Using Computer-Assisted Instruction and the Nonverbal Reading Approach to Teach Word Identification Mari Beth Coleman-Martin, Kathryn Wolff Heller, David F. Cihak, and Kathryn L. Irvine
This study determined if the use of computer-assisted instruction would be an effective method to promote word identification using the Nonverbal Reading Approach (NRA). Three students with severe speech impairments and concomitant physical disabilities or autism were provided decoding and word identification instruction using the NRA across three conditions simulating the natural progression of classroom instruction from teacher-directed to computer-assisted instruction. The three conditions were (a) teacher only, (b) teacher plus computer-assisted instruction, and (c) computer-assisted instruction only. All participants reached criteria in each of the three conditions. Results indicate that the NRA can be effectively delivered through computer-assisted instruction, thus freeing up teacher time and providing students with the ability to practice decoding and word identification independently.
O
ne of the most basic skills taught in schools is word identification. Students who fail to develop strategies for word identification are at serious risk of academic failure because of the debilitating effects on other reading skills, such as fluency and comprehension (Adams, 1990). Word identification strategies, including decoding strategies, may be especially difficult to teach to students who have disabilities that result in a loss of speech. When students do not have the ability to speak a word or its sounds aloud, teachers need to use specialized teaching strategies and adaptations to provide effective and efficient instruction. Students especially at risk for reading difficulties are those who lack speech, due to either a physical disability (e.g., cerebral palsy, brain injury) or autism. Reasons for these differences in reading abilities may be due to different background and reading experiences (Koppenhaver & Yoder, 1993), ineffective reading strategies, and
decreased phonological processing abilities (Vandervelden & Siegel, 1999). Background experiences and reading experiences can differ significantly for students with severe speech and physical impairments or autism. These students may lack common experiences and have fewer literacy experiences due to mobility issues, low expectations, and decreased time in literacy activities (Blischak, 1995; Heller, 2005; Koppenhaver, Evans, & Yoder, 1991; Light & Smith, 1993). Reading experiences can also differ due to these students' limited ability to interact during reading activities. Lack of speech results in an inability to ask questions, request information, and engage in interactional conversations about reading materials (Blischak, 1995). Even if students have augmentative and alternative communication (AAC) systems, the system may not allow for sufficient questionasking, particularly if the student cannot create a novel message due to lack of literacy skills (Heller, Fredrick, Tumlin, & Brineman, 2002). Lack of such experiences may have an effect on literacy learning. Students with severe speech impairments may lack effective reading strategies. Without the use of effective teaching strategies, children with autism or intellectual disabilities may have difficulty understanding instructional tasks, may not re ceive sufficient repetition to assure success and maintenance of the instructional target, or may have insufficient motivation to learn the reading task. Additionally, they may need reading instruction that uses strategies that differ than those from typical literacy instruction (Basil & Reyes, 2003). This is especially true of students who have limited speech in addition to autism or physical disabilities. Research has suggested that early word reading may be causally related with phonological processing abilities (Adams, 1990; Wagner et al., 1997). Several studies have examined the
FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABIUTIES VOLUME 20, NUMBER 2, SUMMER 2005 PAGES 80-90
VOLUME 20, NUMBER 2, SUMMER 2005
81 phonological processing differences in children who are motorically unable to produce speech sounds (Foley & Pollatsek, 1999; Redmond & Johnston, 2001; Vandervelden & Siegel, 1999). When compared to a younger reading-level matched comparison group, individuals with severe speech and physical impairments performed lower in all areas of phonological processing skills (Van-dervelden & Siegel, 1999). This may be related to the inability of individuals with severe motor speech deficits to subvocally rehearse phonemes. Without the ability of subvocal rehearsal, the phonological code may not be retained in short-term memory, thus inhibiting the learning of reading skills (Foley & Pollatsek, 1999). In their examination of phonological processing and working memory, Foley and Pollatsek (1999) found that 12 adult participants with anarthria and dysarthria who had reading levels at or above the third-grade level and who demonstrated average language comprehension at the discourse level still performed less efficiently in decoding than expected given their age and reading levels. Even though their performance wvas not equal to peers', some of the participants with anarthria in this study were able to decode words as well as nonwords. This suggests that the ability to produce speech sounds is helpful but not mandatory for obtaining reading abilities. These results are consistent with findings by Sandberg (2001) in which seven elementary children with severe speech and phvsical impairments performed lower on reading and writing tasks before and after 3 years of school experience. One specific task on which these students