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Computer Instruction in Handwriting, Spelling, and Composing for Students with Specific Learning Disabilities in Grades 4 to 9
Abstract
Effectiveness of iPad computerized writing instruction was evaluated for 4th-9th graders (n = 35) with diagnosed specific learning disabilities (SLDs) affecting writing: dysgraphia (impaired handwriting), dyslexia (impaired spelling), and oral and written language learning disability (OWL LD) (impaired syntax composing). Each of the 18 two-hour lessons had multiple learning activities aimed at improving subword- (handwriting), word- (spelling), and syntax- (sentence composing) level language skills by engaging all four language systems (listening, speaking, reading, and writing) to create a functional writing system. To evaluate treatment effectiveness, normed measures of handwriting, spelling, and composing were used with the exception of one non-normed alphabet writing task. Results showed that the sample as a whole improved significantly from pretest to posttest in three handwriting measures, four spelling measures, and both written and oral syntax construction measures. All but oral syntax was evaluated with pen and paper tasks, showing that the computer writing instruction transferred to better writing with pen and paper. Performance on learning activities during instruction correlated with writing outcomes; and individual students tended to improve in the impaired skill associated with their diagnosis. Thus, although computers are often used in upper elementary school and middle school in the United States (US) for accommodations (alternatives to pen and paper) for students with persisting SLDs affecting writing, this study shows computers can also be used for Tier 3 instruction to improve the writing skills of students in grades 4-9 with history of persisting writing disabilities.
... Instructional programs include interventions developed by clinicians or researchers for specific patients or patient populations, sometimes designed using commonplace software like Microsoft PowerPoint (e.g., Berninger et al., 2015;Lowman and Dressler, 2016;Madeira et al., 2015). This category (instructional programs) also includes commercial/mass market interventions developed for general audiences but seen as potentially promising for youth with disabilities. ...
... In other cases, students with disabilities might exhibit disruptive or inattentive behavior that would interfere with their engagement with any intervention, including those leveraging technology (Ramdoss et al., 2011). When attentional difficulties or other learning challenges such as poor language comprehension interfere with making good progress in instructional programs, this can lower appeal/engagement (Berninger et al., 2015). ...
... That said, other research has found that student populations with the greatest need benefit the most from tech-based instructional programs. For instance, Berninger et al. (2015) found that children demonstrated stronger intervention impacts on assessments closely aligned with their specific learning disability diagnosis (e.g., children with dysgraphia evincing greater gains on measures of handwriting). Likewise, Madeira et al. (2015) found that, after using a literacy-themed app, children with dyslexia out-performed peers without dyslexia on several measures of phonological awareness and a measure of spelling (skill areas in which children with dyslexia typically struggle). ...
Mainstream media praises the potential of digital technology to help youth with disabilities overcome deficits/impairments, often in contrast to other public health messaging cautioning against screen time for general populations of children. This chapter provides a critical review of research into the use and effects of assistive technology, technology-based instructional programs, and Universal Design for Learning (UDL) interventions among children with disabilities. Assistive technology can augment children's learning experiences through digital supports like speech-to-text and captioning. Technology-based instructional programs provide robust educational experiences, aiming to teach important skills to all children generally or to children with disabilities specifically. Universal Design for Learning (UDL) interventions often incorporate technology with the goal of providing multiple means of engagement with learning content, representations of information/concepts, and ways for children to act on and express their knowledge. There is a small body of research focused on these different, sometimes complementary, approaches to leveraging digital technology, depicting them as each fairly promising. The chapter focuses on how these digital tools/programs have been applied to support and scaffold literacy development. Practitioners and caregivers can be cautiously optimistic about the value of these resources when appropriately matched to children's needs. Nevertheless, much work remains in developing an understanding of whom these resources are most effective and under what conditions.
... This lends further credence to the notion that these developmental learning disabilities do not simply resolve after childhood. In their study of a computerized intervention for 4 th -through 9 thgrade children, Berninger et al. (2015) found that targeted instruction improved performance on measures of handwriting, spelling, and syntax for children with dysgraphia, dyslexia, and oral and written language learning disability (relatively synonymous with SLI/DLD). This indicates that students with these learning disabilities are likely to require and benefit from additional multi-modal support for fundamental written language skills (Berninger et al., 2015), though the chosen outcome measures (e.g., the sentence formulation subtest of the CELF-4 as a measure of syntax) leave questions about the validity and reliability of these conclusions. ...
... In their study of a computerized intervention for 4 th -through 9 thgrade children, Berninger et al. (2015) found that targeted instruction improved performance on measures of handwriting, spelling, and syntax for children with dysgraphia, dyslexia, and oral and written language learning disability (relatively synonymous with SLI/DLD). This indicates that students with these learning disabilities are likely to require and benefit from additional multi-modal support for fundamental written language skills (Berninger et al., 2015), though the chosen outcome measures (e.g., the sentence formulation subtest of the CELF-4 as a measure of syntax) leave questions about the validity and reliability of these conclusions. ...
... The advent of new and rapidly changing technology is affecting the ways in which we consider what writing is, and although individuals have had the means to type their writing for over a century, it is still not widely considered to be writing. A debate exists among educators on whether handwriting should be abandoned entirely in favor of electronic writing, or whether to do so would be premature (Berninger et al., 2015;Bouriga & Olive, 2021). Whether a result of this debate or not, little to no research has been conducted in the field of speechlanguage pathology focused on writing in typed contexts. ...
Purpose: Developmental language disorder (DLD) affects individuals through childhood into adulthood. However, we do not know how this disorder affects the written language abilities of college students, for whom writing difficulties may cause significant academic issues. This study sought to explore and characterize the differences in writing ability, planning strategies for writing, and revision tendencies of college students with and without DLD. We also sought to determine whether meaningful differences exist in the types of information gained from handwritten and typed writing samples.
Method: Fifty college-enrolled young adults between the ages of 18 – 22 were recruited and divided in to two equal groups (25 with DLD, 25 with typical language). Each completed two writing prompts (one by hand and one on the computer) and a survey of their writing habits. Their writing samples were analyzed for length, complexity, and the presence of errors at the word and sentence levels. Video recordings of their typing and photos of their handwriting were analyzed for their revision tendencies. Responses to the survey were analyzed for group differences in use of planning strategies.
Results: Expository samples written by college students with DLD are likely to have fewer words and more syntactic errors than the samples written by their peers with typical language. College students with and without DLD are likely to write samples with the same levels of syntactic complexity, lexical diversity, and word-level errors. Typing is conducive to longer samples for college students with and without DLD. There are no major differences in the strategies college students with and without DLD report using for planning for writing assignments. There is no relationship between number of on-line revisions and total number of errors for college students with DLD.
Conclusions: The lack of practically significant group differences between college students with and without DLD in terms of writing quality and complexity highlights the importance of individual strengths-and-needs-based assessment and intervention for this population. Typing is a highly practical and functional manner of measuring writing ability for college students with and without DLD that could yield useful clinical information.
... The combination of digital media and handwriting is possible when tablets are equipped with a stylus. In the school context, digital learning environments such as tablet apps can scaffold the teaching and learning process in an interresting way (Berninger et al., 2015;McKenna, 2012). Nonetheless, their use by teachers is conditional on their acceptability (Amadieu and Tricot, 2014). ...
... Some technologies are currently designed to scaffold pupil learning (Berninger et al., 2015;McKenna, 2012;Puntambekar and Hübscher, 2005;Warschauer, 2007). Thanks to artificial intelligence, digital tablets enable data to be analyzed automatically to provide real-time feedback, and, when equipped with a stylus, tablets could potentially be used as a teaching aid for handwriting (Simonnet et al., 2017). ...
... For instance, if considerable training is necessary to acquire quality handwriting (Hoy et al., 2011), the amount of time dedicated to teaching handwriting varies from 2 minutes to 1 hour per day (Graham et al., 2007). The use of stylus-equipped digital tablets with artificial intelligence -providing learner writers with immediate KR and differentiated lessons -could significantly improve the teaching process as they enable one-to-one instruction (Berninger et al., 2015;McKenna, 2012;Simonnet et al., 2017;Van der Kleij et al., 2015). However, the professional needs of teachers and institutions need to be taken into account when designing acceptable digital devices (Amadieu and Tricot, 2014;Flewitt et al., 2015). ...
... Schneps et al. (2016) report that this software can be very effective for students with dyslexia. Berninger et al., (2015) found that a writing guide on iPads offers benefits for students with dyslexia when undertaking text to speech. This application may improve their handwriting, spelling, and construction of sentence's by using students' ability to listen, speak, read, and write (Berninger et al., 2015). ...
... Berninger et al., (2015) found that a writing guide on iPads offers benefits for students with dyslexia when undertaking text to speech. This application may improve their handwriting, spelling, and construction of sentence's by using students' ability to listen, speak, read, and write (Berninger et al., 2015). ...
... Broadly speaking, typing has just overcome handwriting in both social and working life as electronic typed texts are widespread. Despite the prominent role of typing, this transcription process has been less considered than handwriting in both research and educational practice, and typing formal instruction is not systematically delivered in compulsory schooling in many countries (Berninger et al., 2015;Poole & Preciado, 2016;Spilling et al., 2022;Hayley Weigelt-Marom & Weintraub, 2018). For instance, Italian schools-where the present research was conducted-provide children with handwriting instruction during literacy acquisition, but do not have explicit didactic plans for typing (MIUR, 2012(MIUR, , 2018. ...
... On the contrary, they started to acquire typing later and autonomously. This educational setting in which handwriting was trained from infancy and typing was later self-acquired is common in many countries (Berninger et al., 2015;Grabowski, 2008;Pinet et al., 2022;Poole & Preciado, 2016;Spilling et al., 2022;Weigelt-Marom & Weintraub, 2018) and allows us to compare a formally trained and automatized transcription modality (i.e. handwriting) with a self-trained, and less automatized one (i.e., typing). ...
The automatization of handwriting and typing is sustained by both sensorimotor and linguistic abilities that support the integration of central-linguistic processes with modality-specific peripheral-motor programs. How this integration evolves when handwriting and, especially, typing is not fully automatized has not been well-understood yet. In the present work, we had two main aims: (1) to understand how spelling processing affects handwriting and typing word production in a sample of 9th-grade Italian students who have extensive handwriting practice but less experience with typing, and (2) to unveil if reading and visual-motor integration skills of the writer/typists have a role in integrating spelling processing and motor execution. Thirty-six 9th-grade participants handwrote and typed to dictation words and pseudowords of different lengths and orthographic complexity. To test spelling processing during handwriting and typing, we collected measures of latency (RTs)—i.e. the interval between spoken stimulus availability and starting to write—, of interletter interval mean—i.e., the mean of the intervals between consecutive letters—, and whole response duration—i.e. the execution time of the entire stimulus. We further assessed participants’ reading and visual-motor integration skills to analyze their impact on the chronometric measures as a function of the linguistic proprieties of the stimuli. Our findings show a different pattern of processing for handwriting, the automatized process for our participants, and for typing, for which stronger lexical and sublexical effects emerged. Furthermore, reading and visual-motor skills interacted differently with the two transcription modalities unveiling a modality-specific role of individual skills according to the automatization of handwriting and typing.
... It was important to note that just because technology automatically fixes spelling errors, students still needed to have knowledge of the words to choose from a list of possible spellings. This prior knowledge was based on their reading abilities, which, comprised of phonics knowledge and word meaning to make their choices (Berninger, Nagy, Tanimoto, Thompson, & Abbott, 2014). ...
... The teaching of keyboarding as a writing practice is an emergent field of research, notably more explained in the field of Occupational Therapy. In education, the common themes emerged from researchers such as Berninger, Tanimoto, Thompson, and Abbott (2014), Margen and Balsvik (2016), and Martin and Lambert (2015). The argument seemed to be about differentiating digital writing (keyboarding) versus handwriting. ...
Handwriting is an important subject in primary schools, especially in the Early Years. The importance of writing skill is now seen as a debate with the increasing demand on children to learn technology skills to help them with 21st Century learning—how to write on the keyboard effectively. The topic is important because handwriting is an essential life skill to have with or without technology. In this study, I looked at the importance of both in the context of the qualitative case studies in three schools in Melbourne, Australia. The aim of the research is to explore how do students understand the learning of handwriting and keyboarding in schools? This qualitative case study employed a Thematic Analysis approach in which the central intention was to understand the lived experience of six Year 6 boys across three schools and their attitudes to writing and technology. In this article, I addressed the importance of teaching handwriting to primary school students, especially in the first four years of their school life from Foundation to Year 3. The findings suggest that teachers should continue explicitly teaching handwriting to their students despite the heavy reliance on technology in today’s lifestyle.
