General principles of effective instruction for learners with learning difficulties

Many researchers consider that to help children with learning difficulties such as reading difficulties there needs to be a continuum of services, led by general education. These services should be available to all students who struggle with learning in school as a part of a comprehensive effort to include quality interventions in school.

One generally accepted approach is the multi-tiered system of supports (MTSS). This refers to layered interventions as a continuum that begin in general education classes in regular school¹Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press.. Typically, MTSS consists of three tiers to deliver services. Most commonly, the first two tiers occur in the context of general education and the third tier is provided within a special education context. The key is attending to the periodic or ongoing progress-monitoring data that accompany the implementation of interventions. Tiers differ in terms of instructional time, group size, learning environment, and instructional individualisation.

TIER 1 Education for all students includes core instruction, universal screening, and progress monitoring differentiated in the classroom. Students always begin with differentiated instruction in the general education classroom. Instruction occurs as a part of reading instruction and language arts. Through progress monitoring, the teacher can determine students who are making inadequate progress in learning to read, spell, and write. If possible, the teacher may boost learning by creating smaller groups that are more homogeneous in learning these basic skills. It is estimated (in developed countries) that Tier 1 instruction is sufficient for good progress for 75%–90% of students.

TIER 2 This typically changes the learning environment and increases the extent of pedagogical intervention by providing small-group instruction with three to five students with similar educational needs and a teacher. The focus is on specific aspects of reading and writing. Smaller group size increases the explicitness of instruction as well as opportunities to incorporate attention on self-regulation and executive functions that the child has not yet achieved. The student can also receive increasingly precise corrective and motivating feedback from the teacher. It is estimated that about 10%–25% of students may need Tier 2 interventions.

TIER 3 increases time on task by reducing the size of the instructional group. Instruction is often organised as one-to-one at this level; however, groups of two to three students are also very common. In this tier, there is greater emphasis on individualising the intervention according to the child’s specific needs (for example, letter–sound correspondence, decoding, fluency, comprehension, or spelling). This intervention is usually applied for 2%–10% of students.

Instructing learners with learning difficulties

Fletcher et al.²Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press. have also formulated 10 general principles of effective instruction for students with learning difficulties. These are briefly described as follows:

1. Instructional explicitness. This is described by Torgesen³Torgesen, J. K. (2004). Lessons learned from research on interventions for students who have difficulty learning to read. IN P. McCardle & Chhabra (Eds.) The Voice of evidence in reading research (pp. 355-382). Baltimore: Brookes. as ‘instruction that does not leave anything to chance and does not make assumptions about and knowledge that children will acquire on their own’. The teacher tells the students what they need to know with direct explanations, formally sharing new knowledge and modelling the use of the skill or strategy. Based on research, children with reading difficulties are better supported by reading programmes that include explicit instruction than programmes with a less explicit approach based on discovery and inductive learning.

2. Minimisation of the learning challenge. Instructional design that minimises the learning challenge is accomplished by a task analysis that provides the most efficient method for succeeding with instructional objectives. In reading instruction, explicit teaching of grapheme–phoneme (letter–sound) correspondences, decoding, comprehension strategies, and automaticity practice as units may promote efficiency.

3. Proper terminology. It is important to give students with learning difficulties the vocabulary that essentially captures important concepts and procedures. Once these terms are taught, the teacher and student should use them consistently (for example, what is a phoneme? what is the meaning of the ‘main idea’ of the text?). Students with learning difficulties quite often have problems with vocabulary and background knowledge.

4. Speeded practice. For students with learning difficulties, practice needs to be designed to develop reading fluency. The important automatisation of decoding skill will free limited capacity of attention and working memory for higher order aspects of the tasks, such as reading comprehension. The teacher may ask the child to read the same text repeatedly and measure how long it takes for the child to read the text. This practice will demonstrate to the child that it is possible to read more fluently when repeating reading which will also motivate the child to practice reading.

