According to Wolf and Katzir-Cohen (2001), reading fluency refers to "a level of accuracy and rate where decoding is relatively effortless; where oral reading is smooth and accurate with correct prosody; and where attention can be allocated to comprehension" (p. 219). Difficulties in reading fluency is one of the major problems in children with reading deficits: their reading is slow, hesitant, and sometimes extremely laborious.
The concept of reading fluency plays an important role in theoretical models of reading acquisition. LaBerge and Samuels (1974) proposed that learning to read involves increasing automaticity in processing word units, and thereby increases the cognitive attentional resources for text processing. Similarly, Perfetti's (1985) verbal efficiency model suggests that slow word processing speed interferes with automaticity of reading and, therefore, with comprehension. Despite the theoretical relevance of reading fluency for the development of competent reading skills, it has been largely neglected in reading research (Allington, 1983). In recent years, however, fluency and fluency intervention have regained the attention of both researchers and practitioners ( see, for example, Kame'enui & Simmons, 2001).
The oldest and most commonly used method for facilitating fluency is the repeated reading technique (Samuels, 1985) where certain reading material is read repeatedly until a particular rate is attained. The majority of intervention studies focus on passage-level reading ( see Chard, Vaughn, & Tyler, 2002, for a recent review). Another approach is to focus on training of word recognition, which plays a particularly central role in the complex process of reading. It is often claimed that practicing isolated words is not pedagogically sound because it does not transfer to text reading. However, Levy, Abello, and Lysynchuk (1997) could show that repeated reading of word lists does indeed have a positive effect on reading the same words in connected text. Tan and Nicholson (1997) also found that gains in word recognition speed led to improved comprehension of text. Levy (2001) directly compared the effects of context training versus list training on later reading fluency. She reported no differential benefits from list or contextual training.
Based on findings like that, Torgesen, Rashotte, and Alexander (2001) come to the conclusion that "the primary locus of the repeated reading effect is on individual word reading efficiency" (p. 346). This conclusion is highly plausible as it has been demonstrated that it is the process of word reading that is deficient in reading disabled children (Ben-Dror, Pollatsek, & Scarpati, 1991). Poor readers not only have problems in reading connected texts, but also show the same (or even bigger) problems in reading words in isolation.
In the present study, training of isolated words was given preference over text reading for methodological reasons. We wanted to determine if the method of repeated word reading is efficient to help dysfluent readers build up orthographic representations of (1) a limited set of training words and (2) specifically trained sub-word units (in our case, onset clusters). The assumption was that such representations can further be used for fast and automatic recognition of (1) the trained words and (2) untrained words that include a trained subword unit. Training on the word level only allowed both specific selection of the training material and precise examination of differential effects of our training on certain word types.
Two factors are relevant for fast and fluent word recognition: namely, accuracy and speed. Word reading accuracy is mainly dependent on phonological decoding skills. Quite obviously, problems and mistakes in working out the correct pronunciation of a certain grapheme string will have a strong negative influence on reading accuracy, fluency, and comprehension.
However, decoding in itself is a slow and laborious process. Word reading only becomes fast and automatic once the reader has developed a strategy of direct word recognition. Competent readers are able to recognize and directly retrieve words from an orthographic lexicon consisting of a large number of memory representations of word spellings. This reading strategy is sometimes referred to as "sight word reading" (e.g., Torgesen et al., 2001). However, this terminology is somewhat misleading as it suggests that it is essentially a visual process. As explicated below, current theoretical conceptions of orthographic representations assume that they entail close associations between spoken and written word forms (Ehri, 1992; Perfetti, 1992) and, therefore, involve a heavy verbal component.
Decoding skills are important for the buildup of orthographic representations because these skills provide a so-called "self-teaching mechanism" (Share, 1995). Words that can be decoded correctly can consequently be stored as orthographic representations. If a certain word cannot be decoded adequately, this self-teaching process will not work (Cunningham, Perry, Stanovich, & Share, 2002). Although decoding skills play an important role in the buildup of an orthographic lexicon, they are not sufficient. Indeed, there is a second group of poor readers that is able to decode adequately and, therefore, shows high reading accuracy, but still reads very slowly. Lovett (1987), for example, identified a group of "speed disabled" readers who made only very few mistakes but read nonwords, isolated words, and text much slower than normally developing readers. Wolf and Bowers (1999) also suggest that a group of poor readers characterized by deficits in visual naming speed are mainly deficient in reading fluency but not in reading accuracy. This pattern of performance is especially typical for poor readers in orthographies with consistent grapheme-phoneme correspondences like Dutch (de Jong & van der Leij, 2003) or German (Wimmer, 1993; Wimmer & May ringer, 2002).
Thus, the group of dysfluent readers is in fact nonhomogeneous. Some children still have difficulties with decoding procedures and hesitate because they cannot work out the correct pronunciation of a certain word, while others have adequate decoding skills but are "just" slow. This is a serious problem for intervention research because it is highly likely that during a certain intervention program, some dysfluent readers will make progress while others will not profit from the very same intervention, possibly because it does not tackle their specific problem.
In recent years, research on reading remediation focused mainly on the treatment of phonologically based intervention programs to improve children's decoding skills ( see Lyon & Moats, 1997, for a review). Meticulous intervention studies show consistently that these programs are highly successful in improving reading accuracy, and as a consequence, also reading comprehension. However, this type of intervention is not necessarily successful in improving reading fluency. Torgesen, Rashotte, Alexander, Alexander, and MacPhee (2003) report that each of five phonologically based long-term reading intervention programs was successful in improving reading accuracy and comprehension, but in only one of these studies, children's reading fluency improved as well. In a recent review of research on reading intervention Lyon and Moats (1997) report the "persistent finding" that "improvements in decoding and word-reading accuracy have been far easier to obtain than improvements in reading fluency and automaticity" (p. 579). We assume that helping children develop their decoding skill does not necessarily also help them build up an orthographic lexicon that can be used for fast and automatic direct word recognition. But what else is needed?
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