Preventing Reading Difficulties Before Kindergarten
Americans want their children to start school ready to learn, a goal that includes preparedness for reading instruction. As we discussed in Chapter 4, among those children who are likely to begin school less prepared to learn to read are (1) children living in low-income communities; (2) children with limited English proficiency; (3) preschool children slated to attend an elementary school where achievement is chronically low; (4) children suffering from specific cognitive deficiencies, hearing impairments, and early language impairments; and (5) children whose parents have a history of reading problems. Children who are particularly likely to have difficulty learning to read in the primary grades are those who begin school with less prior knowledge and skill in certain domains, most notably letter knowledge, phonological sensitivity, familiarity with the basic purposes and mechanisms of reading, and language ability.
In this chapter, we discuss research findings on how the various worlds in which infants and toddlers live affect the development of their ability to learn to read. We begin by discussing the role of parents and caregivers, including both the beliefs they hold concerning reading and literacy and the behaviors they engage in with their children in support of literacy development. We then discuss the
literature on preschool environments and their contributions to reading skills development. Next we discuss biological and physical conditions and their effects on reading ability development. We present information on clinic- and pediatrician office-based literacy development efforts. Finally, we examine how children with physical and cognitive impairments have been aided in their efforts to learn to read.
PARENTAL ANDFAMILY INFLUENCES
Adults who live and interact regularly with children can profoundly influence the quality and quantity of their literacy experiences. A wide range of factors in turn affect the nature of these interactions, including the parents' attitudes and beliefs about reading and literacy, the children's motivation for reading, the opportunities parents provide their children and their actual behaviors with them, and the parents' own reading and literacy ability levels.
Parents' Beliefs and Attitudes
There is increasing evidence that parental beliefs and attitudes regarding literacy and reading in particular influence children's literacy development (DeBaryshe, 1995; Baker et al., 1995; Spiegel, 1994). The values, attitudes, and expectations held by parents and other caregivers with respect to literacy are likely to have a lasting effect on a child's attitude about learning to read. The socioemotional context of early literacy experiences relates directly to children's motivation to learn to read later on. Some researchers have found that parents who believe that reading is a source of entertainment have children with a more positive view about reading than do parents who emphasize the skills aspect of reading development (Baker et al., 1997). Another study found that children who view school learning as irrelevant to life outside school are less motivated to invest time and effort in learning to read (Purcell-Gates, 1994; Stipek et al., 1995).
Box 5-1 is an example of how some parents interact with their children during literacy activities. Asking and responding to questions is a principal aspect of parent-child interactions about text (Durkin, 1966). The frequency and manner of responding to children's questions is therefore an important parental influence on early reading ability (Teale, 1978). A study of the interactions during parent-child reading revealed that at least a thousand questions about print and books were asked by two children over a period of several years (Yaden et al., 1984). When parents are shown how to become more responsive and ''dialogic" during shared reading, gains in their children's skills have been recorded (e.g., Whitehurst et al., 1994).
Aspects of literacy likely to be influenced by the family and home environment include print awareness, concepts, and functions; knowledge of narrative structure; literacy as a source of enjoyment; and vocabulary and discourse patterns (Snow and Tabors, 1996; Baker et al., 1995; Clay, 1975; Burns and Casbergue, 1992; Taylor, 1983; Taylor and Dorsey-Gaines, 1988). Studies of children's early language development indicate that parent-child influences are reciprocal: children influence the ways that adults behave toward them, and adults influence children's learning experiences and opportunities (Lewis and Feinman, 1991; Belsky et al., 1984).
Parents who believe their children are interested in reading are more likely to provide abundant print-related experiences than parents who do not perceive such interest (Hiebert, 1981). Parents' interpretations of children's interest in print, however, are partly a function of their expectations of young children's capabilities in general. For example, one parent may judge a child to be interested only if the child asks to have a story read; another parent may judge a child to be interested if he or she expresses pleasure when the parent offers to read a story. Children's interest may also be a function of the kind of reinforcement received for involvement with print in the past (Hiebert, 1986).
A visit to the home of Jaime, 5, and Danny, 3:
Danny has just gotten up from a nap and is lying on the floor, not quite awake yet; Jaime has been watching Mister Rogers and is playing with his blocks and dinosaurs in the living room. In the corner there is a little bookshelf with 20 or so children's books, including three that are due back to the library the next day. (Making sure they are back in time will be Mom's job, since it's her day off from work.) There are also some puzzles, a magnetic board with letters, and a canvas bag filled with plastic farm animals. Dad is sitting on the sofa, reading the newspaper. In a few hours, after the boys' mother comes home from work, he will be leaving for his job as a night guard.
Dad takes the boys into the kitchen for some juice and crackers. As they finish he asks them if they want to hear a story.
"Yes!" they both say.
"Let's read Tacky the Penguin," Jaime says.
"No, I want the caterpillar," Danny whines.
"No! We read that last time!'' Jaime says.
Before they can continue arguing, Dad steps in. "Cut it out you guys; we'll read them both. We read The Hungry Caterpillar lasttime, right? So let's start with Tacky, and then we'll read the caterpillar story, OK?"
The boys seem satisfied with this. They go back to the living room and sit on either side of their father as he begins to read the story of a funny penguin named Tacky. The boys listen intently, sometimes asking questions about something that catches their interest in the pictures. Their father answers; sometimes he says he doesn't know. Danny has apparently forgotten he wanted the caterpillar story; he too is engrossed and recites the rhyming lines and claps the beat as his father reads them. They finish Tacky and then read The Very Hungry Caterpillar.
"OK, guys, I've got some stuff to do, then I'm going to start making dinner before Mom comes home. You can play here or in your room. I don't want to hear any fighting, OK?" Dad goes to the kitchen, gets a stack of bills and his checkbook from the drawer, and sits at the table to write checks.
Jaime stays in the living room and plays with his blocks and dinosaurs.
Danny follows Dad into the kitchen. "I want to write!" he says.
"You want to write, too?"
"Yeah," Danny says.
Dad gets a blank piece of paper and a not-too-sharp pencil and puts it next to him. "OK, sit here and write with me."
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Danny climbs on a chair and takes up the pencil. He begins to write, intently. and makes a series of squiggles:
"Hey, buddy, that's pretty good," Dad says. "What did you write?"
Danny uses the eraser end of the pencil as a pointer and sweeps slowly across the marks he has made. "Daaa. . . . nnnn. . . . yyy," he says, slowly and deliberately. Danny had seen his brother, who was learning to write his name, do the same thing many times.
"How do you write Daddy?" Danny asks.
His father writes it for him and then continues writing checks.
Danny writes a little longer and then goes to join his brother in the living room, who by this time has tired of blocks and dinosaurs and is looking at a big book of nursery rhymes from around the world. He has heard some of these so many times he has memorized them and is reciting them quietly to himself as he points with his finger in the general vicinity of the words he is saying. Danny listens.