... Within the framework of many educational systems, the foundational practice of handwriting endures as the primary medium of written expression for students, from early childhood to late adolescence. Although some schools are increasingly incorporating keyboard-based writing instruction, sometimes introducing it before teaching handwriting (Gamlem et al., 2020;Hultin & Westman, 2013;Spilling et al., 2023), its formal teaching use remains limited (Berninger et al., 2015;Malpique, Valcan, Pino-Pasternak, Ledger, Asil, et al., 2023;Malpique, Valcan, Pino-Pasternak, Ledger, & Kelso-Marsh, 2023;Poole & Preciado, 2016;Weigelt-Marom & Weintraub, 2018). Despite this, keyboard-based digital devices are becoming common in educational settings, playing a pivotal role in fostering inclusivity for children with specific learning disabilities (Morphy & Graham, 2012). ...
Background:
Writing-based spelling is crucial for acquiring written word knowledge, contributing to form lexical representations that integrate motor information. Modern educational settings incorporate multiple modalities, with typing increasingly complementing handwriting. However, evidence on their relative effectiveness in supporting orthographic and semantic learning, particularly when these processes are impaired, remains limited. Aims: This study examines the impact of the two writing modalities on the learning of orthographic and semantic information in typically developing (TD) children and those with developmental dyslexia (DD). Sample: Eighteen Italian middle school students with DD and eighteen age-matched TD readers participated. Methods: Participants learned a set of nonwords, varying in transcription regularity, paired with images, either through typing or handwriting. Their spelling and nonword-image association skills were then tested. Recorded metrics included accuracy, writing duration during learning and spelling tasks, and reaction time in the nonword-image mapping task. Results: TD children benefited from both writing modalities during learning. Crucially, the DD group showed better spelling and nonword-image association performance when learning occurred through typing. Accuracy in retrieving orthographic and semantic information was not significantly affected by the time spent handwriting or typing during learning. Performance differences based on transcription complexity provided insights into the extent to which children internalized lexical representations. Conclusions: Both writing modalities can support orthographic and semantic learning, but the complex graphomotor demands of handwriting may hinder novel word acquisition in dyslexic individuals. Incorporating typing into educational strategies could alleviate the cognitive load associated with handwriting and enhance word retention for these students.
... On the contrary, our observation that varied vocabulary use in the essays was higher in the ASPD/DPCC group than the OCPD/ GVC group could be due to possible impairments in the working memory of individuals with OCPD/GVC. According to the literature (30,32), these deficits could explain the presence of dyslexia in OCPD/GVC; that is, they do not have adequate access to general vocabulary in terms of both variety and richness. However, for individuals with OCPD/GVC, the retrieval of technical vocabulary would be more precise when these are frequently used words. ...
Writing involves the activation of different processing modes than reading comprehension, and therefore the level of activation varies depending on the moment and the task.
Objectives
to analyze the profiles in terms of the proposed coding from the PROESC in terms of personality disorders [Antisocial Personality Disorder (ASPD) with drugs possession and consumption crimes (DPCC) and Obsessive-Compulsive Personality Disorder (OCPD)] with gender violence crimes (GVC) in the prisoners.
Design
The sample was composed of 194 men. The participants were divided into two groups. Group 1 (ASPD; DPCC) consisted of 81 men, and Group 2 (OCPD; GVC) consisted of 113 men.
Main outcome measures
They completed the Demographic, Offense, and Behavioral Interview in Institutions, the International Personality Disorders Examination (IPDE), and Writing Processes Evaluation Battery (PROESC).
Results
Group 2 made more mistake than Group 1 in narratives tasks.
Conclusion
Participants know phoneme-grapheme correspondence rules, language disturbances of a reiterative and persistent nature may appear in those who show compulsive behavior.
... The results of interventions involving written training programs have shown that such training lead to increased fluentwriting (30,32), writing speed from a text (47), and improved spelling of words (47,48) in students. These studies emphasize the importance of enhancing this skill during the early years of learning. ...
Introduction: The aim of this study was to evaluate the effect of sensory-motor training on visual perception skills and attention of 8-and 9-year-old students with slow and normal handwriting speed in the city of Hamedan. Materials and Methods: This study was a quasi-experimental study with a pre-and post-test design. Fourteen slow hand writers (I) and 30 normal hand writers were selected using a purposeful sampling method. Normal hand writers were randomly divided into experimental (II) and control (III) groups. The two experimental groups (I, II) participated in sensory-motor training with emphasized visual perception (16 sessions of 45 minutes) and the control group performed the normal school activities. All participants underwent the Stroop color test and Frostig Visual-Perceptual before and after the training. Results: Frostig and Stroop scores increased significantly in both training groups I and II (P<0.05). Writing speed increased in both experimental groups, but only in third grade students of group II was there a significant increase (P<0.05). Conclusion: Sensory-motor training increased visual perception and attention abilities in second-and third-grade elementary school students. Therefore, it can be concluded that increasing the ability to perceive vision and attention can affect the performance of fine skills such as writing.
... These advancements include the use of robotics, arti cial intelligence, gaming, and fMRI scanning and physiological monitoring Berninger et al., 2019;Gargot et al., 2021;Hopcan & Tokel, 2021;Palmis et al., 2021;Richards et al., 2016). Although there are rapid developments in this area, more research is required to learn about the roles that technology might play in best supporting students speci cally with writing disorders (Berninger, Nagy et al., 2015). Government, 1992Government, , 2005Department of Education and Training Victoria, 2020a;Squelch, 2015;Thielking & Terjesen, 2017). ...
Teachers are obligated to support students with developmental writing disorders, referred to as dysgraphia, in line with policy and legislation related to disability. Dysgraphia is a relatively unknown writing disorder within English classrooms, with an estimated 3-5% of schoolaged students bearing this hidden disability. Within the field of education, research on dysgraphia has always been limited, contributing to insufficient awareness within the teaching community. Consequently, students with dysgraphia may be required to morph into parkour-style athletes to keep pace with the writing demands of the classroom, navigating a range of obstacles. These include a lack of awareness about dysgraphia, or inadequate skills in handwriting, spelling or composition to keep pace with expectations. Students' writing productivity may also seem at odds with their appearance of academic potential and good intellect. However, increased awareness, coupled with the implementation of reasonable adjustments, can better support students with dysgraphia to make learning gains in the classroom.
... Les bilans constituent la base qui orientera la prise en charge qui est centrée sur des tâches fonctionnelles d'écriture comme préconisé au niveau scientifique (Fancher et al., 2018 ;Feder & Majnemer, 2007 ;Grajo et al., 2020 ;Hoy et al., 2011 ;Kadar et al., 2020 ;Lopez & Vaivre-Douret, 2021). Une démarche de priorisation par objectif et d'adaptation à l'enfant et à son environnement afin de favoriser l'investissement de l'enfant est également rapportée par les professionnels et conforme aux pratiques de réadaptation (Wade, 2009 instruction individuelle complexe à mettre en oeuvre (Berninger et al., 2015 ;Bonneton-Botté et al., 2020 ;Simonnet et al., 2017) -Botté et al., 2019 ;Chung et al., 2020). Le fait que des propos des enseignants de classe ordinaire soient rapportés par les parents aux professionnels (e.g., les parents rapportent aux professionnels de santé que l'enfant est décrit par l'enseignant comme « fainéant ou manquant de motivation ») interroge quant à la nature et à la qualité de la chaîne de communication entre professionnels de santé et de l'éducation. ...
A l'heure de l'école inclusive, l'acquisition de l'écriture demeure un enjeu majeur de l'accessibilité pédagogique. Cette étude exploratoire se propose d'analyser les besoins des professionnels français de l'éducation et de la réadaptation susceptibles de collaborer pour mieux repérer, diagnostiquer et prendre en charge les difficultés et les troubles de l'écriture. Ces données pourront contribuer à la conception d'outils numériques d'aide à l'apprentissage de l'écriture à l'attention d'enfants présentant différents types de besoins.
... Almost half of the selected articles (46.8%) elaborated on the topic of grammar, reflecting the growing significance of this topic in TALL research. The finding suggests that technology-enhanced media and tools can significantly facilitate solving syntax-related language problems (Berninger et al., 2015;Vyatkina, 2016). Given the abstract nature of grammar, it has long been recognized as one of the most challenging subjects for both L2 teachers and learners alike. ...
Given the important technology-assisted language learning (TALL)-empowered affordances, a comprehensive understanding of how these TALL tools facilitate learning across different language components, e.g., phonology, morphology, syntax, semantics, and pragmatics, could not only present the panoramic scenery of the subject matter but also inform pedagogy for applied linguistics researchers and practitioners. Despite the increasing attention being paid to the affordances of a particular TALL platform, there is still a lack of more holistic research practice to the affordances for the five language components. To bridge the gap, this study aims to systematically and quantitively revisit the TALL-empowered affordances with respect to these language components. To this end, a total of valid 201 articles published from 2010 to 2023 were selected and coded based on the proposed inclusion/exclusion criteria. Results revealed that different TALL platforms (viz. computer, mobile, tablet, virtual reality, and robot) help improve students' language learning performance and efficacy among the five language components. The implications of the study, in perfect tune with the distance language learning experiences in the post COVID-19 pandemic era, justify the need to take full advantage of the TALL affordances and accelerate the move toward a more technology-friendly field of study. ARTICLE HISTORY
... However, language is also expressed in writing. Writing is a multidimensional skill combining motor, linguistic, and other cognitive skills, but also sensory properties (Berninger et al., 2015;Feder & Majnemer, 2007;Limbu et al., 2019). It is performed by refined movements for complex manipulation of tools, response to visual or auditory stimuli, cooperation of sensory systems and attentional networks as well as proprioception: comprehending the position of one's own body parts and coordinating their movements (Cornish & McManus, 1996;Feder & Majnemer, 2007;Potgieser et al., 2015). ...
Cerebral lateralization of oral language has been investigated in a plethora of studies and it is well established that the left hemisphere is dominant for production tasks in the majority of individuals. However, few studies have focused on written language and even fewer have sampled left-handers. Writing comprises language and motor components, both of which contribute to cerebral activation, yet previous research has not disentangled. The aim of this study was to disentangle the language and motor components of writing
lateralization. This was achieved through the comparison of cerebral activation during (i) written word generation and (ii) letter copying, as assessed by functional Transcranial Doppler (fTCD) ultrasound. We further assessed cerebral laterality of oral language. The sample was balanced for handedness. We preregistered the hypotheses that (i) cerebral lateralization of the linguistic component of writing would be weaker in left-handers compared to righthanders and (ii) oral language and the linguistic component of written language
would not be correlated in terms of cerebral lateralization. No compelling evidence for either of our hypotheses was found. Findings highlight the complexity of the processes subserving written and oral language as well as the methodological challenges to isolate the linguistic component of writing.
... On the other hand, other authors underline the usefulness of technological devices to learn writing in early phases and to motivate students (Genlott & Grönlund, 2013;Trageton, 2012), especially those with specific learning disabilities (e.g. Berninger et al., 2015). A recent meta-analytic review (Feng et al., 2019), comparing paper and digital writing, showed that text quality is similar in these two writing modes, writing fluidity is correlated across the paper and digital mode, and the digital mode allows for faster writing. ...
... The advent of new and rapidly changing technology is affecting the ways in which we consider what writing is, and although individuals have had the means to type their writing for over a century, it is still not widely considered to be writing. A debate exists among educators on whether handwriting should be abandoned entirely in favor of electronic writing or whether to do so would be premature (e.g., Berninger et al., 2015;Bouriga & Olive, 2021). Whether stemming from this debate or not, little to no research has been conducted in the field of speech-language pathology focused on writing in typed contexts. ...
Purpose
The purpose of this study was to conduct a scoping review of literature focused on the effects of developmental language disorder (DLD) on writing skills across the life span to highlight gaps in our knowledge of how to support writing for this population.
Method
We adopted the five-step framework for conducting scoping reviews outlined by Arksey and O'Malley (2005) to identify literature focused on writing outcomes for individuals with DLD in childhood, adolescence, and adulthood.
Results
Seventy-two studies from 1991 to 2022 met review criteria. Results indicated that spelling may be an area of relative weakness for individuals with DLD across the life span. Children and adolescents with DLD also may have relative difficulty with grammar, organization, cohesion, and length of written output. Research on the writing skills of adults with DLD is too sparse to draw broad conclusions about the writing skills of this subset of the population with DLD.