5. Cumulative review. This must be integrated systematically in classroom practices as a way to ensure retention of previously mastered content and skills. New knowledge should be connected to the already existing content and skills.

6. Simple and direct language. Students with learning difficulties are often inefficient processors of language. Therefore, the language of instruction must be simple and direct. The teacher should use short sentences, active voice, unambiguous pronoun antecedents, and other methods to communicate simply, clearly, with simplified explanations. One good method is to ask the student to explain in their own words, which enables checking of their understanding of the material.

7. Incorporation of self-regulation strategies. This principle is related to attentional control, self-regulation, and motivation. These may affect task-orientation, persistence, and learning. Because these students have experienced too many failures in learning situations it will cause them to avoid negative emotions and stress in learning situations and block the learning process. Accordingly, intensive intervention should incorporate motivators and positive feedback from the teacher to help students regulate their attention and behaviour. To encourage hard work, tangible incentives are often required.

8. Comprehensive instructional approach. Too often interventions are too narrow, or students only practice one isolated skill (for example, focusing only on phonics in reading difficulties). Based on research, we know that instruction is more effective if it is focused on all three major components of learning to read: word recognition, automaticity, and comprehension.

9. Extended duration and time on task. Many interventions are too short to provide sufficient time for instruction aimed at students with learning difficulties. Teachers need to monitor carefully how long the student needs support and should continue as long as necessary to support student learning.

10. Progress monitoring. In interventions for students with learning difficulties, teachers need progress-monitoring systems that help the teacher know when to adjust the instructional programme and how to generate ideas for productive adjustments.

In contrast to these principles of effective instruction and intervention, Fletcher et al.⁴Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press. summarise the characteristics of ineffective interventions for students with learning difficulties as follows:

• It does not focus on academic skill,
• It defines academic proficiency narrowly,
• It does not increase instructional time, intensity, or differentiation,
• It does not continually monitor progress and adjust instruction or change programme,
• It teaches for the sake of learning rules, not to master principles,
• It does not engage the child in reading instructional-level material in writing,

It waits for the child to fail and thus leaves the child behind.

Learning to read and word reading difficulties

Based on literature, learning to read for children with reading disabilities is based on the same cognitive processes and developmental steps than for readers without a disability. However, intervention studies demonstrate that dyslexia can be most successfully treated when it is identified early in development and before formal diagnosis. Accordingly, it is possible to prevent early deficits from becoming a disability⁵Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press.⁶Denton, C.A. & Madsen, K.M. (2016). Word reading interventions for students with reading difficulties and disabilities. In R. Schiff, R.M. Joshi (eds.) Interventions in Learning Disabilities. A handbook on systematic training programs for individuals with learning disabilities. (pp.29-45). Springer.

Remedial studies show that foundational skills can be improved in students with difficulties in reading, typically characterised by word recognition difficulties. Results of a meta-analysis⁷Galuschka, K., Ise, E., Krick, k., & Schulte-Körne, (2014). Effectiveness of Treatment Approaches for Children and Adolescents with Reading Disabilities: A Meta-Analysis of Randomized Controlled Trials. PLOS ONE 9(8): e105843. reveal that phonics instruction is the most intensively investigated treatment approach. In addition, it is the only approach where effectiveness in reading and spelling performance for children and adolescents with reading disabilities is statistically confirmed. This finding is consistent with those reported in previous meta-analyses⁸Ehri, L.C., Nunes, S.R., Stahl, S.A., & Willows, D.M. (2001). Systematic phonics instruction helps students learn to read: Evidence from the National Reading Panel’s meta-analysis. Review of Educational Research, 71: 393–447.⁹McArthur G., Eve P.M., Jones K., Banales E., Kohnen S., et al. (2012). Phonics training for English-speaking poor readers. Cochrane Database Syst Rev 12: CD009115.. At the current state of knowledge, it is reasonable to conclude that the systematic instruction of letter–sound correspondences and decoding and the application of these skills in reading and spelling activities is the most effective method for improving literacy skills of children and adolescents with reading disabilities.

