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Article
The Effects of Text-to-Speech on Reading
Outcomes for Secondary Students With
Learning Disabilities
Mary Cece Young1, Carrie Anna Courtad1, Karen H. Douglas1,
and Yun-Ching Chung1
Abstract
This study investigated the effectiveness of text-to-speech
(TTS) on the outcomes of reading comprehension and oral
reading
fluency (ORF) for four secondary students with learning
disabilities. The researchers used a single-case A–B–A–B
withdrawal
design to evaluate the effectiveness of TTS on reading
outcomes. All participants scored higher on reading
comprehension after
using TTS when reading instructional passages and maintained
the skills for 4 weeks. Results on participants’ ORF also
indicated an
increased level of words read per min at the end of each
accommodation condition. Comparison of pre- and posttest
achievement
on the Lexile assessment showed that two of the four
participants increased their reading scores. Major findings are
discussed
with implications for practice and recommendations for future
research to increase the use of TTS in the classroom.
Keywords
assistive technology, learning disabilities, legislation,
secondary, text-to-speech
Reading is a necessary and critical skill. The acquisition of
reading substantially impacts educational outcomes, employ-
ment success, and personal and professional growth (Strang-
man & Dalton, 2005). In the United States, roughly 6 million
secondary students are reading at a level far below their grade.
The National Assessment of Educational Progress (NAEP)
from 2017 indicated that 74% of eighth graders do not have
proficient-level reading skills even though the data showed an
overall slight increase of reading achievement since 2015.
However, it should be noted that the growth rate is with stu-
dents who were higher achieving, whereas students with dis-
abilities remained statistically the same. The NAEP reading
achievement scores for students with disabilities in 12th grade
across the nation have not increased since 2009, the earliest
available data for students with disabilities at that grade level.
In fact, the gap between 12th graders with and without disabil-
ities has increased by 3 points since 2009, indicating that those
with disabilities are continuing to fall behind their peers with-
out disabilities (U.S. Department of Education, 2015, 2009,
2017).
Students With Learning Disabilities (LDs)
Several legislative actions have focused on evidence-based
practices and inclusion of students with disabilities in the gen-
eral education curriculum; yet as indicated by NAEP results,
reading scores have not improved for many students with
disabilities over the years. These results are especially concern-
ing for students with LDs who are the highest population of
students receiving special education services at 35% (Snyder,
de Brey, & Dillow, 2016; Wanzek, Otaiba, & Petscher, 2014).
Approximately 80% of students with LD exhibit deficits in the
area of reading (Cortiella & Horowitz, 2014). In addition, 90%
of students with LD are not able to read material independently
(Vaughn & Wanzek, 2014). Students who have difficulties
making meaning from text are likely to encounter postschool
challenges, such as being unemployed, earning lower incomes,
and exhibiting poor health as adults (Snyder & Dillow, 2013).
In order to reduce the negative postschool outcomes associated
with reading difficulties, addressing adolescents’ lack of read-
ing progress in our high schools is imperative.
Students with LD often experience several years of reading
difficulties that involve deficits in making meaning from text
(Cortiella & Horowitz, 2014). Achieving success in school
requires proficient reading skills to understand all content areas
(Vaughn & Wanzek, 2014). This gap widens in high school as
students struggle to gain information from text that is necessary
1 Illinois State University, Normal, IL, USA
Corresponding Author:
Mary Cece Young, Illinois State University, Campus Box 5910,
Normal,
IL 61790, USA.
Email: [email protected]
Journal of Special Education Technology
2019, Vol. 34(2) 80-91
ª The Author(s) 2018
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/0162643418786047
journals.sagepub.com/home/jst
for learning (Saenz & Fuchs, 2002). To prevent the achieve-
ment gap from further widening between special and general
education students, additional types of reading accommoda-
tions need to be implemented. Technological accommodations
have been known to increase academic outcomes for secondary
students with LD (Stetter & Hughes, 2011).
The National Educational Technology Standards and the
Council for Exceptional Children Technology Specialist estab-
lished standards to train teachers on the use of assistive tech-
nology (AT) when instructing students with disabilities (Parette
& Peterson-Karlan, 2010; Smith & Allsopp, 2005). Even with
these guidelines, many teachers are not routinely using tech-
nology to make content accessible (Okolo & Diederich, 2014).
Adding to this dilemma is that classroom curricula are primar-
ily based in print (Rose, Meyer, & Hitchcock, 2011). Given
this, students who are able to read the text may benefit more
than students who struggle to read. This may lead to a Matthew
Effect that causes the word-rich to get richer and the word-poor
to get poorer (Stanovich, 1986). To aid in addressing this issue,
teachers need to boost students with disabilities’ motivation to
read. Technology is highly motivating to secondary students
with LD and can potentially increase the amount of content
they learn and read (Anderson-Inman, 2009; Bouck, Flanagan,
Miller, & Bassette, 2012).
AT
The availability of AT for individuals with disabilities has
increased dramatically since the 1970s (Poel, 2007). In a recent
state survey, 67% of teachers reported that they believed AT
increased student access to curriculum and outcomes, but only
33% of respondents could make print accessible on the com-
puter for their students (Okolo & Diedrich, 2014). When asked
what contributes to using technology, more than half of the
teachers identified the severity of the students disabilities, as
in, the more severe a students’ disability, the more likely they
were to use technology. The teachers in this study also identi-
fied staff knowledge as a barrier (70%) along with availability
of technology (61%) and funding (61%). Despite increased AT
device presence, teachers are not typically using AT in the
classroom, especially classrooms with students who have a less
severe disability (e.g., LD). Unfortunately, many teachers per-
ceive AT for a certain type of disability, have a lack knowledge
of how to use AT, and identify obtaining devices as
problematic.
The Tech Act, reauthorized in 2004, intensified the previous
legislation to promote the access, knowledge, and obtainability
of AT among students with all disabilities to access curriculum.
Prior to that in 1998, The Tech Act only defined AT as any
piece of equipment or product system, whether acquired com-
mercially, off the shelf, modified, or customized, that is used to
increase, maintain, or improve the functional capabilities of
individuals with disabilities (Assistive Technology Act of.