Conclusions
Overall, research into the writing skills of individuals with DLD is limited, and more information is needed to inform functional evidence-based approaches to assessment and intervention of writing for those with DLD from childhood through adulthood. Additionally, more focus on electronic writing in research is needed, as only two studies included in this review examined typed writing in any form. Results of this review also indicate a need for systematic, uniform approaches to defining and measuring writing skills for those who experience language difficulties.
Supplemental Material
https://doi.org/10.23641/asha.23596797
... In studies that described the use of software and e-readers (Schneps et al., 2013), the effectiveness of technological tools in promoting better reading performance in dyslexics was verified. In a scientific article (Berninger et al., 2015), the effectiveness of pedagogical activities on iPads was investigated, increasing the applicability for children with other specific learning disabilities, such as dysgraphia, which is a specific writing disorder. The results of the application of two technological instruments -Abracadabra (ABRA) and e-Pearlhave described benefits in lettersound recognition, phonological awareness and reading comprehension, also showing positive results in the case of children with reduced attention and low reading performance. ...
ICTs are tools that can support people with dyslexia especially during their education. ICT can contribute to effectively deal with the deficits they present in order to improve their performance and this is proven by more and more research data. Activity also exists in the field of dyslexia detection with the creation of software in this direction. Such softwares have also been designed for the Greek student population but further research is needed in order to enhance their effectiveness.
... Aside from ensuring an intuitive and easy-to-use interface, effectively used technology can reduce hurdles faced in language learning by children with varying abilities (Berninger et al, 2015). For example, a full-caption video or text would not only benefit learners with hearing disorders but can help all learners to improve their language skills (Teng, 2019). ...
The development and use of educational technology (EdTech) products have increased substantially in the last decade. Among other countries, India has witnessed a surge in the supply of EdTech products at the school education level spanning different disciplines. Primary among them has been English language learning EdTech products. In parallel, there has been an increase in demand for the same from stakeholders in India. However, in absence of a reliable framework to evaluate the quality of the available EdTech products in the education landscape, it has become difficult for the stakeholders to make meaningful choices on which product to use or adopt. In this regard, through a review of the literature, this paper identifies criteria to determine the quality of English language learning EdTech products that intend to benefit English as a Second Language (ESL) or English as a Foreign Language (EFL) learners in schools. The identified criteria can benefit decision makers to evaluate the quality of English language learning EdTech products in countries where English is taught as a second or a foreign language.
... Aside from ensuring an intuitive and easy-to-use interface, effectively used technology can reduce hurdles faced in language learning by children with varying abilities (Berninger et al, 2015). For example, a full-caption video or text would not only benefit learners with hearing disorders but can help all learners to improve their language skills (Teng, 2019). ...
The development and use of educational technology (EdTech) products have increased substantially in the last decade. Among other countries, India has witnessed a surge in the supply of EdTech products at the school education level spanning different disciplines. Primary among them has been English language learning EdTech products. In parallel, there has been an increase in demand for the same from stakeholders in India. However, in absence of a reliable framework to evaluate the quality of the available EdTech products in the education landscape, it has become difficult for the stakeholders to make meaningful choices on which product to use or adopt. In this regard, through a review of the literature, this paper identifies criteria to determine the quality of English language learning EdTech products that intend to benefit English as a Second Language (ESL) or English as a Foreign Language (EFL) learners in schools. The identified criteria can benefit decision makers to evaluate the quality of English language learning EdTech products in countries where English is taught as a second or a foreign language.
... The authors believe this finding suggests teachers were leveraging Core5's performance data and recommended companion resources to enrich instruction. Broadly, edtech programs and their accompanying dashboards also can free teachers' time to engage in behavior management to ensure all students are on-task (Berninger et al., 2015). ...
Experts laud the potential of educational technology (edtech) to promote reading among students with disabilities, but supporting evidence is lacking. This study evaluated the effectiveness of the Lexia® Core5® Reading edtech program (Core5) on the Measures of Academic Progress® (MAP) Growth Reading™ and easyCBM oral reading fluency performance of students with reading or language-based disabilities in Grades K to 5. Core5 systematically addresses multiple reading domains and previously was effective in general education. We hypothesized treatment students using Core5 would outperform controls on the reading assessments. This was a cluster randomized effectiveness evaluation, with condition assignment by school (three treatment and two business-as-usual control schools). Participating students in Grades K to 5 (N = 115; nTreatment = 65) were flagged by their district as needing reading intervention and had Individualized Education Program (IEP) designations of specific learning disability, speech or language impairment, or developmental delay. Treatment students used Core5 to supplement Tier 1 instruction for an average of 58.76 minutes weekly for 24.58 weeks. Regressions revealed treatment students outperformed controls on MAP (B = 3.85, CI = 0.57-7.13, p = .022, d = .24), but there were no differences for oral reading fluency. MAP findings confirm edtech can effectively supplement reading instruction for this population.
... Handwriting is a fundamental skill that students must master to succeed in school. Digital tablets in school classrooms encourage the development of new methods to help students learn to write by hand, thanks to computer-assisted supplementary feedback (FB) (Berninger, Nagy, Tanimoto, Thompson, & Abbott, 2015;Bonneton-Botté et al., 2019. The general goal of computer-assisted supplementary FB is to transmit additional information, during or after execution. ...
Learning to write relies on the efficient integration of visual and proprioceptive feedback, with a transition from a control, based on the visual inspection of the written trace at the beginning of the learning process to a more predictive control, based mainly on handwriting movement, in proficient writers. The aim of this study was to test the effect of a partial deletion of the written trace, as well as the effect of supplementary visual information, on handwriting kinematics in a learning task. Twenty-four adults learned to write six new pseudoletters using their non-dominant hand on a touch screen digital tablet. Three pseudoletters were trained with modified visual feedback conditions and the other three, in the control condition, i.e. without any visual modification. Results revealed that, in the short-term, the pseudoletters learned with modified visual feedback were traced faster and more fluently than those learned in the control condition, without spatial accuracy reduction. This method seems to be efficient in adults, which is a prerequisite before testing a method with children.
... Nous avons ôté les articles utilisant les moyens comme des éléments d'un dispositif de contrôle ou utilisés comme moyens de mesure, ainsi que ceux proposant ces moyens numériques comme moyens de rééducation ou de tutorat assisté par ordinateur seul. Évidemment, ceux traitant à la fois de ces usages et de l'aide technique ont été retenus (par exemple Berninger et al., 2015;Klein et al., 2008). ...
Cette thèse a pour objet l’étude de la relation entre les pratiques des enseignants et l’inclusion d’un élève présentant des troubles de l’acquisition des coordinations et qui est équipée d’un ordinateur pour pallier les conséquences de ces troubles. Elle s’intéresse plus particulièrement aux déterminants pesant sur le travail de l’enseignant et aux apprentissages de cet élève par rapport au reste de la classe. Nous nous sommes intéressé à une équipe d’enseignants de différentes disciplines techniques et scientifiques accueillant un même élève de sixième. Nous nous appuyons sur un cadre théorique composite associant une approche ergonomique et une approche didactique à laquelle nous associons une approche instrumentale. Nous montrons que l’inclusion de cet élève en situation de handicap fait l’objet d’arbitrages chez l’enseignant qui sont difficilement compréhensibles sans réinscrire celle-ci dans le jeu complexe des déterminants pesant sur son activité. Les enseignants arbitrent entre des systèmes de prescriptions hétérogènes qui entrent parfois en tension. L’introduction de l’ordinateur perturbe la cohérence des pratiques enseignantes, sans toutefois remettre en cause leur stabilité. Les résultats indiquent également que le recours à l’ordinateur n’induit pas automatiquement une facilitation de l’accès aux apprentissages. De plus, l’usage de l’ordinateur peut induire une modification des conditions d’apprentissage tellement importante que ceux-ci ne puissent plus avoir lieu. Nous montrons également que, dans la mesure où le déploiement de ces ordinateurs pour pallier le handicap n’est pas articulé avec les pratiques des enseignants, il est difficile de mettre en place des usages permettant l’accessibilité aux apprentissages de l’élève équipé.
... As we have not identified previously published reviews on struggling writers' use of STT in secondary education, it is important to explore this research gap. This is especially true with respect to assistive technology, including STT, as it is widely recommended in the IEPs of students in secondary education [27,33,34], and as an educational practice for teachers and teacher candidates in theoretical frameworks [35,36], policy documents [37,38] and instructional materials [39,40]. ...
Purpose
To identify and describe the aims, methodological approaches, and major findings of studies on the use of STT among secondary pupils (age 12–18) with learning difficulties published from January 2000 to April 2022.
Materials and method
This scoping review includes empirical studies published in peer-reviewed journals and grey literature between January 2000 and April 2022. Searches were conducted in April 2022 in three databases: ERIC, PsycINFO and Scopus. In addition, related reviews were manually screened for relevant papers.
Results
Eight peer-revied studies and five publications of grey literature were found to meet the inclusion criteria; two studies employed experimental designs, four employed quasi-experimental designs and seven employed explorative designs. Six studies described STT as an assistive technology (a compensatory aid for poor writing performance); two assessed STT as an instructional technology to determine whether it improves overall writing and related skills (e.g., reading). Results suggest that STT may increase pupils’ abilities to produce texts with fewer errors, provide help with spelling and improve reading comprehension and word recognition. To date, there is a paucity of high-quality research on the use of STT among adolescents with LD.
Conclusion
The scoping review shows that very little research has been conducted on the use of STT for adolescents with learning difficulties in secondary education. Findings from the studies identified five areas of interest: writing related skills, text assessment, writing processes, accuracy of the technology, and participants’ experiences. Findings indicate that writing performance among students with learning difficulties improves when using STT. Parents, teachers, and pupils report positive experiences with the technology, particularly for students with severe reading and writing difficulties.
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IMPLICATIONS FOR REHABILITATION
• There is a great need for more robust research on the use of speech-to-text technology (STT) in educational settings, especially on its effect on writing skills
• Studies describe STT as either an assistive (a compensatory aid for poor writing performance) or instructional technology (aiming to improve learning in general). It is important that practitioners are aware of the different aims and possible consequences of introducing STT to learners with writing difficulties.
• STT provides both opportunities and challenges for writers with learning difficulties in secondary education. Findings indicate that writing performance among students with learning difficulties improves when using STT, yet inaccuracy of the technology was presented as one of the main challenges.
• Parents, teachers, and pupils report positive experiences with the technology, particularly for students with severe reading and writing difficulties.
... Whittaker et al. identified that a properly designed stylus with touch technology encourages handwriting development in children with cognitive and fine motor delays [115]. Similarly, Berninger et al. [9] investigated the effect of iPad based writing instructions for 4-9 grade students with specific learning difficulties. The results showed that computerized writing instruction helped children improve their handwriting skills. ...
According to the oscillation theory of handwriting, letters are formed by the coupled modulation of horizontal and vertical oscillations of the hands. This modulation-oscillation scheme requires human motor control. Hence, one of the reasons for poor handwriting is a lack of fine motor skills. The main objective of this study was to design, develop, and evaluate a hand therapeutic application (HanDex) for children with writing difficulties to enhance their hand dexterity. This paper describes the design, development, and evaluation of the HanDex app. It has mainly six activities for improving tripod grip, hand-eye coordination, spatial organization, letter formation, and fine motor skills. The main principle underlying the design of these activities is the oscillation theory of handwriting. A set of user interface (UI) guidelines have been followed in the UI design for simplicity, user motivation, easy navigation, etc. User evaluation of the prototype was conducted by ten participants in five iterations, and the final product was built by considering their feedback. Subsequently, we conducted case studies on two primary school children with poor handwriting skills to test the effectiveness of the application. This study used a single-subject pretest-posttest design to observe and measure the efficacy of the HanDex application. The posttest results showed a positive impact on letter formation, size of letters, spacing of letters and words, placement, speed, and legibility in these children. Hence, the HanDex app is promising and warrants further investigation in more children with different levels of handwriting difficulty.
... Computer-based programs seem to offer benefits beyond traditional interventions, especially for spelling in writing through word processing programs with speech synthesis, although the evidence is far from conclusive [107,108]. ...