The most effective way to teach children to read is with a phonics-based method that emphasises the systematic use of phonics. This approach builds on a child’s strong foundation of phonological awareness. The explicit instructions focus on the sounds associated with the letters while also focusing on how to manipulate, segment, and blend multiple phonemes into words. Reading instruction advances stepwise from letter names and shapes to the correspondences between letters and sounds, starting with simple and regular phoneme combinations. This then progresses on to phonological decoding that emphasises the sound of each letter and how these letters blend together into words. This training emphasises repeated reading of syllables, words, and simple texts¹⁰Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press.¹¹Denton, C.A. & Madsen, K.M. (2016). Word reading interventions for students with reading difficulties and disabilities. In R. Schiff, R.M. Joshi (eds.) Interventions in Learning Disabilities. A handbook on systematic training programs for individuals with learning disabilities. (pp.29-45). Springer¹²Castles, A., Rastle, K., & Nation, K. (2018). Ending the reading wars: Reading acquisition from novice to expert. Psychological Science in the Public Interest, 19, 5–51..

Because phonics-based instruction is heavily based on phonological awareness, phonemic awareness training is widely recognised as being effective for the remediation of preschool children at risk of reading disabilities¹³Bus, A.G., & van Ijzendoorn, M.H. (1999). Phonological awareness and early reading: A meta-analysis of experimental training studies. Journal of Educational Psychology, 91: 403–414. However, when phonemic awareness interventions are provided to school-aged children and adolescents with reading difficulties, they may no longer have a significant effect on reading or spelling performance. This indicates that phonemic awareness training alone is not sufficient for achieving substantial improvements; however, the combination of phonemic awareness training and reading practice represented by phonics instruction has the potential to increase the reading and spelling performance of children and adolescents with reading disabilities¹⁴Galuschka, K., Ise, E., Krick, k., & Schulte-Körne, (2014). Effectiveness of Treatment Approaches for Children and Adolescents with Reading Disabilities: A Meta-Analysis of Randomized Controlled Trials. PLOS ONE 9(8): e105843..

It may be concluded that consistent with prior research, this analysis demonstrates that severe reading and spelling difficulties can be ameliorated with appropriate treatment. However, it is apparent that there are also many treatment approaches both in the literature and on the Internet that are not based on research findings but promise to help students who struggle with reading. Some examples of these methods are as follows¹⁵Snowling, M.J. (2019) Dyslexia. A very short introduction. New York: Oxford University Press.:

• Studies that try to enhance reading and spelling skills of children and adolescents with reading disabilities using medication (nootropic piracetam) demonstrated only minor effects, and the mean effect size for reading performance did not reach statistical significance. With the possibility of side effects in mind, the risks of medication seem to outweigh any benefits.
• Auditory training intends to foster reading and spelling by focussing on the underlying causes of poor performance. At first glance, this approach seems convenient, but the results of the present meta-analysis (e.g. 4) demonstrate that auditory training does not significantly improve children’s reading and spelling skills.
• Coloured lenses (Irene lenses) could not demonstrate any positive effect on literacy achievement, and many systemic reviews suggest that results in some studies are mainly due to placebo effects.