1998). Additionally, Individuals With Disabilities Act (2004)
requires every individualized education program (IEP) team to
consider AT for students with disabilities during annual
meetings (Parette & Peterson-Karlan, 2010). If the IEP team
determines AT is needed, an AT evaluation is conducted and
listed as a related service or supplementary aid in the student’s
IEP (Parette & Peterson-Karlan, 2010). The intention of this
mandate along with the discussion of Universal Design for
Learning was to increase the consideration of using AT more
frequently to help students access curriculum in the classroom,
regardless of the severity of the disability. However, these
legislative actions did not increase AT in the classrooms as
indicated by Okolo and Diedrich’s study in 2014.
Benefits of Text-to-Speech (TTS)
To assist secondary students in accessing curriculum, students
with reading disabilities oftentimes need compensatory tools
(e.g., TTS). TTS is an AT that can compensate for reading
difficulties and can increase access to text (Stodden, Roberts,
Takahashi, Park, & Stodden, 2012). AT used as a compensa-
tory tool is defined as any tool permitting a person to complete
a task where without the tool, the person is unable to perform
the task at the expected level (Courtad & Bouck, 2013). Gen-
erally, technology has shown to promote independence and
self-worth and to increase motivation and productivity among
students with LD (Edyburn, Higgins, & Boone, 2005). More
specifically, technological speech–synthesized accommoda-
tions have resulted in reading gains for students with LD
(Moorman, Boon, Keller-Bell, Stagliano, & Jeffs, 2010).
Following the use of TTS, Gruner, Ostberg, and Hedenius
(2017) found that students improved reading rates, increased
time spent on reading, and performed better on comprehension
measures. They also noted that both elementary-aged and sec-
ondary students improved their reading rates when using TTS.
However, only elementary school students showed improve-
ment in reading comprehension. Furthermore, Moorman,
Boon, Keller-Bell, Stagliano, and Jeffs (2010) found that the
lowest readers benefited the most from TTS in comprehension.
Specific TTS features have been known to enhance students’
engagement and outcomes (Wood, Moxley, Tighe, & Wagner,
2018). When individualizing TTS through the use of embedded
features (e.g., reading rate, voice type, and highlighting), stu-
dents with LD exhibited educational gains including increased
reading rates and comprehension (Moorman et al., 2010; Tian
& Okolo, 2007; Young, 2013). Research also showed that when
computerized reading speed was set at a faster rate than present
oral reading fluency (ORF), students increased their compre-
hension (Coleman, Carter, & Kildare, 2011).
Reading difficulties for secondary students who struggle to
make meaning from text will likely continue beyond the school
years in their postschool life. TTS is an accommodation that is
nearly ubiquitous, across operating systems, platforms, and
applications (Stodden et al., 2012); yet classroom teachers
reported not using AT on a regular basis (Okolo & Dietrich,
2014). As Okolo and Dietrich wrote, “ . . . research about the
impact of AT remains limited. Few papers in an educational
journal end without a plea for more research” (p. 18).
Young et al. 81
Purpose
In order to answer the professional call for more research on the
impact of AT for students with LD and add to previous research
indicating positive outcomes for students with disabilities, this
study uses AT as an accommodation for secondary students
with LD who struggle to make meaning from text in a tradi-
tional print form. Specifically, this study evaluated the effec-
tiveness of TTS on the reading comprehension of high school
9th graders with LD in a self-contained class. The first author
(i.e., a special education teacher) used the reading accommo-
dation of TTS, Kurzweil 3000, to assist with reading material
for students with LD. She monitored participants’ performance
in reading comprehension through curriculum-based assess-
ments (CBAs) to ensure improvement before measuring the
effects on outcomes in maintenance sessions. The results pro-
vided additional empirical evidence on the effects of TTS when
used as an accommodation for secondary students with LD.
The research questions included the following: (a) Does the
reading comprehension of freshman students with LD increase
when using TTS as measured by CBAs? (b) Will students
maintain the use of TTS following intervention? (c) Does ORF
increase after students use TTS? (d) and To what extent do the
students generalize reading comprehension to pre and post uni-
versal screening assessments (e.g., Lexile)?
Method
Participants
The first author selected participants based on purposive and
convenience sampling. She recruited potential participants for
this study if they met the following criteria: (a) were identified
as having a LD in reading, (b) received services in a 9th-grade
self-contained English class, and (c) had a 95% attendance rate
at the start of the study. In this district and state, students
qualified as having LD after progressing through a response
to intervention (RtI) model, demonstrating a lack of progress at
level three, and having a discrepancy between their cognitive
abilities and their performance. The self-contained English
class was required for all students with LD in reading who had
a Lexile score in the bottom 25% locally or below 900 and had
an IEP with a reading comprehension goal. This class had a
total of enrollment of 11 students. The students in the self-
contained English class were also enrolled in a self-contained
reading class using a different curriculum package, READ 180
by Houghton Mifflin Harcourt (n.d.). Four of the 11 students
meeting the inclusion criteria provided informed assent and
parent permission (see Table 1 for participant demographics).
Only three students completed the entire study through main-
tenance and generalization. Vincent left the study early because
of a change in his class schedule.
Setting
The study took place in a large, Midwest public high school
with an estimated overall student enrollment of 3,500 and
approximately 15% of the students receiving special education
services. Forty percent of these students receiving special edu-
cation services had LD. Twenty percent of the overall student
population received free and/or reduced-price lunch. Research
activities occurred in a computer lab close to the students’ self-
contained English classroom. The computer lab had at least 15
desktop computers with the TTS program, Kurzweil 3000
(Kurzweil Education, 1996), installed on each computer. All
students in the class (n ! 11) used TTS during the scheduled
self-contained English class to access the curriculum; however,
the first author only collected data on the four students parti-
cipating in this study. Students sat at least one seat away from
their peers to minimize distractions. Each TTS session lasted
one class period (i.e., 48 min) for 3 times per week during the
scheduled English class time in the early morning.
