Journal of Deaf Studies and Deaf Education, 2018, 148–163

doi:10.1093/deafed/enx057
Advance Access publication March 5, 2018
Empirical Manuscript

EMPIRICAL MANUSCRIPT

Reading Comprehension and Phonics Research:

Review of Correlational Analyses with Deaf and
Hard-of-Hearing Students
Pamela Luft*
Kent State University
*Correspondence should be sent to Pamela Luft, School of Lifespan Development and Educational Sciences, 150 Terrace Drive, 405 White Hall, Kent State
University, Kent, OH 44242-0001, USA (e-mail: pluft@kent.edu)

Abstract
This manuscript reviews 28 studies of reading research on deaf and hard-of-hearing (DHH) students published since 2000
that used correlational analyses. The examination focused on assessment issues affecting measurement and analysis of
relationships between early phonological or orthographic skills and reading comprehension. Mixed outcomes complicate
efforts to determine evidence-based practices, and to develop an accurate model of reading. Across the 28 studies, DHH
participants represented a wide age range with potential floor and ceiling effects that reduce score variability for valid
correlations. Many studies assessed readers beyond the optimal ages during which early skills develop and are most useful
for reading. Reading skills also were assessed using a diverse array of measures and skill definitions. Particularly for reading
comprehension, word-level and text-level abilities appear to be different constructs. Suggestions include more consistent
skill definitions and differential timing for early- versus later-developing skill assessments to ensure more robust
correlational relationships.

The Search for Evidence-based Practices

in Reading
The federal No Child Left Behind Act of (2001) stipulated that edu-
cators use “scientifically-based research” to guide choices regard-
ing instructional interventions. Subsequently, the Individuals
with Disabilities Education Act (2004) indicated that education for
children with disabilities should include the use of scientifically
based instructional practices (Section 1400(c)(5)(E)). The difficulty
for teachers of deaf and hard-of-hearing (DHH) students is that
few scientifically validated practices have been identified. Two
meta-analyses of literacy research on DHH students found few
practices that met recommended standards identified by Cook
et al. (2014) and the Institute for Educational Sciences (U.S.
Department of Education, 2003). Luckner, Sebald, Cooney, Young,
and Muir’s (2006) reviewed 22 studies of literacy practices recom-
mended by the National Reading Panel (National Institute of
Child Health and Human Development, 2000a, 2000b) used with
DHH students. None of these studies met standards for strong
evidence of effectiveness or even possible evidence of effective-
ness. Easterbrooks and Stephenson (2006) reviewed 10 literacy
practices routinely cited either in the literature or as field-
supported practices with DHH students. Several had weak or
developing evidence leading the authors to recommend their use
while accumulating further substantiation.
One recommended practice for early readers is that they
receive instruction in phonemic awareness and phonics
(National Institute of Child Health and Human Development,
2000a, 2000b). For students with typical hearing, phonemic
awareness and letter knowledge have been the two best school-
entry predictors of how well they learn to read during the first 2
years of instruction (Cunningham, 2001; Ehri, Nunes, Willows,
Shuster, Yaghoub-Zadeh, & Shanahan, 2001; National Institute
of Child Health and Human Development, 2000b). In contrast,
research of early phonics-based instruction for DHH individuals

