., Lignugaris/Kraft, B., Gillam, S., Reutzel, D.R., Olszewski, A… Pyle, D. (2017). Effects of Expository Text Structure Interventions on Comprehension: A Meta-Analysis. Reading Research Quarterly. doi: 10.1002/rrq.179.

 

Vocabulary instruction for reading comprehension

This systematic review examines how vocabulary instruction impacts reading comprehension. The authors looked at intervention outcomes from 36 studies of Pre-K through 12th grade children, with and without disabilities, some English language learners, and all subject to vocabulary intervention. The results guide us to:

  • Teach word meanings to support comprehension. Even just a little definition instruction was found to be helpful, compared to none at all.

  • … however, just being told the definition of a word isn’t enough. Students need to be actively engaged in thinking about the word meaning.

  • Studies easily find an impact on taught vocabulary. What we don’t know is if vocabulary intervention can broadly impact reading comprehension.

  • There also isn’t strong data to indicate that teaching a strategy (instead of specific words; e.g. using context clues) can broadly impact reading comprehension.

Wright, T.S., Cervetti, G. (2016). A systematic review of the research on vocabulary instruction that impacts text comprehension. Reading Research Quarterly. doi: 10.1002/rrq.163.

 

Inference instruction and reading comprehension

image-asset.png

This meta-analysis looked at results from 2nd–9th grade inference interventions (with most on 3rd–8th-graders). The authors identified seven primary types of inference instruction, and describe each. The two most common (over 2/3 of studies) were:

  • using text clues (“…use clues in the text to construct a coherent representation”) &

  • background knowledge (“…use relevant background knowledge to fill in gaps in the text”)

The authors state, “Many of the studies focused on teaching students to locate relevant information in text to generate an inference, to integrate information across text, to provide evidence in the text of their answers to inferential questions, or to activate and integrate background knowledge with information in the text.”

Overall, they found moderate to large effects of inference instruction on reading comprehension for both skilled and unskilled readers. Interestingly, the less skilled readers also, “…benefitted substantially on literal measures of comprehension after receiving inference instruction.” That’s right! Inference instruction not only improved the students’ ability to “read between the lines”, but read, well, the lines as well. The authors predict it may be because: “Many of the studies in this review provided explicit instruction in finding pertinent information in a text and integrating it with prior knowledge to answer inferential questions. It seems that this type of instruction would be especially beneficial to less skilled readers, as it would… require them to attend to important details to which they may not otherwise have noticed.”

They also found that students in small groups achieved better learning outcomes than those in whole-class instruction, and that it didn’t take a ton of instruction to show effects: “Although higher order skills are considered difficult to teach, surprisingly, most of the studies showed positive results in relatively short periods of time (i.e., less than 10 hr).”

Of the various methods of inference instruction, however, it was not possible to determine which was best. The authors explain that this is because so many of the studies used several types of inference instruction within one intervention, plus many methods of teaching one type (e.g. there are many ways to get a child to draw upon background knowledge), so results were impossible to tease apart.

Elleman, A. (2017). Examining the impact of inference instruction on the literal and inferential comprehension of skilled and less skilled readers: a meta-analytic review. Journal of Educational Psychology. doi.org/10.1037/edu0000180.


Practice those inferences!

7.png

It’s no surprise that children need to be able to comprehend language to succeed in school. They need to understand both what is explicitly stated (referential comprehension) and what is implied (inferential comprehension). Those pesky inferences! They’re so important for boosting language comprehension, but the literature tells us more about assessment and treatment of expressive deficits than it does about comprehension in kids with Developmental Language Disorder (DLD), so we don’t really know the best way to address them. This study helps tip that balance and gives an option for treatment.  

Preschool-aged children (all diagnosed with DLD* and receiving weekly services from SLPs) were tested using an informal questionnaire and the Reasoning subtest from the PLAI (Preschool Language Assessment Instrument) both before and after a dialogic reading intervention. To increase the chances that this treatment and its results could be generalized to other settings, the students’ regular SLPs implemented the intervention! Here’s how they did it: they added 20 minutes of dialogic reading, using commercially available books and researcher-developed questions, to the beginning of each speech-language session. Some questions checked referential comprehension (e.g., “What color are Mrs. Dupre’s boots?”) and some questions were inferential (e.g., “What do you think John is going to do with his tools?”). Each book was presented for two consecutive sessions. For incorrectly answered questions, the SLPs scaffolded support using a “least-to-most” cueing hierarchy (e.g. rephrasing the question all the way up to phonemic cues to the answer).