Materials
Classroom textbook. The district adopted a complete curriculum
called Hampton-Brown Edge: Reading, Writing, & Language
(Moore, Short, Smith, & Tatum, 2014). This curriculum con-
tains four reading levels for adolescent students. All partici-
pants in this study used Level A based on students’ reading
levels in the bottom 25th percentile on Lexile scores locally.
Table 1. Participant Demographics.
Name
Age
Initial Eligibility
Ethnicity Used TTS Previously Initial Lexile Scores Percentage
in General EducationGender
Primary and Secondary
Characteristic
Dianna 15 11/2012 African American No 772 40–79
(F) SLD/ADHD
Donald 14 4/2008 African American No 872 40–79%
(M) SLD
Jack 14 12/2009 African American No 186 Less than 40%
(M) SLD/AU
Vincent 15 5/2011 African American No 864 40–79%
(M) SLD
Note. ADHD ! attention deficit/hyperactivity disorder; AU !
autism; SLD ! specific learning disability.
82 Journal of Special Education Technology 34(2)
Before the study began, the first author selected 29 fiction
stories from the The Edge Level A (Moore et al., 2014). In
addition, she used The Edge curricular comprehension assess-
ments for each story. The comprehension assessments con-
sisted of 15 multiple-choice questions, including eight
vocabulary, four literary analysis, and three reading compre-
hension questions.
TTS. Prior to beginning the study, participants attended a train-
ing session conducted by the first author on how to use Kurz-
weil 3000. During this training sessions, students were allowed
to personalize the settings for highlighting text and choose the
voice reading the text. The first author choose the setting for
the
read aloud rate (i.e., how fast the TTS read). These individua-
lized settings became the default each time a participant logged
into Kurzweil 3000 to access the stories.
Dependent Measures
Reading comprehension measures. For this study, the first
author
used a reading comprehension measure to evaluate the effec-
tiveness of TTS among students with reading deficits within a
withdrawal design study as recommended by Perelmutter,
McGregor, and Gordon (2017). After students read each fiction
story, the reading comprehension measures included the CBAs
from the Edge assessments (Moore et al., 2014). The first
author scored the CBAs by grading the percentage of correctly
answered questions out of the 15 total questions for each story.
Additionally, she used the Scholastic Reading Inventory (SRI)
assessment to obtain pre- and posttest Lexile score (Lexile,
n.d.). The SRI is a computerized reading comprehension
assessment that lasts approximately 30 min. It is used to obtain
a reader’s Lexile score ranging from 0 to 1500 and as a uni-
versal screener to determine placement in English courses. The
SRI recommends placing students into categories to identify
their reading needs.
ORF. The first author also used an ORF measure to determine
whether students increased their words read per minute after
auditory and visual exposure to text. The RtI specialist
employed at the high school selected the ORF passages from
Aimsweb (Pearson, 2012). Each student read three paper-based
1-min 8th-grade passages while the teacher documented the
number of words read correctly. Each ORF passage contained
a different topic, so students did not repeatedly read the same
passage. After participants read three passages in one session,
the teacher averaged the scores to determine ORF scores for
that date and time. The teacher conducted ORF assessments in
this manner 6 different times throughout the study: prebaseline,
after each condition, and after the maintenance condition. She
administered a total of 18 ORF assessments during the first half
of the school year.
Social validity. The classroom teaching assistant administered a
teacher-created 8-item Likert-type scale survey to each parti-
cipant in the instructional classroom to gather social validity
information on the procedures and outcomes of the TTS
accommodation (survey available upon request). The survey
asked participants to rate their levels of satisfaction on a 5-
point scale (i.e., 1 ! strongly disagree; 5 ! strongly agree)
regarding the use of TTS. Because the teacher created the
survey at the participants’ readability levels, the participants
read the survey on their own. Mean scores on each item were
reported.
Experimental Design
A single-case A–B–A–B withdrawal design (Gast & Ledford,
2014) was used to evaluate the effectiveness of the TTS accom-
modation on the students’ reading comprehension after reading
passages from the classroom text. Each student served as her or
his own control as this design allowed for intra- and intersub-
ject replication. Students changed conditions after they com-
pleted a predetermined number of CBAs (i.e., five, seven, six,
and seven in the first baseline, first accommodation, the second
baseline, and the second accommodation conditions, respec-
tively). The number of sessions in each condition varied as a
way to control for cyclical threats to internal validity in a
withdrawal design.
Procedures
Training. Before the baseline condition began, students engaged
in a 48-min training session on the use of TTS in the computer
lab with the first author. Students practiced using headphones
to hear the audio readings, turning pages with an example story,
and logging off when they had completed the reading. Training
ended when all students could independently log in, access
stories, and use TTS features for one session with 100%
accuracy.
Generalization. At the beginning and end of the study, the first
author administered the SRI assessment to obtain a current
Lexile score to check for generalization of reading comprehen-
sion skills. She administered the assessment in the computer
lab with all students at one time.
Baseline. The baseline condition (A1) began after students com-
pleted their training on the use of TTS. At the beginning and
end of this condition, the first author administered an ORF test
to measure each student’s words read correctly individually in
a separate setting. Throughout this condition, students read the
fiction stories on the computer while using only the page-
turning icon to progress from page to page. No auditory or
highlighting features of TTS were used when reading during
A1. There was no explicit instruction on the reading material,
nor any specific feedback or reinforcement provided.
When students finished reading, they logged off the com-
puter and answered the reading comprehension CBA questions
in pencil-and-paper format without looking back at the text.
Students read the stories on the computer without TTS for five
sessions in this baseline condition.
Young et al. 83
TTS as an accommodation. Immediately after students
completed
baseline sessions, students began using TTS as an accommoda-
tion with the stories on the computer in the first accommoda-
tion condition (B1). Students accessed the reading in the same
way as in A1 but this time enabled the individualized TTS
features to provide support while reading. Participants enabled
the voice, highlighting, and rate of speed features previously
customized from the training session. After reading the story
with TTS support, each student logged off the computer and
completed the paper-based reading comprehension assessment
without TTS support. Students received no explicit instruction
on the reading material, no specific feedback or reinforcement,
nor any feedback on the use of TTS. Students enabled TTS as
an accommodation to support reading for seven sessions. At the
end of B1, the first author administered an ORF test to each
student in the same manner as baseline.