Received August 29, 2017; revisions received November 20, 2017; editorial decision November 21, 2017; accepted November 24, 2017
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has not shown consistent or strong support. Luckner et al.’s
(2006) review identified 13 reading practices with large effect
sizes; yet, none included use of phonics. Easterbrooks and
Stephenson (2006) characterized phonics instruction with DHH
students as a developing research base and concluded that in-
struction using visual and other support strategies allowed
some DHH students to develop these skills, although some did
not.
As these reviews suggest, individual study outcomes on the
contributions of phonological skills to reading comprehension
of DHH children remain mixed. Several have reported signifi-
cant relationships (Easterbrooks, Lederberg, Miller, Bergeron, &
Connor, 2008; Paul, Wang, Trezek, & Luckner, 2009; Trezek,
Wang, Woods, Gampp, & Paul, 2007). Yet, others have found low
or non-significant correlations (Alvarado, Puente, & Herrara,
2008; Bélanger, Baum, & Mayberry, 2011; Clark, Gilbert, &
Anderson, 2011; Izzo, 2002; Kyle & Harris, 2006; Miller, 2009).
The effects of early and substantial hearing loss are likely to
affect and perhaps alter, the acquisition and importance of
phonics-based skills for young DHH readers. Hearing loss re-
stricts attainment of language fluency if not addressed early
and intensively (Anderson, 2006; Boudreault & Mayberry, 2006;
Friedmann & Szterman, 2005; Lederberg, 2003; Marschark,
Schick, & Spencer, 2006; Mayberry, Chen, Witcher, & Klein, 2011;
Moeller, Toblin, Yoshinaga-Itano, Connor, & Jerger, 2007;
Nicholas & Geers, 2003). Reduced access to the sounds of lan-
guage likely affect the brain’s utilization for reading such that
the mixed and inconclusive research reflect unique develop-
mental trajectories. Identifying consistent skill relationships for
DHH students could provide insights into strategies that may
meet standards for evidence-based practice and result in more
effective instruction.
Concerns with Correlational Research of Phonemic
Awareness and Phonological Skills
Despite the apparent predictive strength of phonemic aware-
ness and letter knowledge for most young readers with normal
hearing, a number of researchers have raised concerns about
the National Reading Panel’s conclusions. Several question their
statistical assumptions or the practical significance of research
cited in support of their findings (Allington, 2013; Almasi, Garas-
York, & Shanahan, 2006; Burns, 2003; Hammill & Swanson,
2006; Paris, 2005). One important concern is that the variables
used to measure phonemic awareness (PA) and reading com-
prehension (RC) do not demonstrate properties of equal vari-
ability (Paris, 2005). Optimal variability for PA occurs within a
very limited time during acquisition. In contrast, RC develops
across an individual’s lifespan with increasing and more stable
score variability over time.
These statistical properties extend to variables beyond PA
and RC such that reading skills may be divided in two separate
clusters. One cluster consists of constrained skills, character-
ized by a limited number of elements that typically are learned
quickly. Young readers progress quickly from floor to asymptote
during early reading instruction. Examples include learning the
26 letter names in English (orthographic awareness, OA) and
the 43 letter-sound relationships (phonemic awareness, PA; and
visually/print-supported phonological skills, PS). The second
cluster consists of unconstrained reading skills that are acquired,
developed, and refined over long periods of time. They consist of
multiple components that are utilized in various ways, may
never be entirely mastered, and comprise non-identical content.
Reading comprehension and vocabulary development both are
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P. Luft | 149
unconstrained skills with each encompassing multiple content
domains.
Statistical correlations between early- and late-developing
and across constrained and unconstrained skills are problem-
atic in that optimal variabilities between these skill clusters
have little timing overlap. Analyses may require sophisticated
causal modeling or exclusion methods in addition to assuring
adequate score dispersion (Thompson, Diamond, McWilliam,
Snyder, & Snyder, 2005). Strong correlational analyses require
adequate variability among identified factors in order to ensure
valid relationships. The need to optimize variability for con-
ducting robust correlational analyses (Gersten et al., 2005;
Thompson et al., 2005) is particularly complicated in identifying
relationships between these reading skill clusters. Phonological
awareness is an early pre-reading skill with its greatest variabil-
ity during the first 18 months of acquisition, typically first grade
and early second grade (Paris, 2005). Other early-acquired and
constrained skills have similar developmental trajectories.
However early reading comprehension, an unconstrained skill,
has low initial variability until students attain initial fluency.
Assessment during periods of greatest score variability for early
code-based skills occurs when RC variability is minimal due to
floor effects; and RC achieves score variability after code-based
skills are minimally variable due to asymptote (Paris, 2005).
Correlational studies assessing across these categories without
adequate variation may be a reason for mixed results with DHH
individuals.
Wang and Williams’ (2014) meta-analysis identified timing
limitations in that phonics- and code-based (early constrained)
skills were more effective up to grade one. After this point, com-
prehension and mixed interventions on language- and
thinking-based skills yielded greater effect sizes. Other research
has likewise found that mature and experienced readers are
less dependent on individual letter codes in comparison with
metacognitive and text-based psycholinguistic reading skills
(Goodman, 1994/2003; Goodman, Goodman, & Paulson, 2009;
Kyle & Harris, 2010; Miller, 2009; Paris, 2005). Differential time-
based developmental trajectories appear to effect measurement
accuracy when analyzing relationships between various early
and later-acquired reading skills.
Another complicating factor is that the multiple skill compo-
nents comprising reading comprehension affect the acquisition
processes. Yet, the range of contributing factors may not be con-
sistently included in research models that target strong and
direct effects. Storch and Whitehurst’s (2002) longitudinal study
of preschool through fourth grade students found that oral lan-
guage abilities had strong and direct effects on later reading,
but only beyond Grade 2. Before this, effects were mediated by
code-related skills so that although oral language abilities were
essential, they had only an indirect role until Grade 3. Another
outcome was that reading accuracy and reading comprehension
were found to be two separate abilities, each of which was influ-
enced by different skills. The authors noted a danger in empha-
sizing phonological processing skills to the extent that other
language skills were underestimated.
Other studies have identified effects of language abilities on
reading acquisition. Cheung, Chen, Lai, Wong, and Hills (2001)
found that oral language influenced acquisition of phonological
skills, which also were influenced by orthographic abilities.
Dickinson, McCabe, Anastasopoulous, Peisner-Feinberg, and
Poe (2003) identified shortcomings in vocabulary development
that limited aspects of initial literacy development to include
phonological sensitivity. Language fluency appears to be a poten-
tially critical, but often under-identified, factor in examining the
 150 | Journal of Deaf Studies and Deaf Education, 2018, Vol. 23, No. 2
development of reading skills. The complexity of statistical
modeling to reflect both direct and indirect effects, and changing
relationships over time leaves most studies unavoidably imper-
fect (Thompson et al., 2005).
The contributions of language fluency to reading skills is of
particular importance for DHH individuals. Childhood delays in
achieving a first language affect both functional and structural
development of the brain with neuroanatomical differences
that contrasted with those due to auditory deprivation (Mayberry
et al., 2011; Pénicaud et al., 2013). MacSweeney, Waters, Brammer,
Woll, and Goswami (2008) found comparable neural networks
that supported phonological similarity judgments made in both
English and British Sign Language but which were negatively
impacted by delayed language acquisition. DHH children’s often-
diminished linguistic abilities likely affect acquisition of phono-
logical and code-based processing, and a range of associated
reading skills. Yet, early indirect relationships are not consis-
tently assessed in studies of reading development (Storch &
Whitehurst, 2002) and may not be of sufficient strength to meet
standards for evidence-based practice, potentially eliminating a
critical factor in research efforts.
An additional issue regards the assessment of research vari-
ables. Luckner et al. (2006) found that across 22 studies and 40
years of literacy investigations, no two studies examined the
same dimensions of literacy. In that even a single construct can
be measured in multiple ways greatly complicates efforts at
cross-study comparisons and accruing a body of evidence-
based practices. For example, within the domain of reading
comprehension, Storch and Whitehurst (2002) found that read-
ing accuracy and text comprehension were separate abilities.
Hannon (2012) reported weak relationships between lower,
word-level skills in comparison with higher-level reading pro-
cesses. She suggested that word reading was a construct sepa-
rate from text-level comprehension skills and each required
differentiated instruction. Burns (2003) similarly identified word
reading and contextualized reading as very different skills.
Overall, the developmental processes for acquiring reading
skills in DHH students appears to be multifaceted and complex,
and potentially unique. The present study sought to re-examine
reading research on DHH children conducted since 2000 that
utilized correlational analyses to examine relationships
between PA/PS, OA, and RC. An examination of timing and
assessment issues could clarify reasons for mixed and inconclu-
sive research results with DHH students. A more accurate
model could offer a potential pathway toward evidence-based
and effective instructional strategies and improved reading out-
comes for these individuals.
The research questions examined the timing of assessing
component skills of reading, and the measures used to identify
and examine these skills. They are as follows:
1. What is the age-based timing of measurements in correlat-
ing early-developing and constrained PA/PS and OA skills
with later-developing and unconstrained skills of reading
comprehension in DHH individuals?
2. In what ways are these reading skill components measured?
Method
This review identified research articles published between 2000
and 2017 that utilized correlational analyses to examine reading
skills of DHH individuals. The search used the university li-
brary’s megadatabase “Discovery”, a service that performs a
simultaneous search of over 300 individual research databases.
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The format allows for searches by keywords, title, or author
with additional features to further limit the search, as needed.
Searches used a range of terms for hearing loss and deafness,
reading comprehension, and phonological skills in both the key-
word and title functions. Each article’s reference list was re-
viewed for additional articles to ensure a comprehensive pool.
Articles were eliminated that did not include an element of cor-
relational analyses (to include regression) in their statistical
procedures, or did not include either phonological or reading
comprehension skills.
Due to the paucity of research in this low-incidence popula-
tion category, studies were not confined to a single language
(English) but included other alphabetic languages. The acquisi-
tion of phonological processes to support reading skills has
been identified as similar across alphabetic languages (Cheung
et al., 2001; Goswami, Ziegler, & Richardson, 2005). Specifically,
phonological processes have been found to remain similar
across languages despite some variation in letter-sound consis-
tency. Some of these differences are pronunciation of letter and
letter clusters in Greek, Italian, German, Spanish which are
more often consistent, whereas English, French, and Hebrew
orthographies have less consistency (Goswami et al., 2005).
However, the reading acquisition processes use similar alpha-
betic learning methods.
Each article was examined to identify: (a) the age of partici-
pants, (b) the analytical methods used, (c) the reported correla-
tional results, (d) the study conclusions regarding PA/PS, OA,
with RC, and (e) measures of these skills. The target age for in-
struction in examining early-developing skills was defined as
the 18 months for optimal PA/PS variability which coincides
with the period of intensive OA instruction during first and early
second grade, calculated to be between 6 and 8 years of age for
the DHH population. This also is consistent with studies indic-
ating that early constrained skills were most effective through
first grade (National Institute of Child Health and Human
Development, 2000b; Storch & Whitehurst, 2002; Wang &
Williams, 2014).
Examination of the articles could not verify that measure-
ment of phonological awareness (PA) utilized an auditory-only
presentation and therefore, the review combined PA with pho-
nological skills (PS). The range of PA/PS are consistently early
developing and infrequently utilized by mature readers
(Goodman et al., 2009; Goodman, 1994/2003; National Institute
of Child Health and Human Development, 2000b; Wang &
Williams, 2014). In addition, a number of commonly used tests
combine PA with other PS in order to create composite scores of
sufficient statistical variability (Comprehensive Test of
Phonological Processing, Dynamic Indicators of Basic Literacy
Skills, the Texas Primary Reading Inventory, the Phonological
Awareness Survey; Paris, 2005). A number of studies included
OA in their analyses, also an early-developing constrained skill
so this was added to the analyses, when present.
Results
The megadatabase search and examinations of reference sec-
tions of potential studies resulted in a total of 28 journal articles
that utilized correlation and/or regression analyses. Table 1 lists
the studies and the components examined. The primary lan-
guage of the participants indicated that 18 used English and the
remaining used a variety of languages, all of which had alpha-
betic orthography.
Research question one examined the ages of the participants
in measuring PA/PS, OA, and RC which affects statistical
 Table 1. Studies of reading comprehension with PA and OA

