DSE recommends RLI for use with children with Down syndrome aged from 5 to 11 years where sufficient commitment and resources are available to plan, prepare and deliver the teaching program consistently for an initial period of at least 20 weeks.
Given the findings from the evaluation study, DSE believes that this reading and language intervention is likely to improve reading and language development for many children with Down syndrome. We therefore recommend its use where sufficient commitment and resources are available to plan, prepare and deliver the teaching program consistently.
How should the intervention can be delivered?
Our study shows that the program can be successfully delivered by teaching assistants. Many primary age pupils with Down syndrome in the United Kingdom will be supported by teaching assistants and we recommend that the intervention is adopted in schools. Other delivery models are also possible. Although, we evaluated the intervention in mainstream schools, it is designed for one-to-one instruction and should be equally suitable for use in special education settings.
Why DSE recommends RLI
DSE recommends RLI for use with children with Down syndrome because:
- Children with Down syndrome share a common developmental profile which can inform more effective educational practice. Most require consistent, high quality teaching over a sustained period to make good progress.
- RLI is based on best practice for reading interventions, combining sight word learning with training in the awareness of sounds in words and the links between letters and sounds, in the context of book reading.
- RLI combines reading and language instruction and is adapted to meet the specific learning needs of children with Down syndrome.
- RLI offers carefully graded activities that are matched to individual learners' needs through a process of initial and continuing assessments.
- RLI offers a well-defined structure for individualized reading and language teaching on a daily basis, including weekly consolidation sessions.
- RLI was evaluated in a rigorous randomized controlled trial.
- The trial involved 57 children with Down syndrome (aged 5 to 10 years) attending 50 mainstream schools in two areas of the UK.
The evaluation study, published in the Journal of Child Psychology and Psychiatry, found that:
- Children receiving the intervention made faster progress on average on a number of measures than children receiving ordinary teaching.
- Gains on four outcome measures were statistically significant (in other words, they are considered unlikely to have occurred by chance) after 20 weeks of intervention. These were single word reading, letter-sound knowledge, phoneme blending and taught expressive vocabulary, reflecting the skills that were most directly targeted by the intervention.
- Children receiving the intervention gained an average 4.6 words on a measure of single word reading over 20 weeks, compared with an average 2.0 words for children in a control group not receiving the intervention: a gain of 2.6 words.
- By the end of the study, 1 in 5 children with Down syndrome achieved word reading scores similar to those expected of typically developing children of the same age.
- Teachers reported that the predictable structure of the intervention led to improved behavior, attention and engagement in learning.
- Rates of progress for individual children varied widely with some children making substantial progress quickly, some children steadily making slower progress, and a few children making little or no progress.
- Children who started the program at a younger age, who had better receptive language skills at the outset, and who received the most intervention sessions generally made the greatest progress.
DSE is supporting the use of RLI
- DSE is publishing a Teacher's Handbook, including video training, example teaching materials and assessment resources.
- DSE is offering training to support the use of RLI, including online seminars and hosting an email discussion forum for educators using the intervention.
- DSE is continuing to invest in research to further evaluate, improve and refine the teaching program
Who may benefit?
Children with Down syndrome aged from 5 years can benefit from the intervention, despite their language and cognitive delays. Many children with Down syndrome will be participating fully in a rich range of literacy activities during their first (reception) year at school. Where this is the case, we recommend starting the intervention in their second year (Year 1) when they will be on average aged around 5½ years. Most students with Down syndrome should continue to benefit from the intervention throughout their primary/elementary school years. However, children who achieve a word reading age of 8 years should discontinue the reading strand and move on to more appropriate activities targeting reading comprehension.
Will some children not benefit?
Some children did not make as much progress as others when receiving the intervention. In general, those who had better language skills, were younger and attended more intervention sessions made more progress. However, some older children, some children with poorer language skills at the start and some children who attended fewer sessions did make good progress.
Of 8 children (16%) who made very little or no progress on word reading throughout the study, we can identify 3 who had particularly poor language skills and who were aged 68 or 70 months at the start, two of whom also had relatively poor behavior ratings. This may suggest that children sharing a similar profile may make little progress on the intervention. However, one child of a similar age with similar language and non-verbal abilities did make progress with word reading on the intervention and it is not clear what initial measures could have predicted the lack of progress for the other 5 children on word reading over 60 weeks.
Some children may not benefit from the intervention. However, it is not possible to predict if an individual child will make little or no progress on any single or multiple measures if taught using the intervention, based on the data we collected. The only way to find out if the intervention will help an individual child is to try it for a sustained period of time.
How often should the children receive the intervention?
The intervention is designed to be delivered through daily 40-minute teaching sessions (or two 20-minute sessions). Many children with Down syndrome need sustained additional support for learning.
The evaluation study found that the children who received the most intervention sessions generally made the greatest progress with word reading. We found that 71% of the children who received 80% more of the recommended intervention sessions achieved gains on word reading scores higher than the average gains for 'teaching as usual', compared with 39% of children who received less than 80% of the recommended sessions. We therefore recommend that is delivered daily throughout term time.
How quickly should we see progress?
Many children made noticeable gains quite quickly, while others progressed more slowly. The evaluation study identified gains on many measures for the initial intervention group when compared to the control group, four of which were statistically significant, after 20 weeks.
Of 28 children in the intervention group during the first phase of the study, 25 (89%) gained one or more word on the word reading measure, whereas only 13 out of 25 children (52%) in the control group gained one or more word, during 20 weeks of intervention or 'teaching as usual', respectively. During this period, 13 children (46%) receiving the intervention gained 5 or more words on the word reading measure, while 3 children (12%) receiving 'teaching as usual' gained 5 or more words. When the original control group (2) moved onto the intervention, 19 (76%) of 25 children gained one or more word on the word reading measure and 10 children (40%) gained 5 or more words.
Progress should therefore be noticeable for many children with Down syndrome within 20 weeks of starting the intervention. However, some will progress more slowly: after 40 weeks of supported intervention, 27 (96%) of the 28 children in the initial intervention group gained two or more words on the word reading measure (compared with 89% gaining one or more words after the first 20 weeks).
In general, children with Down syndrome require consistent, high quality teaching over a sustained period to make good progress. Another study of literacy instruction with children with intellectual disabilities including children with Down syndrome reported that it took 1 to 2 years of teaching before some children made gains. We recommend that teachers monitor the children's progress carefully, using the tools provided with the program, to ensure that individuals are making progress with the skills and knowledge being taught. The program provides guidance about how to adapt teaching to meet the needs of children who are progressing more slowly.
Find out more at online RLI information sessions
DSE hosts regular information sessions for families and educators interested in learning more about RLI. These web seminars can be accessed online for free using a computer and (optionally) a telephone.