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Attention therapy improves reading comprehension in adjudicated teens in a residential facility.

Attention Therapy Improves Reading Comprehension in Adjudicated Teens in a Residential Facility

One of the factors most strongly associated with involvement with the juvenile system is having trouble in academic settings, particularly difficulty in learning to read (Maguin & Loeber, 1996). In addition to low socio-economic status and lack of family involvement (Brier, 1993), difficulty with academic skills stands as a hallmark feature of the population of juvenile offenders. Failure to attain a normal reading level is a significant predictor of incarceration in adulthood as well (Harlow, 2003). Greenberg, Dunleavy, and Kutner (2007) reported in their 2003 National Assessment of Adult Literacy that while only 3% of inmates were considered non-literate, 23.3% were below basis levels of literacy based on an average score of Prose, Document, and Quantitative literacy.

Katsiyannis & Archwamety (1997) found that higher achievement on academic tests, particularly reading, was a significant predictor of both reduced likelihood of incarceration in adolescents, and of decreased recidivism within the juvenile offender population. "While illiteracy and low reading skills are not necessarily direct causes of delinquency--reducing illiteracy through quality education in correctional facilities has been shown to reduce recidivism" (Malmgren & Leone, 2000). Based on such evidence, Keith and McCray (2002) argued that "juvenile justice systems must address not only the social and adaptive needs of these adolescents (youthful offenders), but also their academic needs." The necessity of reading remediation is highlighted by the costs to the incarcerated in the form of limited future social and job opportunities specifically associated with reading difficulties (Maughan, 1995). Additionally, the monetary cost to society for the education of incarcerated youth was estimated to be an average of $29,600 per youth (Acorn, 1991). Given such a price tag, emphasis should be placed on determining the relative efficacy of programs, as well as on means by which costs can be effectively tracked and controlled.

Despite alarming evidence about the necessity of designing good reading interventions for the juvenile offender population, relatively few successful programs have been created. One successful program was initiated by Simpson, Swanson, and Kunkel (1992), who conducted trainings at both a residential facility and a detention center. Their regression statistics demonstrated that for every 10 hours of training, their treatment group improved by about one third of an academic year, moreover, the remediated group had a substantially reduced rate of recidivism (41%) compared to a control group (63%), and the general population (66%). The critical features of this successful reading program were that it was a direct and explicit intervention that treated reading problems within the context of developing broad, cognitive skills. In light of the paucity of published studies, relatively little is known about the efficacy of literacy intervention programs within the juvenile justice system (see Shelley-Tremblay, O'Brien, & Langhinrichsen-Rohling, 2007 for a review).

Another excellent review conducted by Krezmien and Mulcahy (2008) examined the type, quantity, and quality of controlled reading interventions in a juvenile corrections setting. After a literature search, only six studies met their criteria using the descriptors: "literacy, delinquency, behavior, and reading," in all possible combinations from 1978 to 2007. The studies had to have been in peer-reviewed journals, been quantitative or single-case designs, employed reading interventions in a juvenile corrections setting, and included a reading outcome measure. The authors point out that several factors may contribute to the relative paucity of literature in this important area, including: 1) the goal of educational interventions has been to reduce recidivism, not improve educational outcomes, per se, 2) researchers have difficulty gaining access to the secure setting, 3) the participants are transient by nature, and their schedule is often subject to interruptions. Additionally, Shelley-Tremblay et al. (2007) point out that little financial support exists to fund such research within the tight budgets of local and state agencies.

As a result of these and other factors, it is apparent that an inadequate literature exists to determine which, if any, are indeed the "best practices" for reading interventions in the juvenile system. Shelley-Tremblay et al. (2007) presented a series of guidelines for conducting learning disabilities research in this setting, including: employing a true experimental design with appropriate control conditions, using time-efficient and cost efficient remediation strategies, employing interventions that are flexible, and including an adequate range of dependent measures to determine what aspects of the reading process are being influenced by the intervention. The current study that we present in this manuscript is one of the first in the literature to attempt such a comprehensive strategy.