Study Participants Method Reading variables Correlation or regression results Study conclusions

Alvarado, • 28 deaf children, 7–16 years • ANOVA • RC: reading level Correlation • Orthography and fingerspelling offer
Puente, and old • Correlation • Phonology • Sig: Reading level with sign language visual processing strategies for reading
Herrara (2008) • 15 hearing children of for • Regression • Speechreading abilities (p < .01); with orthography comprehension in conjunction with
level control • Orthography (p < .05) sign language
• Fingerspelling • NS: reading level with phonology, with
• Sign language speechreading, with visual similarity
Regression:
• Sig: age with sign language to predict
reading (R2 = .84)

Bélanger, Baum, • 29 Deaf adults, 22–55 years • ANOVA • RC: reading level—groups Regression • Less-skilled deaf readers’ reading
and Mayberry • 16 hearing controls • Linear regression defined by median split • NS: phonological prediction of reading difficulties are not caused by the lack of
(2011) • Phonology level (R2 = .001, p = .86) use of phonological codes
• Speechreading
• Orthography

Clark, Gilbert, • 50 DHH college participants • ANOVA • RC: English reading fluency Correlation • No clear link between PA, reading, and
and Anderson • 51 hearing college • Correlation • PA • Sig: ASL skills with total score, (r = .34, decoding skills.
(2011) participants • Morphological knowledge p = .01); ASL with monomorphemic • Some deaf students demonstrate
• ASL (bilingual) Proficiency words (r = .30, p = .03) and with phonological knowledge and skills
multimorphemic words correct (r = .35,
p = .01)
• NS: ASL with phonology

Colin, Magnan, • 21 deaf 6-year-old • 2 year • RC: written word test Regression • PA was a significant correlate even after
Ecalle and prereaders longitudinal study • Phoneme identification • Sig: word recognition score predicted by controlling for hearing loss
Leybaert • 21 age-matched hearing • ANOVA • Speech intelligibility rhyme decision task (R2 change =28.3%)
(2007) children • Regression • Rhymes

Cupples, Ching, • 101 5-year-old DHH • Correlation • RC: word and nonword Correlation: • PA predicts aspects of early reading in
Crowe, Day, children, 71 with hearing • Multiple reading, passage • NS: PA with passage comprehension 5-year olds with HL who use speech
and Seeto aids, 30 with implants regression comprehension Regression: • Phonological skills are most important
(2013) • PA • Sig: PA with real-word reading, with in the earliest stages of reading
• Letter knowledge word attack, with letter knowledge • Vocabulary at 5 years may be associated
• Receptive vocabulary (ps < .001) when controlling for HA/CI, with reading at later stages of
communication, cognitive ability, development
receptive vocabulary, and demographic
variables

Daigle and • 24 DHH children who used • ANOVA— • RC zigzag test Correlation • Syllabic sensitivity correlated with age
• Graphemic (homophone) • Sig: Age with reading (r = .726, p < .001);

P. Luft
Armand sign language, 10–18 years repeated and reading scores
(2008) in 3 age groups measures similarity of pseudowords DHH graphemic sensitivity with age • DHH had better scores when using both
• 24 age-matched hearing • Correlation • Syllabic similarity (r = .492, p = .015), with reading (r = .719, orthography and phonology
peers • Response time p < .001); DHH syllabic sensitivity with • Not all DHH show graphemic sensitivity

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age (r = .485, p = .016), with reading

151
(r = .599, p = .002)

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 Table 1. (Continued)

152
Study Participants Method Reading variables Correlation or regression results Study conclusions

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Daza, Phillips- • 30 DHH students 8–16 years; • Correlation • RC: sentence-picture Correlation • Good readers were better at spoken

Journal of Deaf Studies and Deaf Education, 2018, Vol. 23, No. 2
Silver, Ruiz- 23 used spoken language, 7 • Covariates: matching and sentence • Sig: partial correlations—reading language, vocabulary, spatial attention,
Cadra, and used sign language; 50% demographic or completion comprehension with vocabulary (r = .56; visuospatial short-term and working
López-López used CIs, 50% used HAs clinical variables • PA: rhyme judgment p = .003), with spatial memory (r = .47; memory, and executive functions.
(2014) to differentiate • Vocabulary p = .014), with visuospatial memory span • Differences in RC of readers was not
between good and • Visual attention and (direct order: r = .63; p < .001) related to PA skills.
poor readers memory

Dillon, de Jong, • 27 DHH children 6–14 years • Comparison of • RC: letter-phoneme match, Correlation • Percentile ranks were in the bottom half
and Pisoni (8 = K-2), all used CIs and standard scores word and nonword reading • Sig: PA scores with all reading: word on PA and reading
(2012) spoken language • Correlation sentence reading reading (r = 1.82, p < .001); word attack • Students had poorer vocabulary scores
• PA: isolated sounds, (r = 1.74, p < .001); PIAT-RC; PIAT-Total despite relatively high reading
monosyllables & syllable (r = 1.86, p < .001), (r = 1.85, p < .001) • Older readers were generally less
count successful
• Vocabulary

Dyer, • 49 DHH, mean age 13 years, • Correlation • RC: cloze Correlation • Deaf readers can make use of
MacSweeney, RA ≈ 7 years; all use BSL • PA and decoding • Sig: Rhyme with reading delay (r = –0.30, phonological structure to some extent
Szczerbinski, and TC • Picture rhyme p < .05), with RAge (r = .39, p < .01); RAge in reading.
Green, and • 81 hearing controls CA • Pseudohomophones with pseudohomophones (r = .46, • Strong relationship between
Campbell matched & RA matched • Rapid automatized naming p < .01); Rapid naming-sign and reading pseudohomophone task, reading, and
(2003) groups • Speech or sign repetition delay (r = –.47, p < .01) (unexpected IQ in the BSL-first language subgroup
direction)
• NS: Reading delay with the
pseudohomophone matching

Easterbrooks, • 44 DHH children, 3–6 years, • T-tests Fall/Spring • RC: passage comprehension Correlation • All measures generally correlated with
Lederberg, 32 in oral-only classes, 7 in • Correlation (graphics and words) • Sig: Age with all raw scores and between Spring word identification and RC
Miller, TC, 5 in bilingual/TC classes • PA measures: Negative for age with passage • Majority of children performed poorly,
Bergeron, and • Speech perception comprehension (-.67), with letter-word particularly on rhyming words with
Connor (2008) • Rhyming alliteration identification (-.58), with vocabulary little improvement; DHH gaps increased
• Syllable-segmentation (-.30) with age
• Phonological processing

Furlonger, • 30 DHH adults, ages 18-61,
Holmes, and profound HL, 17 preferred
Rickards Auslan, 13 preferred spoken
(2014) • Hearing controls matched
on age, gender, & NVIQ.
• ANOVA lo/hi • Word reading Correlation • More proficient deaf readers were better
reading groups • RC: word reading, passage • Sig: PGC with word reading (r = .41, at word reading
using medial split reading with comprehension p < .05); word reading with RC (r = .85, • Both deaf groups made rhyme
• Correlation questions p < .001) judgments above the level of chance.
• Linear regression • PA: phoneme, syllable, • NS: PGC and RC (r = .24) • Deaf participants showed a marked
rhyme; phoneme-grapheme Regression effect for orthographic condition; less-
match • Sig: Three PA measures with reading skilled readers showed greater reliance
• Sign comprehension (at comprehension, (F [3, 27] = 10.17, on orthography
ceiling). p < .001); PA measures with orthography
• Response time information, (F [3, 27] = 10.84, p < .001);
rhyme efficiency was the only significant
unique predictor of RC (14% & 9%) across
tasks

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 Geers (2003) • 181 DHH, 8–9 years; all • Correlation • RC: modified cloze, sentence Correlation • Reading outcome was most highly
implanted by 5 ½ years; 98 • Multiple with picture • All significant (p < .0001) for reading with predicted by linguistic competence.
using oral and 83 using regression • Lexical and rhyming tasks— homophones, rhyme, and digit span • Reading processing skills of word
Total Communication. orthographic or Regression attack, word recognition, and
phonological strategies • Variance in reading principal educational placement did not make a
components score predicted by multiple substantial contribution to reading
student and demographic factors outcomes after demographic
characteristics were accounted for.