continued to perform lower was the task requiring spelling of lengthier words. When encoding errors were examined, students with typically developing speech made more phonetically acceptable errors, and students with severe speech and physical impairments made more omission errors. These results seem to support the findings of Foley and Pollatsek regarding working memory in individuals with severe speech and physical impairments and suggest that this may transfer to writing as well as reading. The process of decoding and encoding required for individuals with severe speech and physical impairments requires the use of internal speaking of phonological codes. One of the interventions found in the literature that addresses internal speech is the Nonverbal Reading Approach (Heller, Fredrick, & Diggs, 1999; Heller et al., 2002). Through the Nonverbal Reading Approach (NRA), students are taught a metacognitive strategy using internal speech for decoding words. This method also uses diagnostic distractor arrays and error analysis to assess students' ability to read target words. The NRA contains elements that have been identified as consistent with good teaching, such as systematic sequencing, drill-repetition-practice-feedback, teacher models, and systematic probes (Swanson, 1999). The NRA is implemented by the teacher in the form of guided practice to teach a decoding strategy to the student, as well as the specific target words. Systematic probes are performed through the use of the diagnostic distractor arrays and error analysis. Students receive corrective feedback and additional instruction for
words on which they make errors. Additionally, the NRA is typically used with a phonological-based reading series, such as those using Direct Instruction, which follows a clear sequence and provides students with additional knowledge of strategies for applying alphabetic knowledge to decode words. This is consistent with Swanson, Hoskyn, and Lee's (1999) meta-analysis of interventions of students with learning disabilities, which found higher effects for interventions that included a combination of direct instruction and strategy instruction. Heller et al. (1999) demonstrated the effectiveness of the NRA in teaching reading recognition to individuals with severe speech and physical impairments. Additionally, the NRA has been effective for students in teaching generalization of the strategy using internal speech to decode words with similar phoneme sequences (Heller et al., 2002). The use of this method provides students who are unable to verbally rehearse words with a strategy for applying alphabetic knowledge through internal speech for reading decoding. One possible method of providing structured independent practice is through the use of computer-assisted instruction (CAI). CAI has enhanced students' word-recognition skills. Fiedorowicz (1986) used CAI procedures that emphasized accuracy and speed of response to letters, syllables, and words to improve decoding skills and phonetic knowledge of students with reading disabilities. Students with learning disabilities also made significant gains in their speed and accuracy with a list of single-syllable, phonetically regular words, given practice with the computer (Jones et al., 1987). Moreover, the effects of this practice generalized to reading unpracticed words containing the same medial vowels with novel initial and final consonants. In another study, students with learning disabilities practiced two- and three-syllable words using a multiplechoice format. The CAI practice transferred to oral reading of the words in print (Torgesen, Waters, Cohen, & Torgesen, 1988). Additionally, CAI has improved reading skills such as vocabulary (Johnson, Gersten, & Carnine, 1987), comprehension (VanDen Meiracker, 1987), and reading engagement (Harper, 1986). CAM offers certain advantages for word recognition for students wvith reading disabilities (Wong, 1991). It affords extensive one-to-one practice within classrooms wvith a minimum of teacher supervisory time (Torgesen et al., 1988) andcvith protection from potential embarrassment in front of classmates. CAI provides immediate response feedback to students so that errors can be corrected immediately. Some CAI programs can monitor both speed and accuracy of response and pace of instruction according to mastery requirements. Also, CAI can alleviate the boredom of traditional drill exercises. CAI has been used effectively with children who have autism for instruction of phonological awareness skills (Heimann, Nelson, Tjus, & Gillberg, 1995; Tjus, Heimann, & Nelson, 1998). In addition, Williams, Wright, Callaghan, and Coughlan (2002) found that students with autism performed better on reading target words when they were pre-
FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
82 sented in a CAI format than when presented in a traditional book format. The authors proposed that this was due to increased time attending to the reading materials on the computer. Little research exists on the use of CAI in teaching word identification to students with impaired speech and accompanying physical disabilities or autism. CAI has the potential of providing efficient practice and time management, should it be used as an alternative to providing repeated practice by the teacher. This study's purpose was to determine if the use of CAI would be an effective method for teaching students to learn target words using the NRA. Computer-assisted instruction was delivered using the guided practice component of the NRA after initial instruction, which is teacher-led, to familiarize the students with the NRA, followed by a combination of teacher and computer instruction to familiarize the student with the CAI.
