Rehabilitation and Remediation in Educational Disability: The Use of the Direct Access Reading Technique

Abstract

Educational disabilities are treated very differently from sensory and physical disabilities in at least two distinct ways. The first centers around the way the individual is typically held responsible for the disability. The child is told, "Try harder!" or "Don't be lazy!" No one would think of telling a child with a visual, hearing or mobility impairment to try harder to see, hear or move; rather these children are given support and encouragement. Individuals with physical disabilities are given rehabilitation; that is, they are taught alternative ways to approach the tasks that are affected by the disability. Individuals with educational disabilities are given remediation; that is, more and more practice in precisely what they cannot do. The need to "cure" is given more emphasis in educational disability than physical disability where the stress is on adaptation. The purpose of this paper is to isolate two specific disabilities that are the primary cause of reading disability and to show how a rehabilitation approach can have a profoundly positive effect on this ubiquitous problem.

Introduction

Kalisky, Zenhausern, and Andrews (1989) distinguished two types of reading disabled individuals that seem to account for a very large percentage of these children. The Phonetic Disabled reader has difficulty converting a word to its sound and the Semantic Disabled reader has difficulty converting a word to its meaning. These are the children who struggle with every word when they read. They are frequently anomic, and suffer from a chronic "tip of the tongue". They have difficulty converting both the printed word and the concepts in their minds into words.

The second type of child is the Semantic Disabled reader. These children will give a perfect word-for-word rendition of text, but have no comprehension of its meaning. They can decode, but decoding does not lead to understanding.

This distinction was verified by the use of two matching tasks. Pairs of words were shown to mainstream, Phonetic and Semantic Disabled readers. The Phonetic group made significantly more errors than either of the other two groups when the task was to determine whether words rhymed. In contrast, the Semantic group made significantly and substantially more errors when the task was to determine whether the words had the same or opposite meanings.

Kalisky, et al. have suggested that these phonetic and semantic disabilities can be directly related to the reading disability on the basis of the standard approaches used when teaching reading. Children come to school with auditory comprehension; that is, when they hear the word "ball" they know it means "a round, bouncy thing." Reading means that when children see the letters b-a-l-l they know it means "a round, bouncy thing". Virtually every reading method is based on the strategy of converting the written word to its phonological counterpart so that meaning is derived from auditory comprehension, that is, the indirect phonological route to meaning. The child sees the word, says the word, and understands the word from its sound. This can be most clearly seen in a phonetic approach, but holds equally well for a sight or "look-say" approach.

This method, while effective for most children, is inappropriate for many of those children who are called "reading disabled." The Phonetic Disabled reader cannot convert the word to its sound, and thus is not able to take the first step required by this approach to reading. The Semantic Disabled reader can translate the words to their sound, but then has difficulty comprehending the meaning of the written word from this sound. Therefore, both the Phonetic and Semantic reading disabilities can be directly related to the indirect phonological approaches typically utilized to teach reading.

Remediation techniques refer to the support system that teachers employ when they alter the direct instructional developmental lessons. They are characterized by utilizing the same learning channels with variation of techniques, instructional group size and demands on student production. Unlike rehabilitation strategies for the blind who learn braille to circumvent their disability, the reading disabled learner tends to receive more of the same instruction (Allington, 1986). While "time on task" and "task analysis" have increased productivity levels, the focus has remained on phonological awareness and segmentation activities.

While the concept of alternate modes of instruction has long been a welcome strategy, alternative techniques such as the Orton Gillingham, Distar, Linguistic Approach, Glass Analysis and the Cassil Span Technique are really variations of the phonological awareness and segmentation procedures which rely on the same neurological systems that are malfunctioning for reading disabled students. A rehabilitative approach is one that does not use those systems.

Fernald (1942) developed a tracing activity which can be classified as a rehabilitative technique when the response of the student is not oral. The student traces the letters either on sandpaper or on a piece of nylon screening to increase the tactile input and then responds in writing, eliminating an oral response. When a student uses large arm kinesthesia and resist methods to learn letter recognition, he is working in alternate modalities. These are rehabilitative techniques that impact on the learner the way braille impacts the blind student, that is, using alternative learning channels. These techniques, however, are time-intensive and are not practical in a large classroom setting. The Direct Access Reading Technique (DART), on the other hand, is more easily incorporated.

DART has been developed as the solution to both Phonetic and Semantic reading disability. If a child has a problem reading that arises because of the indirect phonological route to meaning, then do not use that approach. The child in the Direct Access classroom is never required to read aloud, but is asked to explain what a passage of text means. Trivial deviations in verbiage (e.g., "jet" for "plane") are de-emphasized, at least initially. A typical approach involves pairing the printed word with a picture chosen or drawn by the child.

The picture, rather than the sound of the word, serves as the link between the written word and its conceptualization by the child. Abstract concepts are easily handled by the student. For example, one method used involves a class discussion of a concept (e.g., justice). The children are then asked to draw a picture of the concept based on the discussion. The next section provides a summary of previously successful uses of DART.