This study was based on a reading intervention that has previous been found to be effective in a relatively short term intervention, amenable to the juvenile corrections environment. The intervention was developed by Solan, Larson, Shelley-Tremblay, Silverman, and Ficcara (2001). This technique focuses on combining traditional reading and specific visual attention-based training. Both aspects of training were found to be beneficial to reading disabled (RD) students in the 6th grade at ethnically diverse, urban middle schools, with students showing improvements in reading learning rate from 60% (approximately 3 years of progress in 5 years) before treatment to 379% (approximately 1.5 years of progress in 12 weeks) after treatment. While the obtained results supported the notion of a cognitive link among visual attention, oculomotor readiness, and reading ability, the exact mechanism of the treatment remained unclear.

A follow-up study was conducted such that an intensive visual attention training (AT) procedure was utilized in the absence of direct reading training (Solan, Shelley-Tremblay, Ficarra, Silverman, & Larson, 2003). Attention training consisted of computer-based and paper and pencil activities designed to increase sustained and selective attentional abilities. At the completion of AT, the mean standard attention score of the AT group improved one standard deviation from 95 to 113 (41st to 77th percentiles) on the attention tests. Mean reading comprehension scores of the AT group improved significantly from grade equivalent (GE = 4.1 to GE = 5.2, or from the 23rd to the 35th percentile). Controls, however, showed no significant improvement in GEs or percentiles in reading comprehension after 12 weeks. The study supported the notion that visual attention is malleable and that AT has a significant positive impact on reading comprehension.

Most recently, Solan et al. (2004) have linked the effect of visual attention training to a reduction in coherent-motion detection threshold (CMT) on a test involving a random dot kinematogram. Essentially, reading disabled (RD) students were shown to have a deficit in their visual system, compared with normal readers. This deficit could be detected by the presence of relatively low sensitivity to random motion on a computer display. This deficit has previously been shown in dyslexic adults, and to correlate with abnormal neuroimaging results on a PET scan indicating deficits in the brain system associated with tracking a word and rapidly integrating its location with its meaning (Eden et al., 1996). The fact that Solan et al. (2004) demonstrated that this deficit is amenable to training may provide an important avenue for helping RD youth who have not been responsive to traditional reading instruction. It is this logic that underlies the current project that implemented this remediation program in a residential detention facility.

The current study was a prospective randomized control design incorporating a prescreening process whereby all detainees were assessed for reading disability (quantified as two or more years behind for 6th through 9th grades, and three or more years behind for = 10th graders). Those who qualified as reading disabled were placed in either a six-week (12 sessions, twice/week) AT program, or a no-treatment control. The participants in the visual attention/fluency AT were monitored and encouraged by a college student trainer to ensure compliance and maximum effort during training sessions. Of the studies reviewed in Krezmien and Mulcahy (2008), none of the six were prospective, randomized treatment/control group studies. As such, the current study represents the most methodologically rigorous to date.



All participants were sentenced to reside in a residential, alternative sentencing facility in the southeastern United States. Participants (n = 174) were screened over two and one-half years as part of a larger study of the inmates. Participants for the present investigation were deemed eligible for the current project on the basis of standardized reading test performance (i.e., greater than two years below grade level for middle-school level students or greater than three years below grade level for high school level students). This resulted in 42 incarcerated teenage males being included in the current study. The mean age of the participants was 15.53 years (SD = 1.27) with a range of 13 to 18 years of age (5 years). The participants were incarcerated for a wide array of offenses, including drug possession, drug trafficking, assault, larceny, and many other crimes that were not deemed severe enough to warrant incarceration in the state's primary juvenile detention facility. The mean number of offenses for the participants was 5, with a range from 1 to 11. The participants were ordered to serve their sentence in the facility for a term not less than 10 weeks, with an average length of stay greater than two months. Participants' good behavior resulted in accumulation of sufficient time served to permit graduation from the facility. Negative behaviors resulted in longer duration of stay. Participants took part in daily physical activities, educational activities, and received regular psychological and medical services. Participants were tracked by an aftercare program upon release.

The participants were randomly assigned to participate in either the Attention Therapy (AT, n = 19) or the control group (n = 23). The unequal n resulted from unpredictable student behavior leading to drop-out, transfer to another facility, or escape and subsequent transfer.