Method Participants Three participants were selected for this study (see Table 1). The criteria for selection were (a) having a severe speech impairment, (b) having letter-sound correspondence of the alphabet, (c) having a reading recognition level at or above the first-grade and below the third-grade level, (d) having at least a 2-year difference between chronological age and expected reading level, (e) having never used the NRA, and (f) being able to see print. Alice was an 11-year-old student with cerebral palsy, speech and language disability, and hypoplastic left heart syndrome. She was originally in a program for students with severe and profound intellectual disabilities. However, once she was able to respond in a reliable manner, she was found to have a faster rate of learning than would be expected of a student with that cognitive level. The Comprehensive Test of Nonverbal Intelligence (CTONI; Hammill, Pearson, & Wiederholt, 1996) taken at that time (2 years prior to the study) resulted in an IQ of 81. At the time of this study, she was enrolled in a collaborative program in which she received reading in a resource room and math and writing in a self-contained class-
room for students with orthopedic impairments (OI). She had a 2.9 reading level, according to the Peabody Individual Achievement Test-Revised (PIAT-R; Markwardt, 1989). She used Speaking Dynamically Pro (SDP) on a laptop computer for communication, in addition to being able to verbalize a few words. When choices were presented in a multiple-choice format, she would answer "yeah" to indicate her choice. Beth was a 12-year-old student with autism who was enrolled in a self-contained classroom for students with moderate intellectual disabilities (MOID). Informal teacher assessment revealed word recognition skills at the second-grade level. She used an Inkidu augmentative communication device to communicate. She used the Inkidu or gestures (thumbs up or thumbs down) to indicate her choice when presented with words in a multiple-choice format. Carrie was a 16-year-old girl who had a diagnosis of brain injury due to a stroke she had in third grade. She was enrolled in a classroom for students with MOID. She had splinter skills and was on a first-grade reading recognition level. She used a Dynavox augmentative communication device and gestures to communicate. She indicated her choice in this study by placing her right hand on the evaluator's hand when she heard the correct answer.
Materials and PowerPoint Software The target words were displayed either on index cards or on the computer using PowerPoint software. In both instances, the tester verified that the font size was appropriate for the student and could be seen clearly. Words were displayed using high contrast. All words were presented in lower case because that is the most frequently encountered format in books and reading materials. During CAI, words were presented using the PowerPoint software that came with the standard Microsoft Office package. A series of PowerPoint slides were created for each target word (see Figure 1). Each slide had a visual and auditory component. The first slide for each word began by showing the student the entire word and encouraging her to slowly say the word aloud as the word was slowly pronounced by the computer program. This step was designed to promote active participation by having the student make sounds or sound ap-
TABLE 1 Participants Student
Age
Disability
Placement
Reading recognition
AAC
Alice
11
Cerebral palsy
01 program
2.9 grade levela
SPD
Beth
12
Autism
MOID program
2nd grade levelb
Inkidu
Carrie
16
Brain injury from a stroke
MOID program
1.0 grade level'
Dynavox
Note. AAC = augmentative and alternative communication; 01 = orthopedic impairment; SPD = Speaking Dynamically Pro; MOID = moderate intellectual disabilities. aBased on Peabody Individual Achievement Test-Revised (PIAT-R; Markwardt, 1989). bBased on inventory of words by grade level. 'Based on Edmark Reading Program and graded word lists.
VOLUME 20, NUMBER 2, SUMMER 2005
83 proximations whenever possible. This step helped verify that the student was paying attention. The next slide showved the first phoneme of the target word in a dark color, and the student was instructed to say that sound in her head while the digitized voice said the sound aloud. Subsequent slides showed the followring phonemes presented in the dark color while the preceding phoneme remained on the screen but changed to a lighter color. For each phoneme, the digitized voice said the dark-colored sound aloud. Slides were recorded with timed narration so that there were no breaks between the phonemes. Once each phoneme was presented, the entire word appeared on the screen in the dark color and the student was instructed to sound out the Nvord sloNvly in her head without stopping between sounds while the digitized voice read the word slowly. The next screen showed the entire word in the same dark color with a slightly larger font and instructed the student to read the word in her head quickly while the voice read the word aloud. The final screen for the trial on each word was a reinforcer screen that had a colorful picture and a reinforcement phrase such as "Excellent!"