Jaime, suddenly aware of his audience, holds the book up, as his kindergarten teacher does, and ''reads" to his younger brother.
Danny listens for a few minutes, then says, "I want to read!"
Jaime, a little impatient, says, "Danny, you can't read yet. Look, this is an A, this is an M . . ." and he points to letters that he can recognize on the page.
Danny listens and watches. He starts to make another plea for a turn to read when they hear the key in the latch.
"Mom's home!" Jaime says. He drops the book, and both boys go running to the front entrance.
In the next few hours, the family will have dinner, talk about how the day went, and then Dad will leave for work. Mom will clean up the dinner dishes, play with the boys, and give them a bath.
Finally, just before bed time, they climb into Jaime's bed and Mom tells the boys to choose a book to read for a bedtime story. The boys again argue over what book she will read, and each boy takes a different one from the shelf they have in their room.
"I know," Mom says, "Let's finish Frog and Toad, since we've got to take it back to the library tomorrow."
"Yeah!" both boys say almost in unison, and they run to the living room to get one of the library books.
"Hey, don't run!" Morn calls out. But it's too late; they're already in the living room arguing over who is going to take the book to Mom.
Snow and Tabors (1996) describe four mechanisms of intergenerational transfer of literacy: (1) simple and direct transfer, (2) participation in literacy practice, (3) enjoyment and engagement, and (4) linguistic and cognitive mechanisms. Simple transfer includes activities such as storybook reading and participation in writing shopping lists. Parents reading to and with childrencalled dyadic book readinghas been widely studied (e.g., Chomsky, 1972; Laosa, 1982; Anderson et al., 1985; Teale and Sulzby, 1986); it has been identified as a source of knowledge about print (Clay, 1979), about letters (Burgess, 1982), and about the characteristics of written language (Feitelson and Goldstein, 1986; Purcell-Gates, 1988). Print-rich environmentswhich include the presence of such items as magnetic refrigerator letters, posters, writing materials for making lists and memoranda, and newspapers and books in the home, as well as parent-child attention to environmental printhave been linked to children's acquisition of an awareness of print (Goodman, 1986; Harste et al., 1984).
Literacy practice involves children learning the functional uses of literacy as they engage in a variety of purposeful literacy acts in the everyday life of the family. Key to this means of literacy learning is parents' modeling of literacy as useful in solving problems and the establishment of social literacy practices in which children can participate as a functional and important part of their lives. Children learn from parents how to use literacy to engage in problem-solving activities (Goodman, 1986). Edwards (1995) has demonstrated the effectiveness of parent coaching in holding children's attention, asking questions, interacting with text-relevant comments, and providing feedback to their children. Those who view literacy as social practice argue that children learn the purposes of literacy in the family setting, although they may differ from family to family (Leichter, 1974; Taylor and Dorsey-Gaines, 1988).
Enjoyment and engagement are another way that parents transfer literacy skills to their children. Enthusiasm about literacy activities is suggested by many researchers as a route to development of the child's active engagement in literacy tasks (Snow and Tabors, 1996; Baker et al., 1995). Activities such as family storybook reading promote positive feelings about books and literacy (Taylor and
Strickland, 1986). Lancy and Bergin (1992) found that children who are more fluent and positive about reading came from parent-child pairs who viewed reading as fun, kept stories moving with a "semantic" rather than a strict "decoding" orientation, and encouraged questions and humor while reading. Children who learn from their parents that literacy is a source of enjoyment may be more motivated to persist in their efforts to learn to read despite difficulties they may encounter during the early years. Pretend reading sessions, attempting to identify words and letters on t-shirts and cereal boxes, and play with educational toys were reported by parents as important activities in which their children engaged with print. Baker et al. (1995:245) note that "Parents' descriptions of their children's early efforts to engage in literacy activities often reflected amusement but also suggest awareness of the value of such behaviors.''
Finally, parents help children to develop oral language precursors to literacy by means of linguistic and cognitive mechanisms. Parents in the Baker et al. (1995) study reported that their children enjoyed singing songs heard on the radio or television and chanting nursery rhymes and other rhyming games. Heath (1983) reported that the children of low-income families are often exposed to elaborate narratives in the course of their everyday lives. She suggested that this experience nurtures a high level of familiarity with the structural organization of stories. Mealtime conversation also provides an opportunity for children to acquire knowledge about narratives when family members recount the day's activities, thus giving children an experience that is of well-documented value in learning about language and communication (Snow and Tabors, 1993).
Teaching Parents to Teach Children
Parent-oriented prevention and early intervention services provide alternatives for improving outcomes in language and literacy development. These programs are for parents of young children, whether or not the children receive early childhood center-based services. In general, the services include regularly scheduled home visits by a parent educator. The curriculum used includes informa-
tion on child development, guidance in fostering a child's development, and school readiness. Access to resource materials and developmental and sensory screening is often provided.
Parents as Teachers is one such program for parents beginning in the third trimester of pregnancy and continuing until the children are 3 years old (National Diffusion Network, 1996). At age 3, children in the program performed significantly better than comparison children on tests of cognition and language. Their parents demonstrated more knowledge of the content in the program curriculum. At follow-up in first grade, program children scored significantly better than the comparison group on standardized tests of reading ability. At grade 1, parents who participated in the program were found to be significantly more involved in their children's school experience than were comparison-group parents.
Another program, the Home Instruction Program for Preschool Youngsters (HIPPY), is a home-based instruction program in which parents serve as the child's first teacher. The program provides children with school readiness skills and makes reading one of many activities parents and children do together. In examining four parent education models that included HIPPY, researchers found that they all included effective components addressing cultural awareness, interagency collaboration, and the development of close ties between home and school (Baker and Piotrkowski, 1996). Weaknesses in the programs included lack of theoretical support, insecure funding, and a lack of updated and appropriate curricula.
Although the programs described above assess language or literacy outcomes, their focus is not specific to language and literacy. A number of programs do target language and literacy. A training program on dialogic reading, developed by Whitehurst et al. (1994), in essence reverses the roles between adult and child. When most adults share a book with a preschooler, they read and the child listens. In dialogic reading, the adult helps the child become the teller of the story. Small-group dialogic reading took place in the classroom (e.g., four children to one adult, three to five times per week), and one-on-one dialogic reading took place at home with the same books used in the classroom. The fundamental reading technique is a short interaction between a child and the adult. The adult
prompts the child to say something about the book, evaluates the child's response, expands the child's response by rephrasing and adding information to it, and repeats the prompt-evaluate sequence to make sure that the child has learned from the expansion.
Compared with a control group of children not participating in the program at school and at home, children who participated made significant gains in their development of language skills and concepts of print. In addition, parents' participation in the at-home component of the program strongly affected the degree to which individual children profited from the program. Follow-up testing indicated that the program intervention, which took place in preschool, persisted through the end of kindergarten. The program primarily affects language, and no effects were seen on first- and second-grade reading achievement (Whitehurst, 1997). Thorough follow-up testing has not taken place beyond the second grade.
