Title: How much does Assistive Technology (screenreaders) help people with visual impairements?

Abstract: This paper is about using the Three Cueing System Theory to explain why phonetics is important to reading and listening comprehension. A controlled experiment is performed to determine whether phonetics or word meaning is more important to a developing readers stage of development. Research is performed in Hawaii using the Stanford Achievement Test Edition 9 for the reading tasks. Motivated Strategies for Learning Questionnaire (MSLQ) is used to control the reading task on motivation. The experimental group uses screen reading software to assist them in performing the reading tasks. The two population groups tested are visually impaired participants who determine whether using a screen reader assistive technology improves significantly independent living with significantly higher scores on the Stanford Achievement Test.

Word Count: 5,451

Keywords: Three Cueing System Theory, Readers Stages of Development, Screenreader, Reading Comprehension, Stanford Achievement Test, Motivated Strategies for Learning Questionnaire, disability studies, visual impairments.

Introduction: Twenty-three percent (800,000) of enrolled 17-year-olds read below basic levels, meaning they cannot search for information, understand informational passages, or extend ideas in texts. This does not count the estimated 1.4 million youth that drop out between 9th and 12th grade (Department of Education, MARCH 2002). Better readers need to be educated earlier. There are reader development stages that can be studied so action must be taken to reverse this trend. Stages of reader development will be discussed with an emphasis on the developing reader stage that is the subject of study for this controlled experiment. The Three Cueing System Theory will explain how the developing reader receives and uses semantic, syntactic, graphophonic cues. The graphophonic cues are used only to confirm predictions about semantic and syntactic cues (Wren, 2001).
Semantic, syntactic, graphophonic cues are present while reading silently and when these young readers are reading aloud. Since there are more cues in speech then in the equivalent text (Adams, 1998), this research paper will show if children's understanding of spoken text is better then their understanding of written text. Measurements of reading vocabulary might explain children's spoken vocabulary. Three hypotheses will investigate whether there is a difference between reading and listening vocabulary, sentence reading, and passage comprehension using a sample population of visually impaired readers in Hawaii to study the reading process in developing readers. Two measuring instruments are used for data analysis. The Stanford Achievement Test Edition 9 is administered to a group of students, each on a computer. The visually impaired group will be accommodated with Braille keyboards. The test involves three reading tasks given on vocabulary, sentence reading, and reading comprehension to be completed in the allotted time. The Motivated Strategies for Learning Questionnaire (MSLQ) is used to control for reader motivation during the reading task. Most students reading achievement can be predicted by reader motivation (Kamil, Mosenthal, Pearson, & Barr, 1991). The experimental group given auditory cues uses a screen reader. The sample population will be taken from second graders who are in the second stage of the stages of reader development.

Stages of Reader Development: There is a normal progression of a reader as they start from an emergent reader to eventually become a critical reader (Kamil, Mosenthal, Pearson, & Barr, 1984). A reader becomes a critical reader as they transition from an emerging reader to a developing reader and then to an independent reader usually in 6th grade. The transition from an independent reader to a developing critical reader occurs by 9th grade and a critical reader is the expected result of a high school education. At each stage of reader development there is a transition that marks the readers passage into the next stage of development. Figure 1 shows reader progression from Kindergarten to 12th grade.