Evidence in Support of Dart

Maxwell and Zenhausern (1983) isolated 30 first grade children from suburban NY who were considered "at risk" for reading, scoring on average in the 26th percentile on the Metropolitan Achievement Test. Matched samples of 15 students each were selected and randomly assigned to the Direct Access group or to a control group taught by the traditional techniques used by the school.

Both groups were exposed to one of the reading treatments for 25 sessions over a 5-week period. In order to control for differences in teaching ability, both groups were taught by the same teacher who was a reading specialist and who had received specialized training in the Direct Access procedure. At the end of the 5-week period all students were tested with an alternative form of the Metropolitan Achievement Test. The children exposed to DART showed a significant 30 percentile gain in their reading comprehension, while the group using the standard approach showed no change.

Zenhausern, Minardi, and Maxwell (1984) tested 48 Junior and Senior High School students in a New York State B.O.C.E.S. who were considered chronically reading disabled. The students were matched and assigned to the experimental and control groups; the experimental group consisted of 12 Junior and 12 Senior High School students and the control group consisted of an equal number from each level.

Prior to initiation of the study, all participants were given the Metropolitan Achievement Test appropriate for their grade level. The experimental groups received 5 weeks of Direct Access training on a daily basis, while the control group received a special 5-week program in Reading for Meaning. An experienced reading teacher, specially trained in both procedures, was responsible for teaching both groups. At the end of the 5-week period, all students were given an alternative form of the Metropolitan Achievement Test. The Junior HS students exposed to the Direct Access procedures gained 7 months, and the Senior HS students 1.4 years, in their reading comprehension scores; the group using the control condition showed no change.

Kalisky, Zenhausern, and Andrews (1989) tested 200 children in grades 1 through 10, all of whom were reading substantially below grade level. A workshop on the use of Direct Access was presented to the teachers in Greensboro, NC who were then invited to participate in a 10-week trial of the technique. Nine teachers from Grades 1 through 10 volunteered, and the Metropolitan Achievement Test was given on a pre-post basis to all their students. Direct Access was used in the same classroom in which the control groups were taught using standard procedures. The Direct Access group showed substantial gains at all grade levels. The average gain across the entire spectrum was 13.89 NCE (Normal Curve Equivalents), with the 7th and 8th Grade students showing gains of 17 and 18 NCE respectively. The control groups showed an average gain of 2.11 NCE. This study provides evidence that DART can be incorporated into existing classrooms, making it consistent with the goal of inclusion.

In a long term study still in progress (Zenhausern, 1993), students in the Corrective Reading and Resource Room classes of a New York City school were exposed to DART. The students were given DART as part of their regular work for the school years from 1990 to 1992. There is an ongoing consistent trend for students exposed to DART to show substantial gains. There has been a substantial decrease in the number of students falling into the lowest quarter of District-wide norms. The findings must be considered within the framework of virtually unchanged reading scores in District 20, in which the school is located.

The purpose of this study was to report the long term effectiveness of DART with suburban middle school children who were below expectations in reading. This is the first report of its longitudinal use within a consistent and controlled educational framework that allowed the comparison of growth in reading vocabulary and comprehension both before and after the introduction of the program.

The study is a longitudinal study of 60 children who were exposed to DART or served as a comparison group. The study took place in a suburban NY middle school in the Learning Lab facility. The Learning Lab is a diagnostic teaching facility for the mainstream where students are assigned by the Support Team for instructional interventions based on developmental skills and learning styles. A multi-disciplinary team assigns mainstream students for assessment and instruction to assist students in meeting curriculum based requirements. Students identified as learning disabled may be assigned to the Learning Lab as well.

Subjects

Sixty middle school students completing grades 6, 7 and 8 were monitored over a two year interval. During the first year no experimental treatment was employed. During the second year, 30 students were included in the experimental DART group and another 30 were included in the comparison group. Of the 60 total subjects, 30 had a special education identification of learning disability and 30 mainstream students were included in the study. The special education students were assigned for reading and language difficulties and/or as a foundation for mainstream inclusion. All were included in the mainstream for non-academic subject assignments.

The 30 mainstream students were referred for services in the Learning Laboratory by the Support Team. These children had learning difficulties which interfered with classroom performance and have been maintained in the Developmental but did not qualify for special education since their achievement scores reflect adequate progress from year to year.

Dart Procedures

Students participated in the expansion of vocabulary utilizing picture association at the rate of five words per session. An individual card file was established with rehearsal strategies that reflect rate of recall. Pictures were either drawn or placed on the back of each card. Students had the choice of using 3 x 5 cards or 4 x 6 cards. Vocabulary was chosen from personal and assigned reading tasks appropriate to their diagnosed instructional level. Students were encouraged to use trade books as their primary source. Some basal material was employed. All students used printouts from network activities as a source for vocabulary development. A green highlighter was utilized for "known" words in students' oral vocabulary but not in reading vocabulary. A blue highlighter was used for "unknown" vocabulary, that is, words not in the student's oral vocabulary. Blue vocabulary words were introduced on the blackboard using colored chalk. Students were encouraged to formulate their own image. Markers were provided for personalization.