Another researcher studied literacy-specific intervention with parents whose children attended a public school Head Start program (Neuman et al., 1995). Books were provided to families, and parents were taught to engage in storybook reading strategies that enhanced interaction with the child and to extend the reading to include precursors to reading. One part of the intervention included parent groups, and the other part involved parents reading the books to their children. Parents' reading sessions with children were audiotaped so that the children could listen to their parents reading to them on the tape. Results indicated that the storybook reading became more interactive, with children contributing at increasing levels. Children's concept of print scores and receptive language scores increased compared with children who did not receive the intervention.
Family Literacy Programs
Family literacy programs seek to enhance literacy within families. In contrast, an intergenerational literacy program fuses adult literacy with preschool programs to enhance the literacy growth of adults and children who may be unrelated (Daisey, 1991).
The impetus for family-based programs is broad, ranging from (a) research on the positive influence that family literacy experiences can have on subsequent literacy achievement in school (Schickedanz, 1981; Snow and Goldfield, 1983; Teale and Sulzby, 1986), (b) the relationships between parents' expectations and attitudes regarding educational attainment and children's achievement (Fingeret, 1990), and (c) the widely held belief that it is difficult for a classroom or school to make up for the lack of literacy activities in the family. A review of family-based literacy projects quickly reveals the complexities inherent in attempting to describe, much less evaluate, these programs. The variations among them are enormous; in fact, a hallmark of a successful program is that it is tailored to the needs of the specific population it serves.
An example of a family-based literacy program is the Even Start Family Literacy Program, which was established in 1989 with the goal of integrating early childhood education and adult education for parents into a unified program. The program was evaluated over a period of several years in the mid-1990s by means of a large-scale national survey called the National Evaluation Information System and an in-depth study that provided longitudinal information on a few programs through randomized experimental designs. Evaluators examined short-term effects on children, parents, and families. Five of the measures used related to children's reading ability. The Even Start family literacy program had the greatest impact on availability of reading materials in the home, parents' expectations of their children's success in school, and skills related to children's readiness for school, although researchers evaluating the program cautioned that it is difficult to attribute the positive effects to the program alone.
In a review of the literature, as well as firsthand studies of a sample of 11 Even Start1family literacy projects, researchers note
1 Even Start refers to legislation that was passed in 1988, appropriating funds to initiate, continue, and evaluate family literacy projects. A total of 75 grants were awarded by the U.S. Department of Education in 1989 to local education agencies, which, in hand with Head-Start, Adult-Basic-Education, and other community based programs, were to provide intergenerational literacy experiences.
four features critical to the success of these programs (DeBruinParecki et al., 1997). The first relates to steps taken to ensure participation, which range from the provision of child care and transportation, to addressing emotional barriers such as fear of school and low self-esteem, to recognizing, respecting, and incorporating cultural and familial differences. A second critical feature is the use of a curriculum that is both meaningful and usefulthat includes, for example, English-language instruction, workplace preparation, and modeling and coaching of parent-child literacy activities. The third critical feature is the participation of a stable and capable staff who bring diverse expertise to this work. The final critical feature is the necessary funding to ensure that these programs can be sustained over time.
A research synthesis on family literacy programs notes that "documented research consistently supports the finding that participants in family literacy programs are benefited by increased positive literacy interactions in the home between parent and child as a correlate of their participation" (Tracey, 1994). Projects that rely solely on the family to provide intervention for their young children, not working in conjunction with center-based programs, have had only moderate success; the most effective intervention, taking place during infancy, was a well-designed program using professionals (Abt Associates, 1995).
Preschool Classrooms as Language and Literacy Environments
Having examined family literacy programs in which one component is preschool instruction, we now review the research on preschools more generally. Most studies that examine the quality of preschools use broad-gauge tools that include language and literacy as only one small portion of the assessment. Such studies have found that it is precisely on measures of the language environment that preschool programs serving poor children scored in the inadequate range.
A study of children in North Carolina public preschools found that they had lower ratings on language and reasoning measures than for other aspects of the Early Childhood Environment Rating (Bryant et al., 1993). Scores were particularly low for items involving dramatic play (a context for rich language use), cultural awareness, and professional opportunities, suggesting that the children's language development needs are not being served optimally and that mechanisms for improvement are unavailable. A study of 32 Head Start classrooms similarly found the lowest scores for language and reasoning on the same test (Bryant et al., 1993).
Two other studies have also focused on the language environments in preschool classrooms. The Bermuda Day Care Study showed that quality of conversation in the classroom and amount of one-on-one or small-group interactions that children engaged in were highly related to language measures (Phillips et al., 1987). Also, for low-income children at age 4, the quality of group book reading experiences was found to be correlated with kindergarten language and literacy measures (Dickinson and Smith, 1994). Cognitively challenging conversation and the use of a wide vocabulary by teachers were correlated with the children's subsequent language and literacy development (Dickinson et al., 1993).
The quality of adult-child discourse is important, as is the amount of such interaction. One study found that the amount of cognitively challenging talk that children experience is correlated with the amount of time they talk with adults (Smith and Dickinson, 1994). Another study also found an association between conversational partner and topic (Michell and Stenning, 1983). Given the importance of adult-child interaction, it is disturbing that some children may rarely interact with a preschool teacher, receiving little or no individualized attention (Kontos and Wilcox-Herzog, 1997; Layzer et al., 1993). Modest enhancements of the quality of classroom experiences show positive effects on children's language development and preliteracy skills (Whitehurst et al., 1994).
Finally, Neuman (1996) studied the literacy environment in child care programs. Day care providers were targeted because of their role in providing care for infants, toddlers, and preschoolers; in many situations, the language and literacy needs of these children
are not the caretakers' primary concern. Traditional caretaking, such as keeping children safe, fed, and clean, are often the main focus. Yet many of these children are in special need of early language stimulation and literacy learning.
Caretakers were given access to books and training on techniques for (a) book selection for children of different ages, (b) reading aloud, and (c) extending the impact of books. The program was evaluated with a random sample of 400 3- and 4-year-olds who received the intervention, as well as 100 children in a comparison group. Results showed that literacy interaction increased in the intervention classrooms; literacy interactions averaged five per hour before the intervention and increased to 10 per hour after the intervention. Before the intervention, classrooms had few book centers for children; after the intervention, 93 percent of the classrooms had such centers. Children with caretakers who received the intervention performed significantly better on concepts of print (Clay, 1979), narrative competence (Purcell-Gates and Dahl, 1991), concepts of writing (Purcell-Gates, 1996), and letter names (Clay, 1979) than did children in the comparison group. At follow-up in kindergarten, the children were examined on concepts of print (Clay, 1979), receptive vocabulary (Dunn and Dunn, 1981), concepts of writing (PurcellGates, 1996), letter names (Clay, 1979), and two phonemic awareness measures based on children's rhyming and alliteration capacity (Maclean et al., 1987). Of these measures, children in the reading-aloud group performed significantly better on letter names, phonemic awareness, and concepts of writing.