Gibbs (2004) • Group 1: 15 DHH, moderate • Correlation • RC: word recognition Correlation • Ensuring use of language in advance of
HL, 7–9 years; • Hierarchical • PA • Sig: Vocabulary with word recognition reading would reduce potential barriers
• Group 2: 15 DHH children regression to • Vocabulary (r = .64, p < .01); vocabulary with word and support acquisition of PA
6;2–7;10, all in mainstream partial out • Syntax reading (r = .613, p < .01). • Development of PA may be contingent
and primary language was variance in • NS: Initial phonemes or rhymes with on vocabulary
spoken English 3 groups of reading due to PA. single-word reading; DHH reading with • Some reading may be possible without
30 hearing children controls PA, with memory span closely associated phonological skills.
Regression
• Vocabulary accounted for a further 27%
of the variance in word recognition
(F = 7.13; p < .01) following awareness of
rhyme scores, 26% of the variance
(F = 7.26; p < .01) following awareness of
initial phonemes scores
• Rhyme scores and initial phonemes
accounted for 19.5% (F = 4.0; p < .05) and
12% (F = 5.46; p < .05) of the variance in
word reading

Harris and • Two groups of 30 DHH • ANOVA • Reading age: word reading Regression • Orthography was a significant predictor
Moreno (2004) British children, 7–8 & 13–14 • MANOVA • OA • Sig: Reading of younger deaf by age of reading ability for both older and
years • Regression • Phonology-spelling (p < .05) and orthography (p < .01); younger deaf children
• CA and RA matched hearing reading of older deaf for memory span • Phonology was not a significant
peers (p < .01) and orthography (p < .05); predictor for younger, and marginally
phonology was marginally significant so for older DHH children
(p = .06) • Results suggest little DHH reliance on
phonological coding

Izzo (2002) • 29 primary DHH students, • Descriptive • RC: retelling Correlation • Reading ability was significantly
4.33–13.16 years, from analyses • Age • Sig: Reading with language ability = .58 (p correlated to language ability but not to
residential schools (unlikely • Multiple • Language ability (Signed ≤.001); with age = .50 (p ≤.001); Language PA
to use phonological coding regression English-to-ASL continuum) ability with age = .51 (p ≤.001) • PA may not facilitate reading
strategies) • PA • NS: Reading with PA (r = .09), language development for DHH who use other
ability with PA (r = .03) strategies
Regression • Some DHH with low PA achieved high

P. Luft
• NS: PA with reading reading comprehension
• Sig: Language, age, and PA (R2 = .397,
p = .005); Individual predictors of

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language ability (p = .025)

153
• NS: Individual predictors: age (p = .1280)
and PA (p = .665)

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 Table 1. (Continued)

154
Study Participants Method Reading variables Correlation or regression results Study conclusions

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Johnson and • 43 DHH, 5–15 years divided • ANOVA • RC: single-word reading, Regression • CI age was associated with

Journal of Deaf Studies and Deaf Education, 2018, Vol. 23, No. 2
Goswami into early/late implant • Multiple word chains, read-aloud • Sig: Composite of 4 reading scores with development of oral language, auditory
(2010) groups. Regression with comprehension PA when entered before receptive memory, and PA skills necessary for
• 16 HA user controls questions vocabulary; age at cochlear implantation developing efficient word recognition
• 19 RA hearing controls, 6–9 • PA: rhyme, initial and final with vocabulary and reading outcomes skills. There is a benefit to earlier
years phonemes when using quotient scores; RC with CI, implantation.
• Vocabulary controlling for age & NVIQ: rhyme =.584
• Visual and auditory memory (p < .001), initial phoneme =.364 (p < .05),
• Auditory discrimination final phoneme =.594 (p < .001)
• Speech intelligibility • Receptive vocabulary: up to 38% of
• Speechreading of single additional variance in each reading
words quotient measure
• NS: PA with reading composite scores
after removing variance due to
vocabulary

Koo, Crain, • 51 DHH college students
LaSasso, and grouped into native users of
Eden (2008) ASL, cued speech, oral
• Hearing native users of ASL,
and hearing native speakers
of English
• ANOVA across 5 • RC: silent word reading, Correlation • Deaf native ASL users had the lowest PA
groups passage comprehension • Sig: PDT with passage comprehension accuracy (p < .05).
• Correlation • Phoneme Detection (p < .006) • Silent word reading utilized more sight
• Sig: Negative RC with reaction time for words and perhaps was NS for that
PDT, with silent word reading (τ = −.291, reason.
p < .01)
• NS: word-recognition fluency with PA

Kyle and Harris • 29 British deaf children 7-8 • Descriptive • RC: single-word reading, Correlation • DHH and hearing children did better
(2006) years analyses sentence comprehension • Sig: PA with speechreading (r = .46, when rime items were orthographically
• Hearing controls matched • ANOVA • PA p < .05); vocabulary with SWR (r = .46, and phonologically congruent
for RA • Correlation • Speechreading p < .05), with sentences (r = .70, p < .01), • After controlling for hearing loss,
• Spelling with speechreading (r = .48, p < .01). productive vocabulary and
• Vocabulary • NS: PA with SWR, sentences, or spelling speechreading (language factors) were
significant predictors of reading
• PA did not correlate with RC after
controlling for hearing loss

Kyle and Harris • 29 DHH children, 7-8 years • 3-year • RC: single-word reading, Regression • Vocabulary was the strongest and most
(2010) of age; 7 = oral, 18 = BSL, 4 = longitudinal study cloze sentence • Sig: Word reading at T1 with hearing loss consistent predictor of all reading
combination with 4 assessment comprehension, passage (R2 = .77), with word reading at T2; measures across all time periods
periods comprehension productive vocabulary at T1 accounted • PA not a significant longitudinal
• Correlation • PA for an additional 12% of sentence predicator after Time1 reading levels
• Multiple • Speechreading comprehension at T2; speechreading • DHH children may acquire phonology
regression • Productive vocabulary with productive vocabulary at T1 as a consequence of reading with early
contributed a further 4% and ≈6%, reading associated with later PA
respectively
• NS for Word reading at T2: PA at T1,
hearing loss, and speechreading at T1

Kyle and Harris • 24 British DHH children, 5–6 • 2-year • RC: single-word reading Correlation • Vocabulary at T1 was the most
(2011) years longitudinal • PA • Sig: PA with speechreading vocabulary, consistent significant correlate of
spelling, and word reading (ps < .01)

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 • 23 hearing children 5–6
years, matched for word
recognition
comparative • Letter name and letter- • NS: PA at T1 was not significantly related reading at T2 and T3 even after
study sounds to reading at T2 or T3 controlling for NVIQ and T1 reading.
• Descriptive • Picture spelling • Sig: Reading score at T1 with PA at T2 • Earlier PA was not a longitudinal
analyses • Productive vocabulary (p < .05) correlate of reading after controlling for
• Correlation • Speechreading earlier levels
• ANOVA • Young DHH readers used a whole-word
strategy and 2 years later used a more
alphabetic strategy.