Several sessions a month were restricted to rapid drawings with a pencil. Peers and teacher aids worked to develop a visual image of words that were not presented to the group for instruction. Students were invited to choose between drawing pictures and cutting pictures from magazines. National Geographic magazines proved to be an effective source for all cognitive levels. One student who developed most slowly utilized his social studies text as a source with a loose leaf notebook with clear plastic pockets 8" x 11" to retain picture and vocabulary. All students were required to rehearse for no less than five minutes a day with a study buddy.

Reinforcement strategies varied. Memory games, including concentration, were introduced. Once a word was consistently retrieved without cues for three sessions, the card was placed in the mastery list where vocabulary was eligible for assessment in context. Monthly assessment was conducted on each word in the card file to determine automatization. For each student, no more than five words at a time were permitted to migrate from mastery to working list. Students were allowed to use cards during weekly assessment of comprehension tasks. Progress of students was assessed without access to the file box every two weeks. The students engaged in peer assessment, in which 18" x 36" drawings of phrases were evaluated for accuracy by peers; some examples include dense forest, craggy mountain peak, steel yacht, shimmering river.

Evaluation was on the basis of the Iowa Test of Basic Skills (Forms G and H) which were part of the standard testing program of the school. Scores for the spring 1991, 1992, and 1993 tests were used.

Results

The scores on the Iowa tests for both experimental and comparison groups are presented below (Table 1). These data were subjected to a split-plot analysis of variance with Group (Comparison and Experimental) as the between factor and Area (Vocabulary and Comprehension) and Year as the within factors. The analysis indicated that the main effect of area was significant (F1,58 = 9.97, p < .01) with the Vocabulary subscale (Mean = 43.68) higher than the Comprehension subscale (Mean = 40.01). The main effect of Year was also significant (F2,116= 19.33, p < .01) and Neuman-Keuls analysis indicated that the scores for 1993 (Mean = 44.75) were significantly higher than the scores for 1992 (Mean = 39.81) and 1991 (Mean = 41.06).

Of most importance, however, was the significant interaction between Group and Year (F2,112 = 47.01, p <.01). The means for this interaction can be seen in Table 2. A simple effects analysis showed that there was a significant difference among the three years of the study for both the Comparison and Experimental groups, but the pattern was different for the two groups. The Comparison group showed a steady and significant decline for the three testing periods, but the DART group showed a similar initial drop, followed by a substantial gain. The Comparison group scored higher than the Experimental group for the first two testing periods, but this was reversed for the year following the introduction of DART when there was a substantial gain in mean performance.

The results are clear and need little interpretation. Two groups were followed for three testing periods. Initially, the Comparison group scored significantly higher than the Experimental group and the scores for both showed small losses after the control year of the study. The Comparison group continued this gradual decline after the treatment year, but the Experimental group showed a sharp increase.

Table 2: Interaction of Year and Group Performance (NCE)

General Discussion

The most important practical implication of this study is that a Direct Access approach has been shown to be effective with a chronic special education population. There are, in addition, theoretical implications underlying the effectiveness of the technique. DART is based on the neuropsychological framework of individual differences and the isolation of two distinct subtypes of students with reading achievement problems. The Phonetic Disabled child has a syndrome of problems that are related to the functioning of the brain center that deals with the conversion of mental concepts and perceptual input to the spoken word. They show evidence of dysnomia and phonetic disability. This pattern is consistent with a problem with the left hemisphere speech centers of the brain.

The neuropsychological basis of the problem for the Semantic Disabled child is less clear although the behavior itself is evident. This child has learned to make the connection between the printed word and its sound, but has not learned to make the connection between the printed word and its meaning. It is not an uncommon experience for any of us to suddenly realize that instead of understanding what we were reading, we were merely mouthing words. Whatever this state may be, it is a chronic state for the Semantic Disabled reader.

This model has important social and political implications. A student with an educational disability (e.g., chronic dysnomia) has a disability as surely as a student who is blind and is just as entitled to an accommodation for that disability. The accommodation, however, cannot be typical remediation techniques where the student is given help doing the task within the standard educational framework. Rather the student must be offered an alternative approach which is based on his or her strengths rather than weaknesses.

References

Alpert, Harvey and Carvo, Margaret. _Comprehension Through Keys and Steps
Through Reading_. New York: Casil Publications, 1975.

Fernald, G. (1942). _Remedial Techniques in Basic School Subjects_.
New York: McGraw Hill.

Kaliski, M., Zenhausern, R., Andrews, R. (1989) The direct access
method of teaching reading and the diagnosis and remediation of
reading disability. _International Journal of Neuroscience_, 44, 103-109.

Maxwell, M. & Zenhausern, R. (1983) "Teaching reading to
disabled readers by eliminating the necessity for grapheme to
phoneme conversion." Paper presented at the Eastern Psychological
Association, Philadelphia.

Minardi, A., Zenhausern, R., & Maxwell, M. (1984) "The
remediation of reading disability: A new approach." Paper
presented at the International Neuropsychology Convention, Houston.

Zenhausern, R. (1987) The relationship of reading disability and
the techniques of teaching reading. _International Journal of