Second baseline and accommodation conditions. Participants
began the second baseline condition (A2) in the computer lab
immediately following B1. This condition was conducted in
the same manner as A1, without enabling any TTS features,
for six sessions. Immediately following A2, students returned
to enabling the TTS features on desktop computers to read new
fiction stories in the second accommodation condition (B2).
These sessions were identical to the B1 condition and contin-
ued for seven sessions.
Maintenance. After the second accommodation condition, stu-
dents moved into the maintenance condition. Maintenance data
were collected following the same procedures and instructions
as during baseline conditions, on participants’ accuracy for
reading comprehension questions. No new instructions were
provided to the students. Maintenance sessions were conducted
once a week for 4 weeks. An ORF measure was also collected
at the end of the maintenance condition.
Interobserver Reliability
Interobserver agreement (IOA) data were collected on the
dependent variable during 30% of all sessions or at least once
per condition for each student, whichever was greater (Horner
et al., 2005). Before the study began, the first author trained an
independent observer on how to score the CBAs using similar
practice CBAs. Once the observer scored two CBAs with
100% accuracy, she began scoring CBAs from the study. The
first author gave a copy of each participant’s CBAs to inde-
pendently score. The first author and the secondary scorer
compared scores after independently grading the CBAs. IOA
was calculated by dividing the total number of agreements by
the number of agreements and disagreements and then multi-
plied by 100.
Procedural Reliability
Procedural reliability data were collected in 30% of the ses-
sions for each participant or at least once per condition to
measure treatment fidelity. The first author trained the same
independent observer on how to record the occurrence of the
teacher-directed activities on the researcher-created checklist
of procedures prior to the start of the study. The checklist
entailed activities in baseline, accommodation, and mainte-
nance conditions (available upon request). The procedural
reliability percentages were based on the calculation of the
observed components divided by the number of possible com-
ponents and then multiplied by 100. The resulting calculations
determined the mean procedural reliability for each participant.
Results
The primary purpose of this study was to investigate the effec-
tiveness of TTS on the reading comprehension of 9th-grade
students with LD. Results showed a functional relation
between TTS and reading comprehension performance for all
three participants who completed the study (see Figures 1
and 2). Vincent exited the study during B2 due to a change
in his school schedule. The effects of the TTS maintained for
the three remaining participants. Furthermore, ORF outcomes
indicated that all participants increased the number of words
read correctly throughout the study (see Table 2). Lexile
scores on the district’s universal screener, the SRI, indicated
that two of the four participants increased scores between
the pre- and posttests.
Dianna
The first graph in Figure 1 represents Dianna’s comprehension
and ORF scores during all conditions. Dianna’s comprehension
score in baseline (A1) was between 53% and 66% correct with
a mean of 63%. A Web-based application, Single Case
Research, was used to calculate Tau-U, a measure that esti-
mated the intervention effects by taking into account the non-
overlapping data points and trend between phases (Vannest &
Ninci, 2015; Vannest, Parker, Gonen, & Adiguzel, 2016). Tau-
U is interpreted as small effect (<.20), moderate effect (.20–
.60), large effect (.60–.80), or very large effect (>.80; Vannest
& Ninci, 2015). While in B1, Dianna’s accuracy on reading
comprehension CBAs demonstrated an immediacy of effect
and a Tau-U effect size of 1 CI90% [.42, 1.00] (p ! .00). Her
comprehension scores in B1 ranged between 73% and 93%
correct with a mean of 83%. After moving from B1 to A2,
Dianna’s comprehension score abruptly decreased from 80%
to 53%. While in A2, Dianna’s mean comprehension score was
the same as in A1 at 63%, displaying repeated lower levels
even with one overlapping data point. With the presence of
TTS, Dianna’s B2 data were higher than in A2 and the mean
for B2 was 77% with a Tau-U of .83 CI90% [.29, 1.00] (p ! .01).
Overall, Dianna’s data showed the presence of a functional
relation between TTS and reading comprehension with three
demonstrations of effect across the conditions. In maintenance,
Dianna consistently maintained reading scores with a mean
score of 77%.
84 Journal of Special Education Technology 34(2)
Dianna’s ORF score started at 115 and ended at 127 by the
completion of the study. Using ORF as a progress monitoring
tool, Dianna’s ORF in the fall ranged between the 25th percen-
tile (106 WCPM) and the 50th percentile (133 WCPM). Dia-
nna’s ORF at a winter progress monitoring session was 127
WCPM, still in-between the winter progress monitoring of 25th
percentile (115 WCPM) to 50th percentile (146 WCPM). The
growth expected in that percentile from fall to winter would be
9 in the 25th percentile and 13 in the 50th percentile. Dianna’s
WCPM was 12. Hosp, Hosp, and Howell (2007) suggested
aiming for the last session when using progress monitoring
data. In that case, spring progress monitoring would be in the
50th percentile if the student is below the 50th percentile at the
first progress monitoring data session. The suggested growth
rate in that time frame, according to Hasbrouck and Tindal
(2005), is an additional 9.6 WCPM. Dianna exceeded this with
an additional 12 WCPM. Furthermore, her Lexile scores con-
tinued to increase throughout the study. Her score was 772 at
the start of the study, increased to 879 after B2, and ended at
902 after maintenance.
Donald
Donald’s performance on the comprehension measures during
A1 ranged between 33% and 53% on questions answered cor-
rectly with a mean of 44% (see Figure 1, Graph 2). An imme-
diate increase occurred when Donald moved from A1 to B1. In
B1 with the TTS accommodation, Donald’s accuracy in
10
30
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90
110
130
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10
20
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50
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70
80
90
100
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28
N
um
be
r
of
W
or
ds
R
ea
d
P
er
M
in
ut
e
A
cc
ur
ac
y
of
R
ea
di
ng
C
om
pr
eh
en
si
on
Sessions
Baseline A1 Accommodation B1 Baseline A2
Accommodation B2 Maintenance
10
30
50
70
90
110
130
0
10
20
30
40
50
60
70
80
90
100
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28
N
um
be
r
of
W
or
ds
R
ea
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P
er
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in
ut
e
A
cc
ur
ac
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of
R
ea
di
ng
C
om
pr
eh
en
si
on
Sessions
Baseline A1 Accommodation B1 Baseline A2 Accommodation
B2 Maintenance
Figure 1. Reading comprehension (") and oral reading fluency
(~) data for Dianna and Donald, respectively.