Procedure Preintervention Assessment. Prior to intervention, each student Nvas tested on a series of words to eliminate words that the student had previously learned. Students' words were chosen from higher level lessons on their classroom reading series. Students' teachers provided the researchers with lists of at least 25 possible words. The researchers then eliminated words that were irregular or words that could not be easily decoded. Words from this remaining list were then pretested three times in a one-on-one setting. Each wvord was written on an index card in a font size large enough for the student to see. For each word, three similar words were chosen as distractors. For example, given the target word, "snap," the distractors were "snip, "snare," and "pan." Words and distractors were randomly ordered for each session. For each word, pretesting involved the teacher's telling the student to look at the word and then asking her to identify the correct word from the four choices (i.e., the target word and three distractors in random order). To be included in the study, a word had to have been correctly identified with 33% accuracy or less. Fifteen words were randomly selected for each student from the pool of words that were identified wvith 33% accuracy or less. After words were selected, they were divided into three sets of five. Words were randomly separated into three sets, with adjustments made to the sets so there were no similar words across conditions, thus preventing generalization between conditions. Instruction Using the NRA. Instructional sessions were conducted in a one-on-one setting using the NRA, a systematic method for teaching reading to students with severe speech and physical impairments (Heller et al., 1999). The NRA uses a guided practice component to teach students target words and an evaluation component to determine if the
words have been learned and to identify the types of errors being made. During the guided practice of the NRA, students were taken through three steps: (a) directions about what they were going to do, (b) encouragement to try to say the words aloud after the teacher model to promote active participation, and (c) the use of a metacognitive strategy to decode words using internal speech. The script used for guided practice was identical, whether the student was being taught by the teacher or by the computer with the PowerPoint slides. To start off the session, the student was told that she wvas going to sound out some words. In the first step of guided practice, one word wvas displayed while spoken aloud. The student was encouraged to say the word aloud. Any verbalization or attempt made by the student was acceptable during this step, because this step was to encourage active participation. The rest of guided practice consisted of teaching the student the metacognitive strategy used in the NRA to decode words. This is a three-part process in which the student is taught to (a) individually say the smaller units of the word (typically phonemes for smaller words), using internal speech while the teacher or computer says them aloud; (b) say the smaller units without stopping between the sounds, using internal speech while the teacher or computer says the word aloud slowly; and (c) say them all together fast, using internal speech while the teacher or computer says the word aloud. In this study, to guide the students to break the word down into smaller units, the teacher or computer showed the first phoneme (by covering the rest of the word with a card or highlighting the target phoneme on the computer) and instructed the student to say the sound "in [her] head" while the sound was said aloud by the teacher or computer. Subsequent phonemes were displayed (by uncovering them with a card or highlighting them on a computer), and this procedure was repeated until the end of the word. Next, the student was shown the entire word and told to say the word slowly in her head without stopping between sounds while each phoneme was spoken aloud (by the teacher or computer) as the teacher pointed to each phoneme or each phoneme was highlighted by the computer. Finally, the student was instructed to say the word quickly in her head, followed by the word being read aloud by the teacher or computer. At the end of the trial, reinforcement was provided in the form of praise. Evaluation Using the NRA. After guided practice sessions with either teacher-only, teacher-plus-CAI, or CAI-only instruction, students were provided with a break in which they participated in other activities (e.g., other instruction, snack). Following this break, testing was done using the evaluation component of the NRA, which consists of diagnostic distractor arrays and error analysis. The use of diagnostic distractor arrays involved presenting the target word and three predetermined distractor words that were similar to the target word for the student to choose from. Distractors were carefully selected to help determine the type of errors that were being
84
PowerPoint Slide
man
Computer voice output
Steps
"Let's look at this word together. Say this word with me slowly. nunaann."
Step 1: Active participation
"Now, in your head, say this sound, mmm."v
Step 2: Saying each sound using internal speech
"...aaa..."
Note: There is no break between sounds on these slides.