Preschool Can Make a Difference
The number of months that children spend in preschool has been found to be related to achievement test scores in second grade, behavior problems in third grade, and school retention in kindergarten through third grade (Pianta and McCoy, 1997). Children with more preschool experience had higher achievement scores and fewer behavior problems and were less likely to be required to repeat a grade. The National Center for Education Statistics (1995) found that preschool experience was associated with children's literacy and
numeracy skills. Our review focuses on preschool programs with outcomes on language development and literacy.
Given the pervasive evidence of differences in language and emergent literacy skills associated with class, culture, and linguistic background, it is heartening that preschool has been shown to benefit children's performance in domains that relate to school success (Haskins, 1989; Lee et al., 1988; McKey et al., 1985). A recent comprehensive review of early childhood programs for children from low-income families concludes that preschool programs can produce large effects on IQ during the early childhood years and sizable persistent effects on achievement, grade retention, special education, high school graduation, and socialization (Barnett, 1995).
Head Start is the most widely known early intervention program for economically disadvantaged children, although state and Title I programs provide services for substantial numbers of children. Head Start programs provide or arrange comprehensive services for children and families, including a "developmental" curriculum, psychological and social services, nutrition and health, and parent involvement and education.
Programs designed for children in poverty, including large-scale public programs, were found to produce immediate effects for reading achievement of about 0.5 standard deviation (White and Casto, 1985; McKey et al., 1985; Ramey et al., 1985). On average, these estimated effects declined over time and were negligible several years after children exited the programs. However, some programs produced sizable gains that persisted into the school years. Although a variety of different approaches produced positive effects, the magnitude of initial effects appears to be roughly related to a program's intensity, breadth, and attention to the involvement of the children's parents (Bryant et al., 1994).
An example of a comprehensive preschool program with a randomized design is the Abecedarian Project (Campbell and Ramey, 1994). Infants in the experimental group received enriched day care that stressed language and cognitive development through age 5. At follow-up testing, the children in the experimental group had statistically significant higher reading achievement from age 8 (grade 3) through age 15 (grade 8).
Helping Preschoolers Develop Phonological Awareness
As reviewed earlier in this volume, phonological awareness plays a crucial role in learning to read, and the development of this metaphonological ability typically begins by about age 3 and improves gradually over many years. Because the wide differences among kindergartners in this skill are predictive of future reading achievement, researchers have begun to investigate the possibility of reducing those differences by enhancing the development of phonological awareness prior to the start of school. The results to date suggest that this is a promising approach to reducing young children's risk for future reading difficulties.
Is phonological awareness training helpful for improving this ability in 4- to 5-year-old preschoolers who are at risk for reading difficulties? The available evidence suggests that it is. For instance, Brady et al. (1994) studied 42 inner-city children aged 4 to 5 years. At the outset, fewer than half could generate rhymes, and none could segment simple words into phonemes or read any words. The 21 children who received training were closely matched to the 21 who did not on receptive vocabulary, age, and initial phonological abilities. Training took place in small groups for a total of 18 hours over four months, with three 20-minute sessions per week.
Exercises first directed the children's attention to rhyme (e.g., "One, two, three. Come to me: Which two words rhyme?"), segmentation of morphemes and syllables (e.g., "Say a little bit of 'butterfly . . .Can you say 'butterfly' without the 'but'?"), categorization of sounds (e.g., "Which word doesn't belong: mop, top, pop, can?"), and identification of syllables (e.g., "Do you hear 'doe' in 'window'? In 'doughnut'? In 'candy'?"). The next phase was devoted to illustrating phonemic contrasts (e.g., /p/ vs. /b/) through exercises designed to allow the children to experience the relevant articulatory gestures (Lindamood and Lindamood, 1975) and through segmentation and identification games at the phoneme level (e.g., "Say a little bit of 'boat'''; "Can you say 'boat' without the 'lip-popper'?"; "Which word starts with a lip-popper: 'pool' or 'light'?"). Last, the phonemes in two- and three-phoneme words were segmented using a
"say it and move it" procedure (Blachman, 1987). On the post-tests, 12 of the 21 controls were still unable to generate any rhymes, and only one could segment any words into phonemes. In contrast, all but one of the trained group could generate rhymes, and six succeeded in full phonemic segmentation. As will be reviewed later, methods such as these have produced increases in phonological awareness and in subsequent reading in samples of unselected kindergartners and first graders (Chapter 6) and beginning readers from at-risk groups (Chapter 7).
Somewhat younger at-risk children have also been shown to benefit from training in phonologically oriented instruction. Dorval et al. (1980) selected 22 4-year-olds from one cohort of the Abecedarian Project (described above): 11 from the experimental group (who received the preschool day care intervention) and 11 (matched on familial risk factors) from the control group in that study. The reading readiness component of that program included individual tutoring in phonological awareness and letter-sound knowledge, in brief sessions (3 to 10 minutes) twice per week over 45 weeks. The training method, based on that of Wallach and Wallach (1979), involved several steps, all of which were completed for a single phoneme/letter before proceeding to the next one to be learned. The first steps involved oral exercises in phonological awareness alone: repeating aloud words beginning with the target phoneme, with extra emphasis on enunciating the first phoneme (e.g., /b/-/b/-ball), choosing which of two pictures begins with the target phoneme, and identifying whether or not a picture begins with that phoneme. Next, the letter corresponding to the target phoneme was introduced by having the child trace, and eventually draw, the letter. Additional steps required the child to match letters to pictures or spoken words on the basis of their beginning sounds, differentiating the target item from two other phoneme/letter items that were previously trained.
On the post-test, for each of five phonemes in turn, five picture pairs were shown successively. The child was asked to name the pictures and then to point to the one that began with the phoneme pronounced by the examiner. For the last two blocks of trials, the child was also given two opportunities to identify the target pho-
neme. At the end of each block, knowledge of letter-phoneme associations was tested by asking the child to select which of three letters represented the phoneme. On the phoneme recognition items, on which chance guessing would yield a score of approximately 50 percent correct, the average for the trained group far exceeded that of the controls (88 versus 58 percent correct); all but one of the tutored children were at least 78 percent correct, and all but one of the untrained children were less than 70 percent correct. The experimental group also outperformed the controls (62 versus 31 percent) on the letter recognition items (chance level = 33 percent). Finally, because the same training program had previously been used with 6-year-olds, a comparison could be made of the rates of progress during training for different age groups. It appeared that the amount of benefit per hour of tutoring was essentially equivalent for the 4- and 6-year-old high-risk samples, indicating that little would be gained by delaying instruction until school age.