Gates-MacGintie Reading Tests, Fourth Edition (GMRT)

The Gates-MacGinitie Reading Test, Fourth Edition (GMRT) (MacGinitie, MacGinitie, Maria, Dreyer, & Hughes, 2006) is a silent paper and pencil, multiple-choice reading test that will reveal each subject's actual reading level. Test forms used in this study ranged from the second to tenth grade levels. In the second grade level, the student was instructed to match which picture corresponded with the provided sentence. On the remaining levels, students read passages and then answered questions on the passages.

In order to qualify for participation in the study, participants must have tested two or more years behind in their reading level from their GMRT results. If the subject qualified as two or more years behind, they continued in the study with the pre-tests. If the subject did not qualify, they were excluded from the study. The participants completed only the comprehension section of the test for the grade level they would be entering in the fall, and a Grade Equivalent was established for each subject based on his or her comprehension score.

Woodcock Johnson Non-word Test (WJN). The Woodcock Johnson Non-word Test (WJN) from the Woodcock-Johnson III (Woodcock, McGrew, & Mather, 2001) evaluates the participant's ability to acquire phonemic or sound information from a list of clusters of letters that do not form actual words. The student is instructed to sound out each item on the list to the best of their ability. Depending on how many items are produced correctly, the WJN derives an Age Equivalent Score, as well as a Grade Equivalent Score.

Cognitive Assessment System (CAS)

The Cognitive Assessment System (CAS) is a clinical tool used to measure a child's intelligence formulated from his or her performance on a series of cognitive tasks (Naglieri & Das, 1997). The Expressive Attention (EA) subtest is very similar to the Stroop Test. First the subject must read the names of colors (Red, Blue, Green, Yellow) on the first page while being timed. The next page consists of several colored blocks arranged in rows, and the student must state/read the color of the ink the blocks are printed in going across the page while being timed. This page utilizes the same four colors as the previous page. The last page is composed of the names of the four colors once again; however, the color words are all printed in one of the three other colors of ink. For instance, the word "Blue" is printed in yellow ink. The participant is asked to state the color of the ink each word is printed in while being timed. This page normally takes longer than the previous two because the participant must focus on the ink color and alter his or her attention so as to ignore the printed word during this task. The Receptive Attention Test (RA) involves the active discrimination of upper- and lowercase letter pairs based first on their physical similarity, and then on their lexical identity. This test requires the rapid establishment of set, selective attention to relevant stimulus features, and the ability to change set flexibly. The final subtest, Number Detection (ND), is a cancellation task where participants must cross-out target letter or number sets as a function of their font in a series of two trials. Time and accuracy are recorded for all CAS subtests.

Coherent Motion Threshold (CMT)

The Coherent Motion Threshold (CMT) is a computer-administered, psychophysical threshold task (Hansen, Stein, Orde, Winter, & Talcott, 2001). For this test, the participant was instructed to sit at an arm's length away from the computer screen. During testing, the screen was black with the exception of two adjacent rectangular patches consisting of white dots. In one of the rectangles, the white dots move in a Brownian motion, but in the other rectangle, a varying percentage of dots move horizontally back and forth, while the remainder of the dots move in the Brownian motion (see Figure 1). The percentage of dots in random motion is varied according to a double random staircase method of limits, in which correct responses yield a more difficult response and incorrect responses an easier discrimination. The participant is instructed to select the rectangle consisting of the horizontally moving dots. Poor readers have previously been reported to score in the range of 5.2, while good readers score higher, around 7.1 or more.


Gray Oral Reading Tests, Third Edition (GORT). The Gray Oral Reading Tests, Third Edition (GORT) assesses a student's oral reading ability, taking into account rate, accuracy, and comprehension (Weiderholt & Bryant, 1992). Because the GORT consists of two corollary forms, A and B, each containing 14 stories with five multiple choice questions, it is productive in measuring a change in oral reading ability due to the effects of a reading training program. The GORT is additionally useful in the diagnosis of oral reading disabilities. The GORT provides measures of overall oral reading speed, as well as reading comprehension, and the number of errors in decoding. These scores are used to produce an Oral Reading Quotient (ORQ), used in the current study, which is a standardized index of speed and errors under conditions of acceptable comprehension.