Luetke- • 31 DHH students, 7.9–17.9 • ANCOVA • RC-passage comprehension, Correlation • Reading strongly correlated with
Stahlman and years, no CIs; 9 in general • Correlation word comprehension, word • Sig: Word passage with word blending phonemes and syllables,
Nielsen (2003) education, 22 in self- identification comprehension (r = .970, p = .0001), with segmenting sentences into words, and
contained • PA word identification (r = .832, p = .0001), written English.
• Receptive, expressive and with phonemic substitution (r = .826, • Length of Signed English exposure did
written English p = .0001) not yield higher reading measures or
• Sig: RC with blending phonemes written language.
(r = .723, p = .0001), with syllables • Deaf students may use some different
(r = .720, p = .0001), with written reading strategies.
language (r = .702, p = .0001), with letter
identification (r = .700, p = .0001).

Miller (2009) • 31 Israeli high school and
post-graduate students
with prelingual deafness
• 59 hearing students
• Correlation • RC of word pairs Correlation • No significant evidence that DHH
• MANOVA • PA and phonological • NS: PA, response time, and error rates participants processed word pairs with
decoding overall and for each study condition: less efficiency across conditions
• Response time visual, phonological, and control; DHH • Phonemic skills do not significantly
for sentence comprehension, response impact reading
time, and error rate

Miller (2010) • 83 Israeli prelingually deaf,
21 in primary school (3rd–
4th), 36 in high school
(10th–11th), 26 university
(21–29 years);
• 85 control: 29 primary, 29
high school, 27 university
• MANOVA • RC: sentences and Correlation • DHH participants did not demonstrate
• Correlation questions, semantically • Sig: OA with PA (r = .54, p < .001), by PA growth over time
• Cluster analysis plausible and implausible grade (p ≤ .05); SI with SP sentences • Sentence-level processing showed
sentences (r = .56, p < .001); PA and OA with all individual word meaning using
• PA sentence types (r = .48, p < .001; r = .36, integration with syntactic (structural)
• OA p < .001) knowledge
• OA plays a central role in processing
written text; youngest DHH were non-
strategic in their reading
• DHH participants had poorer PA and OA
than hearing peers

Miller and • 40 prelingually deaf Arab, ½
Achmed from primary (9.17–11.08
(2009) years) and half from
middle-to high school
(14.25–16.00 years)
• MANOVA • RC: word reading
• Correlation • Word categorization: real
word and
pseudohomophones
• Rapid word naming
Correlations
• Sig: Categorization accuracy across real
and pseudo conditions for young deaf
(r = .84, p < .001) and older deaf (r = .60,
p < .01); real word and
• Young and old DHH categorized real
words significantly more accurately
than pseudohomophones which
improved developmentally
• Older deaf and hearing did not differ in

P. Luft
• 40 control group pseudohomophone categorization for recognition of real words, which was
young (r = .39, p < .05) and older deaf not related to phonological
(r = .37, p = .05) development

|
• NS: categorization accuracy associated • Older DHH had rates equal to hearing

155
with speed of processing for the real- controls
word condition

(Continued)

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 Table 1. (Continued)

156
Study Participants Method Reading variables Correlation or regression results Study conclusions

|
Journal of Deaf Studies and Deaf Education, 2018, Vol. 23, No. 2
Miller, Kargin, • 213 DHH, 6th–10th grade; • Cluster analysis • RC: sentence Correlations • Failure to find significant positive
Guldenoglu, Hebrew, Arabic, English, • ANOVA comprehension with • Sig: RC of the 2 sentence types for correlations between PA, phonological
Rathmann, German participants • Correlation questions: semantically syntactic readers (r = .47, p < .001) word decoding skills, and RC.
Kubus, plausible & implausible. • Sig: Negative for syntactic readers for • Reading skills appear to develop
Hauser, and • Phonology: phonological processing with overall independently of phonological
Spurgeon pseudohomophones and sentence comprehension scores processing skills.
(2012) real words (r = −.25, p < .05) • Syntactic deficits offer an explanation
• Response time • NS: RC for semantic or unspecified for difficulties in reading of DHH
• Native written language strategy readers; phonemic processing students
• Strategies: syntactic, among the 3 reader profiles despite large
semantic, or unspecified intergroup differences

Most, Aram, and • 42 DHH, 62–84 months (5–7 • ANONVA • RC: word recognition &
Andorn (2006) years) in 3 placements • Correlation explanation of choice
• 11 hearing peers • PA
• OA
• Letter identification
• Word writing
• Receptive vocabulary
Correlations
• Sig: PA with vocabulary, with general
knowledge, with writing, with reading
explanations (ps < .01), with letter
identification (p < .05)
• PA, letter ID, knowledge and vocabulary
was better for those in individual
inclusion placements
• No statistically significant differences
between individual and group inclusion
programs regarding reading, writing, or
OA

Spencer and • 72 pediatric CI users, tested • Correlation • RC: word comprehension,
Oleson (2008) Simultan-eous (speech & SE) • Multiple word identification, word
Approximately 5.1–11.3 years regression antonyms & synonyms,
(48 months after implant) analogy
• Speech perception: word-
picture identification, vowel
perception
• Speech production: sentence
repetition, story retelling
• Demographic background
Correlation
• Sig: Speech production measures with
each other (r > .73, p < .0001)
Multiple Regression
• Sig: Word reading with correct
phonemes produced (short-long &
retell), with speech perception, with age
at testing (R2 = .59); paragraph
comprehension with correct phonemes
produced, consonant test, speech
perception (R2 = .62)
• Standard scores for reading were in the
low average range for word
identification and passage
comprehension
• Both speech perception and production
skills were strongly correlated with
word identification and passage
comprehension; early speech skills may
predict later reading

Spencer and • 29 CI children, 7;2–17;8; • RC: word comprehension, Correlation • The A/V condition was significantly
Tomblin • 32 hearing controls HC, word attack • Sig: Elision: with word attack (r = .63, correlated with two word reading tasks
(2009) matched on mothers • PA p = .01), with word reading (r = .70, and may be a more accurate measure of
education & word • Rhyme judgment p = .01) phonological processing.
comprehension, nearly 2 • Phonological memory • Sig: Blending and A/V condition with • CI children may hear some sounds (PA)
years younger than DHH • Rapid letter and number word attack (r = .42, p = .05), with word then learn to associate full
naming reading (r = .37, p = .05) pronunciation after seeing print form
• A/O (auditory only) or A/V • Sig: Nonword repetition with A/V (r = .41, (RC); they may learn PA from print (PS)
(auditory-visual) conditions p = .05, r = .38, p = .05); with rapid letter rather than the reverse
naming (r = .49, p = .01, r = .75, p = .01)
• NS: rapid letter naming, nonword
repetition with A/O

Note. CI = cochlear implant; Sig: = statistically significant; NS = non-significant.

