بررسی اثربخشی الگوی پاسخ-به-مداخله در پیشگیری از بیش‌تشخیصی اختلال خواندن

زمینه و هدف: رویکرد پاسخ-به-مداخله، در تلاش برای پیشگیری از بیش‌تشخیصی و برچسب‌زنی اختلال‌های یادگیری به‌ویژه اختلال خواندن طراحی شده است. این پژوهش با هدف بررسی اثربخشی برنامهٔ آموزشی مبتنی‌بر الگوی پاسخ-به-مداخله در پیشگیری از بیش‌تشخیصی اختلال خواندن انجام شد.روش‌بررسی: پژوهش حاضر طرح تک‌آزمودنی ab بود. جامعهٔ آماری را دانش‌آموزان دختر و پسر پایهٔ سوم دبستان‌های دولتی ناحیهٔ سه شهرستان کرج در سال تحصیلی 95-1394 تشکیل دادند. روش نمونه‌گیری هدفمند بود. گروه نمونه (سیزده دختر و هفت پسر) در طرح تک‌آزمودنی ab شرکت کردند. ابزارهای استفاده‌شده، چک‌لیست محقق‌ساختۀ مهارت‌های خواندن، آزمون‌ تشخیصی خواندن (شیرازی و نیلی‌پور، 1384)، آزمون آگاهی واج‌شناختی (سلیمانی و دستجردی کاظمی، 1384)، مقیاس تجدیدنظرشدۀ هوش وکسلر-4 (وکسلر، 2003) و آزمون‌های غیررسمی خواندن (امین‌آبادی و همکاران، 1395) بود. داده‌ها با آزمون نسبت داده‌های غیرهمپوش در سطح معنا‌داری 0٫05 در نرم‌افزار spss تحلیل شد. یافته‌ها: نتایج نشان داد، 55درصد از آزمودنی‌ها با آموزش‌های ردیف اول، 10درصد با آموزش‌های ردیف دوم و 15درصد با آموزش‌های ردیف سوم مداخله به نمرهٔ پذیرفتنی رسیدند و 20درصد نیز پاسخ-به-مداخله نداشتند؛ بنابراین نتایج اثربخشی به این ‌صورت بود: برنامهٔ آموزشی مبتنی‌بر پاسخ-به-مداخله، توان کاهش گروهی از دانش‌آموزان با تشخیص اختلال خواندن را داشت؛ برنامه در بهبود مهارت خواندن موثر بود؛ الگوی کلی حذف برنامه در ردیف‌های مداخله تکرار نشد؛ برنامهٔ آموزشی مبتنی‌بر پاسخ-به-مداخلهٔ خواندن توان تشخیص اختلال خواندن را داشت. نتیجه‌گیری: براساس یافته‌های پژوهش نتیجه گرفته می‌شود که برنامهٔ آموزشی مبتنی‌بر الگوی پاسخ-به-مداخله حداقل برای گروهی از دانش‌آموزان با ضعف خواندن موثر است؛ بنابراین می‌توان آن را به‌منظور کاهش ضعف خواندن دانش‌آموزان و درنتیجه برای پیشگیری از بیش‌تشخیصی آن‌ها به‌عنوان دانش‌آموز دارای اختلال خواندن استفاده کرد.

effectiveness of response to intervention model in preventing overdiagnosis of reading disorder

background & objectives: most students with learning disabilities usually receive unfair labels from teachers, family, and classmates, but sometimes this labeling is done by experts and specialists, which has more destructive effects. certainly, labeling has consequences, but if this labeling results from over–recognition, it will have more irreparable damages. therefore, it is essential to prevent overdiagnosis and, consequently labeling. the consequences of diagnostic errors ranges from adopting the wrong treatment and intervention strategies to the psychological damages caused by such diagnoses. learning disabilities, especially in reading task, are called dyslexia or reading disorders. thus, the formation of a diagnostic response to intervention (rti) model in diagnosing learning disabilities that can distinguish the reading disorder from neurodevelopmental impairment and other types of reading challenges is vital. this study aims to prevent overdiagnosis of disorders. learning and avoiding labeling were based on outward signs. we intended to study the effectiveness of the rti–based training program to prevent the overdiagnosis of reading disorders.methods: the present study has a single–case ab design. the statistical population included the third–grade boy and girl students in district 3 of karaj city, iran in the academic year of 2015–16. via purposive sampling method, among the 110 eligible students screened through a researcher–made checklist, 39 suspected cases of having difficulty reading were selected. after applying the inclusion criteria, 20 students (13 girls and 7 boys) were selected and entered the study. the inclusion criteria were receiving a permit to attend public education schools in the assessment upon entering elementary school and not receiving appropriate interventions for reading disorders before entering the program or during it. the exclusion criteria were the absence of more than three sessions from the intervention or simultaneous receiving of intervention from a private teacher or learning disorder therapist. in this research, these tools were used to collect data: a researcher–made checklist of reading skills, diagnostic reading test (shirazi & nili pour, 2004), phonological awareness test (soleimani & dastjerdi kazemi, 2005), wechsler intelligence scale–fourth edition (wisc–iv) (wechsler, 2003) and unformal reading test (aminabadi et al., 2017). the interventions were carried out based on the reading program of the rti approach (johnson et al., 2006). this program was implemented in three rows of 30–, 45– and 60–minute interventions for groups of 4 to 7, 2 to 4, and only 1 participant(s). each row consisted of 9, 9, and 12 sessions, respectively. three sessions were held every week for the participants in schools, and the sessions for last row were held in the clinic. data were analyzed by a non–overlapping data ratio test at a significance level of 0.05.results: this study results showed that 55% of subjects achieved acceptable scores with the first row training intervention, 10% with the second row, 15% with the third row intervention, and 20% did not respond to the intervention. therefore, effective results showed that the training program based on the rti could reduce a group of students by diagnosing the reading disorder. also, the program was effective in improving reading skills. the general pattern of program deletion was not repeated in the intervention rows. finally, the program could detect reading disorders.conclusion: based on the research findings, the training program based on the rti model is effective, at least for a group of students with poor reading skills. thus, it can be used to reduce students’ poor reading skills and to prevent their overdiagnosis as students with reading disorders.