Young et al. 85
comprehension questions ranged from 60% to 80% with data
moving in a therapeutic, accelerating direction documenting
the effectiveness of TTS. The mean of Donald’s B1 phase was
70% and the Tau-U was 1 CI90% [.42, 1.00] (p ! .00). When
returning to A2, removing TTS, there was an abrupt decrease to
33%. Donald’s range of answering comprehension questions
correctly …

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  • 1. Article The Effects of Text-to-Speech on Reading Outcomes for Secondary Students With Learning Disabilities Mary Cece Young1, Carrie Anna Courtad1, Karen H. Douglas1, and Yun-Ching Chung1 Abstract This study investigated the effectiveness of text-to-speech (TTS) on the outcomes of reading comprehension and oral reading fluency (ORF) for four secondary students with learning disabilities. The researchers used a single-case A–B–A–B withdrawal design to evaluate the effectiveness of TTS on reading outcomes. All participants scored higher on reading comprehension after using TTS when reading instructional passages and maintained the skills for 4 weeks. Results on participants’ ORF also indicated an increased level of words read per min at the end of each accommodation condition. Comparison of pre- and posttest achievement on the Lexile assessment showed that two of the four participants increased their reading scores. Major findings are discussed with implications for practice and recommendations for future research to increase the use of TTS in the classroom. Keywords
  • 2. assistive technology, learning disabilities, legislation, secondary, text-to-speech Reading is a necessary and critical skill. The acquisition of reading substantially impacts educational outcomes, employ- ment success, and personal and professional growth (Strang- man & Dalton, 2005). In the United States, roughly 6 million secondary students are reading at a level far below their grade. The National Assessment of Educational Progress (NAEP) from 2017 indicated that 74% of eighth graders do not have proficient-level reading skills even though the data showed an overall slight increase of reading achievement since 2015. However, it should be noted that the growth rate is with stu- dents who were higher achieving, whereas students with dis- abilities remained statistically the same. The NAEP reading achievement scores for students with disabilities in 12th grade across the nation have not increased since 2009, the earliest available data for students with disabilities at that grade level. In fact, the gap between 12th graders with and without disabil- ities has increased by 3 points since 2009, indicating that those with disabilities are continuing to fall behind their peers with- out disabilities (U.S. Department of Education, 2015, 2009, 2017). Students With Learning Disabilities (LDs) Several legislative actions have focused on evidence-based practices and inclusion of students with disabilities in the gen- eral education curriculum; yet as indicated by NAEP results, reading scores have not improved for many students with disabilities over the years. These results are especially concern- ing for students with LDs who are the highest population of students receiving special education services at 35% (Snyder, de Brey, & Dillow, 2016; Wanzek, Otaiba, & Petscher, 2014). Approximately 80% of students with LD exhibit deficits in the
  • 3. area of reading (Cortiella & Horowitz, 2014). In addition, 90% of students with LD are not able to read material independently (Vaughn & Wanzek, 2014). Students who have difficulties making meaning from text are likely to encounter postschool challenges, such as being unemployed, earning lower incomes, and exhibiting poor health as adults (Snyder & Dillow, 2013). In order to reduce the negative postschool outcomes associated with reading difficulties, addressing adolescents’ lack of read- ing progress in our high schools is imperative. Students with LD often experience several years of reading difficulties that involve deficits in making meaning from text (Cortiella & Horowitz, 2014). Achieving success in school requires proficient reading skills to understand all content areas (Vaughn & Wanzek, 2014). This gap widens in high school as students struggle to gain information from text that is necessary 1 Illinois State University, Normal, IL, USA Corresponding Author: Mary Cece Young, Illinois State University, Campus Box 5910, Normal, IL 61790, USA. Email: [email protected] Journal of Special Education Technology 2019, Vol. 34(2) 80-91 ª The Author(s) 2018 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0162643418786047 journals.sagepub.com/home/jst for learning (Saenz & Fuchs, 2002). To prevent the achieve- ment gap from further widening between special and general
  • 4. education students, additional types of reading accommoda- tions need to be implemented. Technological accommodations have been known to increase academic outcomes for secondary students with LD (Stetter & Hughes, 2011). The National Educational Technology Standards and the Council for Exceptional Children Technology Specialist estab- lished standards to train teachers on the use of assistive tech- nology (AT) when instructing students with disabilities (Parette & Peterson-Karlan, 2010; Smith & Allsopp, 2005). Even with these guidelines, many teachers are not routinely using tech- nology to make content accessible (Okolo & Diederich, 2014). Adding to this dilemma is that classroom curricula are primar- ily based in print (Rose, Meyer, & Hitchcock, 2011). Given this, students who are able to read the text may benefit more than students who struggle to read. This may lead to a Matthew Effect that causes the word-rich to get richer and the word-poor to get poorer (Stanovich, 1986). To aid in addressing this issue, teachers need to boost students with disabilities’ motivation to read. Technology is highly motivating to secondary students with LD and can potentially increase the amount of content they learn and read (Anderson-Inman, 2009; Bouck, Flanagan, Miller, & Bassette, 2012). AT The availability of AT for individuals with disabilities has increased dramatically since the 1970s (Poel, 2007). In a recent state survey, 67% of teachers reported that they believed AT increased student access to curriculum and outcomes, but only 33% of respondents could make print accessible on the com- puter for their students (Okolo & Diedrich, 2014). When asked what contributes to using technology, more than half of the teachers identified the severity of the students disabilities, as in, the more severe a students’ disability, the more likely they were to use technology. The teachers in this study also identi-
