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Reading Skills in Children with Mild to Borderline Intellectual Disability: A Cross-Sectional Study on Second to Eighth Graders

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Title: Reading Skills in Children with Mild to Borderline Intellectual Disability: A Cross-Sectional Study on Second to Eighth Graders
Language: English
Authors: Di Blasi, F. D. (ORCID 0000-0002-2958-2927), Buono, S. (ORCID 0000-0002-3786-3323), Cantagallo, C., Di Filippo, G. (ORCID 0000-0002-3470-7368), Zoccolotti, P. (ORCID 0000-0002-6351-2455)
Source: Journal of Intellectual Disability Research. Aug 2019 63(8):1023-1040.
Availability: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA
Peer Reviewed: Y
Page Count: 18
Publication Date: 2019
Document Type: Journal Articles
Reports - Research
Education Level: Elementary Education
Secondary Education
Early Childhood Education
Grade 2
Primary Education
Grade 3
Grade 4
Intermediate Grades
Grade 5
Middle Schools
Grade 6
Grade 7
Junior High Schools
Grade 8
Descriptors: Reading Skills, Children, Mild Intellectual Disability, Elementary School Students, Secondary School Students, Foreign Countries, Slow Learners, Reading Fluency, Reading Comprehension, Reading Tests, Reading Rate, Accuracy, Instructional Program Divisions, Reading Difficulties
Geographic Terms: Italy
DOI: 10.1111/jir.12620
ISSN: 0964-2633
Abstract: Background: Students with intellectual disabilities (IDs) have various learning difficulties and are at risk for school failure. Large inter-individual differences are described for reading, but it is unclear how these vary as a function of grade. The aim of this study was to examine various reading fluency, accuracy and comprehension parameters in second-to-eighth-grade Italian children with either borderline intellectual functioning (BIF) or mild ID (MID). Methods: We examined 106 children with BIF (67 M and 39 F) and 168 children with MID (107 M and 61 F). The children were in the second to eighth grade and were comparable for chronological age (7 to 14 years). They were administered a battery of tests that assessed fluency and accuracy of word, pseudo-word and text reading, as well as text comprehension. Standardised scores allowed us to compare the performance of the two groups with normative values. Results: Children with ID obtained generally low scores compared with normative values. Those with MID had greater difficulty than those with BIF. Furthermore, difficulty was greater for speed than for accuracy measures and for words than for pseudo-words. Difficulty (particularly in the case of reading speed) tended to be pronounced at later grades. Marked individual differences were present independently of MID-BIF subgrouping, as well as stimulus category and reading parameter. Conclusions: As a group, children with ID showed difficulty in reading acquisition; the effect was greater for children with more severe ID, but large individual differences were observed in children with both BIF and MID. Relatively spared pseudo-word reading skills indicate efficient use of the grapheme-to-phoneme conversion routine. This processing mode may prove more ineffective at higher levels of schooling when even in regular orthographies such as Italian typically developing children rely on lexical activation.
Abstractor: As Provided
Entry Date: 2019
Accession Number: EJ1222334
Database: ERIC
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  Value: <anid>AN0137586053;eul01aug.19;2019Jul22.04:47;v2.2.500</anid> <title id="AN0137586053-1">Reading skills in children with mild to borderline intellectual disability: a cross‐sectional study on second to eighth graders </title> <p>Background: Students with intellectual disabilities (IDs) have various learning difficulties and are at risk for school failure. Large inter‐individual differences are described for reading, but it is unclear how these vary as a function of grade. The aim of this study was to examine various reading fluency, accuracy and comprehension parameters in second‐to‐eighth‐grade Italian children with either borderline intellectual functioning (BIF) or mild ID (MID). Methods: We examined 106 children with BIF (67 M and 39 F) and 168 children with MID (107 M and 61 F). The children were in the second to eighth grade and were comparable for chronological age (7 to 14 years). They were administered a battery of tests that assessed fluency and accuracy of word, pseudo‐word and text reading, as well as text comprehension. Standardised scores allowed us to compare the performance of the two groups with normative values. Results: Children with ID obtained generally low scores compared with normative values. Those with MID had greater difficulty than those with BIF. Furthermore, difficulty was greater for speed than for accuracy measures and for words than for pseudo‐words. Difficulty (particularly in the case of reading speed) tended to be pronounced at later grades. Marked individual differences were present independently of MID–BIF subgrouping, as well as stimulus category and reading parameter. Conclusions: As a group, children with ID showed difficulty in reading acquisition; the effect was greater for children with more severe ID, but large individual differences were observed in children with both BIF and MID. Relatively spared pseudo‐word reading skills indicate efficient use of the grapheme‐to‐phoneme conversion routine. This processing mode may prove more ineffective at higher levels of schooling when even in regular orthographies such as Italian typically developing children rely on lexical activation.</p> <p>Keywords: borderline intellectual functioning; intellectual disability; mild intellectual disability; reading</p> <hd id="AN0137586053-2">Introduction</hd> <p>The ability to read at a proficient level is crucial for success in school and daily life activities. As children with intellectual disabilities (IDs) show various learning difficulties and are at risk of school failure, an accurate assessment of individual literacy achievement is crucial (Allor <emph>et al</emph>. [<reflink idref="bib2" id="ref1">2</reflink>], [<reflink idref="bib1" id="ref2">1</reflink>]). Most children with ID are able to acquire some literacy skills, but their level of literacy varies widely (Katims [<reflink idref="bib21" id="ref3">21</reflink>]; Koritsas & Iacono [<reflink idref="bib22" id="ref4">22</reflink>]; Wei <emph>et al</emph>. [<reflink idref="bib45" id="ref5">45</reflink>]). For example, in a recent large study of school‐aged students with ID of various aetiologies, 29.3% of the children did not read at all and 6.8% read at a logographic stage, 31.9% at an alphabetic stage and only 32% at an orthographic level (Ratz & Lenhard [<reflink idref="bib31" id="ref6">31</reflink>]).</p> <p>The relationship between reading and intelligence is complex. In children with typical development, IQ does not predict reading skills (Share <emph>et al</emph>. [<reflink idref="bib34" id="ref7">34</reflink>]; Siegel [<reflink idref="bib36" id="ref8">36</reflink>]). Similarly, reading disability is not related <emph>per se</emph> to IQ score (Siegel [<reflink idref="bib36" id="ref9">36</reflink>]). There is a continuing controversy over the role that intelligence should be attributed in the case of learning disabilities (e.g. Siegel [<reflink idref="bib36" id="ref10">36</reflink>]; Gresham <emph>et al</emph>. [<reflink idref="bib17" id="ref11">17</reflink>]; Stuebing <emph>et al</emph>. [<reflink idref="bib40" id="ref12">40</reflink>]; Ferrer <emph>et al</emph>. [<reflink idref="bib16" id="ref13">16</reflink>]), in particular concerning the use of discrepancy measures to identify children with specific reading deficits (e.g. Stanovich [<reflink idref="bib38" id="ref14">38</reflink>]). Therefore, it seems that intellectual abilities might play an important role in mediating learning to read, but it is uncertain whether this is a general finding or is specific for children with ID. For example, in a study of adolescents with ID, Levy ([<reflink idref="bib24" id="ref15">24</reflink>]) found that the relationship between phonological processing and reading was mediated by IQ; thus, she proposed that word recognition is an explicit task that requires general cognitive resources. Overall, there is evidence that intellectual skills might play an important role in the acquisition of learning in children with ID (for a review, refer to Conners [<reflink idref="bib10" id="ref16">10</reflink>]). Nevertheless, children with ID who decode extremely well have also been reported (Cossu <emph>et al</emph>. [<reflink idref="bib14" id="ref17">14</reflink>]; Groen <emph>et al</emph>. [<reflink idref="bib18" id="ref18">18</reflink>]).