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"Now in your head, say this word slowly. Don't stop between the sounds. mmmaaannn"
Step 3: Saying the word slowly using internal speech
"Now, in your head, say this word fast. Man."
Step 4: Saying the word quickly using internal speech
"Excellent!"
Step 5: Reinforcer slide
FIGURE 1. A sample of PowerPoint slides for one word showing the steps and the voice output provided by the computer.
VOLUME 20, NUMBER 2, SUMMER 2005
85 made (e.g., vowel confusion, not attending to the ending of words, confusing "b" and "d" sounds). When an incorrect word was selected, the incorrect word that was chosen was recorded and the teacher provided correction. An error analysis wvas also performed to determine the precise error the student was making in each trial and any error pattern that could be detected across the session. During the evaluation part of the NRA, distractors are typically changed to reflect a student's error patterns. For example, if a student confuses two vowel sounds (e.g., "a" and "e"), other target words that contain these vowel sounds will need to have their distractor words changed to contain the vowel that was incorrectly selected. By having words included in the distractor array that contain past errors, the teacher can determine if the student has learned from corrective instruction or if she is repeating the same error pattern. The error would go undetected if the distractors are not changed to assess whether the student is doing it correctly across other words. Throughout each session, the order of the distractors must be randomized so that the target word is not alvays in the same position. Words are also randomized in their presentation across sessions. Evaluation sessions took place in the same setting as instructional sessions. Evaluation sessions began with the teacher explaining that she was going to check to see which words the student knew. Evaluation sessions were identical regardless of the instructional condition. The teacher then presented the written word to the student and guided the student to sound out the word in a manner similar to guided practice; however, during evaluation sessions, the teacher did not provide the sounds for the student. After guiding the student through the strategy for sounding out the wvord, the teacher then told the student that she would provide four choices and that the student should indicate which choice was the word being shown. The teacher then provided all oral choices and recorded the student's choice on a data sheet. The four choices consisted of the target word and three distractors. Oral distractors were used rather than having the student choose between written words because this oral presentation requires that the student accurately decode the word instead of being able to use visual cues within the words to make the correct choice. When providing oral choices, teachers were careful to remain consistent on word presentation so as not to provide unintentional cues. Distractors were chosen based on their phonological similarity to target words rather than their orthographical structure (e.g., "send" and "cinder") because they were being presented orally. Teacher Questionnaire. A questionnaire was developed to determine teachers' opinions about using CAI to guide the student through the NRA decoding process. Questions consisted of the following: ease of use, effectiveness as compared to teacher instruction, efficiency, student motivation, and general impression. Teachers selected answers based on a 5-point Likert scale.
Design A multiple-conditions design with drop-down baselines was used to investigate the effectiveness of teaching word identification using the NRA across three conditions: (a) teacher instruction only, (b) teacher and CAI, and (c) CAI only. Data collection occurred across three students with limited speech and accompanying physical disabilities or autism. Data were graphically displayed across all three conditions and baseline phases. Three baselines were conducted during this study. During each baseline, words were assessed across each student for three sessions. The first baseline consisted of the results of the preintervention assessment of 15 words that were selected for the study. The second and third baselines occurred after treatment phases to assess if the student was able to identify words from the initial baseline, which had not yet been taught. After the first baseline, five words were taught using the NRA with the teacher-only condition. No CAM was used in this condition. The sessions began by teaching the student the words using the guided practice component of the NRA. After receiving guided practice on the five target words for three times each, the students were given a break (e.g., instruction in another area, snack). The students were then tested on mastery of the five target words with the use of the same diagnostic distractor array used during baseline. This was followed by another session in which the students were tested on the same five target words with modifications to the distractor arrays, based on student errors in the preceding session. This procedure allowed the same baseline conditions (with the same distractor arrays) to be present across alternating sessions to assure that arrays were not modified to be easier or harder than baseline conditions. This procedure also allowed the distractor arrays to be modified as needed on the other alternating sessions, based on any patterns found in the error analysis of the preceding sessions' data. Instructional sessions continued until the student reached criterion of 80% for two consecutive sessions, with a minimum of four sessions in this phase to be sure the student had repeated exposure to the NRA. This condition was followed by the second baseline phase. The next treatment phase consisted of a combination of teacher- and computer-assisted instruction. Guided practice consisted of the teacher presenting the words one time using the same procedures as in the teacher-only instruction condition. The teacher then told the student that she was going to look at the words using the computer and started the PowerPoint presentation. The student then watched a PowerPoint presentation, which presented the subsequent two trials per target word in random order. PowerPoint presentations wvere arranged to follow the NRA script as presented in the teacheronly condition. At the end of the presentation, the computer had a reinforcement slide. Next, a break was given, and the evaluation procedure then ensued in the same manner as in the teacher-only phase. Instructional sessions continued until the student reached criterion of 80% for two consecutive ses-
FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
86 sions, with a minimum of four sessions to ensure that the student had enough exposure to CAI. This condition was followed by a third baseline phase. During the last treatment phase, all instruction was done using CAI with PowverPoint presentations. The presentations were set up exactly as in the combination teacher- and computerassisted instruction condition, except that each word was presented three times by the computer only, The teacher told the student that she was going to look at some words using the computer and then set her up in front of the computer and began the presentation. The evaluation procedure occurred in the same manner as in the preceding treatment phases. Instructional session continued until the student reached criterion of 80% for at least two consecutive sessions.