Figure 1

· Stage 0: Pre-reader is when children gain control over language and pretends to read. The readers experiences develop in this stage that lasts until about age five. (Whyte, 1982)
· Stage 1: Emergent readers begin the initial reading or decoding stage that occurs in grades Kindergarten and 1. During this stage the child begins to associate sounds and symbols. The reader brings more to the print than he takes from it. In other words, he is learning to read, learning to decode and to make sense of writing. This stage is sometimes called barking at print or grunting and groaning. Reading is not smooth and may not even be easy to listen to. (Donoghue, 2000).
· Stage 2: Developing readers are in grades 2 through 5 when they gain fluency, decoding skills, and read predictable books. During this and the prior stage, children are learning to relate print to speech, not print to ideas. Adult illiterates (adults who can not read) are often stalled at this stage of reading (Donoghue, 2000). Developing readers begin to apply reading strategies (sentence structure, meaning, phonetic clues), rely on print more than illustrations to create meaning, understand basic punctuation such as periods, exclamations, and question marks. (Guthrie, McGough, Bennett, & Rice, 1996). Later they use a variety of decoding strategies independently (sentence structure, meaning, phonetic clues).
· Stage 3: Independent Readers read to learn between sixth through eighth grades. Before this stage, they learn to read. The task for them is to master ideas in this stage. Ideas are usually presented from just one point of view in this stage. Their increased knowledge of literary elements and genres may allow them to describe character's traits and growth over time, understand the importance of the setting and plot in a story, and compare and contrast books. (Hurst, Wilson, Camp, Cramer, 2002).
· Stage 4: Developing critical readers occur during junior high school at about ages 14-15. The primary characteristic of this stage is that it involves more than one viewpoint. Readers develop the ability to deal with layers of facts and concepts that are added onto those acquired in earlier stages. They can deal with more complex issues and topics. They move between genres with ease, although they may have strong preferences, can interpret sophisticated meaning, can become deeply involved in complex literary discussions through literature circles and can plan appropriate strategies for conducting information searches as they integrate information from various resource materials.
· Stage 5: Critical Readers develop just before college when readers are 17 years old and older. In this stage the reader knows he needs a purpose for his reading. Because his purposes may vary, he may start at the beginning, middle, or end of a chapter or book. The reader who has reached the final stage knows what not to read as well as what to read. The reader understands the qualitativeness of knowledge at this stage, that things are not all black or white, that there are grays and uncertainties. (Flynn, 1989).
It is important to have some understanding of these stages because children do not move through a stage until they have passed through the prior stages. The implication is that children's reading may be difficult to listen to in stages 1 and 2. In these stages, the child is more concerned with saying the words than he is with what the words mean. Then as the child moves through the next stage of reading, he gains fluency with lots of practice reading predictable books, and he can apply decoding skills. Knowing about these stages of reading should help understand what to expect of children as they are reading. Saying the words is the first concern and gaining understanding of the message is secondary to the developing reader. Their focus will be on the print. They have just so much attention to devote to the act of reading and so, after struggling to identify words, there is little attention left for understanding what they read in the early stages of reading.

Developing Readers: This research will study developing readers. A developing reader is one who cannot yet read and understand quickly and easily what he or she is reading. Some characteristics of a developing reader include: Does not always understand what he or she reads, does not pay attention to meaning, finds reading difficult, has difficulty reading long words with several syllables, often self-corrects and repeats, reads slowly, reads without expression or proper intonation, reads word-by-word and does not usually make natural phrase and clause breaks and sounds out new words syllable-by-syllable.
This sounding out action is phonics (Lundberg, Frost, & Petersen, 1988). Phonics deals with letter-sound relationships or correspondences. Phonics is part of word recognition and should be used with other word recognition strategies. Phonics is a pronunciation strategy, must be taught in conjunction with meaning, and is just one part of the reading process. Phonics often gives only an approximation of the word's pronunciation. It deals with generalizations rather than rules because the term rule implies great consistency. For developing readers, it's best to begin with words that have a single speech sound associated with each letter and books that follow the developmental sequence of basic phonics. A basic approach to phonics is to be awhare of consonants, vowels, and word families. (Stanovich, 1993).

· Consonants can be initial consonants (at the beginning of words), final consonants (At the end of words), consonant blends (At the beginning and end of words. (Uhry, & Shepherd, 1993).
· Vowels can be short vowel sounds These are usually in words in which there is one vowel and a consonant is at the end of the word or syllable, such as sat; get; pin; pot; but. Long vowel sounds are usually in words in which there is one vowel and the vowel is at the end of the word, such as go; no; so.
· Phonics should stress word families, such as, at, et, an, en, ig (word families begin with vowels) and the rhyming words associated with them (i.e. at, bat, cat, fat, hat, mat, pat, sat, rat. Beginning phonics depends on two things: a child's ability to discriminate sounds (auditory discrimination), and letters (visual discrimination) (Smith, 1975). Children must be able to hear similarities and differences between sounds, and they must be able to see similarities and differences between written symbols (i.e. b p d). Once children have mastered letters, their sounds and shapes, they move onto first-reader books that have sentences and small paragraphs in them. Children with dyslexia have difficulty with word families (Rack, Snowling, & Olson, 1992) (Perfetti, 1985) (Liberman, & Liberman, 1990).
Phonic cues are used as part of the learning strategies for many developing readers. Because developing readers use speech when reading books aloud in school, students learn how to use many reading and auditory cues. The main cues students' use can be found in the Three Cueing System theory. These cues can be used as a basis to measure reading and listening comprehension in developing readers.