This chapter includes developmental learning, communication, and motor disorders, which affect persons with intellectual disability (ID), autism spectrum disorders (ASD), and/or other neurodevelopmental disorders more often than neurotypical persons, and have a significant influence on the emotional and adaptive development as well as on overall functioning and personality throughout the whole lifespan of the person.Specific learning disorders (SLDs) occur early during the first years of formal schooling, with difficulty in learning, reading, writing, and arithmetic. They occur in the absence of a global impairment of intelligence and intellectual capability, although these disorders are prevalent among children and adults with cognitive impairments within the range of ID. These disorders originate in childhood and often continue into adulthood among many. Various treatments are available showing a varied rate of success for SLDs.Motor disorders such as motor coordination difficulties, tic, and Tourette’s syndrome are common in children and adults with ID. Children and adults with ID also manifest various types of communication disorders including speech sound disorder, speech fluency disorder (stuttering), and social (pragmatic) communication disorder. Social communication disorder is common among children and adults with ASD.There are significant gaps in current knowledge of phenomenology, categorization, aetiology, and natural history of communication, and motor disorders in persons with ID and/or ASD. It is also difficult to decipher the many causal links between these conditions and the frequently associated psychiatric disorders.Although the outcomes of many therapeutic programmes are still ambiguous and underdocumented, treatment of communication and motor disorders, as well as prevention of associated psychiatric problems, seems to be more effective when based on a coordinated multidisciplinary approach.KeywordsSpecific learning disordersMotor disordersCommunication disordersIntellectual disabilitiesChildrenAdults
... Untersuchungen zur Frage, ob die Verwendung einer Tastatur einen Einfluss auf die Anzahl oder Art der Rechtschreibfehler bei Kindern hat, sind uns nicht bekannt. Besonders Schreibanfänger profitieren jedoch von der handschriftlichen Bearbeitung von Aufgaben, indem Buchstaben und größere Schrifteinheiten selbst produziert werden (Berninger et al. 2015). Es lässt sich auch vermuten, dass die Eingabe mit einer Tastatur für Personen, die keine oder wenig Erfahrung in der Texteingabe per Tastatur haben, zusätzliche Fehlerquellen birgt. ...
Zusammenfassung
Digitale Medien haben mittlerweile einen festen Platz im Alltag von Schülerinnen und Schülern. Sie dienen nicht nur der Vermittlung von Lehrinhalten, sondern werden zunehmend auch für das Erbringen von Leistungsnachweisen und zur Diagnostik eingesetzt. Für die Durchführung und Auswertung etablierter Testverfahren zur Erfassung schulischer Leistungen wäre es wünschenswert, wenn sie in einem digitalen Format vorliegen. Aber sind diese Testleistungen vergleichbar? Um dies zu prüfen, wurden verbreitete Papier- und Bleistift-Testverfahren zur Erfassung der Lesegenauigkeit (Verlaufsdiagnostik sinnerfassenden Lesens, VSL), Dekodiergeschwindigkeit (Würzburger Leise Leseprobe – Revision, WLLP-R) und Rechtschreibung (Weingartener Grundwortschatz Rechtschreib-Test, WRT 3+/4+) digitalisiert und in eine kindgerechte Rahmengeschichte eingebettet. Insgesamt führten 237 Kinder der dritten und vierten Klassenstufe aus Bayern und Hessen die Testverfahren zuerst in digitaler Version (via App am Tablet oder Smartphone) und danach als Papier-und-Bleistift-Version durch. Es zeigt sich ein hoher Zusammenhang zwischen den Testleistungen der beiden Testformate, der unterschiedliche Interpretationen zulässt. Chancen und Grenzen digitalisierter Leistungstests werden diskutiert.
... The efficacy of tablets as a writing tool has been supported by studies such as Berninger et al., (2015), which reported that students with learning disabilities showed significant improvements in their writing skills after training on iPads in a series of 18 two-hour sessions. This result supports the notion that digital technologies may facilitate learning as students tend to have higher motivation and spend longer on task than with traditional paper-and-pen assignments (e.g., Clark & Dugdale, 2009;Rogers & Graham, 2008). ...
Studies comparing writing media typically compare different modes of writing (e.g., keyboard typing vs. writing, smartphone tapping vs. writing, etc.). The current study sought to investigate the cognitive outcomes of a more direct comparison: tablet-versus paper-based writing. Thirty-two speakers of L1 English were tasked with memorizing 20 Japanese kanji (stroke orders, Japanese readings, and English translations). Ten kanji were practiced (10 times each) on paper; the other 10 were practiced on an iPad. The kanji that were practiced on paper were more likely to be correctly translated into English at both the post-and delayed posttest, though Japanese scores were statistically equal. Of most intrigue was that while both groups were written with equal accuracy at the posttest, only the kanji practiced on paper showed a significant increase at the delayed posttest (after a period of 24 hours). The results of exit questionnaires indicated that the participants were divided on their preference of writing medium but were unanimous in their agreement that tablets should have a place in modern classrooms. One significant finding is that participants acknowledge the difficulty of tablet-based writing but conclude that what is necessary is more practice-not the avoidance or abandonment of the technology.
... In other studies, carers and educators were recruited as participants and the methods employed varied accordingly. For example, parent questionnaires (Berninger, Abbott, Cook, & Nagy, 2017;Berninger, Nagy, Tanimoto, Thompson, & Abbott, 2015;Biotteau et al., 2019;Bonifacci et al., 2020;Dunn, Zajic, & Berninger, 2020;Iwabuchi, Hirabayashi, Nakamura, & Dim, 2017;Lopez, Hemimou, Golse, & Vaivre-Douret, 2018;Prunty & Barnett, 2017;Richards et al., 2016;Rosenblum, 2018;Vaivre-Douret, Lopez, Dutruel, & Vaivre, 2021), interviews (Beers et al., 2017;Prunty & Barnett, 2017), surveys (Berninger et al., 2019), parent ratings (Nielsen, Henderson, Barnett, Abbott, & Berninger, 2018) or other standardised assessments or reports were gathered by researchers from carers. On the other hand, researchers preferred to primarily survey educators for information related to the specific objectives of their study (Eyo & Nkanga, 2020;Hopcan et al., 2019;Menon, 2016;Ranjeetha Golde & Shobha, 2019). ...
The aim of this scoping review was to systematically map and summarise recent peer-reviewed research on children with dysgraphia between 2015 and May 2021. The research included the perspectives of children, carers, and educators. Dysgraphia is a largely unrecognised specific learning disorder (SLD) in writing that manifests as a disability in handwriting, spelling, and/or composition skills during child development. Data from 77 studies from across five databases were charted to address four key questions and to direct future research. The findings included: (1) limited representations of participants using mostly quantitative methods; (2) children aged 9–14 as suitable for research recruitment; (3) thematic prevalence such as handwriting, spelling, and technology; and (4) low rates of international research output. Thus, future research may focus on compositional difficulties or research participants (children with dysgraphia, carers, and educators) sharing their lived experiences of dysgraphia. This may lead to improved awareness, professional development, and enhanced teacher resources.
... In fact, technological advances have allowed the development of ATs associated with the writing process, namely lexical/syntactic proofreader, speech synthesizer, word predictors and voice dictation. Several US studies reveal the contribution of reviewers on the correction of spelling errors [26] as well as lexical and syntactic spelling, readability, organization, and coherence of the texts produced [27][28][29], although reviewers fail to identify one third of lexical homophone errors [30]. As for the word predictor, severe dysorthographic students show great difficulty in using this AT effectively, while a gain is observed in those with moderate difficulties [31]. ...
In the context where dyslexic and dysorthographic students have great difficulties in writing, this study aims to describe and analyze the perceived relationship between the use of assistive technologies (AT) in writing situations as well as academic self-perception, feeling of self-efficacy and exam anxiety in dyslexic and dysorthographic students. Using standardized questionnaires and semi-structured interviews, data were collected at the beginning and end of the school year from 28 dyslexic and dysorthographic students aged 12 to 13. In terms of quantitative analyses , the average score for each of the scales on the questionnaires was calculated. As for the qualitative data, they were analyzed using a network analysis approach. The main results show that students who can use ATs in a writing situation have a significantly higher self-perception and feeling of self-efficacy than those who do not. Moreover, their use is promising since it is associated with less anxiety at the time of exams at both measurement times. The results obtained are discussed in relation to actions to be encouraged in schools.
... Fiorella and Mayer (2017) examined student's retention and transfer of information and observed that the students who took notes with a computer outperformed those who used pen and paper. Mueller and Oppenheimer (2014) showed that computer note taking negatively affected students' responses to conceptual questions (Experiments 1 and 2) but did not affect memory of factual information which was recalled at the training from kindergarten to primary school (Berninger et al., 2015;Connelly et al., 2007;Cutler & Graham, 2008;Graham & Weintraub, 1996;Morin et al., 2009;Troia et al., 2009;Vander Hart et al., 2010). Generally, students teach themselves to type and acquire suboptimal, idiosyncratic finger-key associations (Yamaguchi & Logan, 2014). ...
The present study investigated cognitive effort of handwriting and typing of undergraduate students. In Experiment 1, we used a secondary reaction time task to assess the cognitive effort required by undergraduates when carrying out handwriting and typing copying tasks. Students had longer reaction times, indicating greater cognitive effort, when typing than when handwriting. In experiments 2a and 2b, we investigated whether the additional cost of typing affected an ongoing activity. Participants performed a short-term memory task that required them to type or write by hand words to recall. As Experiment 1 suggested that typewriting was more effortful than handwriting, so it should leave fewer resources to devote to memorizing words, which would result in a better handwritten than typed recall. Overall, handwriting led to better recall than typing, particularly with the longest lists of words. This implies that, even in undergraduates, typing is still more effortful than handwriting and therefore has a negative impact on performance on an ongoing activity. The educational implications of the findings are discussed.
Community service aims to provide knowledge for children and youth in the introduction and how to use Microsoft Office Word in order to improve their personal skills both towards college and the world of work. This service was carried out in three stages including introduction to Microsoft Office Word software, practice in using Microsoft Office Word, question and answer session. This training activity as a form of community service was carried out in June 2024 and was aimed for elementary to high school level and youth in Kebun Tuli Yotoro, Sentani, Jayapura Regency, and involving Samdhana Institute, lecturer from FMIPA and Faculty of Engineering, lecturer from Ottow Geissler University Papua, students from FMIPA Uncen. Keywords : Training, Microsoft Office Word, Kebun Tuli Yotoro.
Handwriting is an important skill for children during their academic years. It is the coordination of perceptual-motor and cognitive abilities. Some children have difficulties in handwriting, which is an indication of issues in their fine motor skills. Nowadays, technology-based instructions are available to develop fine motor skills in children with handwriting disabilities. This paper describes the details of a newly developed software application namely ‘HanDex’ for children with handwriting difficulties and the experiments conducted to test its effectiveness. The application comprises six hand therapeutic activities which were designed based on the oscillation theory of handwriting. Initially, in the first phase, the experiments were conducted in nine primary school children from various schools, aged 8–12 years. Then, in the second phase, the software training was given to six upper primary school children (10–12 years) with handwriting issues. The results of using this application were promising. So one more study was conducted in another set of nine children (8–11 years) with handwriting difficulties. The participants were assessed by their special educators, class teachers and parents. After the pretest, they received a total of 18 handwriting practice sessions using this new application. At the end of the training sessions, a post test was conducted, to measure the progress in handwriting. The handwriting rubrics with eight handwriting parameters such as letter formation, placement, letter sizing, spacing of letters, legibility, speed, neatness, and spacing of words were used for handwriting assessment. The findings from the study suggested that touch-based hand therapeutic activities were beneficial for children with writing difficulties to improve their handwriting performance and tripod grip.
Dysgraphia is a learning difference that impairs students' capacity to produce legible and coherent written language and poses significant obstacles for their academic and personal growth. With the advent of Assistive Technologies (AT), however, new possibilities emerge for individuals with this learning disability to accomplish tasks that were previously difficult or unfeasible. AT tools target challenges pertaining to writing, spelling, and organizing ideas on paper or digital platforms. Nonetheless, the absence of a comprehensive theoretical framework impedes the systematic incorporation of AT into dysgraphia remediation practices. This paper, therefore, advances a theoretical framework intended to assist educators, researchers, and practitioners in the efficacious utilization of assistive technologies (AT) for the remediation of dysgraphia. This framework examines key components, such as assessment, technology selection, instructional strategies, and evaluation, to establish a coherent approach for dysgraphia remediation. By adhering to this framework, stakeholders of education can cooperate to assess, select, integrate, and evaluate AT solutions customized to individual needs. Ultimately, this approach will enable students with dysgraphia, promote autonomy and enhance their academic and personal development.
Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) Olgu Örnekleri Gülen GÜLER AKSU Dikkat Eksikliği Hiperaktivite Bozukluğu Nedir? Ne Değildir? Mutlu Muhammed ÖZBEK, Hatice AKSU Dikkat Eksikliği Hiperaktivite Bozukluğunun Nedenleri Cem GÖKÇEN, Fatma Subaşı TURGUT. Dikkat Eksikliği Hiperaktivite Bozukluğu’nun (DEHB) Nörobiyolojisi Ali Evren TUFAN Dikkat Eksikliği Hiperaktivite Bozukluğu’nda Fonksiyonel Görüntülemenin Yeri Hicran DOĞRU, Onur Burak DURSUN Dikkat Eksikliği Hiperaktivite Bozukluğu’nda Nöropsikolojik Değerlendirme Emre ÖZDEMİR Okul Öncesi Dönemde Dikkat Eksikliği Hiperaktivite Bozukluğu Fethiye KILIÇASLAN, Meryem Özlem KÜTÜK DEHB’de Okul Öncesi Aile, Öğretmen Tutum ve Davranışları Özge METİN İlkokul Döneminde Dikkat Eksikliği Hiperaktivite Bozukluğu Pelin DAĞ Dikkat Eksikliği Hiperaktivite Bozukluğu’nda Okul Döneminde Aile, Öğretmen Tutumu ve Davranışları Neler Olmalı? Özhan YALÇIN Ergenlik Döneminde Dikkat Eksikliği Hiperaktivite Bozukluğu Bulguları Öznur BİLAÇ Ergenlik Dönemi ve DEHB: Ebeveyn ve Öğretmen Tutumları Nasıl Olmalı? Ozan Kayar Erişkin Dönemde Dikkat Eksikliği Hiperaktivite Bozukluğu ve Yaşam Boyu Yükü Halil KARA Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocukların Kardeşleri Şeyma GÜRBÜZ, Elvan İŞERİ Dikkat Eksikliği Hiperaktivite Bozukluğu ile Birlikte Görülen Ruhsal Sorunları Ayırt Edebilme ve Onlarla Baş Edebilme Seher AKBAŞ Özgül Öğrenme Güçlüğü Eşliğinde Psiko-eğitsel Müdahaleler Ozan KAYAR Dikkat Eksikliği Hiperaktivite Bozukluğu’nda Akademik Destek Nasıl ve Ne Zaman Olmalı? İbrahim DURUKAN Dikkat Eksikliği Hiperaktivite Bozukluğunda Duyusal Özellikler, Öneriler ve Müdahaleler Güneş TURHAN Dikkat Eksikliği Hiperaktivite Bozukluğunun Yaşam Boyu Seyri Hasan KANDEMİR, Ender ATABAY DEHB Hakkında En Sık Sorulanlar ve Yanıtları Müslüm KUL Dikkat Eksikliği Hiperaktivite Bozukluğunda Yapılacak Tetkikler ve Psikometrik Testler Mustafa Tolga TUNAGÜR, Börte GÜRBÜZ ÖZGÜR DEHB’de Oyun Terapisi Tekniklerinin ve Alternatif Oyun Etkinliklerinin Kullanımı Ozan KAYAR Dikkat Eksikliği Hiperaktivite Bozukluğunda Bilişsel Davranışçı Terapiler Özlem ÖZCAN Dikkat Eksikliği Hiperaktivite Bozukluğu ve Bilinçli Farkındalık (Mindfulness) Terapisi Didem Behice ÖZTOP DEHB’de Alternatif/Tamamlayıcı Tedavi Yöntemleri Burcu Akın SARI Dikkat Eksikliği Hiperaktivite Bozukluğunda İlaç Tedavisi Ümit IŞIK Dikkat Eksikliği Hiperaktivite Bozukluğunda Kullanılan İlaçların Kardiyolojik Açıdan Güvenirliği Derya KARPUZ Dikkat Eksikliği Hiperaktivite Bozukluğu ve Genetik Hande AYRALER TANER
Several factors can impede the writing process of students with dyslexia. One recommended adjustment to help them overcome these writing challenges is the use of personal computers for writing. The research underscores the significance of effective keyboarding skills in optimizing the benefits of computer-based writing for these students, with touch-typing being the frequently recommended typing technique. Although research findings point to various reasons that indicate that students with dyslexia may face difficulties in developing fluent touch-typing skills, we found a lack of research in this area. In order to address this gap, in our study we examined and compared 12–13-year-old Slovenian students with dyslexia and their typically developing peers in terms of their existing, self-taught typing technique fluency, the fluency achieved in learning touch-typing and the fluency achieved in learning a simple finger-typing task. We found a significant difference between handwritten and self-taught typing fluency of students with dyslexia, with handwriting being a more fluent form of transcription. The results of students with dyslexia are significantly lower from their peers in handwriting fluency, self-taught typing fluency, touch-typing fluency and simple finger-typing task fluency. However, the learning trends for touch-typing and the simple finger-typing task do not differ between the groups of students. We comment on the differences found and make suggestions when considering typing as an additional or alternative transcription mode.
Some meta-analyses have confirmed the efficacy of technology-enhanced vocabulary learning. However, they have not delved into the specific ways in which technology-based activities facilitate vocabulary acquisition, or into first-language vocabulary learning. We conducted a systematic review that retrieved 1,221 journal articles published between 2011 and 2023, of which 40 met our inclusion criteria. Most of the sampled studies focused on teaching receptive vocabulary knowledge and vocabulary breadth. All utilized cognitive strategies. Their common design features included noticing and receptive or productive retrieval, and most implicitly drew upon dual-coding theory. Our findings highlight the need for a balanced approach to vocabulary learning, encompassing both vocabulary breadth and depth, as well as receptive and productive knowledge. They also suggest that affective and social learning strategies should be promoted alongside the cognitive ones that are currently dominant. Additionally, our identification of commonly and rarely used design features can guide curriculum designers to develop more effective tools. Lastly, we argue that the design of technology-enhanced learning should be theory-driven.
Being able to write a sentence is an essential part of overall writing proficiency, but this can be a challenge for many students. This article provides a systematic review of the extant literature on sentence-writing instruction. Sixteen studies designed to improve sentence writing for students who are typically achieving or have disabilities or other writing needs were reviewed. Across studies, explicit instruction, self-regulation strategies, and sentence-writing practice were associated with improvements in writing. Directions for future research and limitations in the existing knowledge base about sentence-writing instruction and interventions are described.
Handwriting difficulties (HD) are manifested in poor legibility, speed or both, which seem to represent different aspects of handwriting performance; product and process, respectively. As such, they may stem from different deficits in underlying functions. This study examined the distribution of HD manifestations among higher-education students, and the relationship between language, working memory as well as perceptual- and grapho-motor skills and handwriting legibility and speed. The sample included 110 higher-education students (18- to 33-years old), of whom 66 had specific learning disabilities (SLD) and HD and 44 were typically developing. Students were administered a handwriting test and various tests measuring the underlying functions. Results showed three distinct groups of students with HD. Most (62.1%) had poor legibility but not poor speed. Others had only slow handwriting (24.2%) and a minority had both (13.6%). Working memory was found to predict both poor legibility and speed. Yet, whereas having slow handwriting was also predicted by poor spelling and gender, having poor legibility was related to visual-spatial motor organization. These findings indicate that higher-education students with HD are a heterogeneous group. Therefore, for research and educational purposes distinctions should be made with reference to the different HD groups, because each appear to be associated with different underlying deficits.
Students who struggle with writing may also struggle academically. Mobile applications play a vital and supportive role in addressing this issue. The purpose of this research is to examine mobile writing applications and to gather the opinions of teachers and experts on these applications in order to support the writing skills of 1st and 2nd-grade primary school students. In this way, the strengths and weaknesses of the existing applications will be evaluated, and a projection will be kept on the mobile writing application that should be. The researchers applied qualitative and quantitative methods. In order to reveal the needs in question, a number of applications from the Android and IOS stores were reviewed using a rubric devised by the researchers. Semi-structured interviews were conducted to gather opinions from primary school and special education teachers and subject matter experts in primary and special education. The study revealed the insufficiency of targeted applications to support writing skills, particularly regarding accessibility, audio, and visual elements. This finding emphasizes the need for new mobile applications to eliminate the limitations. This study provided vital insights into building a mobile application for addressing writing difficulties that might satisfy the needs. The results of this study include suggestions that will shed light on future research on mobile writing applications.
Writing is one of the most important academic skills in school life, a skill that accompanies students from primary education to adulthood. It is a complex skill that resembles those of an experienced fiddler or chess player. However, for students with specific learning difficulties, writing is an extremely demanding procedure than calls for a combination of “low” and “high” order skills. Hence, it is expected that this category of students struggle with writing, and this condition affects not only their writing performance, but also their academic one, their emotional status, and even their social life. Over the last decades, research has shed light on different aspects of writing, beyond spelling and handwriting, and has offered new approaches that have to do with higher-order skills, such as cognitive and metacognitive skills. This chapter is aimed at discussing the skills and problems in writing of students with learning difficulties and presenting recent findings about the complex nature of those problems, as well as suggestions for interventions to assist those students.
Inklusion und Digitalisierung sind im Begriff, die Gesellschaft in mehreren Dimensionen entscheidend zu verändern. Dazu gehört auch (schulische) Bildung. Inklusive und digitale Bildung als zentrale Aufgaben des Bildungssystems werden allerdings bislang zu selten im Verbund diskutiert. Digitale Bildung ist für die Ermöglichung gesellschaftlicher Teilhabe jedoch grundlegend und muss damit bedeutender Bestandteil von Bildungsprozessen sein. Inhaltlich baut der Sammelband auf ausgewählten Beiträgen der Online-Tagung „Inklusion digital! – Chancen und Herausforderungen inklusiver Bildung im Kontext von Digitalisierung“ auf. Die Artikel spiegeln die aktuellen Diskussionen der Lehrkräfteaus-, -fortund -weiterbildung bezogen auf Inklusion und Digitalisierung aus fachdidaktischer, fachwissenschaftlicher, bildungswissenschaftlicher und sonderpädagogischer Perspektiven wider.
This chapter introduces I Can Succeed (ICS), a treatment model for adolescents with specific learning disorder (SLD), and two applications of it as universal, school-based programs (ICS-ES, elementary school; and ICS-PS, preschool). Based on Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), ICS is a manual-based psychological intervention consisting of 13 weekly sessions followed by six monthly sessions. ICS targets emotional, interpersonal, and academic functioning via skill enhancement and strengthening supportive relationships. In a trial with 40 adolescents diagnosed with SLD, 97% of participants found ICS helpful. Analysis showed improved relationships and a decrease in externalizing and internalizing problems. ICS was then adapted for preventive use, converting it from a one-on-one psychotherapy protocol to a school-based social-emotional learning (SEL) program that aims to enhance all students’ social and emotional skills to decrease and prevent psychopathologies. A study of 419 fourth-grade students found that those who participated in ICS-ES showed improved assertiveness, reduced internalizing symptoms and bullying, and improved academic achievements in their native language. A randomized control trial of six preschools found children participating in ICS-PS improved their emotional, behavioral, EF, and academic functioning. Future research will examine the specific contributions of different aspects of the programs.KeywordsManualized treatmentInterpersonal therapyIPTI Can SucceedSpecific learning disorder
Ausgehend von den entwickelten Qualitätsmerkmalen und Gelingensbedingungen für inklusiven Unterricht (Baumert et al., 2018) diskutiert der Beitrag anhand von 14 Merkmalen die Frage, welche Chancen und Herausforderungen aktuelle Digitalisierungsprozesse für die Gestaltung inklusiven Unterrichts eröffnen können. Mit der Vorstellung von Gelingensbedingungen verfolgt der Beitrag das Ziel, eine Strukturierungshilfe zur Diskussion zu stellen, um im Kontext der komplexen Entwicklungs- und Transformationsprozesse nicht die Orientierung zu verlieren. Diese Gelingensbedingungen sind das (Zwischen-)Ergebnis der interdisziplinären Werkstatt Digitalisierung in inklusiven Settings als Bestandteil des QLB-Projektes BRIDGES an der Universität Vechta. Im Rahmen des Beitrages werden die gemeinsam entwickelten Merkmale vorgestellt und die fachspezifischen Perspektiven der beteiligten Bildungswissenschaften und Fachdidaktiken exemplarisch dargelegt.
This is an English translation of a CPD handbook developed for teachers in Irish-medium/Gaeltacht schools to help them support students with special educational needs learning through Irish.