Attention Tests

The attention processing assessment consisted of the three subtests that comprised the Attention Scales in the Cognitive Assessment System (CAS): Expressive Attention, Number Detection, and Receptive Attention. The standardized directions and extensive normative data analysis were followed exactly as prescribed in the CAS Administration and Scoring Manual: Tests recommended for ages 8-17 years (Naglieri & Das, 1997). Each of the subtests was individually administered to all participants by one of three examiners. The three attention tests not only provide developmental measures of visual attention and the ability to shift attention, but also quantify the potential to avoid responding to habitual features while responding to another feature.

That is, the tests assess how well the child attends to relevant stimuli while being challenged with irrelevant stimuli. The Expressive Attention subtest, the only verbal response test, uses variations in color as distracters and is similar to the Stroop Test (Stroop, 1992). For example, the word "GREEN" is printed in blue, and the child is expected to respond "BLUE." The Number Detection subtest is a timed pencil and paper test that also measures ability to shift attention and resistance to distraction. The child is required to underline certain numbers that appear in regular typeface (e.g., 1, 2, 3) and others that appear in outlined typeface (e.g., 4, 5, 6). Similarly, the Receptive Attention subtest matches letters according to physical similarity (t and t) and lexical similarity (t and T). In each of these two timed tests, the child must work from left to right and top to bottom, and may not recheck the page upon completion. The timed test scoring is based upon number right minus number wrong and time to complete the test. Therefore, the attention quotient represents the combined effects of accuracy and automaticity, that is, correctness as well as speed of response.

Attention Therapy

To the extent that the results in this study apply to the population we have defined, the authors have accepted overlap in the measures of attention and memory. We propose that attention is multidimensional and malleable. It involves arousal, activation, and vigilance. The question is therefore the following: Given the appropriate therapy, can attention be operationalized and cultivated with the expectation of improving the visual processing capacity of the RD child (McIlvane, Dube, Callahan, Lyon, & Krasnegor, 1996). The therapeutic regimen includes both stimulus driven and goal directed voluntary procedures. As noted by Katzir et al. (2006), therapies must provide the participant with the opportunity to enhance executive functioning.

All therapeutic procedures were administered individually and most involved computer assisted programs. Five attention enhancing programs were utilized in each of the 12 one-hour sessions, and the difficulty levels were increased gradually for each participant. The programs were as follows: (a) Perceptual Accuracy, (b) Visual Efficiency, (c) Visual Search, (d) Visual Scan, and (e) Visual Span. Usually time was available to conclude with pencil and paper exercises. Visual processing therapy primarily stressed arousal, activation and vigilance. In order to achieve our goal of stimulating selective and sustained attention, the development of visual memory and cognitive strategies also were emphasized in the therapeutic regimen.

Each therapy session was initiated with the Perceptual Accuracy-Visual Efficiency (PAVE) program. Oculomotor readiness and visual processing efficiency were stressed. The oculomotor segment requires the participant to count the frequency of appearances of a particular digit or letter while following a left-to-right sequential presentation of three equally spaced characters per line on the screen, usually starting at 40 lines per minute. Sixty lines per minute is equivalent to one line per second or a fixation duration of about 300 ms per character. The program automatically adjusts to challenge the individual's performance. Ultimately, 120 lines per minute were reached by most students, which reduces the visual processing time to about 150 ms per character. The therapy promotes the development of saccadic accuracy, automatic orienting and focusing of attention, and the opportunity to process visual stimuli in the right paracentral retinal area.

Perceptual Accuracy is a tachistoscope program intended to develop rapid visual processing. Initially, four digits were flashed on the computer screen at 0.1 seconds, and the individual was required to reproduce them on the screen using the computer keyboard. Although four digits at 0.1 seconds generally was not a challenge, some students found the transition from four to five digits difficult, in which case a double flash was used at first. A few students were able to master six digits at 0.1 seconds. Rapid and accurate visual processing as measured with the tachistoscope correlates significantly with reading readiness in kindergarten (Solan & Mozlin, 1986), with reading in grades 1 through 5 (Solan, 1987a; Solan & Mozlin, 1986), and with arithmetic in grades 4 and 5 (Solan, 1987b).