</p> <p>Evidence of children with different levels of ID (such as mild IDs, hereafter MID, or borderline intellectual functioning, hereafter BIF) is indicative of the variability in reading achievements of these children. In a study of adults with MID, all individuals exhibited reading deficits, and 61% showed severe impairment in word identification tasks (less than 50% of words read correctly; Cohen <emph>et al</emph>. [<reflink idref="bib8" id="ref19">8</reflink>]). Furthermore, for most of them, reading speed was very slow, indicating that word identification was not an automated process and that assembling was the main cognitive strategy used. In this sample, word identification scores were correlated with both total and verbal IQ scores. To account for the performance variability in these children, Conners <emph>et al</emph>. ([<reflink idref="bib11" id="ref20">11</reflink>]) examined a group of children with MID and compared those with higher reading skills and those with similar IDs but lower reading skills. After age was covaried, the group of children with low reading skills performed worse on measures of verbal working memory and phonemic awareness, indicating that these skills may account for the presence of individual differences in decoding over and above IQ levels.</p> <p>Studies of children and adolescents with BIF also typically indicate various levels of ability in school achievement (for a review, refer to Peltopuro <emph>et al</emph>. [<reflink idref="bib29" id="ref21">29</reflink>]). In the first stages of schooling, children with BIF usually learn slowly and less accurately (Vig <emph>et al</emph>. [<reflink idref="bib43" id="ref22">43</reflink>]; MacMillan <emph>et al</emph>. [<reflink idref="bib26" id="ref23">26</reflink>]; Shaw & Gouwens [<reflink idref="bib35" id="ref24">35</reflink>]). Reading and spelling are subsequently acquired, but large variability in performance often persists. In a sample of 55 Indian children with BIF, Karande <emph>et al</emph>. ([<reflink idref="bib20" id="ref25">20</reflink>]) described school difficulties primarily in spelling (92.7%); in fact, only a fourth of the sample showed reading difficulties (25.5%). Kortteinen <emph>et al</emph>. ([<reflink idref="bib23" id="ref26">23</reflink>]) examined four groups of children who varied for the presence/absence of reading difficulty and the presence/absence of BIF. No interaction between these two factors was observed in the performance on different reading tasks, indicating that IQ did not play a significant role in the emergence of reading disabilities. Finally, a study by Claypool <emph>et al</emph>. ([<reflink idref="bib7" id="ref27">7</reflink>]) reported that a group of 59 eleven‐year‐old children with BIF had reading skills similar to those of a control group with average IQs. In this study, results of the group with BIF demonstrated non‐significant correlations between IQ and reading achievement scores. Overall, even though the skills of children with atypical development are characterised by great individual variability, those whose ID is more severe have greater difficulty. Thus, general cognitive abilities may have a different impact on the development of reading at different levels of ID.</p> <p>When evaluating reading skills, the timing of the examination is an important aspect. In regular orthographies, such as Italian (i.e. the language studied here), accuracy is reached relatively early. For example, in a large study comparing various European orthographies, Italian children read 94.9% of words accurately by the end of grade 1, a level similar to that of Greek (96.6%) and Spanish (94.2%) children. At the same age, lower performance levels characterised children's reading in irregular orthographies such as French (72.5%), Danish (70.9%) or English (32.6%; Seymour <emph>et al</emph>. [<reflink idref="bib33" id="ref28">33</reflink>]). By contrast, even in regular orthographies, reading fluency requires a considerably longer period of acquisition. In a reading study with Italian typically developing children, we found that fluency in reading lists of words and non‐words improved across grades following a power law of practice (Zoccolotti <emph>et al</emph>. [<reflink idref="bib46" id="ref29">46</reflink>]). This slow type of acquisition seems to characterise many other visual‐motor tasks, as originally put forward by Newell and Rosenbloom ([<reflink idref="bib27" id="ref30">27</reflink>]). The power law indicates a rate of acquisition in which large initial improvements in performance (typically expressed in terms of time measures) are followed by progressively smaller increases; mathematically, the power function goes to zero at infinite (an extensive discussion of the use of the power law for learning and in particular for developing automated responses is provided by Logan [<reflink idref="bib25" id="ref31">25</reflink>]). Knowing how students with ID learn to read and how the reading trajectories vary as a function of level of schooling (and consequently reading experience) are important steps for designing effective interventions in reading (Channell <emph>et al</emph>. [<reflink idref="bib6" id="ref32">6</reflink>]). However, there has been little research into the prevalence and variation of reading skills as a function of school level.</p> <p>The aim of this study was to examine various reading fluency, accuracy and comprehension parameters in Italian children with either MID or BIF who were in the second to eighth grade. One important theoretical framework for interpreting reading proficiency is provided by the dual‐route cascaded (DRC) model of visual word recognition and reading aloud (Coltheart <emph>et al</emph>. [<reflink idref="bib9" id="ref33">9</reflink>]). According to the DRC model, reading can be accomplished via a grapheme‐to‐phoneme conversion routine (phonological or sub‐lexical route) or by using direct lexical matching so that words are recognised as wholes with reference to entries in the orthographic lexicon (lexical route). Thus, in keeping with the DRC model, we set out to evaluate reading of both lists of words and pseudo‐words. It also seemed important to examine reading in a more functional context, such as text reading. This measure is important as it allows establishing how the basic reading skills of the children are expressed in a condition in which the contextual information may also exert a top‐down influence. Thus, it is well known that contextual information optimises reading fluency (e.g. Perfetti <emph>et al</emph>. [<reflink idref="bib30" id="ref34">30</reflink>]; Stanovich & West [<reflink idref="bib39" id="ref35">39</reflink>]; Simpson <emph>et al</emph>. [<reflink idref="bib37" id="ref36">37</reflink>]).</p> <p>Overall, we focused on the following main questions:</p> <p></p> <ulist> <item> How do the reading skills of students with ID differ from those of students with typical development as a function of stimulus materials (i.e. words, pseudo‐words and texts)?</item> <p></p> <item> Do reading skills differ in students with MID and BIF?</item> <p></p> <item> Do these differences vary as a function of grade level?</item> </ulist> <hd id="AN0137586053-3">Materials and methods</hd> <p></p> <hd id="AN0137586053-4">Participants</hd> <p>Participants included 274 children aged 7 to 14 years of age and who were in the second to eighth grade. The sample was recruited from patients referred to the Diagnostic Clinics of 'Oasi Maria SS' Research Institute (Troina, Italy) for the learning support of children with ID. Children admitted to the clinics between 2013 and 2017 took part in the study. The research was approved by the local ethics committee on 17 June 2013 (2013CEOASI‐17/06). Informed consent for children's participation was obtained from their parents.</p> <p>All children attended public schools in regular classrooms; 62% of the children with MID and 27% of the children with BIF received the support of a special education teacher. Furthermore, 31% of those with MID and 19% of those with BIF attended speech therapy; 27% of children with MID and 20% of those with BIF attended psychomotor therapy.