This study examined affix letter spelling among 6th grade Hebrew-speaking children with dyslexia compared with chronologically age-matched and reading level-matched controls. As different languages are characterized by multiple dimensions of affix spelling complexity, we specifically targeted the following unique dimensions relevant to Hebrew: (i) affix envelope transparency; (ii) affix letter prevalence; (iii) internal morpho-phonological competition; (iv) overtness of the phonological-orthographic link; and (v) phono-morpho-orthographic consistency. The research instrument was a spelling task of 244 words containing affix letters, covering all non-root morphological roles, both inflectional and derivational. Results show that for both frequent and infrequent words, 6th graders with dyslexia perform similarly to reading age-matched controls when spelling involves morphological competition or when the phonological morphological and orthographic link is inconsistent. In frequent words the similarity in performance between the groups extends to the overt phonology criterion as well. In addition, 6th graders with dyslexia were assisted by affix letter prevalence but not by demarcation of the affix envelope, compared with reading age-matched controls. Regarding these criteria, the discrepancy between regular and irregular affix spelling was different between dyslexic children and non-dyslexic controls. These findings indicate that morphological knowledge in dyslexia is not a unified system, and while some morpho-orthographic regularities are acquired more easily, other morpho-orthographic regularities are quite challenging.
Mit diesem Kapitel wird ein Beitrag an die Schulentwicklung hin zu inklusiven Schulen geleistet. Im Zentrum steht eine theoriegeleitete und konzeptionelle Einbindung des Fachwissens aus der Psychomotorik in den Prozess der Entwicklung inklusiver Bildungssysteme und multiprofessioneller Zusammenarbeit. Es wird die theoriegeleitete Entwicklung eines Rahmenmodells für die grafomotorische Förderung beschrieben, auf dessen Basis das Lehrmittel und Konzepts "GRAFINK - Grafomotorik und Inklusion" (Sägesser Wyss, Sahli Lozano & Simovic, 2021) entwickelt wurde.
This chapter makes a contribution to school development towards inclusive schools. The focus is on a theory-led and conceptual integration of the subject knowledge from psychomotricity into the process of developing inclusive education systems and multi-professional cooperation. The theory-led development of a framework model for graphomotor support is described, on the basis of which the teaching aid and concept "GRAFINK - Grafomotorik und Inklusion" (Sägesser Wyss, Sahli Lozano & Simovic, 2021) was developed.
In the current environment, the effects the pandemic have had on children remains unknown. Handwriting was not addressed effectively during online education, an occupation which pediatric occupational therapists are highly qualified to support with children, families, and schools. Concurrently, the use of telehealth as a service delivery method has increased, especially during the pandemic. The ease, flexibility, and satisfaction found with telehealth, time will dictate its continued use. This case study presents a preliminary investigation into the effectiveness and feasibility of the Handwriting Without Tears® (HWT) program via telehealth delivery for handwriting and spelling outcomes for a first grader. A case study pretest/posttest design was used to assess handwriting and spelling gains for a first grade female. The Print Tool and Alphabet15 were used to assess handwriting quality and handwriting speed respectively. The Test of Written Spelling-5 and the Primary Spelling Inventory were used to evaluate spelling. The participant completed 18 synchronous HWT telehealth visits over six weeks. The participant made handwriting legibility and speed gains, but the spelling results were inconclusive. The feasibility of the telehealth service delivery was confirmed with reported participant satisfaction, high attendance, and minimal accommodations required to translate the HWT program to telehealth. The high frequency visits as recommended by a previous systematic review anecdotally was deemed taxing by the participant and family. Further research is warranted to determine the effectiveness of HWT on literacy outcomes, such as handwriting and spelling, delivered via telehealth at a lower frequency of visit.
This is a short course CPD course developed to help teachers in primary and post-primary Irish-medium and Gaeltacht schools to meet the special educational needs of their students. At present it is only available through the medium of Irish but much of the content is transferrable to other immersion education contexts as well as students learning through a second language.
Handwriting and spelling deficits are common struggles experienced by children with specific learning disabilities (SLD), but there is little evidence on interventions that target these areas for children with SLD. To systematically review the research investigating the effectiveness of handwriting and spelling interventions for children with SLD. A systematic review was conducted that included studies focusing on handwriting and/or spelling interventions for children with SLD. A Black and Downs checklist was completed for each included article to evaluate validity and reliability. Effect sizes were calculated of results for a unitless comparison. Eleven studies met the inclusion criteria: six examined handwriting exclusively, three spelling, and two combined spelling and handwriting. The interventions were grouped into categories of tablet-based, sensorimotor, and/or self-management interventions. Themes of occupation-as-ends versus occupation-as-means were also noted. Those interventions that promoted self-management and used occupation-as-means were found to be most effective. Utilizing the handwriting and spelling within treatment as well as encouraging a child’s autonomy and participation are valuable strategies for occupational therapist to use in improving literacy outcomes for children with SLD.
Congress posed questions about the effectiveness of educational technology and how effectiveness is related to conditions and practices. The study identified reading and mathematics software products based on prior evidence of effectiveness and other criteria and recruited districts, schools, and teachers to implement the products. On average, after one year, products did not increase or decrease test scores by amounts that were statistically different from zero. For first and fourth grade reading products, the study found several school and classroom characteristics that were correlated with effectiveness, including student-teacher ratios (for first grade) and the amount of time products were used (for fourth grade). The study did not find characteristics related to effectiveness for sixth grade math or algebra. The study also found that products caused teachers to be less likely to lecture and more likely to facilitate, while students using reading or mathematics software products were more likely to be working on their own. The results reported here are based on schools and teachers who were not using the products in the previous school year. Whether products are more effective when teachers have more experience using them is being examined with a second year of data. The study will involve teachers who were in the first data collection (those who are teaching in the same school and at the same grade level or subject area) and a new group of students. The second-year study will also report results separately for the various products.
Despite the importance of spelling for both writing and reading, there is considerable disagreement regarding how spelling skills are best acquired. During this and virtually all of the last century, some scholars have argued that spelling should not be directly or formally taught as such instruction is not effective or efficient. We conducted a comprehensive meta-analysis of experimental and quasi-experimental studies to address these claims. The corpus of 53 studies in this review included 6,037 students in kindergarten through 12th grade and yielded 58 effect sizes (ESs) that were used to answer eight research questions concerning the impact of formally teaching spelling on spelling, phonological awareness, reading, and writing performance. An average weighted ES was calculated for each question and the quality of included studies was systematically evaluated. Results provided strong and consistent support for teaching spelling, as it improved spelling performance when compared to no/unrelated instruction (ES = 0.54) or informal/incidental approaches to improving spelling performance (ES = 0.43). Increasing the amount of formal spelling instruction also proved beneficial (ES = 0.70). Gains in spelling were maintained over time (ES = 0.53) and generalized to spelling when writing (ES = 0.94). Improvements in phonological awareness (ES = 0.51) and reading skills (ES = 0.44) were also found. The positive outcomes associated with formal spelling instruction were generally consistent, regardless of students’ grade level or literacy skills.
[Correction Notice: An Erratum for this article was reported in Vol 105(4) of Journal of Educational Psychology (see record 2013-35422-001). In the article “Introduction to the Special Issue on Advanced Learning Technologies” by Vincent Aleven, Carole R. Beal, and Arthur C. Graesser ( Journal of Educational Psychology, Advance online publication. September 9, 2013. doi: 10.1037/a0034155), the name of author Arthur C. Graesser was published with an incorrect middle initial. All versions of this article have been corrected.] The 20 articles in this special issue represent a cross-section of interesting, cutting-edge research in advanced learning technologies (ALTs). These advanced technologies are increasingly being used in educational practice and as convenient platforms for rigorous educational research. Although defining ALTs is difficult, ALTs have 3 key elements to varying degrees. First, these technologies are created by designers who have a substantial theoretical and empirical understanding of learners, learning, and the targeted subject matter. Second, these systems provide a high degree of interactivity, reflecting a view of learning as a complex, constructive activity on the part of learners that can be enhanced with detailed, adaptive guidance. Third, the system is capable of assessing learners while they use the system along a range of psychological dimensions. The emphasis in the special issue is not exclusively on the technologies themselves but more fundamentally on the underlying principles of learning, the interactions with the learners, and the impact of the technologies on learning gains. Key challenges are how to develop and use the technologies in ways that are grounded in theory, science, and sensible practice. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Generally, a person who is diagnosed as dyslexic remains diagnosably dyslexic all his/her life. However, occasionally, an individual compensates for his/her difficulties in some way, and by adulthood is no longer diagnosably dyslexic. In what ways are these compensated dyslexics different from both dyslexics and nondyslexics? We compared IQ, achievement test, and spelling error scores in adult dyslexics, adult nondyslexics, and adult compensated dyslexics (N=25) in the two studies reported here. The second study differed from the first in that the subjects were matched for age, education, IQ, and SES. In both studies, compensateds were significantly different from nondyslexics on the WRAT Spelling subtest and Reading Quotient scores. In the second study the compensateds differed from the nondyslexics in total raw score and average reading speed on Gray Oral Reading Test. On the other hand, they were different from dyslexics on all reading and spelling variables in both studies, except for PIAT Reading Comprehension in Study 2. Finally, in Study 2, the compensateds were different from both dyslexics and nondyslexics in average reading speed. In conclusion, it appears that compensation does not result from differences in IQ, education, or SES, though it may be influenced to some extent by sex. Compensateds appear very similar to nondyslexics in their reading and spelling skills; however, there appears to be a difference in the automaticity with which they apply these skills.
Three exploratory studies were carried out to determine if there was continuity in the development of language in young children at the upper and lower extremes of the normal continuum, and if it was possible to use variables from an early assessment to predict their language status at a later date. Studies 1 and 2 examined continuity over 6‐month periods (from approximately 20 to 26 months and 13 to 20 months of age, respectively); Study 3 examined continuity from 8 to 30 months of age. Results provided solid evidence for continuity at the group level but no evidence of an ability to predict outcome for individual children using the vocabulary production, vocabulary comprehension, and gesture production variables included in this study.
This article reports the results of a meta-analysis of 20 research articles containing 89 effect sizes related to the use of digital tools and learning environments to enhance literacy acquisition. Results (weighted effect size of 0.489) demonstrate that technology can have a positive effect on reading comprehension, but little research has focused on the effect of technology on metacognitive, affective, and dispositional outcomes. We conclude that although there is reason to be optimistic about using technology in middle-school literacy programs, there is also reason to encourage the research community to redouble its emphasis on digital learning environments for students in this age range and to broaden the scope of the interventions and outcomes they study. [This report was produced by Learning Point Associates.]
This article provides an overview of (a) issues in definition and diagnosis of specific reading disabilities at the behavioral level that may occur in different constellations of developmental and phenotypic profiles (patterns); (b) rapidly expanding research on genetic heterogeneity and gene candidates for dyslexia and other reading disabilities; (c) emerging research on gene-brain relationships; and (d) current understanding of epigenetic mechanisms whereby environmental events may alter behavioral expression of genetic variations. A glossary of genetic terms (denoted by bold font) is provided for readers not familiar with the technical terms.
Reading fluency has been identified as a key component in effective literacy instruction (National Reading Panel, 2000). Instruction in reading fluency has been shown to lead to improvements in reading achievement. Reading fluency instruction is most commonly associated with guided repeated oral reading instruction. In the present retrospective study we examine the effects of a computer-based silent reading fluency instructional system called Reading Plus (Taylor Associates, Winooski, Vermount, USA) on the reading comprehension and overall reading achievement of a large corpus of students in an urban school setting. Findings indicate that the program resulted in positive, substantial, and significant improvements in reading comprehension and overall reading achievement on a criterion referenced reading test for Grades 5, 6, 7, 8, and 9 and on a norm-referenced test of reading achievement for Grades 4, 5, 6, 7, 8 and 10. Moreover, mean gains made by students in the Reading Plus intervention were greater than mean gains for all students at the state and district level. The findings were generally positive for all subpopulations studied, including special education and regular education students. Qualitative reports from teachers who participated in the study were also supportive of the program. Implications for the study are explored for particular subgroups of students and for the role of fluency instruction with struggling adolescent readers.
This article uses a review of research to consider a fundamental aspect of reading instruction that has been marginalized in policies and practices over the last decade: the development of silent reading habits that involve strong comprehension and optimal reading rates. The review of research attends to typical development and performances of students at different levels and of varying proficiencies, the relationship between oral reading and silent reading comprehension, and typical instruction. Three studies are also summarized that illustrate growing attention to how comprehension-based silent reading can be supported through instruction. Finally, critical questions are raised that require research evidence if students are to be brought to the optimal comprehension-based silent reading rates needed for the digital–global age.