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variability needed for correlational analyses. Few studies re-
ported variabilities of factors and therefore, this could not be
directly examined. Across the 28 studies there was broad age
range. Half (n = 14) used participants that were within the target
ages; however, many included those who were above or below
these ages. Three studies included younger participants who
were potentially just beginning early reading skill acquisition.
Seven studies included older participants expected to have
achieved asymptote for early constrained skills. Four studies
included both below and above target-age participants. Only
three studies used participants solely within the target ages,
with 11 using participants who were entirely outside of the tar-
get ages, 10 of which were older individuals. The “Participants”
column of Table 1 lists the ages of the participants for each
study.
The examination of ages with correlations indicated that of
the 17 studies reporting significant correlations between PA/PS
and RC, 1 study used below target-age participants (Cupples
et al., 2013); 3 used both younger and target-age participants
(Easterbrooks et al., 2008; Kyle & Harris, 2011; Most et al., 2006);
1 used only target-age participants (Colin et al., 2007); 2 used
younger, target age, and older participants (Johnson &
Goswami, 2010; Spencer & Oleson, 2008); 4 used target age and
older participants (Dillon et al., 2012; Geers, 2003; Luetke-
Stahlman, & Nielsen, 2003; Spencer & Tomblin, 2009); and 6
used older participants (Daigle & Armand, 2008; Dyer et al.,
2003; Furlonger et al., 2014; Koo et al., 2008; Miller & Achmed,
2009; Miller, 2010).
A total of 12 studies reported non-significant correlations
between PA/PS and RC including 2 that used participants within
the target-age range (Kyle & Harris, 2006, 2010); 5 that used
within and beyond target-age participants (Alvarado et al., 2008;
Daza et al., 2014; Gibbs, 2004; Harris & Moreno, 2004; Izzo, 2002);
and 5 that used only participants beyond the target age
(Bélanger et al., 2011; Clark et al., 2011; Koo et al., 2008; Miller
et al., 2012; Miller, 2009) with Koo et al. (2008) reporting both sig-
nificant and non-significant correlations. Bélanger et al. (2011)
also used linear regression analyses, finding non-significant
relationship of phonological skills for predicting reading levels
of older (adult) participants (R2 = .001, p = .86).
Six studies reported correlations between orthographic aware-
ness (OA) and RC. Significant correlations included two studies
using target age and older participants (Alvarado et al., 2008; Harris
& Moreno, 2004); and three using older participants (Bélanger et al.,
2011; Daigle & Armand, 2008; Furlonger et al., 2014). One study
reported non-significant correlations for participants beyond
the target ages (Miller, 2010).
Several studies reported significant relationships between
unconstrained skills that would demonstrate variability long
after initial acquisition. Significant relationships between
vocabulary and reading comprehension were reported by two
studies using target-age participants (Kyle & Harris, 2006, 2010),
one using both target age and older participants (Daza et al.,
2014), and one using older participants (Miller & Achmed, 2009).
Significant correlations between sign language and reading
comprehension were reported for mixed younger-through-older
participants (Izzo, 2002), and for older participants (Miller, 2009).
Alvarado et al. (2008) used regression to find a significant rela-
tionship between age and sign language acquisition in predict-
ing reading (t (age) = 4.32, p < .01; t (sign language) = 3.32, p < .01)
for target age and older participants. Clark et al. (2011) also
found significant relationships between ASL skills and RC (r =
.34, p = .01). Vocabulary was significantly correlated with RC in
seven studies, and with PA/PS in seven studies.
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P. Luft | 157
The second research question examined measurements
used for targeted reading skills. PA/PS were measured by tests
of phoneme detection, elision, blending, matching, phonologi-
cal similarity, use of words and nonwords, rhyme decision &
generation, syllabic similarity, and spelling. Not all studies
examined OA skills; however, those that did also used a variety
of measures to identify: letters in words, contrasting ortho-
graphically similar & dissimilar words & nonwords, phoneme-
grapheme correspondence, lexical & rhyming tasks, words in
letter strings (word chains), and rapid letter and number nam-
ing. A number of studies identified letter naming as an early
reading skill and did not report these outcomes as a component
of OA (Easterbrooks et al., 2008; Geers, 2003; Most et al., 2006).
The present study did not re-categorize outcomes or reclassify
measures if not so reported in the original articles.
Studies also used a variety of measures for reading compre-
hension skills. Alvarado et al. (2008) defined this skill based on
academic level while controlling for age. Izzo (2002) assessed
reading comprehension through story retelling and while
Spencer & Oleson (2008) also used story retelling, it was to
assess speech/phonemic production skills. Several studies mea-
sured RC through letter identification, word and/or pseudoword
reading/identification, or word chain tests (Colin et al., 2007;
Cupples et al., 2013; Dillon et al., 2012; Easterbrooks et al., 2008;
Furlonger et al., 2014; Geers, 2003; Gibbs, 2004; Harris & Moreno,
2004; Johnson & Goswami, 2010; Koo et al., 2008; Kyle & Harris,
2006, 2010, 2011; Luetke-Stahlman & Nielsen, 2003; Miller &
Achmed, 2009; Miller, 2009; Spencer & Tomblin, 2009). Most
et al. (2006) used word recognition to examine RC but asked par-
ticipants to explain their answer. Of the 18 studies using letter
and word-based measures, all but 5 reported significant correla-
tions between PA/PS and RC (Gibbs, 2004; Harris & Moreono,
2004; Kyle & Harris, 2006, 2010; Miller, 2009).
A number of the studies used text-level reading to assess RC
such as sentence and short-passage cloze procedures (Cupples
et al., 2013; Daza et al., 2014; Dyer et al., 2003; Geers, 2003; Koo
et al., 2008; Kyle & Harris, 2010; Luetke-Stahlman & Nielsen,
2003; Spencer & Oleson, 2008) with two of these eight reporting
non-significant PA/PS and RC correlations (Daza et al., 2014;
Kyle & Harris, 2010). Others used longer text with RC scores
based on comprehension questions, correct choices, or pictures
(Bélanger et al., 2011; Clark et al., 2011; Cupples et al., 2013;
Daigle & Armand, 2008; Daza et al., 2014; Dillon et al., 2012;
Easterbrooks et al., 2008; Furlonger et al., 2014; Johnson &
Goswami, 2010; Kyle & Harris, 2006, 2010; Luetke-Stahlman &
Nielsen, 2003; Miller et al., 2012; Miller, 2009; Miller, 2010;
Spencer & Oleson, 2008). Of the 16 studies using text-based RC
stimuli, nearly half reported non-significant correlations with
PA/PS (Bélanger et al., 2011; Clark et al., 2011; Daza et al., 2014;
Kyle & Harris, 2006, 2010; Miller et al., 2012; Miller, 2009).
Overall, the 28 studies employed a notable variety of measures
across these reading skills.
Discussion
This study reviewed research on DHH readers that reported on
correlations between early- and late-developing constrained
(PA/PS, OA) and unconstrained (RC) skills. The purpose was to
examine potential effects of assessment timing and constructs
that may contribute to inconsistent outcomes regarding these
skills. The search of research databases identified 28 studies
that fit criteria and reported either significant or non-significant
correlations between PA/PS or OA and RC.
 158 | Journal of Deaf Studies and Deaf Education, 2018, Vol. 23, No. 2