</p> <p>Educational level of parents was classified according to the International Standard Classification of Education (ISCED; UNESCO Institute for Statistics, [<reflink idref="bib41" id="ref37">41</reflink>]). Five educational groups were considered: ISCED level 0 (less than primary education), 24 (4.38%) of parents fell in this category; ISCED level 1 (primary education), 91 (16.6%) of parents; ISCED level 2 (lower secondary), 232 (42.3%) of parents; ISCED level 3 (upper secondary), 176 (32.1%); and ISCED level 6 (university degree), 25 (4.56%). There were no significant differences between children with MID and those with BIF in terms of ISCED levels (<emph>χ</emph><subs>4</subs><sups>2</sups> = 5.44, n.s., based on the mothers' values; and <emph>χ</emph><subs>4</subs><sups>2</sups> = 8.07, n.s., based on the fathers' values).</p> <p>For most individuals in the sample, aetiology was unspecified. The presence of brain damage or genetic diseases was diagnosed in 65 participants (24%); among these, there were children with epilepsy (<emph>N</emph> = 23), genetic mutations (<emph>N</emph> = 17), myopathy (<emph>N</emph> = 10), cerebral palsy (<emph>N</emph> = 8), neurocutaneous syndromes (<emph>N</emph> = 5) and central nervous system malformations (<emph>N</emph> = 2).</p> <p>The children included in the present investigation were separated into two groups on the basis of their full‐scale IQ (FSIQ) scores on the Wechsler Intelligence Scale for Children‐III (Wechsler [<reflink idref="bib44" id="ref38">44</reflink>]): MID group (i.e. FSIQ 50 to 70) and BIF group (i.e. FSIQ 71 to 84) according to the <emph>Diagnostic and Statistical Manual of Mental Disorder</emph>, Fourth Edition (American Psychiatric Association [<reflink idref="bib3" id="ref39">3</reflink>]). The mean ages and FSIQ scores of the subgroups are presented in Table . The BIF subgroup (mean FSIQ = 76.4, SD = 4.03) included 106 children (67 male and 39 female), with a mean age of 10 years 2 months (SD = 1.9, range 7–14.11 years). The MID subgroup (mean FSIQ = 61, SD = 6) included 168 children (107 male and 61 female), with a mean age of 10 years 6 months (SD = 1.9, range 7–14.6 years).</p> <p>Main characteristics of participants</p> <p> <ephtml> <table><thead valign="bottom"><tr><th /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">N = 106</th><th align="center">N = 168</th></tr><tr><th align="left" /><th align="center">CA</th><th align="center">Full IQ</th><th align="left" /><th align="center">CA</th><th align="center">Full IQ</th></tr><tr><th align="center">M/F</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">M/F</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>10/2</td><td>7.4</td><td>0.5</td><td>79.0</td><td>4.9</td><td>8/5</td><td>7.8</td><td>1.0</td><td>61.8</td><td>5.8</td></tr><tr><td>Third grade</td><td>11/6</td><td>8.5</td><td>1.1</td><td>76.9</td><td>4.4</td><td>15/6</td><td>8.5</td><td>0.7</td><td>62.6</td><td>6.4</td></tr><tr><td>Fourth grade</td><td>14/6</td><td>9.5</td><td>0.6</td><td>75.8</td><td>3.7</td><td>15/13</td><td>9.5</td><td>0.7</td><td>61.4</td><td>5.7</td></tr><tr><td>Fifth grade</td><td>9/9</td><td>10.3</td><td>0.6</td><td>76.2</td><td>3.5</td><td>27/11</td><td>10.5</td><td>0.7</td><td>61.0</td><td>5.4</td></tr><tr><td>Sixth grade</td><td>7/7</td><td>11.3</td><td>0.6</td><td>76.8</td><td>4.2</td><td>18/9</td><td>11.8</td><td>1.1</td><td>59.4</td><td>6.4</td></tr><tr><td>Seventh grade</td><td>9/3</td><td>12.4</td><td>0.5</td><td>74.6</td><td>3.8</td><td>12/10</td><td>12.3</td><td>0.7</td><td>61.7</td><td>6.4</td></tr><tr><td>Eighth grade</td><td>7/6</td><td>13.1</td><td>0.5</td><td>76.6</td><td>3.5</td><td>12/7</td><td>13.5</td><td>1.0</td><td>61.8</td><td>6.9</td></tr><tr><td>Total</td><td>67/39</td><td>10.2</td><td>1.9</td><td>76.4</td><td>4.0</td><td>107/61</td><td>10.6</td><td>1.9</td><td>61.2</td><td>6.0</td></tr></tbody></table> </ephtml> </p> <p>1 BIF, borderline intellectual functioning; MID, mild intellectual disability.</p> <p>An analysis of variance (ANOVA) on the FSIQ data with group, gender and grade as unrepeated factors revealed a significant main effect of group (<emph>F</emph><subs>1,239</subs> = 374.21, <emph>P</emph> < 0.001) in that children with MID scored lower (61.22) than children with BIF (76.28); this effect was clearly consistent with the selection criteria. Neither the main effects of gender and grade nor those of all interactions were significant, indicating that these two factors had no role in IQ either directly or for one of the two groups of children. A similar ANOVA was also carried using IQ measures (verbal vs. performance) as a repeated measure. Only the main effect of the group factor was significant (<emph>F</emph><subs>1,239</subs> = 227.34, <emph>P</emph> < 0.01); none of the other main effects and interactions were significant.</p> <hd id="AN0137586053-5">Reading assessment</hd> <p>To assess reading skills (accuracy and speed), we used tests that required reading words and pseudo‐words as well as meaningful texts (standardised for Italian children) that provided norms for the critical ages of interest.</p> <p>In the Text Reading task from the MT Reading Battery for Primary School (Cornoldi & Colpo [<reflink idref="bib13" id="ref40">13</reflink>]), the child is required to read a text passage aloud within a 4‐min time limit; reading speed (total number of syllables divided by total time spent, expressed in seconds) and accuracy (number of errors, adjusted for the amount of text read) are scored. In scoring accuracy, errors, self‐corrections, long pauses (above 5 s) and repetitions are given full (1 error) or partial (1/2 error) credit. Texts vary depending on the child's school grade. Test–retest reliability coefficients are reported as ranging from 0.75 to 0.87 for accuracy and from 0.94 to 0.97 for speed, depending on grade level (Cornoldi & Colpo [<reflink idref="bib13" id="ref41">13</reflink>]). Because groups included children from different grades, individual raw data were converted into <emph>z</emph> scores on the basis of normative data (Cornoldi & Colpo [<reflink idref="bib13" id="ref42">13</reflink>]). In all cases, positive values indicated better performance, and negative values indicated worse performance.</p> <p>In order to assess reading comprehension, the Comprehension task from the MT Reading Battery for Primary School (Cornoldi & Colpo [<reflink idref="bib13" id="ref43">13</reflink>]) was used. In this task, the child is required to read a text silently and to check it subsequently during the answering phase. There are 10 multiple‐choice questions with either three or four alternatives. The total number of correct responses is the measure of performance. Texts vary depending on the child's school grade. Test–retest reliability coefficients are reported between 0.70 and 0.75, depending on grade level (Cornoldi & Colpo [<reflink idref="bib13" id="ref44">13</reflink>]). Raw data are converted into <emph>z</emph> scores on the basis of normative data (Cornoldi & Colpo [<reflink idref="bib13" id="ref45">13</reflink>]), with positive values indicating better performance. It seemed important to consider the actual range of responding possible (in terms of <emph>z</emph> scores) as this test has a closed scale. In particular, note that the lowest performance possible for each grade depends upon the normative reference group's actual performance, taking into account the chance level associated with the various versions of the task (i.e. either 25% or 33%).</p> <p>The Word and Pseudo‐word Reading subtests of the Battery for the Assessment of Developmental Reading and Spelling Disorders (Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref46">32</reflink>]) were also administered. These subtests assess speed and accuracy while reading a list of 112 words (four sets of 28 words that varied for frequency and imageability) and a list of 48 pseudo‐words (three sets of 16 pseudo‐words). Errors and reading speed were scored. Reading speed was calculated by dividing the total number of words read by the total time spent for reading, expressed in seconds; reading accuracy was assessed by counting the number of words incorrectly decoded. Test–retest reliability coefficients are reported as 0.80 for speed and 0.71 for accuracy (Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref47">32</reflink>]). Raw data were converted into <emph>z</emph> scores on the basis of normative data (Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref48">32</reflink>]). In all cases, positive values indicate better performance (i.e. fewer errors and higher speed), whereas negative values indicate worse performance.