Child & Family Behavior Therapy

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Parent Implementation of an Oral Reading

Intervention: A Case Study

Joseph H. Evans , Rachel J. Valleley & Keith D. Allen PhD

To cite this article: Joseph H. Evans , Rachel J. Valleley & Keith D. Allen PhD (2002) Parent Implementation of an Oral
Reading Intervention: A Case Study, Child & Family Behavior Therapy, 24:4, 39-50, DOI: 10.1300/J019v24n04_03

To link to this article: https://doi.org/10.1300/J019v24n04_03

Published online: 08 Sep 2008.

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CASE STUDY

Parent Implementation
of an Oral Reading Intervention:
A Case Study
Rachel J. Valleley
Joseph H. Evans
Keith D. Allen

ABSTRACT. Reading is an extremely important skill that children must

learn; however, many children struggle to become competent readers. One
response to a slow learning rate is to increase opportunities for responding.
In this case study, a child’s parent was recruited to provide additional
oppor tunities for reading practice. A brief oral reading assessment was
conducted to determine which of the reading interventions would be
optimal for in creasing parent adherence and the child’s reading fluency.
The parent was trained to implement a sight word flash card drill to
address word knowl edge out of context, to implement an overcorrection
procedure for errors while reading in context, and to utilize rewards for
reading. Results show that the parent reliably implemented the
intervention as prescribed. In addi

Rachel J. Valleley, Joseph H. Evans, and Keith D. Allen, PhD, are affiliated with the
Munroe-Meyer Institute for Genetics and Rehabilitation, 985450 Nebraska Medi cal
Center, Omaha, NE 68198-5450.
Correspondence may be addressed to Keith D. Allen.
This research was supported in part by grant MCJ 319152 from the Maternal and
Child Health Bureau, Health Resources Services Administration and by grant 90 DD
032402 of the Administration on Developmental Disabilities.
Child & Family Behavior Therapy, Vol. 24(4) 2002
http://www.haworthpressinc.com/store/product.asp?sku=J019
 2002 by The Haworth Press, Inc. All rights reserved. 39
40 CHILD & FAMILY BEHAVIOR THERAPY

tion, the child’s sight word knowledge reliably increased throughout the in
tervention. Finally, the child’s reading fluency showed marked
improvement with a combined overcorrection and reward procedure. The
results of this case study demonstrate that a parent can be taught to
implement reliably a reading program to provide additional reading
practice with good treatment integrity. Follow-up data and additional
implications are discussed. [Arti cle copies available for a fee from The
Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address:
<getinfo@haworthpressinc.com> Website: <http://www.HaworthPress.com> ©
2002 by The Haworth Press, Inc. All rights re served.]

KEYWORDS. Reading, parent implementation, treatment adherence

Reading is one of the most reliable predictors of overall school suc

cess (Beck & Juel, 1992). Certainly word recognition (i.e., accuracy) is
one critical part of reading mastery (Jordan, 1994). But accuracy alone
does not reflect full mastery. Fluent responding (i.e., rate of reading) is
necessary for the learner to be considered competent in this skill area
(Binder, 1996). Fluency is also critical because it is thought to promote
comprehension.
Accuracy and fluency in reading improve through practice (Slocum,
Street, & Gilberts, 1995; Stanovich, 1986). Standard practice
interventions for increasing word accuracy
typically include strategies
such as prompting and modeling during sight word drills (Espin & Deno,
1989; Pavchinski, Evans, & Bostow, 1989), previewing (Daly, Martens,
Hamler, Dool, & Eckert, 1999), read along, and overcorrection (Singh &
-
Singh, 1986; Singh, 1990). If a child’s word accuracy is strong, strate
gies that address fluency, including reinforced rapid reading and repeated
readings have been utilized (Daly, Martens, Hamler, Dool, & Eckert,
1999). A summary of studies on reading strongly supports these types of
-
active responding to increase skill mastery (Skinner, 1998). Further
more, many of these strategies offer the reader multiple repetitions with
-
the same passage. Indeed, increasing the number of opportunities a stu
dent has to learn can lead to improvements in both accuracy and fluency
(Albers & Greer, 1991; Skinner, Ford, Yunker, 1991). Certainly, one
-
way to increase the number of opportunities a child has to read is to in
volve a parent in arranging for practice opportunities conducted outside
of the school day.
Perhaps one of the more significant hurdles confronting a clinician’s
attempt to include a parent in implementation of any intervention is
maintaining parental adherence to specific treatment recommendations.
Case Study 41