The next three perceptual procedures are included in the Computerized Perceptual Therapy Program developed by Dr. Sidney Groffman.1 The Visual Search program required the student to locate a designated stimulus within an array on the screen that was organized into 5 columns and 15 rows. Target stimuli consisted of four or five letters or digits, and the number of stimuli was variable. The response was identified and canceled either with the mouse or by typing the column letter and row number. Time to complete the task was affected by ability to develop an efficient response strategy. After each trial, the computer summarized time (e.g., 31 s) and number of correct and incorrect responses and omissions. The presentation is randomized for each trial. Visual Search training improves visual discrimination, figure-ground perception, and perceptual speed.

In the Visual Scan program, the individual locates and cancels designated target stimuli (e.g., numbers) hidden in a randomized array of distracter stimuli (e.g., letters). Since time is a factor, it is necessary to develop an aggressive strategy in order to identify the target stimuli rapidly and accurately. Enhanced peripheral awareness helps to locate the next target. Since Visual Scan is a timed exercise, visual planning and strategies are necessary to complement perceptual speed and accurate saccades. Visual Scan therapy is also effective in regulating perceptual tempo in individuals who present an imbalance between reflectivity and impulsivity.

Visual Span, the third therapeutic procedure in the Groffman series, combines a number of attributes associated with attention. The individual is required to identify and recall the exact sequence of stimuli presented one at a time at various selected speeds of presentation. Numbers or letters are available, and the length of the sequence increases or decreases automatically depending upon the response accuracy. Visual Span is especially effective in enhancing visual processing and visual sequential memory.

Control Treatment

The control consisted of the normal education classes that were being conducted by the staff of the detention facility. Staff consisted of one full-time head teacher and one full-time aid. These individuals instructed classes of approximately 10 to 18 youths five times per day for one and a half hours. The students worked on all academic subjects, with frequent reviews of basic math and reading skills. Students also worked individually on the Skills Bank software, focusing on reading, math, social studies, and sciences during this time. Students were removed from their education period only (with a few exceptions due to illness, special visitors, or changes in daily schedule) in order to do the AT.


Reading Measures

In order to determine whether AT produced significant improvements in reading, the mean scores for the Gates-MacGinitie reading comprehension scores were analyzed for both the AT and control groups, before and after training. The standard scores were transformed into Normal Curve Equivalents to make them more suitable for parametric statistical analysis. The means displayed in Table 1 show that while the AT group improved 9.736, the control changed only 1.364. A 2 x 2 ANOVA with a between subjects factor of Group (AT vs. Control) and a within subjects factor of Time (Time 1[Pretest] vs. Time 2 [Posttest]) yielded a main effect of Time, f (1, 39) = 11.354, p = .002, partial [[eta].sup.2]= .225, and most critically an interaction between Time and Group, f (1, 39) = 6.461, p = .015, partial [[eta].sup.2] = .142 (see Figure 2).

Table 1. Reading Measures

Measure Group Membership Time Mean Std. Error Change

GATES NCE AT 1 23.211 2.764
 2 32.947 3.228 9.736

 Control 1 23.545 2.569
 2 24.909 3.000 1.364

WJN-NW AT 1 4.747 0.720
 2 5.289 0.863 0.542

 Control 1 4.745 0.669
 2 5.005 0.802 0.260

GORT-ORQ AT 1 97.167 5.776
 2 105.89 6.139 8.722

 Control 1 100.15 5.479
 2 94.15 5.824 -6.000

GATES NCE = Gates MacGinitie Normal Curve Equivalent

WJN-NW = Woodcock Johnson Non-word Decoding Subtest

GORT-ORQ = Grey Oral Reading Test-Oral Reading Quotient

Neither the GORT nor the WJN changed significantly (p >.05). In the case of the WJN, the clinician may take note that the AT group changed about one-half of a year, while the control group changed about one-quarter of a year. The WJN, as a measure of PA was not predicted to change. On the GORT, Table 2 displays a change in means from 97 to 105 for the AT, and of 100 to 94 for the control group.
Table 2. Attention Measures

Measure Group Membership Time Mean Std. Error Change Sig

CAS EA AT 1 8.526 .668
 2 9.053 .670 .527 .299

 Control 1 7.762 .636
 2 8.619 .637 .857 .116

CAS ND AT 1 6.421 .393
 2 7.947 .418 1.526 .001

 Control 1 5.667 .373
 2 7.524 .398 1.857 .001

CAS RA AT 1 6.526 .426
 2 8.421 .530 1.895 .002

 Control 1 5.714 .405
 2 6.762 .504 1.048 .140

CAS EA = Cognitive Assessment System Expressive Attention

CAS ND = Cognitive Assessment System Number Detection

CAS RA = Cognitive Assessment System Receptive Attention

This research was supported by Grant No. 2001-SI-FX-0006
awarded by the Office of Juvenile Justice and Delinquency
Prevention, Office of Justice Programs, U.S. Department of
Justice. Points of view or opinions in this document are those
of the authors and do not necessarily represent the official
position or policies of the U.S. Department of Justice. We wish
to acknowledge the work of Clint Moore in the execution of this

Coherent Motion Threshold

As seen in Figure 3, the CMT reduced very slightly for the Control, and by almost a third for the AT group. An ANOVA indicated no significant main effect of Time, f(1,38) =.498, p =.485, partial [[eta].sup.2] =.013, or of Group, f(1,38) = 1.435, p >.238, partial [[eta].sup.2] =.036. Follow- up analyses indicated that the AT group changed significantly from a T1 mean of 8.41 to a T2 mean of 5.36, t(18) = 2.87, p =.010, d =.659, while the control group did not change, t(20) =.059, p =.954, d =.012.



In order to test the hypothesis that AT would directly improve visual attention, the mean scores for each of the three subtests for all participants were entered into a MANOVA with factors of Time (2) and Group (2). The scores were all hypothesized to increase in the AT group, and were found to moderately correlate with one another, with Pearson's r ranging from.245-.528 (all p <.01). The MANOVA yielded a significant effect of Time, f (3, 36) = 10.670, p <.001. Univariate ANOVAs revealed that only Number Detection and Receptive Attention changed significantly from T1 to T2 for both groups combined, f (1, 38) = 32.070, p <.001, and f (1, 38) = 11.444, p =.002, respectively. Follow-up analysis performed for each group revealed that both Number Detection ( f (1, 18) = 27.725, p <.001) and Receptive Attention ( f (1, 18) = 13.376, p <.002) improved significantly for the AT group. For the control group, only Number Detection improved significantly, f (1, 20) = 13.592, p = .001.


Reading comprehension improved significantly for the AT group only, supporting the primary hypothesis of the study. The Gates-MacGinitie measures only silent reading comprehension, and as such has the largest amount of parallel to the sorts of standardized reading tests (Iowa Test of Basic Skills, PSAT, etc.) that students are likely to encounter in a normal school setting. These scores correspond to a change in Grade Equivalent of 5.3 (Time 1) to 6.6 (Time 2) for the AT group (1.3 years). For the control group, the corresponding scores were 5.0 to 5.4. Another way to conceptualize this change is to convert the amount of change of a learning rate by dividing the years gained by the total time elapsed from pre- to posttest. Following this formula, the AT group began their training at a mean grade level of 8.4, with a mean reading level of 5.3, indicating a learning rate of 63% at the start of the program. The control group had a grade level of 8.2, with a starting grade equivalent of 5.0, yielding a learning rate of 61%. During the period of the training program, the educational activities at the detention facility alone (control group) yielded a learning rate of 0.4 years in 0.33 years of instruction (3 months out of a 10 month school year), or 121%. By contrast, the learning rate of the AT group was 394%. If calculated as gain per hour of instruction, this yields 540 minutes, or 9 hours of instruction. Thus the average gain can said to be.14 years of gain/hour of instruction.

