McArthur 2015a.
Methods | Quasi‐randomised controlled trial 3 treatment groups (phonics, sight words (not relevant), mixed (not relevant)) and 3 control groups (no‐training double‐baseline period for phonics group, sight words (not relevant), mixed (not relevant)) |
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Participants |
Location/setting: Sydney, Australia Criteria: scored below the mean range for their age (i.e. had a Z score lower than –1) on the CC2 irregular‐word reading test or non‐word reading test. No history of neurological or sensory impairment as indicated on a background questionnaire. Used English as their primary language at school and at home. Recruits: full study included 141 dyslexic children recruited from schools, clinics, and newspaper advertisements. This review included the 39 participants who completed 8 weeks of no training (control) and then 8 weeks of pure phonics training (intervention). Sex: 63.8% male; 36.2% female Mean age: 9.42 years (SD 1.71; range 7–12 years) Ethnicity: not reported Sample size: 39 dyslexic children Allocation: quasi‐randomised allocation procedure. Full study had 3 recruitment periods. 3 groups were recruited in each recruitment period. The children included in this review were recruited in the first recruitment period (months 1–6). The other children, recruited for the 2nd and 3rd groups in 2nd and 3rd periods, were not included in this review since they did a mixture of phonics + sight word training). A between‐groups ANOVA established that the groups did not differ in reading ability or age prior to training. Intervention groups:
Control groups:
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Interventions |
Interventions:
Controls:
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Outcomes |
Time of post‐test: immediately after no‐training period (control) and then immediately after 8 weeks of phonics training (experimental) Primary outcomes: trained and untrained irregular word reading accuracy and non‐word reading accuracy Secondary outcomes: word and non‐word reading fluency and reading comprehension Relevant measures: non‐word accuracy (experimental: 20 untrained non‐words printed on flashcards), irregular words (trained) accuracy (experimental: 30 flashcards), irregular words (untrained) accuracy (experimental: 30 flashcards), non‐word fluency (TOWRE: Non‐word subtest), mixed/regular word fluency (TOWRE: Sight Word subtest), reading comprehension (Test of Everyday Reading Comprehension) |
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Notes |
Study start and end dates: not reported Funding: "This research was funded by NHMRC Project 488518 and ARC DP0879556" (quote, p 406). Declared/potential conflict of interest: "no potential conflicts of interest with respect to the research, authorship, and/or publication of this article" (quote, p 406). |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk |
Comment: as noted in the study, this was a quasi‐randomised controlled trial. Quote from publication: "There is good evidence that this quasi‐randomised allocation procedure did not bias the outcomes of this study. First, the groups were very well matched prior to training (see Table 1). Second, for all bar one outcome, groups made similar gains after 16 weeks of training, indicating that allocation did not produce any group that was unusually responsive or unresponsive to treatment. Third, for the exceptional outcome, the group difference was in the predicted direction, indicating that superior group performance was a result of a genuine experimental effect rather than a group allocation effect. Fourth, this study was designed so that there could be no possible bias between allocation to intervention and control groups since each individual participated in both control and intervention periods, and any gains in the control period were controlled for in the intervention period statistically (i.e. we used a double‐baseline design that gauged the effect of no training in each and every participant before they did training)" (p 398). |
Allocation concealment (selection bias) | Low risk | Quote from publication: "Each recruitment period had a fixed start date and an end date. Children were allocated to their group according to when they were recruited for the study. Since children could be allocated to only one group, it is highly unlikely that lack of allocation concealment introduced bias into the study" (pp 398–9). |
Blinding of participants and personnel (performance bias) All outcomes | Low risk |
Quotes from publication: "Unlike drug trials, cognitive treatment trials find it difficult to guarantee double blinding because the type of training cannot be completely concealed from a volunteer. However, neither parents nor children were told their group allocation, and it is highly unlikely that they had the expertise to ascertain the type of training that they were receiving (i.e. they were blind to group allocation). Furthermore, all children received exactly the same type of training in this study. The only difference was the order in which they did the training. This would further obscure group allocation to children and their parents" (p 399). "...we employed four casual testers to help two principal testers. With careful planning, we ensured that no tester assessed the same child twice, and no tester was aware of the child's group allocation (i.e. the tester was blind to group allocation)" (p 399). |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote from publication: "...we employed four casual testers to help two principal testers. With careful planning, we ensured that no tester assessed the same child twice, and no tester was aware of the child's group allocation (i.e. the tester was blind to group allocation)" (p 399). |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Comment: 37 participants dropped out in total (26%). There were similar numbers in each group, and reasons for dropout were random. This is similar to McArthur 2015b, which used almost identical methods. This suggests that attrition was not unusual for reading training studies of this type, and is similar to mean attrition rates for cognitive behavioural interventions done with children with clinical problems (Karlson 2009). |
Selective reporting (reporting bias) | Unclear risk | Comment: data reported for all outcome measures outlined in methods; adequate detail for data to be included in analysis. |
Other bias | Low risk | Comment: none apparent |