  • 5. fied staff knowledge as a barrier (70%) along with availability of technology (61%) and funding (61%). Despite increased AT device presence, teachers are not typically using AT in the classroom, especially classrooms with students who have a less severe disability (e.g., LD). Unfortunately, many teachers per- ceive AT for a certain type of disability, have a lack knowledge of how to use AT, and identify obtaining devices as problematic. The Tech Act, reauthorized in 2004, intensified the previous legislation to promote the access, knowledge, and obtainability of AT among students with all disabilities to access curriculum. Prior to that in 1998, The Tech Act only defined AT as any piece of equipment or product system, whether acquired com- mercially, off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities (Assistive Technology Act of. 1998). Additionally, Individuals With Disabilities Act (2004) requires every individualized education program (IEP) team to consider AT for students with disabilities during annual meetings (Parette & Peterson-Karlan, 2010). If the IEP team determines AT is needed, an AT evaluation is conducted and listed as a related service or supplementary aid in the student’s IEP (Parette & Peterson-Karlan, 2010). The intention of this mandate along with the discussion of Universal Design for Learning was to increase the consideration of using AT more frequently to help students access curriculum in the classroom, regardless of the severity of the disability. However, these legislative actions did not increase AT in the classrooms as indicated by Okolo and Diedrich’s study in 2014. Benefits of Text-to-Speech (TTS) To assist secondary students in accessing curriculum, students with reading disabilities oftentimes need compensatory tools
  • 6. (e.g., TTS). TTS is an AT that can compensate for reading difficulties and can increase access to text (Stodden, Roberts, Takahashi, Park, & Stodden, 2012). AT used as a compensa- tory tool is defined as any tool permitting a person to complete a task where without the tool, the person is unable to perform the task at the expected level (Courtad & Bouck, 2013). Gen- erally, technology has shown to promote independence and self-worth and to increase motivation and productivity among students with LD (Edyburn, Higgins, & Boone, 2005). More specifically, technological speech–synthesized accommoda- tions have resulted in reading gains for students with LD (Moorman, Boon, Keller-Bell, Stagliano, & Jeffs, 2010). Following the use of TTS, Gruner, Ostberg, and Hedenius (2017) found that students improved reading rates, increased time spent on reading, and performed better on comprehension measures. They also noted that both elementary-aged and sec- ondary students improved their reading rates when using TTS. However, only elementary school students showed improve- ment in reading comprehension. Furthermore, Moorman, Boon, Keller-Bell, Stagliano, and Jeffs (2010) found that the lowest readers benefited the most from TTS in comprehension. Specific TTS features have been known to enhance students’ engagement and outcomes (Wood, Moxley, Tighe, & Wagner, 2018). When individualizing TTS through the use of embedded features (e.g., reading rate, voice type, and highlighting), stu- dents with LD exhibited educational gains including increased reading rates and comprehension (Moorman et al., 2010; Tian & Okolo, 2007; Young, 2013). Research also showed that when computerized reading speed was set at a faster rate than present oral reading fluency (ORF), students increased their compre- hension (Coleman, Carter, & Kildare, 2011). Reading difficulties for secondary students who struggle to make meaning from text will likely continue beyond the school years in their postschool life. TTS is an accommodation that is
  • 7. nearly ubiquitous, across operating systems, platforms, and applications (Stodden et al., 2012); yet classroom teachers reported not using AT on a regular basis (Okolo & Dietrich, 2014). As Okolo and Dietrich wrote, “ . . . research about the impact of AT remains limited. Few papers in an educational journal end without a plea for more research” (p. 18). Young et al. 81 Purpose In order to answer the professional call for more research on the impact of AT for students with LD and add to previous research indicating positive outcomes for students with disabilities, this study uses AT as an accommodation for secondary students with LD who struggle to make meaning from text in a tradi- tional print form. Specifically, this study evaluated the effec- tiveness of TTS on the reading comprehension of high school 9th graders with LD in a self-contained class. The first author (i.e., a special education teacher) used the reading accommo- dation of TTS, Kurzweil 3000, to assist with reading material for students with LD. She monitored participants’ performance in reading comprehension through curriculum-based assess- ments (CBAs) to ensure improvement before measuring the effects on outcomes in maintenance sessions. The results pro- vided additional empirical evidence on the effects of TTS when used as an accommodation for secondary students with LD. The research questions included the following: (a) Does the reading comprehension of freshman students with LD increase when using TTS as measured by CBAs? (b) Will students maintain the use of TTS following intervention? (c) Does ORF increase after students use TTS? (d) and To what extent do the students generalize reading comprehension to pre and post uni-
  • 8. versal screening assessments (e.g., Lexile)? Method Participants The first author selected participants based on purposive and convenience sampling. She recruited potential participants for this study if they met the following criteria: (a) were identified as having a LD in reading, (b) received services in a 9th-grade self-contained English class, and (c) had a 95% attendance rate at the start of the study. In this district and state, students qualified as having LD after progressing through a response to intervention (RtI) model, demonstrating a lack of progress at level three, and having a discrepancy between their cognitive abilities and their performance. The self-contained English class was required for all students with LD in reading who had a Lexile score in the bottom 25% locally or below 900 and had an IEP with a reading comprehension goal. This class had a total of enrollment of 11 students. The students in the self- contained English class were also enrolled in a self-contained reading class using a different curriculum package, READ 180 by Houghton Mifflin Harcourt (n.d.). Four of the 11 students meeting the inclusion criteria provided informed assent and parent permission (see Table 1 for participant demographics). Only three students completed the entire study through main- tenance and generalization. Vincent left the study early because of a change in his class schedule. Setting The study took place in a large, Midwest public high school with an estimated overall student enrollment of 3,500 and approximately 15% of the students receiving special education services. Forty percent of these students receiving special edu-
  • 9. cation services had LD. Twenty percent of the overall student population received free and/or reduced-price lunch. Research activities occurred in a computer lab close to the students’ self- contained English classroom. The computer lab had at least 15 desktop computers with the TTS program, Kurzweil 3000 (Kurzweil Education, 1996), installed on each computer. All students in the class (n ! 11) used TTS during the scheduled self-contained English class to access the curriculum; however, the first author only collected data on the four students parti- cipating in this study. Students sat at least one seat away from their peers to minimize distractions. Each TTS session lasted one class period (i.e., 48 min) for 3 times per week during the scheduled English class time in the early morning. Materials Classroom textbook. The district adopted a complete curriculum called Hampton-Brown Edge: Reading, Writing, & Language (Moore, Short, Smith, & Tatum, 2014). This curriculum con- tains four reading levels for adolescent students. All partici- pants in this study used Level A based on students’ reading levels in the bottom 25th percentile on Lexile scores locally. Table 1. Participant Demographics. Name Age Initial Eligibility Ethnicity Used TTS Previously Initial Lexile Scores Percentage in General EducationGender Primary and Secondary Characteristic