instead of "belong"). During the teacher-only condition, she reached criterion of 80% or higher for two consecutive sessions in six sessions. During the second baseline, she tested 100% accuracy on two words and 66% on one word. These three words were discarded and were replaced with three words from the preintervention assessment. Her accuracy during the second baseline with the replacement words ranged from 0% to 20%. In the combined teacher and CAI condition, Alice reached criterion in two sessions. However, data were taken for a minimum of four sessions, as outlined in the procedure. During the third baseline, Alice responded with 20% accuracy for all three sessions. In the CAI-only condition, she reached criterion with two consecutive scores of 80% in the first tvo sessions. The teacher elected to continue taking data for two additional sessions, which resulted in 80% accuracy for all sessions in this condition. Beth responded with 0% to 20% accuracy of the target words during the first baseline (see Figure 3). Beth's errors included missing the beginning sounds (e.g., selecting "block" for "shock"), ending sounds (e.g., selecting "bread" for "brave"), and vowel-based sounds (e.g., choosing "slapped" for "slept"). During the teacher-only condition, she reached criterion in four sessions. During the second baseline, she responded with 0% to 20% accuracy. During the combined teacher and CAI condition, she reached criterion in six sessions. In the third baseline, Beth responded with 20% accuracy across the three sessions. In the CAI-only condition, she reached criterion in three sessions.
Results All three students were able to reach criterion using the NRA with teacher instruction only, teacher- and computer-assisted instruction, and computer-assisted instruction only. The percentage of correctly identified words across each condition was displayed graphically for each student. During the first baseline, Alice responded with 13.3% to 20% accuracy on the 15 words selected from the preintervention assessment (see Figure 2). Her errors tended to either be vowel-based (e.g., choosing "snip" instead of "snap") or involve missing the ending of a word (e.g., choosing "below"
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Sessions FIGURE 2. Percentage of words identified correctly for Alice, across teacher-only instruction, teacher- and computer-assisted instruction, and computer-assisted instruction only. Note. CAI = computer-assisted instruction.
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VOLUME 20, NUMBER 2, SUMMER 2005
87 Teacher Only
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Carrie responded with 0% to 20% accuracy of the target words during the first baseline (see Figure 4.) The types of errors Carrie made tended to be erratic (e.g., selecting "task" for "lost," selecting "plane" for "blame"), as well as beginning, ending, and vowel-based errors. During the teacher-only condition, she reached criterion after 14 sessions. During the second baseline, she responded with 0% accuracy. During the combined teacher and CAI condition, she reached criterion after eight sessions. During the third baseline, she responded with 0% accuracy. During the CAI-only condition, she reached criterion in 12 sessions. In the teacher questionnaire, both teachers reported that the PowerPoint was very easy to use (5.0 mean on a 5-point Likert scale) and that they would use PowerPoint again for student instruction. The teachers reported that using PowerPoint as a form of CAI was about the same in effectiveness as, or somewhat more effective than, teacher instruction (3.5 mean). Both teachers reported that using the PowerPoint presentation was more efficient than teacher instruction by taking less teacher time (4.5 mean). The teachers reported their general impression of using PowerPoint as positive (4.5 mean) and their student's motivation to use this form of instruction as positive (4.5 mean). One of the teachers made the PoNverPoint presentations and one did not; however, both reported that they received instruction on how to do it and would definitely find time to make them in the future (5.0 mean). One student reported that she preferred having the computer teach her the words, and the other two students were unsure of their preference.