Prevention of reading difficulties

Prevention programme for reading difficulties typically include (at preschool, kindergarten, or the beginning of school): screening assessment to identify students with difficulties in acquiring foundational skills in word recognition and fluency, and target interventions to address specific deficits. Screening instruments usually include simple tasks that assess the following¹⁶Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press.¹⁷Snowling, M.J. (2019) Dyslexia. A very short introduction. New York: Oxford University Press.:

1. Phonological awareness (sounds of spoken language: words, syllables, or phonemes; namely, individual sounds as the smallest units of spoken language)
2. Letter knowledge (naming letters or Letter knowledge)
3. Grapheme–phoneme correspondences (letter–sound) also GraphoLearn
4. Rapid automatised naming (RAN)
5. Verbal working memory
6. Reading accuracy of syllables and short familiar words

Prevention programmes usually focus on children who have difficulties in these screening tasks and are therefore considered at risk of reading difficulties¹⁸Puolakanaho, A., Ahonen, T., Aro, M., Eklund, K., Leppänen, P., Poikkeus, A., Tolvanen, A., Torppa, M. & Lyytinen, H. (2007). Very early phonological and language skills: estimating individual risk of reading disability. Journal of Child Psychology and Psychiatry, 48 (9), 923–931.. Classroom and tutorial studies show that early intervention may reduce the number of these students, including those who might eventually be characterised as dyslexic as well as those who are economically disadvantaged and may be poorly prepared to read. Intervention studies that address the bottom 10%–25% of the student population will significantly reduce the number of at-risk students¹⁹Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press..

The acquisition of well-developed reading skills is a fundamental goal of children’s early educational experiences. During the initial years of formal education, children need to learn the skills associated with both reading and writing because these skills are utilised later in their education both to transmit and to evaluate knowledge. Studies of children early in their educational experiences indicate substantial stability in children’s literacy-related skills. Children who develop good literacy skills early on are likely to be good readers at the end of elementary school, and children who have weak literacy skills early in elementary school are likely to remain poor readers²⁰Lonigan, C. J., & Phillips, B. M. (2016). Response to instruction in preschool: Results of two randomized studies with children at significant risk of reading difficulties. Journal of Educational Psychology, 108(1), 114–129..

Because early reading skills predict later school performance, there has been increasing recognition of the significance of the preschool years for the development of later academic skills, including reading. Studies of children prior to school entry have identified the skills (phonological awareness, letter knowledge) that are predictive of later reading ability. These emergent literacy skills are conceptualised as the basic building blocks onto which children’s later literacy skills are built. Children with well-developed emergent literacy skills are those least likely to develop later reading problems.

In preventive interventions, the main focus has been on developing phonological awareness and letter-sound connections. Usually, interventions are organised and conducted in classrooms or small groups, sometimes as one-to-one sessions in early childhood education. Sometimes, direct teaching of reading, spelling, and writing of letters and familiar words are included in these programmes. There are also approaches that try to strengthen oral language skills, such as vocabulary and narrative. One example of these methods is ‘dialogic reading’ in which the child and the adult read a book together. The adult prompts the child with questions about the story as it unfolds to create a dialogue and increase the child’s vocabulary and language comprehension. Research evidence suggests that early interventions delivered by trained teaching assistants can be effective in promoting the foundations of literacy in children at risk of dyslexia associated with poor oral language at school entry²¹Hulme, C., & Melby-Lervåg, M. (2015). Educational interventions for children’s learning difficulties. In A. Thapar et. Al. (eds.) Rutter’s Child and Adolescent Psychiatry (pp. 533-44. Wiley..

Computer-aided technologies and serious games such as GraphoGame (GG) or GraphoLearn (GL) are also very good research-based methods when combined with traditional teaching to boost the prerequisites of reading skills such as letter–sound connections. There are already versions of the GG/GL games in some African local languages and research evidence that shows the effectiveness of this approach.

Research of early interventions²²Fletcher, J.M., Lyon, G.R., Fuchs, L.S. & Barnes, M.A. (2019). Learning disabilities. From identification to intervention. Second edition. New York: The Guilford Press. support the idea that early intervention is more effective than remediation after children fall behind, while the explicit instruction in the alphabetic principle is more effective than providing implicit or incidental instruction. Group size is also important, and based on research, small group instruction (ratio of 1:3) is likely sufficient for many young struggling readers at TIER 2. In terms of instruction methods, the synthetic phonics approaches are effective.