</p> <hd id="AN0137586053-6">Procedure</hd> <p>Children were individually examined by a qualified psychologist in a room in which distractions were limited. The Wechsler Intelligence Scale for Children was given first, followed by the MT Reading Battery (Cornoldi & Colpo [<reflink idref="bib13" id="ref49">13</reflink>]) and the subtests of the Battery for the Assessment of Developmental Reading and Spelling Disorders (Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref50">32</reflink>]). All tests were administered following the standard procedures. Two sessions of approximately 1 h were usually needed to complete testing.</p> <hd id="AN0137586053-7">Data analysis</hd> <p>Comparisons between the two groups of children were carried out on the <emph>z</emph> scores. <emph>z</emph>‐score data allowed us to evaluate the degree of impairment in the various conditions with respect to age‐matched reference data (expected values: mean = 0 and SD = 1). This is particularly important in conditions in which levels vary in terms of general difficulty. Indeed, when conditions involving different basic levels of difficulty are used to compare groups of individuals with typical versus atypical development, most difficult conditions should be expected to produce larger differences in the less proficient group. This is known as the overadditivity effect (for a discussion, refer to Faust <emph>et al</emph>. [<reflink idref="bib15" id="ref51">15</reflink>]). Descriptive statistics for all <emph>z</emph>‐score measures are reported in Appendix 1, and data for raw reading measures are reported in Appendix 2.</p> <p>Two separate ANOVAs were carried out on the data of the MT Reading Battery, which included text reading and the subtests of the Battery for the Assessment of Developmental Reading and Spelling Disorders (Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref52">32</reflink>]), which involved reading lists of words or non‐words, respectively.</p> <p>For both ANOVA groups, gender and grade were entered as unrepeated factors. As children with BIF and MID often fail in academic performance, only a loose relationship exists between grade and chronological age. Therefore, age was entered as a covariate nested with the grade factor in all ANOVAs.</p> <p>Different repeated measures were considered in the two ANOVAs. In the ANOVA on the MT Reading data (Cornoldi & Colpo [<reflink idref="bib13" id="ref53">13</reflink>]), reading parameters (accuracy, speed and comprehension) were entered as a repeated measure. In the ANOVA on the Word and Pseudo‐word Reading subtests, the repeated measures were lexicality (words vs. pseudo‐words) and reading parameter (accuracy vs. speed).</p> <p>We also looked at individual differences. In particular, we examined the proportion of performance on the various tests and reading parameters that fell below a cut‐off point (−1.65 <emph>z</emph> score). Under normality assumptions, ~5% of a population should fall below this value.</p> <hd id="AN0137586053-8">Results</hd> <p>Descriptive statistics on the <emph>z</emph>‐score data from the MT Text Reading and Comprehension tasks from the MT Reading Battery for Primary School are presented in Appendix 1. Data represent <emph>z</emph> scores with respect to the normalisation sample (Cornoldi & Colpo [<reflink idref="bib13" id="ref54">13</reflink>]). For example, data on reading accuracy in children with BIF indicated small differences from normative values (all means were within half a standard deviation) even though a deviant performance was present in third graders for mean performance (−1.41) and large inter‐individual variability (2.1 as opposed to an expected value of 1). Inspection of individual cases indicated that this deviance was mostly due to two outliers performing worse than 4 SDs below the mean of the normative sample. Performance in children with MID was somewhat lower (and more variable) with means within half a standard deviation of the norms in the second, third and fifth grades; means between −0.5 and −1.0 in the fourth and sixth grades; and even lower performance (less than −1.0) in the seventh and eighth grades.</p> <p>The ANOVA on these data showed that the main effect of group was significant (<emph>F</emph><subs>1,198</subs> = 5.37, <emph>P</emph> < 0.05), indicating worse performance in children with MID (−1.18) than in children with BIF (−0.52) relative to peers. No main effect was detected for gender (<emph>F</emph> < 1) or grade (<emph>F</emph><subs>6,198</subs> = 1.22, n.s.). The group by grade interaction was significant (<emph>F</emph><subs>6,198</subs> = 3.16, <emph>P</emph> < 0.01), indicating worse performance in seventh and eighth graders relative to the standardisation sample, especially in children with MID. The reading measure effect was significant (<emph>F</emph><subs>2,396</subs> = 6.07, <emph>P</emph> < 0.01), indicating less impaired performance in reading accuracy (−0.52) than in reading speed (−1.28) and comprehension (−1.26), which did not differ from each other. The reading parameter by group (<emph>F</emph><subs>2,396</subs> = 3.35, <emph>P</emph> < 0.05) and the reading parameter by grade (<emph>F</emph><subs>12,396</subs> = 1.85, <emph>P</emph> < 0.05) and reading parameter by group by grade (<emph>F</emph><subs>12,396</subs> = 2.61, <emph>P</emph> < 0.01) interactions were significant.</p> <p>This last interaction is illustrated in Fig. . Inspection of the figure indicated that (a) in the case of reading speed, lower performance at higher grades was present from grade 6, and this effect was much more marked in the case of children with MID; (b) in the case of accuracy, the same trend was present but limited to the two last grades and to children with MID; and (c) in the case of reading comprehension, mean performance tended to decrease relative to peers with the increasing grade level for both groups (which did not differ from each other). However, this profile actually paralleled that of the minimal possible performance on the test.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/EUL/01aug19/jir12620-fig-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="jir12620-fig-0001.jpg" title="1 Reading accuracy, reading speed and text comprehension on MT Text Reading test. Values indicate mean z scores and confidence levels. Data are presented as a function of grade (from 2 to 8) and group (MID and BIF). In the case of comprehension, the measure is a closed scale such that there is lower limit for possible performance as a function of grade. Minimal possible performance is plotted along with experimental data. BIF, borderline intellectual functioning; MID, mild intellectual disability." /> </p> <p></p> <p>Descriptive statistics (in terms of <emph>z</emph> scores relative to the normalisation sample; Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref55">32</reflink>]) for the Word and Pseudo‐word Reading subtests are presented in Appendix 1 for both accuracy and speed parameters.</p> <p>The ANOVA on these data showed the main effect of the group factor (<emph>F</emph><subs>1,234</subs> = 7.55, <emph>P</emph> < 0.01), indicating worse performance in children with MID (−1.89) than in children with BIF (−1.14) relative to peers. No main effect was detected for gender (<emph>F</emph> < 1), grade (<emph>F</emph><subs>6,234</subs> = 1.38, n.s.) or reading parameter (<emph>F</emph><subs>1,234</subs> = 2.06, n.s.). The group by grade interaction was significant (<emph>F</emph><subs>6,234</subs> = 2.39, <emph>P</emph> < 0.05), indicating that, across reading conditions, performance was generally worse in children with MID at higher grades (with an average decrease per year of −0.41 <emph>z</emph> scores) but not in children with BIF (average change with grade = −0.01 <emph>z</emph> score).</p> <p>The main effect of lexicality was significant (<emph>F</emph><subs>1,234</subs> = 12.08, <emph>P</emph> < 0.001), indicating lower performance for words (−2.11) than pseudo‐words (−0.93). The first‐order interactions between lexicality and group (<emph>F</emph><subs>1,234</subs> = 4.31, <emph>P</emph> < 0.05) and lexicality and grade (<emph>F</emph><subs>6,234</subs> = 3.52, <emph>P</emph> < 0.01) and reading parameter by grade (<emph>F</emph><subs>6,234</subs> = 13.89, <emph>P</emph> < 0.05) were significant, as were the higher order lexicality by group by grade (<emph>F</emph><subs>6,234</subs> = 3.86, <emph>P</emph> = 0.001) and lexicality by reading parameter by group by grade (<emph>F</emph><subs>6,234</subs> = 3.21, <emph>P</emph> < 0.01).</p> <p>We focused on the higher order interaction; relevant data are presented in Fig. . Inspection of the figure revealed the following: (a) across conditions and groups, word reading performance was more impaired than pseudo‐word reading performance; (b) in the case of reading speed, performance declined at higher grades relative to the standardisation sample, especially in the case of words and much less in the case of pseudo‐words, where this trend was present only in the last two grades; (c) in the case of reading accuracy, performance did not change appreciably with grade level except for the eighth grade (in the case of words); and (d) differences between the two groups were most apparent in the case of reading speed (as compared with accuracy) and words (as compared with pseudo‐words).</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/EUL/01aug19/jir12620-fig-0002.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="jir12620-fig-0002.jpg" title="2 Reading accuracy and reading speed on the Word and Pseudo‐word Reading subtests from the Battery for the Assessment of Developmental Reading and Spelling Disorders (Sartori et al.[32]). Values indicate mean z scores and confidence levels. Data are presented as a function of grade (from 2 to 8) and group (MID and BIF). BIF, borderline intellectual functioning; MID, mild intellectual disability." /> </p> <p></p> <p>No other interactions were significant. In particular, this was the case for the reading parameter by group and reading parameter by group and grade as well as all interactions including the gender factor. All interactions involving four or five factors were not significant except for the one on lexicality by reading parameter by group by grade described earlier.</p> <p>Individual variability in the two reading tests can be appreciated in Figs  (MT Reading Battery) and (Word and Pseudo‐word Reading subtests from the Battery for the Assessment of Developmental Reading and Spelling Disorders), which show the proportion of children who fell below the −1.65 cut‐off on the various reading parameters.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/EUL/01aug19/jir12620-fig-0003.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="jir12620-fig-0003.jpg" title="3 Proportions of children who obtained a z score below −1.65 in reading accuracy (a), reading speed (b) and text comprehension (c) in the MT Text Reading test. Data are presented as a function of grade (from 2 to 8) and group (MID and BIF). BIF, borderline intellectual functioning; MID, mild intellectual disability." /> </p> <p></p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/EUL/01aug19/jir12620-fig-0004.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="jir12620-fig-0004.jpg" title="4 Proportions of children who obtained a z score below −1.65 in reading accuracy for words (a) and pseudo‐words (b) and in reading speed for words (c) and pseudo‐words (d) in the Word and Pseudo‐word Reading subtests from the Battery for the Assessment of Developmental Reading and Spelling Disorders (Sartori et al.[32]). Data are presented as a function of grade (from 2 to 8) and group (MID and BIF). BIF, borderline intellectual functioning; MID, mild intellectual disability." /> </p> <p></p> <p>As for the MT test (Fig. ), there were comparatively few children performing below the cut‐off in terms of accuracy up to the fifth grade; in the last three grades, a higher proportion was observed in the case of children with MID. Also for speed, slower than expected performance was considerably more frequent at higher grades (with some variability between the two groups). Finally, data for comprehension also showed a developmental trend. Few children performed below the cut‐off up to fourth grade (even though they are somewhat higher than the expected 5%). By the fifth grade, about 40% of children performed below the cut‐off, and this trend increased, although with some variability, in subsequent grades, being maximal at the eighth grade (where about 70% of children showed a performance below the cut‐off).</p> <p>At the Word and Pseudo‐word Reading subtests, performance below the cut‐off for accuracy (Fig. a,b) showed a clear lexicality asymmetry with fewer children showing a low performance for pseudo‐words than words. In fact, relatively few (10–20%) children were incorrect in reading pseudo‐words in early grades; these proportions increased somewhat (but with notable exceptions) at later grades. As for reading words, in the second grade only, the proportion of performance below the cut‐off was near 20%; by the third grade, about 40% of children performed below the cut‐off, and no clear grade effect was apparent. Also for reading speed (Fig. c,d), a clear difference as a function of the lexical value of the stimulus was present. Relatively few children with BIF had a low performance at all grades in the case of pseudo‐words, and this was also the case for children with MID up to the fifth grade. Performance below the cut‐off was generally more frequent and more stable across grades in the case of reading words. In the last three grades, there was a tendency for children with MID to show higher incidence of performance below the cut‐off.</p> <hd id="AN0137586053-13">Discussion</hd> <p>The results clearly showed that in reading tasks, children with ID generally scored lower than the norms on the basis of the performance of typically developing children. As expected, reading difficulties were generally larger for children with MID, relative to peers, than for children with BIF. Furthermore, they were greater for speed than for accuracy and for words than pseudo‐words. However, when interpreting these results, it should be kept in mind that individual differences were particularly marked independent of MID–BIF subgrouping as well as stimulus category and reading parameters.</p> <hd id="AN0137586053-14">Lexicality effect</hd> <p>As compared with normative values, the difference in lexicality effect was particularly marked. On average, children with ID had a mean of −2.11 <emph>z</emph> value in reading words and one of −0.93 <emph>z</emph> value in reading pseudo‐words (i.e. 1.18 <emph>z</emph>‐score difference). Note that this does not indicate that children with BIF/MID read pseudo‐words better than words but rather that the large advantage in reading words (with respect to pseudo‐words) present in typically developing children (i.e. the lexicality effect) was greatly attenuated in these children. This pattern was apparent when raw data for accuracy and speed measures in the Word and Pseudo‐word Reading subtests were examined (Appendix 2). Based on the DRC model (Coltheart <emph>et al</emph>. [<reflink idref="bib9" id="ref56">9</reflink>]), relative sparing in reading pseudo‐words indicates an efficient use of the grapheme‐to‐phoneme conversion routine (sub‐lexical route) in children with ID. These results are consistent with findings of the study by Conners <emph>et al</emph>. ([<reflink idref="bib12" id="ref57">12</reflink>]): children with ID relied substantially on phonological processing skills for word and non‐word identification.</p> <p>Italian is a language with a very regular orthography. Therefore, reading based on grapheme‐to‐phoneme conversion (sub‐lexical route) is in principle appropriate for reading all Italian words. Evidence though suggests that Italian readers take advantage of lexical information; hence, lexical activation appears particularly important to foster reading fluency (Pagliuca <emph>et al</emph>. [<reflink idref="bib28" id="ref58">28</reflink>]). Developmental studies show that children begin to benefit from lexical information (i.e. show an effect of word frequency) by the third grade (Zoccolotti <emph>et al</emph>. [<reflink idref="bib46" id="ref59">46</reflink>]). So one possible explanation is that, thanks to the regularity and consistency of the grapheme‐to‐phoneme conversion rules of Italian, children with ID reach a relatively good level of sub‐lexical reading, which proves to be relatively effective at early grades. At higher levels of reading experience, reliance on sub‐lexical reading becomes progressively less effective when children are compared with typically developing children. This is in keeping with the presence of larger difficulties at later grades, particularly in the case of reading fluency and in the case of children with MID. The present data are not directly informative as to what is the likely source for the difficulty in lexical acquisition, and this remains as an open question for future research.