Interobserver Reliability and Procedural Integrity Interobserver reliability (IOR) and procedural reliability measures were conducted for 25% of the sessions for each student. IOR was conducted during testing sessions by one of the researchers observing the session and recording student responses. Data from the teacher were then compared to those of the researcher using a point-by-point method. Agreements were then divided by agreements plus disagreements and multiplied by 100 to arrive at the percentage of IOR. The IOR checks resulted in a mean of 97.3% across participants. To assess procedural integrity, the researchers observed the teachers during instructional sessions using a data sheet outlining the step-by-step procedures for the condition. The teachers' adherence to outlined teacher behaviors was recorded with a "+" for correct performance of a step and "-" for incorrect performance or omission of a step. The number of pluses was then divided by the number of pluses and minuses and multiplied by 100 to determine the percentage of procedural reliability. The procedural reliability checks resulted in a mean of 98.6% across participants.
Discussion The purpose of this study was to determine if the use of CAI would be an effective method for teaching students to learn word identification using the NRA. CAI was delivered using
FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES
88 Teacher Only
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Sessions FIGURE 4. Percentage of words identified correctly for Carrie, across teacher-only instruction, teacher- and computer-assisted instruction, and computer-assisted instruction only. Note. CAI = computer-assisted instruction.
the guided practice component of the NRA. Participants were first instructed by the teacher, to familiarize them with the NRA. They were then instructed via a combination of teacherand computer-assisted instruction, to familiarize them with the CAI. The final phase consisted of CAI only. This progression was believed to be similar to the natural progression that may occur in a classroom, with the teacher doing the initial instruction and then the student becoming more independent. The results indicate that all three participants were able to acquire target words during each of the three conditions using the NRA. All participants reached criterion of 80% for 2 consecutive sessions in between 3 and 14 sessions. These results are consistent with other studies that demonstrate the effectiveness of the NRA (Heller et al., 1999; Heller et al., 2002). This study is unique in the literature in that CAI was used to deliver the guided practice portion of the NRA in txvo conditions. Using PowerPoint slides to introduce and teach decoding of new words without teacher instruction was found to be an effective method of teaching new words. In addition, the teachers involved in the study reported that the use of the PowverPoint slides was as effective as, or somewhat more effective than, teacher instruction. Teachers reported that this was attributed to the consistent presentation of the material that followed an exact script and to students' finding the CAI motivating. The rate at which the students learned the words across all three conditions varied across students. Most of the students took longer to learn the words in the teacher-only condition.
The teachers attributed this to the students' getting acquainted with the NRA because it was a new strategy for them. In the combined teacher and CAI and CAI-only conditions, Alice had the fastest acquisition rate. This is consistent with her having the highest reading level of all the students. Beth had a slower acquisition rate in the combined teacher and CAI condition, but the teacher attributed this to a difference in the Windows version (i.e., XP vs. Windows 98). The platform differences resulted in the PowerPoint slides running a little slower, wvhich caused the student to become distracted initially. Carrie took the longest to learn the words across all three conditions, which is consistent with her having the lowest reading level. However, all three students were able to reach 80% accuracy once by the first, second, or third session and go on to reach criterion of 80% accuracy for two consecutive sessions during the CAI-only condition. Other factors that may have influenced the rate at which the students learned the words were their familiarity with the computer and with answering questions. All three students had familiarity with the computer and with using technology because they were all augmentative and alternative communication (AAC) users. Alice and Beth were also used to answering questions in a multiple-choice format. However, the teacher reported that Carrie had not been asked to respond to questions in a multiple-choice format. Before the study began, she had to be taught to respond in this format. For example, she was asked, "What is your name?" and given a multiplechoice format to choose from. Her having to learn a different
VOLUME 20, NUMBER 2, SUMMER 2005
format for responding, as well as the time it took to become acquainted with the NRA, may have resulted in her taking longer to learn the words with the teacher-only condition. However, her ability to move to 80% acquisition in the CAIonly condition after three sessions (and finally reaching criterion of txvo consecutive sessions) indicates that the use of CAI was effective. Generalization of the NRA appears to have occurred with Alice. During the initial baseline, Alice correctly identified 13% to 20% of all the target words. During the second baseline session, Alice tested at 100% accuracy on two untaught words and 66% accuracy on one untaught word. This may have been a function of learning hoNw to decode using the NRA strategy. This is consistent with a previous study in which students with severe speech and physical impairments learned to decode unknown words using the NRA (Heller et al., 2002). Alice also appeared to be internalizing the NRA. During CAI, Alice was observed moving the cursor under the displayed word in union with the computer vocalizing the sounds. It appeared as if she had learned the script and was following along with it. This is consistent with the initial findings of a study in which students internalized the NRA and used it as a metacognitive strategy to decode words (Swinehart-Jones & Heller, 2005). There may be several advantages to using PowerPoint slides to teach word identification. First, this form of CAI was found to be a more efficient strategy than teacher instruction only. Students with speech impairments, particularly those wvith physical disabilities, often can do very little academically without one-on-one adult assistance. The use of CAI can provide students with repetition in learning the target word, thus allowving the teacher more efficient use of his or her time. Second, CAI allows for instruction across multiple settings. PowerPoint is a widely available program. This allows students to not only practice words in the classroom but also have access to them in multiple environments on laptop computers, or to take PowerPoint presentations home on disks for homework. A third advantage of CAI use is motivation. Many students are motivated by the computer. Students who have never been able to work independently might be motivated by being able to do so. There are several limitations of this study. One limitation is the propensity for technology difficulties. Because of computer slowness, Beth was distracted and may not have performed to the best of her ability. This is a limitation of many CAI studies because technology can be unreliable. Another limitation is that the PowerPoint presentations were created by only one of the two teachers. Although the participating teacher reported it as time-consuming, she thought she would use this strategy again for student instruction. The teacher also reported that as she learned to program the PowerPoint slides, she became much faster over time. It took only 4 minutes for one of the authors to create the PowerPoint presentation for one word. However, she has experience using PowerPoint and is familiar with the NRA script. Once the presentation for a word is created, the slides for that word can be copied and
89
pasted, which decreases the time required to make the entire presentation where words are presented multiple times. However, teachers may not be willing to create PowerPoint presentations because of limited knowledge of the program or limited time. Nonetheless, it cannot be ascertained if creating the PowerPoint presentations would be feasible for teachers from this study. Future research is needed in the area of CAI with the NRA. Future studies should evaluate the feasibility of having teachers create presentations for their students. Further replication is also needed to confirm the effectiveness of computerassisted instruction in delivering the script of the NRA across more students with a range of disabilities. Additionally, one teacher suggested having more interesting slides for reinforcement. Future studies could have the reinforcer slides include more interesting properties, such as animation. In summary, this study is unique in the literature in that computer-assisted instruction was used to deliver the guided practice portion of the NRA. Although the NRA has been shown to be effective with individuals who have severe speech and physical impairments, this study further demonstrates the effectiveness of this approach with participants with speech impairments who have different physical impairments than those in the original studies. Furthermore, this study includes a student with autism. Most important, the study demonstrates that CAI is an effective and efficient method for teaching students word identification. ABOUT THE AUTHORS
Mari Beth Coleman-Martin, MEd, is the assistantproject directorfor the Georgia Bureau for Students with Physical and Health Impairments, as well as a doctoral student at Georgia State University. Her research interests include literacy instruction and assistive technology. Kathryn Wolff Heller, PhD, is a professor in the EducationalPsychology and Special Education Department at Georgia State University. Her research interests include literacy and effective instructionfor students with physical and health impairments. David F. Cihak, MEd, is the assistant director of the Center of Collaborative Education (CCE) at Georgia State University and a doctoral student in the Department of EducationalPsychology and Special Education. His areas of research have focused on effective instructionalstrategiesfor classroom and community settings. Kathryn L Irvine, MEd, is a student at Georgia State University. She is enrolled in the Specialist Program in Special Education with a concentration in assistive technology. Address: Kathryn W Heller, Dept. of Educational Psychology and Special Education (EPSE), PO Box 3979 Georgia State University, Atlanta, GA 303023979; e-mail:
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