Three Cueing System Theory: Three cues used in this system for meanings are semantic, syntactic and graphophonic cues. Semantic or meaning cues apply to background knowledge and the context of the sentence or passage to identify words. Graphophonic or visual/audio cues apply to what is known letter-sound correspondences to decode words. Syntactic or sentence structure cues apply to what is known about how our language goes together to identify words (Adams, 1998). Figure 2 displays the functional relationship.

Figure 2

Semantic Cueing System: Semantic cues refer to the meaning that has become associated with language through prior knowledge and experience. Semantic context consists of meaningful relations among words and ideas. Readers/viewers construct meaning when they relate the information in the text to what they know. When they use their background knowledge, meaning contained in illustrations, and meaning contained in the words and their relationships, they are making use of semantic cues. The key question readers/viewers ask when they are making use of semantic cues is, what would make sense? Self-correction when the text does not make sense is an indication of the children's level of appreciation for and effective use of meaning cues. Effective readers have extensive knowledge of a wide range of topics and related language. To build students' experiential and language base, and to encourage reading for meaning students must be helped to learn to use the semantic cueing system by teaching them to ask themselves as they read, what would make sense here? Did that make sense? (Adams, 1998).

Syntactic Cueing System: Syntactic cues refer to the structure of language or how language works. Readers who use information such as sentence structure, word order, function words, and word endings as they read are making use of syntactic cues. Self-correction of miscues that do not sound right (in terms of normal English sentence structure) provides evidence of the students' appreciation for and use of syntactic cues. It should be recognized, however, that English as a Second Language (ESL) students will bring a different experience and understanding to the phrase sounds right. To build children's knowledge of how language works, literature must be provided with repeated syntactic and semantic patterns, thus encouraging students to make predictions based on their knowledge of such patterns. This demonstrate through oral reading how to use syntactic cues to predict and recognize miscues (Model self-correcting because of these miscues. Have students listen for parts of the passage that don't sound right so that they can develop an awareness of what the term actually means) (Adams, 1998).
Good readers are able to decode words quickly and automatically without any dependence on semantic or syntactic cues, but poor readers struggle with each word and try to guess what each word is based upon its context. (Wren, 2001)

Graphophonic Cueing System: Graphophonic cues refer to knowledge about the sound-symbol system and how readers apply this knowledge as they read. This includes knowledge about directionality and spacing as students develop the concept of word and learn to track print. Effective readers develop generalizations about letter-sound relationships and integrate this knowledge with their use of the semantic and syntactic cueing systems. Phonological awareness is an understanding of the sound structure of language, which develops initially in oral language. (Adams, 1998).
Students with well-developed phonological awareness are then able to map their developing knowledge of sound and letter correspondence onto an underlying understanding of how language can be segmented and blended into its component parts. This would include an understanding of words, syllables, rhymes, and finally, individual sounds. There is a growing body of evidence suggesting a strong connection between students' phonological awareness and their reading development. Research shows that being able to segment and blend language is an essential skill if students are to be able to use graphophonic cues effectively in reading. Many children enter school with some phonological awareness. If they have had lots of experience with oral language, they are often able to detect words that rhyme or words that start with the same sound. Phonological awareness continues to develop as children learn to read. Their attempts at temporary spelling also support the development of phonological awareness as they segment the words they want to spell (Ball, & Blachman, 1991; Byrne, & Fielding-Barnsley, 1989 & 1991).
Research Question: Simple knowledge of the sounds of the words (the graphophonic cue) is insufficient on its own. It must be supplemented by knowledge of the meaning of the word (semantic cue) and how this is changed by its place in the sentence (syntactic cue) as well as practical knowledge and common sense (pragmatic cue) (Adams 1998). Since there are more cues in speech then in the equivalent text, is a visual impaired children's understanding of spoken text better then their understanding of written text? (Therefore measurements of reading vocabulary might explain visual impaired children's spoken vocabulary).

Research Question: Simple knowledge of the sounds of the words (the graphophonic cue) is insufficient on its own. It must be supplemented by knowledge of the meaning of the word (semantic cue) and how this is changed by its place in the sentence (syntactic cue) as well as practical knowledge and common sense (pragmatic cue) (Adams 1998). Since there are more cues in speech then in the equivalent text, is children's understanding of spoken text better then their understanding of written text? (Therefore measurements of reading vocabulary might explain children's spoken vocabulary).

Recient reviews ( i.e. Ayersman, 1996; Chen & Rada 1996; Cochran-Smith, 1991; Mayer 1997;Reinking, Labbo, & McKenna, 1997; Scott, Cole& Engle, 1992; US Congress, 1995; Flood, Health, & Lapp, 1997; Reinking et al, 1998; Rouet, Levonen, Dillon & Spiro, 1996, van Oostendorp & de Mul, 1996) provide a number of observations about the use of technologies to support literacy and learning. As newer technologies of information and communication continually appear, they raise concerns about generalizability of findings from earlier technologies (Kamil, Mosenthal, Pearson, & Barr, 2000). Studies with visually impaired readers have used repeated readings listening to tape recorded books and computer speech synthesis as early as 1989. With the advance of computing power and screen readers allowing multiculteral voice selections close to natural voice inflection makes findings of the past incompatable with technology use of today. In 2003 the most rescent research has been an ergonomic assessment of low vision & blind assistive technology. In 2002 there were a couple of usability studies about using a screenreader to search on the Internet with a finding that more websites need to be section 508 of the Rehabilitation Act complient (accessable to all). There are no studies focused specifically about using a screen reader for reading as a early intervension tool (visually impaired accomidation) for children who are developing readers.

Hypotheses: Each of the hypotheses controls for any systematic error by controlling for reader motivation that makes the controlled experiment more sensitive to reading and listening differences.
The first hypotheses will test vocabulary. Vocabulary is the basically all the words that the reader knows. Vocabulary includes synonyms, multiple meaning and context words.
H1n. Controlling for motivation, there will be no difference in reading and listening vocabulary.
H1a. Controlling for motivation, there will be an increase in listening vocabulary compared to reading vocabulary.

The second hypotheses will test sentence understanding. Sentence understanding is a reading process above vocabulary because it involves the semantic cues from the meaning of words as well syntactic cues from the surrounding words by the graphophonic cues that allow understanding of how language can be segmented and blended into its component parts. Sentence understanding tests have variously been called tests of recall vocabulary or of recognition vocabulary (Kamil, Mosenthal, Pearson, & Barr, 1991). The first mental requirement is to recognize the word and find its meaning in the lexical store. This is then put in working memory in order to perform a process involving the search and retrieval of other words that can adequately express this concept. Then there is a formulation process whereby the lexemes and grammatical information are selected for the appropriate register and so on. These are then sequenced and matched with sounds and intonation patterns and finally produced. The test involves recall and recognition but performance on the test is determined by much more than the retrieval of the item to working memory and the successful completion of the chain of events in output. The fact that a child can define the word corn as a noun does not prove that they can define it as a verb, and the fact that a child can give some definition of a word or can recognize a simple definition of a word does not show that he has thorough acquaintance with the word. Sentence understanding is concerned with meaning and the ability to define that meaning.
H2n. Controlling for motivation, there will be no difference in reading achievement.
H2a. Controlling for motivation, there will be an increase in listening sentence understanding compared to reading sentence understanding.

