Literacy and Language Interventions Via Telepractice for School-Age Children
Condition: Literacy-language Intervention
Study type: Interventional

Summary: 
      Telepractice refers to the application of telecommunication technology (e.g., Skype, Webex,
      Zoom) to the delivery of speech-language and audiology services. The development of
      telepractice, an emerging alternative to traditional service delivery, has been driven by the
      need for equitable access and cost-effective services to all client, regardless of
      geographical locations, physical conditions, or social and economic status (Theodoros, 2011).

      The purpose of this study is to examine the feasibility of telepractice-delivered
      intervention targeting literacy (i.e., reading and writing) and literate language skills
      (e.g., narrative skills) to promote better academic outcomes in school-age children. The
      investigators conduct a single-subject, multiple probe design across four participants to
      examine the functional relation between a telepractice intervention and two educational
      outcomes - reading self-corrections and narrative ability. Participants with language and
      literacy needs receive three weekly intervention sessions via ZOOM (a videoconferencing
      software). A single-subject, multiple-probe design across participants enables the
      examination of treatment effectiveness: If three replications of treatment effect are
      established across participants (i.e., visual analysis indicates evident behavioral change on
      progress-monitoring assessment), the proposed intervention yields a high likelihood of
      producing benefits to children who share similar learning needs.

      In addition to intervention effectiveness of telepractice, the investigators examine
      feasibility along two dimensions: Fidelity and scoring reliability. Fidelity here includes
      two components - fidelity of intervention (i.e., whether the intervention activities are
      implemented as intended) and procedural fidelity of probe assessment administration (whether
      the progress-monitoring probes are administered as intended). Scoring reliability (e.g.,
      interobserver agreement) examines if the interventionist's scoring is consistent with a
      reliability coder's scoring. Evidence derived from analyses of fidelity, reliability, and
      intervention effectiveness will be examined collectively to determine the feasibility of
      delivering literacy and language intervention via telepractice.
    

Detailed description: 
      The single-subject multiple-probe design comprises four phases: (a) eligibility
      determination, (b) a baseline condition, wherein participants receive business-as-usual
      practice, (c) a 15-week intervention condition, and (d) a maintenance condition (see Figure
      1).

      Eligibility determination. The investigators employ a two-stage screening procedure
      (psycho-educational assessments) to identify children in Grade 1 to 5 who demonstrate
      language-based learning difficulties. Following the completion of the two-stage screening,
      the investigators conduct a mock tutoring session to familiarize the potential participants
      with the technology platform. The interventionist fills out a behavior checklist that
      consists of steps needed to be accomplished in the mock session to determine if the child
      meets the minimum criteria for telepractice candidacy.

      Baseline condition. In the baseline condition, the interventionist meets with each
      participant three times a week to collect baseline data. Participants receive
      business-as-usual instruction-that is, the interventionist stops the child immediately at
      point of miscues, supplies the word, and tells the child to continue reading.

      Intervention condition. The proposed intervention program consists of three components: (a)
      Word reading and phonics instruction, (b) applying a comprehension monitoring strategy to
      improve text reading accuracy, and (c) complex sentences use in written text. With each
      participant, instruction is delivered in three 50-minute weekly sessions across 15 weeks.
      Intervention activities delivered in the first, second, and third session of the week is
      outlined in Figure 1. The interventionist collects the CUBED Narrative Language Measure (NLM)
      probe on the fourth day of the week when no instruction is given. The 3-minute reading probes
      will be administered on a weekly basis.

      Maintenance condition. Across three weeks of no intervention, each of the progress-monitoring
      assessments is administered once per week.
    

Intervention name(s): Children in Grade 1 to 5 with literacy and language needs
Intervention type(s): Behavioral
Intervention description(s): The investigators deliver a telepractice-based intervention targeting: (a) Word reading and phonics instruction, (b) applying a comprehension monitoring strategy to improve text reading accuracy, and (c) complex sentences use in written text. Participants receive 3 online 50-minute tutoring session weekly across 15 weeks.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment