514856

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RSEXXX10.1177/0741932513514856Remedial and Special EducationGarwood et al.

Article
Remedial and Special Education

Improving Reading Comprehension and

2014, Vol. 35(3) 181–194
© Hammill Institute on Disabilities 2014
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DOI: 10.1177/0741932513514856

Emotional-Behavioral Disorders: Recent rase.sagepub.com

Research Synthesized

Justin D. Garwood, MEd1, Nelson C. Brunsting, MA1, and

Leslie C. Fox, MS1

Abstract
As the reading difficulties experienced by students with emotional-behavioral disorders (EBD) receive more attention,
the corresponding call for evidence-based practices has become more pronounced. We conducted a systematic review
of comprehension and fluency interventions for middle and high school students with EBD served outside of the general
education classroom in the years since the Individuals With Disabilities Education Improvement Act (2004). This literature
synthesis represents a response to previous reviews to provide an updated state of the field regarding reading intervention
research for students with EBD. The nine studies meeting inclusion criteria, all of which employed a single-subject design,
contained a variety of intervention procedures and practices. Results indicated an increased amount of research involving
middle and high school students with EBD. Effect sizes are reported, in addition to implications and recommendations for
school-based practitioners and directions for future research.

Keywords
emotional or behavioral disorders, reading comprehension, reading fluency, special education, adolescent literacy

It is estimated that between 2% and 20% of K-12 students
exhibit signs of emotional-behavioral disorders (EBD) at
some point during childhood or adolescence (Lane, Barton-
Arwood, Nelson, & Wehby, 2008; Walker, Ramsey, &
Gresham, 2004). While the point prevalence of EBD (i.e.,
the percentage of students in a given school year with EBD)
ranges from 2% to 20%, the cumulative prevalence of EBD
for students throughout their school years rises from 37% to
39% (Forness, Freeman, Paparella, Kauffman, & Walker,
2012). Individuals with EBD demonstrate the following
characteristics: strained relationships, behavior problems,
and academic deficits (Bullis & Yovanoff, 2006; Wagner &
Davis, 2006; Walker et al., 2004). Behaviors typical to stu-
dents with EBD include externalizing behaviors such as
physical or verbal aggression, noncompliance, and hyperac-
tivity (Stouthamer-Loeber & Loeber, 2002), as well as
internalizing symptoms such as anxiety and depression
(Morris, Shah, & Morris, 2002). Academically, students
with EBD enter high school three-and-a-half-grade levels
below students who are typically developing (Nelson,
Benner, Lane, & Smith, 2004), and their reading compre-
hension deficits are sustained or worsened as they progress
through school (Coutinho, 1986; Lane et al., 2008).
Considering that almost 40% of students experience an
EBD before adulthood (Forness et al., 2012) and of all the
students receiving special education services those with an
EBD gain eligibility least often (i.e., 7.5%; U.S. Department
of Education, 2008), these struggles in reading comprehen-
sion, a fundamental skill necessary for success in school
and beyond, are troubling and require further attention.
In a meta-analysis of the academic outcomes for students
with EBD, comorbidity between academic and behavioral
struggles ranged from 25% to 97% (Reid, Gonzalez,
Nordness, Trout, & Epstein, 2004). Although only 8% of all
youth with disabilities receive grades below a C, 14% of
students with EBD receive grades of D or F and 33% do not
perform at grade level on academic tasks (Wagner &
Cameto, 2004). Considering post-secondary outcomes, stu-
dents with Emotional Disturbance (ED), the label under
which many students with EBD receive special education
services, have the highest rate of criminal arrest (49.4%),
1
The University of North Carolina at Chapel Hill, USA
Corresponding Author:
Justin D. Garwood, School of Education, The University of North
Carolina at Chapel Hill, Peabody Hall, CB 3500, Chapel Hill, NC 27599-
3500, USA.
Email: garwoodj@email.unc.edu
182
the lowest community participation (33.3%), and the sec-
ond lowest rate of post-secondary school enrollment
(44.9%), when compared with other students served in spe-
cial education (Sanford et al., 2011). Academic struggles
correlate highly with maladaptive behaviors and hinder the
transition to life after formal schooling (Lane, Carter,
Pierson, & Glaeser, 2006; Reid et al., 2004).
Students with EBD rarely make significant gains in aca-
demics over the course of their education (Nelson et al.,
2004). Students with EBD struggle with reading compre-
hension and progress at a slower rate than their peers (Lane
et al., 2008); this is particularly troubling, given the critical
importance of comprehension in establishing reading profi-
ciency (Faggella-Luby & Deshler, 2008). Conflicting evi-
dence regarding the interaction between students’ behavioral
challenges and reading intervention complicates the issue.
Nelson, Benner, and Gonzalez (2003) found that the prob-
lem behavior of students with EBD can negatively affect
the results of traditionally successful reading interventions,
while others have discovered reading interventions to have
a positive effect on both academics and behavior (Lane
et al., 2002). Regardless of directionality, the struggles of
students with EBD demonstrate a critical need to improve
their reading skills.
Adolescent Literacy
Roughly 8 million students in Grades 4 to 12 experience
problems reading at grade level (Biancarosa & Snow,
2006). Research into adolescent literacy has increased sig-
nificantly in the last 10 years as reading instruction for
middle and high school students has become a priority
(Cassidy, Valadez, Garrett, & Barrera, 2010; Henk,
Marinak, & Melnick, 2013). A focus on early literacy
achievement in the last 20 years has yielded some promis-
ing results for students through 3rd grade; however, these
gains have not been sustained at the 8th- or 12th-grade
level (Biancarosa & Snow, 2006). More recently, the 2009
National Assessment of Education Progress found that
only 31% of 8th graders met reading proficiency (Henk
et al., 2013).
The National Reading Panel (2000) identified the fol-
lowing constructs of reading: (a) phonemic awareness, (b)
phonics, (c) vocabulary, (d) fluency, and (e) comprehen-
sion. While phonemic awareness and explicit phonics
instruction are often the target of early literacy research,
struggles in decoding only affect 10% of students and com-
prehension of text remains the most daunting task for older
readers (Biancarosa & Snow, 2006). Reading comprehen-
sion is a skill particularly important to adolescent students,
as it is critical to academic success in all content areas
(Moje, 2008). Comprehension of text is crucial at the mid-
dle and high school levels, as students move beyond a
Remedial and Special Education 35(3)
model of learning to read to one of learning to read to learn
(Biancarosa & Snow, 2006; Chall, 1983).
Reading fluency, most often identified as words read
correctly per minute (Vandenberg, Boon, Fore, & Bender,
2008), contributes to a student’s proficiency in reading
comprehension (National Reading Panel, 2000). An inabil-
ity to read fluently places greater demands on cognitive
abilities and forces the reader to focus on decoding strate-
gies, leaving less capacity for comprehension (Levy &
Chard, 2001; Rasinski et al., 2005). Fluency instruction
should be continued with middle and high school students,
especially those who struggle with reading (Rasinski et al.,
2005). In their study investigating the predictors of reading
comprehension in ninth-grade students, Rasinski and col-
leagues found that 28% of the variation in a high school
graduation exam focused on comprehension was accounted
for by fluency.
Literacy and Students With EBD
Griffith, Trout, Hagaman, and Harper (2008) published a
comprehensive review of interventions designed to improve
the literacy functioning of adolescent students with EBD,
they identified 17 studies published between 1965 and
2005. Griffith and colleagues found that spelling was the
most common focus of literacy interventions for adoles-
cents, constituting more than one third of all studies, which
is consistent with the findings from a previous meta-analy-
sis (Reid et al., 2004). In addition, the types of interventions
used with middle and high school students have varied
greatly and thus limited the recommendations researchers
can make to practitioners (Griffith et al., 2008). Among
their conclusions, Griffith and colleagues documented sev-
eral implications for future research, including (a) the par-
ticipants and settings chosen for intervention research
should accurately reflect the reality of an adolescent stu-
dent, and (b) greater emphasis should be placed on all types
of literacy interventions, but reading comprehension is par-
ticularly under-researched and in need of attention.
Significantly more research on interventions targeting
reading skills for students with EBD has been conducted at
the elementary level (Rivera, Al-Otaiba, & Koorland,
2006). Rivera and colleagues noted a lack of evidence-
based practices for this population in elementary school,
despite increased attention being given to the reading needs
of students with behavior challenges. A more recent review
by Griffith, Hurley, and Hagaman (2009) found treatment
integrity (TI) in literacy interventions for students of all
ages with EBD to be reported in roughly half of the 44 iden-
tified studies, which is a salient concern given the pressing
need to establish evidence-based interventions. If no data
on TI are available, it is not possible to determine the cause
of the intervention effects.
Garwood et al.
The work done by Griffith et al. (2008) is the only known
review in the literature with an emphasis on the reading out-
comes of secondary students with EBD. The findings from
Griffith and colleagues provided an in-depth summary of
this work, which addressed a significant gap in the research.
The review, however, focused on a wide range of teaching
environments (e.g., general education, self-contained class-
room, university lab setting) and worked with a broad defi-
nition of literacy (e.g., spelling, phonemic awareness,
vocabulary). Due to the increased understanding of the
importance of reading fluency and comprehension for ado-
lescent literacy, our review was guided by, and a direct
response to, the recommendations of Griffith and col-
leagues. Therefore, our review focuses on interventions
outside of the general education classroom (i.e., the reality
of most adolescent students identified with EBD) and liter-
acy outcomes most pressing for students at the secondary
level (e.g., comprehension and fluency).
Purpose
In their review, which included studies published through
2005, Griffith et al. (2008) noted a surprising absence of
literature reviews focused on the literacy needs of adoles-
cents with EBD. The purpose of the current review is to
serve as a response to the work of Griffith and colleagues to
make recommendations for reading interventions for mid-
dle and high school students identified with EBD. Our
intent is to review the specific strategies attempted with stu-
dents with EBD to present the quantity and characteristics
of the research focused on adolescent students’ reading
skills. A focus on interventions conducted outside of the
general education classroom is relevant as research has doc-
umented students in self-contained classrooms score sig-
nificantly lower in oral language and broad reading
compared with those in general education settings (Maggin,
Wehby, Moore Partin, Robertson, & Oliver, 2011). While
not all placements outside of the regular classroom are self-
contained in nature, many students with EBD find them-
selves in this setting.
Our review examined studies published between 2004
and 2012 targeting reading comprehension or fluency out-
comes for secondary students with EBD in non-general
education classroom settings. Our synthesis was guided by
the following questions:
1. What is the number and nature of published studies
focused on reading fluency or comprehension out-
comes for secondary students with EBD in special
education?
2. What were the research designs and elements of the
studies completed since 2004?
a. Has the rate of publication of research on
interventions targeting reading comprehension
183
or fluency for the target population increased
since 2004?
b. Has there been an increase in the percentage of
these studies’ reporting of TI?
3. What are the effect sizes of the identified
interventions?
Method
Article Selection
A systematic search for intervention studies focusing on
reading comprehension or fluency outcomes for secondary
students with EBD in a self-contained or resource room set-
ting was conducted in a three-stage search process: (a) elec-
tronic, (b) hand, and (c) ancestral review.
Electronic Search
Four databases were used to perform the electronic search:
Academic Search Complete, Electronic Resources
Information Center (ERIC), PsycINFO, and Education Full
Text (H. W. Wilson). Within the four databases, we con-
ducted a broad search to include exact matches and any
variations of the following terms: (Field 1) secondary, high
school, middle school, adolescent, freshmen, sophomore,
junior, and senior; (Field 2) general education, special edu-
cation, resource room, self-contained, and intervention;
(Field 3) read, comprehension, and fluency; and (Field 4)
emotion, behavior, and EBD. The initial results contained
211 articles for possible inclusion. Each article was inserted
into an Excel spreadsheet and subsequently coded by the
authors. If the title and abstract indicated any possibility for
inclusion in the review, it was flagged and the entire article
pulled to be read in full. Although we were only interested
in interventions designed to improve comprehension or flu-
ency outcomes, we examined all articles with reading com-
prehension or fluency as either the dependent or independent
variable to be sure we did not miss any studies. The major-
ity of articles from the electronic search were not relevant to
the current review (i.e., not about students with EBD, not
related to literacy), most likely because of the broad search
terms utilized. We expected this may happen, as we
attempted to capture every article with any possibility of
relevance. Seventeen possible articles were identified by
reading abstracts and titles.
Hand Search and Ancestral Review
A list comprised of each journal meeting initial inclusion
criteria was created. The first author conducted hand
searches in journals in which two or more of the identified
articles were published, beginning at 2004 and ending in
2012. The following three journals were identified and
184
reviewed: Journal of Special Education, Behavioral
Disorders, and Journal of Emotional and Behavioral
Disorders. Finally, the first and second authors conducted
an ancestral review of all included studies. The reference
list of each article was reviewed to identify any articles
missed in the previous searches. One article was identified
in the ancestral search to be included in this review (Daly,
Garbacz, Olson, Persampieri, & Ni, 2006).
Application of Inclusion Criteria
Articles were included in this review if they met the follow-
ing criteria: (a) contain a school-based intervention with
reading comprehension or fluency as the dependent vari-
able; (b) identify and differentiate outcomes for students
with EBD; (c) focus on middle or high school students in a
self-contained setting or resource room; (d) implement an
experimental, quasi-experimental, or single-subject
research design; (e) occur in the United States between
2004 and 2012; and (f) published in English in a peer-
reviewed journal.
School-based reading intervention for students with EBD. Some
studies were excluded because they involved an interven-
tion for students in either a residential treatment center or
some form of juvenile detention facility (e.g., Allen-
DeBoer, Malmgren, & Glass, 2006; Rogevich & Perin,
2008). While these settings are still held accountable for
students’ academic progress, there are considerable differ-
ences between correctional institutions and public or pri-
vate schools (e.g., type of instruction, staff qualifications,
security and access). A review of interventions conducted
with students in these settings may be appropriate, but it is
beyond the scope of this focused review. The dependent
variable must have been either reading comprehension or
fluency, or a combination of both; however, the intervention
itself could address these outcomes through any means nec-
essary. While some reading interventions may be designed
to assess associations with other aspects of literacy (e.g.,
spelling), we were only interested in those studies reporting
intervention effects for comprehension or fluency.
Grade level. It was necessary to develop more specific crite-
ria for the grade-level marker due to the variance in states’
definitions of secondary education. For some, secondary
education implies high school. For others, it also includes
middle school, while many others consider secondary liter-
acy as including Grades 4 to 12 (Cassidy et al., 2010). The
elementary school environment differs from middle and
high schools to a substantial degree, but the distinction
between middle and high schools can vary by district.
Therefore, we used the school’s designation between ele-
mentary, middle, and high schools. In this review,
primary school refers to students in elementary grades,
Remedial and Special Education 35(3)
while secondary refers to middle and high schools. A study
involving both elementary and secondary students was
excluded because the results of the intervention, while posi-
tive, were not differentiated for each group, making it not
possible for us to examine outcomes for secondary-age stu-
dents (McDaniel, Houchins, & Perry, 2013).
Research design. To increase the generalizability of these
studies to various educational settings, only studies utiliz-
ing experimental, quasi-experimental, or single-subject
research methods were included. One qualitative article dis-
covered, but not included, focused on student and teacher
perceptions of a reading program (McDaniel, Duchaine, &
Jolivette, 2010). While we recognize qualitative research
can add much to the knowledge base, the focus of our
review was to document the empirical research conducted
with secondary students with EBD since 2004 as a response
to Griffith et al. (2008). Finally, studies were required to be
published in a peer-reviewed journal, as the authors con-
sider the external peer-review process to be an important
marker of research quality; thus, dissertations were also
excluded.
Effect Size
To determine effect sizes on dependent variables related to
comprehension and fluency, we calculated the Improvement
Rate Difference (IRD; Parker, Vannest, & Brown, 2009) for
each participant in each phase of each study. IRD is calcu-
lated by subtracting the proportion of “improved” data
points in the baseline phase(s) from the proportion of
“improved” data points in the intervention phase(s).
Although Percentage of Non-Overlapping Data (PND;
Scruggs, Mastropieri, & Casto, 1987) has frequently been
used to determine effect sizes for research with single-case
designs, it can have high levels of error (Wolery, Busick,
Reichow, & Barton, 2010), demonstrates ceiling and floor
effects, and does not have a sampling distribution (Parker et
al., 2009). We chose IRD as it has a known sampling distri-
bution, which allows for the calculation of confidence inter-
vals (CIs). CIs are especially useful for the current review,
due to the small samples and relatively few data points
reported in many single-case research studies. In addition,
IRD is a non-parametric statistic and provides better fit for
single-subject designs, which often do not have standard
distributions. Concurrent validity has been established with
IRD (Parker et al., 2009), as it correlates highly with other
measures of effect sizes: R2 (.86), Kruskal–Wallis W (0.86),
and PND (0.83).
Behavioral outcomes were reported in some studies in
addition to academic outcomes. In these instances, only the
dependent variables associated with comprehension or flu-
ency were analyzed in IRD calculations. Many studies
included a baseline (A), a priming intervention (B), and the
Garwood et al.
full intervention (C), with the multiple baseline occurring in
between Phases B and C. In these instances, IRD was calcu-
lated and reported separately for both phases (i.e., A to B
and B to C). Two articles used alternating treatments design
to test the impact of two treatments to the control treatment.
Similar to its calculation in the multiple-baseline designs,
IRD was calculated by comparing A to B and B to C, and
the effect sizes are reported for both phases. For each study,
we report the IRD range across participants and the omni-
bus IRD, computed by summing the improvement scores
for each phase across cases before dividing them by the
total score of the summed cases, for each dependent vari-
able related to comprehension or fluency. We also report the
95% CIs for each omnibus IRD. Newcombe’s (1998) score
method was selected as it could account for small sample
sizes and instances where the IRD score was 1.0. Information
for the interpretation of IRD scores is included with the
results.
Results
A total of nine articles met inclusion criteria, appearing in
the following peer-reviewed journals: Behavioral Disorders,
Behavioral Interventions, Journal of Emotional and
Behavioral Disorders, Journal of Evidence-Based Practices
for Schools, Journal of Special Education, Journal of
Special Education Technology, Psychology in the Schools,
and School Psychology Review. Each of the nine studies
employed a single-subject research design, which was simi-
lar in proportion to the results of Griffith and colleagues
(2008), who found 82% of their included studies used sin-
gle-subject designs.
Table 1 contains descriptive results from included stud-
ies, focusing on participant demographics (i.e., gender, age,
ethnicity), reading levels, school setting, intervention,
dependent variables, and results.
Participant Characteristics
A total of 38 participants were involved in the nine studies.
Gender information was provided in every study, with
males representing 79% of the included sample. The par-
ticipants’ ages were also documented in each of the nine
studies, with a range between 11.4 and 16 years represent-
ing middle and high schools. This is a marked improvement
in the research literature, as Griffith et al. (2008) found that
more than half (52%) of the studies they reviewed did not
provide the gender of participants, and almost a quarter
(24%) did not report their age. Reading levels of the partici-
pants were reported in 78% of the studies, with a mean
range between Grades 3 and 7.3.
Description of behavior. The label of EBD is not used to pro-
vide students with special education services; rather, it is a
185
term to describe a set of behaviors. A label of EBD, as
defined by the respective authors, was present in each of the
studies’ samples. The following labels often used to describe
students with EBD were included: EBD, ED, and behavior
disorder (BD). The labels were assigned to the students in
the following ways: school classification for special educa-
tion (method not specified; six studies), state guidelines
(two studies), and the Individuals With Disabilities Educa-
tion Improvement Act of 2004 (IDEA; one study).
Placement Setting
Fifty-six percent of included studies were implemented in
middle schools; high schools comprised 22% of the set-
tings, and combined middle and high schools accounted for
the other 22%. Regarding school setting, 78% (n = 7) of the
settings in the included studies were public schools, 11%
were private schools, and 11% were not reported.
Intervention Characteristics
Intervention setting. The interventions took place in the fol-
lowing classroom settings: self-contained classrooms
(67%), resource rooms (11%), and outside of their special
education classrooms (e.g., private office or unused room;
22%).
Intervention type. The following interventions were imple-
mented: repeated readings (RR; Meyer & Felton, 1999),
cognitive mapping, choice with antecedent instruction and
reward, listening-while-reading (LWR), corrective reading
(CR; Englemann et al., 1999), text mapping, peer-assisted
learning, and self-graphing. Three practices were incorpo-
rated more than once; however, no reading practice was
implemented more than twice.
Two studies (Alber-Morgan, Ramp, Anderson, & Martin,
2007; Strong, Wehby, Falk, & Lane, 2004) used RR in their
intervention. Alber-Morgan et al. (2007) used the RR condi-
tion in two ways. First, they implemented RR with system-
atic error correction and next with prediction where the
student was asked to predict the plot of the story based on
the title. Strong et al. (2004) used RR as a supplement to CR
in an attempt to improve the student’s fluency. Lingo,
Slaton, and Jolivette (2006) used CR to improve students’
fluency and appropriate behaviors during academic instruc-
tion. The CR program is based on the concept of Direct
Instruction (Becker & Carnine, 1981). Implemented in
small groups or as a whole class, CR incorporates a scripted
curriculum focusing on reading accuracy, fluency, and com-
prehension for Grades 3 to 12 during 45-min lessons, 4 to 5
days per week (Englemann et al., 1999).
Cognitive mapping is a tool for improving the reading
comprehension of students with high-incidence disabilities
(Blankenship, Ayres, & Langone, 2005). Blankenship and
186 Remedial and Special Education 35(3)

Table 1. Participants and Descriptive Data.

Setting of participants Dependent
Study Participants Reading level prior to intervention Intervention variable Results

Alber-Morgan, Ramp,
Anderson, and Martin
(2007)
Blankenship, Ayres, and
Langone (2005)
Daly, Garbacz, Olson,
Persampieri, and Ni
(2006)
Hale et al. (2005)
Lingo, Slaton, and Jolivette
(2006)
Schmitt, McCallum, Hale,
Obeldobel, and Dingus
(2009)
Stone, Boon, Fore, Bender,
and Spencer (2008)
Strong, Wehby, Falk, and
Lane (2004)
Sutherland and Snyder
(2007)
3 males, 1 female, Grades 2–6 (M = 4) Self-contained RR (B); RR + ORF; RC Increase in WCPM and
ages 12–15, Grades day treatment Prediction (C) RC for all participants
6–7, 50% AA, 50% classroom in a for both phases
Cauc. public school
2 males, 1 female, age Grades 5–7 (M = 6.3) Self-contained Use of cognitive RC Higher RC for all
15, Grade 9 classroom in a maps on computer participants
public high school during reading
1 AA female, 1 Cauc. Grade 4 (M = 4) Special education Choice; antecedent ORF Increase in WCPM for
male, age 13, classroom in a instruction; reward both participants
Grade 7 public middle
school
4 males, ages 12–14 Grades 3.4–5.1 (M Self-contained Listening (B); LWR RC Listening increased
= 4.3) classroom (C) comprehension rates,
not comprehension
6 males, 1 female, Grades 1.9–4.9 (M Special education Corrective reading + ORF Increased WCPM on
ages 11.6–14.2, = 3) resource room Direct instruction corrective reading and
Grades 6–7, 85.7% in a public middle grade-level passages
AA, 14.3% Hispanic school
3 males, 1 female, Not provided Private day school for LWR (B); LWR using RC accuracy Increased RC for all
ages 13–16, 75% students with EBD text-to-speech and rate and comprehension
AA, 25% Cauc. technology (C) accuracy for three
students
3 males, 1 female, age Grades 5.0–8.7 (M Self-contained Teacher generated RC Increased RC for all
15, Grade 9 = 7.3) classroom in a text maps (B); students
public high school maintenance:
student text maps
(C)
6 males, ages 12–14, Not provided Self-contained school Corrective reading ORF and RC Increased ORF during
Grades 7–8, 67% for students with (B); Corrective RR for four students;
AA, 33% Cauc. EBD within a public reading + RR (C) mean RC scores
school district during RR increased
for all
2 males, 2 females, Grades 5–7 (M = Self-contained PALS with self- ORF Increased ORF for all
ages 11.4–13.6, 5.75) classroom for graphing (B); participants
75% AA, 25% Cauc. students with EBD maintenance (C)
in a public middle
school

Note. AA = African American; Cauc. = Caucasian; RR = repeated reading; WCPM = words correct per minute; RC = reading comprehension; EBD = emotional-behavioral
disorder; LWR = listening-while-reading; ORF = oral reading fluency; PALS = Peer-Assisted Learning Strategies.