The third hypotheses will test passage understanding. Passage understanding is a reading process above sentence understanding because it involves the use of more graphophonic cues that allow understanding a whole paragraphs meaning. Reading comprehension checks for initial understanding (action, reason, sequence), interpretation (inference, external meaning), critical analysis and initial understanding of specific detail and strategies. The ability to define is thus a crucial factor as to whether a student can respond adequately. Additionally, responses to reading and listening comprehension tests assume that there is a rich store of synonyms or antonyms that can be readily brought to use to aid in the comprehension process. (Kamil, Mosenthal, Pearson, & Barr, 1991). Therefore a response to a reading and listening comprehension test is a test of the ability to explicit expresses one's knowledge of a given meaning rather than only of recognition or even recall.
H3n. Controlling for motivation, there will be no difference in reading and listening comprehension.
H3a. Controlling for motivation, there will be an increase in listening comprehension compared to reading comprehension.
Sample Population: A pooled sample 0f 2nd graders will be selected from all Hawaii State Department of Education (DOE) High Schools during the month June 2003 for the controlled experiment. The selected Elementary School standard scores can be compared to state standard scores and to the United States averages. Random assignment to the control group (s=30) and experimental group (s=30) will be done by using a random number generator with 2 class rosters once the school is selected.

Experimental Group Screen Reader Software: A screen reader is a computer program that will interpret computerized text or text that has been scanned from a printed page, and then generate a voice that will read the text aloud to the user This Assistive Technology enable the user to hear text on computer screen spoken aloud using a computer (synthesized) voice. Text readers are useful for many students with learning disabilities since they offer auditory feedback to a text environment. They are also used for those readers who have visual impairment and need to rely more on their other senses to be independent. Students who have an auditory strength can use their general language sensibility to catch errors in syntax and overall structure. For reading immense amounts of text, screen readers are clearly one of the most useful tools for students with learning disabilities. Visual impairments include low vision, color blindness, and blindness. People who are completely blind cannot use a computer monitor and must receive information from their computers via another sense - hearing or touch. People with low vision can also receive information through sound or touch, or they can modify their computer displays so the screen is more legible. i.e. using screen magnification and/or different color combinations. Section 504 of the Rehabilitation Act of 1973 and The Americans with Disabilities Act (ADA) of 1990 protect students with disabilities from discrimination that may occur as a result of misconceptions, attitudinal barriers, and/or failure of the institution to provide appropriate accommodations, auxiliary aids, or services. Assistive technology (i. e. screen readers) refers to equipment that helps break down the physical and programmatic barriers for people with disabilities. Typically, this includes software and equipment which interface with your computers to make them accessible.

Screen readers effect the reading process in the following ways: Decoding refers to the act of interpreting the sounds of the letters, combining these sounds into syllables and combining syllables to make recognizable words; Fluency refers to the speed and comfort with which one can recognize written language, including words and phrases that are automatically recognized by sight; Comprehension describes the act of connecting the meaning of the sentences and phrases one has decoded to meaningful concepts, images and ideas in the mind of the reader.
Figure 3 shows the controlled experiment. A 15-20 minute Motivated Strategies for Learning Questionnaire (MSLQ) will be will be give first, followed by a pretest. Afterward the experimental group will receive its treatment and then the posttest will be administered.
The experimental group will use an advanced computer assistive technology to support the reading process for developing readers. The experimental group will use a screen reader such as the JAWS software. JAWS is a commercially available off the shelf software normally used by people with visual impairment. There will be a 30-minute training period so that all students can use the software and feel comfortable doing so. Students will be walked through answering 2 test questions using the screenreader. During the controlled experiment, all students in the experimental group will use earphones so there will be no distractions to other students around them when the screenreader is being used. The screenreader can be used whenever the student needs to use it. Whenever the student uses the screen reader, its use will be recorded and linked to time used and questions used on.

Figure 3

Measuring Instruments:
1. Stanford Achievement Test Edition 9: This test alignment with state curriculums and frameworks, national standards and projects, and instructional methods. Outstanding reading selections written and illustrated exclusively by well-known authors and illustrators of children's and of young people's literature. Clear, simple directions assist in administration. Students get complete directions at the beginning of each sitting to avoid starts and stops that interrupt concentration. Performance on content clusters and process clusters. All possible precautions have been taken to avoid bias by doing a statistical analyses as well as review by a panel of prominent minority-group educators. Timed for normalized scores. Empirical normative information in national, catholic, private, urban, and high SES sets. Special screen reading procedures have been developed that allow for appropriate test level assignments. (Gregory, 2000) The measurements include:
o Reading vocabulary (Synonyms, multiple meaning, context).
o Sentence reading
o Reading comprehension (Initial understanding (action, reason, sequence), interpretation (inference, external meaning), critical analysis, initial understanding (specific detail) and strategies).