Given that 4- and 5-year-olds, even those from high-risk backgrounds, can successfully be trained in phonological awareness and letter-sound associations, is this sufficient to permit a young child to discover the alphabetic principle and use it to read simple words? This question was pursued in a series of clever experiments by Byrne and Fielding-Barnsley (1989). Their criterion for mastery of the alphabetic principle was success by a child in choosing, say, "mow" rather than "sow" as the pronunciation for the printed word "mow'' after the child had been taught to read the words "mat" and "sat." (Only children with no prior knowledge of the relevant letters were included.)
First, transfer was not achieved by children who could readily be trained to differentiate compound words (e.g., bus stop vs. doorstop) or pseudowords (bifsek vs. fotsek), indicating that learned associations at the morphemic/syllabic level do not transfer to the phonemic level. Second, neither was the criterion met by children who were trained to the criterion in segmenting the initial phoneme from the last part (rime) of numerous words beginning with the relevant phonemes (e.g., by asking the child to make a frog puppet talk in its funny way, saying "m . . . at," and "s . . . ad"), indicating that segmental awareness alone is not sufficient for discovery of the
alphabetic principle. Third, even when these same children were then trained to identify the first sounds (/m/ and /s/) of numerous words, such that they could correctly say which of two words started with the same sound as "mat" (or as "sat"), transfer did not occur. That is, phonemic awareness was not sufficient for the emergence of the alphabetic principle. Finally, after these children were trained to associate the letter M with /m/ and S with /s/, transfer did occur for the children who had succeeded on the prior tasks. However, even if they mastered the letter-sound associations, children who had not succeeded on the phonological awareness training did not meet the criterion for knowing the alphabetic principle. In short, "neither phonemic awareness nor knowledge of the correspondence between letters and phonemes is sufficient for the emergence of initial insights into the alphabetic principle. But both in combination seem . . . to firmly promote its acquisition in otherwise preliterate children" (Byrne and Fielding-Barnsley, 1989:317).
Subsequent experiments of a similar nature demonstrated that both aspects of phonemic awareness segmentation and identity are usually necessary for successful transfer. That is, before children demonstrated mastery of the alphabetic principle, most needed to know that /m/ is a component of /mat/, that words like /mat/ and / mow/ start with the same component, and that /m/ is symbolized by a particular graphic form.
Taken together, the results of these training studies indicate that phonological awareness can be successfully enhanced through training in young children who are not yet very advanced in metaphonological skill. The same techniques and exercises that have been designed for slightly older children (see Chapter 6) can, with little modification, apparently be used with children at least as young as 4 years, and perhaps even earlier. It is also encouraging that substantial effects have been demonstrated with samples who are at risk for future reading difficulties due to economic disadvantage. To increase school preparedness of these children and those from other at-risk groups, however, it is clear that instruction in phonological awareness ought to be accompanied by training in letters and letter-sound associations also. Children who enter school with these com-
petencies will be better prepared to benefit from formal reading instruction.
Program Quality of Preschools
The overall program quality in a child care setting has been found to be an important determinant of positive effects on language and preliteracy skills (see Barnett et al., 1987, for a review). The evaluation of public preschool programs in North Carolina found evidence that participation in the programs reduced the degree of delay of high-risk children in communicative skills (Bryant et al., 1993). The quality of the preschool program attended was related to children's vocabulary scores at kindergarten, as well as to kindergarten reading scores for boys only. These effects were found even though, in general, the preschool programs evaluated were of generally mediocre quality. The analysis of children in Head Start classes by Bryant et al. (1993) showed that classroom quality was related to child outcomes on measures of school readiness, independent of the quality of children's home environments. Assessments of programs like CARE (Roberts et al., 1989; Wasik et al., 1990), the Infant Health and Development Program (IHDP, 1990; Brooks-Gunn et al., 1994), the Comprehensive Child Development Program (St. Pierre and Lopez, 1994), and Even Start (St. Pierre et al., 1993) have documented the enhanced value of high-quality classroom-based experiences for children in poverty, with bigger effects from more intensive and higher-quality programs, as well as evidence for positive effects on language development in particular.
How Universal Is the Impact of Preschools?
The evidence that preschool can have a beneficial effect on children's early language and literacy development is heartening, but we need to know whether preschool experiences have similarly positive results for all subgroups of children at risk. Low-income African American and Hispanic children, particularly Spanish-speaking Hispanic children, have similar immediate benefits from preschool
experiences as European American children; however, those benefits are not maintained as the low-income African American and Hispanic children progress through the early grades. An analysis of data from the National Longitudinal Survey of Youth shows positive effects of Head Start attendance on European American children's vocabulary scores and a reduction in their grade retention, compared with siblings who did not attend preschool or who attended preschools other than Head Start (Currie and Thomas, 1995). In this analysis, positive effects of Head Start or of other preschool experiences were not found for African American children. Barnett and Camilli (1996), however, have presented a critique of these findings.
Important points to consider are that the African American children may be attending Head Start programs of lower quality, may subsequently attend poor schools, or may have less developed vocabulary to begin with and thus need even more intensive interventions than the European American children. They may benefit less from Head Start classrooms in which standard English is used because they are more comfortable with a dialect of English (African American Vernacular English) that their caregivers are reluctant or unable to use, so that optimal adult-child communication is disrupted. Very little is known about the impact of speaking nonstandard dialects like African American Vernacular English on access to learning in preschool or primary classrooms, a question we address in Chapter 9.
Spanish-speaking children attending English-language preschools also may face special problems. A recent study compared children from Spanish-speaking homes who were in English-medium Head Start classrooms to those in a Spanish-medium pilot classroom and to their English-speaking classmates (Bronson, 1996, as cited in Dickinson and Howard, 1997). The social adjustment of Spanish-speaking children in English-medium classrooms lagged behind that of other children in the same classrooms, whereas that of the children in the Spanish-medium classroom was greatly advanced over both groups. Given the power of preschool children's social development to predict long-range outcomes, including literacy (Cohen et al., 1995), these results are striking.
Of further concern is the risk that Spanish-speaking children will lose Spanish while acquiring English in all-English preschools (Fillmore, 1991). After immigration, the shift to English as a first language from generation to generation is a universal and inevitable process (Pedone, 1981). However, Hispanic families are experiencing a very rapid shift toward English monolingualism among children of immigrant parents, leading to difficulties in communication across generations within households.
Many would argue that Head Start is one factor in this shift. Head Start was initiated before the recent upsurge in immigration, and planning within Head Start has not yet articulated specific policies for language-minority children comparable to those, for example, that guide services to non-English speakers in public elementary schools (SocioTechnical Applications Research, 1996). The same report indicates that English is the language of instruction in most Head Start classrooms. Within the Head Start community of educators and parents, developing readiness for school is often equated with learning English, despite the evidence that a strong basis in a first language promotes school achievement in the second language (Cummins, 1979; Lanauze and Snow, 1989). Research is needed to examine whether high-quality preschool experiences are equally beneficial to Spanish-speaking children when offered in English as when offered in Spanish.