Interventions that are too complex, too demanding, or do not produce

immediate results are much less likely to produce adherence by the par
ent (Allen & Warzak, 2000). Fortunately, previous studies indicate that
brief oral reading assessments, which are generally reliable and valid
indicators of reading skill, are sensitive to short-term instructional growth
(Shinn, Good, Knutson, & Tilly, 1992). Thus, brief oral reading
assessments allow clinicians to give parents relatively immediate feed
back (i.e., reinforcement) about progress that is being made in their
child’s reading skills. In addition, clinicians can take advantage of the
sensitive nature of oral reading by “testing” potential treatment compo
nents before selecting an intervention (Daly, Martens, Dool & Hintze,
1998; Daly et al., 1999). This allows clinicians potentially to rule out
ineffective conditions by identifying treatments that fail to produce im
mediate results. Finally, brief oral reading assessments allow clinicians to
select the treatment that produces the best results with the least amount of
effort required of the parent. Each of these features of brief oral reading
assessments have the potential to enhance parent adherence.
The purpose of this case study is to explore the implementation of a
reading enhancement program by a parent. Brief oral reading assess
ments were used to identify the optimal treatment, to reinforce adher
ence, and to make informed decisions about modifying instructional
methods. Both reading interventions include use of reinforcers. The
parent was trained to implement a sight word flash card drill and an
overcorrection reading procedure to provide additional reading expo
sure
for her son.

METHOD

Participant and Setting

Sam was a seven-year-old Caucasian male in the second grade at a
private school for students with learning disabilities. He had been re
moved from his public school during the first grade and had been veri
fied as having a Specific Learning Disability in Reading, Writing, and
Mathematics. Training on the procedures and progress monitoring was
conducted in an outpatient treatment center.

Dependent Measures
The two primary dependent measures for this case study were sight
word knowledge and reading fluency. Sight word knowledge was mea
42 CHILD & FAMILY BEHAVIOR THERAPY

sured during clinic-based probes using the Dolch Basic Sight Word List
at the pre-primer level (Dolch, 1948). Reading fluency was defined as
words per minute correct (WPM-C) during clinic-based brief reading
assessments.

Procedures
Assessment. Of 86 possible pre-primer Dolch Sight Words, Sam cor
rectly identified 22 of those words. Children in second grade would typi
cally be expected to accurately identify all of these words. Sam’s sight
word recognition was sufficiently poor that a standard, easily
implemented sight word “flash card” procedure was selected for use by
the parent.
Sam also read a “beginning first grade passage” out loud to a clini
cian. Sam correctly read 8 words per minute, where a typical child in
second grade would be expected to read at least 40 words per minute
correctly on a second grade passage (Fuchs & Deno, 1982). Because this
assessment indicated that Sam had significant reading accuracy deficits,
it was decided to focus on improving accuracy (e.g., preview ing,
overcorrection, and read along) rather than speed (e.g., repeated readings
and rewards for increased reading rate).
Brief oral reading “tests” were conducted to determine whether a pre
viewing, overcorrection, or read along procedure would be best to im
prove Sam’s reading accuracy and to promote parental adherence (see
Figure 1). The results of the treatment testing show that the
overcorrection procedure was most likely to produce rewarding gains in
oral reading and to reinforce parent adherence to the procedure.
Training. Following the baseline assessment, the parent was instructed
to begin implementation of a sight word flash-card procedure involving
modeling, feedback, and adding new words. Selecting from the Dolch
Sight Words, she was instructed to present 14 words to Sam each day,
with 8 words being known. The parent was asked always to include 8
known words in the set of 14 to ensure success. For those that were read
incor rectly, the parent modeled the correct version before placing it into
an in correct pile. Incorrect words were reviewed with Sam until he read
them correctly. Words identified correctly on three consecutive days
were dropped from the rotation and new unknown words were included.
A moti vation program was also established in which Sam could earn a
reward from a “grab bag” of preferred activities, privileges, and treats for
correctly identifying 8 words without correction. The decision to have
the initial re ward criteria match the number of known words was made
to ensure suc
Case Study 43