The first research question examined the age of participants
in correlating early-acquired and constrained skills of PA/PS
and/or OA with reading comprehension. Across the 28 studies,
10.7% (n = 3) used participants within the target-age group
defined as 6–8 years of age; 1 was below the target age (3.6%), 10
were older (35.7%), with most using mixed ages (n = 14, 50%). Of
the 17 studies reporting significant correlations between PA/PS
and RC, 6 (35.3%) were with older participants and 4 (23.5%)
were with target age and older participants. More studies used
older readers despite PA/PS and OA being early-acquired skills
with attainment of asymptote expected by 8 or 9 years of age. Of
the 12 studies that did not report significant PA/PS and RC corre-
lations, 5 (41.7%) were with target age and older participants, 4
(33.3%) were with older participants, with Koo et al. (2008) re-
porting both significant and non-significant correlations. Six
studies reported on relationships between OA and RC with five
that were significant (two with target age and older, three with
older participants) and one that indicated non-significant corre-
lations using older participants.
Those studies using participants within the target ages for
PA/PS and OA would not likely have had sufficient variability for
the later-developing skill of reading comprehension. This is
most salient for correlations with text-based reading which is
not attained until a child is beyond floor levels, at age 9 or above
(National Institute of Child Health and Human Development,
2000b; Wang & Williams, 2014). Only studies correlating PA/PS
or OA with word recognition would tend to have equal variabil-
ity across these factors. Of the three studies using only target-
age participants, one reported a significant correlation between
PA/PS and RC (Colin et al., 2007) and two reported non-
significant correlations (Kyle & Harris, 2006, 2010). None of the
studies examining OA and RC used target-age participants.
Outcome patterns are difficult to ascertain and interpret
among the remaining studies and varying ages. For those using
older participants, six reported significant correlations between
PA/PS and RC (Daigle & Armand, 2008; Dyer et al., 2003;
Furlonger et al., 2014; Koo et al., 2008; Miller & Achmed, 2009;
Miller, 2010) while five reported non-significant correlations
(Bélanger et al., 2011; Clark et al., 2011; Koo et al., 2008; Miller
et al., 2012; Miller, 2009). Five studies reported significant OA
and RC correlations with three that used only older participants
(Bélanger et al., 2011; Daigle & Armand, 2008; Furlonger et al.,
2014) and two that used target age and older participants
(Alvarado et al., 2008; Harris & Moreno, 2004).
The correlation results for older participants would be ex-
pected to approach asymptote or ceiling effects with reduced
variability although few studies identified these. Daigle and
Armand (2008) reported ceiling effects although only with hear-
ing participants for graphemic coding. Miller (2009) reported
ceiling effects on PA/PS for his older participants and Luetke-
Stahlman and Nielsen (2003) reported ceiling effects for initial
and final phonemes for their mixed-age participants. Although
their study used ANOVA, James, Rajput, Brinton, and Goswami
(2008) reported that their results for PA/PS and RC for DHH chil-
dren approximately 5–10 years of age were impacted by ceiling
effects for syllable awareness. These studies suggest that DHH
readers experience similar age-based ceiling and asymptote ef-
fects although reported by only 3 of the 21 studies using mixed
and older participants.
Another statistical concern is with floor effects. The National
Reading Panel characterized children below first grade as being
nonreaders, with this skill being acquired gradually through
first and second grade. About 2 of the 28 studies (Cupples et al.,
2013; Easterbrooks et al., 2008) reported floor effects with a
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number of their participants unable to perform several reading
tasks. This emphasizes the importance of timing assessments
to ensure maximum variability to achieve robust correlations,
and avoidance of both floor and ceiling effects among develop-
ing skill sequences.
Age of participants was not a factor in studies reporting cor-
relations between unconstrained skills. Significant relation-
ships were reported by four studies for vocabulary and RC, two
for language and RC, and two for sign language and reading
level or RC. Similarly, a meta-analysis of 57 studies examining
phonological coding with DHH individuals (Mayberry, del
Giudice, & Lieberman, 2011) identified the importance of lin-
guistic skills. Half of the studies had significant effect sizes for
PA/PS with RC; however, the mean effect size was .35 (low to
medium) and represented just 11% of the variance in RC scores.
By comparison, language ability predicted 35% of the variance
in RC. The importance of these linguistic skills, also reported by
Storch and Whitehurst (2002), suggests a need for further exam-
ination of unconstrained skills that may contribute to the read-
ing comprehension of DHH individuals. Such correlations
would be less affected by timing once individuals had attained
initial fluency.
Research question two examined the measures used for as-
sessing component reading skills as a source of potential dispar-
ity in reported relationships. PA/PS was measured in more than
10 different ways with this variety suggesting that these discrete
skills may be dissimilar enough to warrant caution in making
cross-study generalizations. Assessment of OA skills also used
approximately 10 different measures with some that contrasted
phonemic with graphemic strategies in conjunction with PA/PS
development. Spelling was analyzed for orthography in Harris
and Moreno (2004) but not in other studies. Orthographic skills
were included in several other studies but reported in terms of
other linguistic competencies (e.g., Miller & Achmed, 2009). Again,
the variety of assessment targets within OA suggests caution in
reporting potential acquisition patterns across studies.
Notably diverse was the range of skills and the types of mea-
sures used to assess reading comprehension. These included
individual word or pseudoword reading, sentence reading, and
passage comprehension measured by retelling, explanation of
answers, correct picture or answer choice, or cloze procedures.
Research into testing and test construction has identified partic-
ular difficulties for DHH students that result from wording of
questions and items, and use of shorter versus longer passages
such that scores do not accurately reflect their abilities
(Alvermann & Phelps, 2002; Johnson & Mitchell, 2008; Lollis &
LaSasso, 2009; Martin & Mounty, 2005; Weinstock & Mounty,
2005). Explanations or responses that are evaluated based on
comparisons with hearing participant norms are likely to pro-
duce relatively poorer scores.
Tests of pseudoword word reading fluency and differentia-
tion between words and pseudowords may be negatively
affected by DHH students’ frequently diminished linguistic
skills (Luckner, 2013). A panel review of the Dynamic Indicators
of Basic Literacy Skills (DIBELS) identified only one of seven
subtests as genuinely assessing reading comprehension. Many
commercially available reading assessments and several used
in these studies have similar tests and subtests. Other test con-
cerns were raised by LaSasso (1980) with regard to cloze proce-
dures such that DHH individuals’ cloze scores did not correlate
well with predicted passage difficulty. DHH students tend to
have much poorer performance levels when held to typical
scoring standards (Kelly & Ewoldt, 1984). A number of the 28
studies utilized cloze procedures.