The rates are valuable in that they provide a metric against which this technique may be compared to other educational interventions. For the studies that were reviewed in Krezmien and Mulcahy (2008 above), similar learning rates can be computed. While each of these studies had serious limitations, including lack of control groups and statistical inadequacies, perhaps the best controlled was that of Allen-DeBoer, Malmgren, & Glass (2006). These authors used a multiple-baseline design across four participants to calculate the effect of daily, one-on-one, 30-minute Corrective Reading instruction over nine weeks. If converted to total instruction time, this equals 1,350 minutes, or 22.5 hours. An average of their participants' scores allows computation of their comprehension gains on the Gray Oral Reading Tests, 3rd edition (GORT-3), which began at the grade equivalent of 3.9 (note however, that 2 of their 4 subjects were < GE 1.9 at start). The posttest scores of 5.2 indicate a net increase of 1.3 years. Interestingly, this is the same effect size as in the present AT intervention. However, their average gain is 1.3 years in 22.5 hours, or a rate of.06 years/hour. This rate of gain is less than 10% that of the AT condition. This suggests that while phonics based instruction, like Corrective Reading, may be effective, their efficacy may be less than AT.

Another finding was that the students' oral reading did not improve significantly in either group, suggesting a limit on the generalizability of the attention training procedure. It may be that repeated practice with selective attention arrays enhances cognitive selection processes in data input, but the output process (speech) remains relatively unaffected. This raises the possibility of developing attention-based training for oral reading and public speaking.

Interestingly, one of the attention subscales that improved significantly in the AT group, but not the control group was Receptive Attention (RA). As noted above, RA requires the rapid establishment of set, selective attention to relevant stimulus features, and the ability to change set flexibly. The improvement in this test may indicate at least some of what underlies the significant increase seen in the AT group. The AT group was able to complete a greater number of test items than the Control group, and thus was able to earn higher scores on the comprehension measure. It must be stressed that the improvement seen was not simply in speed, but in fluency. That is, participants were only given points for correct comprehension questions, and no points for merely attempting a larger number of items.

As indicated by Mulcahy, Krezmien, Leone, Houchins, & Baltodano (2008), one of the major difficulties with conducting research in a prison setting is being able to use true experimental methods. The "gold standard" of experimental research is to employ random assignment of otherwise equivalent participants to the experimental treatment and control groups. It must be stressed that this level of control in the current study was only possible in the context of an ongoing, multi-year relationship between the facility and the researchers. Only after considerable time and effort were the goals of the facility and those of the research team aligned.

Additional considerations included the inclusion of sufficient numbers of experimental and control subjects (n approximately [greater than or equal to] 20 for both groups), as well as sufficient time in training (45 minutes/session). Participant effort was maintained by stressing the intrinsic value of reading, as well as by trainers who developed enough of a rapport with the detainees to be able to talk about their plans after release, such as work, graduation, and college. Another important feature of this research design was the inclusion of additional measures to corroborate and explore the potential salutatory effects of the intervention, such as measures of oral reading, phonological skill, magnocellular functioning, and general attentional abilities. This study was limited by the number of available participants who could be assigned to two different experimental groups, and so was unable to control for non-specific treatments effects such as effect of spending time with an enthusiastic college student twice per week (i.e., unable to have an attention-only control condition). As in the public schools, detention facilities are highly resistant to allow some participants to be assigned to a condition that would involve time socializing as opposed to being educated.

Future research should be undertaken to assess the effects of reading remediation on recidivism, as well as consider whether there are concomitant changes in the juvenile delinquents psycho-social adjustment (i.e., depression, locus of control, academic self-esteem, and frequency and severity of ADHD symptoms). Ultimately, any RD intervention study must be seen as an intervention against recidivism and toward better eventual integration with society. By working with aftercare providers and local juvenile justice systems it may be possible to track additional positive outcomes (resistance to risk-taking, drugs, and violence) experienced by a juvenile delinquent who has had the opportunity to gain confidence in their reading ability.


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(1.) Available from RC Instruments, 21444 Hague Road, Noblesville, IN 46060.

Biographical sketch

DR. JOHN SHELLEY-TREM BLAY is an Associate Professor of Psychology. He specializes in the biological bases of reading disability, as well as psychophysiological research methodologies.

DR. JENNIFER LANG HINRIC HSEN-ROHLING is a Professor of Psychology. She studies violence, suicidality, risky behaviors, and addictions.

JOSHUA EYER is currently a Doctoral student in Clinical/Health Psychology at the University of North Carolina at Charlotte.
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Author:Shelley-Tremblay, John; Langhinrichsen-Rohling, Jennifer; Eyer, Joshua
Publication:Journal of Correctional Education
Date:Sep 1, 2012
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