FIGURE 1. Brief Oral Reading Assessment Results for Treatment

cess in light of Sam’s long learning history of experiencing reading as

a punishing task.
 After the sight word drill had been in place for several weeks and no
change was noted in reading fluency, the overcorrection procedure was
implemented by the parent during daily oral reading of first grade level
passages in the home. While reading a passage, any word errors or hesi
tations of more than 5 seconds by Sam resulted in the clinician reading
the word out loud, followed by Sam repeating the word three times. Sam
was then required to reread the sentence and continue reading the
passage. The parent was asked to have Sam practice reading for about
10-15 minutes each day and then to conclude the reading session by
having him read a new passage (probe) selected in advance by the clini
cian. The parent recorded the WPM-C score and rewarded Sam for sim
ply participating in the reading exercise with access to a “grab bag” of
reinforcers.
Progress monitoring. Sam’s mother returned to the clinic over a five
month period to monitor progress and to problem-solve any difficulties
she was having with the procedure. After four weeks of the sight word
flash card drill, the reward criterion was raised to 9 words correctly
identified. After 7 weeks of the overcorrection procedure and no marked
sustained improvement in fluency, it was deemed reasonable to place
greater de
44 CHILD & FAMILY BEHAVIOR THERAPY

mands on fluency, and the reward contingency was changed from a

partici pation reward to a performance reward. With this change, access
to the grab bag became contingent on increasing three WPM-C from the
baseline rate. The criterion was continuously increased by three WPM-C
after three consecutive days of meeting the previous criterion.

Data Collection
Sam’s progress was monitored both at home and in the clinic. During
each clinical session, the primary investigator presented the 86 Dolch
Sight Word flash-cards and an unknown beginning first grade passage.
Progress was monitored in the home through reading probes conducted
at the end of most reading sessions.

Treatment Integrity and Reliability

The parent was asked to keep track of words read correct each day and
the rewards delivered. Integrity data show that the parent practiced with
the child each day, applied the proper criterion for reinforcement, and
delivered rewards when earned. The parent was also asked to record the
amount of time spent reading each day and to tape record the reading
probe. Sam’s mother correctly implemented the procedure with an av
erage accuracy of 93.6%. Finally, Sam’s mother returned copies of the
tape recordings and the words per minute correct was scored by the pri
mary investigator. The reliability data demonstrate that Sam’s mother
accurately calculated WPM-C (Reliability = 99%).

RESULTS
With the introduction of the sight word practice, marked initial im
provements in Sam’s sight word knowledge were noted (see Figure 2),
with continued improvements over the next four weeks. When the re
ward criterion was increased to 9 words correct, both word recognition
and rate of learning, appear to have improved. After the sight word flash
card procedure had been in place for several weeks, the overcorrection
procedure was implemented by the parent in the home. Figure 3 shows
that after 5 weeks of the overcorrection procedure, there was no marked
or sustained improvement in fluency. With the addition of the perfor
mance contingency, fluency showed a marked immediate improvement
s P B- e
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46 CHILD & FAMILY BEHAVIOR THERAPY

Sam’s mother also conducted reading probes at home to monitor his

progress. During the initial overcorrection phase, Sam correctly read on
average 17.4 words per minute, ranging from 9 to 34 WPM-C. When the
performance criteria and reward were added, Sam’s average words per
minute correct raised to 30.6, ranging from 12 to 74 WPM-C during
home reading probes. Thus, it appears that adding the overcorrection and
reward program increased his reading speed both at home and in the
clinic.
At 3 month follow-up, gains in sight word knowledge and reading
fluency had maintained (see Figures 2 & 3). While comprehension was
not specifically targeted, comprehension had improved as measured by
standardized achievement tests conducted at school (Standard Score
Passage Comprehension changed from 66 to 82). Furthermore, Sam
correctly identified 84 of the 86 Dolch Sight Words, read 38 WPM-C on
a beginning first grade passage, and 30 WPM-C on an end of second
grade passage. Finally, Sam had been returned to a regular education
classroom in the public school system without special supports for read
ing.