</p> <hd id="AN0137586053-15">Role of orthographic regularity</hd> <p>As stated earlier, Italian has a highly regular orthography. So it is possible that the emergence of specific difficulties with lexical processing after the achievement of some reading experience is peculiar to languages with regular orthographies. Indeed, some studies with children with ID learning a language with irregular orthography (typically English) reported difficulties also in phonological decoding (Jenkinson [<reflink idref="bib19" id="ref60">19</reflink>]; Cawley & Parmar [<reflink idref="bib5" id="ref61">5</reflink>]; Conners <emph>et al</emph>. [<reflink idref="bib11" id="ref62">11</reflink>]; Conners [<reflink idref="bib10" id="ref63">10</reflink>]; Barker <emph>et al</emph>. [<reflink idref="bib4" id="ref64">4</reflink>]). Direct cross‐linguistic comparisons between languages with different levels of orthographic regularity are needed to substantiate these findings arising from studies on single languages.</p> <hd id="AN0137586053-16">Reading comprehension</hd> <p>As expected, both children with BIF and with MID showed difficulties in reading comprehension. As the test used in the present study features an alternative choice response with a relatively small number of items, variability was somewhat limited. Therefore, in evaluating this test, we considered the minimum possible performance in terms of standardised scores, which can be obtained in the test at each grade level. Empirically, we observed that the minimum possible performance increased with grade, as typically developing children become more efficient and less variable in the task with age. As an effect of this, the task allowed for a wider range of performance at higher grades. This seems important to interpret the pattern of findings for this comprehension measure. In particular, performance of both groups of children was generally lower at higher grades. However, this change in performance paralleled the greater sensitivity of the task in allowing the detection of severe deficits. Therefore, a conservative interpretation of the pattern of results is that children with BIF and children with MID were impaired in text comprehension, but the greater deficit observed at higher grades can be seen as owing to the greater sensitivity of the test in detecting deficits at higher grades. Also of note is that the two groups of children were not clearly different in this task. Again, it is possible that this is due to the relatively poor level of discrimination of the task. Further studies are needed to pinpoint more effectively the comprehension deficit shown by these children and to identify the specific cognitive and linguistic precursors to reading comprehension (van Wingerden <emph>et al</emph>. [<reflink idref="bib42" id="ref65">42</reflink>]).</p> <hd id="AN0137586053-17">Individual differences in reading as a function of intellectual disability</hd> <p>As stated earlier, inter‐individual variability seems to be the rule when examining the performance of children with BIF or MID. In keeping with the literature (e.g. Conners [<reflink idref="bib10" id="ref66">10</reflink>]), children with ID were poor in reading, and a more severe ID (such as MID) was associated with greater reading difficulties than a less severe ID (such as BIF). Still, in both BIF and MID subgroups, a sizeable proportion of children scored within normal limits. This finding is in keeping with the observation that even children with severe ID may show entirely preserved reading skills (Cossu <emph>et al</emph>. [<reflink idref="bib14" id="ref67">14</reflink>]; Groen <emph>et al</emph>. [<reflink idref="bib18" id="ref68">18</reflink>]). The reasons for this variability are still not well understood and certainly deserve further research. At any rate, from a clinical standpoint, individual variability is important as it requires an accurate diagnostic evaluation of the reading profile of the child. The present data indicate that focusing on grade level is as important as examining all reading parameters, especially with regard to the relative efficiency of sub‐lexical and lexical reading.</p> <hd id="AN0137586053-18">Educational implications</hd> <p>The profile of reading shown by children with ID may prove useful in planning individually targeted interventions. For example, on the basis of the present findings, we expect that a number of children with ID in higher grades should show clear lexical asymmetry with greater difficulty in reading words compared with pseudo‐words relative to the standardisation sample. In these children, we propose that training should focus on stimulating lexical expansion with verbal exercises using both written and acoustic materials. Furthermore, focusing on individual variability in reading skills and grade level may be important for examining the effectiveness of training programmes.</p> <hd id="AN0137586053-19">Direction for future research</hd> <p>The present results point to the presence of large individual differences over and above the presence and severity of ID. The origin of this variability is still poorly understood and is an important challenge for future research. Perhaps, it would be useful to focus on the cognitive correlates of the reading performance of these children to account for these individual differences.</p> <hd id="AN0137586053-20">Conclusions</hd> <p>Overall, the present study indicated that as a group, children with ID showed atypical reading acquisition. The difficulty was greater for children with more severe ID, although large individual differences were observed in both children with BIF and children with MID. The profile of reading impairment points to relatively spared sub‐lexical reading and, conversely, impaired lexical processing. Particularly in the case of reading fluency, both group and individual data indicate greater difficulty in higher grades, that is, when reading experience is greater. It is proposed that children with ID may lack the ability to develop orthographic lexical representations, which are known to be important for fostering reading speed among typically developing readers. Further studies are needed to understand which cognitive factors modulate the large variability in reading skills shown by children with ID.</p> <hd id="AN0137586053-21">Source of funding</hd> <p>No external funding was received for the research reported in the paper.</p> <hd id="AN0137586053-22">Conflict of Interest</hd> <p>No conflicts of interest have been declared.</p> <p>1 Appendix</p> <p>Mean (and SDs) <emph>z</emph> scores for the different reading tests based on normative data. Data are presented for the subgroups of children with BIF and MID separately at the different grade levels.</p> <p>MT Reading test: z ‐score accuracy in text reading</p> <p>Data indicate <emph>z</emph> scores (and SDs) based on normalisation data at the various grade levels (Cornoldi & Colpo [<reflink idref="bib13" id="ref69">13</reflink>]).</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>−0.08</td><td>1.20</td><td>0.01</td><td>1.00</td></tr><tr><td>Third grade</td><td>−1.41</td><td>2.10</td><td>−0.23</td><td>1.07</td></tr><tr><td>Fourth grade</td><td>−0.30</td><td>0.80</td><td>−0.95</td><td>2.38</td></tr><tr><td>Fifth grade</td><td>0.10</td><td>0.70</td><td>−0.48</td><td>1.40</td></tr><tr><td>Sixth grade</td><td>−0.50</td><td>1.20</td><td>−0.89</td><td>1.81</td></tr><tr><td>Seventh grade</td><td>0.30</td><td>1.60</td><td>−1.71</td><td>2.86</td></tr><tr><td>Eighth grade</td><td>0.40</td><td>0.60</td><td>−1.85</td><td>3.16</td></tr></tbody></table> </ephtml> </p> <p>MT Reading test: z ‐score speed in text reading</p> <p>Data indicate <emph>z</emph> scores (and SDs) based on normalisation data at the various grade levels (Cornoldi & Colpo [<reflink idref="bib13" id="ref70">13</reflink>]).</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>−0.45</td><td>0.80</td><td>−0.15</td><td>0.58</td></tr><tr><td>Third grade</td><td>−0.47</td><td>0.60</td><td>−0.54</td><td>0.50</td></tr><tr><td>Fourth grade</td><td>−1.20</td><td>2.00</td><td>−1.12</td><td>1.27</td></tr><tr><td>Fifth grade</td><td>−0.40</td><td>0.80</td><td>−0.76</td><td>1.47</td></tr><tr><td>Sixth grade</td><td>−1.40</td><td>1.40</td><td>−1.69</td><td>1.55</td></tr><tr><td>Seventh grade</td><td>−1.40</td><td>4.00</td><td>−2.38</td><td>2.16</td></tr><tr><td>Eighth grade</td><td>−1.30</td><td>1.40</td><td>−3.37</td><td>4.22</td></tr></tbody></table> </ephtml> </p> <p>MT Reading test: z ‐score reading comprehension</p> <p>Data indicate <emph>z</emph> scores (and SDs) based on normalisation data at the various grade levels (Cornoldi & Colpo [<reflink idref="bib13" id="ref71">13</reflink>]).