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. 2018 Nov 14;2018(11):CD009115. doi: 10.1002/14651858.CD009115.pub3

Blythe 2006.

Methods Randomised controlled trial
1 intervention group (phonics + phonological awareness) and 1 control group (untrained)
Participants Location/setting: medium‐sized private primary school in Western Sydney, Australia
Criteria: received weekly group‐based remedial reading instruction at the school and referred to the study by a support teacher.
Recruits: the participants had no other comorbid specific learning disorders. They had a mean delay of 13 months on a word reading task (subtest on WIAT‐II); 11 months on a reading comprehension task (subtest on WIAT‐II), and 25 months on a pseudoword decoding task (subtest on WIAT‐II). Participants had a mean FSIQ of 100.15 (SD 9.38).
Sex: 15 males; 5 females
Mean age: 101.35 months (SD 17.58 months; range not reported)
Ethnicity: not reported
Sample size: 20 English‐speaking dyslexic primary students
Allocation: random allocation
Intervention group: n = 10 (mean age 99.8 months; SD 18.94; range not reported)
Control group: n = 10 (mean age 102.9 months; SD 16.98; range not reported)
Interventions Intervention:Phonics Alive! 2: The Sound Blender (version 1.2): 10‐week training programme. "Program consists of 12 modules which systematically build skills in phoneme awareness, phoneme‐grapheme correspondences, sound and letter blending, and speed of processing" (quote, p 41)
Control: students continued to receive their school‐based reading instruction (both in‐class and at a weekly remedial group with the support teacher).
Procedure: children in the intervention group continued their school‐based instruction while they did their training at home and at school on a computer. At home, each training module took approximately 15 minutes to complete. Students were instructed to repeat each module until they reached a mastery level of 90% correct. Upon mastery of a module, students had to complete review worksheets. According to parents, a mean of 3.6 computer modules were attempted per child per week. "Thus, over the 10‐week training period, students completed a mean of 46 module attempts which represented approximately 11.5 hours of on‐computer time" (quote) (in addition to 30 minutes/week with researcher: 5 hours). At school, children did "a weekly, 30 minute, one‐on‐one session with the researcher where the student's progress was assessed by reviewing their progress chart and completed worksheets (5 minutes) and completing the current module on a computer (to verify mastery)." (quote) Any remaining time was spent playing a "nonsense word game" (quote) (p 41).
Outcomes Time of post‐test: immediately after training completed
Primary outcomes: non‐word reading accuracy (WIAT‐II: Pseudoword Decoding subtest), regular and irregular word reading accuracy (WIAT‐II: Word Reading subtest) and reading comprehension (WIAT‐II subtest)
Notes Contacted author for post‐test SDs
Study start and end dates: not reported
Funding: not reported
Potential/declared conflicts of interest: none reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote from publication: "participants were randomly assigned to either a control or treatment condition" (p 41).
Quote from personal communication: "participants who met selection criteria were randomly assigned to either the Tx [treatment] or Ct [control] condition by drawing eligible names from a hat and placing sequentially into Tx/Ct until all were assigned."
Allocation concealment (selection bias) Low risk Comment: could not foresee assignment due to central allocation of participants to groups.
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk Quote from personal communication: "given this was a simple Tx/Ct [treatment/control] design there was no way to blind study participants or personnel from knowledge of who was in the treatment group. However, the trainer had no previous knowledge or awareness of the participants and was not involved in the referral process (they were referred by the school counsellor)."
Comment: participants were children with little understanding of reading treatment techniques and hence were unlikely to understand allocation.
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Quote from personal communication: "Initial assessment of IQ and reading was conducted by the investigator on all participants PRIOR to their random assignment to Tx [treatment] or Ct [control] conditions, and thus the assessor was unaware of their future status in the study. Given this was a pilot study, post‐treatment assessment was conducted by the same assessor on all students and this precluded the assessor conducting blind post‐treatment assessments."
Comment: study used objective tests of literacy‐related skills that are designed to avoid assessor bias.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Comment: DF values indicated that data for all randomised participants were included in the analyses. Author sent post‐test SD.
Selective reporting (reporting bias) Unclear risk Comment: data reported for all reading tests listed in methods; adequate detail for data to be included in analysis.
Other bias Low risk Comment: none apparent