s Rl
DISCUSSION
Results show that this parent effectively enhanced the reading perfor
mance of a student with significant delays in reading accuracy and flu
ency. The parent reliably implemented the skill and motivational aspects
of the program. In light of the fact that this student was already receiving
individualized intervention in a private school for students with learning
disabilities, it appears that the parent-implemented inter vention
contributed to improved accuracy and fluency.
The parent’s adherence to the program may have been the result of a
strong level of motivation to improve her child’s reading even before
implementation of the program. However, the parent’s adherence may
also have been tied, in part, to the success of the initial assessment in
identifying accuracy as a significant area of weakness for immediate in
tervention. By targeting accuracy first, the clinician was able to select an
intervention that was both easily implemented and also provided a high
probability of success. The immediate improvements in sight word
recognition could be expected to reinforce the student for participation
and the parent for adherence to program implementation.
Interestingly, although the flash-card drills and the overcorrection
g
procedure produced changes in accuracy, they did not produce im
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48 CHILD & FAMILY BEHAVIOR THERAPY

provements in fluency. Not until the reward contingency was changed

from a participation reward to a performance reward did marked im
provements in fluency occur . These results are consistent with previous
studies that have shown that students should receive feedback about their
rates of performance (Lindsley, 1990; Pavchinski et al., 1989). Al though
it is impossible to attribute the changes in fluency to the addition of the
performance contingency alone, these results do seem to support the
notion that there is a link between use of reinforcers and improve ment in
reading achievement.
These results also demonstrate the importance of using data to make
clinical decisions. The decision to start with an accuracy intervention was
based on the initial assessment demonstrating significant deficits in this
area. That choice proved important in establishing early success and
possibly promoting treatment adherence. The decision to increase the
sight word criteria was also based on the data showing gradual but slow
improvements. That decision proved important in increasing the level
and rate of sight word learning. The decision to use the overcorrection
procedure, initially with a participation reward instead of a performance
reward, was also made based on the initial assessment showing such poor
word recognition. That decision proved ineffective. The decision to move
from a participation contingency to a performance contingency during
overcorrection was based on the fact that the Sight Word Proce dure was
working so well with the performance criteria and the Overcorrection
Procedure would not work as well without it. That decision also proved
valuable. Although the exact timing of each of these changes was not
ideal in terms of demonstrating clear experimental control, these deci
sions made sense clinically. That is, clinical decisions can rarely be made
based solely on the data. Clinical decisions require integrating in
formation provided by data along with information about the needs of the
client.
As a result of the clinical decisions that were made, caution must be
used in interpreting the results too broadly. First, it is unknown whether
the performance reward targeting fluency would have been useful from
the beginning. Second, it is difficult to tell whether the changes in flu
ency were ultimately a result of increased word knowledge, the perfor
mance reward, or some combination. Regardless, it seems clear that a
parent can be taught simple reading interventions that can be imple
mented in the home and monitored by a clinician to improve reading ac
curacy and fluency in children markedly. In addition, the results support
the general notion that reading skills are critical to overall academic per
formance. Providing Sam with additional home-based reading prac
Case Study 49

tice resulted in increased sightword knowledge and reading-fluency that

helped integrate him back into a regular education classroom with out
modifications.
Additional research in this area of parent implementation of a home
reading program would need to replicate this case study to determine
whether highly motivated parents are necessary for treatment success.
Furthermore, it would be important to determine what the minimal
amount of support by the clinician is necessary for improving reading
skills and training parents in implementation of a home reading pro
gram.
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RECEIVED: 09/21/01
REVISED: 12/03/01
ACCEPTED: 12/24/01