</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>−0.76</td><td>0.90</td><td>−0.82</td><td>1.11</td></tr><tr><td>Third grade</td><td>−0.64</td><td>0.60</td><td>−0.89</td><td>0.55</td></tr><tr><td>Fourth grade</td><td>−0.90</td><td>0.70</td><td>−0.91</td><td>0.70</td></tr><tr><td>Fifth grade</td><td>−1.40</td><td>0.80</td><td>−1.57</td><td>0.80</td></tr><tr><td>Sixth grade</td><td>−1.20</td><td>1.00</td><td>−1.18</td><td>0.69</td></tr><tr><td>Seventh grade</td><td>−1.60</td><td>0.80</td><td>−1.71</td><td>1.04</td></tr><tr><td>Eighth grade</td><td>−1.90</td><td>0.90</td><td>−1.90</td><td>1.10</td></tr></tbody></table> </ephtml> </p> <p>Word and Pseudo‐word Reading subtests: z ‐score accuracy</p> <p>Data indicate <emph>z</emph> scores (and SDs) based on normalisation data at the various grade levels (Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref72">32</reflink>]).</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Word</th><th align="center">Pseudo‐word</th><th align="center">Word</th><th align="center">Pseudo‐word</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>−0.73</td><td>1.30</td><td>−0.30</td><td>0.90</td><td>−0.93</td><td>1.71</td><td>−0.38</td><td>1.22</td></tr><tr><td>Third grade</td><td>−2.61</td><td>2.20</td><td>−1.24</td><td>1.90</td><td>−1.54</td><td>3.30</td><td>−0.39</td><td>1.48</td></tr><tr><td>Fourth grade</td><td>−1.80</td><td>2.50</td><td>−1.20</td><td>1.90</td><td>−2.07</td><td>2.63</td><td>−1.13</td><td>1.64</td></tr><tr><td>Fifth grade</td><td>−1.20</td><td>2.00</td><td>−0.50</td><td>1.50</td><td>−2.12</td><td>3.58</td><td>−0.86</td><td>2.27</td></tr><tr><td>Sixth grade</td><td>−2.10</td><td>3.40</td><td>−0.70</td><td>1.60</td><td>−2.24</td><td>3.51</td><td>−1.41</td><td>1.91</td></tr><tr><td>Seventh grade</td><td>−1.60</td><td>3.50</td><td>−0.70</td><td>2.20</td><td>−2.12</td><td>2.86</td><td>−1.42</td><td>2.25</td></tr><tr><td>Eighth grade</td><td>−0.50</td><td>1.80</td><td>0.30</td><td>1.00</td><td>−5.50</td><td>7.71</td><td>−0.98</td><td>2.18</td></tr></tbody></table> </ephtml> </p> <p>Word and Pseudo‐word Reading subtests: z ‐score reading time</p> <p>Data indicate <emph>z</emph> scores (and SDs) based on normalisation data at the various grade levels (Sartori <emph>et al</emph>. [<reflink idref="bib32" id="ref73">32</reflink>]).</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Word</th><th align="center">Pseudo‐word</th><th align="center">Word</th><th align="center">Pseudo‐word</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>−1.74</td><td>3.20</td><td>−0.33</td><td>1.00</td><td>−0.55</td><td>0.86</td><td>0.03</td><td>0.68</td></tr><tr><td>Third grade</td><td>−2.18</td><td>2.80</td><td>−1.03</td><td>1.90</td><td>−1.42</td><td>1.83</td><td>−0.67</td><td>1.54</td></tr><tr><td>Fourth grade</td><td>−1.20</td><td>2.00</td><td>−0.50</td><td>1.70</td><td>−2.38</td><td>3.22</td><td>−1.23</td><td>2.18</td></tr><tr><td>Fifth grade</td><td>−1.60</td><td>2.10</td><td>−0.40</td><td>1.00</td><td>−2.72</td><td>4.33</td><td>−1.36</td><td>2.66</td></tr><tr><td>Sixth grade</td><td>−1.80</td><td>1.90</td><td>−0.50</td><td>1.20</td><td>−2.99</td><td>1.93</td><td>−1.37</td><td>1.24</td></tr><tr><td>Seventh grade</td><td>−2.40</td><td>3.90</td><td>−1.30</td><td>2.90</td><td>−4.61</td><td>4.71</td><td>−2.97</td><td>3.09</td></tr><tr><td>Eighth grade</td><td>−2.10</td><td>1.80</td><td>−1.10</td><td>1.80</td><td>−3.82</td><td>5.06</td><td>−1.74</td><td>2.51</td></tr></tbody></table> </ephtml> </p> <p>2 Appendix</p> <p>Mean (and SDs) raw scores from reading tests. Data are presented for the subgroups of children with BIF and MID separately at the different grade levels.</p> <p>MT Reading test: accuracy in text reading</p> <p>Data indicate mean (and SDs) errors at the various grade levels. For the scoring procedure, see the main text. Note that different texts are presented at different grade levels.</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>8.08</td><td>10.00</td><td>7.77</td><td>7.33</td></tr><tr><td>Third grade</td><td>10.73</td><td>9.24</td><td>5.63</td><td>5.25</td></tr><tr><td>Fourth grade</td><td>5.89</td><td>3.64</td><td>8.39</td><td>10.44</td></tr><tr><td>Fifth grade</td><td>5.13</td><td>4.47</td><td>8.70</td><td>8.49</td></tr><tr><td>Sixth grade</td><td>8.86</td><td>5.96</td><td>12.21</td><td>10.43</td></tr><tr><td>Seventh grade</td><td>4.00</td><td>6.16</td><td>12.84</td><td>12.96</td></tr><tr><td>Eighth grade</td><td>3.17</td><td>3.24</td><td>11.59</td><td>12.12</td></tr></tbody></table> </ephtml> </p> <p>MT Reading test: speed in text reading</p> <p>Data indicate mean (and SDs) reading times (in seconds per word) at the various grade levels. Note that different texts are presented at different grade levels.</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>0.89</td><td>0.33</td><td>0.80</td><td>0.21</td></tr><tr><td>Third grade</td><td>0.60</td><td>0.18</td><td>0.61</td><td>0.18</td></tr><tr><td>Fourth grade</td><td>0.51</td><td>0.20</td><td>0.55</td><td>0.27</td></tr><tr><td>Fifth grade</td><td>0.42</td><td>0.14</td><td>0.48</td><td>0.25</td></tr><tr><td>Sixth grade</td><td>0.40</td><td>0.14</td><td>0.44</td><td>0.16</td></tr><tr><td>Seventh grade</td><td>0.36</td><td>0.26</td><td>0.41</td><td>0.16</td></tr><tr><td>Eighth grade</td><td>0.29</td><td>0.09</td><td>0.38</td><td>0.20</td></tr></tbody></table> </ephtml> </p> <p>MT Reading test: reading comprehension</p> <p>Data indicate mean (and SDs) correct responses at the various grade levels. Different texts are presented at different grade levels.</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>5.83</td><td>1.80</td><td>5.75</td><td>2.26</td></tr><tr><td>Third grade</td><td>4.53</td><td>2.24</td><td>3.56</td><td>1.98</td></tr><tr><td>Fourth grade</td><td>4.30</td><td>1.89</td><td>4.81</td><td>2.20</td></tr><tr><td>Fifth grade</td><td>4.50</td><td>1.65</td><td>4.17</td><td>1.76</td></tr><tr><td>Sixth grade</td><td>4.57</td><td>2.28</td><td>4.27</td><td>1.82</td></tr><tr><td>Seventh grade</td><td>3.30</td><td>1.83</td><td>3.90</td><td>2.34</td></tr><tr><td>Eighth grade</td><td>4.23</td><td>1.83</td><td>4.39</td><td>2.35</td></tr></tbody></table> </ephtml> </p> <p>Word and Pseudo‐word Reading subtests: accuracy</p> <p>Data indicate mean (and SDs) percentage of errors at the various grade levels.</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Word</th><th align="center">Pseudo‐word</th><th align="center">Word</th><th align="center">Pseudo‐word</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>11.68</td><td>8.35</td><td>17.71</td><td>9.63</td><td>12.98</td><td>10.66</td><td>18.59</td><td>12.74</td></tr><tr><td>Third grade</td><td>12.97</td><td>8.33</td><td>23.90</td><td>19.70</td><td>9.95</td><td>11.77</td><td>16.57</td><td>15.46</td></tr><tr><td>Fourth grade</td><td>7.10</td><td>6.73</td><td>20.52</td><td>15.86</td><td>8.23</td><td>7.04</td><td>19.87</td><td>13.68</td></tr><tr><td>Fifth grade</td><td>5.95</td><td>5.24</td><td>14.70</td><td>12.35</td><td>8.13</td><td>9.56</td><td>17.16</td><td>18.89</td></tr><tr><td>Sixth grade</td><td>5.55</td><td>6.08</td><td>12.95</td><td>10.05</td><td>5.72</td><td>6.31</td><td>16.51</td><td>12.15</td></tr><tr><td>Seventh grade</td><td>5.28</td><td>9.27</td><td>12.85</td><td>13.47</td><td>6.57</td><td>7.66</td><td>17.23</td><td>14.06</td></tr><tr><td>Eighth grade</td><td>1.37</td><td>1.57</td><td>6.25</td><td>6.13</td><td>5.50</td><td>6.82</td><td>13.71</td><td>13.67</td></tr></tbody></table> </ephtml> </p> <p>Word and Pseudo‐word Reading subtests: reading time</p> <p>Data indicate mean (and SDs) reading times (in seconds per stimulus) at the various grade levels.</p> <p></p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center">Children with BIF</th><th align="center">Children with MID</th></tr><tr><th align="center">Word</th><th align="center">Pseudo‐word</th><th align="center">Word</th><th align="center">Pseudo‐word</th></tr><tr><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Mean</th><th align="center">SD</th></tr></thead><tbody valign="top"><tr><td>Second grade</td><td>2.92</td><td>2.26</td><td>2.71</td><td>0.92</td><td>2.07</td><td>0.61</td><td>2.39</td><td>0.61</td></tr><tr><td>Third grade</td><td>2.23</td><td>1.24</td><td>2.73</td><td>1.20</td><td>1.90</td><td>0.80</td><td>2.49</td><td>1.00</td></tr><tr><td>Fourth grade</td><td>1.34</td><td>0.56</td><td>1.92</td><td>0.76</td><td>1.65</td><td>0.89</td><td>2.23</td><td>1.00</td></tr><tr><td>Fifth grade</td><td>1.23</td><td>0.52</td><td>1.62</td><td>0.46</td><td>1.46</td><td>1.06</td><td>2.00</td><td>1.19</td></tr><tr><td>Sixth grade</td><td>1.01</td><td>0.36</td><td>1.48</td><td>0.48</td><td>1.23</td><td>0.36</td><td>1.82</td><td>0.52</td></tr><tr><td>Seventh grade</td><td>0.94</td><td>0.55</td><td>1.45</td><td>0.83</td><td>1.26</td><td>0.67</td><td>1.93</td><td>0.90</td></tr><tr><td>Eighth grade</td><td>0.79</td><td>0.21</td><td>1.25</td><td>0.41</td><td>1.00</td><td>0.59</td><td>1.40</td><td>0.58</td></tr></tbody></table> </ephtml> </p> <ref id="AN0137586053-23"> <title> References </title> <blist> <bibl id="bib1" idref="ref2" type="bt">1</bibl> <bibtext> Allor J. 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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Reading Skills in Children with Mild to Borderline Intellectual Disability: A Cross-Sectional Study on Second to Eighth Graders