  • 10. Dianna 15 11/2012 African American No 772 40–79 (F) SLD/ADHD Donald 14 4/2008 African American No 872 40–79% (M) SLD Jack 14 12/2009 African American No 186 Less than 40% (M) SLD/AU Vincent 15 5/2011 African American No 864 40–79% (M) SLD Note. ADHD ! attention deficit/hyperactivity disorder; AU ! autism; SLD ! specific learning disability. 82 Journal of Special Education Technology 34(2) Before the study began, the first author selected 29 fiction stories from the The Edge Level A (Moore et al., 2014). In addition, she used The Edge curricular comprehension assess- ments for each story. The comprehension assessments con- sisted of 15 multiple-choice questions, including eight vocabulary, four literary analysis, and three reading compre- hension questions. TTS. Prior to beginning the study, participants attended a train- ing session conducted by the first author on how to use Kurz- weil 3000. During this training sessions, students were allowed to personalize the settings for highlighting text and choose the voice reading the text. The first author choose the setting for the read aloud rate (i.e., how fast the TTS read). These individua- lized settings became the default each time a participant logged into Kurzweil 3000 to access the stories. Dependent Measures
  • 11. Reading comprehension measures. For this study, the first author used a reading comprehension measure to evaluate the effec- tiveness of TTS among students with reading deficits within a withdrawal design study as recommended by Perelmutter, McGregor, and Gordon (2017). After students read each fiction story, the reading comprehension measures included the CBAs from the Edge assessments (Moore et al., 2014). The first author scored the CBAs by grading the percentage of correctly answered questions out of the 15 total questions for each story. Additionally, she used the Scholastic Reading Inventory (SRI) assessment to obtain pre- and posttest Lexile score (Lexile, n.d.). The SRI is a computerized reading comprehension assessment that lasts approximately 30 min. It is used to obtain a reader’s Lexile score ranging from 0 to 1500 and as a uni- versal screener to determine placement in English courses. The SRI recommends placing students into categories to identify their reading needs. ORF. The first author also used an ORF measure to determine whether students increased their words read per minute after auditory and visual exposure to text. The RtI specialist employed at the high school selected the ORF passages from Aimsweb (Pearson, 2012). Each student read three paper-based 1-min 8th-grade passages while the teacher documented the number of words read correctly. Each ORF passage contained a different topic, so students did not repeatedly read the same passage. After participants read three passages in one session, the teacher averaged the scores to determine ORF scores for that date and time. The teacher conducted ORF assessments in this manner 6 different times throughout the study: prebaseline, after each condition, and after the maintenance condition. She administered a total of 18 ORF assessments during the first half of the school year.
  • 12. Social validity. The classroom teaching assistant administered a teacher-created 8-item Likert-type scale survey to each parti- cipant in the instructional classroom to gather social validity information on the procedures and outcomes of the TTS accommodation (survey available upon request). The survey asked participants to rate their levels of satisfaction on a 5- point scale (i.e., 1 ! strongly disagree; 5 ! strongly agree) regarding the use of TTS. Because the teacher created the survey at the participants’ readability levels, the participants read the survey on their own. Mean scores on each item were reported. Experimental Design A single-case A–B–A–B withdrawal design (Gast & Ledford, 2014) was used to evaluate the effectiveness of the TTS accom- modation on the students’ reading comprehension after reading passages from the classroom text. Each student served as her or his own control as this design allowed for intra- and intersub- ject replication. Students changed conditions after they com- pleted a predetermined number of CBAs (i.e., five, seven, six, and seven in the first baseline, first accommodation, the second baseline, and the second accommodation conditions, respec- tively). The number of sessions in each condition varied as a way to control for cyclical threats to internal validity in a withdrawal design. Procedures Training. Before the baseline condition began, students engaged in a 48-min training session on the use of TTS in the computer lab with the first author. Students practiced using headphones to hear the audio readings, turning pages with an example story, and logging off when they had completed the reading. Training ended when all students could independently log in, access
  • 13. stories, and use TTS features for one session with 100% accuracy. Generalization. At the beginning and end of the study, the first author administered the SRI assessment to obtain a current Lexile score to check for generalization of reading comprehen- sion skills. She administered the assessment in the computer lab with all students at one time. Baseline. The baseline condition (A1) began after students com- pleted their training on the use of TTS. At the beginning and end of this condition, the first author administered an ORF test to measure each student’s words read correctly individually in a separate setting. Throughout this condition, students read the fiction stories on the computer while using only the page- turning icon to progress from page to page. No auditory or highlighting features of TTS were used when reading during A1. There was no explicit instruction on the reading material, nor any specific feedback or reinforcement provided. When students finished reading, they logged off the com- puter and answered the reading comprehension CBA questions in pencil-and-paper format without looking back at the text. Students read the stories on the computer without TTS for five sessions in this baseline condition. Young et al. 83 TTS as an accommodation. Immediately after students completed baseline sessions, students began using TTS as an accommoda- tion with the stories on the computer in the first accommoda- tion condition (B1). Students accessed the reading in the same way as in A1 but this time enabled the individualized TTS