The differences in assessing and comparing comprehension
achievement across single-word and connected text reading
scores likely contributes to the mixed outcomes reported by
these studies. Single-word reading utilizes sight-word and word
attack or phonemic skills and is dissimilar to sentence or pas-
sage comprehension skills that require multiple psycholinguis-
tic processes (Goodman et al., 2009; Goodman, 1994/2003; Kyle &
Harris, 2010; Miller, 2009; Paris, 2005). The National Reading
Panel’s conclusion that PA is foundational for assisting with the
alphabetic relationships for reading and spelling is based on its
utility for word and pseudoword reading, with much smaller ef-
fects reported for contextualized reading (National Institute of
Child Health and Human Development, 2000b). Word- and passage
reading have been identified as separate constructs (Allington,
2013; Burns, 2003; Hannon, 2012; Storch & Whitehurst, 2002) with
Dillon et al. (2012) describing even sentence-level comprehension
as inferior to passage comprehension in relying more on phono-
logical knowledge than authentic comprehension skills.
Among the 17 studies finding significant correlations
between PA/PS and RC, more used word-level reading alone
(29.4%) or in combination with text reading responses (41.2%)
for a total of 82.3%. This is in contrast with studies that used
only using text reading with 17.6% reporting significant relation-
ships between PA/PS and RC. For the 11 studies reporting non-
significant correlations, 54.6% used word or word measures in
combination with others, whereas 45.5% used only text reading
measures. The Alvarado et al. (2008) method for determining
reading level in correlation with age was not included in these
calculations.
The five studies examining OA and RC correlations included
just one study using only word-level reading to measure RC
(Harris & Moreno, 2004), the others using text-level responses
alone (Bélanger et al., 2011; Daigle & Armand, 2008; Furlonger
et al., 2014, Miller, 2010), and the Miller study reporting non-
significant correlations.
The difficulty in the current review is that the varying mea-
sures likely obscured patterns as well as differences among the
reading constructs and PA/PS and OA subskills. This was further
complicated by participant age effects on variability across early,
constrained and later, unconstrained skills. Even for studies
within the target-age range reading measures varied with Colin
et al. (2007) using a word recognition test, and with the Kyle &
Harris studies using word reading, word recognition, and sentence
comprehension. Assessing the contributions of early-acquired
skills to those that occur later is important, but require differential
timing that may be best addressed using longitudinal methodol-
ogy, such as used by the Kyle and Harris studies. This would
accommodate differential developmental trajectories among com-
ponent skills while also monitoring fluctuating direct and indirect
relationships that are characteristic of developing readers.
Summary and Recommendations
This review identified several age-based and construct mea-
surement concerns in studies of relationships between early-
and later-developing reading skills. Participant ages suggested
probable floor and ceiling effects with reduced variability for
robust and valid correlations, although relatively few were re-
ported. Most of the 28 studies tested participants outside the
optimal ages for PA/PS, OA, or RC. Another issue was with as-
sessments that created composite scores to enhance statistical
robustness but that confounded tracking of discrete skills.
Reading skills of PA/PS, OA, and RC were not consistently
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P. Luft | 159
defined among studies or assessments. These issues likely have
contributed to inconsistent findings and ongoing obstacles to
identifying evidence-based literacy practices with DHH indivi-
duals (e.g., Luckner et al., 2006).
Although these 28 studies used similar research methodol-
ogy and skill targets, the variety of skill and construct measure-
ments, ages of participants, and stages of skill development
preclude drawing any conclusions. A particular challenge is
that the formulation of robust and parsimonious research mod-
els limits examination of the potentially multiple related skills
that contribute to fluent reading comprehension. One observa-
tion is that assessment of skill constructs that reflect age-based
timing constraints across early- and later-developing skills, and
that capture multiple and varying contributions of component
skills across readers’ maturation may be best achieved through
longitudinal research designs.
One consistent relationship regardless of age, was among
unconstrained skills of vocabulary, language (English or sign
language), and reading comprehension. Importantly, Miller
et al. (2012) found that linguistic skills based on syntactic pro-
cessing were more effective for adolescent DHH readers than
semantic (word-based) strategies. Wang and Williams (2014)
also reported that language and thinking skills yielded larger RC
effect sizes once readers understood the written code. The diffi-
culty for many DHH readers is with their struggle to attain pri-
mary language fluency prior to reading instruction. Studies
using hearing children rarely examine linguistic abilities in that
most achieve basic skills in early childhood. Yet, Storch and
Whitehurst (2002) confirmed the importance of these skills for
later reading with normal hearing readers. Linguistic skills are
at least as important for DHH readers (Mayberry et al., 2011).
This review limited itself to correlational studies which does
not allow for identification of causal relationships. The field
continues to wrestle with isolating significant contributing fac-
tors and the interrelationships that characterize the develop-
mental trajectory of skillful readers. These relationships evolve
over time and show unequal rates of growth, with further com-
plications from skill co-dependencies and effects due to co-
developing cognitive and linguistics competencies (Paris, 2005).
Research needs to move beyond cross-sectional and correla-
tional studies into longitudinal and multi-skill component
analyses.
Another significant issue raised by this review is the dispar-
ity in skill and construct measurement. This likely contributes
to the difficulty in accumulating a consistent body of research
that: (a) describes the nature and timing of the important fac-
tors that contribute to the development of fluent reading, and
(b) isolates potential evidence-based instructional practices.
Word- and text-level reading typically are treated as inter-
changeable aspects of “reading comprehension” but instead, are
unique skill clusters that should be differentiated for assess-
ment and instruction. The comingling of these two constructs
obscures potentially productive research avenues that other-
wise could more accurately identify optimal developmental pat-
terns and processes that lead to fluent text reading.
To summarize, this review has several potential implica-
tions for the planning of future research:
• Research methodologies should examine reading skills
across the developmental trajectory that expand beyond
common correlational approaches in order to accurately
represent causal connections, maturational change, and
varying skill contributions across the acquisition-to-mastery
continuum. Models should allow for potential direct and
 160 | Journal of Deaf Studies and Deaf Education, 2018, Vol. 23, No. 2
indirect and evolving effects of component skills in order to
identify potentially effective and evidence-based practices.
• Researchers, diagnosticians, and educators need to develop
and adhere to consistent definitions of critical reading skills
and subskills. For example, Scarborough and Brady (2002)
defined reading and speech skill terms beginning with the
morpheme “phon” to ensure consistency. At a minimum,
word reading should be clearly differentiated from compre-
hension of connected text, and subskills should be unambig-
uously identified and defined.
• Research on instruction should not only distinguish between
the two major reading constructs but also reflect the distinc-
tive cognitive skills from which each construct develops.
Many early-acquired skills (e.g., OA, PA, PS, and word identifi-
cation) are learned through memorization, rote practice, and
direct instruction processes. In contrast, comprehension of
connected text is a higher-order cognitive skill that requires
analysis and interpretation through inquiry and discovery
learning processes (Borich, 2014). Connected text comprehen-
sion is more than a sum of individual word identifications.
The historic struggles of DHH individuals to become fluent read-
ers may have created a situation in which singular subskills
have become overly emphasized and presumed as prerequisites
for text comprehension. Examining the higher-order cognitive
skills necessary to develop connected text comprehension may
prompt investigations into more effective instructional strate-
gies. These should consider phrase-level reading or “chunking”
which provide the foundations for comprehension of sentences,
paragraphs, and increasingly larger segments of text. This has
been an approach used with hearing students (Barrera, Liu,
Thurlow, & Chamberlain, 2006; Rasinski, 1994; Rasinski,
Yildirim, & Nageldinger, 2011) or students with learning disabil-
ities (Casteel, 1990). DHH students also have abilities to acquire
phrase-level skills (Albertini & Mayer, 2011; Kelly, 2003; Luft &
Fochman, accepted with revision) although not consistently
(Albertini & Mayer, 2011; Atwell, 2013; Kelly, 2003; Schirmer,
Bailey, & Lockman, 2004), perhaps affected by varying levels of
language fluency. The goal of reading instruction is to develop
fluent comprehension of connected text. This is not achieved
through a linear progression that begins with discrete phono-
logical, orthographic, and single-word reading (Hannon, 2012).
Nor should it be assumed that phrase-level reading cannot be
introduced until after mastery of these discrete and early-
developing skills.
The complex and interrelated nature of achieving fluent text
reading suggests potential insights from Goodman’s sociopsy-
cholinguistic theory of reading (1994/2003). Its foundations in
language and cognitive processes of literacy may help in identi-
fying practices that also address the linguistic challenges of
DHH readers, and their effects on connected text reading (Kelly,
2003; Mayberry et al., 2011; Miller et al., 2012). We need a better
understanding of DHH reading skill development that results in
a more accurate model of the relative contributions and timing
of skills that comprise fluent reading comprehension and the
causal processes by which developing readers assemble related
skills into a fluent cognitive package. At that point, educators
and researchers can finally remedy the many decades of read-
ing mediocrity that still characterize the abilities of too many
DHH students.
Conflict of Interest
No conflicts of interest were reported.
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by University of Durham user
on 29 March 2018
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