The effects of mechanical interference, rate of production, and contentless production signals to write more on the quantity and quality of 4th- and 6th-grade learning disabled (LD) students' compositions were examined. A more rapid rate of production did not have a positive impact on the quantity or quality of what LD students produced. The mechanics of writing, however, interfered with both the quantity and quality of compositions. Furthermore, the introduction of contentless production signals led to substantial increases in the amount of text produced as well as small improvements in quality. The results indicated that LD students' writing problems are due, in part, to difficulties with mechanics and problems in sustaining production during writing. Implications for instruction are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Mastering sentence-construction skills is essential to learning to write. Limited sentence-construction skills may hinder a writer's ability to translate ideas into text. It may also inhibit or interfere with other composing processes, as developing writers must devote considerable cognitive effort to sentence construction. The authors examined whether instruction designed to improve sentence-construction skills was beneficial for more and less skilled 4th-grade writers. In comparison with peers receiving grammar instruction, students in the experimental treatment condition became more adept at combining simpler sentences into more complex sentences. For the experimental students, the sentence-combining skills produced improved story writing as well as the use of these skills when revising. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
focuses on measurement issues in the area of printed word recognition and its component orthographic and phonological coding skills [i.e., reading skills] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Two instructional experiments used randomized, controlled designs to evaluate the effectiveness of writing instruction for
students with carefully diagnosed dyslexia, which is both an oral reading and writing disorder, characterized by impaired
word decoding, reading, and spelling. In Study 1 (4th to 6th grade sample and 7th to 9th grade sample), students were randomly
assigned to orthographic or morphological spelling treatment but all students were taught strategies for planning, writing,
and reviewing/revising narrative and expository texts. Both treatments resulted in improvement on three measures of spelling
and one measure of composition. Morphological treatment resulted in better improvement in spelling pseudowords, whereas orthographic
treatment resulted in better improvement in rate of reading pseudowords. In Study 2 (4th to 6th grade sample), students were
randomly assigned to explicit language treatment (phonological working memory+phonological-orthographic spelling+science
report writing training) or nonverbal problem solving treatment (virtual reality-based computer simulation, drawing maps,
and building clay models). Both treatments used science content material and resulted in significant improvement in spelling
and reading pseudowords (accuracy and rate). The surprising finding was that hands-on, engaging science problem solving led
to more improvement in phonological working memory than did specialized phonological instruction. Only when spelling instruction
emphasized orthography or morphology (Study 1) did real word spelling improve.
The purpose of this study was to investigate the relations among oral and silent reading fluency and reading comprehension for students in Grades 6 to 8 (n = 1,421) and the use of fluency scores to identify middle school students who are at risk for failure on a high-stakes reading test. Results indicated moderate positive relations between measures of fluency and comprehension. Oral reading fluency (ORF) on passages was more strongly related to reading comprehension than ORF on word lists. A group-administered silent reading sentence verification test approximated the classification accuracy of individually administered ORF passages. The correlation between a maze task and comprehension was weaker than has been reported for elementary students. The best predictor of a high-stakes reading comprehension test was the previous year's administration of the grade-appropriate test; fluency and verbal knowledge measures accounted for only small amounts of unique variance beyond that accounted for by the previous year's administration.
Individual differences in word recognition, spelling, and reading comprehension for 324 children at a mean age of 16 were predicted from their reading-related skills (phoneme awareness, phonological decoding, rapid naming and IQ) at a mean age of 10 years, after controlling the predictors for the autoregressive effects of the correlated reading skills. There were significant and longitudinally stable individual differences for all four reading-related skills that were independent from each of the reading and spelling skills. Yet the only significant longitudinal prediction of reading skills was from IQ at mean age 10 for reading comprehension at mean age 16. The extremely high longitudinal latent-trait stability correlations for individual differences in word recognition (.98) and spelling (.95) left little independent outcome variance that could be predicted by the reading-related skills. We discuss the practical and theoretical importance of these results and why they differ from studies of younger children.
In the current study, 42 secondary students (10th, 11th, and 12th grade students) and 51 elementary students (4th and 5th grade students) read 400 word passages silently and aloud. During aloud reading, words correct per minute (WCPM) were recorded. After reading each passage, students answered 10 multiple-choice comprehensionquestions. Results showed comprehension was significantly higher when students read passages aloud, as opposed to silently. No interaction was found between comprehension and grade level (elementary versus secondary). Discussion is focused on theories of reading comprehension and applied implications for assessing comprehensionfollowing the administration of Curriculum-Based Measurement (CBM) reading probes.
Good and poor fifth-grade writers differed, after controlling for multiple comparisons, in 42 brain regions on group maps and then individual brain analyses for functional magnetic resonance imaging (fMRI) contrast between tapping adjacent fingers sequentially and same finger repeatedly. Of these, 11 regions were correlated with both handwriting and spelling (transcription). Gender differences on the fMRI contrast, with girls more activated, occurred only in left superior parietal, which was correlated with handwriting and spelling. Significance of serial organization of fingers for handwriting and spelling is discussed.
The first findings from a 5-year, overlapping-cohorts longitudinal study of typical language development are reported for (a) the interrelationships among Language by Ear (listening), Mouth (speaking), Eye (reading), and Hand (writing) in Cohort 1 in 1st and 3rd grade and Cohort 2 in 3rd and 5th grade; (b) the interrelationships among three modes of Language by Hand (writing manuscript letters with pen and keyboard and cursive letters with pen) in each cohort in the same grade levels as (a); and (c) the ability of the 1st graders in Cohort 1 and the 3rd graders in Cohort 2 to apply fast mapping in learning to spell pseudowords. Results showed that individual differences in Listening Comprehension, Oral Expression, Reading Comprehension, and Written Expression are stable developmentally, but each functional language system is only moderately correlated with the others. Likewise, manuscript writing, cursive writing, and keyboarding are only moderately correlated, and each has a different set of unique neuropsychological predictors depending on outcome measure and grade level. Results support the use of the following neuropsychological measures in assessing handwriting modes: orthographic coding, rapid automatic naming, finger succession (grapho-motor planning for sequential finger movements), inhibition, inhibition/switching, and phonemes skills (which may facilitate transfer of abstract letter identities across letter formats and modes of production). Both 1st and 3rd graders showed evidence of fast mapping of novel spoken word forms onto written word forms over 3 brief sessions (2 of which involved teaching) embedded in the assessment battery; and this fast mapping explained unique variance in their spelling achievement over and beyond their orthographic and phonological coding abilities and correlated significantly with current and next-year spelling achievement.
Purpose: The purpose of this study was to determine whether specific language impairment (SLI) and dyslexia are distinct developmental disorders.
Method: Study 1 investigated the overlap between SLI identified in kindergarten and dyslexia identified in 2nd, 4th, or 8th grades in a representative sample of 527 children. Study 2 examined phonological processing in a subsample of participants, including 21 children with dyslexia only, 43 children with SLI only, 18 children with SLI and dyslexia, and 165 children with typical language/reading development. Measures of phonological awareness and nonword repetition were considered.
Results: Study 1 showed limited but statistically significant overlap between SLI and dyslexia. Study 2 found that children with dyslexia or a combination of dyslexia and SLI performed significantly less well on measures of phonological processing than did children with SLI only and those with typical development. Children with SLI only showed only mild deficits in phonological processing compared with typical children.
Conclusions: These results support the view that SLI and dyslexia are distinct but potentially comorbid developmental language disorders. A deficit in phonological processing is closely associated with dyslexia but not with SLI when it occurs in the absence of dyslexia.
To propose a five-step multigating, multimodal procedure for research case definition and identification of attention-deficit/hyperactivity disorder (AD/HD) in population-based epidemiologic studies.Methods
Subjects included a birth cohort of all children born in Rochester, MN, during 1976 to 1982 who remained in Rochester after age 5. Systematic screening for potential cases of AD/HD required four initial steps that included information from school and medical records, a computerized diagnostic index, and private psychiatry records—sources available for all children. In step 5, research diagnostic criteria were applied to all potential cases. The model for defining cases consisted of applying combinations of three categories of information (DSM-IV criteria, questionnaire results, and clinical diagnosis). Validity of the model was tested by comparing different measures (e.g., medication treatment, substance abuse, school outcomes, comorbidities) between subgroups of AD/HD cases who met DSM-IV criteria and those who did not. Chi-square and Wilcoxon sum tests were used to compare categorical and continuous scaled variables between these two groups.ResultsAmong 5718 subjects, 1344 potential cases were identified, 379 of whom met research criteria for AD/HD. No significant difference in gender, treatment, school outcome and specialty of professionals making clinical diagnoses was found between cases who did (N = 228) and did not (N = 151) meet DSM-IV criteria. Compared with cases that met DSM-IV criteria, cases who did not meet DSM-IV criteria were more likely to be inattentive (33.8% vs. 17.1%; P < 0.001), older when criteria were met (mean age 12.8 vs. 10.5; P < 0.01), and have fewer psychiatric comorbidities (17.9% vs. 32.0%; P < 0.001).Conclusion
These data underscore the importance of using multiple sources and combinations of documented information for case definition. If DSM-IV criteria alone had been used in this study, 151 mild cases of AD/HD would not have been identified. Studies done in this thorough manner will further the understanding of frequency, risk factors, natural history, treatment, and outcome of children within the spectrum of AD/HD.
The purpose of this review is to learn from rigorous evaluations of alternative technology applications how features of using technology programs and characteristics of their evaluations affect reading outcomes for students in grades K-12. The review applies consistent inclusion standards to focus on studies that met high methodological standards. A total of 84 qualifying studies based on over 60,000 K-12 participants were included in the final analysis. Consistent with previous reviews of similar focus, the findings suggest that educational technology applications generally produced a positive, though small, effect (ES = +0.16) in comparison to traditional methods. There were differential impacts of various types of educational technology applications. In particular, the types of supplementary computer-assisted instruction programs that have dominated the classroom use of educational technology in the past few decades were not found to produce educationally meaningful effects in reading for K-12 students (ES = +0.11), and the higher the methodological quality of the studies, the lower the effect size. In contrast, innovative technology applications and integrated literacy interventions with the support of extensive professional development showed more promising evidence. Although many more rigorous, especially randomized, studies of newer applications are needed, what unifies the methods found in this review to have great promise is the use of technologies in close connection with teachers’ efforts.
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Initial confirmatory factor analyses showed that parental ratings of 209 children and youth with dyslexia in a family genetics study loaded onto factors for Inattention (Self-Regulation of Covert Attention based on two indicators—Focused and Goal-Directed Attention) and Hyperactivity (Overt Behavior based on two indicators—Motor Control and Inhibition); neither indicator is correlated with age. Structural equation modeling then evaluated a multi-level neural architecture with Covert Attention and Overt Behavior at one level, Word-Level Language Processes (Orthographic, Phonological, and Rapid Automatic Naming) at a second level, and Reading and Writing Achievement at a third level. Covert Attention, but not Overt Behavior, was significantly related to factors for orthographic coding of written words and rapid naming of orthographic stimuli, but not to the phonological coding factor for aural words. These orthographic, rapid naming, and phonological factors had significant paths to reading and writing outcomes, but the Covert Attention factor had links to reading and writing outcomes only through the mediating orthographic and rapid naming factors. Treatment and brain imaging studies provided converging evidence that attention may exert greater effects on orthographic word form than phonological word form. The neurolinguistic significance for a complex brain system, modeled at different levels of analysis, is that non-language processes such as attention may exert distal influences even though language exerts direct proximal influences on reading and writing outcomes; this claim is supported by recent physiological findings about the role of fast visual system as an attention gating mechanism in processing letter sequences. The educational significance is that instruction should direct dyslexic's attention to the orthographic units within written words to facilitate the translating of orthographic into phonological word forms.
Professionals across disciplines who assess and teach students with language problems should develop their own standards for best professional practices to improve the diagnostic and treatment (instructional) services in schools and nonschool settings rather than assessing only for eligibility for categories of special education services according to federal and state special education laws. Participation of professionals from multiple disciplines on teams is necessary but not sufficient unless cross-disciplinary conceptual frameworks are developed and used. Best practices for assessment and intervention for language problems should take into account the patterning of test and other assessment data within 3 kinds of profiles: (1) domains of development-cognition/memory, oral language, sensory and motor, attention and executive function, and social emotional; (2) academic skills-reading, writing, and math; and (3) phenotypes specific to neurogenetic or neurodevelopmental conditions that may apply to the case at hand.