colleagues had students use a computer software program
to organize and understand information from a general edu-
cation textbook. Although cognitive mapping can be
accomplished with paper and pencil, the researchers
believed that computer software would help engage the stu-
dents in an effective manner (Blankenship et al., 2005). In a
separate study, teacher- and student-generated text maps to
improve reading comprehension were the focus (Stone,
Boon, Fore, Bender, & Spencer, 2008). Using assessment
questions as a guide, teachers created text maps to use as a
teaching tool for students. Students were assessed with
comprehension questions and later created their own text
maps based on a review of instructional content and map
components.
Daly et al. (2006) used choice with antecedent instruc-
tion and reward as an intervention to improve student’s oral
reading fluency. Students were allowed to choose how they
would be instructed in reading (e.g., modeling, error correc-
tion). If students met pre-determined fluency goals, they
could be rewarded with items like pens, soda, and gift cer-
tificates (Daly et al., 2006).
Two studies used LWR interventions. Hale et al. (2005)
implemented a listening condition and LWR, while using
silent reading as a control. In the LWR condition, an experi-
menter read a passage as students followed along by read-
ing silently to themselves. Schmitt, McCallum, Hale,
Obeldobel, and Dingus (2009) provided an extension of the
study by Hale et al. (2005), using text-to-speech software to
allow students to listen to a pre-recorded, computerized
voice during the LWR condition. While both studies
resulted in improved rates of comprehension for partici-
pants, Schmitt and colleagues (2009) documented less suc-
cess than Hale et al. (2005) during the LWR condition.
Finally, Sutherland and Snyder (2007) implemented
reciprocal peer tutoring and self-graphing in a study
designed to decrease disruptive behavior, while increasing
reading fluency and active responding in students with
EBD. During self-graphing, students monitored their words
Garwood et al.
read correctly per minute and errors (Sutherland & Snyder,
2007). Using social competence data and other curriculum-
based information about the students, the teacher paired stu-
dents together during the peer-mediated portion of the
intervention. The model used for peer tutoring was Peer-
Assisted Learning Strategies (PALS; Fuchs, Fuchs, &
Kazdan, 1999). The PALS program has been documented
as an effective strategy to improve the academic outcomes
of students with disabilities and those typically developing
(Sutherland & Snyder, 2007).
Length and duration of interventions. All nine included stud-
ies reported intervention length, which ranged from 9 to 80
sessions (M = 32.67), as well as intervention duration. Mean
intervention duration ranged from 10 min to 1 hr, with an
overall mean of 31.28 min.
Interventionists. All nine of the studies reported who imple-
mented the intervention. In four of the studies, teachers
were the implementers (Blankenship et al., 2005; Lingo et
al., 2006; Stone et al., 2008; Sutherland & Snyder, 2007).
One study had multiple implementers (e.g., teacher and
research assistant; Strong et al., 2004). The interventions in
the four remaining studies were led by someone from the
research team (Alber-Morgan et al., 2007; Daly et al., 2006;
Hale et al., 2005; Schmitt et al., 2009).
Training of the implementer. Information regarding the train-
ing of the person implementing the intervention was
reported in 56% of the studies (n = 5). In three studies
(Lingo et al., 2006; Strong et al., 2004; Sutherland & Sny-
der, 2007), teachers received training, while graduate stu-
dents received training in two studies (Alber-Morgan et al.,
2007; Daly et al., 2006), and research assistants (RAs) were
trained in one study (Strong et al., 2004). The duration of
the training was reported in two studies, with teachers
receiving training for 3 hr (Lingo et al., 2006) or 5 hr (Strong
et al., 2004). Strong and colleagues also trained the research
assistant, who implemented the second phase of the inter-
vention, for 2 hr prior to implementation. Teachers received
training in CR in two studies (Lingo et al., 2006; Strong et
al., 2004). Similarly, a research assistant was trained in RR
(Strong et al., 2004).
Design and Dependent Measures
Research design. The nine studies encompassed a variety of
single-subject research designs. Researchers used the fol-
lowing designs at the following rates: multiple baselines
across participants (45%), multiple probes across behaviors
and tasks (22%), alternating treatment across participants
(22%), and multiple probes across participants (11%).
Dependent variables. The most commonly used dependent
variables were words correct per minute (WCPM; 56%)
187
and reading comprehension levels (56%), followed by error
rate (i.e., errors per minute or errors per 30 s; 44%), reading
comprehension rates (22%), and behavior (22%). The fol-
lowing standardized measures were used across the eight
studies reporting measure: Mississippi Curriculum Test,
Analytical Reading Inventory, Wechsler Individual Achieve-
ment Test, Scholastic Reading Inventory, Woodcock
Reading Mastery Test–Revised Normative Update, Wood-
cock–Johnson III, and Guided Oral Reading Test–Third
Edition. The two studies including measures of behavior
assessed similar constructs. Lingo et al. (2006) assessed
appropriate behavior (e.g., being in assigned area) and
inappropriate behavior (e.g., noncompliance, off-task),
and Sutherland and Snyder (2007) measured active
responding and disruptive behavior (e.g., calling out,
throwing paper).
Agreement, Validity, and Fidelity
Interobserver agreement (IOA). IOA was calculated across
sessions or data in five studies (Blankenship et al., 2005;
Daly et al., 2006; Schmitt et al., 2009; Stone et al., 2008;
Sutherland & Snyder, 2007), across dependent variables in
three studies (Hale et al., 2005; Strong et al., 2004; Suther-
land & Snyder, 2007), and across participants in two studies
(Alber-Morgan et al., 2007; Lingo et al., 2006). Sutherland
and Snyder (2007) calculated both across observation ses-
sions (19%) and across weekly assessments (39%); thus,
the study was counted as calculating IOA by multiple meth-
ods. Ranges for IOA were 69% to 100% across variables,
82% to 100% across participants, and 93% to 100% across
sessions or data probes. Means for IOA ranged from 86.1%
to 100% for single variables, 94% to 100% across partici-
pants, and 93% to 100% across sessions or data probes.
TI. When using TI to assess fidelity, it is important to con-
sider (a) percentage of intervention sessions assessed for TI
and (b) range of TI. Studies ranged from measuring TI on
the first day (Stone et al., 2008), to measuring TI on 2 days
(Schmitt et al., 2009), to measuring across seven observa-
tions (Strong et al., 2004), to measuring 16% to 22% of the
time (Alber-Morgan et al., 2007; Blankenship et al., 2005),
and to measuring across all participants (Daly et al., 2006;
Hale et al., 2005; Lingo et al., 2006; Sutherland & Snyder,
2007). Eight of the nine studies reported a mean percentage
for TI. Forty-five percent of the studies reported 100% TI,
and the total range for means of TI ranged from 72.1% to
100%. Sutherland and Snyder (2007) reported that the rea-
son for 72.1% TI in the partner reading portion of their
intervention was mainly due to individual school absence,
but reported higher TI (87% and 89%) for intervention
when partner reading was implemented.
The documentation of TI was achieved through several
different methods. Lingo et al. (2006) calculated TI through
observations of teacher behaviors and then divided the
188
number of observed behaviors by the number of planned
teacher behaviors. The result was multiplied by 100 to pro-
vide the authors with a percentage for TI. Strong et al.
(2004) used a procedural checklist on four occasions to
observe the trained research assistant in implementation of
the intervention. Hale et al. (2005) relied on tape recordings
of intervention sessions, which were scored by an indepen-
dent experimenter. Schmitt et al. (2009) used a procedural
checklist scored by an independent experimenter. A research
assistant used a daily checklist of intervention procedures
during the study by Sutherland and Snyder (2007). Similarly,
Stone et al. (2008) employed a paraprofessional in the
school to complete an observational checklist. Daly et al.
(2006) relied on an independent observer to complete a pro-
cedural checklist. A trained paraprofessional equipped with
a checklist of seven yes or no questions was the means of
measuring TI in the study by Blankenship et al. (2005).
Finally, the first author in the study by Alber-Morgan et al.
(2007) used a procedural checklist for TI.
Social validity. Important to social validity is the surveying
of participants’ opinions about the intervention. In their
article on the evidence base of single-subject research in
special education, Horner et al. (2005) detailed several criti-
cal components of social validity a research team should
document. Included among those components was an
assessment of the intervention by typical intervention
agents (e.g., teachers or students; Horner et al., 2005).
Sixty-seven percent of the included studies reported social
validity data with this type of assessment. Three studies
assessed social validity from students’ perspectives (Alber-
Morgan et al., 2007; Schmitt et al., 2009; Stone et al., 2008),
two studies reported from the teachers’ perspectives (Lingo
et al., 2006; Sutherland & Snyder, 2007), and one study
included a teacher’s report of student opinion (Blankenship
et al., 2005).
All student participants in the study by Alber-Morgan et
al. (2007) indicated that they felt their reading had improved.
Teachers reported that students were receptive to the com-
puter program in the study by Blankenship et al. (2005). All
teachers and most students in the Lingo et al. (2006) study
indicated that they would use the program again. The major-
ity of students in the study by Schmitt et al. (2009) felt that
the intervention improved their comprehension and decod-
ing skills. Text maps were regarded by the students as aid-
ing in their comprehension during the study by Stone et al.
(2008). Sutherland and Snyder (2007) reported that the stu-
dents in their study preferred intervention texts over tradi-
tional texts.
Outcomes
Five studies reported that students’ WCPM increased
(Alber-Morgan et al., 2007; Daly et al., 2006; Lingo et al.,
Remedial and Special Education 35(3)
2006; Strong et al., 2004; Sutherland & Snyder, 2007). Four
studies also reported higher levels of comprehension
(Alber-Morgan et al., 2007; Blankenship et al., 2005;
Schmitt et al., 2009; Stone et al., 2008) and two studies
documented higher rates of comprehension (Hale et al.,
2005; Schmitt et al., 2009). Errors decreased in two studies
(Alber-Morgan et al., 2007; Lingo et al., 2006). Disruptive
behavior decreased and active responding increased in
Sutherland and Snyder (2007).
While it is not uncommon to conceptualize reading flu-
ency as a measure of reading speed and accuracy (i.e.,
words read correctly per minute), others have recognized
fluency as a multidimensional construct. Rasinski,
Reutzel, Chard, and Linan-Thompson (2011) defined flu-
ency as a measure of not only automaticity but also pros-
ody. In addition, Rasinski and colleagues suggested that a
measure of comprehension should be included in any mea-
sure of reading fluency. In line with the recommendations
of Rasinski and colleagues for more research with reading
fluency as a dependent variable, five studies in this review
of reading interventions did include fluency; however,
each study measured fluency as WCPM. Beyond third
grade, WCPM is simply a measure of accuracy, which
does not fully capture fluency as defined by Rasinski and
colleagues. Two studies included a measure of compre-
hension along with fluency (Alber-Morgan et al., 2007;
Strong et al., 2004).
Two studies measured the rate of reading comprehension
in the same way by multiplying the number of correctly
answered multiple-choice questions by 60 and dividing by
the number of seconds spent reading, listening, or LWR
(Hale et al., 2005; Schmitt et al., 2009). The resulting num-
ber was multiplied by 100 to gauge the student’s compre-
hension rate.
Reading comprehension, the ultimate goal of literacy
instruction, was measured as the dependent variable in six
studies. However, only two of the studies used a measure of
comprehension beyond multiple-choice questions or fill in
the blanks. Alber-Morgan et al. (2007) used oral question-
ing and verbal responses from students, which were
recorded verbatim. Blankenship et al. (2005) used not only
multiple-choice questions but also essays and oral responses.
Given the multidimensional nature of reading comprehen-
sion (Duke & Carlisle, 2011), assessments of comprehen-
sion beyond multiple choice would be of value in future
research.
Follow-up. Follow-up or maintenance levels were reported
in 33% of the included studies (Daly et al., 2006; Stone et
al., 2008; Sutherland & Snyder, 2007). It should be noted
that Stone et al. (2008) displayed the results of their second
intervention phase as maintenance, but they refer to it as
Intervention Part 2 in their method.
Garwood et al. 189

