Galuschka Katharina, Ise Elena, Krick Kathrin, Schulte-Körne Gerd
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Munich, Munich, Germany.
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
PLoS One. 2014 Feb 26;9(2):e89900. doi: 10.1371/journal.pone.0089900. eCollection 2014.
Children and adolescents with reading disabilities experience a significant impairment in the acquisition of reading and spelling skills. Given the emotional and academic consequences for children with persistent reading disorders, evidence-based interventions are critically needed. The present meta-analysis extracts the results of all available randomized controlled trials. The aims were to determine the effectiveness of different treatment approaches and the impact of various factors on the efficacy of interventions. The literature search for published randomized-controlled trials comprised an electronic search in the databases ERIC, PsycINFO, PubMed, and Cochrane, and an examination of bibliographical references. To check for unpublished trials, we searched the websites clinicaltrials.com and ProQuest, and contacted experts in the field. Twenty-two randomized controlled trials with a total of 49 comparisons of experimental and control groups could be included. The comparisons evaluated five reading fluency trainings, three phonemic awareness instructions, three reading comprehension trainings, 29 phonics instructions, three auditory trainings, two medical treatments, and four interventions with coloured overlays or lenses. One trial evaluated the effectiveness of sunflower therapy and another investigated the effectiveness of motor exercises. The results revealed that phonics instruction is not only the most frequently investigated treatment approach, but also the only approach whose efficacy on reading and spelling performance in children and adolescents with reading disabilities is statistically confirmed. The mean effect sizes of the remaining treatment approaches did not reach statistical significance. The present meta-analysis demonstrates that severe reading and spelling difficulties can be ameliorated with appropriate treatment. In order to be better able to provide evidence-based interventions to children and adolescent with reading disabilities, research should intensify the application of blinded randomized controlled trials.
患有阅读障碍的儿童和青少年在阅读和拼写技能的习得方面存在显著障碍。鉴于持续性阅读障碍对儿童造成的情感和学业影响，基于证据的干预措施至关重要。本荟萃分析提取了所有可用的随机对照试验结果。目的是确定不同治疗方法的有效性以及各种因素对干预效果的影响。对已发表的随机对照试验的文献检索包括在教育资源信息中心（ERIC）、心理学文摘数据库（PsycINFO）、医学期刊数据库（PubMed）和考科蓝图书馆（Cochrane）中进行电子检索，以及检查参考文献。为了查找未发表的试验，我们搜索了临床试验网站（clinicaltrials.com）和ProQuest，并联系了该领域的专家。可以纳入22项随机对照试验，共49组实验组与对照组的比较。这些比较评估了五种阅读流畅性训练、三种音素意识指导、三种阅读理解训练、29种自然拼读法指导、三种听觉训练、两种药物治疗以及四种使用彩色覆盖物或镜片的干预措施。一项试验评估了向日葵疗法的有效性，另一项研究了运动锻炼的有效性。结果显示，自然拼读法指导不仅是研究最频繁的治疗方法，也是唯一一种在患有阅读障碍的儿童和青少年的阅读和拼写表现方面其疗效得到统计学证实的方法。其余治疗方法的平均效应量未达到统计学显著性。本荟萃分析表明，通过适当治疗可以改善严重的阅读和拼写困难。为了能够更好地为患有阅读障碍的儿童和青少年提供基于证据的干预措施，研究应加强盲法随机对照试验的应用。
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