Based on the research on invented and developmental spelling, this book provides a practical way for teachers to study words with students. The framework of the book is keyed to the five stages of spelling or orthographic development so that it complements the use of any existing phonics, spelling, and vocabulary curriculums. The book presents more than 300 word study activities which are set up to follow literacy development from emergent to more mature, specialized stages. Often presented in a game-like format, these activities are actually mini-lessons that draw upon what students concurrently are learning in developmental reading and writing. Chapters in the book are (1) How Words Are Learned; (2) Words and the Development of Orthographic Knowledge; (3) Getting Started: The Assessment of Orthographic Development; (4) What Is Word Study?; (5) Word Study for Emergent Learners in the Preliterate Stage; (6) Word Study for Beginners in the Letter Name Stage; (7) Word Study for Transitional Learners in the Within Word Pattern Stage; and (8) Word Study for Intermediate and Specialized Readers and Writers in the Syllable Juncture and Derivational Constancy Stages. Contains 107 references. A 109-item glossary and a 74-item list of children's literature for word study are attached. (RS)
: To compare risk of written language disorder (WLD) in children with and without speech-language impairment (S/LI) from a population-based cohort.
: Subjects included all children born between 1976 and 1982 in Rochester, Minnesota, who remained in the community after age 5 years (n = 5718). Records from public and private schools, medical agencies, and tutoring services were abstracted. S/LI was determined based on eligibility criteria for an individualized education plan. Incident cases of WLD were identified by research criteria using regression-based discrepancy, non-regression-based discrepancy, and low-achievement formulas applied to cognitive and academic achievement tests. Incidence of WLD (with or without reading disorder [RD]) was compared between children with and without S/LI. Associations were summarized using hazard ratios.
: Cumulative incidence of WLD by age 19 years was significantly higher in children with S/LI than in children without S/LI. The magnitude of association between S/LI and WLD with RD was significantly higher for girls than for boys. This was not true for the association between S/LI and WLD without RD.
: Risk for WLD is significantly increased among children with S/LI compared with children without S/LI based on this population-based cohort. Early identification and intervention for children at risk for WLD could potentially influence academic outcomes.
Background. Previous research in linguistic development in writing has primarily addressed the acquisition of writing, early linguistic development of writing, and spoken-written interactions in the primary phase. This study explored linguistic development in older writers in the secondary phase.Aims. The aims of this 2-year study were to investigate both the linguistic constructions in secondary-aged students' writing, and to explore their understanding of their own writing processes.Sample. The data reported here draws on the first year data collection: a sample comprising two pieces of writing, narrative, and argument, drawn from pupils in year 8 (aged 12-13) and year 10 (aged 14-15). The writing sample was stratified by age, gender, and writing quality.Methods. The writing was subject to linguistic analysis at both sentence and text level, using purpose-built coding frames and a qualitative analysis sheet.Results. The linguistic analysis indicates that the patterns of linguistic development show that the influences of oral speech characteristics are strongest in weaker writing than good writing.Conclusions. Cognitive research into the translation from thought to text needs to address more explicitly the fact that good writing requires not only production of text, but also shaping of text. Although, it is well-understood that learning to be a writer draws on 'talk knowledge', this study makes it clear that one key element in learning to write with accomplishment is, in part at least, learning how not to write the way you talk, or rather acquiring adeptness in transforming oral structures into written structures.
In this invited article, we present an ongoing research program in the area of writing. Although this program has focused on students with learning disabilities (LD) and other struggling writers, it has also concentrated more broadly on issues involving writing development and general writing instruction. One purpose of this review was to share our basic findings in each of these areas, as they have important implications for teaching writing to students with LD. Another purpose was to illustrate how an ongoing research program develops and grows over time. To make this process more concrete, we employed several different literacy devices, including drawing an analogy between the development of our research program and the development of the story line for Star Trek II: The Wrath of Khan. Our final purpose was to describe the research we plan to do in the near future.
This study examines the impact of computer technology (CT) on mathematics education in K-12 classrooms through a systematic
review of existing literature. A meta-analysis of 85 independent effect sizes extracted from 46 primary studies involving
a total of 36,793 learners indicated statistically significant positive effects of CT on mathematics achievement. In addition,
several characteristics of primary studies were identified as having effects. For example, CT showed advantage in promoting
mathematics achievement of elementary over secondary school students. As well, CT showed larger effects on the mathematics
achievement of special need students than that of general education students, the positive effect of CT was greater when combined
with a constructivist approach to teaching than with a traditional approach to teaching, and studies that used non-standardized
tests as measures of mathematics achievement reported larger effects of CT than studies that used standardized tests. The
weighted least squares univariate and multiple regression analyses indicated that mathematics achievement could be accounted
for by a few technology, implementation and learner characteristics in the studies.
KeywordsMeta-analysis-Technology-Mathematics-Achievement-Attitude
This paper elaborates on the components of a working definition of developmental dyslexia. It follows the general format of
a paper by Lyon published in Annals of Dyslexia in 1995, which elaborated on a working definition proposed in 1994 (Lyon,
1995). The current definition agreed on by the work group updates and expands on the working definition from 1994.
Individuals who are anxious about computers may be at a disadvantage in their learning. This investigation focused on the use of home computers for educational purposes. It compared computer anxiety in adolescents with and without a history of special needs related to language difficulties. Participants were 55 17-year-olds with specific language impairment (SLI) and 72 typically developing (TD) peers. Participants completed interviews regarding computer anxiety as well as computer importance and computer enjoyment. Measures of psycholinguistic skills, perceived ease of use and general anxiety were also obtained. Results showed that adolescents with SLI experience more computer anxiety than TD peers and that females are more anxious than males. Level of general anxiety, perceived ease of use and language ability had a direct association and were predictive of level of computer anxiety in adolescents with SLI. In contrast, only perceived ease of use was significantly predictive in TD adolescents. Gender was not a significant predictor in the context of other influential variables. The findings reveal a complex relationship between linguistic, attitudinal and emotional factors and computer anxiety. Adolescents with SLI who are at a greater risk may require multifaceted support for a number of influencing factors including general anxiety.
In this article, I discuss research on the use of technology to support the writing of students with learning disabilities. Struggling writers can benefit from a wide range of computer applications for writing. Word processing, spelling checkers, word prediction, and speech recognition offer support for transcription and revision. Word processing also opens up opportunities for more meaningful publication of writing. Outlining programs and concept mapping software can help with planning. New forms of writing, including Internet chat, blogs, multimedia, and wikis, have not been studied extensively, but they may offer both opportunities and challenges to struggling writers. In addition to describing the research, I try to articulate some general themes and principles that I hope will be helpful to both teachers and researchers. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (from the journal abstract)
We determined the incidence of written-language disorder (WLD) among children with and without attention-deficit/hyperactivity disorder (ADHD) in a population-based birth cohort.
Subjects included a birth cohort of all children born in 1976-1982 who remained in Rochester, Minnesota, after 5 years of age (N = 5718). Information from medical, school, and private tutorial records was abstracted. Cumulative incidences of WLD with or without reading disability (RD), identified with any of 3 formulas, among children with and without ADHD and hazard ratios (HRs) were calculated.
For both genders, the cumulative incidence of WLD by 19 years of age was significantly higher for children with ADHD than for children without ADHD (boys: 64.5% vs 16.5%; girls: 57.0% vs 9.4%). The magnitude of association between ADHD and WLD with RD was significantly higher for girls than for boys (adjusted HR: girls: 9.8; boys: 4.2; P < .001). However, this was not true for WLD without RD (adjusted HR: girls: 7.4; boys: 6.6; P = .64).
ADHD is strongly associated with an increased risk of WLD (with or without RD) for both boys and girls. Girls with ADHD are at higher risk of having WLD with RD compared with boys with ADHD, whereas boys and girls are at the same risk of having WLD without RD.
The benefits of modern technologies such as personal computers, in-vehicle navigation systems, and electronic organizers are evident in everyday life. However, only recently has it been proposed that the increasing use of personal computers in producing written texts may significantly contribute to the loss of handwriting skills. Such a fundamental change of human habits is likely to have generalized consequences for other basic fine motor skills as well. In this article, the authors provide evidence that the skill to produce precisely controlled arm-hand movements is related to the usage of computer keyboards in producing written text in everyday life. This result supports the notion that specific cultural skills such as handwriting and typing shape more general perceptual and motor skills. More generally, changing technologies are associated with generalized changes of the profile of basic human skills.
An overview of research topics and findings from an interdisciplinary, programmatic line of research on writing over the past 25 years is presented. The cross-sectional assessment studies (grades 1 to 9) showed which measures uniquely explained variance in handwriting, spelling, and composing and thus validated their use in assessment. These and the longitudinal studies (grades 1 to 5 and 3 to 7) contributed to knowledge of the cognitive processes of writing, within a working memory architecture that orchestrates multiple component processes in time to achieve specific writing goals, especially the translation of ideas into words, syntax, and text, and transcription (handwriting and spelling) by pen and by keyboard. Combined brain imaging and behavioral studies of writing have provided converging evidence for brain–behavior relationships for handwriting, spelling, and composing and for the role of temporally coordinated working memory, including an orthographic loop with a graphic-motor envelope for word production. A series of instructional studies for at-risk writers, which was taught to all levels of language to overcome working memory inefficiencies, were organized according to the developmental steppingstones in writing acquisition and show that writing problems can be prevented. Other studies with older, struggling writers validated effective instructional approaches for helping struggling writers become reading-writers who integrate both written language skills in literacy learning.
The aim of this study was to report the incidence rates and other epidemiologic characterizations of written-language disorder. There have been no epidemiologic studies on the incidence of written-language disorder in the United States, and the use of a population-based birth cohort, longitudinally followed, is the most powerful method for reaching this objective.
In this population-based, retrospective birth cohort study, subjects included 5718 children born between 1976 and 1982 in Rochester, Minnesota, who remained in the community after 5 years of age. Records from all public and nonpublic schools, medical facilities, and private tutorial services were reviewed and results of all individually administered IQ and achievement tests, and extensive medical, educational, and socioeconomic information, were collected. The essential features of writing problems from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision were included in our operationalized definition of written-language disorder. Written-language disorder incident cases were established by using research criteria based on 3 formulas (regression-based discrepancy, nonregression-based discrepancy, and low achievement).
Cumulative incidence rates of written-language disorder varied from 6.9% to 14.7% depending on the formula. Boys were 2 to 3 times more likely to be affected than girls regardless of the formula. Among all written-language disorder cases (N = 806), 25% (n = 203) had written-language disorder without a reading disability. Specifics of the writing problems were identified for 87% (n = 702) of written-language disorder cases.
In this population-based birth cohort of school-aged children, written-language disorder was at least as frequent as reading disabilities and significantly more frequent among boys than girls.
A total of 38 problem learners comprising adolescents with learning disabilities and low achievers participated in this study. Of these, 20 were untrained control participants; the remainder were trained to plan, write, and revise opinion essays. Trainees were randomly divided into pairs and taught to collaboratively use interactive dialogues to plan and revise their essays (but they wrote their essays separately). The results from multivariate analyses of variance (MANOVAs) and effect sizes indicated that trainees improved significantly from pretest to posttest in clarity and cogency of written opinion essays, and maintained such gains. Additional analyses indicated that they surpassed the untrained control group. Questionnaire data indicated trainees improved in self-efficacy of writing only. The same finding held true in comparison with untrained participants. The discussion integrates the trainees' performance data with the questionnaire data and considers the research implications and limitations of the study.
Propose a five-step multigating, multimodal procedure for research case definition and identification of attention-deficit/hyperactivity disorder (AD/HD) in population-based epidemiologic studies.
Subjects included a birth cohort of all children born between 1976 and 1982 who remained in Rochester after age 5. Screening for AD/HD required 4 steps, using these sources: school/medical records, computerized diagnostic index, and private psychiatry records. In step 5, research criteria were applied to potential cases. The model for defining cases used combinations of three categories of information (DSM-IV, questionnaire, clinical diagnosis). Validity was tested by comparing medication treatment, substance abuse, school outcomes, and comorbidities between cases who did or did not meet DSM-IV criteria.
Among 5718 subjects, 1344 potential cases were identified; 379 met research criteria. No difference in gender, treatment, school outcome, or professional making clinical diagnoses was found between cases who did (N=228) and did not (N=151) meet DSM-IV criteria. However, cases not meeting DSM-IV criteria were more inattentive (33.8% vs. 17.1%; p < 0.001), older (age 12.8 vs. 10.5 years; p=0.01), with less substance abuse (15.2% vs. 26.3%; p < 0.001) and psychiatric comorbidities (43.1% vs. 54.4%; p=0.031).
If only DSM-IV criteria were applied, 151 cases would not have been identified. This study underscores the importance of using multiple sources and combinations of documented information for case definition and identification.