Table 2. Effect Sizes of Included Studies Calculated With Improvement Rate Differences.
Study Phase Dependent variable Case IRD range Omnibus IRD 95% CI

Alber-Morgan, Ramp, Anderson, and Martin (2007) A1–B1(RR) ORF .91 to 1.00 .93 .80 < .93 < .98
B1–C1(RR + Prediction) .66 to .92 .82 .63 < .82 < .91
A1–B1(RR) RC .45 to 1.00 .71 .53 < .71 < .82
B1–C1(RR + Prediction) −.03 to .42 .29 .07 < .29 < .48
Blankenship, Ayres, and Langone (2005) A1–B1(CBCM) RC .84 to .97 .93 .80 < .93 < .96
Daly, Garbacz, Olson, Persampieri, and Ni (2006) A1–B1(Choice; A-I-R) ORF .92 to .95 .94 .76 < .94 < .98
B1–C1(Maintenance) −.14 to .05 −.04 −.26 < −.04 < .17
Hale et al. (2005) A1–B1(Listening) RC −.25 to .47 .12 −.16 < .12 < .38
B1–C1(LWR) .15 to .50 .38 .14 < .38 < .57
Lingo, Slaton, and Jolivette (2006) A1–B1(CR + Direct instruction) ORF .52 to 1.00 .85 .60 < .85 < .92
Schmitt, McCallum, Hale, Obeldobel, and Dingus A1–B1(LWR) RC .10 to .38 .21 −.01 < .21 < .40
(2009)
B1–C1(LWR + text-to-speech) .30 to .70 .42 .20 < .42 < .59
Stone, Boon, Fore, Bender, and Spencer (2008) A1–B1(Teacher text map) RC .50 to 1.0 .85 .56 < .85 < .96
B1–C1(Maintenance: Student text map) −1.0 to .67 .01 −.28 < .01 < .29
Strong, Wehby, Falk, and Lane (2004) A1–B1(CR) ORF .51 to .80 .71 .51 < .71 < .82
B1–C1(CR + RR) .05 to 1.00 .70 .54 < .70 < .81
Sutherland and Snyder (2007) A1–B1(PALS + Self-graphing) ORF .42 to .88 .60 .30 < .60 < .77
B1–C1(Maintenance) .00 to .50 .28 −.35 < .28 < .54

Note. 95% CIs were calculated using Newcombe’s (1998) adjusted Wilson score method for computing differences in proportions, without a continuity correction. IRD
= improvement rate difference; CI = confidence interval; RR = repeated reading; ORF = oral reading fluency; RC = reading comprehension; CBCM = computer-based
cognitive mapping; A-I-R = antecedent, instruction, reward; LWR = listening-while-reading; CR = corrective reading; PALS = Peer-Assisted Learning Strategies.