It is clearly the case that young children have an amazing capacity for language learning, including learning second or foreign languages. Having a bilingual capability by learning English as a second language can be seen as an asset for anyone. However, the asset may turn into a risk for young Hispanic children getting ready for reading, if learning a foreign language comes at the expense of building on very early home language development in ways that promote the metalinguistic experiences needed for alphabetic reading. When toddlers are stretching their language capacities, putting together their native language expertise in ways that will promote their future success at reading, learning a second language cannot take the place of learning with one's own first language. Pre-schoolers' experiences with their own language allow, for example, phonemic sensitivity to develop; the child can then experience the alphabetic insight and get
the idea needed for learning to read. The undeniable asset of a second language need not be provided at a time or in a way that could create a risk to the child's preparation for reading.
HEALTH FACTORS AND PRIMARY PREVENTION
Performance at any age is the result of two categories of interrelated factors: biological integrity and environmental determinants. Recent research demonstrating the brain's susceptibility and responsiveness to changes in its environment has made the distinction between biological and social influences increasingly complex and reciprocal. It has been shown that developmental capacities can be enhanced by positive environmental stimuli, even in cases of early biological deficiencies (such as exposure to drugs or poor nutrition). For instance, Hawley et al. (1993) found that the single most powerful determinant of child outcomes for children who had been exposed to drugs before birth was the quality of their postnatal environment.
Programs have therefore been developed in hospitals, clinics, and community centers to lower prenatal, perinatal, and postnatal risks for mothers and their infants. These programs provide services such as prenatal care, nutritional supplements for pregnant women and children, hospital-based services, and home visits to enhance natural caregiving. Table 5-1 presents information on a selection of prevention and intervention programs aimed at improving the chances of at-risk infants. By enhancing children's health and developmental status, interventions at this early age are effective in improving their chances for success in learning to read later on.
Because of their regular contact with children during early childhood, pediatricians and other health care and human service professionals have the opportunity to promote reading. At routine visits, they can help guide parents and encourage children's literacy development. In the pediatrician's office or well-baby clinic alone there is a wide range of professionals well versed in observing a child's growth, noting needs, and communicating with caretakers for the child's benefit. In many cases, social service agencies and organizations also have opportunities to assist the child and the family. Often because of a referral from medical or social services, speech and
language therapists or professionals in reading clinics become involved with a child's development with respect to reading.
There is a growing shift in medical circles from treatment of a condition after it is identified to prevention and health promotion at very early ages (Green, 1994). Prevention efforts fall into three categories: (1) intervention to ameliorate illness and prevent complications when it is known that the child is in difficulty, (2) identifying probable problems with early screening devices, and (3) anticipatory guidance for all families (Osborn, 1996).
For reading problems, the first category affects a small but important number of children who must be referred to specialists beyond the pediatrician or family practitioner (e.g., medical specialties, speech and language therapists, occupational and physical therapists). The acumen of the pediatrician's diagnosis at the earliest possible time is crucial. For example, the early detection of deafness correlates with higher reading scores among profoundly deaf children, regardless of the onset of deafness (congenital versus after birth) (Padden and Tractenberg, 1996).
For the second category of prevention in pediatric settings, there are screening devices related to reading that have focused more on the child's visual functions, although more recent efforts to assess phonological processing deficits as well are being undertaken (Nelson, 1996). There is also a parent screening device that could allow identification of home factors that are likely to impede literacy development, but it has not been systematically studied for effectiveness (Davis et al., 1991, 1993).
The third category, anticipatory guidance, affects the greatest number of children. The pediatrician can give parents guidelines for dealing with different aspects of growth and development (Green, 1994). The time spent in regular pediatric visits is limited, however, and complete coverage of the suggested topics would require more than an hour. Studies of pediatric visits document that less than a minute is given over to anticipatory guidance (Korsch et al., 1971).
A number of pediatric literacy programs are in place in large cities around the country. A good example is Reach Out and Read (ROR), which was first launched in 1989 in Boston City Hospital by
TABLE 5-1 Examples of Intervention Programs for Infants and Young Children
Age Range of Children Targeted
Description of Intervention
Statewide effort (Massachusetts) to provide prenatal care for high-risk mothers through clinics within health centers, high schools, and other community centers.
The number of infants with one or more risks declined from 37 percent in 1990 to 34 percent in 1994 (National Education Goals Panel, 1996).
Provision of nonintrusive, developmentally appropriate care services to preterm and low-birthweight infants in neonatal intensive care units of hospitals aimed at preventing developmental delays.
Faster development with fewer medical problems (Als et al., 1994).
Nutritional supplementation for pregnant women, mothers, and children from economically disadvantaged families to ensure adequate diets.
Improved academic performance of children (Pollitt et al., 1993)
Home visits of mothers of low-birthweight infants to enhance quality of care through provision of emotional and social support to mothers and instruction on child development using a developmentally ordered curriculum
Children of mothers actively engaged in program developed faster than those of passively engaged mothers. Mothers with inadequate housing, health care, child care and social/emotional support were less likely to become actively engaged (Liaw et al., 1995).
Birth to 5
Preschool and day care centers serve children with special needs in the same environment as other children. Community-based child care arrangements provided for children with chronic otitis media.
Children with chronic otitis media who attended day care during the first three years of life were more often alone, had fewer verbal interactions with peers, and were less attentive to story reading (Feagans and Manlove, 1994).
NOTE: These programs were selected based on the expertise of the committee and on the basis that they had been formally evaluated.
Table is on previous page
pediatricians and early childhood educators. It has three components:
· waiting room volunteers who model reading aloud and book sharing,
· giving a picture book to children at each visit from six to 60 months of age, and
· reading guidance and modeling by pediatrician at each visit.
This program has since been replicated and disseminated across the country, varying in the nature of the waiting room activities, the actual people hired to read in the waiting room, and the sort of advice given to parents to guide them in reading activities with their children.
In a 1991 evaluation of the program in Boston, 79 parents were interviewed about their children's daily routines and favorite activities. Parents who spontaneously mentioned looking at books in response to either question were categorized as having a literacy orientation. Results of the evaluation indicated that parents who had been given a book at the pediatrician's office were more likely to report a literacy orientation (parents mentioning looking at books, reading books as a favorite activity, going to the library, etc.) Having been exposed to waiting room readers or to guidance by the pediatrician had no association with literacy orientation.
In a report on the effectiveness of pediatric literacy programs, Needlman (1997) presents the results of evaluations of four additional programs: (1) the Providence Prospective Study (N = 100) (High et al., 1996), (2) the Atlanta Replication (N = 124) and Extension Study (N = 47) (Hazzard et al., 1996), (3) the Oakland Calfornia Replication Study (N = 96) (Bethke, 1997), and (4) the Pediatrician-Enhanced Early Learning Study (N = 300) (Needlman, 1997). Each of these programs provides similar core experiences for parents and their young children. The results of the four additional evaluations were similar to the findings of the 1991 study presented above. Additional findings were that the program was not consistently effective for parents with higher education, although it was consistently effective for parents with less education, and that the program
did not increase children's scores on the preschool language scale (Needlman, 1997).