After 10 weeks, the children seemed to infer better than before the intervention (and maintained the skill), but the authors hesitated to attribute the change only to the intervention because of the order they administered the informal questionnaires (see the results section for specifics). That detail aside, here’s a useful finding for clinicians: overall, the preschoolers improved the quality of their responses to questions. We’ve all worked with the kid who makes us think, “Well, he’s not wrong, but he didn’t exactly get it, either.” How do you even score that? In this case, the authors modeled their scoring scale after the PLAI Reasoning subtest:

  •  Correct/Adequate = 4 points

  • Acceptable = 3 points

  • Ambiguous = 2 points

  • Incorrect/Inadequate = 1 point  

A scoring scale like this is great because it can help us see the small changes a child makes over the course of intervention. The authors stated that “as intervention progressed, their responses, while not always completely correct, improved in quality.” That’s a trend in the right direction, and exactly what we want to see from progress report to progress report!

The takeaway: we still need more research on how to assess and treat inferential comprehension in young children, but dialogic reading intervention (including inferential questions) is a promising option for improving the quality of children’s answers to inferential questions.

Want to know more? See this study and a previous study by van Kleeck, Vander Woude, & Hammett (2006) for examples of questions and scripts for this intervention.

**Note: The children in this study were those with Specific Language Impairment (SLI), which is a child with Developmental Language Disorder (DLD) and normal nonverbal intelligence. We use DLD throughout our website for consistency purposes (read more here). 

Desmarais, C., Nadeau, L., Trudeau, N., Filiatrault-Veilleux, P., & Maxes-Fournier, C. (2013). Intervention for improving comprehension in 4-6 year old children with specific language impairment: Practicing inferencing is a good thing. Clinical Linguistics & Phonetics. doi: 10.3109/02699206.2013.791880.

An incredible inference intervention for children with DLD

So much of story comprehension depends on inferencing, or making assumptions and connections beyond what’s stated in a story. We know that children with developmental language disorder (DLD) struggle with inferencing, but we don’t have (much) good evidence for treatments to target it. Until now, that is—Dawes et al. are here to help with a fabulous, free, feasible treatment for inferential comprehension.

8.png

The researchers randomly assigned 5- to 6-year-olds with DLD to an inferential comprehension treatment condition or to a control phonological awareness treatment condition. Both groups attended 30-minute small-group treatment sessions twice a week for 8 weeks. The inferential comprehension treatment used strategies including narrative retell, dialogic reading, think-alouds, and graphic organizers (see Table 2 for full list). And, great news—the activities for all four books used in the intervention are available for free! 

Children’s inferential comprehension ability was tested before, immediately after, and 8 weeks after the treatment using different stories. (The assessments are ALSO freely available, because these researchers are amazing.) Children in the treatment group improved significantly more than the control group on inferential comprehension measures and maintained their improvement after 8 weeks. This is about as good as it gets—a scripted, free program that you can deliver in groups with strong evidence for improvement after a short period of treatment.

For more info about profiles of children who struggle with inferential comprehension, see this article by the same researchers.

Dawes, E., Leitão, S., Claessen, M., & Kane, R. (2018). A randomized controlled trial of an oral inferential comprehension intervention for young children with developmental language disorder. Child Language Teaching and Therapy. doi: 10.1177/0265659018815736.


Looking for even more evidence-aligned materials?

Try these, from the LARRC team. They developed a classroom curriculum to stimulate language comprehension in children from preschool to third grade. This link provides over 400, 30-minute language comprehension lessons, available for FREE! Backed by research like this.

 


Thank you for taking this course!

To earn continuing education credit, you must take this quiz (score 80% to pass; three attempts allowed):

Did you update your reporting info (top) and pass your quiz (above)? Then, congrats, you’re done! Please fill out a feedback survey:

Did you see a journal article you want (above), but don’t have access? Try our tips for finding free PDFs.

Need help? Contact us at communications@theinformedslp.com