· Unlike other states, Hawaii is a single unified school district with a diverse school population. Approximately 12.9% of the students receive special education services. The Hawaii Department of Special Education mandates annual testing for public school students in grades 3, 6, 8, and 10. The Stanford Achievement Test (9th Edition) is used for large-scale assessment. A study of the 1995 data revealed that an average of 64% of students with disabilities were tested. "One of the major issues was establishing a norm group for students with disabilities that truly reflected the demographics, including culture, language, and ethnicity of Hawaii." Whereas students in Hawaii were found to represent some of the national norms, there were areas where students performed differently. Jenkins (A UH professor) recommends that other states that use standardized measurements establish norms for their own state, rather than rely exclusively on national norms. (Gronna, Jenkins, & Chin-Chance, 1998).

2. Motivated Strategies for Learning Questionnaire (MSLQ): (Pintrich, Smith, Garcia, & McKeachie, 1991) Three processes are measured, 15 min to complete, 7 point Likert scale:
o Planning activities help activate relevant aspects that make organizing and comprehending material easier.
o Monitoring activities assist in understanding and integrating the material.
o Regulating activities assist in checking and correcting learning behaviors. (Strongest predictors of success measured as a final achievement score).
· The three factors measured by this test include motivation, learning strategies, and resource management strategies.
o Motivation is measured by asking questions related to motivation, expectancy for success and test anxiety.
o Learning strategies are measured by asking questions related to rehearsal, elaboration, organization and metacognition.
o Resource management strategies are measured by asking questions related to self-effort and time and study place.
· The reliability and predictive validity of the Motivated Strategies for Learning Questionnaire (MSLQ) is proven successful in several studies (Pintrich, & Smith, 1993).
Once the data is collected on the computer with the Stanford Achievement Test Edition 9 pretest, posttest and MSLQ, the raw data files can be directly imported into SAS (Statistical Analysis Software) for a Multiple Analysis of Variance (MANOVA) and Multiple Analysis of Covariance (MANCOVA) to test hypotheses and control for motivation.
Data Analysis: Data analysis will be performed using SAS. A MANOVA will be used to compare reading comprehension, reading vocabulary, sentence reading. This tests H1, H2 & H3 by showing several criterion measures and their significant positive effects. It keeps a = .05 so there is no inflated overall type I error and checks correlation among variables via the covariance matrix. Small differences on the variables may combine to produce a reliable overall difference. A canceling out effect on reading achievement will be seen in subtest scores.
The manova phrase in PROC GLM in SAS results in several overall multivariate tests (Wilk's lambda, Pillai's trace, Hotelling-Lawley trace and Roy's greatest root), which, in different ways, reduce the three reading responses to one dimension. The printh option yields the hypothesis SS matrix for the factor (reading). The following is a list of some of the reported test statistics for MANOVA that will be used to analyze the Stanford Achievement Test scores :
· Wilks' Lambda = pooled ratio of error variances to effect variance plus error variance.
· Hotelling's trace = pooled ratio of effect variance to error variance.
· Pillai's criterion = pooled effect variances.
A MANCOVA will be performed to control for factors to increase the statistical power (sensitivity) of the design. Motivation can be controlled using a correlation coefficient derived from Motivated Strategies for Learning Questionnaire (MSLQ) to make the reading test scores more sensitive. Less motivated students may be better suited to not use a screen reader while more motivated students may do better using it for their reading scores which can be seen by checking for interaction effects. Posthoc contrast analysis tests using demographic data, can be done for a between group analysis (i.e. gender, culture, age, SES).

Limitations of Study: There are a few limitations to this study. The Stanford Achievement Test and MSLQ survey can only use the scores from those students whose parents consent by signing the releasing scores. The Stanford Achievement Test is a standardized test (academic task) given by Hawaii Department of Education. There may be other reading tasks better suited to specific classrooms in Hawaii. The population sample taken is from a limited sample avaliable of visually impaired students who are avaliable for testing.

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Last Updated: May 12, 2003