EARLY INTERVENTION FOR CHILDREN WITH PHYSICAL AND COGNITIVE IMPAIRMENTS
In our discussion in Chapter 4 of risk factors associated with early reading difficulties, we identified children who are deaf or hearing impaired, who have language impairments, and who have cognitive deficits as needing early intervention that may reduce their risk of reading difficulties. Here we review programs to address their early intervention needs as related to reading outcomes when the children are in the primary grades.
Children with Hearing Impairments
Most deaf children begin kindergarten and first grade with very limited English vocabularies and delayed recognition of syntactic structures in English. Deaf children perform as well as hearing children on nonverbal tasks (Furth, 1966; Rittenhouse, 1979) demonstrating that they have the cognitive abilities to learn and achieve in school. They also have the perceptual skills needed to differentiate letters and can learn a finger-spelled alphabet as early as age 3 1/2 (Quigley, 1969).
While having cognitive capacities for learning, deaf children face a serious obstacle in learning to read because they lack the speech foundation on which reading ordinarily rests. Additionally, limitations in the experience of deaf children reduce their opportunities to acquire vocabulary and to master the full set of linguistic structures that hearing children usually acquire by the age of 6 (Andrews and Mason, 1986). In a longitudinal experimental study of 45 deaf children between 5 and 8 years of age, Andrews and Mason found that deaf children's reading abilities are increased through opportunities to match their internalized manual language to printed word. Because deaf children are unable to develop strategies to ''sound out" new words, they naturally bypass the phonological system and move
through a "holophrastic" system, matching signs and meanings of whole words to print.
The authors identify a three-stage model of reading development according to which deaf children learn: First, the child learns about printed word symbols and can label pictures with manual signs. At the second stage, the child can recognize words on signs and food labels, can recognize the alphabet using finger spelling, and can read and print a first name. Finally, at the third stage, the child learns to actively break down letters into words and makes significant gains in sight word vocabulary, spelling, and printed knowledge. Parents and preschool teachers can enhance deaf children's communicative and reading ability growth by beginning very early to communicate with these children through finger spelling and manual signing.
Although there is evidence suggesting that highly skilled college deaf readers show speech coding during reading (Hanson et al., 1991), other evidence suggests that deaf children can encode print directly with meaning without using auditory decoding or phonological mediation (Ewoldt and Hammermeister, 1986; Stotsky, 1987). Literacy instructional practices that focus on building subskills, such as phonological awareness, rather than on providing opportunities to derive meaning from text are less effective with deaf children. In a case study of three profoundly deaf preschool children, Williams (1994) found that the children's understanding of written language and uses of literacy were appropriate despite their delayed receptive language development. A recent study (LilloMartin et al., 1997) found that improvements on segmentation of sounds of English words were made after phonological training but not after semantic training.
Early identification of hearing-impaired children and early intervention to begin teaching them symbolic language can be paramount for later achievement (Robinshaw, 1994). One model of comprehensive services for these children is the SKI-HI Institute's Project Insite (National Diffusion Network, 1996). This comprehensive program provides screening, audiological, diagnostic, and assessment services and complete home intervention programming for children from birth through age 5 and their families. Audiological services, hearing aid evaluation and loaner system, video units and
tapes for total communication, hearing aid molds, psychological services, and transition to educational environments are included. Children with hearing impairments who enroll in this program experience increases in language growth, including auditory, communication language, and vocabulary levels. A recent evaluation revealed that children who took part in the program experienced the greatest amount of growth and development in the domain of cognition, communication, and language.
Children with Language Impairments
Most children who receive a diagnosis of specific language impairment receive treatment during the preschool years. Understandably, the primary goal of such interventions is to address the oral language difficulties of the child, and their efficacy has been evaluated accordingly (Dattilo and Camarata, 1991; Fey, 1990; Friedman and Friedman, 1980). Because it is now recognized that these children are also at risk for later reading problems, it is important to identify what kinds of early interventions, if any, might also be effective in reducing that risk (Fey et al., 1995a; Kirchner, 1991). To date, the kinds of help that these preschoolers currently receive does not appear to affect longer-term literacy outcomes (Fey et al., 1995b; Yancey, 1988; Huntley et al., 1988), nor does the amount of speech-language therapy a child receives reduce the risk for future reading difficulties (Aram and Nation, 1980; Bishop and Edmundson, 1987; Stark et al., 1984).
As described earlier, successful readers ordinarily acquire a great deal of information about print concepts during the preschool years, and children who begin school knowing less about the nature and purposes of books and reading are less likely to be high achievers in reading. Studies have shown that preschoolers with specific language impairment are less knowledgeable about print and about story structure than are other children of the same age (Bishop and Adams, 1990; Weismer, 1985; Gillam and Johnston, 1985). In one study, this weakness was not found to be associated with the child's exposure to and participation in literacy activities; instead, the children with specific language impairment apparently learned less about
print concepts than their age mates with better language skills did (Gillam and Johnston, 1985). Moreover, interventions that produced differences in the quality of parental book reading have had inconsistent effects on oral language abilities for children with specific language impairment and have not examined long-term reading achievement outcomes (Dale et al., 1996; Whitehurst et al., 1989).
Second, children with limited phonological awareness at the time of school entry are at risk for reading failure, and training on the phonological structure of spoken words enhances not only awareness but also reading skills. Not surprisingly, given that metalinguistic skills tend to develop in conjunction with basic language abilities (Chaney, 1992), children with specific language impairment tend to be somewhat behind, on average, in attaining the insight that words are composed of smaller component sounds (Catts, 1991a, 1993). To date, one intervention study has produced impressive short- and long-term gains in phonological awareness by children with specific language impairment, compared with untreated samples of preschoolers with specific language impairment and those with normal language abilities (Warrick et al., 1993). A similar program, provided for somewhat lower-functioning language-impaired children, was less successful (O'Connor et al., 1993).
In sum, although some promising results have been obtained in these early intervention studies, no clear-cut means has yet been established for reducing the high degree of risk associated with specific language impairment.
Children with Cognitive Deficits
Research has shown that special education in early childhood has significant effects on young children with cognitive deficits (Carta et al., 1991; Casto and Mastropieri, 1986; Mallory, 1992). These children have apparently intact physical sensory systems but still exhibit significant delays in learning and developing their capacities to remember, think, coordinate, and solve problems. It is not clear whether particular program features have targeted outcomes for young children and whether there are significant effects on reading achievement.
There has been considerable controversy about how best to structure early interventions for young children. For instance, researchers disagree about the extent to which content learning should be presented directly (typically called a didactic or behavioristic approach), as opposed to embedding content in the child's play or self-directed interests (generally called the developmental or constructivist approach). Some research suggests that better overall achievement results from more developmental approaches (Schweinhart et al., 1986), particularly for infants and toddlers (Mintzer et al., 1992).