IRD Effect Size
Following the recommendation of the American
Psychological Association (2001), effect sizes were calcu-
lated. Ranges, omnibus IRD, and 95% CIs for oral reading
fluency and reading comprehension for each study are dis-
played in Table 2. Interpretation of IRD effect sizes is rela-
tively straightforward. IRD scores range from –1.0 to 1.0,
with any IRD greater than 0.50 representing an improve-
ment over chance. The highest score possible, a 1.0, is cal-
culated when every data point from the intervention phase(s)
in a study has a greater magnitude in the desired direction
than every data point from the baseline phase(s) of the same
study. With regard to interpretation of IRD, Parker et al.
(2009) tentatively suggested the following benchmarks:
very small to questionable (<0.50), moderate (0.50–0.70),
large (0.70–0.75), and very large (>0.75). The CI is useful
as well for interpreting IRD, as it reveals the degree of con-
fidence one can have in the omnibus IRD score. For
instance, in Table 2, the Blankenship et al. (2005) study has
a 95% CI = [.80, .96], which means we can have 95% con-
fidence the true IRD score falls within those values; there-
fore, we are at least 95% confident that the study by
Blankenship and colleagues had a “very large” effect size.
In addition, CIs provide a measure of precision wherein the
narrower the CIs, the more precision present in the study
(Harper, 1999).
Oral reading fluency. The IRD of individual cases across
studies on oral reading fluency ranged from 0.51 to 1.00
during the priming phase, from 0.05 to 1.00 during the
intervention phase, and from –0.14 to 0.50 for the mainte-
nance phase. Omnibus IRD for oral reading fluency vari-
ables during the intervention phase across studies ranged
from 0.60 to 0.94 (M = 0.84).
Reading comprehension. The IRD for individual cases across
studies on reading comprehension ranged from –0.25 to
1.00 during the priming phase, from –0.03 to 1.00 during
the phase, and from –1.00 to 0.67 for the maintenance
phase. Omnibus IRD for reading comprehension variables
during the intervention phase across studies ranged from
0.29 to 0.93 (M = 0.57).
Discussion
The majority of interventions conducted with students with
EBD have focused on behavioral outcomes (Levy & Chard,
2001). Most children with deficits in reading do not receive
services until they are 9 years old and continue to struggle
in high school and beyond (Benner, Nelson, Ralston, &
Mooney, 2010). To overcome these reading deficits, it is
important for secondary students with EBD to receive inter-
ventions targeting comprehension and fluency. This review
is the first of its kind to focus on the comprehension and
fluency rates of secondary students with EBD within an
aggregated environment (i.e., a self-contained classroom or
a resource room). For research to be meaningful for practi-
tioners, intervention settings should reflect the daily reali-
ties of adolescents with EBD (Griffith et al., 2008).
This literary synthesis answers the call from the review
by Griffith et al. (2008), in which the authors stated that
190
reading comprehension should become the primary focus of
literacy intervention research for students with EBD. In
their review, they found only five studies (29%) in a 40-year
period (i.e., an average of only one every 8 years) focused
on reading comprehension or fluency for students with
EBD. The current review found nine studies since 2004
emphasizing these aspects of literacy, documenting a
marked improvement by the research community at a rate
of approximately one study per year to address the compre-
hension or fluency needs of secondary students with EBD.
Prior to the Strong et al. (2004) study, which was included
in both reviews, the only other interventions since 1965
addressing comprehension or fluency took place in 2002
(one study), 1996 (one study), and 1989 (two studies).
All nine included studies reported TI, with eight of the
nine reporting mean scores. The studies included in this
review assessed and reported TI at a rate of almost double
the “almost half” of studies reporting TI as documented by
Griffith et al. (2009). Although there is still room for
improvement in the frequency of assessment of TI, this
increase is a positive trend in the literature.
Differential Effects for Included Studies
For all five interventions targeting oral reading fluency, the
omnibus IRD was calculated to be above chance (i.e.,
>0.50). Four of these studies had 95% CIs where the lower
bound was above chance. Of these, two studies (Alber-
Morgan et al., 2007; Strong et al., 2004) implemented a
baseline intervention where the students received some
instruction, and then implemented a focused intervention
with omnibus IRDs of 0.82 and 0.70, respectively, provid-
ing researchers and practitioners with a high degree of con-
fidence in their positive results. Regarding studies targeting
reading comprehension outcomes, two of five had omnibus
IRDs above chance (Blankenship et al., 2005; Stone et al.,
2008). Although both interventions appear to be promising,
neither implemented a priming intervention. The other three
interventions targeting reading comprehension included a
priming intervention, but had IRD scores below chance
(Alber-Morgan et al., 2007; Hale et al., 2005; Schmitt et al.,
2009). The lack of results for a reading intervention for ado-
lescent students with EBD including a priming intervention
and demonstrating an effect size above chance remains an
important avenue for future research.
Beyond the effect sizes reported in Table 2, differential
effects can be examined for the included studies. The range
of effects for fluency measures was moderate to very large,
while the range for comprehension was questionable to
very large. Of the five studies reporting a very large effect
size, three included students with the lowest on average
reading levels (i.e., Grades 3–4; Alber-Morgan et al., 2007;
Daly et al., 2006; Lingo et al., 2006). Substantial effects for
students with the lowest reading levels are encouraging, as
Remedial and Special Education 35(3)
it indicates that even secondary students reading at an ele-
mentary level can significantly improve their reading
achievement with proper intervention. The two studies
reporting small to questionable effect sizes were both
implemented by researchers (Hale et al., 2005; Schmitt et
al., 2009), while 60% of the studies reporting very large
effects were implemented by teachers (Blankenship et al.,
2005; Lingo et al., 2006; Stone et al., 2008). This finding
was surprising, yet encouraging, as it suggests that teachers
were able to generate larger effects with the students.
Indeed, in the one intervention including multiple imple-
menters, the teacher-delivered intervention resulted in a
slightly larger effect for students (Strong et al., 2004).
Researchers may know the intervention, but teachers know
their students.
With the exception of LWR, all interventions included in
the review yielded moderate to very large effect sizes for
students’ literacy skills. RR used in isolation (Alber-Morgan
et al., 2007) or in conjunction with CR (Strong et al., 2004)
yielded large to very large effect sizes for students’ oral
reading fluency. Despite previous research suggesting that
RR is not an evidence-based practice for students with
learning disabilities (LD; Chard, Ketterlin-Geller, Baker,
Doabler, & Apichatabutra, 2009), results herein indicate a
promising approach for students with EBD. Griffith and
colleagues (2008) suggested that the most effective inter-
ventions for students’ reading skills were those relying on
repetition and direct instruction. Results from Strong et al.
(2004) and Lingo et al. (2006) support this hypothesis.
The intervention demonstrating the most significant
effects for reading comprehension was mapping
(Blankenship et al., 2005; Stone et al., 2008). Story map-
ping was the only intervention to yield an effect size beyond
moderate. Because mapping was used with great success
for students’ reading comprehension levels in both studies,
teachers of students with EBD may find the strategy help-
ful. Finally, the uses of choice by Daly et al. (2006) and
peer-assisted instruction by Sutherland and Snyder (2007)
may owe some of their respective positive effects to the
motivating factors of the interventions. Allowing students
to choose their type of instruction or work closely with
peers during academic instruction may increase student
engagement and motivation to a substantial degree.
Motivation is a critical part of reading achievement, espe-
cially for adolescent students (Ehren, 2009).
Limitations and Future Directions
The findings of this literature review should be considered
within the context of four limitations. First, although sev-
eral steps were taken to ensure that this review would be a
full and complete representation of the targeted literature, it
is possible that some articles were missed. The inclusion
criteria may have excluded one or more studies with an
Garwood et al.
evidence-based practice because it was situated in a juve-
nile or residential treatment center with adjudicated youth.
Among the population of incarcerated youth with a disabil-
ity, researchers have found EBD to be the most commonly
reported disability (Gagnon, Barber, Van Loan, & Leone,
2009); however, the majority of students with EBD are not
educated in juvenile corrections institutions. While it will
remain important for future research to examine the literacy
outcomes of incarcerated youth with a disability, our review
focused on the settings in which students with EBD most
frequently receive reading instruction (i.e., public or private
schools).
Second, and similar to Griffith et al. (2008), we excluded
studies where students without EBD were involved in the
intervention, and no separation of the outcomes based on
student disability was documented. A third limitation of the
current study is the possibility of publication bias. There
may be studies of similar interventions which have found
either no effect or an iatrogenic effect which remain “in the
file drawer.” At the current time of manuscript preparation,
we are not aware of any previous studies having calculated
publication bias for studies reporting IRD effect sizes.
However, we attempted to address the issue by searching all
peer-reviewed journals on the four major search engines
without limiting based on various indicators of journal
quality. Nonetheless, studies of similar interventions which
did not reveal significant results may remain unpublished.
Finally, by limiting the review to empirical articles, we
may have excluded studies containing supplemental and
contextual evidence to help answer our research questions.
In all, 31% to 81% of students with EBD underachieve in
reading, and there is a strong relationship between low
reading performance and overall low academic achieve-
ment (Mattison, 2008; Scott & Shearer-Lingo, 2002). Social
skills interventions addressing the behavior issues of stu-
dents with EBD are certainly needed, but effective aca-
demic instruction can also decrease disruptive behaviors
(Wehby, Lane, & Falk, 2003). Results from a study included
in this review suggest that behavioral problems may
decrease during interventions focused on the academic
needs of students with EBD (Sutherland & Snyder, 2007).
As academic struggles often provide the antecedent for
behavioral problems (Gunter, Denny, Jack, Shores, &
Nelson, 1993), it would seem prudent to address the reading
needs of adolescent with EBD. Future research using quali-
tative or mixed methods may also help in the analysis of
behavior improvement through academic intervention.
Implications for Educators
Literacy skills are a vital component of communication,
employment, and participation in the community (Copeland
& Keefe, 2007). The teachers and students included in these
studies reported a preference for the interventions over
191
regular instruction and indicated that they would continue
to use the methods introduced by researchers. However,
although the interventions appeared to have significant
effects and high social validity, it is important to note the
need for further research, as it is not yet possible to assess
these interventions as an evidence-based practice for stu-
dents with EBD served in non-general education settings.
While professional development in these types of inter-
ventions would be beneficial to current school practitioners,
it may also be important to include coursework related to
these teaching methods in teacher preparation. In addition
to pre-service teachers focusing on special education, those
studying to become general education teachers may also
benefit from such coursework. Given the unfortunate under-
identification of students with EBD, future general educa-
tion teachers would benefit from instruction on issues
relevant to students with EBD.
Implications for Research
Griffith and colleagues (2008) called for a better description
of participants in intervention research. Every study
included in the current review provided an adequate descrip-
tion of participants in terms of age, gender, and disability,
according to the criteria set forth by Horner et al. (2005).
However, because there is a wide range of behaviors associ-
ated with a student identified as EBD, we suggest that the
authors of empirical studies include detailed information
about each participant’s pre-intervention behavior. In the
current review, two studies provided a short narrative
description of participant behavior (Blankenship et al.,
2005; Sutherland & Snyder, 2007) and three studies pro-
vided information about participant behavior in a table
(Alber-Morgan et al., 2007; Lingo et al., 2006; Strong et al.,
2004). The success of an intervention could vary depending
on the type of problem behaviors exhibited by the student.
Indeed, there is evidence to suggest that students with inter-
nalizing and externalizing behavior disorders may respond
to reading interventions differently (Hagan-Burke et al.,
2011). In addition, future research on the reading abilities of
students with EBD should include the reading levels of each
participant. Especially at the secondary level, where stu-
dents have a wide range of reading abilities, reporting the
effectiveness of an intervention in relation to a participant’s
reading ability would provide important information.
While none of the included interventions have been doc-
umented as an evidence-based practice for students with
EBD, some have been researched extensively with students
identified as having a LD. Research has demonstrated the
comorbidity of LD, particularly reading deficits, for stu-
dents with emotional or behavioral concerns (Hinshaw,
1992; Maguin, Loeber, & LeMahieu, 1993; Vaughn, Levy,
Coleman, & Bos, 2002). Therefore, reading interventions
with demonstrated success for students with LD, such as
192
PALS (Fuchs et al., 1999), may be a viable option. Continued
reading research conducted with adolescents with EBD will
hopefully lead to the establishment of an evidence-based
practice.
Conclusion
The deficits in reading comprehension and fluency at the
secondary level for adolescents with EBD, often arising
from struggles with phonemic awareness and decoding in
early literacy development (Lane, Fletcher, Carter, Dejud,
& DeLorenzo, 2007), require immediate intervention.
While the current review documents an increased focus in
recent years, the combined results of the current review and
the review by Griffith and colleagues (2008) reveal only
13 studies focused on the comprehension or fluency needs
of students with EBD in public or private school in nearly
half a century of educational research. Furthermore, the last
known study was conducted over 4 years ago (Schmitt
et al., 2009). While the first decade of the new millennium
seemed to indicate a favorable trend in the quantity of stud-
ies, another research gap appears to be forming. Adolescents
with EBD, and their teachers, need a sustained and improved
research agenda focused on reading to establish evidence-
based practices.
Acknowledgments
The authors would like to express their gratitude to Dr.
Kathleen Lane and Dr. Greg Benner for their guidance dur-
ing the writing and editing of this manuscript.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
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