  • 14. features to provide support while reading. Participants enabled the voice, highlighting, and rate of speed features previously customized from the training session. After reading the story with TTS support, each student logged off the computer and completed the paper-based reading comprehension assessment without TTS support. Students received no explicit instruction on the reading material, no specific feedback or reinforcement, nor any feedback on the use of TTS. Students enabled TTS as an accommodation to support reading for seven sessions. At the end of B1, the first author administered an ORF test to each student in the same manner as baseline. Second baseline and accommodation conditions. Participants began the second baseline condition (A2) in the computer lab immediately following B1. This condition was conducted in the same manner as A1, without enabling any TTS features, for six sessions. Immediately following A2, students returned to enabling the TTS features on desktop computers to read new fiction stories in the second accommodation condition (B2). These sessions were identical to the B1 condition and contin- ued for seven sessions. Maintenance. After the second accommodation condition, stu- dents moved into the maintenance condition. Maintenance data were collected following the same procedures and instructions as during baseline conditions, on participants’ accuracy for reading comprehension questions. No new instructions were provided to the students. Maintenance sessions were conducted once a week for 4 weeks. An ORF measure was also collected at the end of the maintenance condition. Interobserver Reliability Interobserver agreement (IOA) data were collected on the dependent variable during 30% of all sessions or at least once per condition for each student, whichever was greater (Horner
  • 15. et al., 2005). Before the study began, the first author trained an independent observer on how to score the CBAs using similar practice CBAs. Once the observer scored two CBAs with 100% accuracy, she began scoring CBAs from the study. The first author gave a copy of each participant’s CBAs to inde- pendently score. The first author and the secondary scorer compared scores after independently grading the CBAs. IOA was calculated by dividing the total number of agreements by the number of agreements and disagreements and then multi- plied by 100. Procedural Reliability Procedural reliability data were collected in 30% of the ses- sions for each participant or at least once per condition to measure treatment fidelity. The first author trained the same independent observer on how to record the occurrence of the teacher-directed activities on the researcher-created checklist of procedures prior to the start of the study. The checklist entailed activities in baseline, accommodation, and mainte- nance conditions (available upon request). The procedural reliability percentages were based on the calculation of the observed components divided by the number of possible com- ponents and then multiplied by 100. The resulting calculations determined the mean procedural reliability for each participant. Results The primary purpose of this study was to investigate the effec- tiveness of TTS on the reading comprehension of 9th-grade students with LD. Results showed a functional relation between TTS and reading comprehension performance for all three participants who completed the study (see Figures 1 and 2). Vincent exited the study during B2 due to a change in his school schedule. The effects of the TTS maintained for
  • 16. the three remaining participants. Furthermore, ORF outcomes indicated that all participants increased the number of words read correctly throughout the study (see Table 2). Lexile scores on the district’s universal screener, the SRI, indicated that two of the four participants increased scores between the pre- and posttests. Dianna The first graph in Figure 1 represents Dianna’s comprehension and ORF scores during all conditions. Dianna’s comprehension score in baseline (A1) was between 53% and 66% correct with a mean of 63%. A Web-based application, Single Case Research, was used to calculate Tau-U, a measure that esti- mated the intervention effects by taking into account the non- overlapping data points and trend between phases (Vannest & Ninci, 2015; Vannest, Parker, Gonen, & Adiguzel, 2016). Tau- U is interpreted as small effect (<.20), moderate effect (.20– .60), large effect (.60–.80), or very large effect (>.80; Vannest & Ninci, 2015). While in B1, Dianna’s accuracy on reading comprehension CBAs demonstrated an immediacy of effect and a Tau-U effect size of 1 CI90% [.42, 1.00] (p ! .00). Her comprehension scores in B1 ranged between 73% and 93% correct with a mean of 83%. After moving from B1 to A2, Dianna’s comprehension score abruptly decreased from 80% to 53%. While in A2, Dianna’s mean comprehension score was the same as in A1 at 63%, displaying repeated lower levels even with one overlapping data point. With the presence of TTS, Dianna’s B2 data were higher than in A2 and the mean for B2 was 77% with a Tau-U of .83 CI90% [.29, 1.00] (p ! .01). Overall, Dianna’s data showed the presence of a functional relation between TTS and reading comprehension with three demonstrations of effect across the conditions. In maintenance, Dianna consistently maintained reading scores with a mean score of 77%.
  • 17. 84 Journal of Special Education Technology 34(2) Dianna’s ORF score started at 115 and ended at 127 by the completion of the study. Using ORF as a progress monitoring tool, Dianna’s ORF in the fall ranged between the 25th percen- tile (106 WCPM) and the 50th percentile (133 WCPM). Dia- nna’s ORF at a winter progress monitoring session was 127 WCPM, still in-between the winter progress monitoring of 25th percentile (115 WCPM) to 50th percentile (146 WCPM). The growth expected in that percentile from fall to winter would be 9 in the 25th percentile and 13 in the 50th percentile. Dianna’s WCPM was 12. Hosp, Hosp, and Howell (2007) suggested aiming for the last session when using progress monitoring data. In that case, spring progress monitoring would be in the 50th percentile if the student is below the 50th percentile at the first progress monitoring data session. The suggested growth rate in that time frame, according to Hasbrouck and Tindal (2005), is an additional 9.6 WCPM. Dianna exceeded this with an additional 12 WCPM. Furthermore, her Lexile scores con- tinued to increase throughout the study. Her score was 772 at the start of the study, increased to 879 after B2, and ended at 902 after maintenance. Donald Donald’s performance on the comprehension measures during A1 ranged between 33% and 53% on questions answered cor- rectly with a mean of 44% (see Figure 1, Graph 2). An imme- diate increase occurred when Donald moved from A1 to B1. In B1 with the TTS accommodation, Donald’s accuracy in 10
  • 20. ea di ng C om pr eh en si on Sessions Baseline A1 Accommodation B1 Baseline A2 Accommodation B2 Maintenance 10 30 50 70 90 110 130 0
  • 21. 10 20 30 40 50 60 70 80 90 100 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 N um be r of W or ds R
  • 23. on Sessions Baseline A1 Accommodation B1 Baseline A2 Accommodation B2 Maintenance Figure 1. Reading comprehension (") and oral reading fluency (~) data for Dianna and Donald, respectively. Young et al. 85 comprehension questions ranged from 60% to 80% with data moving in a therapeutic, accelerating direction documenting the effectiveness of TTS. The mean of Donald’s B1 phase was 70% and the Tau-U was 1 CI90% [.42, 1.00] (p ! .00). When returning to A2, removing TTS, there was an abrupt decrease to 33%. Donald’s range of answering comprehension questions correctly …