One preschool program built on a developmental model that had positive follow-up results in reading achievement for children with cognitive deficits is High/Scope model (see Box 5-2). The High/ Scope Perry Preschool program is based on the constructivist educational theories of Jean Piaget and John Dewey (Hohmann and Weikart, 1995). It advocates active learning by providing children with opportunities to act according to their personal initiative and engage in direct key experiences with people, materials, events, and ideas. High/Scope's aims are to foster the development of intrinsic motivation and independent thinking and acting, provide a safe environment for social interaction and learning, and build a sense of community among students and staff through teamwork and cooperative group activities. The curriculum is guided by five components, including active learning (as described above), learning environment, adult-child interaction, daily routine, and assessment.
The preschool space is divided into various "interest areas" (e.g., water play, drawing and painting, pretend play, "reading" and ''writing") with a wide assortment of materials made available to the children. A daily routine is followed that includes small-group time, large-group time, outside time, transition times, and the "plan-doreview process"a three-step process aimed at teaching children to take responsibility and make choices, thereby exercising control over their lives. Adults regularly engage children in conversation, soliciting their responses to experiences, offering encouragement and focusing on their strengths, using a problem-solving approach to conflicts that arise, and generally building authentic relationships with them. Finally, teachers meet to plan and share their observations of
Structured arranging and equipping of classroom
Rooms divided into centers (e.g.. for dramatic play. art. books. blocks. music). Each has an ample supply and variety of needed items (specifics are listed in curriculum). Materials are stored in the areas where they are used. Space is available for storing and displaying children's work and belongings. Adults familiarize children with the names and contents of the areas. Equipment is charged and added throughout the year.
Environment accommodates children with disabilities.
General characteristics (e.g.. consistent transitions), planning time, work time, clean-up time, recall time, small-group time, outside time, and circle time.
Planning in a team and teaching methods
Maintain a comfortable, secure environment.
Support children's actions and language.
Help children make choices and decisions.
Help children solve their own problems and do things for themselves.
Support active learning, enhance language, develop concepts through experiencing and representing different aspects of classification, seriation, number, spatial relations, and time.
students on a daily basis, using the High/Scope Child Observation Record and taking daily anecdotal notes to inform their assessments.
The 58 key experiences or skills included in the High/Scope curriculum are distributed among several domains: creative representations, language and literacy, initiative and social relations, movement, music, classification, serration, number, space, and time. For example, in the category of language and literacy are six key experiences that include talking with others about personally meaningful experiences, describing objects, events and relations, writing in various ways (such as drawing, scribbling, and invented spelling) and reading in various ways (such as reading storybooks, signs, symbols, and one's own writing) (Hohmann and Weikart, 1995:345).
Results from the reading subtest of the California Achievement Test for the High/Scope Perry Preschool study indicate that children in the program consistently scored better than those in the control group. Children in the program also had fewer special education placements for mild mental retardation and, when placed in special education, spent fewer years there than did those not in the program. The standardized effect sizes (and, as a result, patterns of statistical significance) in the Perry Preschool study suggest the possibility that effects on reading grew over time. Follow-up studies comparing experimental group children with randomly assigned peers indicated the persistence of social and educational benefits extending into adulthood (Schweinhart et al., 1985).
Other studies compared cognitively oriented programs and academically oriented programs as a means of intervention for preschool children with cognitive deficits. The effect of program features was examined in a randomized design with children who had mild to moderate disabilities (Dale and Cole, 1988). Direct instruction (Becker et al., 1975; Becker, 1977) is a program with academic skills as content. Distar language is the preschool version and includes an extensive analysis of language skills involved and a particular teaching method. Instruction is systematic, teacher directed, and fast paced, with procedures for error correction and reinforcement. Mediated instruction (Haywood et al., 1992) is a program with cognitive processes as content. It teaches generalizable cognitive strategies, with an emphasis on enhancing motivation to want to learn through systems of task-intrinsic reinforcement. Children are taught to identify problems, monitor their responses, and avoid impulsive, rapid responding.
The preschool interventions (children ages 3 to 5) produced differential results that were consistent with the models of the two different programs. The direct instruction group had significantly higher performance on two tests of language development. The mediated instruction group had significantly higher verbal and memory scores and scores on mean length of utterance derived from language samples.
In follow-up studies, significant differential effects were found on two measures of cognitive ability, favoring the mediated instruc-
tion group, but none of the measures of academic ability, including reading ability, showed a significant differential effect. By the second year of follow-up, there were no significant differential effects of the two programs, although the overall benefits of the early intervention appeared to continue, including reading achievement (Cole et al., 1989).
The important finding of this study was that, at the end of the first year in the preschool programs and at follow-up when children were 9 years old, there was an interaction between the treatment and aptitude. Children who showed higher general cognitive ability before the preschool intervention gained more from direct instruction; children who had lower general cognitive ability before the intervention gained more from mediated instruction (Cole et al., 1993). This effect was significant at age 9 in tests of reading comprehension (Mills et al., 1995).
In sum, some promising findings indicate the nature of early intervention for children with cognitive deficits that reduce their high degree of risk for reading difficulties. Even with these interventions, children with cognitive deficiencies remain at risk for reading difficulties and need ongoing intensive interventions.
Children who arrive at school ready to learn have typically had the opportunity to acquire a good deal of knowledge about language and literacy during their preschool years. Well before formal reading instruction is appropriate, many informal opportunities for learning about literacy are available, to varying degrees, in most American homes and child care settings. Ideally, these opportunities mean that children have acquired some level of awareness of print and of the utility of literacy, that they may have some specific knowledge of letters or frequently encountered words, that they have developed some capacity to play with and analyze the sound system of their native language, and that they are motivated to use literacy. Language development during the preschool years, in particular the development of a rich vocabulary and of some familiarity with the language forms used for communication and books, constitutes an-
other equally important domain of preparation for formal reading instruction.
Primary prevention of reading difficulties during the preschool years involves ensuring that families and group care settings for young children offer the experiences and support that make these language and literacy accomplishments possible. Parents and other caregivers should spend time in one-on-one conversation with young children, read books with them, provide writing materials, support dramatic play that might incorporate literacy activities, demonstrate the uses of literacy, and maintain a joyful, playful atmosphere around literacy activities. For most children, these primary prevention efforts will ensure that they are ready for formal reading instruction.
Some children require more intensive secondary prevention efforts, including children in high-risk groups as well as those who have been identified as having language or cognitive delays or other sorts of impairments that may make literacy learning difficult. During this developmental period, secondary prevention does not look very different from primary prevention, differing primarily in intensity, quantity, and maintenance of the highest possible quality of interactions around language and literacy. Family-focused efforts are often designed to remove impediments to the availability of such support at home, through parent education, job training, and the provision of social services. Excellent preschools can also make a difference for at-risk children; excellent in this case implies providing rich opportunities to learn and to practice language and literacyrelated skills in a playful and motivating setting. Substantial research confirms the value of such preschools in preventing or reducing reading difficulties for at-risk children.