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Di+Blasi%2C+F%2E+D%2E%22">Di Blasi, F. D.</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-2958-2927">0000-0002-2958-2927</externalLink>)<br /><searchLink fieldCode="AR" term="%22Buono%2C+S%2E%22">Buono, S.</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-3786-3323">0000-0002-3786-3323</externalLink>)<br /><searchLink fieldCode="AR" term="%22Cantagallo%2C+C%2E%22">Cantagallo, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Di+Filippo%2C+G%2E%22">Di Filippo, G.</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-3470-7368">0000-0002-3470-7368</externalLink>)<br /><searchLink fieldCode="AR" term="%22Zoccolotti%2C+P%2E%22">Zoccolotti, P.</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6351-2455">0000-0002-6351-2455</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Intellectual+Disability+Research%22"><i>Journal of Intellectual Disability Research</i></searchLink>. Aug 2019 63(8):1023-1040.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Wiley-Blackwell. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8598; Fax: 781-388-8232; e-mail: cs-journals@wiley.com; Web site: http://www.wiley.com/WileyCDA
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 18
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2019
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Elementary+Education%22">Elementary Education</searchLink><br /><searchLink fieldCode="EL" term="%22Secondary+Education%22">Secondary Education</searchLink><br /><searchLink fieldCode="EL" term="%22Early+Childhood+Education%22">Early Childhood Education</searchLink><br /><searchLink fieldCode="EL" term="%22Grade+2%22">Grade 2</searchLink><br /><searchLink fieldCode="EL" term="%22Primary+Education%22">Primary Education</searchLink><br /><searchLink fieldCode="EL" term="%22Grade+3%22">Grade 3</searchLink><br /><searchLink fieldCode="EL" term="%22Grade+4%22">Grade 4</searchLink><br /><searchLink fieldCode="EL" term="%22Intermediate+Grades%22">Intermediate Grades</searchLink><br /><searchLink fieldCode="EL" term="%22Grade+5%22">Grade 5</searchLink><br /><searchLink fieldCode="EL" term="%22Middle+Schools%22">Middle Schools</searchLink><br /><searchLink fieldCode="EL" term="%22Grade+6%22">Grade 6</searchLink><br /><searchLink fieldCode="EL" term="%22Grade+7%22">Grade 7</searchLink><br /><searchLink fieldCode="EL" term="%22Junior+High+Schools%22">Junior High Schools</searchLink><br /><searchLink fieldCode="EL" term="%22Grade+8%22">Grade 8</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Reading+Skills%22">Reading Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Mild+Intellectual+Disability%22">Mild Intellectual Disability</searchLink><br /><searchLink fieldCode="DE" term="%22Elementary+School+Students%22">Elementary School Students</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+School+Students%22">Secondary School Students</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Slow+Learners%22">Slow Learners</searchLink><br /><searchLink fieldCode="DE" term="%22Reading+Fluency%22">Reading Fluency</searchLink><br /><searchLink fieldCode="DE" term="%22Reading+Comprehension%22">Reading Comprehension</searchLink><br /><searchLink fieldCode="DE" term="%22Reading+Tests%22">Reading Tests</searchLink><br /><searchLink fieldCode="DE" term="%22Reading+Rate%22">Reading Rate</searchLink><br /><searchLink fieldCode="DE" term="%22Accuracy%22">Accuracy</searchLink><br /><searchLink fieldCode="DE" term="%22Instructional+Program+Divisions%22">Instructional Program Divisions</searchLink><br /><searchLink fieldCode="DE" term="%22Reading+Difficulties%22">Reading Difficulties</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Italy%22">Italy</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/jir.12620
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0964-2633
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Students with intellectual disabilities (IDs) have various learning difficulties and are at risk for school failure. Large inter-individual differences are described for reading, but it is unclear how these vary as a function of grade. The aim of this study was to examine various reading fluency, accuracy and comprehension parameters in second-to-eighth-grade Italian children with either borderline intellectual functioning (BIF) or mild ID (MID). Methods: We examined 106 children with BIF (67 M and 39 F) and 168 children with MID (107 M and 61 F). The children were in the second to eighth grade and were comparable for chronological age (7 to 14 years). They were administered a battery of tests that assessed fluency and accuracy of word, pseudo-word and text reading, as well as text comprehension. Standardised scores allowed us to compare the performance of the two groups with normative values. Results: Children with ID obtained generally low scores compared with normative values. Those with MID had greater difficulty than those with BIF. Furthermore, difficulty was greater for speed than for accuracy measures and for words than for pseudo-words. Difficulty (particularly in the case of reading speed) tended to be pronounced at later grades. Marked individual differences were present independently of MID-BIF subgrouping, as well as stimulus category and reading parameter. Conclusions: As a group, children with ID showed difficulty in reading acquisition; the effect was greater for children with more severe ID, but large individual differences were observed in children with both BIF and MID. Relatively spared pseudo-word reading skills indicate efficient use of the grapheme-to-phoneme conversion routine. This processing mode may prove more ineffective at higher levels of schooling when even in regular orthographies such as Italian typically developing children rely on lexical activation.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2019
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1222334
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1222334
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/jir.12620
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 18
        StartPage: 1023
    Subjects:
      – SubjectFull: Reading Skills
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Mild Intellectual Disability
        Type: general
      – SubjectFull: Elementary School Students
        Type: general
      – SubjectFull: Secondary School Students
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Slow Learners
        Type: general
      – SubjectFull: Reading Fluency
        Type: general
      – SubjectFull: Reading Comprehension
        Type: general
      – SubjectFull: Reading Tests
        Type: general
      – SubjectFull: Reading Rate
        Type: general
      – SubjectFull: Accuracy
        Type: general
      – SubjectFull: Instructional Program Divisions
        Type: general
      – SubjectFull: Reading Difficulties
        Type: general
      – SubjectFull: Italy
        Type: general
    Titles:
      – TitleFull: Reading Skills in Children with Mild to Borderline Intellectual Disability: A Cross-Sectional Study on Second to Eighth Graders
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            NameFull: Buono, S.
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            NameFull: Cantagallo, C.
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            NameFull: Di Filippo, G.
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            NameFull: Zoccolotti, P.
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